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Sample records for higher quality primary

  1. Quality Management in Higher Education

    OpenAIRE

    Svoboda, Petr

    2017-01-01

    The thesis deals with quality management theory as an important part of management science. The primary objective of this work is an identification, formulation and analysis of such managerial issues in quality of higher education, which either are not known, or whose resolution is not considered fully sufficient. The thesis contains a bibliography of more than 200 related scientific works and presents selected issues of quality management in higher education, such as quality perception or it...

  2. Assessing primary care data quality.

    Science.gov (United States)

    Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

    2018-04-16

    Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

  3. Quality of Higher Education

    DEFF Research Database (Denmark)

    Zou, Yihuan

    is about constructing a more inclusive understanding of quality in higher education through combining the macro, meso and micro levels, i.e. from the perspectives of national policy, higher education institutions as organizations in society, individual teaching staff and students. It covers both......Quality in higher education was not invented in recent decades – universities have always possessed mechanisms for assuring the quality of their work. The rising concern over quality is closely related to the changes in higher education and its social context. Among others, the most conspicuous...... changes are the massive expansion, diversification and increased cost in higher education, and new mechanisms of accountability initiated by the state. With these changes the traditional internally enacted academic quality-keeping has been given an important external dimension – quality assurance, which...

  4. Quality Assessment in the Primary care

    Directory of Open Access Journals (Sweden)

    Muharrem Ak

    2013-04-01

    Full Text Available -Quality Assessment in the Primary care Dear Editor; I have read the article titled as “Implementation of Rogi Kalyan Samiti (RKS at Primary Health Centre Durvesh” with great interest. Shrivastava et all concluded that assessment mechanism for the achievement of objectives for the suggested RKS model was not successful (1. Hereby I would like to emphasize the importance of quality assessment (QA especially in the era of newly established primary care implementations in our country. Promotion of quality has been fundamental part of primary care health services. Nevertheless variations in quality of care exist even in the developed countries. Accomplishment of quality in the primary care has some barriers like administration and directorial factors, absence of evidence-based medicine practice lack of continuous medical education. Quality of health care is no doubt multifaceted model that covers all components of health structures and processes of care. Quality in the primary care set up includes patient physician relationship, immunization, maternal, adolescent, adult and geriatric health care, referral, non-communicable disease management and prescribing (2. Most countries are recently beginning the implementation of quality assessments in all walks of healthcare. Organizations like European society for quality and safety in family practice (EQuiP endeavor to accomplish quality by collaboration. There are reported developments and experiments related to the methodology, processes and outcomes of quality assessments of health care. Quality assessments will not only contribute the accomplishment of the program / project but also detect the areas where obstacles also exist. In order to speed up the adoption of QA and to circumvent the occurrence of mistakes, health policy makers and family physicians from different parts of the world should share their experiences. Consensus on quality in preventive medicine implementations can help to yield

  5. Quality Assurance in Chinese Higher Education

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    Li, Yuan

    2010-01-01

    Quality assurance has been integrated into the fabric of higher education in China, with the issue of quality in higher education--how to evaluate it and how to enhance it--now taking centre stage in Chinese higher education. In the past decade, the development of quality assurance in Chinese higher education has covered a broad spectrum of…

  6. Hungary Higher Education Quality Assurance System

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    Che Ru-shan

    2013-07-01

    Full Text Available Higher education quality assurance system has drawn much attention since 1980s. Most countries are committed to build the higher education quality assurance system to meet international standards. Under such an international trend, Hungary also actively promotes higher education reform, and established Hungarian Accreditation Committee and in order to ensure the quality of higher education.

  7. Job satisfaction of primary care team members and quality of care.

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    Mohr, David C; Young, Gary J; Meterko, Mark; Stolzmann, Kelly L; White, Bert

    2011-01-01

    In recent years, hospitals and payers have increased their efforts to improve the quality of patient care by encouraging provider adherence to evidence-based practices. Although the individual provider is certainly essential in the delivery of appropriate care, a team perspective is important when examining variation in quality. In the present study, the authors modeled the relationship between a measure of aggregate job satisfaction for members of primary care teams and objective measures of quality based on process indicators and intermediate outcomes. Multilevel analyses indicated that aggregate job satisfaction ratings were associated with higher values on both types of quality measures. Team-level job satisfaction ratings are a potentially important marker for the effectiveness of primary care teams in managing patient care.

  8. Associations between structural capabilities of primary care practices and performance on selected quality measures.

    Science.gov (United States)

    Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Zaslavsky, Alan M; Schneider, Eric C

    2009-10-06

    Recent proposals to reform primary care have encouraged physician practices to adopt such structural capabilities as performance feedback and electronic health records. Whether practices with these capabilities have higher performance on measures of primary care quality is unknown. To measure associations between structural capabilities of primary care practices and performance on commonly used quality measures. Cross-sectional analysis. Massachusetts. 412 primary care practices. During 2007, 1 physician from each participating primary care practice (median size, 4 physicians) was surveyed about structural capabilities of the practice (responses representing 308 practices were obtained). Data on practice structural capabilities were linked to multipayer performance data on 13 Healthcare Effectiveness Data and Information Set (HEDIS) process measures in 4 clinical areas: screening, diabetes, depression, and overuse. Frequently used multifunctional electronic health records were associated with higher performance on 5 HEDIS measures (3 in screening and 2 in diabetes), with statistically significant differences in performance ranging from 3.1 to 7.6 percentage points. Frequent meetings to discuss quality were associated with higher performance on 3 measures of diabetes care (differences ranging from 2.3 to 3.1 percentage points). Physician awareness of patient experience ratings was associated with higher performance on screening for breast cancer and cervical cancer (1.9 and 2.2 percentage points, respectively). No other structural capabilities were associated with performance on more than 1 measure. No capabilities were associated with performance on depression care or overuse. Structural capabilities of primary care practices were assessed by physician survey. Among the investigated structural capabilities of primary care practices, electronic health records were associated with higher performance across multiple HEDIS measures. Overall, the modest magnitude and

  9. Quality of Higher Education

    DEFF Research Database (Denmark)

    Zou, Yihuan; Zhao, Yingsheng; Du, Xiangyun

    . This transformation involves a broad scale of change at individual level, organizational level, and societal level. In this change process in higher education, staff development remains one of the key elements for university innovation and at the same time demands a systematic and holistic approach.......This paper starts with a critical approach to reflect on the current practice of quality assessment and assurance in higher education. This is followed by a proposal that in response to the global challenges for improving the quality of higher education, universities should take active actions...... of change by improving the quality of teaching and learning. From a constructivist perspective of understanding education and learning, this paper also discusses why and how universities should give more weight to learning and change the traditional role of teaching to an innovative approach of facilitation...

  10. Slack resources and quality of primary care.

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    Mohr, David C; Young, Gary J

    2012-03-01

    Research generally shows that greater resource utilization fails to translate into higher-quality healthcare. Organizational slack is defined as extra organizational resources needed to meet demand. Divergent views exist on organizational slack in healthcare. Some investigators view slack negatively because it is wasteful, inefficient, and costly, whereas others view slack positively because it allows flexibility in work practices, expanding available services, and protecting against environmental changes. We tested a curvilinear relationship between organizational slack and care quality. The study setting was primary care clinics (n=568) in the Veterans Health Administration. We examined organizational slack using the patient panel size per clinic capacity ratio and support staff per provider ratio staffing guidelines developed by the Veterans Health Administration. Patient-level measures were influenza vaccinations, continuity of care, and overall quality of care ratings. We obtained 2 independent patient samples with approximately 28,000 and 62,000 observations for the analysis. We used multilevel modeling and examined the linear and quadratic terms for both organizational slack measures. We found a significant curvilinear effect for panel size per clinic capacity for influenza vaccinations and overall quality of care. We also found support staff per provider exhibited a curvilinear effect for continuity of care and influenza vaccinations. Greater available resources led to better care, but at a certain point, additional resources provided minimal quality gains. Our findings highlight the importance of primary care clinic managers monitoring staffing levels. Healthcare systems managing a balanced provider workload and staff-mix may realize better patient care delivery and cost management.

  11. Quality of higher education and the labor market in developing countries

    DEFF Research Database (Denmark)

    Boccanfuso, Dorothée; Larouche, Alexandre; Trandafir, Mircea

    2015-01-01

    While many studies examine the effect of primary education quality on labor market outcomes in developing countries, little is known about the effects at higher levels. We exploit the quasi-experiment provided by a large-scale education reform launched in Senegal in 2000 to investigate how quality...... improvements at the university level affect employment. Our difference-in-difference estimates suggest that young high-skilled workers experienced a nine percentage-point employment gain relative to older workers. They are also more likely to have “better” jobs (in the service industry or government......), suggesting a reduction in the mismatch between the quality of high-skill labor demanded and supplied....

  12. Higher prices, higher quality? Evidence from German nursing homes.

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    Herr, Annika; Hottenrott, Hanna

    2016-02-01

    This study investigates the relationship between prices and quality of 7400 German nursing homes. We use a cross section of public quality reports for all German nursing homes, which had been evaluated between 2010 and 2013 by external institutions. Our analysis is based on multivariate regressions in a two stage least squares framework, where we instrument prices to explain their effect on quality controlling for income, nursing home density, demographics, labour market characteristics, and infrastructure at the regional level. Descriptive analysis shows that prices and quality do not only vary across nursing homes, but also across counties and federal states and that quality and prices correlate positively. Second, the econometric analysis, which accounts for the endogenous relation between negotiated price and reported quality, shows that quality indeed positively depends on prices. In addition, more places in nursing homes per people in need are correlated with both lower prices and higher quality. Finally, unobserved factors at the federal state level capture some of the variation of reported quality across nursing homes. Our results suggest that higher prices increase quality. Furthermore, since reported quality and prices vary substantially across federal states, we conclude that the quality and prices of long-term care facilities may well be compared within federal states but not across. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Quality of Primary Health Care for children and adolescents living with HIV

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    Leticia do Nascimento

    Full Text Available Abstract Objective: to evaluate the quality of health care for children and adolescents living with HIV, among the different types of Primary Health Care services of Santa Maria, Rio Grande do Sul. Method: cross-sectional study, developed with 118 Primary Health Care professionals. The Primary Care Evaluation Instrument, Professional version, was used. For verification of the variables associated with the high score, Poisson Regression was used. Results: the professionals of the Family Health Strategy, when compared to those of the Primary Health Units, obtained a greater degree of orientation to primary care, both for the overall score and for the derived attributes score, as well as for the integrality and community orientation attributes. A specialization in Primary Health Care, other employment and a statutory work contract were associated with quality of care. Conclusion: the Family Health Strategy was shown to provide higher quality health care for children and adolescents living with HIV, however, the coverage is still low. The need was highlighted to expand this coverage and invest in vocational training directed toward Primary Care and making the professionals effective, through public selection procedure, as well as an improvement program that recognizes the care requirements, in these settings, of children and adolescents infected with HIV.

  14. Practice-level quality improvement interventions in primary care: a review of systematic reviews.

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    Irwin, Ryan; Stokes, Tim; Marshall, Tom

    2015-11-01

    To present an overview of effective interventions for quality improvement in primary care at the practice level utilising existing systematic reviews. Quality improvement in primary care involves a range of approaches from the system-level to patient-level improvement. One key setting in which quality improvement needs to occur is at the level of the basic unit of primary care--the individual general practice. Therefore, there is a need for practitioners to have access to an overview of the effectiveness of quality improvement interventions available in this setting. A tertiary evidence synthesis was conducted (a review of systematic reviews). A systematic approach was used to identify and summarise published literature relevant to understanding primary-care quality improvement at the practice level. Quality assessment was via the Critical Appraisal Skills Programme tool for systematic reviews, with data extraction identifying evidence of effect for the examined interventions. Included reviews had to be relevant to quality improvement at the practice level and relevant to the UK primary-care context. Reviews were excluded if describing system-level interventions. A range of measures across care structure, process and outcomes were defined and interpreted across the quality improvement interventions. Audit and feedback, computerised advice, point-of-care reminders, practice facilitation, educational outreach and processes for patient review and follow-up all demonstrated evidence of a quality improvement effect. Evidence of an improvement effect was higher where baseline performance was low and was particularly demonstrated across process measures and measures related to prescribing. Evidence was not sufficient to suggest that multifaceted approaches were more effective than single interventions. Evidence exists for a range of quality improvement interventions at the primary-care practice level. More research is required to determine the use and impact of quality

  15. Higher Education Quality Assessment Model: Towards Achieving Educational Quality Standard

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    Noaman, Amin Y.; Ragab, Abdul Hamid M.; Madbouly, Ayman I.; Khedra, Ahmed M.; Fayoumi, Ayman G.

    2017-01-01

    This paper presents a developed higher education quality assessment model (HEQAM) that can be applied for enhancement of university services. This is because there is no universal unified quality standard model that can be used to assess the quality criteria of higher education institutes. The analytical hierarchy process is used to identify the…

  16. Quality Street: Encountering Higher Education's Accountabilities

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    Leihy, Peodair; Salazar, José Miguel

    2017-01-01

    This article offers a new approach to quality, focusing on the dimensions that gather around it. The mismatched goals of controlling and improving higher education continue to trouble the conceptual clarity of accountability. Quality in higher education emerges as something agreed upon (to varying efficacy) through accountability measures, rather…

  17. APPROACH TO QUALITY ASSURANCE IN HIGHER EDUCATION

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    Zora Arsovski

    2007-03-01

    Full Text Available Quality assurance in higher education is streamed in two interconnected concepts: (1 quality management according to ISO 9000 and (2 Bologna process. In this paper both concepts are presented, with point on internal state and term plan activities for quality improvement in higher education in Serbia.

  18. Implementing a Quality Management Framework in a Higher Education Organisation: A Case Study

    Science.gov (United States)

    O'Mahony, Kim; Garavan, Thomas N.

    2012-01-01

    Purpose: This paper aims to report and analyse the lessons learned from a case study on the implementation of a quality management system within an IT Division in a higher education (HE) organisation. Design/methodology/approach: The paper is based on a review of the relevant literatures and the use of primary sources such as document analysis,…

  19. [Quality Indicators of Primary Health Care Facilities in Austria].

    Science.gov (United States)

    Semlitsch, Thomas; Abuzahra, Muna; Stigler, Florian; Jeitler, Klaus; Posch, Nicole; Siebenhofer, Andrea

    2017-07-11

    Background The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. Objective The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. Methods We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Results Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). Conclusion This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Quality in Higher Education: United Arab Emirates Perspective

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    Soomro, Tariq Rahim; Ahmad, Reyaz

    2012-01-01

    Quality in higher education is the major concern among researchers. Managing quality in higher education in a multicultural population with different approaches is not only challenging but an uphill task. This paper will focus on quality concern in higher education keeping in view, the United Arab Emirates (UAE) perspectives. A model to maintain…

  1. GENERIC QUALITY STANDARDS VS. SPECIFIC QUALITY STANDARDS: THE CASE OF HIGHER EDUCATION

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    Laila El Abbadi

    2011-06-01

    Full Text Available Quality as a new requirement for the field of higher education leads institutions to seek to satisfy generic or specific quality standards imposed directly or indirectly by its customers. The aim of this study is to compare between ISO9001, as a generic quality standard, and the Code of Practice of the Quality Assurance Agency for Higher Education (QAA, as a specific quality standard. A correlation matrix is drawn and correlation rates are calculated to show similarities and differences between them. This paper shows, first, that ISO9001 and QAA Code of Practice are compatible. Second, implementing a quality management system in accordance with ISO9001 requirements can constitute an adequate framework for the application of the QAA Code of Practice requirements. Third, to make the ISO9001 requirements closer to a specific quality standard in the field of higher education, it is recommended to complete these standards by specific requirements to the field of higher education.

  2. Quality Assurance: Strategic Choices for Higher Education in Turkey

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    Mahmut ÖZER

    2011-01-01

    Full Text Available As the number of students and higher education institutions in the world increases and there is a growing difficulty in financing the higher education systems, decision-makers have begun to show more interest in quality assurance. As quality assurance is given special attention in European countries, developing countries such as Turkey are interested in importing quality assurance systems. It is not possible to set quality assurance without sensitivity toward quality and without having quality as a cultural practice. The most likely encountered quality assurance approach in the world is that the higher education institution itself is responsible for its quality. In addition, external quality assurance procedures used are based on (academic peer review rather than on bureaucratic evaluations. Moreover, there is a lively debate across the world regarding the bureaucratic regulations of the quality assurance agencies and institutions that restrict the autonomy of higher education institutions. Without taking into consideration of the existing centralized structure of the higher education system in Turkey, of meeting social demands for the higher education, and of current higher education enrollment rates, the possible establishment of a quality assurance mechanism that may have sanctions on universities in Turkey is a threat to already limited autonomy of universities and is having a risk of additional bureaucratic burden. By laying out the roles and responsibilities of Turkish Council of Higher Education, the government and universities, this article discusses policies that should be adopted regarding the quality assurance.

  3. Assessment of the Quality Management Models in Higher Education

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    Basar, Gulsun; Altinay, Zehra; Dagli, Gokmen; Altinay, Fahriye

    2016-01-01

    This study involves the assessment of the quality management models in Higher Education by explaining the importance of quality in higher education and by examining the higher education quality assurance system practices in other countries. The qualitative study was carried out with the members of the Higher Education Planning, Evaluation,…

  4. Quality assessment in higher education using the SERVQUALQ model

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    Sabina Đonlagić

    2015-01-01

    Full Text Available Economy in Bosnia and Herzegovina is striving towards growth and increased employment and it has been proven by empirical studies worldwide that higher education contributes to socio-economic development of a country. Universities are important for generation, preservation and dissemination of knowledge in order to contribute to socio-economic benefits of a country. Higher education institutions are being pressured to improve value for their activities and providing quality higher education service to students should be taken seriously. In this paper we will address the emerging demand for quality in higher education. Higher education institutions should assess quality of their services and establish methods for improving quality. Activities of quality assurance should be integrated into the management process at higher education institutions. This paper is addressing the issue of service quality measurement in higher education institutions. The most frequently used model in this context is the SERVQUAL model. This model is measuring quality from the students' point of view, since students are considered to be one of the most important stakeholders for a higher education institution. The main objective of this research is to provide empirical evidence that the adapted SERVQAL model can be used in higher education and to identify the service quality gap based on its application at one institution of higher education (Faculty of Economics in Bosnia and Herzegovina. Furthermore, results of the gap analysis using the SERVQUAL methodology provide relevant information in which areas improvement is necessary in order to enhance service quality.

  5. Quality of higher education: organisational or educational?

    DEFF Research Database (Denmark)

    Zou, Yihuan; Du, Xiangyun; Rasmussen, Palle

    2012-01-01

    Based on a study of Chinese university self-evaluation reports, this paper argues that higher education institutions are trying to manage the tensions between educational and organisational quality and the increasing and worldwide concerns about quality assurance. After 30 years of dramatic...... remain an important basis for external review. In an attempt to examine the institutional understanding of quality in higher education, the authors conducted a content analysis study of 53 self-evaluation reports written by a wide range of higher education institutions in China. This study concludes...... educational reform, China has established a nationwide evaluation system for assessing its higher education institutions. This comprehensive system includes a series of procedures for both internal self-evaluation and external peer reviewing, among which self-evaluation reports prepared by each institution...

  6. Primary Science Quality Mark--2016 Update

    Science.gov (United States)

    Turner, Jane

    2016-01-01

    Back in May 2011, an article in "Primary Science" described how the idea for a quality mark for primary science was developed from an initial conversation at an Association for Science Education annual conference (Turner, Marshall and Elsmore, 2011). Its intention then, as now, was to support and champion good practice and raise the…

  7. Ranking Quality in Higher Education: Guiding or Misleading?

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    Bergseth, Brita; Petocz, Peter; Abrandt Dahlgren, Madeleine

    2014-01-01

    The study examines two different models of measuring, assessing and ranking quality in higher education. Do different systems of quality assessment lead to equivalent conclusions about the quality of education? This comparative study is based on the rankings of 24 Swedish higher education institutions. Two ranking actors have independently…

  8. Primary care practice and facility quality orientation: influence on breast and cervical cancer screening rates.

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    Goldzweig, Caroline Lubick; Parkerton, Patricia H; Washington, Donna L; Lanto, Andrew B; Yano, Elizabeth M

    2004-04-01

    Despite the importance of early cancer detection, variation in screening rates among physicians is high. Insights into factors influencing variation can guide efforts to decrease variation and increase screening rates. To explore the association of primary care practice features and a facility's quality orientation with breast and cervical cancer screening rates. Cross-sectional study of screening rates among 144 Department of Veterans Affairs (VA) medical centers and for a national sample of women. We linked practice structure and quality improvement characteristics of individual VA medical centers from 2 national surveys (1 to primary care directors and 1 to a stratified random sample of employees) to breast and cervical cancer screening rates determined from a review of random medical records. We conducted bivariate analyses and multivariate logistic regression of primary care practice and facility features on cancer screening rates, above and below the median. While the national screening rates were high for breast (87%) and cervical cancer (90%), higher screening rates were more likely when primary care providers were consistently notified of specialty visits and when staff perceived a greater organizational commitment to quality and anticipated rewards and recognition for better performance. Organization and quality orientation of the primary care practice and its facility can enhance breast and cervical cancer screening rates. Internal recognition of quality performance and an overall commitment to quality improvement may foster improved prevention performance, with impact varying by clinical service.

  9. Quality of chronic kidney disease management in primary care: a retrospective study.

    Science.gov (United States)

    Van Gelder, Vincent A; Scherpbier-De Haan, Nynke D; De Grauw, Wim J C; Vervoort, Gerald M M; Van Weel, Chris; Biermans, Marion C J; Braspenning, Jozé C C; Wetzels, Jack F M

    2016-01-01

    Early detection and appropriate management of chronic kidney disease (CKD) in primary care are essential to reduce morbidity and mortality. To assess the quality of care (QoC) of CKD in primary healthcare in relation to patient and practice characteristics in order to tailor improvement strategies. Retrospective study using data between 2008 and 2011 from 47 general practices (207 469 patients of whom 162 562 were adults). CKD management of patients under the care of their general practitioner (GP) was qualified using indicators derived from the Dutch interdisciplinary CKD guideline for primary care and nephrology and included (1) monitoring of renal function, albuminuria, blood pressure, and glucose, (2) monitoring of metabolic parameters, and alongside the guideline: (3) recognition of CKD. The outcome indicator was (4) achieving blood pressure targets. Multilevel logistic regression analysis was applied to identify associated patient and practice characteristics. Kidney function or albuminuria data were available for 59 728 adult patients; 9288 patients had CKD, of whom 8794 were under GP care. Monitoring of disease progression was complete in 42% of CKD patients, monitoring of metabolic parameters in 2%, and blood pressure target was reached in 43.1%. GPs documented CKD in 31.4% of CKD patients. High QoC was strongly associated with diabetes, and to a lesser extent with hypertension and male sex. Room for improvement was found in all aspects of CKD management. As QoC was higher in patients who received structured diabetes care, future CKD care may profit from more structured primary care management, e.g. according to the chronic care model. Quality of care for chronic kidney disease patients in primary care can be improved. In comparison with guideline advice, adequate monitoring of disease progression was observed in 42%, of metabolic parameters in 2%, correct recognition of impaired renal function in 31%, and reaching blood pressure targets in 43% of chronic

  10. Does quality influence utilization of primary health care? Evidence from Haiti.

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    Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

    2018-06-20

    Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

  11. Monitoring quality in Israeli primary care: The primary care physicians' perspective

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    Nissanholtz-Gannot Rachel

    2012-06-01

    Full Text Available Abstract Background Since 2000, Israel has had a national program for ongoing monitoring of the quality of the primary care services provided by the country's four competing non-profit health plans. Previous research has demonstrated that quality of care has improved substantially since the program's inception and that the program enjoys wide support among health plan managers. However, prior to this study there were anecdotal and journalistic reports of opposition to the program among primary care physicians engaged in direct service delivery; these raised serious questions about the extent of support among physicians nationally. Goals To assess how Israeli primary care physicians experience and rate health plan efforts to track and improve the quality of care. Method The study population consisted of primary care physicians employed by the health plans who have responsibility for the quality of care of a panel of adult patients. The study team randomly sampled 250 primary-care physicians from each of the four health plans. Of the 1,000 physicians sampled, 884 met the study criteria. Every physician could choose whether to participate in the survey by mail, e-mail, or telephone. The anonymous questionnaire was completed by 605 physicians – 69% of those eligible. The data were weighted to reflect differences in sampling and response rates across health plans. Main findings The vast majority of respondents (87% felt that the monitoring of quality was important and two-thirds (66% felt that the feedback and subsequent remedial interventions improved medical care to a great extent. Almost three-quarters (71% supported continuation of the program in an unqualified manner. The physicians with the most positive attitudes to the program were over age 44, independent contract physicians, and either board-certified in internal medicine or without any board-certification (i.e., residents or general practitioners. At the same time, support for the

  12. Reinforcing Quality Assurance in Romanian Higher Education

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    Ana-Maria Dima

    2010-07-01

    Full Text Available Since 1993, the quality assurance system in Romania has gained considerable experience. This experience was recently recognized in 2008 by the ENQA: European Association for Quality Assurance in Higher Education through the admission of ARACIS as a full member of EQAR: the European Quality Assurance Register. The Board of ENQA agreed to grant ARACIS’s full membership of ENQA for five years from 2 June 2009. This article explores the benefits of membership for the Romanian Agency for Quality Assurance in Higher Education – ARACIS, comparing to other regional and global quality assurance agencies networks. The common features and differences between ARACIS and other European agencies are questioned through the frameworks of ENQA and INQAAHE as a case study.

  13. Quality Assurance in Higher Education: A Review of Literature

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    Ryan, Tricia

    2015-01-01

    This paper examines the literature surrounding quality assurance in global higher education. It provides an overview of accreditation as a mechanism to ensure quality in higher education, examines models of QA, and explores the concept of quality (including definitions of quality and quality assurance). In addition, this paper provides a review of…

  14. Nullifying quality: the marketasation of higher education

    DEFF Research Database (Denmark)

    Bendixen, Carsten; Jacobsen, Jens Christian

    2017-01-01

    higher education. In the long run it will hardly benefit educational programmes if institutions of higher educations fail to ‘stand for’ quality that, in the very least, can supplement the fulfilment of politically determined targets and standards. In this way the market will have not only graduates who......The increasing dominance of educational markets means that quality of higher education has the character of open signifiers of periodic occurrence, embedded institutionally as ways of consensual communication on how to go on as smoothly as possible. This promotes the growth of context dependent...... nullification processes. On the other hand, institutions have to adopt standards in education as a measure of outcome indicators for benchmarking. When quality is replaced by standards and if standards are equivalent to labour market relevance this might signal the beginning of overall external control over...

  15. On Q: Causing Quality in Higher Education.

    Science.gov (United States)

    Seymour, Daniel T.

    This book presents college and university education as a quality-oriented service with students, parents, and legislators as customers demanding quality. It attempts to blend the concept of strategic management of quality in industry with the latest thinking on the administration of higher education. The first chapter discusses the importance of…

  16. Apropos of the Quality Management in Higher Education

    Directory of Open Access Journals (Sweden)

    A. G. Kislov

    2012-01-01

    Full Text Available The paper is devoted to introduction and implementation of quality management system in the sphere of Russian higher education. The research demanded the prehistory observation of the above processes, their legal bases analysis, as well as setting the existing practices of the state control and supervision of education in compliance with the principles of TQM (Total Quality Management. Different normative acts and documents have been reviewed concerning accreditation of higher educational establishments, and determining the state policy of quality improvement of the higher school functioning. The author emphasizes that participation of different organizations - including educational ones – in certification procedures and competitions in the quality sphere is considered voluntary according to the Russian legislation. However, for getting the state accreditation educational establishments have no other way apart from setting the internal structures responsible for students training quality. The above structures in educational establishments look rather strange and alien duplicating in their best the state control and supervision system. They appear to be quite expansive for educational establishments and demanding extra time and effort from the staff. In conclusion the author points out that the state policy forcing the quality management issues reflects the interests of certain social groups, namely those who directly participate in external supervision of higher educa- tional institutions. The research findings can be applied while correcting the educational policy of the Russian Federation, and developing the concepts of regulatory legal acts in the higher educational sphere.

  17. From Quality Assurance to Quality Enhancement in the European Higher Education Area

    Science.gov (United States)

    Gvaramadze, Irakli

    2008-01-01

    This article focuses on recent trends in quality assurance initiatives, analyses how the European Higher Education Area promotes quality enhancement mechanisms and their implications for quality cultures in universities. It presents and discusses two approaches towards quality enhancement both at the institutional and programme level: 1. Quality…

  18. IMPROVEMENT OF QUALITY ASSURANCE SYSTEM ACTIVITIES OF HIGHER EDUCATION INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Z. M. Sultalieva

    2016-01-01

    Full Text Available Abstract. The aim of the article is the improvement of quality assessment system of higher education institutions in the aspect of management. The problems of quality improvement are revealed and classified. The analysis of criteria assessment sets used to define the efficiency of higher education institutions activity is carried out. The components of quality of higher education institutions activity are specified. The structural model of quality assessment system of higher education institutions activity is offered. The analysis of macro environment of a university based on the method of strategic management is carried out, i.e. PEST analysis. As a result of the research a new model of macro criteria model of quality assessment system of higher education institutions, characterizing quality management as an approach to university efficiency is offered, moreover, this system can define the level of its competitiveness in the aspect of quality management. 

  19. Effectiveness of a quality-improvement program in improving management of primary care practices

    Science.gov (United States)

    Szecsenyi, Joachim; Campbell, Stephen; Broge, Bjoern; Laux, Gunter; Willms, Sara; Wensing, Michel; Goetz, Katja

    2011-01-01

    Background: The European Practice Assessment program provides feedback and outreach visits to primary care practices to facilitate quality improvement in five domains (infrastructure, people, information, finance, and quality and safety). We examined the effectiveness of this program in improving management in primary care practices in Germany, with a focus on the domain of quality and safety. Methods: In a before–after study, 102 primary care practices completed a practice assessment using the European Practice Assessment instrument at baseline and three years later (intervention group). A comparative group of 102 practices was included that completed their first assessment using this instrument at the time of the intervention group’s second assessment. Mean scores were based on the proportion of indicators for which a positive response was achieved by all of the practices, on a scale of 0 to 100. Results: We found significant improvements in all domains between the first and second assessments in the intervention group. In the domain of quality and safety, improvements in scores (mean scores were based on the proportion of indicators for which a positive response was achieved by all of the practices, on a scale of 0 to 100) were observed in the following dimensions: complaint management (from a mean score of 51.2 at first assessment to 80.7 at second assessment); analysis of critical incidents (from 79.1 to 89.6); and quality development, quality policy (from 40.7 to 55.6). Overall scores at the time of the second assessment were significantly higher in the intervention group than in the comparative group. Interpretation: Primary care practices that completed the European Practice Assessment instrument twice over a three-year period showed improvements in practice management. Our findings show the value of the quality-improvement cycle in the context of practice assessment and the use of established organizational standards for practice management with the

  20. Accuracy and Quality of Spirometry in Primary Care Offices.

    Science.gov (United States)

    Hegewald, Matthew J; Gallo, Heather M; Wilson, Emily L

    2016-12-01

    Spirometry is necessary for the optimal management of patients with respiratory disease. The quality of spirometry performed in the primary care setting has been inconsistent. We aimed to evaluate spirometer accuracy, determine the clinical significance of inaccurate spirometers, and assess the quality of spirograms obtained in primary care offices. We tested 17 spirometers used in primary care offices with a waveform generator; accuracy and precision were assessed using American Thoracic Society criteria. The clinical significance of inaccurate instruments was determined by applying the FEV 1 /FVC error from an obstructed waveform to a clinical data set. Spirogram quality was determined by grading spirograms using acceptability and repeatability criteria. The relationship between the number of tests performed by a clinic and test quality was assessed. Only 1 of 17 spirometers met accuracy criteria, with mean errors for FVC, FEV 1 , and FEV 1 /FVC ranging from 1.7 to 3.1%. Applying the percentage error to a clinical data set resulted in 28% of tests being recategorized from obstructed to nonobstructed. Of the spirograms reviewed, 60% were considered acceptable for clinical use. There was no association between the number of tests performed by a clinic and spirometry quality. Most spirometers tested were not accurate. The magnitude of the errors resulted in significant changes in the categorization of patients with obstruction. Acceptable-quality tests were produced for only 60% of patients. Our results raise concerns regarding the utility of spirometry obtained in primary care offices without greater attention to quality assurance and training.

  1. General practitioners versus other physicians in the quality of primary care: a cross-sectional study in Guangdong Province, China.

    Science.gov (United States)

    Zou, Yaming; Zhang, Xiao; Hao, Yuantao; Shi, Leiyu; Hu, Ruwei

    2015-10-09

    The primary care in China can be provided by general practitioners (GPs) and other physicians (non-GPs). However, China's general practice system has never been really established. Chinese patients tend to consider the quality of primary care provided by GPs much lower than that of non-GPs. Besides, many GPs presently prefer leaving their own positions and seeking better development in big hospitals, which has made the already weak GP system weaker. Yet, few studies have specially compared the quality of primary care provided by Chinese GPs and other physicians and no studies have explored the independent predictors of Chinese GPs' intentions to stay on their current job. In this study, we aimed to compare the quality of primary care offered by GPs with non-GPs and to explore the independent predictors of GPs' future work intentions. This cross-sectional study applied multi-stage random cluster sampling methodology. The data were collected from November 2013 to September 2014 in Guangdong Province. In total, 401 effective questionnaires were selected from the physicians. Quality of primary care was assessed using the Primary Care Assessment Tool (PCAT) Provider Part, representing six primary care domains: ongoing care, coordination (i.e., referrals and information systems), comprehensiveness (i.e., service available and service provided), family-centeredness, community orientation and cultural competence. Of 401 participating physicians, 163 (40.6 %) were GPs. The total PCAT score was 26.32 ± 2.24 which was the sum score of the six domains and represent the quality of primary care. GPs achieved significantly different total scores and scores on three individual scales: comprehensiveness: service available, comprehensiveness: service provided and community orientation. Multiple linear regressions revealed GPs had a higher total score and scores for comprehensiveness: service provided and community orientation after adjusting for sociodemographic characteristics

  2. Exploring the Notion of Quality in Quality Higher Education Assessment in a Collaborative Future

    Science.gov (United States)

    Maguire, Kate; Gibbs, Paul

    2013-01-01

    The purpose of this article is to contribute to the debate on the notion of quality in higher education with particular focus on "objectifying through articulation" the assessment of quality by professional experts. The article gives an overview of the differentiations of quality as used in higher education. It explores a substantial…

  3. A Conceptual Analysis of Quality in Quality Function Deployment-Based Contexts of Higher Education

    Science.gov (United States)

    Matorera, Douglas

    2015-01-01

    The purpose of this paper is to assess and evaluate how higher education institutions (HEIs) using Quality Function Deployment draw out the relevancy and potential of the model in shaping their concept of "Quality" and how that Quality can be assured in higher education institutions' (HEIs') programmes. An intensive literature review was…

  4. Is quality assurance in higher education contextually relative ...

    African Journals Online (AJOL)

    It does this by raising questions such as whether quality in higher education is the same as, for example, quality of clothing or the quality of meat in local butcheries. The article questions ... AJOL African Journals Online. HOW TO USE AJOL.

  5. 78 FR 47191 - Air Quality Designations for the 2010 Sulfur Dioxide (SO2) Primary National Ambient Air Quality...

    Science.gov (United States)

    2013-08-05

    ... Air Quality Designations for the 2010 Sulfur Dioxide (SO[bdi2]) Primary National Ambient Air Quality... air quality designations for certain areas in the United States for the 2010 primary Sulfur Dioxide (SO 2 ) National Ambient Air Quality Standard (NAAQS). The EPA is issuing this rule to identify areas...

  6. Effects of Increased Competition on Quality of Primary Care in Sweden

    DEFF Research Database (Denmark)

    Dietrichson, Jens; Ellegård, Lina Maria; Kjellsson, Gustav

    quality is scarce, in particular regarding primary care. This paper adds evidence from recent reforms of Swedish primary care that affected competition in municipal markets differently depending on the pre- reform market structure. Using a difference-in-differences strategy, we demonstrate...... that the reforms led to substantially more entry of private care providers in municipalities where there were many patients per provider before the reforms. The effects on primary care quality in these municipalities are modest: we find small improvements in subjective measures of overall care quality......, but no significant effects on the rate of avoidable hospitalizations or patients’ satisfaction with access to care. We find no indications of quality reductions....

  7. Quality Assurance in Higher Education: Proposals for Consultation.

    Science.gov (United States)

    Higher Education Funding Council for England, Bristol.

    This document sets out for consultation proposals for a revised method for quality assurance of teaching and learning in higher education. The proposals cover: (1) the objectives and principles of quality assurance; (2) an approach to quality assurance based on external audit principles; (3) the collection and publication of information; (4)…

  8. Perceptions of Higher Education Quality at Three Universities in Vietnam

    Science.gov (United States)

    Pham, Huong Thi; Starkey, Louise

    2016-01-01

    Purpose: Vietnam is experiencing rapid expansion in the provision of higher education that requires quality assurance appropriate for the Vietnamese-centralised Confucian cultural context. This paper aims to examine the concept of quality from the perspectives of academic leaders, quality assurance members and academics at three higher education…

  9. How eight primary care practices initiated and maintained quality monitoring and reporting.

    Science.gov (United States)

    Sloane, Philip D; Wroth, Thomas; Halladay, Jacquie; Bray, Paul; Spragens, Lynn; Stearns, Sally; Zimmerman, Sheryl

    2011-01-01

    Primary care medical practices increasingly are asked by payers, employers, and government agencies to report quality data, but the process of doing so is not well delineated. Providers and office staff in a diverse sample of eight primary care practices in North Carolina comprised this study population. Interviews were conducted and self-administered questionnaires were disseminated in practices that were successfully reporting data to one or more of 4 reporting programs. Our measures included responses to open-ended and Likert scale questions about experiences and potential facilitators and barriers, as well as subscales of the Practice Assessment tool and the Culture of Group Practices instrument. Study practices had stronger change histories, higher information and quality emphases, and lower business emphases than historical comparison practices. Motivation to participate, a leader who catalyzes the process, and establishment of new systems characterized successful practices. Staff time, information technology challenges, and resistance from some providers were common barriers. Practices achieve a sustainability state when numerous barriers have been successfully overcome and tangible results achieved from the process. Implementing and sustaining quality reporting requires a complex set of motivators, facilitators, and strategies to overcome inherent barriers that can present themselves in practices that seek to implement changes in this direction.

  10. Is quality of higher educational institutions in Western Balkan real?

    Directory of Open Access Journals (Sweden)

    Živaljević Aleksandra

    2015-01-01

    Full Text Available The paper presents a survey conducted in November of 2013 in 120 higher education institutions in the Western Balkans Countries, with purpose to determine which models are used for quality improvement in Western Balkans higher educational institutions, and whether critical conditions for continuous quality improvement have been met by applying those models. Data were obtained by using questionnaire which consisted of 24 questions related to 2 previously defined hypotheses. Gathered data were tested with Student's t test to determine if there is a significant difference between the groups of higher educational institutions which use different quality models, as well as between private and public higher educational institutions. Authors argue that the rules imposed by Governments do not provide sufficient incentive for meeting the critical conditions for the continuous quality improvement. Legal framework and mandatory accreditation conducted by government bodies lead higher educational institutions to fulfil the formal requirements, distancing them from the essence of quality management, i.e. from self-criticism and motivation to consistently deliver better results than the previous ones and giving them the illusion of achieving quality through compliance with formal criteria.

  11. Quality Improvement in Virtual Higher Education: A Grounded Theory Approach

    Science.gov (United States)

    Mahdiuon, Rouhollah; Masoumi, Davoud; Farasatkhah, Maghsoud

    2017-01-01

    The article aims to explore the attributes of quality and quality improvement including the process and specific actions associated with these attributes--that contribute enhancing quality in Iranian Virtual Higher Education (VHE) institutions. A total of 16 interviews were conducted with experts and key actors in Iranian virtual higher education.…

  12. The health-related quality of life was not improved by targeting higher hemoglobin in the Normal Hematocrit Trial.

    Science.gov (United States)

    Coyne, Daniel W

    2012-07-01

    The Normal Hematocrit Trial (NHT) was the largest trial of epoetin randomizing 1265 hemodialysis patients with cardiac disease to lower (9-11 g/dl) or higher (13-15 g/dl) hemoglobin (Hgb), hypothesizing that higher Hgb would reduce mortality, and improve survival and quality of life. The trial was terminated early, and a 1998 publication reported that targeting higher hematocrit levels led to an insignificant increase in the primary end points (death or myocardial infarct), or risk ratio 1.3, 95% confidence interval (CI), 0.9-1.90, but the P-value was not given, and all-cause death risk was not reported. A higher target reportedly did not increase hospitalization rates, but did significantly improve the 'physical function' domain of quality of life. Comparing the 1996 Food and Drug Administration (FDA)-filed clinical trial report to the 1998 publication, however, found several discrepancies. Among these, the 1998 article reported interim trial results with only the adjusted CI but did not state that the unadjusted CIs were 99.912th percentile, and despite being a secondary end point, reported only the association of achieved Hgb with higher quality of life score. Randomization to the higher target had actually increased the risk for the primary end point (risk ratio 1.28, 95% CI=1.06-1.56; P=0.0112; 99.92% CI=0.92-1.78), the risk of death (risk ratio 1.27, 95% CI=1.04-1.54), non-access thrombotic events (P=0.041), and hospitalization rate (P=0.04), while 'physical function' did not improve (P=0.88). Hence, disclosure of these results in the 1998 publication or access to the FDA-filed report on the NHT in the late 1990s would likely have led to earlier concerns about epoetin safety and greater doubts about its benefits.

  13. Quality and Quality Assurance in Ethiopian Higher Education. Critical Issues and Practical Implications.

    NARCIS (Netherlands)

    Kahsay, M.

    2012-01-01

    This book critically examines quality and quality assurance in the Ethiopian higher education context. More specifically, the main research problem that guided the study was: ‘how and under what circumstances do the public Universities in Ethiopia assure quality of their education, and what

  14. Quality provisioning and accountability in African higher | Maila ...

    African Journals Online (AJOL)

    Excellence in educational quality provisioning and accountability is an obligatory function for higher education. Currently certain scholars allege that poor provisioning and lack of accountability are rife in most higher education institutions. They cite varied reasons for the failures. Of note, African higher education institutions ...

  15. Quality assurance for primary batteries. Qualitaetssicherung fuer Primaerbatterien

    Energy Technology Data Exchange (ETDEWEB)

    Ruedinger, G [Varta AG, Ellwangen (Germany, F.R.)

    1989-11-01

    Apart from a few applications in tube sets, the use of primary batteries was limited until well into the fifties to the current supply of lighting units, predominantly of flashlights. Only with the invention of the transistor and of integrated circuits, the primary battery took an important place among electric components. As a consequence, this component had to meet much different requirements. In order to ensure the quality of an article produced in enormous quantities - several hundred million units per year with a great variety of types, with nine different systems and of approx. 100 different types - it became indispensable to set up a well equipped quality assurance system. (orig.).

  16. The Enigma of Quality in Greek Higher Education. A mixed methods study of introducing quality management into Greek higher education.

    NARCIS (Netherlands)

    Papadimitriou, A.; Papadimitriou, Antigoni

    2011-01-01

    This study investigated the adoption of quality management in Greek universities as an outcome of organizational processes. It examined a period in the first decade of the 21st century when program evaluation and quality management were heavily debated in Greece. The study recognizes that higher

  17. Living with schizophrenia: Health-related quality of life among primary family caregivers.

    Science.gov (United States)

    Hsiao, Chiu-Yueh; Lee, Chun-Te; Lu, Huei-Lan; Tsai, Yun-Fang

    2017-12-01

    To examine influencing factors of health-related quality of life in primary family caregivers of people with schizophrenia receiving inpatient psychiatric rehabilitation services. Families, particularly primary family caregivers, have become more important than ever in mental health care. Yet, research on health-related quality of life among primarily family caregivers is limited. A correlational study design was used. A convenience sample of 122 primary family caregivers participated in the study. Data were analysed with descriptive statistics, Pearson's product-moment correlation, t test, one-way analysis of variance and a hierarchical multiple regression analysis. Primary family caregivers who were parents, older, less educated, and had a lower monthly household income, increased affiliate stigma and decreased quality of family-centred care experienced poor health-related quality of life. Particularly, monthly household income, affiliate stigma and quality of family-centred care appeared to be the most critical determinants of health-related quality of life. Efforts to enhance satisfaction of life should focus on reducing affiliate stigma as well as increasing monthly household income and strengthening the quality of family-centred care. Findings may assist in the development of culturally integrated rehabilitation programmes to decrease affiliate stigma and increase family engagement as a means of promoting quality of life for primary family caregivers living with people who have schizophrenia. © 2017 John Wiley & Sons Ltd.

  18. Multimorbidity and quality of preventive care in Swiss university primary care cohorts.

    Directory of Open Access Journals (Sweden)

    Sven Streit

    Full Text Available Caring for patients with multimorbidity is common for generalists, although such patients are often excluded from clinical trials, and thus such trials lack of generalizability. Data on the association between multimorbidity and preventive care are limited. We aimed to assess whether comorbidity number, severity and type were associated with preventive care among patients receiving care in Swiss University primary care settings.We examined a retrospective cohort composed of a random sample of 1,002 patients aged 50-80 years attending four Swiss university primary care settings. Multimorbidity was defined according to the literature and the Charlson index. We assessed the quality of preventive care and cardiovascular preventive care with RAND's Quality Assessment Tool indicators. Aggregate scores of quality of provided care were calculated by taking into account the number of eligible patients for each indicator.Participants (mean age 63.5 years, 44% women had a mean of 2.6 (SD 1.9 comorbidities and 67.5% had 2 or more comorbidities. The mean Charlson index was 1.8 (SD 1.9. Overall, participants received 69% of recommended preventive care and 84% of cardiovascular preventive care. Quality of care was not associated with higher numbers of comorbidities, both for preventive care and for cardiovascular preventive care. Results were similar in analyses using the Charlson index and after adjusting for age, gender, occupation, center and number of visits. Some patients may receive less preventive care including those with dementia (47% and those with schizophrenia (35%.In Swiss university primary care settings, two thirds of patients had 2 or more comorbidities. The receipt of preventive and cardiovascular preventive care was not affected by comorbidity count or severity, although patients with certain comorbidities may receive lower levels of preventive care.

  19. Older Patients' Perspectives on Quality of Serious Illness Care in Primary Care.

    Science.gov (United States)

    Abu Al Hamayel, Nebras; Isenberg, Sarina R; Hannum, Susan M; Sixon, Joshua; Smith, Katherine Clegg; Dy, Sydney M

    2018-01-01

    Despite increased focus on measuring and improving quality of serious illness care, there has been little emphasis on the primary care context or incorporation of the patient perspective. To explore older patients' perspectives on the quality of serious illness care in primary care. Qualitative interview study. Twenty patients aged 60 or older who were at risk for or living with serious illness and who had participated in the clinic's quality improvement initiative. We used a semistructured, open-ended guide focusing on how older patients perceived quality of serious illness care, particularly in primary care. We transcribed interviews verbatim and inductively identified codes. We identified emergent themes using a thematic and constant comparative method. We identified 5 key themes: (1) the importance of patient-centered communication, (2) coordination of care, (3) the shared decision-making process, (4) clinician competence, and (5) access to care. Communication was an overarching theme that facilitated coordination of care between patients and their clinicians, empowered patients for shared decision-making, related to clinicians' perceived competence, and enabled access to primary and specialty care. Although access to care is not traditionally considered an aspect of quality, patients considered this integral to the quality of care they received. Patients perceived serious illness care as a key aspect of quality in primary care. Efforts to improve quality measurement and implementation of quality improvement initiatives in serious illness care should consider these aspects of care that patients deem important, particularly communication as an overarching priority.

  20. Quality Assurance for Higher Education Franchising.

    Science.gov (United States)

    Yorke, Mantz

    1993-01-01

    The practice of "franchising" higher education programs, or provision of educational programs through vendors, is examined as it occurs in the United Kingdom as a result of recent educational policy changes. A set of principles for assuring the quality of such programs is proposed. (MSE)

  1. QUALICOPC, a multi-country study evaluating quality, costs and equity in primary care.

    NARCIS (Netherlands)

    Schäfer, W.L.A.; Boerma, W.G.W.; Kringos, D.S.; Maeseneer, J. de; Gress, S.; Heinemann, S.; Rotar-Pavlic, D.; Seghieri, C.; Svab, I.; Berg, M.J. van den; Vainieri, M.; Westert, G.P.; Willems, S.; Groenewegen, P.P.

    2011-01-01

    Background: The QUALICOPC (Quality and Costs of Primary Care in Europe) study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects primary

  2. Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

    Science.gov (United States)

    2014-01-01

    Background Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. Methods This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression. Results Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions. Conclusions There is an association between adverse psychosocial work conditions and poor quality of life among

  3. Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study.

    Science.gov (United States)

    Teles, Mariza Alves Barbosa; Barbosa, Mirna Rossi; Vargas, Andréa Maria Duarte; Gomes, Viviane Elizângela; Ferreira, Efigênia Ferreira e; Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição

    2014-05-15

    Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression. Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions. There is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.

  4. Characteristics of primary care practices associated with high quality of care.

    Science.gov (United States)

    Beaulieu, Marie-Dominique; Haggerty, Jeannie; Tousignant, Pierre; Barnsley, Janet; Hogg, William; Geneau, Robert; Hudon, Éveline; Duplain, Réjean; Denis, Jean-Louis; Bonin, Lucie; Del Grande, Claudio; Dragieva, Natalyia

    2013-09-03

    No primary practice care model has been shown to be superior in achieving high-quality primary care. We aimed to identify the organizational characteristics of primary care practices that provide high-quality primary care. We performed a cross-sectional observational study involving a stratified random sample of 37 primary care practices from 3 regions of Quebec. We recruited 1457 patients who had 1 of 2 chronic care conditions or 1 of 6 episodic care conditions. The main outcome was the overall technical quality score. We measured organizational characteristics by use of a validated questionnaire and the Team Climate Inventory. Statistical analyses were based on multilevel regression modelling. The following characteristics were strongly associated with overall technical quality of care score: physician remuneration method (27.0; 95% confidence interval [CI] 19.0-35.0), extent of sharing of administrative resources (7.6; 95% CI 0.8-14.4), presence of allied health professionals (15.3; 95% CI 5.4-25.2) and/or specialist physicians (19.6; 95% CI 8.3-30.9), the presence of mechanisms for maintaining or evaluating competence (7.7; 95% CI 3.0-12.4) and average organizational access to the practice (4.9; 95% CI 2.6-7.2). The number of physicians (1.2; 95% CI 0.6-1.8) and the average Team Climate Inventory score (1.3; 95% CI 0.1-2.5) were modestly associated with high-quality care. We identified a common set of organizational characteristics associated with high-quality primary care. Many of these characteristics are amenable to change through practice-level organizational changes.

  5. Student Perceptions on Service Quality of Higher Education: an Empirical Study

    OpenAIRE

    Rahayu, Fatik; Murtanto, Murtanto; Ekasari, Ayu

    2007-01-01

    Educational literatures suggest that there is mounting pressure from customers of higher education to close the gap between their expectation of institutional performance and the actual performance (Widrick et al., 2002; Pariseau and Mc Daniel, 1997; Shank et al., 1995). Therefore, it is imperative that higher educations actively monitor the quality of their service. This study deals with measuring the service quality in higher education. The service quality of higher education in this resear...

  6. Benchmarking as an Instrument for Improvement of Quality Management in Higher Education

    Directory of Open Access Journals (Sweden)

    Narimantas Kazimieras Paliulis

    2015-06-01

    Full Text Available Conditioned by globalisation and constant change, higher education institutions (HEIs are forced to pursue new instruments for quality assurance in higher education. States seem to pursue this aim by attempting to create an efficiently operating system of higher education that satisfies needs of diverse societal groups. Quality dimension is the most important element of efficient and effective higher education. From the perspective of a state, assessment and monitoring of quality are instruments for the management of processes of higher education. The article substantiates these statements using the evolution of the dimension of quality in the European and Lithuanian higher education in the course of the Bologna Process. The article also presents a benchmarking method and discusses its development and application tendencies in business organisations. Also, it looks at possibilities to apply this method in higher education. The main aim of this article is to explore benchmarking as an effective instrument for the improvement of performance quality in HEIs and complement the already implemented quality management systems. Another aim is to suggest this method to national agencies for quality assurance in higher education for monitoring and analysis of qualitative changes on the systematic level. The object of the article is the improvement of performance quality in HEIs. Benchmarking is proposed for the use in higher education on the institutional level as an instrument that complements presently introduced quality management systems in Lithuanian HEIs. This way, it will contribute to the formation of the culture of quality in higher education.

  7. Fostering evidence-based quality improvement for patient-centered medical homes: Initiating local quality councils to transform primary care.

    Science.gov (United States)

    Stockdale, Susan E; Zuchowski, Jessica; Rubenstein, Lisa V; Sapir, Negar; Yano, Elizabeth M; Altman, Lisa; Fickel, Jacqueline J; McDougall, Skye; Dresselhaus, Timothy; Hamilton, Alison B

    Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation. Our evaluation objectives were to (a) assess design element implementation, (b) describe implementation barriers and facilitators, and (c) assess successful quality improvement project completion and spread. We analyzed administrative records and conducted interviews with 85 organizational leaders. We developed and applied criteria for assessing design element implementation using hybrid deductive/inductive analytic techniques. All quality councils implemented interdisciplinary leadership and a structured quality improvement process, and all but one completed at least one quality improvement project and a toolkit for spreading improvements. Quality councils were perceived as most effective when service line leaders had well-functioning interdisciplinary communication. Matching positions within leadership hierarchies with appropriate supportive roles facilitated frontline quality improvement efforts. Two key resources were (a) a dedicated internal facilitator with project management, data collection, and presentation skills and (b) support for preparing customized data reports for identifying and addressing practice level quality issues. Overall, quality councils successfully cultivated interdisciplinary, multilevel primary care quality improvement leadership with accountability mechanisms and generated frontline innovations suitable for spread. Practice level performance data and quality improvement project management support

  8. QUALITY IN HIGHER EDUCATION FROM DIFFERENT PERSPECTIVES: A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Goutam Kumar Kundu

    2017-03-01

    Full Text Available The purpose of this paper is to provide an overview of existing research and present a holistic understanding of quality in higher education. This literature review builds on major sources of relevant research relating to educational quality methodologies, quality literacy and multi-dimensional concept of quality. The paper attempts to understand quality in education as a relationship amongst all the participants and resources of an educational institution. Based on the results of the literature review, the paper attempts to establish the foundation for a comprehensive understanding and analysis of quality focussing on higher education. This literature review provides a frame of reference that serves as a basis for future research regarding role of quality in education.

  9. The association between culture, climate and quality of care in primary health care teams.

    Science.gov (United States)

    Hann, Mark; Bower, Peter; Campbell, Stephen; Marshall, Martin; Reeves, David

    2007-09-01

    Culture and climate represent shared beliefs and values that may influence quality of care in health care teams, and which could be manipulated for quality improvement. However, there is a lack of agreement on the theoretical and empirical relationships between climate and culture, and their relative power as predictors of quality of care. This study sought to examine the association between self-report measures of climate and culture in primary care teams and comprehensive measures of quality of care. The data were derived from a cross-sectional survey of 492 professionals in 42 general practices in England. Self-report measures of culture (the Competing Values Framework) and climate (the Team Climate Inventory) were used, together with validated measures of quality of care from medical records and self-report. The majority of practices could be characterized as 'clan' culture type. Practices with a dominant clan culture scored higher on climate for participation and teamwork. There were no associations between culture and quality of care, and only limited evidence of associations between climate and quality. The current analysis would not support the hypothesis that culture and climate are important predictors of quality of care in primary care. Although larger studies are required to provide a definitive test, the results may suggest the need for a more complex model of the associations between culture, climate and outcomes, and further research may be required into the interaction between culture and climate with other determinants of behaviour such as internal and external incentives.

  10. Emblems of Quality in Higher Education. Developing and Sustaining High-Quality Programs.

    Science.gov (United States)

    Haworth, Jennifer Grant; Conrad, Clifton F.

    This book proposes an "engagement" theory of program quality to evaluate and improve higher education programs at all degree levels. Based on interviews with 781 participants in a national study of Masters degree programs, it focuses on the interactive roles of students, faculty, and administrators in developing high-quality programs…

  11. The quality movement in higher education in the United States.

    Science.gov (United States)

    Buchanan, H S

    1995-09-01

    Continuous quality improvement (CQI), often implemented as part of an integrated management system called total quality management (TQM), has been institutionalized within many manufacturing, military and service organizations in the USA as a response to declining market share, low productivity and customer complaints about poor quality. Signs and symptoms suggest that higher education has similar problems which are systematic and relate to the quality ot higher education, financing, facilities, curriculum and graduates. In the 1990S, the quality movement has begun to spread to the field of education as a means of diagnosing and treating the problems widely recognized as residing in US educational institutions, especially in colleges and universities. Many business leaders and authors believe that 'quality is the most important strategic issue facing top management in the 1990s'. This belief arises partly due to the fact that managers are beginning to understand the relationship between healthy, high quality organizations and healthy profits. This article traces the recent US quality movement from its roots in manufacturing and the military, its adoption by service institutions, and its more recent application by higher education institutions.

  12. Gender-heterogeneous working groups produce higher quality science.

    Directory of Open Access Journals (Sweden)

    Lesley G Campbell

    Full Text Available Here we present the first empirical evidence to support the hypothesis that a gender-heterogeneous problem-solving team generally produced journal articles perceived to be higher quality by peers than a team comprised of highly-performing individuals of the same gender. Although women were historically underrepresented as principal investigators of working groups, their frequency as PIs at the National Center for Ecological Analysis and Synthesis is now comparable to the national frequencies in biology and they are now equally qualified, in terms of their impact on the accumulation of ecological knowledge (as measured by the h-index. While women continue to be underrepresented as working group participants, peer-reviewed publications with gender-heterogeneous authorship teams received 34% more citations than publications produced by gender-uniform authorship teams. This suggests that peers citing these publications perceive publications that also happen to have gender-heterogeneous authorship teams as higher quality than publications with gender uniform authorship teams. Promoting diversity not only promotes representation and fairness but may lead to higher quality science.

  13. Gender-heterogeneous working groups produce higher quality science.

    Science.gov (United States)

    Campbell, Lesley G; Mehtani, Siya; Dozier, Mary E; Rinehart, Janice

    2013-01-01

    Here we present the first empirical evidence to support the hypothesis that a gender-heterogeneous problem-solving team generally produced journal articles perceived to be higher quality by peers than a team comprised of highly-performing individuals of the same gender. Although women were historically underrepresented as principal investigators of working groups, their frequency as PIs at the National Center for Ecological Analysis and Synthesis is now comparable to the national frequencies in biology and they are now equally qualified, in terms of their impact on the accumulation of ecological knowledge (as measured by the h-index). While women continue to be underrepresented as working group participants, peer-reviewed publications with gender-heterogeneous authorship teams received 34% more citations than publications produced by gender-uniform authorship teams. This suggests that peers citing these publications perceive publications that also happen to have gender-heterogeneous authorship teams as higher quality than publications with gender uniform authorship teams. Promoting diversity not only promotes representation and fairness but may lead to higher quality science.

  14. Primary health care quality and hospitalizations for ambulatory care sensitive conditions in the public health system in Porto Alegre, Brazil.

    Science.gov (United States)

    Gonçalves, Marcelo Rodrigues; Hauser, Lisiane; Prestes, Isaías Valente; Schmidt, Maria Inês; Duncan, Bruce Bartholow; Harzheim, Erno

    2016-06-01

    To investigate the relation of hospitalization for ambulatory care sensitive conditions (ACSC) with the quality of public primary care health services in Porto Alegre, Brazil. Cohort study constructed by probabilistic record linkage performed from August 2006 to December 2011 in a population ≥18 years of age that attended public primary care health services. The Primary Care Assessment Tool (PCATool-Brazil) was used for evaluation of primary care services. Of 1200 subjects followed, 84 were hospitalized for primary care sensitive conditions. The main causes of ACSC hospital admissions were cardiovascular (40.5%) and respiratory (16.2%) diseases. The PCATool average score was 5.3, a level considerably below that considered to represent quality care. After adjustment through Cox proportional hazard modelling for covariates, >60 years of age [hazard ratio (HR): 1.13; P = 0.001), lesser education (HR: 0.66; P = 0.02), ethnicity other than white (HR: 1.77; P = 0.01) and physical inactivity (HR: 1.65; P = 0.04) predicted hospitalization, but higher quality of primary health care did not. Better quality of health care services, in a setting of overwhelmingly low quality services not adapted to the care of chronic conditions, did not influence the rate of avoidable hospitalizations, while social and demographic characteristics, especially non-white ethnicity and lesser schooling, indicate that social inequities play a predominant role in health outcomes. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. QUALITY ASSURANCE SYSTEMS IN POLISH AND UKRAINIAN HIGHER EDUCATION. A COMPARATIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Marta Tutko

    2015-02-01

    Full Text Available The article deals with the progress made to develop external and internal quality assurance systems in Polish and Ukrainian higher education in the European Higher Education Area background. The focus of the paper is on the extent to which quality assurance systems in these countries are following the Standards and Guidelines for Quality Assurance in the European Higher Education Area. Furthermore, internal and external quality assur-ance in the European context is presented in the article. The authors of the article also conducted a comparative analysis of quality assurance systems in Polish and Ukrainian higher education.

  16. Making Sense of an Elusive Concept: Academics’ Perspectives of Quality in Higher Education

    Directory of Open Access Journals (Sweden)

    Lazarus Nabaho

    2017-11-01

    Full Text Available Objective: Since the 1990s studies on how stakeholders in higher education perceive quality have burgeoned. Nevertheless, the majority of studies on perception of quality in higher education focus on students and employers. The few studies on academics’ perceptions of quality in higher education treat academics as a homogeneous group and, therefore, do not point out cross-disciplinary perspectives in perceptions of quality. This article explores how academics across six disciplines perceive quality in higher education. Method: The article is anchored in the interpretivist paradigm. Data was collected from 14 purposely selected academics at Makerere University in Uganda and analyzed using thematic analysis. Results: The findings show that academics perceive quality in higher education as transformation, fitness for purpose, and exceptional. The findings further demonstrate that a stakeholder group or an individual stakeholder can subscribe to a notion of quality in higher education but voice divergent views on its variants. Similarly, the academic discipline, the perceived purpose of higher education, and the problems within a higher education system have an influence on stakeholders’ conception of quality in higher education. Conclusions: From the findings it can be inferred that quality in higher education defies a single definition and that stakeholders’ perceptions of quality do not take place in a vacuum. Implication for Theory and/or Practice: The multidimensional nature of quality and the contestations around it necessitate a multidimensional approach to assuring and assessing it.

  17. Trading Quality across Borders: Colonial Discourse and International Quality Assurance Policies in Higher Education

    Science.gov (United States)

    Blanco Ramírez, Gerardo

    2014-01-01

    Accountability and quality assurance have become central discourses in higher education policy throughout the world. However, accountability and quality assurance involve power and control. Practices and ideas about quality developed in the Global North are spreading rapidly across the Global South, leading to increased uniformity in the…

  18. EDUCATION OF VOLITIVE QUALITIES IN PRIMARY SCHOOLSTUDENTS

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    Pablo Ángel Martínez-Morales

    2016-07-01

    Full Text Available The paper aims to present the results of the application of the methodology developed by the author, as a scientific result of his doctoral studies, aimed at the education of volitional qualities self control and perseverance, respect to teaching in primary school students. The evaluation of the methodology was carried out through a pretest and posttest pre-experiment with only one group, an intentional sample of two groups, one from third and one from fourth grade. Observation of teaching activities used and techniques designed to ascertain the level of knowledge, emotional bond and behavioral manifestations in primary school students in relation to volitional qualities in study. It was found, when analyzing the final results, positive changes in self-control and perseverance in the school sample, compared to the initial stage of the pre - experiment. These results were verified statistically by applying Spearman ́s rank correlation coefficient test and Wilcoxon ́s peer and allocated ranks, using SPSS.

  19. Physicians' perceptions about the quality of primary health care services in transitional Albania

    NARCIS (Netherlands)

    Kellici, Neritan; Dibra, Arvin; Mihani, Joana; Kellici, Suela; Burazeri, Genc

    AIM: To date, the available information regarding the quality of primary health care services in Albania is scarce. The aim of our study was to assess the quality of primary health care services in Albania based on physicians' perceptions towards the quality of the services provided to the general

  20. Primary controls on species richness in higher taxa.

    Science.gov (United States)

    Rabosky, Daniel L

    2010-12-01

    The disparity in species richness across the tree of life is one of the most striking and pervasive features of biological diversity. Some groups are exceptionally diverse, whereas many other groups are species poor. Differences in diversity among groups are frequently assumed to result from primary control by differential rates of net diversification. However, a major alternative explanation is that ecological and other factors exert primary control on clade diversity, such that apparent variation in net diversification rates is a secondary consequence of ecological limits on clade growth. Here, I consider a likelihood framework for distinguishing between these competing hypotheses. I incorporate hierarchical modeling to explicitly relax assumptions about the constancy of diversification rates across clades, and I propose several statistics for a posteriori evaluation of model adequacy. I apply the framework to a recent dated phylogeny of ants. My results reject the hypothesis that net diversification rates exert primary control on species richness in this group and demonstrate that clade diversity is better explained by total time-integrated speciation. These results further suggest that it may not possible to estimate meaningful speciation and extinction rates from higher-level phylogenies of extant taxa only.

  1. Factors Influencing Assessment Quality in Higher Vocational Education

    Science.gov (United States)

    Baartman, Liesbeth; Gulikers, Judith; Dijkstra, Asha

    2013-01-01

    The development of assessments that are fit to assess professional competence in higher vocational education requires a reconsideration of assessment methods, quality criteria and (self)evaluation. This article examines the self-evaluations of nine courses of a large higher vocational education institute. Per course, 4-11 teachers and 3-10…

  2. Opportunity or Exploitation? Women and Quality Assurance in Higher Education

    Science.gov (United States)

    Morley, Louise

    2005-01-01

    Based on interviews with 18 UK women academics and managers on quality and power in higher education, this article interrogates the impact of quality assurance discourses and practices on women in higher education. Micro-level analysis of the effects of audit and the evaluative state seem to suggest that hegemonic masculinities and gendered power…

  3. Lower- Versus Higher-Income Populations In The Alternative Quality Contract: Improved Quality And Similar Spending.

    Science.gov (United States)

    Song, Zirui; Rose, Sherri; Chernew, Michael E; Safran, Dana Gelb

    2017-01-01

    As population-based payment models become increasingly common, it is crucial to understand how such payment models affect health disparities. We evaluated health care quality and spending among enrollees in areas with lower versus higher socioeconomic status in Massachusetts before and after providers entered into the Alternative Quality Contract, a two-sided population-based payment model with substantial incentives tied to quality. We compared changes in process measures, outcome measures, and spending between enrollees in areas with lower and higher socioeconomic status from 2006 to 2012 (outcome measures were measured after the intervention only). Quality improved for all enrollees in the Alternative Quality Contract after their provider organizations entered the contract. Process measures improved 1.2 percentage points per year more among enrollees in areas with lower socioeconomic status than among those in areas with higher socioeconomic status. Outcome measure improvement was no different between the subgroups; neither were changes in spending. Larger or comparable improvements in quality among enrollees in areas with lower socioeconomic status suggest a potential narrowing of disparities. Strong pay-for-performance incentives within a population-based payment model could encourage providers to focus on improving quality for more disadvantaged populations. Project HOPE—The People-to-People Health Foundation, Inc.

  4. Elements and indicators for identification of quality of primary education

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    Sučević Vlasta M.

    2015-01-01

    Full Text Available Education is one of the main pillars of the quality of knowledge, and, in turn, social progress in general. There are numerous positions concerning quality of education, some more, and some less detailed. In order to determine the quality of a primary school, for example as 'poor', 'mediocre' or 'excellent', we use, more or less precisely, a certain idea about the value, and thus identify, again with a certain extent of accuracy, the position of the school in question in relation to other schools. In terms of the quality of education, it is necessary to analyze all segments of educational process. This includes the analysis of objectives of educational process, products of quality education as well as adequate and accessible technical-instrumental, that is, operational-procedural level of quality of educational process. Most authors connect the quality of primary education to results, that is, outcomes of education. In order to achieve quality of education, we need to achieve quality of particular components or elements of the whole of education. This paper deals with theoretical review of elements and indicators of quality of basic education, and provides a review of pedagogical strategies and their effect on certain components of quality with the aim to improve the effects on pedagogical and didactical resources of the quality of education.

  5. Preparation of esters of gallic acid with higher primary alcohols

    NARCIS (Netherlands)

    Kerk, G.J.M. van der; Verbeek, J.H.; Cleton, J.C.F.

    1951-01-01

    The esters of gallic acid and higher primary alcohols, especially fatty alcohols, have recently gained considerable interest as possible antioxidants for fats. Two independent methods for the preparation of these esters are described. In the first method the hitherto unknown compound galloyl

  6. Assessment of quality indicators in spanish higher military education

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    Olmos Gómez Maria del Carmen

    2016-01-01

    Full Text Available The quality assessment is subject to multiple interpretations of its content and purpose, and also regarding to methods and techniques used to develop it. Although purposes of assessment are varied, usually pursuit three goals: Improvement, accountability and information. Currently, the concept of quality evaluation has been replaced by the management of educational quality, as Matthew [6] point “the new culture of evaluation is no longer oriented to penalty, ranking or selection of people, as provide a reasoned and reasonable information to guide the management of educational improvement”. Military Training Centres are externally evaluated by an experts External Evaluation Unit to identify strengths and weaknesses on their self-evaluation system and focus on important aspects related to the organization of the Centre, development of work plans, teacher’s style and students learning strategies, system of evaluation and qualification and accurate recommendations to improve all that. This research focuses on the evaluation of quality indicators for the external evaluation of higher education at Military Education Centres in Spain and it is funded by a joint project between University of Granada and MADOC. The technique used for collecting and analysing information was a content description of several documents provided by these military educational authorities, arising the identification and extraction of relevant indicators on the evaluation of higher education. This analysis was primarily based on standards and indicators systems by ANECA (National Agency for Quality Assessment and Accreditation adapted to the Military Higher Education, but also it was consider other standards by international agencies and evaluative institutions, such as University of Chile, University of Paraguay, Canarias Agency for Quality Assessment and Accreditation and Agency for Quality Education System University of Castilla y León. The analysis realize a usual

  7. Assessment of quality indicators in Spanish higher military education

    Directory of Open Access Journals (Sweden)

    Olmos Gómez Maria del Carmen

    2016-01-01

    Full Text Available The quality assessment is subject to multiple interpretations of its content and purpose, and also regarding to methods and techniques used to develop it. Although purposes of assessment are varied, usually pursuit three goals: Improvement, accountability and information. Currently, the concept of quality evaluation has been replaced by the management of educational quality, as Matthew [6] point “the new culture of evaluation is no longer oriented to penalty, ranking or selection of people, as provide a reasoned and reasonable information to guide the management of educational improvement”. Military Training Centres are externally evaluated by an experts External Evaluation Unit to identify strengths and weaknesses on their self-evaluation system and focus on important aspects related to the organization of the Centre, development of work plans, teacher’s style and students learning strategies, system of evaluation and qualification and accurate recommendations to improve all that. This research focuses on the evaluation of quality indicators for the external evaluation of higher education at Military Education Centres in Spain and it is funded by a joint project between University of Granada and MADOC. The technique used for collecting and analysing information was a content description of several documents provided by these military educational authorities, arising the identification and extraction of relevant indicators on the evaluation of higher education. This analysis was primarily based on standards and indicators systems by ANECA (National Agency for Quality Assessment and Accreditation adapted to the Military Higher Education, but also it was consider other standards by international agencies and evaluative institutions, such as University of Chile, University of Paraguay, Canarias Agency for Quality Assessment and Accreditation and Agency for Quality Education System University of Castilla y León. The analysis realize a usual

  8. Unravelling Quality Culture in Higher Education: A Realist Review

    Science.gov (United States)

    Bendermacher, G. W. G.; oude Egbrink, M. G. A.; Wolfhagen, I. H. A. P.; Dolmans, D. H. J. M.

    2017-01-01

    There is a growing belief that higher education institutions should nurture a "quality culture" in which structural/managerial and cultural/psychological elements act in synergy to continuously improve education. Notwithstanding the positive connotation of the "quality culture" concept, its exact configuration remains subject…

  9. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

    OpenAIRE

    Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri

    2016-01-01

    Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected...

  10. Programme evaluation: Maintaining quality in higher education ...

    African Journals Online (AJOL)

    The evaluation of educational or social programmes is paramount for establishing success or impact in higher education. Evaluation questions about programme goals (e.g. better performance of first-year students) or about the quality of programme strategies (design and implementation) and effectiveness of delivery ...

  11. Quality of Health Assistants in primary Health centres in Rural Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Enakshi Ganguly

    2013-01-01

    Full Text Available Introduction Health assistants are important functionaries of the primary health care system in India. Their role is supervision of field-based services among other things. A quality assurance mechanism for these health assistants is lacking. The present study was undertaken with the objectives of developing a tool to assess the quality of health assistants in primary health centres (PHCs and to assess their quality using this tool. Methodology Health assistants from three PHCs in the Wardha district of India were observed for a year using a tool developed from primary health care management Aavancement program modules. Data was collected by direct observation, interview, and review of records for quality of activities. Results Staff strength of health assistants was 87.5%. None of the health assistants were clear about their job descriptions. A supervisory schedule for providing supportive supervision to auxiliary nurse midwives (ANMs was absent; most field activities pertaining to maternal and child health received poor focus. Monthly meetings lacked a clear agenda, and comments on quality improvement of services provided by the ANMs were missing. Conclusion Continuous training with sensitization on quality issues is required to improve the unsatisfactory quality.

  12. Conceptualising primary labour relationship quality

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    Lukas I. Ehlers

    2017-05-01

    Full Text Available Background: A typology of desirable social conditions in supervisory relationships suggested that such conditions may also be desirable in other forms of labour relationships. A literature review confirmed that trust, compliance, fairness and good faith can be confidently regarded as universally desirable social conditions in all forms of individual or collective labour relationships between employers and employees. Aim: The purpose of this study was to determine if primary labour relationship quality (PLQ can be confidently conceptualised as a social construct that strongly relates to the perceived levels of compliance, fairness and good faith in supervisory or primary labour relationships. Setting: A combination of random and convenience sampling approaches was implemented to collect PLQ related data from 454 voluntary respondents, who were subordinate employees in the Tshwane region. Methods: A quantitative research methodology was adopted. This included conceptual definition of the PLQ construct, objective measurement of PLQ levels of voluntary respondents in an adequately sized sample, factor analysis and testing for relationships and differences in means between variables. Results: Data analysis results confirmed that it can be confidently concluded that the conceptual definition of PLQ was valid, and that positive PLQ perceptions of subordinate employees were significantly related to at least two other forms of desirable organisational outcomes. Conclusion: PLQ perceptions can be confidently defined as a distinct subjective quality estimate that is assimilated from unique expectations and perceptions of the levels of compliance, fairness, good faith and trust that a supervisor displays in a labour relationship with an immediate subordinate.

  13. Internal Resources to Improve the Quality of Higher Education

    Directory of Open Access Journals (Sweden)

    Tatyana V. Zak

    2016-03-01

    Full Text Available The article deals with the situation in the Russian higher education system. The factors affecting the improvement of the quality of higher education are analyzed. The emphasis is on mass universities. The main obstacles to improving the quality of education in these institutions are the Institute of collective reputation and the high costs of the struggle for improving the quality of education.The necessity of focusing on the actuation of the internal resources to improve the quality associated with the change in the educational process: giving students the right to choose the timing exams and training period at university. The implementation of the proposed measures will reduce the opportunity costs associated with quality improvement activities. The proposed change in the organization of the learning process opens the possibility to estimate the activity of universities in terms of medium-term implementation of educational programs. The use of this indicator will not only combine the two different targets of universities, but also to minimize the costs of opportunistic behavior of teachers and management.

  14. Primary Education as a Foundation for Qualitative Higher Education in Nigeria

    Science.gov (United States)

    Etor, Comfort R.; Mbon, Usen F.; Ekanem, Ekpenyong E.

    2013-01-01

    Primary education is universally accepted as the foundation laying level of education in all nations of the world. It provides the mini-structural framework on which the quality of other levels of education is anchored. It is on this premise that this paper examines the pertinent issues that, if properly addressed would recapture and refocus…

  15. Is higher nursing home quality more costly?

    Science.gov (United States)

    Giorgio, L Di; Filippini, M; Masiero, G

    2016-11-01

    Widespread issues regarding quality in nursing homes call for an improved understanding of the relationship with costs. This relationship may differ in European countries, where care is mainly delivered by nonprofit providers. In accordance with the economic theory of production, we estimate a total cost function for nursing home services using data from 45 nursing homes in Switzerland between 2006 and 2010. Quality is measured by means of clinical indicators regarding process and outcome derived from the minimum data set. We consider both composite and single quality indicators. Contrary to most previous studies, we use panel data and control for omitted variables bias. This allows us to capture features specific to nursing homes that may explain differences in structural quality or cost levels. Additional analysis is provided to address simultaneity bias using an instrumental variable approach. We find evidence that poor levels of quality regarding outcome, as measured by the prevalence of severe pain and weight loss, lead to higher costs. This may have important implications for the design of payment schemes for nursing homes.

  16. Programme Evaluation: Maintaining Quality in Higher Education

    Science.gov (United States)

    Loots, A.

    2008-01-01

    The evaluation of educational or social programmes is paramount for establishing success or impact in higher education. Evaluation questions about programme goals (e.g. better performance of first-year students) or about the quality of programme strategies (design and implementation) and effectiveness of delivery (coordinator inputs and…

  17. The Quality Movements in Higher Education in the United States.

    Science.gov (United States)

    Miller, Richard I.

    1996-01-01

    Discussion of various quality control strategies in American higher education looks at and compares Total Quality Management (TQM), outcomes assessment, Deming's 14 points, the Malcolm Baldrige National Quality Award, the ISO 9000 series, restructuring, reengineering, and performance indicators. It is suggested that colleges and universities will…

  18. Team climate and quality of care in primary health care: a review of studies using the Team Climate Inventory in the United Kingdom.

    Science.gov (United States)

    Goh, Teik T; Eccles, Martin P

    2009-10-29

    Attributes of teams could affect the quality of care delivered in primary care. The aim of this study was to systematically review studies conducted within the UK NHS primary care that have measured team climate using the Team Climate Inventory (TCI), and to describe, if reported, the relationship between the TCI and measures of quality of care. The databases MEDLINE, EMBASE, and CINAHL were searched. The reference lists of included article were checked and one relevant journal was hand-searched. Eight papers were included. Three studies used a random sample; the remaining five used convenience or purposive samples. Six studies were cross sectional surveys, whilst two were before and after studies. Four studies examined the relationship between team climate and quality of care. Only one study found a positive association between team climate and higher quality care in patients with diabetes, positive patient satisfaction and self-reported effectiveness. While the TCI has been used to measure team attributes in primary care settings in the UK it is difficult to generalise from these data. A small number of studies reported higher TCI scores being associated with only certain aspects of quality of care; reasons for the pattern of association are unclear. There are a number of methodological challenges to conducting such studies in routine service settings. Further research is needed in order to understand how to measure team functioning in relation to quality of care.

  19. Team climate and quality of care in primary health care: a review of studies using the Team Climate Inventory in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Goh Teik T

    2009-10-01

    Full Text Available Abstract Background Attributes of teams could affect the quality of care delivered in primary care. The aim of this study was to systematically review studies conducted within the UK NHS primary care that have measured team climate using the Team Climate Inventory (TCI, and to describe, if reported, the relationship between the TCI and measures of quality of care. Findings The databases MEDLINE, EMBASE, and CINAHL were searched. The reference lists of included article were checked and one relevant journal was hand-searched. Eight papers were included. Three studies used a random sample; the remaining five used convenience or purposive samples. Six studies were cross sectional surveys, whilst two were before and after studies. Four studies examined the relationship between team climate and quality of care. Only one study found a positive association between team climate and higher quality care in patients with diabetes, positive patient satisfaction and self-reported effectiveness. Conclusion While the TCI has been used to measure team attributes in primary care settings in the UK it is difficult to generalise from these data. A small number of studies reported higher TCI scores being associated with only certain aspects of quality of care; reasons for the pattern of association are unclear. There are a number of methodological challenges to conducting such studies in routine service settings. Further research is needed in order to understand how to measure team functioning in relation to quality of care.

  20. The Quest for Strategic Malaysian Quality National Primary School Leaders

    Science.gov (United States)

    Ali, Hairuddin Mohd

    2012-01-01

    Purpose: The purpose of this paper is to investigate the nine-point strategic leadership characteristics of Malaysian Quality National Primary School Leaders (QNPSL) and to indicate the implications of these findings for the current educational management and leadership practices in their quest for Malaysian quality education.…

  1. Quality Assurance in Transnational Higher Education. ENQA Workshop Report 11

    Science.gov (United States)

    Bennett, Paul; Bergan, Sjur; Cassar, Daniela; Hamilton, Marlene; Soinila, Michele; Sursock, Andree; Uvalic-Trumbic, Stamenka; Williams, Peter

    2010-01-01

    The present report is the product of an ENQA (European Association for Quality Assurance in Higher Education) Bologna Seminar "Quality Assurance in Transnational Education: from words to action" hosted by the Quality Assurance Agency (QAA, UK) in London in December, 2008. The seminar discussed the current trends in Transnational…

  2. Service Quality in Higher Education Using an Enhanced SERVQUAL Approach

    Science.gov (United States)

    Tan, Kay C.; Kek, Sei W.

    2004-01-01

    Customer service and quality are driving forces in the business community. As higher educational institutions tussle for competitive advantage and high service quality, the evaluation of educational service quality is essential to provide motivation for and to give feedback on the effectiveness of educational plans and implementation. This…

  3. Worldviews and Quality in Higher Education: a dichotomy between productivity and social responsibility

    Directory of Open Access Journals (Sweden)

    Julio Bertolin

    2013-11-01

    Full Text Available This paper addresses and analyzes concepts that have been often used by important stakeholders to refer to challenges and to quality in higher education. The aim is to identify the conceptualizations of quality in higher education that underlie the use of different concepts such as efficiency and equity. Based on publications by important multilateral organizations, these terms are correlated with the conceptualizations of higher education and, at the political level, with two major contemporary socioeconomic models: neoliberalism and social welfare state. Finally, two ideological tendencies for the understanding of quality in higher education are presented: quality as productivity and quality as social responsibility.

  4. Quality of Life among Primary Caregivers of Women with Breast Cancer: A Review

    Directory of Open Access Journals (Sweden)

    Jawad Ghaleb Obaidi

    2013-04-01

    Full Text Available Background: Cancer diagnosis has a significant impact not only on women, but also on their Primary caregivers. Understanding the effects of a breast cancer diagnosis on physical and mental health outcomes in caregivers is important because these variables are key components of quality of life. Quality of life is a multi-dimensionalconstruct measuring overall enjoyment of life. This study intends to describe the impact of caring for women with breast cancer on the quality of life among their primary caregivers.Method: We conducted a comprehensive search in PubMed, MEDLINE andCINAHL. In addition, we used the web search engine “Google” for abstracts from 2007 to 2012. A total of eight studies were reviewed that met the following inclusion criteria: adult women with breast cancer, research conducted in English. Studies ranged from 2007-2011. The total sample size in the eight studies on adult caregivers totaled 789 participants. The average age of participants in all of the studies was 49.55 years.There were seven studies that had a quantitative focus,which mainly used a questionnaire and survey to estimate quality of life among primary caregivers. The qualitative approach included in-depth interviews and a focus group.Results: Accumulating evidence has supported the concept that cancer affects not only the patients but also their primary caregiver's quality of life.They face multiple challenges in caring for women with breast cancer, including physical, emotional, social, and financial stress that affects the caregiver's quality of life.Conclusion: Breast cancer diagnosis not only affects the patient's quality of life, but in parallel, also affects the quality of life of the primary caregiver. Thus more focus should be placed on providing moral and social support, and educational resources to improve the level of the caretaker's quality of life.

  5. Quality Assurance in Higher Education in Zimbabwe

    Science.gov (United States)

    Garwe, Evelyn Chiyevo

    2014-01-01

    The purpose of this paper is to furnish local and global stakeholders with detailed information regarding the development and current status of quality assurance in the Zimbabwean higher education sector. The study used document analysis, observation and interviews with key informants as sources of data. This paper addresses the dearth of…

  6. Quality Instruction as a Motivating Factor in Higher Education

    Science.gov (United States)

    Sogunro, Olusegun A.

    2017-01-01

    The importance of quality instruction in motivating students in higher education cannot be overemphasized. Without quality instruction, students' motivation to learn recedes. Five focus groups of graduate students aided the data collection for this study. More than one-third of the 119 participating graduate students involved in this study claimed…

  7. "Folk" Understandings of Quality in UK Higher Hospitality Education

    Science.gov (United States)

    Wood, Roy

    2015-01-01

    Purpose: The purpose of this paper is to provide an overview of the evolution of "folk" understandings of quality in higher hospitality education and the consequent implications of these understandings for current quality concerns in the field. Design/methodology/approach: The paper combines a historical survey of the stated topic…

  8. Application of Total Quality Management System in Thai Primary Schools

    Science.gov (United States)

    Prueangphitchayathon, Setthiya; Tesaputa, Kowat; Somprach, Kanokorn

    2015-01-01

    The present study seeks to develop a total quality management (TQM) system that can be applied to primary schools. The approach focuses on customer orientation, total involvement of all constituencies and continuous improvement. TQM principles were studied and synthesized according to case studies of the best practices in 3 primary schools (small,…

  9. Doing a Good Job - The Effect of Primary Task Quality on Well-Being and Job Satisfaction

    DEFF Research Database (Denmark)

    Sasser, Maja; Sørensen, Ole H.

    2016-01-01

    and thus their assessment of primary task quality. The paper proposes a measure for primary task quality and uses it in the analyses of responses from 1,247 preschool teachers and teaching assistants in 94 public daycare centers in Denmark. The results indicate that an important factor for employees......This paper investigates whether employees’ assessment of their primary task quality has a significant impact on their well-being and job satisfaction, respectively. Furthermore, the paper hypothesizes that professional values and norms affect employees’ quality expectations on their work tasks...... of the quality of their primary task job performance....

  10. Quality Management in Higher Education: Towards a Better Understanding of an Emerging Field

    Science.gov (United States)

    Pratasavitskaya, Halina; Stensaker, Bjorn

    2010-01-01

    The article analyses how quality management is understood in higher education research. By reviewing a number of academic contributions addressing quality management issues in "Quality in Higher Education" from 1995-2008, the article identifies central concepts associated with quality management, discusses whether there are commonalities to be…

  11. The Massification of Higher Education in the UK: Aspects of Service Quality

    Science.gov (United States)

    Giannakis, Mihalis; Bullivant, Nicola

    2016-01-01

    This article explores several aspects of service quality for the provision of higher education. Alongside the trend of the massification of higher education over the past two decades, higher education institutions are required to review quality across a range of outputs, besides teaching and learning. The study was undertaken within the…

  12. Reforms, Leadership and Quality Management in Greek Higher Education

    Science.gov (United States)

    Papadimitriou, Antigoni

    2011-01-01

    This article reports on research to form an understanding of how to account whether and how quality management (QM) has been adopted in Greek higher education. Greece only recently introduced quality assurance policies. In this study, I will describe governmental reforms related to QM policies until 2010. An issue that is frequently addressed…

  13. Guiding and Modelling Quality Improvement in Higher Education Institutions

    Science.gov (United States)

    Little, Daniel

    2015-01-01

    The article considers the process of creating quality improvement in higher education institutions from the point of view of current organisational theory and social-science modelling techniques. The author considers the higher education institution as a functioning complex of rules, norms and other organisational features and reviews the social…

  14. Meeting the Challenge: Quality Systems in Private Higher Education in Kuwait

    Science.gov (United States)

    Al-Atiqi, Imad M.; Alharbi, Lafi M.

    2009-01-01

    In Kuwait, as in other rapidly-developing higher education systems, one major area of concern is ensuring the quality of education offered by private providers. This paper briefly reviews the history of the development of higher education in Kuwait since its inception in 1936. It considers various quality systems currently in place in other…

  15. Financial Intelligence and the Quality of Higher Education in Africa ...

    African Journals Online (AJOL)

    Financial Intelligence and the Quality of Higher Education in Africa. ... Improving the quality of curriculum development in private Universities in Africa from time to time is a task that is very essential to achieving ... AJOL African Journals Online.

  16. Implementation and translation: from European standards and guidelines for quality assurance to education quality work in higher education institutions

    NARCIS (Netherlands)

    Westerheijden, Donald F.; Kohoutek, Jan; Eggins, Heather

    2014-01-01

    The Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG for short) have been part of the regulative infrastructure of the European Higher Education Area (EHEA) since 2005 (European Association for Quality Assurance in Higher Education, 2009).

  17. Quality assessment in higher education using the SERVQUALQ model

    OpenAIRE

    Đonlagić, Sabina; Fazlić, Samira

    2015-01-01

    Economy in Bosnia and Herzegovina is striving towards growth and increased employment and it has been proven by empirical studies worldwide that higher education contributes to socio-economic development of a country. Universities are important for generation, preservation and dissemination of knowledge in order to contribute to socio-economic benefits of a country. Higher education institutions are being pressured to improve value for their activities and providing quality higher education s...

  18. Supervision Vs Education Quality in Primary Education

    Directory of Open Access Journals (Sweden)

    Jhoel Ruber Mota Fonseca

    2016-11-01

    Full Text Available This article has as objective to interpret the voices of teachers supervising vs quality of education in primary education, as today, supervision entails progress and improvement in the performance of the duties of teachers in the learning environment is therefore, that through this content conflicts present information to achieve changes within educational institutions towards organizational efficiency and under supplied. In it, a qualitative paradigmatic approach as a methodological foundation that allows us to interpret educational supervision through delos social actors which is made up of managers, teachers and supervisors in the context of primary education, established likewise was necessary to collect the information through direct observation technique using as an interview script whose implementation was key informants comprised of a primary teacher education, a supervisor and from this the researcher, thus achieving the corresponding analysis according to the information provided for each, which allowed the development of argumentative skills teachers, establishing rules and procedures that provide guidelines for creating answers to the problem. For with following aims determined in the investigation, vital agents that help teachers to be highly competent in their daily practice, using teaching strategies that will enable success in the classroom, whose purpose is the achievement orientation and optimization in the process of teaching and student learning. In this sense, a reflection about the role it should play the supervisor to achieve educational quality is performed, demonstrating spaces mediation, integration, participation and collaboration with respect to the performance of the master whose aim is to be efficient and effective in its educational work of the educational system.

  19. [Incorporation of Information and Communication Technologies and quality of primary healthcare in Brazil].

    Science.gov (United States)

    Santos, Alaneir de Fátima Dos; Fonseca, Délcio; Araujo, Lucas Lobato; Procópio, Cristiane da Silva Diniz; Lopes, Érica Araújo Silva; Lima, Angela Maria de Lourdes Dayrell de; Reis, Clarice Magalhães Rodrigues Dos; Abreu, Daisy Maria Xavier de; Jorge, Alzira Oliveira; Matta-Machado, Antonio Thomaz

    2017-06-05

    Information and Communication Technologies (ICTs) are means to handle information, streamline communication, and contribute to patient care. This article describes the incorporation of Information and Communication Technologies in primary care and its association with quality, based on the Brazilian National Program for the Improvement of Access and Quality in Primary Care (PMAQ in portuguese). This was a cross-sectional study with 17,053 teams. An Index of Incorporation of ICTs was created, which included: information infrastructure, systems, and utilization. Regression analysis was used to assess associations. Only 13.5% of the teams had a high degree of ICTs. The strongest association was seen in the utilization of information. ICTs can contribute to improving quality of primary care.

  20. Quality assessment of diagnosis and antibiotic treatment of infectious diseases in primary care

    DEFF Research Database (Denmark)

    Saust, Laura Trolle; Monrad, Rikke Nygaard; Hansen, Malene Plejdrup

    2016-01-01

    QIs, especially disease-specific QIs concerning the diagnostic process, is needed. KEY POINTS In order to improve the use of antibiotics in primary care, measurable instruments, such as quality indicators, are needed to assess the quality of care being provided. A total of 11 studies were found......OBJECTIVE: To identify existing quality indicators (QIs) for diagnosis and antibiotic treatment of patients with infectious diseases in primary care. DESIGN: A systematic literature search was performed in PubMed and EMBASE. We included studies with a description of the development of QIs...... for diagnosis and antibiotic use in patients with infectious diseases in primary care. We extracted information about (1) type of infection; (2) target for quality assessment; (3) methodology used for developing the QIs; and (4) whether the QIs were developed for a national or international application. The QIs...

  1. Total Quality Management Practices in Turkish Primary Schools

    Science.gov (United States)

    Toremen, Fatih; Karakus, Mehmet; Yasan, Tezcan

    2009-01-01

    Purpose: The purpose of this paper is to determine the extent of total quality management (TQM) practices in primary schools based on teachers' perceptions, and how their perceptions are related to different variables. Design/methodology/approach: In this study, a survey based descriptive scanning model was used. This study was carried out in…

  2. Reflection on Quality Assurance System of Higher Vocational Education under Big Data Era

    Directory of Open Access Journals (Sweden)

    Jiang Xinlan

    2015-01-01

    Full Text Available Big data has the features like Volume, Variety, Value and Velocity. Here come the new opportunities and challenges for construction of Chinese quality assurance system of higher vocational education under big data era. There are problems in current quality assurance system of higher vocational education, such as imperfect main body, non-formation of internally and externally incorporated quality assurance system, non-scientific security standard and insufficiency in security investment. The construction of higher vocational education under big data era requires a change in the idea of quality assurance system construction to realize the multiple main bodies and multiple layers development trend for educational quality assurance system, and strengthen the construction of information platform for quality assurance system.

  3. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

    Science.gov (United States)

    Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Kelechi, Ohiri

    2016-01-01

    Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System—AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Result: Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement (t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. Conclusion: The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities. PMID:28462280

  4. Quality of sickness certification in primary health care: a retrospective database study.

    Science.gov (United States)

    Skånér, Ylva; Arrelöv, Britt; Backlund, Lars G; Fresk, Magdalena; Aström, Amanda Waleh; Nilsson, Gunnar H

    2013-04-12

    In the period 2004-2009, national and regional initiatives were developed in Sweden to improve the quality of sickness certificates. Parameters for assessing the quality of sickness certificates in primary health care have been proposed. The aim of this study was to measure the quality of sickness certification in primary health care by means of assessing sickness certificates issued between 2004 and 2009 in Stockholm. This was a retrospective study using data retrieved from sickness certificates contained in the electronic patient records of 21 primary health care centres in Stockholm County covering six consecutive years. A total number of 236 441 certificates were used in the current study. Seven quality parameters were chosen as outcome measures. Descriptive statistics and regression models with time, sex and age group as explanatory variables were used. During the study period, the quality of the sickness certification practice improved as the number of days on first certification decreased and the proportion of duly completely and acceptable certificates increased. Assessment of need for vocational rehabilitation and giving a prognosis for return to work were not significantly improved during the same period. Time was the most influential variable. The quality of sickness certification practice improved for most of the parameters, although additional efforts to improve the quality of sickness certificates are needed. Measures, such as reminders, compulsory certificate fields and structured guidance, could be useful tools to achieve this objective.

  5. US Accreditation in Mexico: Quality in Higher Education as Symbol, Performance and Translation

    Science.gov (United States)

    Blanco-Ramirez, Gerardo

    2015-01-01

    Quality practices in higher education involve more than mere compliance with standards and technical mandates; given the complexity of the decisions involved in quality in higher education, this concept, quality, can be analyzed as symbol and performance. This paper utilizes translation as heuristic to analyze the implementation of US…

  6. Students' Perceptions of Higher Education Quality at Notre Dame University-Louaize in Lebanon

    Science.gov (United States)

    Saad, Nada

    2013-01-01

    Understanding how students perceive quality of education and identifying the most important quality factors from their perspectives represent a first stage for quality improvement and customer satisfaction in higher education. The purpose of this project was to investigate how higher education students in Lebanon perceived the concept of quality…

  7. Impact Evaluation of Quality Assurance in Higher Education: Methodology and Causal Designs

    Science.gov (United States)

    Leiber, Theodor; Stensaker, Bjørn; Harvey, Lee

    2015-01-01

    In this paper, the theoretical perspectives and general methodological elements of impact evaluation of quality assurance in higher education institutions are discussed, which should be a cornerstone of quality development in higher education and contribute to improving the knowledge about the effectiveness (or ineffectiveness) of quality…

  8. Quality and safety training in primary care: making an impact.

    Science.gov (United States)

    Byrne, John M; Hall, Susan; Baz, Sam; Kessler, Todd; Roman, Maher; Patuszynski, Mark; Thakkar, Kruti; Kashner, T Michael

    2012-12-01

    Preparing residents for future practice, knowledge, and skills in quality improvement and safety (QI/S) is a requisite element of graduate medical education. Despite many challenges, residency programs must consider new curricular innovations to meet the requirements. We report the effectiveness of a primary care QI/S curriculum and the role of the chief resident in quality and patient safety in facilitating it. Through the Veterans Administration Graduate Medical Education Enhancement Program, we added a position for a chief resident in quality and patient safety, and 4 full-time equivalent internal medicine residents, to develop the Primary Care Interprofessional Patient-Centered Quality Care Training Curriculum. The curriculum includes a first-or second-year, 1-month block rotation that serves as a foundational experience in QI/S and interprofessional care. The responsibilities of the chief resident in quality and patient safety included organizing and teaching the QI/S curriculum and mentoring resident projects. Evaluation included prerotation and postrotation surveys of self-assessed QI/S knowledge, abilities, skills, beliefs, and commitment (KASBC); an end-of-the-year KASBC; prerotation and postrotation knowledge test; and postrotation and faculty surveys. Comparisons of prerotation and postrotation KASBC indicated significant self-assessed improvements in 4 of 5 KASBC domains: knowledge (P < .001), ability (P < .001), skills (P < .001), and belief (P < .03), which were sustained on the end-of-the-year survey. The knowledge test demonstrated increased QI/S knowledge (P  =  .002). Results of the postrotation survey indicate strong satisfaction with the curriculum, with 76% (25 of 33) and 70% (23 of 33) of the residents rating the quality and safety curricula as always or usually educational. Most faculty members acknowledged that the chief resident in quality and patient safety enhanced both faculty and resident QI/S interest and

  9. The Academic Quality Handbook: Enhancing Higher Education in Universities and Further Education Colleges.

    Science.gov (United States)

    McGhee, Patrick

    This book is intended as an introduction to the management of quality assurance and enhancement in higher education, particularly in England. The text focuses on the relationship between institutional quality assurance and the auditing authority of the British Quality Assurance Agency for Higher Education. The chapters of part 1, "The Quality…

  10. Comparing Alternative Instruments to Measure Service Quality in Higher Education

    Science.gov (United States)

    Brochado, Ana

    2009-01-01

    Purpose: The purpose of this paper is to examine the performance of five alternative measures of service quality in the high education sector--service quality (SERVQUAL), importance-weighted SERVQUAL, service performance (SERVPERF), importance-weighted SERVPERF, and higher education performance (HEdPERF). Design/methodology/approach: Data were…

  11. Making Sense of an Elusive Concept: Academics' Perspectives of Quality in Higher Education

    Science.gov (United States)

    Nabaho, Lazarus; Aguti, Jessica Norah; Oonyu, Joseph

    2017-01-01

    Objective: Since the 1990s studies on how stakeholders in higher education perceive quality have burgeoned. Nevertheless, the majority of studies on perception of quality in higher education focus on students and employers. The few studies on academics' perceptions of quality in higher education treat academics as a homogeneous group and,…

  12. Constructing Assessment Model of Primary and Secondary Educational Quality with Talent Quality as the Core Standard

    Science.gov (United States)

    Chen, Benyou

    2014-01-01

    Quality is the core of education and it is important to standardization construction of primary and secondary education in urban (U) and rural (R) areas. The ultimate goal of the integration of urban and rural education is to pursuit quality urban and rural education. Based on analysing the related policy basis and the existing assessment models…

  13. Addressing the Wicked Problem of Quality in Higher Education: Theoretical Approaches and Implications

    Science.gov (United States)

    Krause, Kerri-Lee

    2012-01-01

    This article explores the wicked problem of quality in higher education, arguing for a more robust theorising of the subject at national, institutional and local department level. The focus of the discussion rests on principles for theorising in more rigorous ways about the multidimensional issue of quality. Quality in higher education is proposed…

  14. Performance indicators used to assess the quality of primary dental care

    NARCIS (Netherlands)

    González, Grisel Zacca; Klazinga, Niek; ten Asbroek, Guus; Delnoij, Diana M.

    2006-01-01

    An appropriate quality of medical care including dental care should be an objective of every government that aims to improve the oral health of its population. OBJECTIVES: To determine performance indicators that could be used to assess the quality of primary dental care at different levels of a

  15. Does Accelerating Access to Higher Education Lower Its Quality? The Australian Experience

    Science.gov (United States)

    Pitman, Tim; Koshy, Paul; Phillimore, John

    2015-01-01

    In the pursuit of mass higher education, fears are often expressed that the quality of higher education suffers as access is increased. This quantitative study considers three proxies of educational quality: (1) prior academic achievement of the student, (2) attrition and retention rates and (3) progression rates, to establish whether educational…

  16. Assessment of users’ expectations, perceived quality and satisfaction with primary care in Greece

    Directory of Open Access Journals (Sweden)

    Vasilios Raftopoulos

    2010-01-01

    Full Text Available Aim: To explore users’ expectations, their perceived quality and their satisfaction with primary care services an anonymous questionnaire has been administered to a sample of 212 users.Background: Patient satisfaction with quality of primary care is a dominant concept in quality assurance and quality improvement programs.Methods: It has been used the Expectations-Perceived Quality-Satisfaction with Primary Care Services Scale (E-PQ-SPCSS that was developed and validated in this study. Data were analysed using SPSS, version 18.Results: The overall satisfaction with the primary care services was 97.2%, with the medical care provided was 95.3% and with nursing care was 92.5%. Nursing care was provided to 126 (59.4% users. These users were more satisfied (p<0.0001 with global nursing care provided (4.52±0.70 than those who were not provided a nursing care intervention (3.53±1.73. Age correlated with global satisfaction with primary care (r=0.315, p<0.001 with medical (r=0.194, p<0.001 and nursing care (r=0.183, p<0.001 as well as with expectations totalscore (r=0.295, p<0.001, perceived quality of care total score (r=0.366, p<0.001 and satisfaction with care total score (r=0.207, p=0.002. Based on Cattell’s visual scree plot, four factors accounting for 64.34% of the item covariance were extracted and rotated through factor analysis (nurse’s technical and interpersonal competence, physician’s interpersonal competence, physician’s technical competence and structure characteristics.Conclusions: The psychometric properties of the E-PQ-SPCSS were good enough indicating that the scales are reliable and adequate for group comparisons.

  17. Oral health-related quality of life in primary Sjögren's syndrome.

    Science.gov (United States)

    Fernández-Martínez, Gladyz; Zamora-Legoff, Víctor; Hernández Molina, Gabriela

    2018-05-10

    To assess health-related quality of life (HRQoL) and oral health-related quality of life, and correlate them with unstimulated whole salivary flow (UWSF) and oral sicca symptoms in patients with primary Sjögren's syndrome (PSS). We included 60 patients with PSS and 60 healthy controls matched according to gender and age (±3 years). We measured the UWSF and scored the European League Against Rheumatism (EULAR) Sjögren's Syndrome Patient Reported Index (ESSPRI). We assessed the short version of the SF-36 as a generic measurement of HRQoL and the Xerostomia Quality of Life Scale (XeQoLS) questionnaire to evaluate oral quality of life. We evaluated oral symptoms using an 8-item Visual Analogue Scale (VAS) questionnaire. We observed a poorer HRQoL (lower scores in SF-36) and oral quality of life (higher scores in XeQoLS), as well as a greater severity of symptoms in the VAS questionnaire upon comparing patients vs. controls. The XeQoL correlated with the UWSF (τ = -0.24, P = .008), the ESSPRI (τ =0.45, P = .0001), VAS 1-2 and VAS 5-8 and the SF-36 score (τ = -0.28, P = .002). Patients with PSS had a poorer HRQoL and oral quality of life than controls. UWSF contributes to the oral quality of life which, in turn, has an impact on HRQoL. Symptomatic treatment of xerostomia as well as the prevention of infections, decay and tooth loss would help to improve the oral quality of life in these patients. Copyright © 2018 Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. The influence of heart disease on characteristics, quality of life, use of health resources, and costs of COPD in primary care settings

    Directory of Open Access Journals (Sweden)

    Hernandez-Barrera Valentín

    2010-02-01

    Full Text Available Abstract Background To evaluate the influence of heart disease on clinical characteristics, quality of life, use of health resources, and costs of patients with COPD followed at primary care settings under common clinical practice conditions. Methods Epidemiologic, observational, and descriptive study (EPIDEPOC study. Patients ≥ 40 years of age with stable COPD attending primary care settings were included. Demographic, clinical characteristics, quality of life (SF-12, seriousness of the disease, and treatment data were collected. Results were compared between patients with or without associated heart disease. Results A total of 9,390 patients with COPD were examined of whom 1,770 (18.8% had heart disease and 78% were males. When comparing both patient groups, significant differences were found in the socio-demographic characteristics, health profile, comorbidities, and severity of the airway obstruction, which was greater in patients with heart disease. Differences were also found in both components of quality of life, physical and mental, with lower scores among those patients with heart disease. Higher frequency of primary care and pneumologist visits, emergency-room visits and number of hospital admissions were observed among patients with heart diseases. The annual total cost per patient was significantly higher in patients with heart disease; 2,937 ± 2,957 vs. 1,749 ± 2,120, p Conclusion Patients with COPD plus heart disease had greater disease severity and worse quality of life, used more healthcare resources and were associated with greater costs compared to COPD patients without known hearth disease.

  19. Access and quality in South African higher education: the twin ...

    African Journals Online (AJOL)

    with the transformation agenda in South Africa. It is proposed that a comprehensive quality assurance framework with embedded commitment to access is likely to respond appropriately to national development prerogatives of higher education access. South African Journal of Higher Education Vol. 21 (3) 2007: pp. 385-399.

  20. Investigation of Malaysian Higher Education Quality Culture and Workforce Performance

    Science.gov (United States)

    Ali, Hairuddin Mohd; Musah, Mohammed Borhandden

    2012-01-01

    Purpose: The purpose of this study is to examine the relationship between the quality culture and workforce performance in the Malaysian higher education sector. The study also aims to test and validate the psychometric properties of the quality culture and workforce performance instruments used in the study. Design/methodology/approach: A total…

  1. Service Quality, Students' Satisfaction and Behavioural Intentions in STEM and IC Higher Education Institutions

    Directory of Open Access Journals (Sweden)

    Dunja Meštrović

    2017-03-01

    Full Text Available Service quality, students' satisfaction and their behavioural intentions are recognised as rather important aspects in higher education institution's strategy in a competitive higher education marketplace, which enable them to attract and retain students in science, technology, engineering and mathematics (STEM and information-communication (IC study areas. This research aimed to study the relationship between service quality, students' satisfaction and behavioural intentions of STEM and IC students of the University of Rijeka Departments. Partial least squares structural equation modelling using SmartPLS 3.0 software was performed on student survey data, confirming a direct, positive and significant relationship between higher education service quality and students' satisfaction and between students' satisfaction and their behavioural intentions. According to indirect effects analysis, perceived higher education service quality has an an indirect, positive and significant impact on students' behavioural intentions through students' satisfaction. The results indicate that higher education service quality is an imperative for higher education sector. Based on the findings of this study, useful to policy makers in the services industry in general and in higher education sector in particular, improvements can be planned all service quality dimensions as a key factor to attract, educate and retain STEM and IC students in Croatia.

  2. The Quality of Educational Services- Institutional Case Study From the Romanian Higher Education

    Directory of Open Access Journals (Sweden)

    Luminiţa NICOLESCU

    2010-02-01

    Full Text Available The present paper approaches the topic of the quality of educational services, emphasizing on higher education, as a field of services of large public interest that has high influences at individual, group and society level. The paper starts by looking at the influencing factors for the quality of higher education from the perspective of the regulations and practices at both European and national level. In this context, the internal evaluation of quality at institutional level is a new requirement for higher education institutions in Romania. Part of the evaluation process is represented by the requirement to develop informational data bases. The paper exemplifies the results that can be obtained by monitoring quality and collecting information, and concludes with a set of recommendations for managing quality at institutional level.

  3. Essential elements of professional nursing environments in Primary Care and their influence on the quality of care.

    Science.gov (United States)

    Gea-Caballero, Vicente; Castro-Sánchez, Enrique; Júarez-Vela, Raúl; Díaz-Herrera, Miguel Ángel; de Miguel-Montoya, Isabel; Martínez-Riera, José Ramón

    Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. Accreditation and Quality Assurance in the Egyptian Higher Education System

    Science.gov (United States)

    Schomaker, Rahel

    2015-01-01

    Purpose: This study aims to analyze the quality of the Egyptian accreditation system. With a view on the high competition in the domestic labor market as well as with regards to the international competitiveness of Egyptian graduates and the potential role of Egyptian universities in the international market for higher education, a high quality of…

  5. Key elements of high-quality practice organisation in primary health care: a systematic review.

    Science.gov (United States)

    Crossland, Lisa; Janamian, Tina; Jackson, Claire L

    2014-08-04

    To identify elements that are integral to high-quality practice and determine considerations relating to high-quality practice organisation in primary care. A narrative systematic review of published and grey literature. Electronic databases (PubMed, CINAHL, the Cochrane Library, Embase, Emerald Insight, PsycInfo, the Primary Health Care Research and Information Service website, Google Scholar) were searched in November 2013 and used to identify articles published in English from 2002 to 2013. Reference lists of included articles were searched for relevant unpublished articles and reports. Data were configured at the study level to allow for the inclusion of findings from a broad range of study types. Ten elements were most often included in the existing organisational assessment tools. A further three elements were identified from an inductive thematic analysis of descriptive articles, and were noted as important considerations in effective quality improvement in primary care settings. Although there are some validated tools available to primary care that identify and build quality, most are single-strategy approaches developed outside health care settings. There are currently no validated organisational improvement tools, designed specifically for primary health care, which combine all elements of practice improvement and whose use does not require extensive external facilitation.

  6. Health-Related Quality of Life of Latin-American Immigrants and Spanish-Born Attended in Spanish Primary Health Care: Socio-Demographic and Psychosocial Factors

    Science.gov (United States)

    Salinero-Fort, Miguel Ángel; Gómez-Campelo, Paloma; Bragado-Alvárez, Carmen; Abánades-Herranz, Juan Carlos; Jiménez-García, Rodrigo; de Burgos-Lunar, Carmen

    2015-01-01

    Background This study compares the health-related quality of life of Spanish-born and Latin American-born individuals settled in Spain. Socio-demographic and psychosocial factors associated with health-related quality of life are analyzed. Methods A cross-sectional Primary Health Care multi center-based study of Latin American-born (n = 691) and Spanish-born (n = 903) outpatients from 15 Primary Health Care Centers (Madrid, Spain). The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was used to assess health-related quality of life. Socio-demographic, psychosocial, and specific migration data were also collected. Results Compared to Spanish-born participants, Latin American-born participants reported higher health-related quality of life in the physical functioning and vitality dimensions. Across the entire sample, Latin American-born participants, younger participants, men and those with high social support reported significantly higher levels of physical health. Men with higher social support and a higher income reported significantly higher mental health. When stratified by gender, data show that for men physical health was only positively associated with younger age. For women, in addition to age, social support and marital status were significantly related. Both men and women with higher social support and income had significantly better mental health. Finally, for immigrants, the physical and mental health components of health-related quality of life were not found to be significantly associated with any of the pre-migration factors or conditions of migration. Only the variable “exposure to political violence” was significantly associated with the mental health component (p = 0.014). Conclusions The key factors to understanding HRQoL among Latin American-born immigrants settled in Spain are age, sex and social support. Therefore, strategies to maintain optimal health outcomes in these immigrant communities should include public policies on

  7. Placements: An Underused Vehicle for Quality Enhancement in Higher Education?

    Science.gov (United States)

    Kettis, Asa; Ring, Lena; Gustavsson, Maria; Wallman, Andy

    2013-01-01

    Placements have the potential to contribute more effectively to the quality of higher education. The aim of this article is to discuss how placements can be made more worthwhile for individual students, while also contributing to the overall quality of teaching and learning at HEIs as well as to the development of workplace cultures that are…

  8. Service quality perceptions in primary health care centres in Greece

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2012-01-01

    Abstract Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402

  9. Service quality perceptions in primary health care centres in Greece.

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2014-04-01

    The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.

  10. Leading quality improvement in primary care: recommendations for success.

    Science.gov (United States)

    Van Hoof, Thomas J; Bisognano, Maureen; Reinertsen, James L; Meehan, Thomas P

    2012-09-01

    Leadership is increasingly recognized as a potential factor in the success of primary care quality improvement efforts, yet little is definitively known about which specific leadership behaviors are most important. Until more research is available, the authors suggest that primary care clinicians who are committed to developing their leadership skills should commit to a series of actions. These actions include embracing a theory of leadership, modeling the approach for others, focusing on the goal of improving patient outcomes, encouraging teamwork, utilizing available sources of power, and reflecting on one's approach in order to improve it. Primary care clinicians who commit themselves to such actions will be more effective leaders and will be more prepared as new research becomes available on this important factor. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Engaging in Enhancement: Implications of Participatory Approaches in Higher Education Quality Assurance

    Science.gov (United States)

    Groen, Jovan F.

    2017-01-01

    Stemming from increased levels of participation and diversity of the student base and from growing scrutiny on the quality of university degrees, governments have begun establishing mechanisms to monitor and support quality in higher education. Faced with administrative quality assurance structures, academics often complain that little is…

  12. Quality Control in Primary Schools: Progress from 2001-2006

    Science.gov (United States)

    Hofman, Roelande H.; de Boom, Jan; Hofman, W. H. Adriaan

    2010-01-01

    This article presents findings of research into the quality control (QC) of schools from 2001-2006. In 2001 several targets for QC were set and the progress of 939 primary schools is presented. Furthermore, using cluster analysis, schools are classified into four QC-types that differ in their focus on school (self) evaluation and school…

  13. Effect of the rate of heating on the quality of the primary tar in low-temperature coal-carbonization process

    Energy Technology Data Exchange (ETDEWEB)

    Turskii, Y I

    1956-01-01

    Two stages are observed. The first stage yields products of the primary and partial decomposition of coal, mainly water, CO/sub 2/, and CO as decomposition products of functional groups (-COOH, > CO, - OH, and so forth). No tar is formed in this stage. The structural decomposition and tar formation occur in the second stage. The rate of heating is important for the quality of the tar obtained. The slow rate of heating with both stages following each other yields a good-quality tar, richer in C and H, with lower O content. In case of high rate of heating both stages overlap. The tar is of poorer quality with higher specific gravity, and contains more O and asphaltenes. The complete experimental data are given in detail.

  14. Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Selected Malaysian Adults

    Directory of Open Access Journals (Sweden)

    Ibnteesam Pondor

    2017-09-01

    Full Text Available Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI. DDC in Malaysian Ringgit (RM was calculated from dietary intake and national food prices. Linear regression models were fitted to determine associations between DDC and M-HEI scores and predictors of diet quality. The mean M-HEI score of respondents was 61.31 ± 10.88 and energy adjusted DDC was RM10.71/2000 kcal (USD 2.49. The highest quintile of adjusted DDC had higher M-HEI scores for all respondents (Q1: 57.14 ± 10.07 versus Q5: 63.26 ± 11.54, p = 0.001. There were also positive associations between DDC and M-HEI scores for fruits (p < 0.001 and vegetables (p = 0.017 for all respondents. Predictors of diet quality included carbohydrate (β = 0290; p < 0.001 and fat intakes (β = −0.242; p < 0.001 and energy adjusted DDC (β = 0.196; p < 0.001. Higher dietary cost is associated with healthy eating among Malaysian adults.

  15. Higher Education Quality in Kenya: A Critical Reflection of Key Challenges

    Science.gov (United States)

    Odhiambo, George O.

    2011-01-01

    This article examines the unique challenges facing Kenya's public higher education institutions. It explores the struggle to develop quality and quality assurance mechanisms against a background of rapidly diminishing income, brain drain, political interference and the negative aspects of globalisation. The challenges have consequently led to a…

  16. Embedding Quality Culture in Higher Education in Ghana: Quality Control and Assessment in Emerging Private Universities

    Science.gov (United States)

    Ntim, Stephen

    2014-01-01

    High quality provision has been one of the key aims of the current reforms in higher educational institutions across the globe since the beginning of the century and the millennium. Consequently this has led to the increasing demand for quality assurance (QA). This report identifies those institutional processes and structures that support the…

  17. An Empirical Investigation into the Construct of Higher Education Service Quality

    Directory of Open Access Journals (Sweden)

    Jaroslav Dado

    2011-01-01

    Full Text Available The paper addresses the issue of higher education service quality measurement and stresses the need of devising psychometrically as well as diagnostically sound measurement instruments, suitable to the context being investigated. The study builds upon the SERVQUAL scale, the inventory successfully tried and tested across a broad spectrum of service industries. Notwithstanding significant resemblance with the original five dimensions of service quality, research findings indicate six-dimensional structure of the construct of higher education service quality. Study performed on a sample of Engineering Management students reveals perceptions falling short of expectations across all of the determinants of service quality. The largest negative gap between students’ perceptions and expectations has been discovered concerning the potential for future career development, whereas research findings indicate the same dimension to be the most important predictor of students’ future behavioral intentions. In an attempt to inspire further interests in this field, managerial implications and directions for future research have been discussed.

  18. Quality Management in Higher Education: Review and Perspectives

    Science.gov (United States)

    Papanthymou, Anastasia; Darra, Maria

    2017-01-01

    This paper is a review which presents a summary of 52 studies from 2006 to 2016 in Quality Management (QM) within Higher Education Institutes (HEIs). The aim of this paper is to submit evidence regarding the level of QM in HEIs, particularly in developing countries, and also to enhance the research in the field of QM. The findings reveal that from…

  19. Quality and effectiveness of different approaches to primary care delivery in Brazil

    Directory of Open Access Journals (Sweden)

    Trindade Thiago G

    2006-12-01

    Full Text Available Abstract Background Since 1994, Brazil has developed a primary care system based on multidisciplinary teams which include not only a physician and a nurse, but also 4–6 lay community health workers. This system now consists of 26,650 teams, covering 46% of the Brazilian population. Yet relatively few investigations have examined its effectiveness, especially in contrast with that of the traditional multi-specialty physician team approach it is replacing, or that of other existing family medicine approaches placing less emphasis on lay community health workers. Primary health care can be defined through its domains of access to first contact, continuity, coordination, comprehensiveness, community orientation and family orientation. These attributes can be ascertained via instruments such as the Primary Care Assessment Tool (PCATool, and correlated with the effectiveness of care. The objectives of our study are to validate the adult version of this instrument in Portuguese, identify the extent (quality of primary care present in different models of primary care services, and correlate this extent with measures of process and outcomes in patients with diabetes, hypertension and coronary heart disease (CHD. Methods/Design We are conducting a population-based cross-sectional study of primary care in the municipality of Porto Alegre. We will interview a random sample totaling 3000 adults residing in geographic areas covered by four distinct models of primary care of the Brazilian national health system or, alternatively, by one nationally prominent complementary health care service, as well as the physicians and nurses of the health teams of these services. Interviews query perceived quality of care (PCATool-Adult Version, patient satisfaction, and process indicators of management of diabetes, hypertension and known CHD. We are measuring blood pressure, anthropometrics and, in adults with known diabetes, glycated hemoglobin. Discussion We hope to

  20. Quality assurance in transnational higher education: a case study of the tropEd network.

    Science.gov (United States)

    Zwanikken, Prisca A C; Peterhans, Bernadette; Dardis, Lorraine; Scherpbier, Albert

    2013-03-27

    Transnational or cross-border higher education has rapidly expanded since the 1980s. Together with that expansion issues on quality assurance came to the forefront. This article aims to identify key issues regarding quality assurance of transnational higher education and discusses the quality assurance of the tropEd Network for International Health in Higher Education in relation to these key issues. Literature review and review of documents. From the literature the following key issues regarding transnational quality assurance were identified and explored: comparability of quality assurance frameworks, true collaboration versus erosion of national education sovereignty, accreditation agencies and transparency. The tropEd network developed a transnational quality assurance framework for the network. The network accredits modules through a rigorous process which has been accepted by major stakeholders. This process was a participatory learning process and at the same time the process worked positive for the relations between the institutions. The development of the quality assurance framework and the process provides a potential example for others.

  1. Childhood obesity, self-esteem and health-related quality of life among urban primary schools children in Kuching, Sarawak, Malaysia.

    Science.gov (United States)

    Lee, P Y; Cheah, W l; Chang, C T; Siti Raudzah, G

    2012-08-01

    There is limited data on childhood obesity and its impact on children from diverse cultural backgrounds. This study is aimed at determining the association between obesity, self-esteem and health-related quality of life (HRQOL) among Malaysian urban primary school children of different ethnicity. A cross-sectional study was conducted involving 311 children aged 11-13 years from primary schools in Kuching, Sarawak. Self-esteem and health-related quality of life (HRQOL) were measured using the Lawrence Self-esteem Questionnaire (LAWSEQ) questionnaire and the Paediatric Quality of Life Inventory (PedsQL), respectively. Body weight and height were taken and body mass index for age calculated. The prevalence of overweight and obesity among the children were 18.2% and 15.2% respectively. Parent-proxy and child self-reported PedsQL scores were higher for normal weight children compared to thin and obese children, but lower than overweight children. At the subscale level, only parent-proxy PedsQL scores in psychosocial health and emotional component were significantly different between overweight and obese children (p=0.019, p=0.02). The Self-esteem score was significantly correlated with parent and child PedsQL scores. Although obesity was associated with lower HRQOL among children, both parent and child PedsQL scores among the overweight group were higher than that for the normal weight group. Overweight and obesity did affect quality of life and self-esteem of children in this study, particularly in the areas of psychosocial and emotional health. Policy makers and programme managers should take into consideration the impact of obesity on children and parents in designing intervention programmes.

  2. Structural Dynamics of Education Reforms and Quality of Primary Education in Uganda

    Science.gov (United States)

    Nyenje, Aida

    2016-01-01

    This paper examines Uganda's recent undertaking to reform her Primary School education System with a focus on the effect of structural dynamics of education reforms and the quality of primary education. Structural dynamics in the context of this study is in reference to the organizational composition of the education system at the government,…

  3. Quality Assurance in Higher Education: Reflection, Criticism, and Change

    Science.gov (United States)

    Yingqiang, Zhang; Yongjian, Su

    2016-01-01

    Quality assurance in modern higher education is both an accountability-oriented ideology and a technological method. It has also evolved into a increasingly rationalist and professionalized power mechanism. Its advocacy of compliance, technological mythology, and imbalance between power and responsibility are inherent disadvantages of higher…

  4. Implementing clinical governance in English primary care groups/trusts: reconciling quality improvement and quality assurance.

    Science.gov (United States)

    Campbell, S M; Sheaff, R; Sibbald, B; Marshall, M N; Pickard, S; Gask, L; Halliwell, S; Rogers, A; Roland, M O

    2002-03-01

    To investigate the concept of clinical governance being advocated by primary care groups/trusts (PCG/Ts), approaches being used to implement clinical governance, and potential barriers to its successful implementation in primary care. Qualitative case studies using semi-structured interviews and documentation review. Twelve purposively sampled PCG/Ts in England. Fifty senior staff including chief executives, clinical governance leads, mental health leads, and lay board members. Participants' perceptions of the role of clinical governance in PCG/Ts. PCG/Ts recognise that the successful implementation of clinical governance in general practice will require cultural as well as organisational changes, and the support of practices. They are focusing their energies on supporting practices and getting them involved in quality improvement activities. These activities include, but move beyond, conventional approaches to quality assessment (audit, incentives) to incorporate approaches which emphasise corporate and shared learning. PCG/Ts are also engaged in setting up systems for monitoring quality and for dealing with poor performance. Barriers include structural barriers (weak contractual levers to influence general practices), resource barriers (perceived lack of staff or money), and cultural barriers (suspicion by practice staff or problems overcoming the perceived blame culture associated with quality assessment). PCG/Ts are focusing on setting up systems for implementing clinical governance which seek to emphasise developmental and supportive approaches which will engage health professionals. Progress is intentionally incremental but formidable challenges lie ahead, not least reconciling the dual role of supporting practices while monitoring (and dealing with poor) performance.

  5. Depression, quality of life and primary care: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Panos Andriopoulos

    2013-12-01

    Conclusion: The prevalence of both depressive symptomatology and impairment of quality of life is significant and primary care with simple, validated tools can be the setting for identifying and helping such patients.

  6. An Effect of the Co-Operative Network Model for Students' Quality in Thai Primary Schools

    Science.gov (United States)

    Khanthaphum, Udomsin; Tesaputa, Kowat; Weangsamoot, Visoot

    2016-01-01

    This research aimed: 1) to study the current and desirable states of the co-operative network in developing the learners' quality in Thai primary schools, 2) to develop a model of the co-operative network in developing the learners' quality, and 3) to examine the results of implementation of the co-operative network model in the primary school.…

  7. Clients' perception of the quality of primary health service and its ...

    African Journals Online (AJOL)

    This study assessed perceived quality of primary health care and identified predictors in the ... Outcome measured were patients' satisfaction with doctors and nurses' ... using regression analyses with p-value < 0.005 considered significant.

  8. Criteria that ensure the quality of higher education in tourism and sport management study programme

    OpenAIRE

    Mikalauskas, Rimantas; Jasinskas, Edmundas; Švagždienė, Biruta

    2012-01-01

    The quality of higher education is predominantly determined by the work of academic staff and organization of instructional process; the criteria of higher education institution’s infrastructure are of moderate importance. Professional qualities of teaching staff that are related to communication with students during lectures are important for quality assurance; effective communication with others was found to be the most important personal quality of teaching staff. Professional qualities we...

  9. Emotional distress and self-reported quality of life among primary ...

    African Journals Online (AJOL)

    Objectives: To investigate emotional symptoms and domain quality of life (QOL) among primary caregivers of stroke survivors and to determine survivor-related and caregiver-related predictors of these variables. Design: A cross-sectional study. Setting: Medical units of the two major hospitals of the Obafemi Awolowo ...

  10. The quality of primary care provided to the elderly in Israel.

    Science.gov (United States)

    Podell, Rachel; Shriqui, Vered Kaufman; Sagy, Yael Wolff; Manor, Orly; Ben-Yehuda, Arie

    2018-06-04

    In view of increasing global and local trends in population ageing and the high healthcare utilization rates among the elderly, this study assesses the quality of primary care provided to the elderly population in Israel. It examines changes in quality over time, how quality varies across sub-groups of the elderly, and how quality in Israel compares with other countries. Data originate from the National Program for Quality Indicators in Community Healthcare (QICH), which operates in full collaboration with Israel's four HMOs. The study population included all elderly Israeli residents aged 65 years or older during 2002-2015 (N = 879,671 residents in 2015). Seven elderly-specific quality indicators from within the QICH framework were included: influenza and pneumococcal vaccinations, benzodiazepine overuse, long-acting benzodiazepine use, body weight documentation, weight loss and underweight. In addition, two non-age specific quality indicators relating to diabetes mellitus were included: the rate of HbA1C documentation and uncontrolled diabetes. Data were collected from patient electronic medical records (EMR) in accordance with each HMO, and aggregated by three variables: gender, age, and socio-economic position (SEP). During the measurement period, vaccination rates significantly increased (Influenza: from 42.0% in 2002 to 63.2% in 2015; and pneumococcal vaccination: from 25.8% in 2005 to 77.0% in 2015). Body weight documentation (in 65-74 year old persons) increased from only 16.3% in 2003 to 80.9% in 2015. The rate of underweight (BMI quality of care for the elderly in comparison with the international healthcare community. Overall, the quality of care received by elderly Israelis has improved substantially since measurements first began; yet, females receive lower quality care than males. Monitoring results of primary care quality indicators can contribute to population's successful aging; both chronic conditions at earlier ages (e.g. diabetes), and

  11. Yoga and Quality of Life in Women with Primary Dysmenorrhea: A Systematic Review.

    Science.gov (United States)

    McGovern, Christina E; Cheung, Corjena

    2018-06-14

    Primary dysmenorrhea is a prevalent condition causing quality of life (QOL) reduction for many women, resulting from pain as well as parallel social and psychological distress. Yoga reduces pain and sympathetic reactivity, thus promoting QOL. This article reports a systematic review of the evidence for the effectiveness of yoga as a QOL improvement method for women with primary dysmenorrhea. The PRISMA guidelines were used in preparation of this review. Ovid MEDLINE, PsycINFO, CINAHL, Scopus, PubMed, ScienceDirect, Cochrane Database of Systematic Reviews (CDSR), and Cochrane Central Register of Controlled Trials (CENTRAL) were screened through January 2017 using the keywords yoga, meditation, menstrual cycle, dysmenorrhea, pelvic pain, and prostaglandins. English-language randomized controlled trials (RCTs) and quasi-experimental studies regarding yoga, primary dysmenorrhea, and QOL were eligible; all yoga styles were included. Two independent reviewers rated the methodological quality of each study selected for review using the Downs and Black checklist; possible scores ranged from 0 to 32. Ratings were established through consensus. The search yielded a total of 378 articles, of which 14 (age range 13-45 years, N = 1409) met the criteria for final review: 8 RCTs and 6 quasi-experimental studies. Downs and Black ratings were predominantly moderate in quality with moderate risk of bias, ranging from 15 to 23 (RCTs) and 10 to 17 (quasi-experimental studies). Statistically significant improvements along most QOL domains, including physical pain, sleep, concentration, negative feelings, social relationships, work capacity, and overall QOL, were identified after a yoga intervention. Results indicate preliminary evidence for yoga as a safe and effective QOL improvement method for women with primary dysmenorrhea. Practitioners may consider yoga for management of primary dysmenorrhea. However, future research using larger RCTs of high methodological quality is needed to

  12. Feasibility study and methodology to create a quality-evaluated database of primary care data

    Directory of Open Access Journals (Sweden)

    Alison Bourke

    2004-11-01

    Conclusions In the group of practices studied, levels of recording were generally assessed to be of sufficient quality to enable a database of quality-evaluated, anonymised primary care records to be created.

  13. Scenarios of Quality Assurance of Stakeholder Relationships in Finnish Higher Education Institutions

    Science.gov (United States)

    Lyytinen, Anu; Kohtamäki, Vuokko; Kivistö, Jussi; Pekkola, Elias; Hölttä, Seppo

    2017-01-01

    Although the role and significance of the external stakeholders of higher education institutions has grown in recent years, quality assurance of stakeholder relationships remains a new phenomenon in the management practices of higher education institutions and in higher education research. Based on interviews and expert panel data, this article…

  14. Russian Higher Education and European Standards of Quality Assurance

    Science.gov (United States)

    Motova, Galina; Pykko, Ritta

    2012-01-01

    This article considers the relevance and implementation of European approaches to quality assurance in the context of the Russian educational system. It covers the issues of transformation of the higher education system during the post-Soviet period, specific features of the state accreditation system, the impact of the European Standards and…

  15. Rewarding quality teaching in higher education: the evading dream ...

    African Journals Online (AJOL)

    Teaching, and specifically quality teaching, has for many centuries been the defining characteristic of the academic profession. However, since the dawning of the 20th century, it seems that the very basis of the global higher education institutional reward system is the belief that working with, contributing to, and pursuing ...

  16. Quality Education and the Marketplace: An Exploration of Neoliberalism and its Impact on Higher Education

    OpenAIRE

    Mandy Frake

    2008-01-01

    This paper is an in attempt to open discussion about the impact of globalization and theories of neoliberalism on higher education. More specifically, viewing higher education institutions as a market place, where the more a product costs, the greater supply and quality of the product should be received; the quality of education received by university students should also reflect this. Considering the conflict between teaching and research in higher education, quality of education beco...

  17. Mediatizing Higher Education Policies: Discourses about Quality Education in the Media

    Science.gov (United States)

    Cabalin, Cristian

    2015-01-01

    This article presents a critical-political discourse analysis of the media debate over quality assurance in higher education, which occurred in Chile after the 2011 student movement. Students criticized the privatization of higher education and the multiple flaws of this sector, which included corruption scandals during the process of quality…

  18. "INTEGRATED QUALITY MANAGEMENT" AS A SUBJECT IN HIGHER EDUCATION CURRICULUM

    Directory of Open Access Journals (Sweden)

    Stevan Živojinović

    2007-03-01

    Full Text Available The importance of introduction of "Integrated quality management" into higher education curricula arises from the need for students to grasp synergetic application of new and advanced approaches to theoretical and practical management quality and process based management in particular as well as understanding a unified concept which improves conformity and linking of all levels in management hierarchy (normative, strategic and operational toward accomplishment of successful business performance. A curriculum is proposed (as a contribution to a map of necessary knowledge to be expected from prospective quality personnel with appropriate topics in accordance with studies objective and chosen up-to-date options of management concepts and methods.

  19. Health-related quality of life of patients of Brazilian primary health care

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    Bruna de Oliveira Ascef

    2017-11-01

    Full Text Available ABSTRACT OBJECTIVE To analyze the Health-Related Quality of Life (HRQoL of patients of the primary health care of the Brazilian Unified Health System (SUS and its associated factors. METHODS This is a cross-sectional study with data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015. Data were collected with a questionnaire that included the EuroQol 5 Dimensions (EQ-5D instrument. Patients from the five regions of Brazil were interviewed. Multiple linear regression was used to analyze their Health-Related Quality of Life and its associated factors. RESULTS Of the total of 8,590 patients, the most frequent dimensions were pain/discomfort (50.7% and anxiety/depression (38.8%. About 10% of the patients reported extreme problems in these dimensions. The following factors were significantly associated with a worse quality of life: being female; having arthritis, osteoarthritis, or rheumatism; cerebrovascular accident; heart disease; depression; health self-assessment as poor or very poor; drinking alcoholic beverages once or more per month; dieting to lose weight, avoiding salt consumption, and reducing fat intake. Significant association was observed between a better quality of life and: living in the North and Southeast regions of Brazil; practicing physical activities; and having a higher educational level. No association was observed with factors related to the health services. CONCLUSIONS The Health-Related Quality of Life of patients was influenced by demographic and socioeconomic factors that were related to health conditions and lifestyle, being useful to guide specific actions for promoting health and the integral care to patients of the Brazilian Unified Health System.

  20. A Proposed Framework for Applying the National Standards of Quality Assurance in Higher Education in Sudan from the Teaching Staff’s Perspective - Faculties of Business Administration

    Directory of Open Access Journals (Sweden)

    Alfatih Alamin Elfaki

    2017-08-01

    Full Text Available This study aimed to clarify the importance of having national standards and their role in achieving quality, as well as establishing a framework for the actual application of national standards in quality assurance so as to achieve quality in higher education institutions. The researchers  followed a descriptive analytical method to achieve the objectives of the study and developed a questionnaire covering primary and secondary variables that have a role in the design of specific models to help in applying the national standards by the Sudanese universities. The questionnaire included one dependent variable; the effective application of national standards of quality assurance in higher education institutions, and the four main variables (independent are: the national standards of quality assurance in higher education in Sudan, the standard of quality assurance, the standard of teaching and learning and the standard of scientific research and publication. The study revealed a number of conclusions: there were statistically significant differences in the extent of familiarity with the  national quality assurance standards in Sudan according to the academic rank of the  faculty members; there were also significant differences in the extent of compliance with the  national quality assurance standards in Sudan according to the academic rank of the faculty members; there was full agreement between the national standards for quality assurance in Sudan and the international standards for quality assurance; and  there were statistically significant differences in that the absence of specific models would have a negative impact on effective application of national standards of quality assurance in higher education in Sudan, according to the academic rank of the faculty members. Keywords: Quality, The program, Standards, University, Total quality management.

  1. Collaborative Network Management for Enhancing Quality Education of Primary Schools

    Science.gov (United States)

    Chaikoed, Wisithsak; Sirisuthi, Chaiyuth; Numnaphol, Kochaporn

    2017-01-01

    This research aims to study the network and collaborative factors that enhance quality education of primary schools. Different methods were used in this research work: (1) Related approaches, theories, and research literatures and (2) Scholars were interviewed on 871 issues in the form of questionnaire, and the collaborative network factors were…

  2. Yellowjackets use nest-based cues to differentially exploit higher-quality resources

    Science.gov (United States)

    Taylor, Benjamin J.; Schalk, Dane R.; Jeanne, Robert L.

    2010-12-01

    While foraging, social insects encounter a dynamic array of food resources of varying quality and profitability. Because food acquisition influences colony growth and fitness, natural selection can be expected to favor colonies that allocate their overall foraging effort so as to maximize their intake of high-quality nutrients. Social wasps lack recruitment communication, but previous studies of vespine wasps have shown that olfactory cues influence foraging decisions. Odors associated with food brought into the nest by successful foragers prompt naive foragers to leave the nest and search for the source of those odors. Left unanswered, however, is the question of whether naive foragers take food quality into account in making their decisions about whether or not to search. In this study, two different concentrations of sucrose solutions, scented differently, were inserted directly into each of three Vespula germanica nests. At a feeder away from the nest, arriving foragers were given a choice between two 1.5 M sucrose solutions with the same scents as those in the nest. We show that wasps chose higher-quality resources in the field using information in the form of intranidal food-associated odor cues. By this simple mechanism, the colony can bias the allocation of its foraging effort toward higher-quality resources in the environment.

  3. Student satisfaction as an element of education quality monitoring in innovative higher education institution

    Science.gov (United States)

    Razinkina, Elena; Pankova, Ludmila; Trostinskaya, Irina; Pozdeeva, Elena; Evseeva, Lidiya; Tanova, Anna

    2018-03-01

    Topicality of the research is confirmed by increasing student involvement into the educational process, when not only the academic staff and administration participate in the improvement of higher education institution's activity, but also education customers - students. This adds a new dimension to the issue of monitoring education quality and student satisfaction with higher education. This issue echoes the ideas of M. Weber about the relationship between such components as cognitive motivation, personal development and student satisfaction with higher education. Besides, it is essential to focus on the approach of R. Barnet to defining the quality of education with the emphasis on a priority of development of an educational institution as the system that meets customers' needs. Monitoring student satisfaction with education quality has become an integral part of the educational process not only in a number of European universities, which have used this monitoring for decades, but also in Russian universities, which are interested in education quality improvement. Leading universities in Russia, including Peter the Great St. Petersburg Polytechnic University, are implementing policies targeted at increasing student satisfaction with higher education quality. Education quality monitoring as a key element in the system of providing feedback to students contributes greatly to this process.

  4. Influence of Examinations Oriented Approaches on Quality Education in Primary Schools in Kenya

    Science.gov (United States)

    Mackatiani, Caleb Imbova

    2017-01-01

    This paper provides a critical appraisal of the influence of examinations oriented approaches on quality education in primary schools in Kenya. The purpose of the study was to determine effects of examination oriented teaching approaches on learning achievement among primary school pupils in Kakamega County, Kenya. It explored the assumptions…

  5. Organisation and quality of primary surgical intervention for ovarian cancer in Denmark

    DEFF Research Database (Denmark)

    Marx, Charlotte; Bendixen, Anette; Høgdall, Claus

    2007-01-01

    The positive effect on survival of maximal primary cytoreductive surgery for ovarian cancer is well established, and the highest rates of optimal cytoreduction are achieved by gynecological oncologists. Danish women have not only one of the highest incidences of ovarian cancer, but also the highest...... mortality rate. From 1981 to 1989, the overall Danish optimal debulking rate was 25% in patients with stage III and IV tumors. The primary aim of the present study was, therefore, to evaluate the organisation and quality of current primary surgical intervention for ovarian cancer in Denmark....

  6. Higher cortisol is associated with poorer executive functioning in preschool children: The role of parenting stress, parent coping and quality of daycare

    Science.gov (United States)

    Wagner, Shannon L.; Cepeda, Ivan; Krieger, Dena; Maggi, Stefania; D’Angiulli, Amedeo; Weinberg, Joanne; Grunau, Ruth E.

    2016-01-01

    Child executive functions (cognitive flexibility, inhibitory control, working memory) are key to success in school. Cortisol, the primary stress hormone, is known to affect cognition; however, there is limited information about how child cortisol levels, parenting factors and child care context relate to executive functions in young children. The aim of this study was to examine relationships between child cortisol, parenting stress, parent coping, and daycare quality in relation to executive functions in children aged 3–5 years. We hypothesized that (1) poorer executive functioning would be related to higher child cortisol and higher parenting stress, and (2) positive daycare quality and positive parent coping style would buffer the effects of child cortisol and parenting stress on executive functions. A total of 101 children (53 girls, 48 boys, mean age 4.24 years ±0.74) with complete data on all measures were included. Three saliva samples to measure cortisol were collected at the child’s daycare/preschool in one morning. Parents completed the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P), Parenting Stress Index (PSI), and Ways of Coping Questionnaire (WCQ). The Early Childhood Environment Rating Scale – Revised (ECERS-R) was used to measure the quality of daycare. It was found that children with poorer executive functioning had higher levels of salivary cortisol, and their parents reported higher parenting stress. However, parent coping style and quality of daycare did not modulate these relationships. Identifying ways to promote child executive functioning is an important direction for improving school readiness. PMID:26335047

  7. Quality Assurance in Higher Education in 20 MENA Economies

    Science.gov (United States)

    El Hassan, K.

    2013-01-01

    The last decades have witnessed an increased concern in higher education over accountability, quality and productivity, and a struggle to meet increasingly complex challenges. This is more so in Middle East and North African (MENA) economies that witnessed a large expansion as a result of a high social demand and massification policies adopted by…

  8. Formative and summative assessment of science in English primary schools: evidence from the Primary Science Quality Mark

    Science.gov (United States)

    Earle, Sarah

    2014-05-01

    Background:Since the discontinuation of Standard Attainment Tests (SATs) in science at age 11 in England, pupil performance data in science reported to the UK government by each primary school has relied largely on teacher assessment undertaken in the classroom. Purpose:The process by which teachers are making these judgements has been unclear, so this study made use of the extensive Primary Science Quality Mark (PSQM) database to obtain a 'snapshot' (as of March 2013) of the approaches taken by 91 English primary schools to the formative and summative assessment of pupils' learning in science. PSQM is an award scheme for UK primary schools. It requires the science subject leader (co-ordinator) in each school to reflect upon and develop practice over the course of one year, then upload a set of reflections and supporting evidence to the database to support their application. One of the criteria requires the subject leader to explain how science is assessed within the school. Sample:The data set consists of the electronic text in the assessment section of all 91 PSQM primary schools which worked towards the Quality Mark in the year April 2012 to March 2013. Design and methods:Content analysis of a pre-existing qualitative data set. Text in the assessment section of each submission was first coded as describing formative or summative processes, then sub-coded into different strategies used. Results:A wide range of formative and summative approaches were reported, which tended to be described separately, with few links between them. Talk-based strategies are widely used for formative assessment, with some evidence of feedback to pupils. Whilst the use of tests or tracking grids for summative assessment is widespread, few schools rely on one system alone. Enquiry skills and conceptual knowledge were often assessed separately. Conclusions:There is little consistency in the approaches being used by teachers to assess science in English primary schools. Nevertheless

  9. Stakeholder Perception of Service Quality in Qatar Higher Education Institutions: An Application to Qatar University

    OpenAIRE

    Shurair, Amal S.

    2017-01-01

    Managing quality of services offered by institutions of higher education is important in any country due to the inherent aim of producing quality graduates from programs offered in the university. Qatar has made substantial investments in higher education. Qatar University, being the national university of the country, the perception of stakeholders on the service quality in education becomes an important factor for developing a quality education system. Therefore, the main goal of this thesi...

  10. Quality assurance systems of higher education - The case of european institutions: origin, evolution and trends

    Directory of Open Access Journals (Sweden)

    Ángela Corengia

    2014-11-01

    Full Text Available http://dx.doi.org/10.5007/1983-4535.2014v7n3p61 The purpose of this research is to analyze the origin, evolution, performance and trends of higher education quality assurance systems in the following European countries: Denmark, Norway, Sweden, Finland, Austria, Italy, Switzerland, Germany, Netherlands, United Kingdom and France. It also studies the performance and impact of the organizations that join the European Quality Assurance Agencies together. The main sources of data collection were in situ semi-structured interviews to members of these agencies. It was found that in higher education institutions there is a strong trend towards the development of ‘internal quality assurance systems' in response to the public policies known as 'quality audits'. This overview about what is taking place in Europe may provide innovative instruments that could be considered for higher education quality evaluation and accreditation in Latin-American countries: quality audits, disciplinary agencies, evaluation of the quality assurance agencies, among others.

  11. Directing Improvements in Primary Care Patient Experience through Analysis of Service Quality.

    Science.gov (United States)

    Hudson Smith, Mel; Smith, David

    2018-06-03

    To examine the influence of dimensions of service quality on patient experience of primary care. Data from the national GP Patient Survey in England 2014/15, with responses from 858,351 patients registered at 7,918 practices. Expert panel and principal component analysis helped identify relevant dimensions of service quality. Regression was then used to examine the relationships between these dimensions and reported patient experience. Aggregated scores for each practice were used, comprising the proportion of positive responses to each element of the study. Of eight service quality dimensions identified, six have statistically significant impacts on patient experience but only two have large effects. Patient experience is highly influenced by practice responsiveness and the interactions with the physician. Other dimensions have small or even slightly negative influence. Service quality provided by nurses has negligible effect on patient experience. To improve patient experience in primary health care, efforts should focus on practice responsiveness and interactions with the physician. Other areas have little influence over patient experience. This suggests a gap in patients' perspectives on health care, which has policy implications for patient education. © Health Research and Educational Trust.

  12. Total Quality Management in Higher Education: Applying Deming's Fourteen Points.

    Science.gov (United States)

    Masters, Robert J.; Leiker, Linda

    1992-01-01

    This article presents guidelines to aid administrators of institutions of higher education in applying the 14 principles of Total Quality Management. The principles stress understanding process improvements, handling variation, fostering prediction, and using psychology to capitalize on human resources. (DB)

  13. Reconciling Organisational Culture and External Quality Assurance in Higher Education

    Science.gov (United States)

    Naidoo, Dhaya

    2013-01-01

    Organisational culture and external quality assurance have both been presented as significant drivers of effectiveness, efficiency and excellence in higher education institutions. However, these assumptions have not been critically examined given the philosophical, conceptual and methodological contestations surrounding both constructs. A…

  14. Prospective Assessment of Sleep Quality Before and After Primary Total Joint Replacement.

    Science.gov (United States)

    Manning, Blaine T; Kearns, Sean M; Bohl, Daniel D; Edmiston, Tori; Sporer, Scott M; Levine, Brett R

    2017-07-01

    Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration. In the early postoperative period (4.7±2.0 weeks), patients reported significant increases in sleep disturbance as denoted by increased length of time to fall asleep (P=.006) and mean nightly awakenings (P=.002) compared with the preoperative baseline. At late postoperative follow-up (40.8±19.5 weeks), patients' sleep quality subsequently improved above the preoperative baseline. Approximately 40% of patients tried a new sleeping method postoperatively, the most common being new pillow placement. No significant differences in pre- or postoperative sleeping trends were noted between THA and TKA patients. These findings suggest transient sleep disturbance is common in the early postoperative period, with subsequent improvement by 10-month follow-up after a primary TJA. Given the growing importance of patient satisfaction in health care systems, orthopedic surgeons must manage patients' expectations while working with them to optimize sleep quality after TJA. A multimodal approach with preoperative counseling, early postoperative sleep modifications, and possibly preemptive use of medications may improve transient sleep disturbance among TJA patients. [Orthopedics. 2017; 40(4):e636-e640.]. Copyright 2017, SLACK Incorporated.

  15. Pedagogy, Accountability, and Perceptions of Quality by Type of Higher Education in Egypt and Jordan

    Science.gov (United States)

    Assaad, Ragui; Badawy, Eslam; Krafft, Caroline

    2016-01-01

    A number of reasons have been proposed for the poor quality of higher education in the Arab world, including the poor incentive structures of public higher education institutions. The expansion of private higher education has been hailed as an important part of enhancing incentives and thus improving education quality. However, it is not clear…

  16. The Impact of ISO Quality Management Systems on Primary and Secondary Schools in Spain

    Science.gov (United States)

    Arribas Díaz, Jorge Antonio; Martínez-Mediano, Catalina

    2018-01-01

    Purpose: The purpose of this study is to evaluate the application of quality management systems (QMS) based on international standards of quality in education (ISO 9001:2008) and ascertain the influence of this quality model on primary and secondary schools in Spain. Design/methodology/approach: The study was conducted in 26 publicly funded,…

  17. Socio-Economic Consequences of Improved Indoor Air Quality in Danish Primary Schools

    DEFF Research Database (Denmark)

    Wargocki, Pawel; Foldbjerg, Peter; Eriksen, Kurt Emil

    2014-01-01

    are taken into consideration: a) increased PISA score increases productivity; b) increased PISA score reduces the duration of primary education; c) improved indoor air quality reduces absenteeism in teachers. The results show that improved air quality in Danish schools could result in an increase...... in the Gross Domestic Product (GDP) of €173 million per annum, and in the public finances of €37 million per annum...

  18. Students’ perception of quality in higher education: An empirical investigation

    Directory of Open Access Journals (Sweden)

    Zafrul Allam

    2018-05-01

    Full Text Available Students’ evaluation of quality in higher education is becoming increasingly important and widely accepted. Various researchers have reported that “high quality” education creates sustainability among students to accomplish their goals over a period of time. The intention of the present study was to explore students’ perceptions of quality in higher education in terms of curriculum content, learning and teaching experiences, institutional resources and outcome and assessment. A total of 91 students were randomly selected from the business and engineering colleges within Prince Sattam bin Abdulaziz University. The data were analyzed using descriptive and inferential statistics to obtain accurate results pertaining to the motif of the research. The findings revealed that total institutional factors emerged as one of the most prominent predictors of the outcome and assessment within the two different aforementioned disciplines. This paper concludes with suggestions for further investigation.

  19. Assessment of quality of prescribing in patients of hypertension at primary and secondary health care facilities using the Prescription Quality Index (PQI) tool.

    Science.gov (United States)

    Suthar, Jalpa Vashishth; Patel, Varsha J

    2014-01-01

    To determine the quality of prescribing in hypertension in primary and secondary health care settings using the Prescription Quality Index (PQI) tool and to assess the reliability of this tool. An observational cross-sectional study was carried out for 6 months in order to assess quality of prescribing of antihypertensive drugs using Prescription Quality Index (PQI) at four primary (PHC) and two secondary (SHC) health care facilities. Patients attending these facilities for at least 3 months were included. Complete medical history and prescriptions received were noted. Total and criteria wise PQI scores were derived for each prescription. Prescriptions were categorized as poor (score of ≤31), medium (score 32-33) and high quality (score 34-43) based on PQI total score. Psychometric analysis using factor analysis was carried out to assess reliability and validity. Total 73 hypertensive patients were included. Mean age was 61.2 ± 11 years with 35 (48%) patients above 65 years of age. Total PQI score was 26 ± 11. There was a significant difference in PQI score between PHC and SHC (P hypertensive patients was poor, somewhat better in primary as compared to secondary health care facility. PQI is reliable for measuring prescribing quality in hypertension in Indian set up.

  20. Patients living with disabilities: The need for high-quality primary care.

    Science.gov (United States)

    Lofters, Aisha; Guilcher, Sara; Maulkhan, Niraj; Milligan, James; Lee, Joseph

    2016-08-01

    To compare the potential risk factors for lower-quality primary care, the potential markers of unmet needs in primary care, and the willingness to participate in future research among primary care patients with versus without physical disabilities. A waiting room survey using a convenience sample. A family health team (FHT) in Kitchener-Waterloo, Ont, with a designated Mobility Clinic. A total of 40 patients seen at the FHT Mobility Clinic and 80 patients from the general patient population of the same FHT. Socioeconomic status and social capital, number of self-reported emergency department visits and hospitalizations in the preceding year, and willingness of the patients in the 2 groups to participate in future research studies. Patients from the Mobility Clinic were more than twice as likely to be receiving benefits or social assistance (75.0% vs 32.1%, P data for research, 82.5% of Mobility Clinic patients agreed versus 55.0% of those in the general patient population (P = .004). In this study, patients with disabilities were at a social disadvantage compared with their peers without disabilities and were more likely to use the emergency department, suggesting that they had unmet health needs. Future research should continue to explore this patient population and to investigate if an interprofessional primary health care team approach focused on patients with disabilities can help to increase quality of care. Copyright© the College of Family Physicians of Canada.

  1. Quality of life in patients with primary hypothyroidism related to BMI

    NARCIS (Netherlands)

    Kelderman-Bolk, Nienke; Visser, Theo J.; Tijssen, Jan P.; Berghout, Arie

    2015-01-01

    Objective: Many patients treated for primary hypothyroidism have an unexplained reduced quality of life (QOL). We studied the relation between QOL and various parameters in treated hypothyroid patients. Design and methods: QOL analysis was done in 90 consecutive patients (77.8% females) treated for

  2. Psychological status and quality of life among primary caregivers of individuals with mental illness: a hospital based study.

    Science.gov (United States)

    Jeyagurunathan, Anitha; Sagayadevan, Vathsala; Abdin, Edimansyah; Zhang, YunJue; Chang, Sherilyn; Shafie, Saleha; Rahman, Restria Fauziana Abdul; Vaingankar, Janhavi Ajit; Chong, Siow Ann; Subramaniam, Mythily

    2017-05-19

    This study aimed to explore the psychological status and quality of life among primary caregivers of individuals suffering from various mental illnesses including early psychosis, chronic schizophrenia, depressive disorders, anxiety disorders and dementia. A total of 350 primary caregivers with relatives seeking treatment at a tertiary psychiatric hospital were recruited for this study. Socio-demographic data was obtained and the brief version of the World Health Organisation Quality of Life instrument was used to assess caregiver's quality of life (QOL). Psychological status among primary caregivers was assessed using the General Anxiety Disorder - 7 item (GAD-7) and Patient Health Questionnaire - 9 item (PHQ-9) scales. Family Interview Schedule (FIS) was used to assess the impact of caregiving relating to social problems, interpersonal strain among family members, work related problems and financial difficulties as a result of their relative's illness. The socio-demographic and clinical correlates of QOL, PHQ-9 and GAD-7 were examined using multiple linear and logistic regression analyses. Associations between QOL domains and psychological status was examined using multiple linear regression analyses. The mean age of the primary caregivers was 49.7 years (SD = 13.2), ranging from 21 to 82 years, with a preponderance of females (67.6%), aged 50-64 years old (45.7%). Majority were of Chinese ethnicity (57.5%), had secondary level education (43.1%), were married (65.2%), and employed (64.9%). 18.3% of primary caregivers had symptoms of depression (based on PHQ-9 cut-off point of 10 or greater) while 12.7% had symptoms of anxiety (based on GAD-7 cut-off point of 10 or greater). Multiple linear and logistic regression analyses revealed that primary caregivers aged between 35-49 years and 50-64 years, unemployed, living with others, providing care to those diagnosed with dementia and who had higher FIS scores were significantly more likely to report symptoms

  3. Psychometric Quality of a Student Evaluation of Teaching Survey in Higher Education

    Science.gov (United States)

    Oon, Pey-Tee; Spencer, Benson; Kam, Chester Chun Seng

    2017-01-01

    Student evaluations of teaching (SET) are used globally by higher education institutions for performance assessment of academic staff and evaluation of course quality. Higher education institutions commonly develop their own SETs to measure variables deemed relevant to them. However, "home-grown" SETs are rarely assessed…

  4. Two-Year Costs and Quality in the Comprehensive Primary Care Initiative.

    Science.gov (United States)

    Dale, Stacy B; Ghosh, Arkadipta; Peikes, Deborah N; Day, Timothy J; Yoon, Frank B; Taylor, Erin Fries; Swankoski, Kaylyn; O'Malley, Ann S; Conway, Patrick H; Rajkumar, Rahul; Press, Matthew J; Sessums, Laura; Brown, Randall

    2016-06-16

    The 4-year, multipayer Comprehensive Primary Care Initiative was started in October 2012 to determine whether several forms of support would produce changes in care delivery that would improve the quality and reduce the costs of care at 497 primary care practices in seven regions across the United States. Support included the provision of care-management fees, the opportunity to earn shared savings, and the provision of data feedback and learning support. We tracked changes in the delivery of care by practices participating in the initiative and used difference-in-differences regressions to compare changes over the first 2 years of the initiative in Medicare expenditures, health care utilization, claims-based measures of quality, and patient experience for Medicare fee-for-service beneficiaries attributed to initiative practices and a group of matched comparison practices. During the first 2 years, initiative practices received a median of $115,000 per clinician in care-management fees. The practices reported improvements in approaches to the delivery of primary care in areas such as management of the care of high-risk patients and enhanced access to care. Changes in average monthly Medicare expenditures per beneficiary did not differ significantly between initiative and comparison practices when care-management fees were not taken into account (-$11; 95% confidence interval [CI], -$23 to $1; P=0.07; negative values indicate less growth in spending at initiative practices) or when these fees were taken into account ($7; 95% CI, -$5 to $19; P=0.27). The only significant differences in other measures were a 3% reduction in primary care visits for initiative practices relative to comparison practices (Pinitiative practices relative to comparison practices (P=0.006 and Pinitiative have reported progress in transforming the delivery of primary care. However, at this point these practices have not yet shown savings in expenditures for Medicare Parts A and B after

  5. Quality Education and the Marketplace: An Exploration of Neoliberalism and its Impact on Higher Education

    Directory of Open Access Journals (Sweden)

    Mandy Frake

    2010-05-01

    Full Text Available This paper is an in attempt to open discussion about the impact of globalization and theories of neoliberalism on higher education. More specifically, viewing higher education institutions as a market place, where the more a product costs, the greater supply and quality of the product should be received; the quality of education received by university students should also reflect this. Considering the conflict between teaching and research in higher education, quality of education becomes questionable. This paper explores issues of neoliberalism resulting in a greater demand for the completion of research in higher education institutions. Furthermore, the imperialism of higher education leading towards the demand for more research, the teaching versus research nexus within universities, and discussion of how these theories impact international students will be examined throughout this paper

  6. IMPACT OF COMORBIDITY AND SOCIOECONOMIC STATUS ON QUALITY OF LIFE IN PATIENTS WITH CHRONIC DISEASES WHO ATTEND PRIMARY HEALTH CARE CENTRES.

    Science.gov (United States)

    Tüzün, Hakan; Aycan, Sefer; İlhan, Mustafa Necmi

    2015-09-01

    The aim of the study was to analyse the impact of chronic disease on the quality of life (QoL) and how QoL changes with comorbidity and socioeconomic status in persons who attend primary health care centres. The group of participants comprised 2,560 people who contacted six primary health care centres in Ankara. The level of QoL was determined by the World Health Organization Quality of Life Questionnaire Abbreviated Version (WHOQOL-BREF). Mental disorders and diabetes-hypertension comorbidity had the most negative effect on the QoL. In the physical domain of the WHOQOL-BREF, the effect of diabetes-hypertension comorbidity is greater than the additive effect of hypertension and diabetes individually. The co-occurrence of any disease with cardiovascular disease does not change QoL within any domain, except for the co-occurrence of any disease with musculoskeletal diseases which deteriorated QoL in the physical domain. The higher income and socioeconomic status corresponded to higher QoL. The effect of comorbidity on QoL can be different from the additive effects of the co-occurring diseases. Socioeconomic factors undoubtedly affect the relationship between chronic diseases and QoL, and this relationship points to health inequities among socioeconomic groups.

  7. Preferred teacher-student interpersonal behaviour: Differences between Polish primary and higher education students' perceptions

    NARCIS (Netherlands)

    Sztejnberg, A.; Brok, den P.J.; Hurek, J.

    2004-01-01

    This study investigated differences between students’ perceptions of their best teachers in primary and higher education in Poland. Teacher behavior was conceptualized in terms of the teacher-student interpersonal relationship and described in terms of eight behavioral sectors – leadership,

  8. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria: Successes and Challenges.

    Science.gov (United States)

    Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri

    2016-01-01

    Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System-AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement ( t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities.

  9. Higher Dietary Cost Is Associated with Higher Diet Quality: A Cross-Sectional Study among Selected Malaysian Adults.

    Science.gov (United States)

    Pondor, Ibnteesam; Gan, Wan Ying; Appannah, Geeta

    2017-09-16

    Food price is a determining factor of food choices; however its relationship with diet quality is unclear in Malaysia. This study aimed to examine socio-economic characteristics and daily dietary cost (DDC) in relation to diet quality in the state of Selangor, Malaysia. Dietary intake was assessed using a Food Frequency Questionnaire (FFQ) and diet quality was estimated using a Malaysian Healthy Eating Index (M-HEI). DDC in Malaysian Ringgit (RM) was calculated from dietary intake and national food prices. Linear regression models were fitted to determine associations between DDC and M-HEI scores and predictors of diet quality. The mean M-HEI score of respondents was 61.31 ± 10.88 and energy adjusted DDC was RM10.71/2000 kcal (USD 2.49). The highest quintile of adjusted DDC had higher M-HEI scores for all respondents (Q1: 57.14 ± 10.07 versus Q5: 63.26 ± 11.54, p = 0.001). There were also positive associations between DDC and M-HEI scores for fruits ( p diet quality included carbohydrate (β = 0290; p healthy eating among Malaysian adults.

  10. Availability and quality of coronary heart disease family history in primary care medical records: implications for cardiovascular risk assessment.

    Science.gov (United States)

    Dhiman, Paula; Kai, Joe; Horsfall, Laura; Walters, Kate; Qureshi, Nadeem

    2014-01-01

    The potential to use data on family history of premature disease to assess disease risk is increasingly recognised, particularly in scoring risk for coronary heart disease (CHD). However the quality of family health information in primary care records is unclear. To assess the availability and quality of family history of CHD documented in electronic primary care records. Cross-sectional study. 537 UK family practices contributing to The Health Improvement Network database. Data were obtained from patients aged 20 years or more, registered with their current practice between 1(st) January 1998 and 31(st) December 2008, for at least one year. The availability and quality of recorded CHD family history was assessed using multilevel logistic and ordinal logistic regression respectively. In a cross-section of 1,504,535 patients, 19% had a positive or negative family history of CHD recorded. Multilevel logistic regression showed patients aged 50-59 had higher odds of having their family history recorded compared to those aged 20-29 (OR:1.23 (1.21 to 1.25)), however most deprived patients had lower odds compared to those least deprived (OR: 0.86 (0.85 to 0.88)). Of the 140,058 patients with a positive family history recorded (9% of total cohort), age of onset was available in 45%; with data specifying both age of onset and relative affected available in only 11% of records. Multilevel ordinal logistic regression confirmed no statistical association between the quality of family history recording and age, gender, deprivation and year of registration. Family history of CHD is documented in a small proportion of primary care records; and where positive family history is documented the details are insufficient to assess familial risk or populate cardiovascular risk assessment tools. Data capture needs to be improved particularly for more disadvantaged patients who may be most likely to benefit from CHD risk assessment.

  11. HPV testing for primary cervical screening: Laboratory issues and evolving requirements for robust quality assurance.

    Science.gov (United States)

    Carozzi, Francesca Maria; Del Mistro, Annarosa; Cuschieri, Kate; Frayle, Helena; Sani, Cristina; Burroni, Elena

    2016-03-01

    This review aims to highlight the importance of Quality Assurance for Laboratories performing HPV test for Cervical Cancer Screening. An HPV test, to be used as primary screening test, must be validated according to international criteria, based on comparison of its clinical accuracy to HC2 or GP5+/6+ PCR-EIA tests. The number of validated platforms is increasing and appropriate Quality Assurance Programs (QAPs) which can interrogate longitudinal robustness and quality are paramount. This document describes the following topics: (1) the characteristics of an HPV laboratory and the personnel training needs, to ensure an elevated quality of the entire process and the optimal use of the resources; (2) the Quality Assurance, as both internal (IQA) and external quality assessment (EQA) systems, to be implemented and performed, and the description of the existing EQAs, including limitations; (3) general considerations for an optimal EQA program for hrHPV primary screening Due to the importance of Quality Assurance for this field, international efforts are necessary to improve QA International Collaboration. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Factors that Impact Quality of E-Teaching/Learning Technologies in Higher Education

    Science.gov (United States)

    Daukilas, Sigitas; Kaciniene, Irma; Vaisnoriene, Daiva; Vascila, Vytautas

    2008-01-01

    The article analyzes and assesses factors that have impact upon the quality of eTeaching/learning technologies in higher education; it is on their basis that the concept of eTeaching/learning quality is denied. Research data about the students' motives in choosing various teaching/learning technologies for the development of their competence are…

  13. Quality assurance policies and practices in Scandinavian higher education systems: convergence or different paths?

    DEFF Research Database (Denmark)

    Kalpazidou Schmidt, Evanthia

    2017-01-01

    Because there is close cooperation on quality assurance in the Scandinavian countries, one would expect there to be convergence of quality assurance policies and practices in Scandinavian higher education. Few studies have analysed these quality assurance policies and practices from a comparative...... quality assurance. The debate is compelling with regard to the Swedish case in particular, with its ‘one size fits all’ approach and exclusive focus on outcomes which has been heavily criticised by the higher education institutions and has turned out to be controversial from the European viewpoint....... viewpoint. Based on empirical evidence produced in connection with studies of recent quality reforms in Scandinavia and an approach based on linking diffusion and translation theories with institutionalist perspectives focusing on path dependency, the paper contributes to the current debate on Scandinavian...

  14. Higher Education Quality: Perception Differences among Internal and External Stakeholders

    Science.gov (United States)

    Abidin, Munirul

    2015-01-01

    Conceptually, education quality of higher education can be determined by evaluation of their stakeholders's satisfaction level. The purpose of this study is to describe how students as external stakeholder and lecturers as internal stakeholder, perceived their satisfaction of learning experience in the university. This study was conducted in…

  15. The geospatial data quality REST API for primary biodiversity data.

    Science.gov (United States)

    Otegui, Javier; Guralnick, Robert P

    2016-06-01

    We present a REST web service to assess the geospatial quality of primary biodiversity data. It enables access to basic and advanced functions to detect completeness and consistency issues as well as general errors in the provided record or set of records. The API uses JSON for data interchange and efficient parallelization techniques for fast assessments of large datasets. The Geospatial Data Quality API is part of the VertNet set of APIs. It can be accessed at http://api-geospatial.vertnet-portal.appspot.com/geospatial and is already implemented in the VertNet data portal for quality reporting. Source code is freely available under GPL license from http://www.github.com/vertnet/api-geospatial javier.otegui@gmail.com or rguralnick@flmnh.ufl.edu Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.

  16. Long-Run Benefits from Universal High-Quality Preschooling

    DEFF Research Database (Denmark)

    Bauchmüller, Robert; Gørtz, Mette; Rasmussen, Astrid Würtz

    2014-01-01

    This paper investigates the role of preschool quality for children's school performance at the end of primary school. We construct five structural quality indicators based on unique Danish administrative register data. 30,444 children finishing primary school's 9th grade in 2008 and who attended ...... in children's test results in Danish. Boys benefit more from preschool quality than girls. Ethnic minority children benefit from higher staff stability....

  17. Quality Assurance in Higher Technical Education and the Context of Youth Empowerment for Sustainable Development

    Directory of Open Access Journals (Sweden)

    Olufunmilayo T. Iyunade, Ph.D

    2014-06-01

    Full Text Available Recent empirical evidences on higher technical education at a national scale focused on the relevance, student’s poor perception, low enrolment and progression rates, and the growing impact of globalization on the management of higher technical and vocational education with little or no reference point to the factor of quality assurance. This paper therefore correlates quality assurance factors in higher technical education and the context of youth empowerment for sustainable development. A survey of public technical colleges was done in Ogun State. From an estimate population of 637 final year students and 28 instructors and management staff, a simple of 376 students and 17 instructors and management staff were selected using the stratify random sampling technique. A 4-point rating scale validated questionnaires tagged: ‘Higher Technical Education, Youth Empowerment and Sustainable Development Scale (HTEYESDS (r=0.79, complemented with focus Group Discussion (FGD was used for data collection. Three research questions were raised and answered. Data were analysed using descriptive and inferential statistics of Pearson correlation, multiple regression and analysis of variance at 0.05 apha level. Results showed that poor quality assurance limits the capacity of higher technical education in the empowerment of youth for sustainable development (82.6%. Quality assurance factors significantly correlated with higher technical education in the empowerment of youth for sustainable development (r=0.188; P < 0.05. It was therefore recommended that government should neither neglect nor compromise the factors of quality assurance in higher technical education as they predicts youth empowerment drive in the system.

  18. Balanced Scorecard: A Strategy for the Quality Improvement of Islamic Higher Education

    Science.gov (United States)

    Ilyasin, Mukhamd; Zamroni

    2017-01-01

    The main issue in improving the quality of Islamic Higher Education is to increase the competence and professionalism of teachers and education personnel to achieve its vision and mission in the middle of the complexity of the demands of society and the changing times. so that the quality of education and governance of Islamic Religion clean and…

  19. Quality assurance and evaluation system in japanese higher education

    Directory of Open Access Journals (Sweden)

    Ana Mami Yamaguchi

    2016-03-01

    Full Text Available Abstract In this paper we aim to contribute to the debate over accountability and assessment of higher education (HE by introducing the Japanese system. We first discuss the circumstances and issues surrounding Japanese HE and then examine the historical development of the quality assurance and evaluation system. Since the 1990s, with the implementation of policies that focused on liberalization, deregulation and increased institutional autonomy, the role of the government has shifted from setting strict regulations and quality standards to organizing an evaluation system for assessing the learning outcomes and improving accountability of the HE institutions. Finally, we suggest how Japan may take hints from Brazil in organizing an evaluation system on a national level that can more efficiently support and assess HE institutions

  20. Evaluating and Enhancing Outcomes Assessment Quality in Higher Education Programs

    Science.gov (United States)

    Wolf, Kenneth; Goodwin, Laura

    2007-01-01

    Accreditation is a mark of distinction indicating that an institution has met high standards set by the profession, and an increasingly important feature of the accreditation process in higher education is "outcomes assessment." This article presents two rubrics for evaluating the quality of an institution's outcomes assessment system. One rubric…

  1. Use of an electronic medical record improves the quality of urban pediatric primary care.

    Science.gov (United States)

    Adams, William G; Mann, Adriana M; Bauchner, Howard

    2003-03-01

    To evaluate the quality of pediatric primary care, including preventive services, before and after the introduction of an electronic medical record (EMR) developed for use in an urban pediatric primary care center. A pre-postintervention analysis was used in the study. The intervention was a pediatric EMR. Routine health care maintenance visits for children eye-to-eye contact with patients was reduced, and 4 of 7 reported that use of the system increased the duration of visits (mean: 9.3 minutes longer). All users recommended continued use of the system. Use of the EMR in this study was associated with improved quality of care. This experience suggests that EMRs can be successfully used in busy urban pediatric primary care centers and, as recommended by the Institute of Medicine, must play a central role in the redesign of the US health care system.

  2. The Effectiveness of the Higher Education Quality Assessment System: Problems and Countermeasures in China

    Science.gov (United States)

    Guangli, Zhou

    2016-01-01

    The effectiveness of the higher education quality assessment system is essentially a matter of policy evaluation. On the macro level, such a system refers to external quality assessment, which includes government evaluation, quality certification, and university rankings. Depending on the degree of government intervention, the external quality…

  3. A Risk and Standards Based Approach to Quality Assurance in Australia's Diverse Higher Education Sector

    Science.gov (United States)

    Australian Government Tertiary Education Quality and Standards Agency, 2015

    2015-01-01

    The Australian Government Tertiary Education Quality and Standards Agency's (TEQSA's) role is to assure that quality standards are being met by all registered higher education providers. This paper explains how TEQSA's risk-based approach to assuring higher education standards is applied in broad terms to a diverse sector. This explanation is…

  4. Positive Attitude toward Healthy Eating Predicts Higher Diet Quality at All Cost Levels of Supermarkets☆

    Science.gov (United States)

    Aggarwal, Anju; Monsivais, Pablo; Cook, Andrea J.; Drewnowski, Adam

    2014-01-01

    Shopping at low-cost supermarkets has been associated with higher obesity rates. This study examined whether attitudes toward healthy eating are independently associated with diet quality among shoppers at low-cost, medium-cost, and high-cost supermarkets. Data on socioeconomic status (SES), attitudes toward healthy eating, and supermarket choice were collected using a telephone survey of a representative sample of adult residents of King County, WA. Dietary intake data were based on a food frequency questionnaire. Thirteen supermarket chains were stratified into three categories: low, medium, and high cost, based on a market basket of 100 commonly eaten foods. Diet-quality measures were energy density, mean adequacy ratio, and total servings of fruits and vegetables. The analytical sample consisted of 963 adults. Multivariable regressions with robust standard error examined relations between diet quality, supermarket type, attitudes, and SES. Shopping at higher-cost supermarkets was associated with higher-quality diets. These associations persisted after adjusting for SES, but were eliminated after taking attitudinal measures into account. Supermarket shoppers with positive attitudes toward healthy eating had equally higher-quality diets, even if they shopped at low-, medium-, or high-cost supermarkets, independent of SES and other covariates. These findings imply that shopping at low-cost supermarkets does not prevent consumers from having high-quality diets, as long as they attach importance to good nutrition. Promoting nutrition-education strategies among supermarkets, particularly those catering to low-income groups, can help to improve diet quality. PMID:23916974

  5. Water quality control device and water quality control method for reactor primary coolant system

    International Nuclear Information System (INIS)

    Wada, Yoichi; Ibe, Eishi; Watanabe, Atsushi.

    1995-01-01

    The present invention is suitable for preventing defects due to corrosion of structural materials in a primary coolant system of a BWR type reactor. Namely, a concentration measuring means measures the concentration of oxidative ingredients contained in a reactor water. A reducing electrode is disposed along a reactor water flow channel in the primary coolant system and reduces the oxidative ingredients. A reducing counter electrode is disposed along the reactor water flow channel in the primary coolant system, and electrically connected to the reducing electrode. The reactor structural materials are used as a reference electrode providing a reference potential to the reducing electrode and the reducing counter electrode. A potential control means controls the potential of the reducing electrode relative to the reference potential based on the signals from the concentration measuring means. A stable reference potential in a region where an effective oxygen concentration is stable can be obtained irrespective of the change of operation conditions by using the reactor structural materials disposed to a boiling region in the reactor core as a reference electrode. As a result, the water quality can be controlled at high accuracy. (I.S.)

  6. Analysis of professional quality of students majored with logistics management in the higher vocational college based on AHP

    Directory of Open Access Journals (Sweden)

    Dai Chengxia

    2016-01-01

    Full Text Available To strength training of the professional quality of students in the higher vocational college, and then explore an effective way to train the professional quality of students in the higher vocational college is a very necessary and urgent task. On this basis, this paper aims at investigating the situation of the professional quality of the students majored with the logistics management in the higher vocational college according to the requirements of the industry and enterprise, constructs a multi-dimensional space of the professional quality by the use of the AHP analysis method, and proposes the training method of the professional quality, in order to further improve the professional quality of students in the higher vocational college, and provide reference for the training of the students majored with the logistics management in the higher vocational college.

  7. QUALICOPC, a multi-country study evaluating quality, costs and equity in primary care

    Directory of Open Access Journals (Sweden)

    Van den Berg Michael J

    2011-10-01

    Full Text Available Abstract Background The QUALICOPC (Quality and Costs of Primary Care in Europe study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects primary care systems have on the performance of health care systems. QUALICOPC is funded by the European Commission under the "Seventh Framework Programme". In this article the background and design of the QUALICOPC study is described. Methods/design QUALICOPC started in 2010 and will run until 2013. Data will be collected in 31 European countries (27 EU countries, Iceland, Norway, Switzerland and Turkey and in Australia, Israel and New Zealand. This study uses a three level approach of data collection: the system, practice and patient. Surveys will be held among general practitioners (GPs and their patients, providing evidence at the process and outcome level of primary care. These surveys aim to gain insight in the professional behaviour of GPs and the expectations and actions of their patients. An important aspect of this study is that each patient's questionnaire can be linked to their own GP's questionnaire. To gather data at the structure or national level, the study will use existing data sources such as the System of Health Accounts and the Primary Health Care Activity Monitor Europe (PHAMEU database. Analyses of the data will be performed using multilevel models. Discussion By its design, in which different data sources are combined for comprehensive analyses, QUALICOPC will advance the state of the art in primary care research and contribute to the discussion on the merit of strengthening primary care systems and to evidence based health policy development.

  8. The expansion of higher education: A consideration of control, funding and quality

    OpenAIRE

    Bathmaker, A.-M.

    2003-01-01

    Since the Robbins Report of 1963, higher education in the UK has undergone major expansion, changing it from an elite to a mass system. This chapter explores the changing socio-economic context in which this transformation has taken place, and considers how the expansion of higher education has raised issues of control, quality and funding.

  9. Drug utilization research in primary health care as exemplified by physicians' quality assessment groups.

    Science.gov (United States)

    von Ferber, L; Luciano, A; Köster, I; Krappweis, J

    1992-11-01

    Drugs in primary health care are often prescribed for nonrational reasons. Drug utilization research investigates the prescription of drugs with an eye to medical, social and economic causes and consequences of the prescribed drug's utilization. The results of this research show distinct differences in drug utilization in different age groups and between men and women. Indication and dosage appear irrational from a textbook point of view. This indicates nonpharmacological causes of drug utilization. To advice successfully changes for the better quality assessment groups of primary health care physicians get information about their established behavior by analysis of their prescriptions. The discussion and the comparisons in the group allow them to recognize their irrational prescribing and the social, psychological and economic reasons behind it. Guidelines for treatment are worked out which take into account the primary health care physician's situation. After a year with 6 meetings of the quality assessment groups the education process is evaluated by another drug utilization analysis on the basis of the physicians prescription. The evaluation shows a remarkable improvement of quality and cost effectiveness of the drug therapy of the participating physicians.

  10. Academic goals and learning quality in higher education students.

    Science.gov (United States)

    Valle, Antonio; Núñez, José C; Cabanach, Ramón G; González-Pienda, Julio A; Rodríguez, Susana; Rosário, Pedro; Muñoz-Cadavid, María A; Cerezo, Rebeca

    2009-05-01

    In this paper, the relations between academic goals and various indicators that define the quality of the learning process are analyzed. The purpose was to determine to what extent high, moderate, or low levels of academic goals were positively or negatively related to effort regulation, the value assigned to academic tasks, meta-cognitive self-regulation, self-efficacy, beliefs about learning control, and management of time and study environment. The investigation was carried out with a sample of 632 university students (70% female and 30% male) and mean age of 21.22 (SD=2.2).The results show that learning goals, or task orientation, are positively related to all the indictors of learning quality considered herein. Although for other kinds of goals-work-avoidance goals, performance-approach goals, and performance-avoidance goals-significant relations were not found with all the indicators, there was a similar tendency of significant results in all cases; the higher the levels of these goals, the lower the levels of the indicators of learning quality.

  11. How improving practice relationships among clinicians and nonclinicians can improve quality in primary care.

    Science.gov (United States)

    Lanham, Holly J; McDaniel, Reuben R; Crabtree, Benjamin F; Miller, William L; Stange, Kurt C; Tallia, Alfred F; Nutting, Paula

    2009-09-01

    Understanding the role of relationships health care organizations (HCOs) offers opportunities for shaping health care delivery. When quality is treated as a property arising from the relationships within HCOs, then different contributors of quality can be investigated and more effective strategies for improvement can be developed. Data were drawn from four large National Institutes of Health (NIH)-funded studies, and an iterative analytic strategy and a grounded theory approach were used to understand the characteristics of relationships within primary care practices. This multimethod approach amassed rich and comparable data sets in all four studies, which were all aimed at primary care practice improvement. The broad range of data included direct observation of practices during work activities and of patient-clinician interactions, in-depth interviews with physicians and other key staff members, surveys, structured checklists of office environments, and chart reviews. Analyses focused on characteristics of relationships in practices that exhibited a range of success in achieving practice improvement. Complex adaptive systems theory informed these analyses. Trust, mindfulness, heedfulness, respectful interaction, diversity, social/task relatedness, and rich/lean communication were identified as important in practice improvement. A model of practice relationships was developed to describe how these characteristics work together and interact with reflection, sensemaking, and learning to influence practice-level quality outcomes. Although this model of practice relationships was developed from data collected in primary care practices, which differ from other HCOs in some important ways, the ideas that quality is emergent and that relationships influence quality of care are universally important for all HCOs and all medical specialties.

  12. QUALITY ASSURANCE IN RWANDAN HIGHER LEARNING EDUCATION: IS THE SYSTEM ADAPTIVE OR COMPLEX?

    Directory of Open Access Journals (Sweden)

    Nathan Kanuma Taremwa

    2014-01-01

    Full Text Available Developing knowledge infrastructure by massive investments in education and training are taken as a benchmark in facilitating the acceleration and possible increases in skills, capacities and competences of Rwandan people has become apriority issue in the recent years. This notion is relevant to vision 2020 where human resource development and building of a knowledge based economy are fundamental pillars. In the past years, several policy reforms have taken place in education sector. However, the overarching question is if such reforms are becoming adaptive or complex and if such reforms will not compromise the quality of education in higher learning education in Rwanda? The main objective of the study was to investigate the impact of changes in Higher Learning Institutions on the quality of education in Rwanda. This research had three hypotheses, namely; there is an impact of changes in Higher Learning Institutions on quality of education in Rwanda; the current complexity in Rwandan education system is affecting the quality of education in HLIs; Tailoring education system to the regional reforms and implementation strategies is affecting the quality of education in Rwanda. This study was carried out in 10 higher learning institutions (5 public, 5 private and 2 Ministry of Education directorates (HEC and REB. Key informants were the senior management/head of institutions, experienced academic staff, and students. The parameters considered included; the learning methods, assessment styles, workloads, language of instruction, merging of public HLIs, curriculum, and the transformation of some private higher learning institutions into company forms. Main research instruments were questionnaires and interview guides. Both qualitative and quantitative research was collected. Analyses were done using SPSS and excel packages. Major findings indicate that the system is still in transition with indicative gaps. Ample time would therefore be necessary for

  13. Quality of weight-loss counseling by Dutch practice nurses in primary care: an observational study

    NARCIS (Netherlands)

    Dillen, S.M. van; Noordman, J.; Dulmen, S. van; Hiddink, G.J.

    2015-01-01

    BACKGROUND/OBJECTIVE: To assess the quality of weight-loss counseling provided by Dutch primary care practice nurses (PNs) to overweight and obese patients including both PNs' compliance with the Five A's Model for behavioral counseling in primary care, and the use of different communication styles.

  14. Academic Staff Quality in Higher Education: An Empirical Analysis of Portuguese Public Administration Education

    Science.gov (United States)

    Sarrico, Cláudia S.; Alves, André A.

    2016-01-01

    Higher education accreditation frameworks typically consider academic staff quality a key element. This article embarks on an empirical study of what academic staff quality means, how it is measured, and how different aspects of staff quality relate to each other. It draws on the relatively nascent Portuguese experience with study programme…

  15. Student Motivations, Quality and Status in Adult Higher Education (AHE) in China

    Science.gov (United States)

    Wang, Naixia; Morgan, W. John

    2009-01-01

    This article examines an important and yet neglected aspect of the relationship between higher education and the labour market in contemporary China. It does this through a detailed case study of student motivations, quality and status in adult higher education (AHE) in the city of Taiyuan, Shanxi Province. This is a region which has seen major…

  16. Primary Physical Education (PE): School Leader Perceptions about Classroom Teacher Quality Implementation

    Science.gov (United States)

    Lynch, Timothy; Soukup, Gregory J., Sr.

    2017-01-01

    Quality physical education (QPE) in primary school optimises children's well-being. However, international research indicates that the preparation of classroom teachers is impeded by systemic barriers, resulting in low-classroom teacher confidence, competence and subsequent interest. This empirical research investigates school principal…

  17. Eating School Lunch Is Associated with Higher Diet Quality among Elementary School Students.

    Science.gov (United States)

    Au, Lauren E; Rosen, Nila J; Fenton, Keenan; Hecht, Kenneth; Ritchie, Lorrene D

    2016-11-01

    Few studies have assessed the dietary quality of children who eat meals from home compared with school meals according to the 2010 Dietary Guidelines for Americans. The objective of this study was to examine diet quality for elementary school students in relation to source of breakfast and lunch (whether school meal or from an outside source). An observational study was conducted of students in 43 schools in San Diego, CA, during the 2011-2012 school year. Fourth- and fifth-grade students (N=3,944) completed a diary-assisted 24-hour food recall. The Healthy Eating Index-2010 (HEI-2010) scores of children who ate breakfast and lunch at school were compared with the HEI-2010 scores of children who obtained their meals from home and a combination of both school and home. Analysis of variance, χ 2 test, and generalized estimating equation models adjusted for age, sex, race/ethnicity, grade, language, and school level clustering were performed. School lunch eaters had a higher mean±standard deviation overall diet quality score (HEI-2010=49.0±11.3) compared with students who ate a lunch obtained from home (46.1±12.2; P=0.02). There was no difference in overall diet quality score by breakfast groups. Students who ate school breakfast had higher total fruit (P=0.01) and whole fruit (P=0.0008) scores compared with students who only ate breakfast obtained from home. Students who ate school foods had higher scores for dairy (P=0.007 for breakfast and Pempty calories from solid fats and added sugars (P=0.01 for breakfast and P=0.007 for lunch). Eating school lunch was associated with higher overall diet quality compared with obtaining lunch from home. Future studies are needed that assess the influence of the Healthy Hunger-Free Kids Act on children's diet quality. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  18. Beyond quality improvement: exploring why primary care teams engage in a voluntary audit and feedback program.

    Science.gov (United States)

    Wagner, Daniel J; Durbin, Janet; Barnsley, Jan; Ivers, Noah M

    2017-12-02

    Despite its popularity, the effectiveness of audit and feedback in support quality improvement efforts is mixed. While audit and feedback-related research efforts have investigated issues relating to feedback design and delivery, little attention has been directed towards factors which motivate interest and engagement with feedback interventions. This study explored the motivating factors that drove primary care teams to participate in a voluntary audit and feedback initiative. Interviews were conducted with leaders of primary care teams who had participated in at least one iteration of the audit and feedback program. This intervention was developed by an organization which advocates for high-quality, team-based primary care in Ontario, Canada. Interview transcripts were coded using the Consolidated Framework for Implementation Research and the resulting framework was analyzed inductively to generate key themes. Interviews were completed with 25 individuals from 18 primary care teams across Ontario. The majority were Executive Directors (14), Physician leaders (3) and support staff for Quality Improvement (4). A range of motivations for participating in the audit and feedback program beyond quality improvement were emphasized. Primarily, informants believed that the program would eventually become a best-in-class audit and feedback initiative. This reflected concerns regarding existing initiatives in terms of the intervention components and intentions as well as the perception that an initiative by primary care, for primary care would better reflect their own goals and better support desired patient outcomes. Key enablers included perceived obligations to engage and provision of support for the work involved. No teams cited an evidence base for A&F as a motivating factor for participation. A range of motivating factors, beyond quality improvement, contributed to participation in the audit and feedback program. Findings from this study highlight that efforts to

  19. The Need for Context-Sensitive Measures of Educational Quality in Transnational Higher Education

    Science.gov (United States)

    Pyvis, David

    2011-01-01

    This paper argues that the current approach to educational quality formation in transnational higher education promotes educational imperialism, and that guidelines and practices should be altered to embrace context-sensitive measures of quality. The claims are sustained by findings from a study that investigated how academics understood and…

  20. Functional bowel disorders in primary care: factors associated with health-related quality of life and doctor consultation.

    Science.gov (United States)

    Lee, Victoria; Guthrie, Else; Robinson, Andrew; Kennedy, Anne; Tomenson, Barbara; Rogers, Anne; Thompson, David

    2008-02-01

    The role of psychological factors in irritable bowel syndrome (IBS) remains unclear, particularly in a primary care setting, where relatively little research on this common and costly condition has been carried out. The aim of this study was to investigate the relative contribution of physical and psychological factors to health-related quality of life and health-care utilization in patients with functional bowel disease (IBS-like symptoms) in primary care. We also wished to establish the relevance of formal diagnostic criteria to IBS in the primary care setting. This study used a cross-sectional design. Four hundred twenty patients with functional bowel disorders in primary care completed a series of measures, including bowel symptom status and severity, severity of psychological distress, personality, and quality of life. The number of visits to a general practitioner (GP) in the previous 12 months was recorded. The following variables were independently and highly significantly associated with health-related quality of life in patients with functional bowel disorders in primary care: total psychological symptom score, diarrhea severity, abdominal pain for >12 weeks, and abdominal distension. A similar pattern emerged between patients who met meet Rome II criteria for IBS and patients who did not meet Rome II criteria for IBS. Relatively few variables (either physical or psychological) had a major impact on the number of GP consultations, with the exception of frequency of bowel movements. This study confirms that psychological factors are significantly associated with health-related quality of life in patients with IBS in primary care. Physical symptom severity is also important. Relatively few symptom measures, either physical or psychological, have a major impact on doctor consultation rates in primary care.

  1. Laboratory audit as part of the quality assessment of a primary HPV-screening program.

    Science.gov (United States)

    Hortlund, Maria; Sundström, Karin; Lamin, Helena; Hjerpe, Anders; Dillner, Joakim

    2016-02-01

    As primary HPV screening programs are rolled out, methods are needed for routine quality assurance of HPV laboratory analyzes. To explore the use of similar design for audit as currently used in cytology-based screening, to estimate the clinical sensitivity to identify women at risk for CIN 3 or worse (CIN3+). Population-based cohort study conducted within the cervical screening program in Stockholm, Sweden, in 2011-2012. All women with histopathologically confirmed CIN3+ in the following two years were identified by registry analysis. Primary HPV and cytology screening results were collected. For women who had not been HPV tested, biobanked cytology samples were HPV-tested. If the original HPV result had been negative, the sample and subsequent biopsies were analyzed with broad HPV typing (general primer PCR and Luminex). 154 women had a biobanked prediagnostic cytology sample taken up to 2 years before a histopathologically confirmed CIN3+. The high-risk HPV-positivity was 97% (148/154 women), whereas 143/154 (94%) women had had a cytological abnormality. Among the six HPV-negative samples, one sample was HPV 33 positive in repeat testing whereas the other five cases were HPV-negative also on repeat testing, but HPV-positive in the subsequent tumor tissue. A sensitivity of the HPV test that is higher than the sensitivity of cytology suggests adequate quality of the testing. Regular audits of clinical sensitivity, similar to those of cytology-based screening, should be used also in HPV-based screening programs, in order to continuously monitor the performance of the analyzes. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Positive attitude toward healthy eating predicts higher diet quality at all cost levels of supermarkets.

    Science.gov (United States)

    Aggarwal, Anju; Monsivais, Pablo; Cook, Andrea J; Drewnowski, Adam

    2014-02-01

    Shopping at low-cost supermarkets has been associated with higher obesity rates. This study examined whether attitudes toward healthy eating are independently associated with diet quality among shoppers at low-cost, medium-cost, and high-cost supermarkets. Data on socioeconomic status (SES), attitudes toward healthy eating, and supermarket choice were collected using a telephone survey of a representative sample of adult residents of King County, WA. Dietary intake data were based on a food frequency questionnaire. Thirteen supermarket chains were stratified into three categories: low, medium, and high cost, based on a market basket of 100 commonly eaten foods. Diet-quality measures were energy density, mean adequacy ratio, and total servings of fruits and vegetables. The analytical sample consisted of 963 adults. Multivariable regressions with robust standard error examined relations between diet quality, supermarket type, attitudes, and SES. Shopping at higher-cost supermarkets was associated with higher-quality diets. These associations persisted after adjusting for SES, but were eliminated after taking attitudinal measures into account. Supermarket shoppers with positive attitudes toward healthy eating had equally higher-quality diets, even if they shopped at low-, medium-, or high-cost supermarkets, independent of SES and other covariates. These findings imply that shopping at low-cost supermarkets does not prevent consumers from having high-quality diets, as long as they attach importance to good nutrition. Promoting nutrition-education strategies among supermarkets, particularly those catering to low-income groups, can help to improve diet quality. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  3. Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden.

    Science.gov (United States)

    Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas

    2017-07-14

    Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier

  4. Assessing Quality and Evaluating Performance in Higher Education: Worlds Apart or Complementary Views?

    Science.gov (United States)

    Sarrico, Claudia S.; Rosa, Maria J.; Teixeira, Pedro N.; Cardoso, Margarida F.

    2010-01-01

    This paper reflects on quality assessment and performance evaluation in higher education, namely by analysing the insufficient link between those two aspects. We start by reviewing the current state of the art regarding different processes and mechanisms of quality assessment and performance evaluation and discuss some of the major issues…

  5. Quality Differences of Higher Education and Its Determinants in a Less-Developed Country

    Science.gov (United States)

    Sarmiento Espinel, Jaime Andrés; Silva Arias, Adriana Carolina; Van Gameren, Edwin

    2015-01-01

    Two key measures to determine the quality of higher education are the performance of students and the accreditation of a programme's quality. We analyse the difference in the distributions of the student's scores in a standardised test of economics knowledge between accredited and non-accredited undergraduate economics programmes in a…

  6. Does higher quality early child care promote low-income children's math and reading achievement in middle childhood?

    Science.gov (United States)

    Dearing, Eric; McCartney, Kathleen; Taylor, Beck A

    2009-01-01

    Higher quality child care during infancy and early childhood (6-54 months of age) was examined as a moderator of associations between family economic status and children's (N = 1,364) math and reading achievement in middle childhood (4.5-11 years of age). Low income was less strongly predictive of underachievement for children who had been in higher quality care than for those who had not. Consistent with a cognitive advantage hypothesis, higher quality care appeared to promote achievement indirectly via early school readiness skills. Family characteristics associated with selection into child care also appeared to promote the achievement of low-income children, but the moderating effect of higher quality care per se remained evident when controlling for selection using covariates and propensity scores.

  7. The Operation Mechanisms of External Quality Assurance Frameworks of Foreign Higher Education and Implications for Graduate Education

    Science.gov (United States)

    Lin, Mengquan; Chang, Kai; Gong, Le

    2016-01-01

    The higher education quality evaluation and assurance frameworks and their operating mechanisms of countries such as the United Kingdom, France, and the United States show that higher education systems, traditional culture, and social background all impact quality assurance operating mechanisms. A model analysis of these higher education quality…

  8. Parental Choice and Learner Achievement in Primary Education in Rachuonyo Sub County, Kenya: Focusing on Quality of Education

    Science.gov (United States)

    Oyier, Charles Richard; Odundo, Paul Amollo; Obat, Rispa Atieno; Lilian, Ganira Khavugwi; Akondo, Joseph Ochieng

    2015-01-01

    Kenyan government launched Free Primary Education (FPE) in 2003 to make schooling affordable to all parents, but less attention has been paid to the quality assurance and equity of the education system. Studies have indicated that the FPE policy sacrificed the quality of education and this led to parents avoiding FPE offered in primary schools and…

  9. The relationship between general practice characteristics and quality of care: a national survey of quality indicators used in the UK Quality and Outcomes Framework, 2004–5

    Directory of Open Access Journals (Sweden)

    Armstrong David

    2006-11-01

    Full Text Available Abstract Background The descriptive information now available for primary care in the UK is unique in international terms. Under the 'Quality and Outcomes Framework' (QOF, data for 147 performance indicators are available for each general practice. We aimed to determine the relationship between the quality of primary care, as judged by the total QOF score, social deprivation and practice characteristics. Methods We obtained QOF data for each practice in England and linked these with census derived data (deprivation indices and proportion of patients born in a developing country. Characteristics of practices were also obtained. QOF and census data were available for 8480 practices. Results The median QOF score was 999.7 out of a possible maximum of 1050 points. Three characteristics were independently associated with higher QOF scores: training practices, group practices and practices in less socially deprived areas. In a regression model, these three factors explained 14.6% of the variation in QOF score. Higher list sizes per GP, turnover of registered patients, chronic disease prevalence, proportions of elderly patients or patients born in a developing country did not contribute to lower QOF scores in the final model. Conclusion Socially deprived areas experience a lower quality of primary care, as judged by QOF scores. Social deprivation itself is an independent predictor of lower quality. Training and group practices are independent predictors of higher quality but these types of practices are less well represented in socially deprived areas.

  10. [Formula: see text]Higher cortisol is associated with poorer executive functioning in preschool children: The role of parenting stress, parent coping and quality of daycare.

    Science.gov (United States)

    Wagner, Shannon L; Cepeda, Ivan; Krieger, Dena; Maggi, Stefania; D'Angiulli, Amedeo; Weinberg, Joanne; Grunau, Ruth E

    2016-01-01

    Child executive functions (cognitive flexibility, inhibitory control, working memory) are key to success in school. Cortisol, the primary stress hormone, is known to affect cognition; however, there is limited information about how child cortisol levels, parenting factors and child care context relate to executive functions in young children. The aim of this study was to examine relationships between child cortisol, parenting stress, parent coping, and daycare quality in relation to executive functions in children aged 3-5 years. We hypothesized that (1) poorer executive functioning would be related to higher child cortisol and higher parenting stress, and (2) positive daycare quality and positive parent coping style would buffer the effects of child cortisol and parenting stress on executive functions. A total of 101 children (53 girls, 48 boys, mean age 4.24 years ±0.74) with complete data on all measures were included. Three saliva samples to measure cortisol were collected at the child's daycare/preschool in one morning. Parents completed the Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P), Parenting Stress Index (PSI), and Ways of Coping Questionnaire (WCQ). The Early Childhood Environment Rating Scale - Revised (ECERS-R) was used to measure the quality of daycare. It was found that children with poorer executive functioning had higher levels of salivary cortisol, and their parents reported higher parenting stress. However, parent coping style and quality of daycare did not modulate these relationships. Identifying ways to promote child executive functioning is an important direction for improving school readiness.

  11. Reinterpreting Higher Education Quality in Response to Policies of Mass Education: The Australian Experience

    Science.gov (United States)

    Pitman, Tim

    2014-01-01

    This article explores the relationship between mass education, higher education quality and policy development in Australia in the period 2008-2014, during which access to higher education was significantly increased. Over this time, which included a change of national government, the discursive relationship between mass higher education and…

  12. Online self-assessment as a quality assurance tool in higher professional education

    NARCIS (Netherlands)

    Prof. Rene Butter

    2014-01-01

    Theme: Quality Assurance in Higher Education An online tool was developed for (potential) students to assess the congruence between the characteristics of an educational program and student preferences (Butter & Van Raalten, 2010)

  13. Trance, Transparency and Transformation: The Impact of External Quality Monitoring on Higher Education.

    Science.gov (United States)

    Stensaker, Bjorn

    2003-01-01

    Discusses the impact of external quality monitoring (EQM) on higher education and identifies areas in which changes have taken place as a result of such external initiatives. Suggests that the lack of effects related directly to quality improvement should not be conceived as an EQM design error, but rather as a misconception of how organizational…

  14. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

    Science.gov (United States)

    McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

    2018-01-01

    Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

  15. Attention-Deficit Hyperactivity Disorder (ADHD) in Epilepsy and Primary ADHD: Differences in Symptom Dimensions and Quality of Life.

    Science.gov (United States)

    Ekinci, Ozalp; Okuyaz, Çetin; Erdoğan, Semra; Gunes, Serkan; Ekinci, Nuran; Kalınlı, Merve; Teke, Halenur; Direk, Meltem Çobanoğulları

    2017-12-01

    We aimed to (1) compare quality of life (QOL) among children with epilepsy, epilepsy and attention-deficit hyperactivity disorder (ADHD), and primary ADHD and (2) compare ADHD symptom dimensions and subtypes between children with epilepsy-ADHD and primary ADHD. A total of 140 children; 53 with epilepsy, 35 with epilepsy-ADHD, and 52 with primary ADHD were included. KINDL-R (quality of life measure), Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S), and Conners' Parent Rating Scale (CPRS) were completed. Neurology clinic charts were reviewed for epilepsy-related variables. Children with epilepsy-ADHD had the lowest (poorest) KINDL-R total scores. Epilepsy-ADHD group had more inattentiveness symptoms, whereas primary ADHD group had more hyperactivity/impulsivity symptoms. The frequencies of ADHD combined and inattentiveness subtypes were 60% and 40% in children with epilepsy-ADHD and 80.7% and 19.3% in children with primary ADHD, respectively ( P = .034). ADHD in epilepsy is associated with a significantly poor quality of life and predominantly inattentiveness symptoms.

  16. An Empirical Analysis of the Service Quality Gap in Business Education: Evidence from Higher Education in Pakistan

    Science.gov (United States)

    Sardar, Amber; Amjad, Shehla; Ali, Ubaid

    2016-01-01

    This survey investigated the relationship and gap between students' expectations and perceptions of perceived service quality of education, emphasizing the least effective service quality dimension. The study was based on primary data, which turned out to be most significant. Data were collected from 349 of 405 students through a questionnaire…

  17. Availability and quality of coronary heart disease family history in primary care medical records: implications for cardiovascular risk assessment.

    Directory of Open Access Journals (Sweden)

    Paula Dhiman

    Full Text Available The potential to use data on family history of premature disease to assess disease risk is increasingly recognised, particularly in scoring risk for coronary heart disease (CHD. However the quality of family health information in primary care records is unclear.To assess the availability and quality of family history of CHD documented in electronic primary care records.Cross-sectional study.537 UK family practices contributing to The Health Improvement Network database.Data were obtained from patients aged 20 years or more, registered with their current practice between 1(st January 1998 and 31(st December 2008, for at least one year. The availability and quality of recorded CHD family history was assessed using multilevel logistic and ordinal logistic regression respectively.In a cross-section of 1,504,535 patients, 19% had a positive or negative family history of CHD recorded. Multilevel logistic regression showed patients aged 50-59 had higher odds of having their family history recorded compared to those aged 20-29 (OR:1.23 (1.21 to 1.25, however most deprived patients had lower odds compared to those least deprived (OR: 0.86 (0.85 to 0.88. Of the 140,058 patients with a positive family history recorded (9% of total cohort, age of onset was available in 45%; with data specifying both age of onset and relative affected available in only 11% of records. Multilevel ordinal logistic regression confirmed no statistical association between the quality of family history recording and age, gender, deprivation and year of registration.Family history of CHD is documented in a small proportion of primary care records; and where positive family history is documented the details are insufficient to assess familial risk or populate cardiovascular risk assessment tools. Data capture needs to be improved particularly for more disadvantaged patients who may be most likely to benefit from CHD risk assessment.

  18. The Contribution of Professional Accreditation to Quality Assurance in Higher Education

    Science.gov (United States)

    de Paor, Cathal

    2016-01-01

    This article examines the extent to which the professional accreditation of professional higher education programmes can complement other quality assurance endeavours being carried out. An analysis of a sample of professional accreditation reports for pharmacy education programmes in Ireland provides insight into the priorities of the regulatory…

  19. Medical Students' Personal Qualities and Values as Correlates of Primary Care Interest

    Science.gov (United States)

    Borges, Nicole J.; Jones, Bonnie J.

    2004-01-01

    Medical schools must use selection methods that validly measure applicants' noncognitive qualities, but primary-care (PC) schools have a particular need. This study correlated entering students' personality and values scores with their professed interest in PC. 93 medical students completed instruments assessing personality (16PF & PSP), values,…

  20. The Role of Higher Education in National Quality Infrastructure Policy-Making

    Directory of Open Access Journals (Sweden)

    Jelena Ruso

    2017-05-01

    Full Text Available The aim of the paper is to raise awareness of the importance of the policy makers’ knowledge and expertise about quality infrastructure (QI for the successful policy-making. This article, which addresses the role of higher education in Serbian quality infrastructure policy-making, is an analysis of QI related contents of higher education institution curriculum. The target institutions are public faculties from whose official websites the data were collected. Depending on the keywords, the analysis was performed in order to classify the faculties into three categories. After reviewing the 307 subject titles and descriptions of undergraduate courses, the results show that the concepts of QI are widely recognized as an important and popular topic. The analysis of the QI adoption and diffusion indicates that although some of the faculties might be ‘leaders’ in a particular dimension, they still do not necessarily fall into the ‘leader’ category. JEL Classification:I21, I23, H54, L15

  1. The questionnaire on teacher interaction from the primary to the higher education context in Turkey

    NARCIS (Netherlands)

    Telli, S.; Brok, den P.J.; Wubbels, Th.; Brok, den P.; Tartwijk, van J.; Levy, J.; Fraser, B.

    2010-01-01

    The purpose of the study was to compare the three versions of Questionnaire on Teacher Interaction (QTI) developed for the Turkish context from the point of Model Teacher Interpersonal Behaviour (MITB) and its scales. Total number 1767 students from primary, secondary and higher education

  2. Quality of life in primary school children: The Health Oriented Pedagogical Project (HOPP).

    Science.gov (United States)

    Ringdal, Kristen; Ringdal, Gerd Inger; Olsen, Helene Kristin; Mamen, Asgeir; Fredriksen, Per Morten

    2018-05-01

    The primary aim of the present study was to evaluate the association between parents' level of education, measurements of physical attributes, and quality of life in a general sample of primary school children. The children's and the parents' versions of the Inventory of Life Quality in Children and Adolescents (ILC) were used to measure health-related quality of life (QOL) in 2140 school children (response rate 93%) and 1639 parents (response rate 71%) recruited from nine primary schools in Norway. A set of physical characteristics were also measured in the children: body mass index (BMI), waist circumference, average daily minutes of physical activity, aerobic fitness, and handgrip strength. The regression analysis showed stronger relationships between the covariates and QOL for the parents' assessments than for the children's. Parents' level of education was significantly related to children's QOL, with the strongest association for parental QOL assessment. Among the physical variables, aerobic fitness ( B = 0.01, p > .001 in both samples), and handgrip strength in the parents' sample ( B = 0.21, p < .05) were significantly related to the children's QOL. The present study replicated the well-known finding that parents' sociodemographic status is important for children's QOL. Our new contribution is to show that the physiological variables aerobic fitness and muscular strength also contributed significantly to explain variance in QOL. This opens up interesting perspectives on how to improve QOL among children through more emphasis on physical activity and physical fitness in schools.

  3. Quality tools and resources to support organisational improvement integral to high-quality primary care: a systematic review of published and grey literature.

    Science.gov (United States)

    Janamian, Tina; Upham, Susan J; Crossland, Lisa; Jackson, Claire L

    2016-04-18

    To conduct a systematic review of the literature to identify existing online primary care quality improvement tools and resources to support organisational improvement related to the seven elements in the Primary Care Practice Improvement Tool (PC-PIT), with the identified tools and resources to progress to a Delphi study for further assessment of relevance and utility. Systematic review of the international published and grey literature. CINAHL, Embase and PubMed databases were searched in March 2014 for articles published between January 2004 and December 2013. GreyNet International and other relevant websites and repositories were also searched in March-April 2014 for documents dated between 1992 and 2012. All citations were imported into a bibliographic database. Published and unpublished tools and resources were included in the review if they were in English, related to primary care quality improvement and addressed any of the seven PC-PIT elements of a high-performing practice. Tools and resources that met the eligibility criteria were then evaluated for their accessibility, relevance, utility and comprehensiveness using a four-criteria appraisal framework. We used a data extraction template to systematically extract information from eligible tools and resources. A content analysis approach was used to explore the tools and resources and collate relevant information: name of the tool or resource, year and country of development, author, name of the organisation that provided access and its URL, accessibility information or problems, overview of each tool or resource and the quality improvement element(s) it addresses. If available, a copy of the tool or resource was downloaded into the bibliographic database, along with supporting evidence (published or unpublished) on its use in primary care. This systematic review identified 53 tools and resources that can potentially be provided as part of a suite of tools and resources to support primary care practices in

  4. Applying Total Quality Management Tools Using QFD at Higher Education Institutions in Gulf Area (Case Study: ALHOSN University

    Directory of Open Access Journals (Sweden)

    Adnan Al-Bashir

    2016-07-01

    Full Text Available Human power’s quality plays the key role in the growth and development of societies where the quality of human powers can be enriched with the high quality education provided by the higher education institutions. The higher education institutions are hereby an important sector of any society since it defines the overall quality of human lives. This research will investigate the application of Total Quality Management (TQM tools at the higher education institutions; specifically at ALHOSN University. In this study five tools were implemented at ALHOSN University’s engineering college including: Quality Function Deployment, Affinity Diagrams, Tree Diagrams, Pareto Charts, and Fishbone Diagrams. The research will reveal that the implementation of TQM tools has a great benefit for higher education institutions where they have uncovered many area of potential improvement as well as the main causes of some of the problems the Faculty of Engineering is facing. Also, it will show that the implementation of TQM tools on higher education institution systems will enhance the performance of such institutions.

  5. Specific Remedy for Specific Problem: Measuring Service Quality in South African Higher Education

    Science.gov (United States)

    de Jager, Johan; Gbadamosi, Gbolahan

    2010-01-01

    This study commences a process of developing a scale for the measurement of service quality in higher education in South Africa and also examines the relationship between the measures of service quality on the one hand and some other related variables such as intention to leave the university, trust in management of the university and the overall…

  6. Balanced Scorecard in Higher Education Institutions: Congruence and Roles to Quality Assurance Practices

    Science.gov (United States)

    Reda, Nigusse W.

    2017-01-01

    Purpose: The purpose of this paper is twofold: first, to highlight the congruence and roles of the balanced scorecard in the quality assurance practices in higher education institutions, and second, to propose a balanced scorecard model for higher education institutions. Design/methodology/approach: A descriptive literature review was used to…

  7. Sustaining quality in the community: trends in the performance of a structured diabetes care programme in primary care over 16 years.

    Science.gov (United States)

    Riordan, F; McHugh, S M; Harkins, V; Marsden, P; Kearney, P M

    2018-04-29

    To examine the quality of care delivered by a structured primary care-led programme for people with Type 2 diabetes mellitus in 1999-2016. The Midland Diabetes Structured Care Programme provides structured primary care-led management. Trends over time in care processes were examined (using a chi-squared trend test and age- and gender-adjusted logistic regression). Screening and annual review attendance were reviewed. A composite of eight National Institute for Health and Care Excellence-recommended processes was used as a quality indicator. Participants who were referred to diabetes nurse specialists were compared with those not referred (Student's t-test, Pearson's chi-squared test, Wilcoxon-Mann-Whitney test). Proportions achieving outcome targets [HbA 1c ≤58 mmol/mol (7.5%), blood pressure ≤140/80 mmHg, cholesterol diabetes aged ≥18 years: 1998/1999 (n=336); 2003 (n=843); 2008 (n=988); and 2016 (n=1029). Recording of some processes improved significantly over time (HbA 1c , cholesterol, blood pressure, creatinine), and in 2016 exceeded 97%. Foot assessment and annual review attendance declined. In 2016, only 29% of participants had all eight National Institute for Health and Care Excellence processes recorded. A higher proportion of people with diabetes who were referred to a diabetes nurse specialist had poor glycaemic control compared with those not referred. The proportions meeting blood pressure and lipid targets increased over time. Structured primary care led to improvements in the quality of care over time. Poorer recording of some processes, a decline in annual review attendance, and participants remaining at high risk suggest limits to what structured care alone can achieve. Engagement in continuous quality improvement to target other factors, including attendance and self-management, may deliver further improvements. © 2018 Diabetes UK.

  8. Patient-reported quality indicators for osteoarthritis: a patient and public generated self-report measure for primary care.

    Science.gov (United States)

    Blackburn, Steven; Higginbottom, Adele; Taylor, Robert; Bird, Jo; Østerås, Nina; Hagen, Kåre Birger; Edwards, John J; Jordan, Kelvin P; Jinks, Clare; Dziedzic, Krysia

    2016-01-01

    People with osteoarthritis desire high quality care, support and information. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators can be used to benefit patients by measuring whether minimum standards of quality care are being met from a patient perspective. The aim of this study was to describe how a Research User Group (RUG) worked alongside researchers to co-produce a set of self-reported quality indicators for people with osteoarthritis when visiting their general practitioner or practice nurse (primary care). These were required in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE quality standards for OA. This article describes the public involvement in the MOSAICS study. This was 1) the co-development by RUG members and researchers of an Osteoarthritis Quality Indicators United Kingdom (OA QI (UK)) questionnaire for use in primary care, and 2) the comparison of the OA QI (UK) with a similar questionnaire developed in Norway. This study shows how important and effective a research user group can be in working with researchers in developing quality care indicators for osteoarthritis for use in a research study and, potentially, routine use in primary care. The questionnaire is intended to benefit patients by enabling the assessment of the quality of primary care for osteoarthritis from a patient's perspective. The OA QI (UK) has been used to examine differences in the quality of osteoarthritis care in four European countries. Background People with osteoarthritis (OA) desire high quality care, support and information about OA. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators (QI) can be used to benefit patients by measuring whether minimum standards of quality care (e.g. NICE quality standards) are being met from a patient perspective. A Research User Group (RUG

  9. Higher prices, higher quality? Evidence from German nursing homes

    OpenAIRE

    Herr, Annika; Hottenrott, Hanna

    2016-01-01

    Objectives: This study investigates the relationship between prices and quality of 7,400 German nursing homes controlling for income, nursing home density, demographics, labour market characteristics, and infrastructure at the regional level. Method: We use a cross section of public quality reports for all German nursing homes, which had been evaluated between 2010 and 2013 by external institutions. Our analysis is based on multivariate regressions in a two stage least squares framework, wher...

  10. Health Demands Characteristics and Quality of Life in the Elderly Monitored in the Primary Care

    Directory of Open Access Journals (Sweden)

    Jéssica Maria Arouca de Miranda

    2017-02-01

    Full Text Available Background: To characterize the demands of health and quality of elderly peoplemonitored in the primary care of Rio Grande do Norte/Brazil. Methods and Findings: This is a descriptive, cross-sectional study of a quantitative approach with elderly patients monitored by the primary care. The sample was given for convenience, obtaining 120 participants. The research was conducted through an interview with theapplication of the following questionnaires: Mini Mental State Examination, Socio-demographic Data and Pain Characteristics, Short-Form-36, Mini Nutritional Assessment, the primary activities of daily living, the instrumental activities of daily living, Prism 7 and the Geriatric Depression Scale. Data analysis was performed using the SPSS statistical program, in which descriptive and association tests were used.The main demands were related to functionality, followed by nutritional and geriatric depression. The quality of life presented worse results in the domain of general health status and better scores in the emotional and mental health aspects. Regarding the dimensions, the physical health obtained aworse score. Conclusion: Based on the characterization of the health demands found, it is suggested to perform other studies with the same population, enabling to plan and implementing a multidimensional intervention and improving the quality of life of the elderly people. Keywords: Elderly; Quality of Life; Aging; Elderly Health; Nursing.

  11. The Student as Customer: The Discourse of "Quality" in Higher Education.

    Science.gov (United States)

    Baldwin, Gabrielle

    1994-01-01

    It is argued that bringing the cultures of business, industry and advertising into higher education, in the form of quality assurance systems, goes beyond a healthy challenge to be destructive of many traditional values of university culture. Imposition, and acceptance, of the language of management reflects this phenomenon. (MSE)

  12. Do Men Produce Higher Quality Ejaculates When Primed With Thoughts of Partner Infidelity?

    Science.gov (United States)

    Pham, Michael N; Barbaro, Nicole; Holub, Andrew M; Holden, Christopher J; Mogilski, Justin K; Lopes, Guilherme S; Nicolas, Sylis C A; Sela, Yael; Shackelford, Todd K; Zeigler-Hill, Virgil; Welling, Lisa L M

    2018-01-01

    Sperm competition theory can be used to generate the hypothesis that men alter the quality of their ejaculates as a function of sperm competition risk. Using a repeated measures experimental design, we investigated whether men produce a higher quality ejaculate when primed with cues to sperm competition (i.e., imagined partner infidelity) relative to a control prime. Men ( n = 45) submitted two masturbatory ejaculates-one ejaculate sample for each condition (i.e., sperm competition and control conditions). Ejaculates were assessed on 17 clinical parameters. The results did not support the hypothesis: Men did not produce higher quality ejaculates in the sperm competition condition relative to the control condition. Despite the null results of the current research, there is evidence for psychological and physiological adaptations to sperm competition in humans. We discuss methodological limitations that may have produced the null results and present methodological suggestions for research on human sperm competition.

  13. Attitudinal Variables Affecting Education Reforms and Quality of Primary Education in Uganda

    Science.gov (United States)

    Nyenje, Aida; Nkata, James

    2016-01-01

    This paper establishes the extent to which attitudinal variables affect the education reforms and subsequently the quality of primary education in Uganda. The paper is based on the views of a wide spectrum of different education stakeholders including: policy analysts, Members of Parliament (MPs), education officers, Headteachers, teaching staff,…

  14. [Professional quality of life in workers of the Toledo primary care health area].

    Science.gov (United States)

    Villarín Castro, A; Méndez García, T; Zuzuárregui Gironés, M S; Sánchez Serrano, S; Conejo Ocaña, R

    2015-01-01

    To determine the professional quality of life in the workers of the Toledo Primary Care Health Area and to analyse its components. Descriptive, cross-sectional study, performed on workers of the Toledo Primary Care Health Area with an online self-administered questionnaire. age, sex, health centre, professional group, seniority, management experience, collaboration in working groups, employment situation, and the PQL-35 professional quality of life questionnaire. A total of 430 completed questionnaires were received (45.3%), of which 68.4% were women. The mean age was 47.7±8.6 years old. Mean seniority was 21.5±9.7 years. PQL-35 results were: perception of management support 4.8±1.5; perception of workload 6.2±1.3; intrinsic motivation 7.9±1.1; job disconnection capacity 6.3±2.6; and professional quality of life 5.2±2.1. Gender differences were found in perception of management support (4.5±1.5 in males vs 4.9±1.5 in females; P=.031) and professional quality of life (4.9±2.0 vs 5.3±2.1; p=.044). Depending on the professional group, differences were found in the perception of workload (6.4±1.1 in physicians, 6.3±1.3 in nurses, 5.9±1.6 in non-sanitary professionals, and 5.3±1.2 in support units professionals; Pquality of life in the workers of the Toledo Primary Care Health Area is similar to that of other Spanish Health Areas, even in a time of economic crisis. The intrinsic motivation of the professionals is very high, in contrast with their high perception of workload and their low perception of management support. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  15. Quality Management in the Higher Education of the Republic of Moldova as a Framework for University Performance

    Directory of Open Access Journals (Sweden)

    Prisacaru Veronica

    2017-12-01

    Full Text Available This investigation is focused on two objectives: 1 explaining the relationship between quality management and performance management in higher education; 2 evaluating the existing quality management systems in the higher education institutions of the Republic of Moldova. In order to accomplish the first objective, a comparative theoretical analysis of the quality management and performance management was carried out in terms of common aspects and distinctive peculiarities. Consequently, it was reasoned that the performance management system of a higher education institution is created and functions on the basis of the quality management system by extending the area of the quality objectives to the level at which they will ensure performance or, in other terms, by moving towards excellence. In order to achieve the second objective, an opinion survey for the teaching and managerial staff from 6 universities was carried out. As a consequence of processing the obtained results, there were identified problems related to the functioning of the quality management systems. The investigation resulted in the formulation of a set of recommendations for the higher education institutions of the Republic of Moldova in order to increase the efficiency of the quality management systems functioning and thus to ensure an efficient management.

  16. Quality Assurance and the Shift Towards Private Governance in Higher Education

    DEFF Research Database (Denmark)

    Hartmann, Eva

    2017-01-01

    This contribution focuses on quality assurance (QA) agencies in the sphere of higher education. It develops a theoretical framework that interrelates systems theory with Gramsci's theory of hegemony with a view to situating this new control of universities in the broader context of a further...... differentiation of society and emerging heterarchical modes of governance. A closer study of the emerging European market of QA agencies highlights the European dimension of this differentiation and the role of the market in advancing a variable geometry in the context of the European Higher Education Area....

  17. Total Quality Management in Higher Education: Clearing the Hurdles. A Survey on Strategies for Implementing Quality Management Practices in Higher Education. A GOAL/QPC Application Report.

    Science.gov (United States)

    Seymour, Daniel

    Based on a survey of Quality Management (QM) practitioners at 21 colleges, this study presents the 10 most difficult implementation hurdles to QM in higher education and a set of hurdle-clearing strategies. The hurdles are: (1) lack of time to implement QM; (2) perception that QM is something for janitorial and housing staffs but not applicable to…

  18. Quality Assurance Strategies of Higher Education in Iraq and Kurdistan: A Case Study

    Science.gov (United States)

    Kaghed, Nabeel; Dezaye, Ahmed

    2009-01-01

    This paper reports on two different strategies that have been implemented in Iraq to improve quality assurance in the higher education sector in Iraq. One strategy has been developed by the Ministry of Higher Education and Scientific Research in Baghdad. It involved conducting a pilot study at the University of Babylon. This pilot included…

  19. OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion

    NARCIS (Netherlands)

    Marshall, Martin; Klazinga, Niek; Leatherman, Sheila; Hardy, Charlie; Bergmann, Eckhard; Pisco, Luis; Mattke, Soeren; Mainz, Jan

    2006-01-01

    PURPOSE: This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health

  20. Specific psychological variables predict quality of diet in women of lower, but not higher, educational attainment.

    Science.gov (United States)

    Lawrence, Wendy; Schlotz, Wolff; Crozier, Sarah; Skinner, Timothy C; Haslam, Cheryl; Robinson, Sian; Inskip, Hazel; Cooper, Cyrus; Barker, Mary

    2011-02-01

    Our previous work found that perceived control over life was a significant predictor of the quality of diet of women of lower educational attainment. In this paper, we explore the influence on quality of diet of a range of psychological and social factors identified during focus group discussions, and specify the way this differs in women of lower and higher educational attainment. We assessed educational attainment, quality of diet, and psycho-social factors in 378 women attending Sure Start Children's Centres and baby clinics in Southampton, UK. Multiple-group path analysis showed that in women of lower educational attainment, the effect of general self-efficacy on quality of diet was mediated through perceptions of control and through food involvement, but that there were also direct effects of social support for healthy eating and having positive outcome expectancies. There was no effect of self-efficacy, perceived control or outcome expectancies on the quality of diet of women of higher educational attainment, though having more social support and food involvement were associated with improved quality of diet in these women. Our analysis confirms our hypothesis that control-related factors are more important in determining dietary quality in women of lower educational attainment than in women of higher educational attainment. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. QUALITY OF HIGHER EDUCATION IN BANGLADESH: APPLICATION OF A MODIFIED SERVQUAL MODEL

    Directory of Open Access Journals (Sweden)

    Md. Mamun-ur-Rashid

    2017-02-01

    Full Text Available Progressive importance, swelling investment, and mounting national and global competition necessitate evaluation of the service quality of higher education. Quantifiable indicators such as student teacher ratio, student number, women participation, establishing new departments, and increase in the number of universities are no longer enough unless the student’s stand point is considered. This research probed the service quality of higher education in a public university in southern Bangladesh utilizing modified SERVQUAL gap model. The t-test results suggest that there is a significant service gap in all the selected service dimensions such as learning, teaching, recognition, assessment system, internet and library facilities, campus life, and non-academic administration. The results also mirror that little more than half (54.1% students are satisfied with the service quality of the selected university and almost similar proportion (52.1 % of the students have future interest in studying in the same university. Regression analysis reveals that learning and recognition are two important determinants of client’s overall satisfaction with the service of selected university. Importance Performance Analysis (IPA advocates that the university should take immediate step in improving internet and library facilities, campus life, and non-academic administration. Factor analysis output confirms that slight modification of the proposed seven set model into six set factors can be employed by the management as off-the-rack service quality measurement tool.

  2. Building Collegiate E-Loyalty: The Role of Perceived Value in the Quality-Loyalty Linkage in Online Higher Education

    Science.gov (United States)

    Kilburn, Brandon; Kilburn, Ashley; Davis, Dexter

    2016-01-01

    E-service quality of online higher education reflects the student's perception of quality of online exchanges across four dimensions: fulfillment, efficiency, system availability and privacy. This study links e-service quality to intentions to remain loyal as mediated by perceived value in an online higher education environment. AMOS is used to…

  3. Governance of Higher Education--The Role of Proximity in Teaching Quality

    Science.gov (United States)

    Macheridis, Nikos; Paulsson, Alexander

    2016-01-01

    The starting point of this article is the relation between teaching quality and expectations by different governance actors in higher education. Managing a department in a public university is, to a large extent, about the coordination of governance actors, involving government authorities as well as the university and the faculty. Internally, the…

  4. Defining the Quality of Higher Education around Ethics and Moral Values

    Science.gov (United States)

    Prisacariu, Anca; Shah, Mahsood

    2016-01-01

    The context of higher education across the world currently presents evidence of university failures. These failures are evident in areas such as governance, financial and risk management, conduct of senior leaders and quality assurance issues surrounding international education. Having this in mind, the present paper argues the need to add a new…

  5. Benchmarks and Quality Assurance for Online Course Development in Higher Education

    Science.gov (United States)

    Wang, Hong

    2008-01-01

    As online education has entered the main stream of the U.S. higher education, quality assurance in online course development has become a critical topic in distance education. This short article summarizes the major benchmarks related to online course development, listing and comparing the benchmarks of the National Education Association (NEA),…

  6. Assessing the Students' Evaluations of Educational Quality (SEEQ) Questionnaire in Greek Higher Education

    Science.gov (United States)

    Grammatikopoulos, Vasilis; Linardakis, M.; Gregoriadis, A.; Oikonomidis, V.

    2015-01-01

    The aim of the current study was to provide a valid and reliable instrument for the evaluation of the teaching effectiveness in the Greek higher education system. Other objectives of the study were (a) the examination of the dimensionality and the higher-order structure of the Greek version of Students' Evaluation of Educational Quality (SEEQ)…

  7. Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

    OpenAIRE

    Teles, Mariza Alves Barbosa; Barbosa, Mirna Rossi; Vargas, Andréa Maria Duarte; Gomes, Viviane Elizângela; e Ferreira, Efigênia Ferreira; Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição

    2014-01-01

    Background Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. Methods This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health...

  8. 40 CFR Appendix P to Part 50 - Interpretation of the Primary and Secondary National Ambient Air Quality Standards for Ozone

    Science.gov (United States)

    2010-07-01

    ... the data handling procedures for the reported data). 2.3Comparisons with the Primary and Secondary... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY...

  9. [Outcome-quality of treatment for headache on primary care conditions].

    Science.gov (United States)

    Lang, E; Eisele, R; Jankowsky, H; Kastner, S; Bickel, A; Martus, P; Neundörfer, B

    2000-12-01

    Little is known about the outcome-quality of treatment for headache on primary care conditions in Germany. All physicians (2100) of middle franconia, a bavarian greater district with 1,6 Mio. inhabitants, involved in outpatient management were asked to include consecutively patients in the study which suffer from migraine (at least 2 attacks/month) and/or tension type headache (at least 8 days/month) of at least 4 weeks duration. Before and after a 6 months interval patients documented the following outcome data in a questionnaire: pain intensity during the last attack (numeric rating scale), pain dependent disability (Brief Pain Inventory, German version), health related quality of life (SF-36, German version) and depressivity (Allgemeine Depressionsskala). The pain chronification state (Mainz Pain Staging System) has been assessed by the physician. Therapy was not standardized and included the natural spectrum of medicamental and non-medicamental therapy of headache. Agreement of therapy with recommendations of the "Arzneimittelkommission der Deutschen Aerzteschaft" has been assessed. 24 physicians participated in the study. Pre-post-data of 80 patients (46+/-14 y) could be analysed. Initially 67% were classified in pain chronification state I, 27% in state II and 6% in state III. Medicamental therapy agreed with recommendations in approximately 50% of patients, non-medicamental therapy has been used rarely. The pain intensity, pain dependent disability, depression and quality of life improved significantly. 45% and 55% of patients improved in at least 2 of 6 outcome-parameters by 30% of baseline value or by half standard deviation of the corresponding pre-post-differences, respectively. The latter outcome-measure reflects a medium effect size. On primary care conditions about 50% of patients suffering from migraine and/or tension type headache (predominantly low chronification stae) perceive a therapy effect that corresponds to a medium effect size.

  10. Designing Excellence and Quality Model for Training Centers of Primary Health Care: A Delphi Method Study.

    Science.gov (United States)

    Tabrizi, Jafar-Sadegh; Farahbakhsh, Mostafa; Shahgoli, Javad; Rahbar, Mohammad Reza; Naghavi-Behzad, Mohammad; Ahadi, Hamid-Reza; Azami-Aghdash, Saber

    2015-10-01

    Excellence and quality models are comprehensive methods for improving the quality of healthcare. The aim of this study was to design excellence and quality model for training centers of primary health care using Delphi method. In this study, Delphi method was used. First, comprehensive information were collected using literature review. In extracted references, 39 models were identified from 34 countries and related sub-criteria and standards were extracted from 34 models (from primary 39 models). Then primary pattern including 8 criteria, 55 sub-criteria, and 236 standards was developed as a Delphi questionnaire and evaluated in four stages by 9 specialists of health care system in Tabriz and 50 specialists from all around the country. Designed primary model (8 criteria, 55 sub-criteria, and 236 standards) were concluded with 8 criteria, 45 sub-criteria, and 192 standards after 4 stages of evaluations by specialists. Major criteria of the model are leadership, strategic and operational planning, resource management, information analysis, human resources management, process management, costumer results, and functional results, where the top score was assigned as 1000 by specialists. Functional results had the maximum score of 195 whereas planning had the minimum score of 60. Furthermore the most and the least sub-criteria was for leadership with 10 sub-criteria and strategic planning with 3 sub-criteria, respectively. The model that introduced in this research has been designed following 34 reference models of the world. This model could provide a proper frame for managers of health system in improving quality.

  11. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

    Directory of Open Access Journals (Sweden)

    Janya McCalman

    2018-03-01

    Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

  12. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

    Science.gov (United States)

    McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

    2018-01-01

    Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

  13. Provider perceptions of an integrated primary care quality improvement strategy: The PPAQ toolkit.

    Science.gov (United States)

    Beehler, Gregory P; Lilienthal, Kaitlin R

    2017-02-01

    The Primary Care Behavioral Health (PCBH) model of integrated primary care is challenging to implement with high fidelity. The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) was designed to assess provider adherence to essential model components and has recently been adapted into a quality improvement toolkit. The aim of this pilot project was to gather preliminary feedback on providers' perceptions of the acceptability and utility of the PPAQ toolkit for making beneficial practice changes. Twelve mental health providers working in Department of Veterans Affairs integrated primary care clinics participated in semistructured interviews to gather quantitative and qualitative data. Descriptive statistics and qualitative content analysis were used to analyze data. Providers identified several positive features of the PPAQ toolkit organization and structure that resulted in high ratings of acceptability, while also identifying several toolkit components in need of modification to improve usability. Toolkit content was considered highly representative of the (PCBH) model and therefore could be used as a diagnostic self-assessment of model adherence. The toolkit was considered to be high in applicability to providers regardless of their degree of prior professional preparation or current clinical setting. Additionally, providers identified several system-level contextual factors that could impact the usefulness of the toolkit. These findings suggest that frontline mental health providers working in (PCBH) settings may be receptive to using an adherence-focused toolkit for ongoing quality improvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. The Work-Related Quality of Life Scale for Higher Education Employees

    Science.gov (United States)

    Edwards, Julian A.; Van Laar, Darren; Easton, Simon; Kinman, Gail

    2009-01-01

    Previous research suggests that higher education employees experience comparatively high levels of job stress. A range of instruments, both generic and job-specific, has been used to measure stressors and strains in this occupational context. The Work-related Quality of Life (WRQoL) scale is a measure designed to capture perceptions of the working…

  15. Importance of the Primary Radioactivity Standard Laboratory and Implementation of its Quality Management

    Science.gov (United States)

    Sahagia, Maria; Razdolescu, Anamaria Cristina; Luca, Aurelian; Ivan, Constantin

    2007-04-01

    The paper presents some specific aspects of the implementation of the quality management in the Radionuclide Metrology Laboratory, from IFIN-HH, the owner of the primary Romanian standard in radioactivity. The description of the accreditation, according to the EN ISO/IEC 17025:2005, is presented.

  16. Importance of the Primary Radioactivity Standard Laboratory and Implementation of its Quality Management

    International Nuclear Information System (INIS)

    Sahagia, Maria; Razdolescu, Anamaria Cristina; Luca, Aurelian; Ivan, Constantin

    2007-01-01

    The paper presents some specific aspects of the implementation of the quality management in the Radionuclide Metrology Laboratory, from IFIN-HH, the owner of the primary Romanian standard in radioactivity. The description of the accreditation, according to the EN ISO/IEC 17025:2005, is presented

  17. Quality in primary health care services in sub-Sahara Africa: right or ...

    African Journals Online (AJOL)

    The Primary Health Care (PHC) system has been the foundation for the operation of the health system in most of Sub-Sahara Africa following the Alma Ata Declaration in 1978. Quality of care is an important determinant of health services utilization, and is a health outcome of public health importance. It is known that the ...

  18. QUALITY ASSESSMENT IN HIGHER EDUCATION: ARE RUSSIAN UNIVERSITIES FOCUSED ON THE EDUCATIONAL NEEDS OF STUDENTS?

    Directory of Open Access Journals (Sweden)

    Sergey Trapitsin

    2015-06-01

    Full Text Available The article touches on the issue of meeting the students' educational needs as a crucial point in the quality of education improvement. The main consumers of educational services are students whose perceptions of the educational quality is analyzed. According to the research the primary attention of the administration have be paid to the dissatisfaction of the consumer and only then to ensure the satisfaction. The focus on the factors causing negative evaluation and dissatisfaction of students, using tactics quick fix ("quick patch" is recommended.

  19. Student Perceptions of Service Quality in a Multi-Campus Higher Education System in Spain

    Science.gov (United States)

    Gallifa, Josep; Batalle, Pere

    2010-01-01

    Purpose: This paper aims to present an in-depth case study with student perceptions of service quality, discussing the relevance of these perceptions for the important issue of quality improvement in higher education. Design/methodology/approach: The paper presents institutional research carried out in a multi-campus system in Spain made up of…

  20. A dementia care management intervention: which components improve quality?

    Science.gov (United States)

    Chodosh, Joshua; Pearson, Marjorie L; Connor, Karen I; Vassar, Stefanie D; Kaisey, Marwa; Lee, Martin L; Vickrey, Barbara G

    2012-02-01

    To analyze whether types of providers and frequency of encounters are associated with higher quality of care within a coordinated dementia care management (CM) program for patients and caregivers. Secondary analysis of intervention-arm data from a dementia CM cluster-randomized trial, where intervention participants interacted with healthcare organization care managers (HOCMs), community agency care managers (CACMs), and/ or healthcare organization primary care providers (HOPCPs) over 18 months. Encounters of 238 patient/caregivers (dyads) with HOCMs, CACMs, and HOPCPs were abstracted from care management electronic records. The quality domains of assessment, treatment, education/support, and safety were measured from medical record abstractions and caregiver surveys. Mean percentages of met quality indicators associated with exposures to each provider type and frequency were analyzed using multivariable regression, adjusting for participant characteristics and baseline quality. As anticipated, for all 4 domains, the mean percentage of met dementia quality indicators was 15.5 to 47.2 percentage points higher for dyads with HOCM--only exposure than for dyads with none (all P < .008); not anticipated were higher mean percentages with increasing combinations of provider-type exposure-up to 73.7 percentage points higher for safety (95% confidence interval 65.2%-82.1%) with exposure to all 3 provider types compared with no exposure. While greater frequency of HOCM-dyad encounters was associated with higher quality (P < .04), this was not so for other provider types. HOCMs' interactions with dyads was essential for dementia care quality improvement. Additional coordinated interactions with primary care and community agency staff yielded even higher quality.

  1. Quality of Life of Patients with Spinal Metastasis from Cancer of Unknown Primary Origin: A Longitudinal Study of Surgical Management Combined with Postoperative Radiation Therapy.

    Science.gov (United States)

    Ma, Yifei; He, Shaohui; Liu, Tielong; Yang, Xinghai; Zhao, Jian; Yu, Hongyu; Feng, Jiaojiao; Xu, Wei; Xiao, Jianru

    2017-10-04

    Patients with spinal metastasis from cancer of unknown primary origin have limited life expectancy and poor quality of life. Surgery and radiation therapy remain the main treatment options, but, to our knowledge, there are limited data concerning quality-of-life improvement after surgery and radiation therapy and even fewer data on whether surgical intervention would affect quality of life. Patients were enrolled between January 2009 and January 2014 at the Changzheng Hospital, Shanghai, People's Republic of China. The quality of life of 2 patient groups (one group that underwent surgery followed by postoperative radiation therapy and one group that underwent radiation therapy only) was assessed by the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire during a 6-month period. A subgroup analysis of quality of life was performed to compare different surgical strategies in the surgical group. A total of 287 patients, including 191 patients in the group that underwent surgery and 96 patients in the group that underwent radiation therapy only, were enrolled in the prospective study; 177 patients completed all 5 checkpoints and 110 patients had died by the final checkpoint. The surgery group had significantly higher adjusted quality-of-life scores than the radiation therapy group in each domain of the FACT-G questionnaire (all p quality of life in patients with spinal metastasis from cancer of unknown primary origin in the 6-month assessment. In terms of surgical strategies, circumferential decompression seems better than laminectomy alone in quality-of-life improvement. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

  2. Pruritus is associated with severely impaired quality of life in patients with primary sclerosing cholangitis.

    Science.gov (United States)

    Gotthardt, Daniel Nils; Rupp, Christian; Bruhin, Miriam; Schellberg, Dieter; Weiss, Karl H; Stefan, Reinhard; Donnerstag, Nadine; Stremmel, Wolfgang; Löwe, Bernd; Juenger, Jana; Sauer, Peter

    2014-12-01

    Quality of life, fundamental to the individual patient, has shown a lack of correlation with severity in research on several diseases. Thus, we aimed to identify factors associated with quality of life in patients with primary sclerosing cholangitis. The Short Form Health Survey and the Patient Health Questionnaire were used to assess quality of life and depression. Complete data sets of 113 patients were analyzed for correlation with sex, age, presence of concomitant inflammatory bowel disease and dominant stenosis, frequency of pruritus, and Mayo Risk Score. Physical functioning decreased with age (P<0.001). Further, women experienced more prominent role limitations because of physical (P<0.03) and emotional (P<0.01) problems. Although patients' quality of life and depression scores were only slightly lower than normal, more frequent pruritus was associated with a considerable reduction in quality of life in terms of physical and social functioning, general and mental health, bodily pain, vitality, and roles (because of physical problems) (P<0.01). It did not differ significantly according to the Mayo Risk Score or the presence of dominant stenoses. Depression scores were only significantly affected in patients with more frequent pruritus. Pruritus severely affects quality of life in patients with primary sclerosing cholangitis and is associated with depression to varying extents, although the most commonly used parameters of disease severity do not correspond to quality of life in these patients. These findings need to be considered with respect to treatment outcomes and indications for liver transplantation.

  3. Acceptability of the Conceptions of Higher Education Quality to First Year Students of the Study Field of Pedagogy

    Science.gov (United States)

    Žibeniene, Gintaute; Savickiene, Izabela

    2014-01-01

    The article presents which conceptions of higher education quality are most acceptable to first-year students of the study field of pedagogy. It is significant to analyse students' opinions as more than 10 years ago the EU member states agreed that higher education institutions bear responsibility for the quality of higher education. Being members…

  4. Quality Circles in Higher Education: Quality, Satisfaction, and Climate.

    Science.gov (United States)

    Kay, Carol; Healy, Margaret

    The effect of quality circles at Iowa State University on absenteeism, performance evaluation, perceptions of the organization climate, job satisfaction, and perceived opportunities for professional and personal growth was measured in this study. The process of quality circles is designed to promote job fulfillment and organizational productivity…

  5. Quality Assurance in Higher Education: Which Pasts to Build On, What Futures to Contemplate?

    Science.gov (United States)

    Singh, Mala

    2010-01-01

    The paper is a reflection on the pasts and futures of quality assurance in higher education. It poses questions about the correlation between the geographical and political spread of quality assurance on the one hand and the resulting educational benefits on the other; about the divergences between critics and practitioners on the likely impacts…

  6. "How to Strike the Right Balance between Quality Assurance and Quality Control in the Perceptions of Individual Lecturers": A Comparison of UK and Dutch Higher Education Institutions

    Science.gov (United States)

    Teelken, Christine; Lomas, Laurie

    2009-01-01

    This paper focuses on the way lecturers observe, feel restrained by and cope with quality management systems that have been implemented in the higher education systems of the United Kingdom and the Netherlands. As two sides of the same coin, quality enhancement and quality control are of increased significance in European Higher Education…

  7. Quality of Care for Patients with Chronic Respiratory Diseases: Data for Accreditation Plan in Primary Healthcare.

    Science.gov (United States)

    Kurpas, Donata; Szwamel, Katarzyna; Mroczek, Bożena

    There are scarce reports in the literature on factors affecting the assessment of the quality of care for patients with chronic respiratory diseases. Such information is relevant in the accreditation process on implementing the healthcare. The study group consisted of 133 adult patients with chronic respiratory diseases and 125 adult patients with chronic non-respiratory diseases. In the present study, the level of satisfaction from healthcare provided by the primary healthcare unit, disease acceptance, quality of life, health behaviors, and met needs were examined, as well as associations between variables with the use of correspondence analysis. The results are that in patients with chronic respiratory diseases an increase in satisfaction depends on the improvement of well-being in the mental sphere. The lack of problems with obtaining a referral to a specialist and a higher level of fulfilled needs also have a positive effect. Additionally, low levels of satisfaction should be expected in those patients with chronic respiratory diseases who wait for an appointment in front of the office for a long time, report problems with obtaining a referral to additional tests, present a low level of health behaviors, and have a low index of benefits.

  8. The impact of childhood acute rotavirus gastroenteritis on the parents’ quality of life: prospective observational study in European primary care medical practices

    Directory of Open Access Journals (Sweden)

    Domingo Javier

    2012-05-01

    Full Text Available Abstract Background Rotavirus (RV is the commonest cause of acute gastroenteritis in infants and young children worldwide. A Quality of Life study was conducted in primary care in three European countries as part of a larger epidemiological study (SPRIK to investigate the impact of paediatric rotavirus gastroenteritis (RVGE on affected children and their parents. Methods A self-administered questionnaire was linguistically validated in Spanish, Italian and Polish. The questionnaire was included in an observational multicentre prospective study of 302 children aged Results Questionnaire responses showed that acute RVGE in a child adversely affects the parents’ daily life as well as the child. Parents of children with RVGE experience worry, distress and impact on their daily activities. RVGE of greater clinical severity (assessed by the Vesikari scale was associated with higher parental worries due to symptoms and greater changes in the child’s behaviour, and a trend to higher impact on parents’ daily activities and higher parental distress, together with a higher score on the symptom severity scale of the questionnaire. Conclusions Parents of a child with acute RVGE presenting to primary care experience worry, distress and disruptions to daily life as a result of the child’s illness. Prevention of this disease through prophylactic vaccination will improve the daily lives of parents and children.

  9. Specific psychological variables predict quality of diet in women of lower, but not higher, educational attainment

    DEFF Research Database (Denmark)

    Lawrence, Wendy; Schlotz, Wolff; Crozier, Sarah

    2011-01-01

    Our previous work found that perceived control over life was a significant predictor of the quality of diet of women of lower educational attainment. In this paper, we explore the influence on quality of diet of a range of psychological and social factors identified during focus group discussions......, and specify the way this differs in women of lower and higher educational attainment. We assessed educational attainment, quality of diet, and psycho-social factors in 378 women attending Sure Start Children's Centres and baby clinics in Southampton, UK. Multiple-group path analysis showed that in women...... of self-efficacy, perceived control or outcome expectancies on the quality of diet of women of higher educational attainment, though having more social support and food involvement were associated with improved quality of diet in these women. Our analysis confirms our hypothesis that control...

  10. The effect of financial incentives on the quality of health care provided by primary care physicians.

    Science.gov (United States)

    Scott, Anthony; Sivey, Peter; Ait Ouakrim, Driss; Willenberg, Lisa; Naccarella, Lucio; Furler, John; Young, Doris

    2011-09-07

    The use of blended payment schemes in primary care, including the use of financial incentives to directly reward 'performance' and 'quality' is increasing in a number of countries. There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system-wide reform. Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost-effective relative to other ways to improve the quality of care. The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs) and to identify:i) the different types of financial incentives that have improved quality;ii) the characteristics of patient populations for whom quality of care has been improved by financial incentives; andiii) the characteristics of PCPs who have responded to financial incentives. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of Systematic Reviews (CDSR) (The Cochrane Library), MEDLINE, HealthSTAR, EMBASE, CINAHL, PsychLIT, and ECONLIT. Searches of Internet-based economics and health economics working paper collections were also conducted. Finally, studies were identified through the reference lists of retrieved articles, websites of key organisations, and from direct contact with key authors in the field. Articles were included if they were published from 2000 to August 2009. Randomised controlled trials (RCT), controlled before and after studies (CBA), and interrupted time series analyses (ITS) evaluating the impact of different financial interventions on the quality of care delivered by primary healthcare physicians (PCPs). Quality of care was defined as patient reported outcome

  11. TENS and heat therapy for pain relief and quality of life improvement in individuals with primary dysmenorrhea: A systematic review.

    Science.gov (United States)

    Igwea, Sylvester Emeka; Tabansi-Ochuogu, Chidinma Samantha; Abaraogu, Ukachukwu Okoroafor

    2016-08-01

    The present systematic review aimed to synthesize evidence for the effectiveness of TENS and heat therapy interventions from randomized trials. Six relevant databases were searched for studies on TENS and heat therapy for primary dysmenorrhea. Menstrual pain intensity and quality of life were the primary and secondary outcomes respectively. The search yielded 46 citations from which six studies on TENS and three studies on heat therapy were systematically reviewed. On the PEDRO quality scale, the trials methodological quality was 4.8 out of 10 for TENS and 6.3 out of 10 for heat therapy. TENS and heat therapy both showed evidence of pain reduction, but no study included quality of life as an outcome. Meta-analysis was not possible due to substantial heterogeneity in included studies. TENS and heat therapy show potential as adjunct remedies in the management of primary dysmenorrhea, but rigorous high quality trials are still needed to made conclusive recommendation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers.

    Science.gov (United States)

    Odusola, Aina O; Stronks, Karien; Hendriks, Marleen E; Schultsz, Constance; Akande, Tanimola; Osibogun, Akin; van Weert, Henk; Haafkens, Joke A

    2016-01-01

    Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Qualitative study using semi-structured individual interviews with primary care staff (n = 11) and health insurance managers (n=4). Data were analysed using standard qualitative techniques. Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider-insurer relationships; automated administration systems; and tailoring guidelines/patient education. By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA.

  13. Measuring Teaching Quality in Higher Education: Assessing Selection Bias in Course Evaluations

    Science.gov (United States)

    Goos, Maarten; Salomons, Anna

    2017-01-01

    Student evaluations of teaching (SETs) are widely used to measure teaching quality in higher education and compare it across different courses, teachers, departments and institutions. Indeed, SETs are of increasing importance for teacher promotion decisions, student course selection, as well as for auditing practices demonstrating institutional…

  14. The Status of Quality Assurance and Accreditation Systems within Higher Education Institutions in the Republic of Yemen

    Science.gov (United States)

    Anaam, Mahyoub Ali; Alhammadi, Abdullah Othman; Kwairan, Abdulwahab Awadh

    2009-01-01

    The purpose of this paper is to provide an overview of the status of quality assurance and accreditation systems within higher education institutions in Yemen. The paper initially describes the stages of development and changes that have occurred in the field of quality and accreditation in Yemeni higher education. The paper shows that no formal…

  15. Quality Teaching in a Managerial Setting: Higher Education Challenges in Australia

    Directory of Open Access Journals (Sweden)

    Therese Demediuk

    2011-02-01

    Full Text Available Australian universities face increased challenges in a global higher education marketplace. They have responded to this competitive environment by introducing greater efficiency and accountability measures. One key measure is the quality of teaching and in particular, the delivery of student-centred teaching. However, the reforms have changed the working lives of academic teachers who now have greater reporting and administrative responsibilities with less sense of collegiality in the sector. In these circumstances, it is not clear that teaching staff will share the same perceptions of quality teaching as their institutions expect. This paper examines the utility of role theory and learning organization theory as part of a project which will examine the ways in which implicit knowledge can be made explicit and shared in the organization as part of academic teachers’ roles. The paper hypothesizes that when academics share their perceptions of good teaching, universities will benefit from a coherent set of quality teaching indicators which are aligned with their organizational cultures.

  16. External Quality Assurance in Higher Education: How Can It Address Corruption and Other Malpractices?

    Science.gov (United States)

    Martin, Michaela

    2016-01-01

    Corruption and malpractices in higher education are today a major concern in nearly all higher education systems worldwide. It is a multifaceted phenomenon and has become particularly visible in the academic domain. This paper represents an exploration of the possible role that quality assurance can play in addressing corruption and malpractices.…

  17. Development of a core set of quality indicators for paediatric primary care practices in Europe, COSI-PPC-EU.

    Science.gov (United States)

    Ewald, Dominik A; Huss, Gottfried; Auras, Silke; Caceres, Juan Ruiz-Canela; Hadjipanayis, Adamos; Geraedts, Max

    2018-06-01

    Paediatric ambulatory healthcare systems in Europe are, because of historical reasons, diverse and show strikingly different outcomes. All across Europe, the benchmarking of structures, processes and outcomes could reveal opportunities for improving Paediatric Primary Care (PPC). The aim of this study was to develop a set of Quality Indicators (QIs) to assess and monitor PPC in Europe. In a three-step process, we used the available external evidence and European expert consensus in a modified RAND/UCLA Appropriateness Method (RAM) to develop an indicator set. (1) A broad literature and online research of published QI and guidelines yielded an inventory of 1516 QI. (2) A collaborative panel of paediatric senior experts from the European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) from 15 European countries participated in a first consensus process to reduce the initial indicator inventory by eliminating not PPC-focused indicators and duplicates. (3) In a second consensus process, the panel rated the QI regarding validity and feasibility. The final QI set "COSI-PPC-EU" consists of 42 indicators in five categories of PPC: (A) health promotion/prevention/screening (13 QI), (B) acute care (9 QI), (C) chronic care (8 QI), (D) practice management (3 QI) and (E) patient safety (9 QI). COSI-PPC-EU represents a consented set of a limited number of valid quality indicators for the application in paediatric primary care in different healthcare systems throughout Europe. What is Known: • Paediatric ambulatory healthcare systems in Europe are diverse and show strikingly different outcomes. • There are known gaps in quality performance measures of paediatric primary care in Europe. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care. What is New: • A set of 42 quality indicators for primary paediatric care in Europe was developed in a multi

  18. Quality Assurance and Its Impact from Higher Education Institutions' Perspectives: Methodological Approaches, Experiences and Expectations

    Science.gov (United States)

    Bejan, Stelian Andrei; Janatuinen, Tero; Jurvelin, Jouni; Klöpping, Susanne; Malinen, Heikki; Minke, Bernhard; Vacareanu, Radu

    2015-01-01

    This paper reports on methodological approaches, experiences and expectations referring to impact analysis of quality assurance from the perspective of three higher education institutions (students, teaching staff, quality managers) from Germany, Finland and Romania. The presentations of the three sample institutions focus on discussing the core…

  19. Nominal Group Technique and its Applications in Managing Quality in Higher Education

    Directory of Open Access Journals (Sweden)

    Rafikul Islam

    2011-09-01

    Full Text Available Quality management is an important aspect in all kinds of businesses – manufacturing or service. Idea generation plays a pivotal role in managing quality in organizations. It is thenew and innovative ideas which can help corporations to survive in the turbulent business environment. Research in group dynamics has shown that more ideas are generated by individuals working alone but in a group environment than the individuals engaged in a formal group discussion. In Nominal Group Technique (NGT, individuals work alone but in a group setting. This paper shows how NGT can be applied to generate large number of ideas to solve quality related problems specifically in Malaysian higher education setting. The paper also discusses the details of NGT working procedure andexplores the areas of its further applications.

  20. Higher frequency of brain abnormalities in neuromyelitis optica spectrum disorder patients without primary Sjögren's syndrome.

    Science.gov (United States)

    Gu, Li-Na; Zhang, Min; Zhu, Hui; Liu, Jing-Yao

    2016-10-01

    Neuromyelitis optica spectrum disorder often co-exists with primary Sjögren's syndrome. We compared the clinical features of 16 neuromyelitis optica spectrum disorder patients with ( n = 6) or without primary Sjögren's syndrome ( n = 10). All patients underwent extensive clinical, laboratory, and MRI evaluations. There were no statistical differences in demographics or first neurological involvement at onset between neuromyelitis optica spectrum disorder patients with and without primary Sjögren's syndrome. The laboratory findings of cerebrospinal fluid oligoclonal banding, serum C-reactive protein, antinuclear autoantibody, anti-Sjögren's-syndrome-related antigen A antibodies, anti-Sjögren's-syndrome-related antigen B antibodies, and anti-Sm antibodies were significantly higher in patients with primary Sjögren's syndrome than those without. Anti-aquaporin 4 antibodies were detectable in 67% (4/6) of patients with primary Sjögren's syndrome and in 60% (6/10) of patients without primary Sjögren's syndrome. More brain abnormalities were observed in patients without primary Sjögren's syndrome than in those with primary Sjögren's syndrome. Segments lesions (> 3 centrum) were noted in 50% (5/10) of patients without primary Sjögren's syndrome and in 67% (4/6) of patients with primary Sjögren's syndrome. These findings indicate that the clinical characteristics of neuromyelitis optica spectrum disorder patients with and without primary Sjögren's syndrome are similar. However, neuromyelitis optica spectrum disorder patients without primary Sjögren's syndrome have a high frequency of brain abnormalities.

  1. Future orientation and health quality of life in primary care: vitality as a mediator.

    Science.gov (United States)

    Hirsch, Jameson K; Molnar, Danielle; Chang, Edward C; Sirois, Fuschia M

    2015-07-01

    Temporal perspective, including views about future goals, may influence motivational processes related to health. An adaptive sense of future orientation is linked to better health, but little research has examined potential underlying factors, such as vitality. In a sample of 101 primary care patients, we examined whether belief in the changeability of the future was related to mental and physical energization and, in turn, to health-related quality of life. Participants were working, uninsured primary care patients, who completed self-report measures of future orientation, vitality, and health-related quality of life. Mediation models, covarying age, sex, and race/ethnicity indicated that vitality significantly mediated the association between future orientation and the outcomes of general health, mental health, social functioning, bodily pain, and role limitations due to emotional and physical reasons. Vitality exerted an indirect-only effect on the relation between future orientation and physical functioning. Our findings suggest that adaptive beliefs about the future may promote, or allow access to, physical and mental energy and, in turn, may result in better mental and physical health functioning. Individual-level and public health interventions designed to promote future orientation and vitality may beneficially influence quality of life and well-being.

  2. Measuring Service Quality in Higher Education: Development of a Hierarchical Model (HESQUAL)

    Science.gov (United States)

    Teeroovengadum, Viraiyan; Kamalanabhan, T. J.; Seebaluck, Ashley Keshwar

    2016-01-01

    Purpose: This paper aims to develop and empirically test a hierarchical model for measuring service quality in higher education. Design/methodology/approach: The first phase of the study consisted of qualitative research methods and a comprehensive literature review, which allowed the development of a conceptual model comprising 53 service quality…

  3. The Incorporation of Quality Attributes into Online Course Design in Higher Education

    Science.gov (United States)

    Lenert, Kathleen Anne; Diane P. Janes

    2017-01-01

    A survey was designed incorporating questions on 28 attributes (compiled through a literature review) and considered to be quality features in online academic courses in higher education. This study sought to investigate the ongoing practice of instructional designers and instructors in the United States with respect to their incorporation of…

  4. Relationship Quality in Higher Education Marketing: The Role of Social Media Engagement

    Science.gov (United States)

    Clark, Melissa; Fine, Monica B.; Scheuer, Cara-Lynn

    2017-01-01

    The landscape in consumer marketing is changing due to the rise in popularity of social media. This shift has also affected how higher education institutions build relationships with their stakeholders. This study explores how social media engagement impacts relationship quality between the university and one of its key stakeholder groups,…

  5. Challenges for Quality Primary Education in Papua New Guinea—A Case Study

    Directory of Open Access Journals (Sweden)

    Ravinder Rena

    2011-01-01

    Full Text Available There is an urgent need to reform the educational system to achieve universal primary education in Papua New Guinea (PNG. Even after 35 years of independence, PNG has been struggling to educate an estimated 2 million elementary- and primary-aged children and faces numerous challenges in providing Education for All (EFA. This study was conducted in four primary schools of Buma Yong area of Lae district of Morobe Province, PNG. The study revealed that the quality of education has been deteriorated over the past few decades. Many schools in PNG do not have classrooms, teachers, and basic facilities. As a result, the children are losing interest in going to school. The children dropped out of school so as to assist their families in the household and agricultural activities. It also reveals that the dropout rate of girls is more than that of the boys due to the gender disparity in the country. The study recommended that budgetary allocations should be increased so as to improve the infrastructural facilities and encourage the children to attend primary school and thus achieve the Millennium Development Goal/Education For All in PNG.

  6. Measuring Quality of Healthcare Outcomes in Type 2 Diabetes from Routine Data: a Seven-nation Survey Conducted by the IMIA Primary Health Care Working Group.

    Science.gov (United States)

    Hinton, W; Liyanage, H; McGovern, A; Liaw, S-T; Kuziemsky, C; Munro, N; de Lusignan, S

    2017-08-01

    Background: The Institute of Medicine framework defines six dimensions of quality for healthcare systems: (1) safety, (2) effectiveness, (3) patient centeredness, (4) timeliness of care, (5) efficiency, and (6) equity. Large health datasets provide an opportunity to assess quality in these areas. Objective: To perform an international comparison of the measurability of the delivery of these aims, in people with type 2 diabetes mellitus (T2DM) from large datasets. Method: We conducted a survey to assess healthcare outcomes data quality of existing databases and disseminated this through professional networks. We examined the data sources used to collect the data, frequency of data uploads, and data types used for identifying people with T2DM. We compared data completeness across the six areas of healthcare quality, using selected measures pertinent to T2DM management. Results: We received 14 responses from seven countries (Australia, Canada, Italy, the Netherlands, Norway, Portugal, Turkey and the UK). Most databases reported frequent data uploads and would be capable of near real time analysis of healthcare quality.The majority of recorded data related to safety (particularly medication adverse events) and treatment efficacy (glycaemic control and microvascular disease). Data potentially measuring equity was less well recorded. Recording levels were lowest for patient-centred care, timeliness of care, and system efficiency, with the majority of databases containing no data in these areas. Databases using primary care sources had higher data quality across all areas measured. Conclusion: Data quality could be improved particularly in the areas of patient-centred care, timeliness, and efficiency. Primary care derived datasets may be most suited to healthcare quality assessment. Georg Thieme Verlag KG Stuttgart.

  7. The effect of self-administered superficial local hot and cold application methods on pain, functional status and quality of life in primary knee osteoarthritis patients.

    Science.gov (United States)

    Aciksoz, Semra; Akyuz, Aygul; Tunay, Servet

    2017-12-01

    To investigate the effect of the self-administered superficial local hot and cold applications on pain, and the functional status and the quality of life in primary knee osteoarthritis patients. Superficial local hot and cold application is used as a nonpharmacological method for the treatment of knee osteoarthritis. However, various guidelines for the management of knee osteoarthritis have conflicting recommendation for hot and cold therapy. A randomised clinical trial design. The sample consisted of patients (n = 96) who were diagnosed with primary knee osteoarthritis. During the application stage, patients were designated to the hot and cold application groups and administered hot and cold application twice a day for 3 weeks together with standard osteoarthritis treatment. The control group only used standard osteoarthritis treatment. The data were collected with a Descriptive Information Form, a Pain Scale, the WOMAC Osteoarthritis Index, the Nottingham Health Profile (NHP) and a Patient Satisfaction Evaluation Form. Outcome measures included pain intensity, functional status and quality of life. We found decreased primary measurement pain scores and improved functional status scores and quality of life scores after the application programme compared to the pre-application stage in both the hot and cold application groups. Once the application was completed, the pain scores, functional status scores and quality-of-life scores on the second measurements were found to be still statistically lower than the pre-application scores but higher than the first measurement ([p  .05). It was found that both hot and cold application resulted in a mild improvement in pain, functional status and quality of life, but this improvement was not sufficient to create a significant difference between the groups. This study contributes to the literature on hot and cold application methods as self-management strategies for patients with knee osteoarthritis. © 2017 John Wiley

  8. Quality Administration and Management in Higher Education in Nigeria: Implications for Human Resource Development

    Science.gov (United States)

    Akinyemi, Gbenga M.; Abiddin, Norhasni Zainal

    2013-01-01

    The dynamic changes in today's world have made countries of the world masters of their own destinies. In this light, it has become noted today that "the affluence or penury of nations depends largely on the quality of higher education". This is informed by the fact that higher education systems of a nation is the "machinery of…

  9. Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers

    Directory of Open Access Journals (Sweden)

    Aina O. Odusola

    2016-02-01

    Full Text Available Background: Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA that can be modified through timely and long-term treatment in primary care. Objective: We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Design: Qualitative study using semi-structured individual interviews with primary care staff (n = 11 and health insurance managers (n=4. Data were analysed using standard qualitative techniques. Results: Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider–insurer relationships; automated administration systems; and tailoring guidelines/patient education. Conclusions: By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA.

  10. The UNIQUe Label: Supporting a Culture of Innovation and Quality in Higher Education

    Science.gov (United States)

    Boonen, Annemie; Bijnens, Helena

    European higher education institutions will need significant reforms, in order to guarantee their leading role in a globalized knowledge economy. These reforms can be enhanced by improving the way in which traditional universities integrate new technologies both in their educational activities and throughout their strategic and operational processes. The UNIQUe institutional accreditation scheme, analyzed and described in this chapter, intends to support this process of integrating the use of new technologies in higher education. With its specific open approach to quality in e-Learning, UNIQUe emphasizes innovation and creativity in a process that includes self-assessment and constructive dialog with peers and stakeholders involved. UNIQUe intends to use the institutional quality label as a catalyst for continuous improvement and change while setting up collaborative bench learning processes among universities for the adoption and integration of e-Learning.

  11. Quality Procedures in the European Higher Education Area and Beyond--Visions for the Future: Third ENQA Survey. ENQA Occasional Papers 18

    Science.gov (United States)

    Grifoll, Josep; Hopbach, Achim; Kekalainen, Helka; Lugano, Nathalie; Rozsnyai, Christina; Shopov, Todor

    2012-01-01

    Higher education reforms over the last decade, resulting in the establishment of the European Higher Education Area, with new social demands and expectations, have greatly impacted quality assurance in higher education. As a follow-up activity to two previous surveys on external quality procedures, the European Association for Quality Assurance in…

  12. [Job satisfaction and improvement factors in primary care professionals].

    Science.gov (United States)

    Pérez-Ciordia, I; Guillén-Grima, F; Brugos, A; Aguinaga, I

    2013-09-06

    The quality of services in a health system is related to the level of satisfaction of its professionals. The aim of this article is to determine job satisfaction in primary care professionals and rank those factors capable of improving it. Descriptive study carried out in Navarre in 2010. A validated questionnaire was sent by post to the population of the study: primary care doctors, pediatricians and nurses. Variables on socio-demographic data were collected and job satisfaction was self-evaluated on a scale of 1 to 10. Respondents were asked to rank 10 factors that could improve the previously mentioned satisfaction. Averages were compared and bivariate analysis was carried out using the chi-square test, studying the association between variables through the Odds Ratio (OR). The adjusted analysis was realized through unconditional logistic regression. We collected 432 questionnaires (77.5%). Average satisfaction was 6.7 (scale of 1 to 10), higher in nursing. Women showed a higher average than men (6.90:6.34). The workers at urban health centers (OR: 1.71; CI: 1.10-2.65) showed a higher risk of dissatisfaction with respect to professionals at rural centers. The training activities of the professional is the most highly valued item, followed by economic questions and questions of care pressure, with no differences found by profession. Job satisfaction is a dimension of quality management in primary care and its study enables identification of problems or opportunities for improvement with an impact on the quality of the services offered.

  13. Telemedicine spirometry training and quality assurance program in primary care centers of a public health system.

    Science.gov (United States)

    Marina Malanda, Nuria; López de Santa María, Elena; Gutiérrez, Asunción; Bayón, Juan Carlos; Garcia, Larraitz; Gáldiz, Juan B

    2014-04-01

    Forced spirometry is essential for diagnosing respiratory diseases and is widely used across levels of care. However, several studies have shown that spirometry quality in primary care is not ideal, with risks of misdiagnosis. Our objective was to assess the feasibility and performance of a telemedicine-based training and quality assurance program for forced spirometry in primary care. The two phases included (1) a 9-month pilot study involving 15 centers, in which spirometry tests were assessed by the Basque Office for Health Technology Assessment, and (2) the introduction of the program to all centers in the Public Basque Health Service. Technicians first received 4 h of training, and, subsequently, they sent all tests to the reference laboratory using the program. Quality assessment was performed in accordance with clinical guidelines (A and B, good; C-F, poor). In the first phase, 1,894 spirometry tests were assessed, showing an improvement in quality: acceptable quality tests increased from 57% at the beginning to 78% after 6 months and 83% after 9 months (passessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; pquality of spirometry tests improved in all centers. (2) The program provides a tool for transferring data that allows monitoring of its quality and training of technicians who perform the tests. (3) This approach is useful for improving spirometry quality in the routine practice of a public health system.

  14. Zen and the Art of Higher Education Maintenance: Bridging Classic and Romantic Notions of Quality.

    Science.gov (United States)

    Shields, Patricia M.

    Uses Robert Pirsig's ideas in "Zen and the Art of Motorcycle Maintenance" to explore two ways of viewing quality in higher education: the romantic and the classic. Analyzes historical and contemporary literature on quality using insights of Alfred Whitehead, Pirsig, and John Dewey, urging a vision that is honest and that incorporates…

  15. Total Quality Management in Higher Education.

    Science.gov (United States)

    Sherr, Lawrence A.; Lozier, G. Gredgory

    1991-01-01

    Total Quality Management, based on theories of W. Edward Deming and others, is a style of management using continuous process improvement characterized by mission and customer focus, a systematic approach to operations, vigorous development of human resources, long-term thinking, and a commitment to ensuring quality. The values espoused by this…

  16. Association between obesity, quality of life, physical activity and health service utilization in primary care patients with osteoarthritis.

    NARCIS (Netherlands)

    Rosemann, T.J.; Grol, R.P.T.M.; Herman, K.; Wensing, M.J.P.; Szecsenyi, J.

    2008-01-01

    ABSTRACT: OBJECTIVE: To assess the association of obesity with quality of life, health service utilization and physical activity in a large sample of primary care patients with osteoarthritis (OA). METHODS: Data were retrieved from the PraxArt project, representing a cohort of 1021 primary care

  17. Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study.

    Science.gov (United States)

    Mundt, Marlon P; Agneessens, Filip; Tuan, Wen-Jan; Zakletskaia, Larissa I; Kamnetz, Sandra A; Gilchrist, Valerie J

    2016-06-01

    Primary care teams play an important role in providing the best quality of care to patients with diabetes. Little evidence is available on how team communication networks and team climate contribute to high quality diabetes care. To determine whether primary care team communication and team climate are associated with health outcomes, health care utilization, and associated costs for patients with diabetes. A cross-sectional survey of primary care team members collected information on frequency of communication with other care team members about patient care and on team climate. Patient outcomes (glycemic, cholesterol, and blood pressure control, urgent care visits, emergency department visits, hospital visit days, medical costs) in the past 12 months for team diabetes patient panels were extracted from the electronic health record. The data were analyzed using nested (clinic/team/patient) generalized linear mixed modeling. 155 health professionals at 6 U.S. primary care clinics participated from May through December 2013. Primary care teams with a greater number of daily face-to-face communication ties among team members were associated with 52% (rate ratio=0.48, 95% CI: 0.22, 0.94) fewer hospital days and US$1220 (95% CI: -US$2416, -US$24) lower health-care costs per team diabetes patient in the past 12 months. In contrast, for each additional registered nurse (RN) who reported frequent daily face-to-face communication about patient care with the primary care practitioner (PCP), team diabetes patients had less-controlled HbA1c (Odds ratio=0.83, 95% CI: 0.66, 0.99), increased hospital days (RR=1.57, 95% CI: 1.10, 2.03), and higher healthcare costs (β=US$877, 95% CI: US$42, US$1713). Shared team vision, a measure of team climate, significantly mediated the relationship between team communication and patient outcomes. Primary care teams which relied on frequent daily face-to-face communication among more team members, and had a single RN communicating patient care

  18. Primary care team communication networks, team climate, quality of care, and medical costs for patients with diabetes: A cross-sectional study

    Science.gov (United States)

    Mundt, Marlon P.; Agneessens, Filip; Tuan, Wen-Jan; Zakletskaia, Larissa I.; Kamnetz, Sandra A.; Gilchrist, Valerie J.

    2016-01-01

    Background Primary care teams play an important role in providing the best quality of care to patients with diabetes. Little evidence is available on how team communication networks and team climate contribute to high quality diabetes care. Objective To determine whether primary care team communication and team climate are associated with health outcomes, health care utilization, and associated costs for patients with diabetes. Methods A cross-sectional survey of primary care team members collected information on frequency of communication with other care team members about patient care and on team climate. Patient outcomes (glycemic, cholesterol, and blood pressure control, urgent care visits, emergency department visits, hospital visit days, medical costs) in the past 12 months for team diabetes patient panels were extracted from the electronic health record. The data were analyzed using nested (clinic/team/patient) generalized linear mixed modeling. Participants 155 health professionals at 6 U.S. primary care clinics participated from May through December 2013. Results Primary care teams with a greater number of daily face-to-face communication ties among team members were associated with 52% (Rate Ratio=0.48, 95% CI: 0.22, 0.94) fewer hospital days and US$1220 (95% CI: -US$2416, -US$24) lower health-care costs per team diabetes patient in the past 12 months. In contrast, for each additional registered nurse (RN) who reported frequent daily face-to-face communication about patient care with the primary care practitioner (PCP), team diabetes patients had less-controlled HbA1c (Odds Ratio=0.83, 95% CI: 0.66, 0.99), increased hospital days (RR=1.57, 95% CI: 1.10, 2.03), and higher healthcare costs (β=US$877, 95% CI: US$42, US$1713). Shared team vision, a measure of team climate, significantly mediated the relationship between team communication and patient outcomes. Conclusions Primary care teams which relied on frequent daily face-to-face communication among more

  19. Between Efficiency and Transformation: The Opinion of Deans on the Meaning of Quality in Higher Education

    Science.gov (United States)

    Olaskoaga-Larrauri, Jon; Barrenetxea-Ayesta, Miren; Cardona-Rodríguez, Antonio; Mijangos-Del Campo, Juan José; Barandiaran-Galdós, Marta

    2016-01-01

    The literature on quality management at higher education institutions has for some time been working on the basis of two issues: a) the diversity of ideas as to what "quality" means, which makes it harder to apply the principles of quality management in this context; and b) the idea that this diversity is in some way a response to the…

  20. Playing language games: higher education quality dynamics in Dutch national policies since 1985

    NARCIS (Netherlands)

    Weenink, Kasja; Aarts, Noelle; Jacobs, Sandra

    2017-01-01

    Higher education quality is a vague, ambiguous, multiple, and essentially contested concept. Quality’s contested character involves endless disputes about its proper use which makes it problematic to handle in governmental policies. Wittgenstein’s notion of language games is used to understand how,

  1. Beyond accreditation: a multi-track quality-enhancing strategy for primary health care in low- and middle-income countries.

    Science.gov (United States)

    Saleh, Shadi S; Alameddine, Mohamad S; Natafgi, Nabil M

    2014-01-01

    Many define an equitable health care system as one that provides logistical and financial access to "quality" care to the population. Realizing that fact, many low- and middle-income countries started investing in enhancing the quality of care in their health care systems, recently in primary health care. Unfortunately, in many instance, these investments have been exclusively focused on accreditation due to available guidelines and existing accrediting structures. A multi-track quality-enhancing strategy (MTQES) is proposed that includes, in addition to promoting resource-sensitive accreditation, other quality initiatives such as clinical guidelines, performance indicators, benchmarking activities, annual quality-enhancing projects, and annual quality summit/meeting. These complementary approaches are presented to synergistically enhance a continuous quality improvement culture in the primary health care sector, taking into consideration limited resources available, especially in low- and middle-income countries. In addition, an implementation framework depicting MTQES in three-phase interlinked packages is presented; each matches existing resources and quality infrastructure. Health care policymakers and managers need to think about accreditation as a beginning rather than an end to their quest for quality. Improvements in the structure of a health delivery organization or in the processes of care have little value if they do not translate to reduced disparities in access to "quality" care, and not merely access to care.

  2. Comparison between Primary Teacher Educators' and Primary School Teachers' Beliefs of Primary Geography Education Quality

    Science.gov (United States)

    Bent, Gert Jan; Bakx, Anouke; den Brok, Perry

    2016-01-01

    In this study teacher educators' beliefs concerning primary geography education have been investigated and compared with primary school teachers' beliefs. In this study 45 teacher educators and 489 primary school teachers completed a questionnaire, and nine teacher educators have been interviewed as well. It has been found that teacher educators…

  3. A Phenomenographic Study of Students' Conceptions of Quality in Learning in Higher Education in Rwanda

    Science.gov (United States)

    Mbabazi Bamwesiga, Penelope; Fejes, Andreas; Dahlgren, Lars-Owe

    2013-01-01

    The aim of this study is to understand the different ways that university students conceptualise quality in learning by drawing on a phenomenographic approach. A total of 20 students in higher education in Rwanda were interviewed and analysis of the interviews generated an outcome space of conceptions of quality in learning as transformation,…

  4. Embedding systematic quality assessments in supportive supervision at primary healthcare level: application of an electronic Tool to Improve Quality of Healthcare in Tanzania.

    Science.gov (United States)

    Mboya, Dominick; Mshana, Christopher; Kessy, Flora; Alba, Sandra; Lengeler, Christian; Renggli, Sabine; Vander Plaetse, Bart; Mohamed, Mohamed A; Schulze, Alexander

    2016-10-13

    Assessing quality of health services, for example through supportive supervision, is essential for strengthening healthcare delivery. Most systematic health facility assessment mechanisms, however, are not suitable for routine supervision. The objective of this study is to describe a quality assessment methodology using an electronic format that can be embedded in supervision activities and conducted by council health staff. An electronic Tool to Improve Quality of Healthcare (e-TIQH) was developed to assess the quality of primary healthcare provision. The e-TIQH contains six sub-tools, each covering one quality dimension: infrastructure and equipment of the facility, its management and administration, job expectations, clinical skills of the staff, staff motivation and client satisfaction. As part of supportive supervision, council health staff conduct quality assessments in all primary healthcare facilities in a given council, including observation of clinical consultations and exit interviews with clients. Using a hand-held device, assessors enter data and view results in real time through automated data analysis, permitting immediate feedback to health workers. Based on the results, quality gaps and potential measures to address them are jointly discussed and actions plans developed. For illustrative purposes, preliminary findings from e-TIQH application are presented from eight councils of Tanzania for the period 2011-2013, with a quality score quality dimensions at baseline. Clinical practice was unsatisfactory in six councils, with more mixed results for availability of infrastructure and equipment, and for administration and management. In contrast, client satisfaction scored surprisingly high. Over time, each council showed a significant overall increase of 3-7 % in mean score, with the most pronounced improvements in staff motivation and job expectations. Given its comprehensiveness, convenient handling and automated statistical reports, e-TIQH enables

  5. Spirometry in primary care

    Science.gov (United States)

    Coates, Allan L; Graham, Brian L; McFadden, Robin G; McParland, Colm; Moosa, Dilshad; Provencher, Steeve; Road, Jeremy

    2013-01-01

    Canadian Thoracic Society (CTS) clinical guidelines for asthma and chronic obstructive pulmonary disease (COPD) specify that spirometry should be used to diagnose these diseases. Given the burden of asthma and COPD, most people with these diseases will be diagnosed in the primary care setting. The present CTS position statement was developed to provide guidance on key factors affecting the quality of spirometry testing in the primary care setting. The present statement may also be used to inform and guide the accreditation process for spirometry in each province. Although many of the principles discussed are equally applicable to pulmonary function laboratories and interpretation of tests by respirologists, they are held to a higher standard and are outside the scope of the present statement. PMID:23457669

  6. Quality of life in Chinese patients with schizophrenia treated in primary care.

    Science.gov (United States)

    Li, Yan; Hou, Cai-Lan; Ma, Xin-Rong; Zhong, Bao-Liang; Zang, Yu; Jia, Fu-Jun; Lin, Yong-Qiang; Lai, Kelly Y C; Chiu, Helen F K; Ungvari, Gabor S; Hall, Brian J; Cai, Mei-Ying; Ng, Chee H; Xiang, Yu-Tao

    2017-08-01

    In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. This study examined the quality of life (QOL) in patients with schizophrenia treated in primary care and explored the demographic and clinical characteristics associated with QOL. Altogether, 612 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. QOL, psychotic and depressive symptoms, extra-pyramidal symptoms and insight were assessed using standardized instruments. Data analyses were conducted with the one sample t-test and multiple linear regression analyses. Compared with the normative data for the Chinese general population, significantly lower scores in physical and mental QOL domains were found in the patient group. Older age, being unemployed, major medical conditions, no smoking, more severe depressive and negative symptoms, more frequent insomnia, and suicidality were independently associated with poor physical QOL. Male gender, more severe depressive and anxiety symptoms, more frequent insomnia, and suicidality were independently associated with poor mental QOL. Patients with schizophrenia treated in primary care had lower level of QOL in comparison with general population. Effective measures need to be implemented to improve their QOL. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  7. Primary Care Practices’ Abilities And Challenges In Using Electronic Health Record Data For Quality Improvement

    Science.gov (United States)

    Cohen, Deborah J.; Dorr, David A.; Knierim, Kyle; DuBard, C. Annette; Hemler, Jennifer R.; Hall, Jennifer D.; Marino, Miguel; Solberg, Leif I.; McConnell, K. John; Nichols, Len M.; Nease, Donald E.; Edwards, Samuel T.; Wu, Winfred Y.; Pham-Singer, Hang; Kho, Abel N.; Phillips, Robert L.; Rasmussen, Luke V.; Duffy, F. Daniel; Balasubramanian, Bijal A.

    2018-01-01

    Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical quality measures that their electronic health records (EHRs) generate. To determine whether EHRs produce reports adequate to the task, we examined survey responses from 1,492 practices across twelve states, supplemented with qualitative data. Meaningful-use participation, which requires the use of a federally certified EHR, was associated with the ability to generate reports—but the reports did not necessarily support quality improvement initiatives. Practices reported numerous challenges in generating adequate reports, such as difficulty manipulating and aligning measurement time frames with quality improvement needs, lack of functionality for generating reports on electronic clinical quality measures at different levels, discordance between clinical guidelines and measures available in reports, questionable data quality, and vendors that were unreceptive to changing EHR configuration beyond federal requirements. The current state of EHR measurement functionality may be insufficient to support federal initiatives that tie payment to clinical quality measures. PMID:29608365

  8. Primary Care Practices' Abilities And Challenges In Using Electronic Health Record Data For Quality Improvement.

    Science.gov (United States)

    Cohen, Deborah J; Dorr, David A; Knierim, Kyle; DuBard, C Annette; Hemler, Jennifer R; Hall, Jennifer D; Marino, Miguel; Solberg, Leif I; McConnell, K John; Nichols, Len M; Nease, Donald E; Edwards, Samuel T; Wu, Winfred Y; Pham-Singer, Hang; Kho, Abel N; Phillips, Robert L; Rasmussen, Luke V; Duffy, F Daniel; Balasubramanian, Bijal A

    2018-04-01

    Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical quality measures that their electronic health records (EHRs) generate. To determine whether EHRs produce reports adequate to the task, we examined survey responses from 1,492 practices across twelve states, supplemented with qualitative data. Meaningful-use participation, which requires the use of a federally certified EHR, was associated with the ability to generate reports-but the reports did not necessarily support quality improvement initiatives. Practices reported numerous challenges in generating adequate reports, such as difficulty manipulating and aligning measurement time frames with quality improvement needs, lack of functionality for generating reports on electronic clinical quality measures at different levels, discordance between clinical guidelines and measures available in reports, questionable data quality, and vendors that were unreceptive to changing EHR configuration beyond federal requirements. The current state of EHR measurement functionality may be insufficient to support federal initiatives that tie payment to clinical quality measures.

  9. Productivity as an Indication of Quality in Higher Education: The Views of Employed Graduates in Greece

    Science.gov (United States)

    Eliophotou Menon, Maria

    2016-01-01

    The paper investigates the views of Greek university graduates on the link between higher education and productivity in order to determine the extent to which productivity can be considered to be an indication of quality in higher education. It also investigates the perceived effect of the type and content of higher education on productivity;…

  10. Improving the quality of nurse clinical documentation for chronic patients at primary care clinics: A multifaceted intervention.

    Science.gov (United States)

    Mahomed, Ozayr H; Naidoo, Salsohni; Asmall, Shaidah; Taylor, Myra

    2015-09-25

    Deficiencies in record keeping practices have been reported at primary care level in the public health sector in South Africa. These deficiencies have the potential to negatively impact patient health outcomes as the break in information may hinder continuity of care. This disruption in information management has particular relevance for patients with chronic diseases. The aim of this study was to establish if the implementation of a structured clinical record (SCR) as an adjunct tool to the algorithmic guidelines for chronic disease management improved the quality of clinical records at primary care level. A quasi-experimental study (before and after study with a comparison group) was conducted across 30 primary health care clinics (PHCs) located in three districts in South Africa. Twenty PHCs that received the intervention were selected as intervention clinics and 10 facilities were selected as comparison facilities. The lot quality assurance sampling (LQAS) method was used to determine the number of records required to be reviewed per diagnostic condition per facility. There was a a statistically significant increase in the percentage of clinical records achieving compliance to the minimum criteria from the baseline to six months post-intervention for both HIV patients on antiretroviral treatment and patients with non-communicable diseases (hypertension and diabetes). A multifaceted intervention using a SCR to supplement the educational outreach component (PC 101 training) has demonstrated the potential for improving the quality of clinical records for patients with chronic diseases at primary care clinics in South Africa.

  11. Nurturing Quality of Higher Education through National Ranking: A Potential Empowerment Model for Developing Countries

    Science.gov (United States)

    Kusumastuti, Dyah; Idrus, Nirwan

    2017-01-01

    This paper reviews the recently introduced National Higher Education ranking system in Indonesia in order to evaluate its potential as a sustainable model to improve the quality of higher education in the country. It is a scaffold towards an established world-universities ranking system that may prove formidable for a developing country. This…

  12. A World of Brands: Higher Education and the Emergence of Multinational Quality Franchises

    Science.gov (United States)

    Blanco Ramírez, Gerardo

    2014-01-01

    This article explores the concepts of "brand" and "franchise" in the development of international quality assurance. The impact of corporate language and culture on higher education is evident and has been extensively analysed. Recent attention given to branding of universities reflects the ever-growing influence of corporate…

  13. A History and Critique of Quality Evaluation in the UK

    Science.gov (United States)

    Harvey, Lee

    2005-01-01

    Purpose: To provide a history of the emergence of quality systems from the mid-1980s. To show how quality became a primary policy concern in higher education policy. To map the development of quality processes and raise questions about dominant approaches and express concerns for the future. Design/methodology/approach: Historical document…

  14. Primary display latency criteria based on flying qualities and performance data

    Science.gov (United States)

    Funk, John D., Jr.; Beck, Corin P.; Johns, John B.

    1993-01-01

    With a pilots' increasing use of visual cue augmentation, much requiring extensive pre-processing, there is a need to establish criteria for new avionics/display design. The timeliness and synchronization of the augmented cues is vital to ensure the performance quality required for precision mission task elements (MTEs) where augmented cues are the primary source of information to the pilot. Processing delays incurred while transforming sensor-supplied flight information into visual cues are unavoidable. Relationships between maximum control system delays and associated flying qualities levels are documented in MIL-F-83300 and MIL-F-8785. While cues representing aircraft status may be just as vital to the pilot as prompt control response for operations in instrument meteorological conditions, presently, there are no specification requirements on avionics system latency. To produce data relating avionics system latency to degradations in flying qualities, the Navy conducted two simulation investigations. During the investigations, flying qualities and performance data were recorded as simulated avionics system latency was varied. Correlated results of the investigation indicates that there is a detrimental impact of latency on flying qualities. Analysis of these results and consideration of key factors influencing their application indicate that: (1) Task performance degrades and pilot workload increases as latency is increased. Inconsistency in task performance increases as latency increases. (2) Latency reduces the probability of achieving Level 1 handling qualities with avionics system latency as low as 70 ms. (3) The data suggest that the achievement of desired performance will be ensured only at display latency values below 120 ms. (4) These data also suggest that avoidance of inadequate performance will be ensured only at display latency values below 150 ms.

  15. Quality of Primary Health Care for children and adolescents living with HIV.

    Science.gov (United States)

    Nascimento, Leticia do; Paula, Cristiane Cardoso de; Magnago, Tania Solange Bosi de Souza; Padoin, Stela Maris de Mello; Harzheim, Erno; Silva, Clarissa Bohrer da

    2016-08-29

    to evaluate the quality of health care for children and adolescents living with HIV, among the different types of Primary Health Care services of Santa Maria, Rio Grande do Sul. cross-sectional study, developed with 118 Primary Health Care professionals. The Primary Care Evaluation Instrument, Professional version, was used. For verification of the variables associated with the high score, Poisson Regression was used. the professionals of the Family Health Strategy, when compared to those of the Primary Health Units, obtained a greater degree of orientation to primary care, both for the overall score and for the derived attributes score, as well as for the integrality and community orientation attributes. A specialization in Primary Health Care, other employment and a statutory work contract were associated with quality of care. the Family Health Strategy was shown to provide higher quality health care for children and adolescents living with HIV, however, the coverage is still low. The need was highlighted to expand this coverage and invest in vocational training directed toward Primary Care and making the professionals effective, through public selection procedure, as well as an improvement program that recognizes the care requirements, in these settings, of children and adolescents infected with HIV. avaliar a qualidade de atenção à saúde da criança e adolescente vivendo com HIV, entre os diferentes tipos de serviço de Atenção Primária à Saúde, de Santa Maria, Rio Grande do Sul. estudo transversal, desenvolvido com 118 profissionais da Atenção Primária à Saúde. Utilizou-se o Instrumento de Avaliação da Atenção Primária, versão Profissionais. Para verificação das variáveis associadas ao alto escore, foi utilizada a Regressão de Poisson. os profissionais da Estratégia Saúde da Família, quando comparados aos de Unidades Básicas de Saúde, obtiveram maior grau de orientação à atenção primária, tanto pelo escore geral quanto

  16. Health-related quality of life in patients by COPD severity within primary care in Europe

    NARCIS (Netherlands)

    Jones, P. W.; Brusselle, G.; Dal Negro, R. W.; Ferrer, M.; Kardos, P.; Levy, M. L.; Perez, T.; Soler-Cataluna, J. J.; van der Molen, T.; Adamek, L.; Banik, N.

    Pan-European data on health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD) are lacking. This cross-sectional epidemiological study evaluated health status in 1817 COPD patients from an 'all-comers' primary care population in seven European countries (87% stable

  17. Assessment of the Quality of Electronic Administrative Services in a Greek Higher Education Institution: ? Case Study

    Science.gov (United States)

    Papanthymou, Anastasia; Darra, Maria

    2018-01-01

    The basic aim of this paper is to investigate the perceptions, attitudes and experiences of the students of the Department of Primary Education of University of the Aegean about the quality of the provided services to them by the Secretariat of Administrative Electronic Services. The survey was conducted during the second semester of the academic…

  18. Quality of Higher Education: Organisational or Educational? A Content Analysis of Chinese University Self-Evaluation Reports

    Science.gov (United States)

    Zou, Yihuan; Du, Xiangyun; Rasmussen, Palle

    2012-01-01

    Based on a study of Chinese university self-evaluation reports, this paper argues that higher education institutions are trying to manage the tensions between educational and organisational quality and the increasing and worldwide concerns about quality assurance. After 30 years of dramatic educational reform, China has established a nationwide…

  19. Framing and Enhancing Distributed Leadership in the Quality Management of Online Learning Environments in Higher Education

    Science.gov (United States)

    Holt, Dale; Palmer, Stuart; Gosper, Maree; Sankey, Michael; Allan, Garry

    2014-01-01

    This article reports on the findings of senior leadership interviews in a nationally funded project on distributed leadership in the quality management of online learning environments (OLEs) in higher education. Questions were framed around the development of an OLE quality management framework and the situation of the characteristics of…

  20. Effect of a tailor-made continuous medical education program for primary care physicians on self-perception of physicians' roles and quality of care.

    Science.gov (United States)

    Twig, Gilad; Lahad, Amnon; Kochba, Ilan; Ezra, Vered; Mandel, Dror; Shina, Avi; Kreiss, Yitshak; Zimlichman, Eyal

    2010-09-01

    A survey conducted among Israel Defense Force primary care physicians in 2001 revealed that they consider patients' needs more than they do organizational needs and that the education PCPs currently receive is inadequate. In 2003 the medical corps initiated a multi-format continuous medical education program aimed at improving skills in primary care medicine. To measure and analyze the effect of the tailor-made CME program on PCPs' self-perception 3 years after its implementation and correlate it to clinical performance. In 2006 a questionnaire was delivered to a representative sample of PCPs in the IDF. The questionnaire included items on demographic and professional background, statements on self-perception issues, and ranking of roles. We compared the follow-up survey (2006) to the results of the original study (2001) and correlated the survey results with clinical performance as measured through objective indicators. In the 2006 follow-up survey PCPs scored higher on questions dealing with their perception of themselves as case managers (3.8 compared to 4.0 on the 2001 survey on a 5 point scale, P = 0.046), perceived quality of care and education (3.5 vs. 3.8, P = 0.06), and on questions dealing with organizational commitment (3.5 vs. 3.8, P = 0.01). PCPs received higher scores on clinical indicators in the later study (odds ratio 2.05, P < 0.001). PCPs in the IDF perceived themselves more as case managers as compared to the 2001 survey. A tailor-made CME program may have contributed to the improvement in skills and quality of care.

  1. Quality Of Life And Prevalence Of Burnout Syndrome In Higher Education Teachers

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Campos

    2017-09-01

    Full Text Available Introduction: Burnout Syndrome, in the twenty-first century, appears among the most common mental disorder among teachers resulting from the interaction between  individual aspects and the working environment, interpreted as a response to chronic job stress.  Objective: To evaluate the prevalence of burnout syndrome and quality of life of higher education teachers in the city of Cajazeiras, Paraíba, Brazil.  Method: This is a descriptive cross-sectional study performed with 174 teachers from institutions of higher education.  Results: The burnout syndrome was observed in only 3.4% of teachers. However, the recorded data require a closer look at the health of the teachers investigated, since a considerable part of them are in the score limit for disease development. Regarding the quality of life of teachers who presented the manifestations of the syndrome, the physical and psychological domains were shown to be the worst for most subjects.  Conclusion: There are teachers in higher education, executing their  profession, affected by burnout syndrome, suggesting a  relationship between this psychosocial phenomenon and the labor context, permeating  the three dimensions proposed by Maslach and Leiter: emotional exhaustion, depersonalization and the lack of personal fulfillment.   DOI: https://doi.org/10.3823/2512

  2. Appreciative Inquiry for quality improvement in primary care practices.

    Science.gov (United States)

    Ruhe, Mary C; Bobiak, Sarah N; Litaker, David; Carter, Caroline A; Wu, Laura; Schroeder, Casey; Zyzanski, Stephen J; Weyer, Sharon M; Werner, James J; Fry, Ronald E; Stange, Kurt C

    2011-01-01

    To test the effect of an Appreciative Inquiry (AI) quality improvement strategy on clinical quality management and practice development outcomes. Appreciative inquiry enables the discovery of shared motivations, envisioning a transformed future, and learning around the implementation of a change process. Thirty diverse primary care practices were randomly assigned to receive an AI-based intervention focused on a practice-chosen topic and on improving preventive service delivery (PSD) rates. Medical-record review assessed change in PSD rates. Ethnographic field notes and observational checklist analysis used editing and immersion/crystallization methods to identify factors affecting intervention implementation and practice development outcomes. The PSD rates did not change. Field note analysis suggested that the intervention elicited core motivations, facilitated development of a shared vision, defined change objectives, and fostered respectful interactions. Practices most likely to implement the intervention or develop new practice capacities exhibited 1 or more of the following: support from key leader(s), a sense of urgency for change, a mission focused on serving patients, health care system and practice flexibility, and a history of constructive practice change. An AI approach and enabling practice conditions can lead to intervention implementation and practice development by connecting individual and practice strengths and motivations to the change objective.

  3. ENQA: 10 Years (2000-2010): A Decade of European Co-Operation in Quality Assurance in Higher Education

    Science.gov (United States)

    Crozier, Fiona, Ed.; Costes, Nathalie, Ed.; Ranne, Paula, Ed.; Stalter, Maria, Ed.

    2010-01-01

    The history of ENQA (European Association for Quality Assurance in Higher Education) arises in the late 1990s when the first formal procedures for quality assurance begun to stabilize on a national level. As a result of the European Pilot Projects in the field of external quality assurance during the nineties, participants felt the need for…

  4. Influence of educational process in the higher pedagogical school for the development of the professional mobility of the future primary school teachers

    Directory of Open Access Journals (Sweden)

    Oxana Kilichenko

    2018-01-01

    Full Text Available The article describes the particular features of the organization of educational process in order to develop professional mobility of future primary school teachers. The terms and criteria for the definition of "professional mobility of teachers" are analyzed. The main states of the problem of the organization of the educational process in the higher pedagogical school to develop mobile professional are determined. Keywords: professional mobility of primary school teachers, the criteria for determining, the educational process in the higher pedagogical school.

  5. Total Quality Management Elements and Results in Higher Education Institutions: The Greek Case

    Science.gov (United States)

    Psomas, Evangelos; Antony, Jiju

    2017-01-01

    Purpose: The purpose of this paper is to determine the main total quality management (TQM) elements adopted and the respective results achieved by higher education institutions (HEIs) in Greece. Design/methodology/approach: A research study was designed and carried out in private sector Greek HEIs. Fifteen HEIs were approached through interviews…

  6. Army Programs: Army Finance and Accounting Quality Assurance Program

    National Research Council Canada - National Science Library

    1988-01-01

    This regulation discusses the primary responsibilities of commanders and staff officers at installation and higher levels for execution of the Army Finance and Accounting Quality Assurance (QA) Program...

  7. Virtual Patient Technology: Engaging Primary Care in Quality Improvement Innovations.

    Science.gov (United States)

    Blok, Amanda C; May, Christine N; Sadasivam, Rajani S; Houston, Thomas K

    2017-02-15

    Engaging health care staff in new quality improvement programs is challenging. We developed 2 virtual patient (VP) avatars in the context of a clinic-level quality improvement program. We sought to determine differences in preferences for VPs and the perceived influence of interacting with the VP on clinical staff engagement with the quality improvement program. Using a participatory design approach, we developed an older male smoker VP and a younger female smoker VP. The older male smoker was described as a patient with cardiovascular disease and was ethnically ambiguous. The female patient was younger and was worried about the impact of smoking on her pregnancy. Clinical staff were allowed to choose the VP they preferred, and the more they engaged with the VP, the more likely the VP was to quit smoking and become healthier. We deployed the VP within the context of a quality improvement program designed to encourage clinical staff to refer their patients who smoke to a patient-centered Web-assisted tobacco intervention. To evaluate the VPs, we used quantitative analyses using multivariate models of provider and practice characteristics and VP characteristic preference and analyses of a brief survey of positive deviants (clinical staff in practices with high rates of encouraging patients to use the quit smoking innovation). A total of 146 clinical staff from 76 primary care practices interacted with the VPs. Clinic staff included medical providers (35/146, 24.0%), nurse professionals (19/146, 13.0%), primary care technicians (5/146, 3.4%), managerial staff (67/146, 45.9%), and receptionists (20/146, 13.7%). Medical staff were mostly male, and other roles were mostly female. Medical providers (OR 0.031; CI 0.003-0.281; P=.002) and younger staff (OR 0.411; CI 0.177-0.952; P=.038) were less likely to choose the younger, female VP when controlling for all other characteristics. VP preference did not influence online patient referrals by staff. In high

  8. The Methodological Approaches to Formation of the Internal System of Quality of Education of Higher Education Institution

    Directory of Open Access Journals (Sweden)

    Doronin Stepan A.

    2017-12-01

    Full Text Available The necessity of creation of a national conception of formation of the internal system of quality assurance of higher education institutions with obligatory introduction of methodological approach in its structure is substantiated; the variant of its terminological provision with clarification of the content of concepts of «quality of education», «internal system of quality of education», «methodological approach» is proposed; positioning of the approach in the system of other standard scientific instruments (method, methodology, program, algorithm is done; arguments for the orientation of the methodology of formation of the internal system of quality assurance of higher education institutions towards the socio-cultural model of paradigm are provided; a hierarchical classification of methodological approaches with allocation of the philosophical, scientific, concrete-scientific, technological levels and the characteristics of their purpose and contents is presented.

  9. Teacher Salaries and the Shortage of High-Quality Teachers in China's Rural Primary and Secondary Schools

    Science.gov (United States)

    Xuehui, An

    2018-01-01

    Teacher salary level and structure are not only important factors affecting the supply of primary and secondary school teachers, but they are also crucial to attracting, training, and retaining high-quality teachers, thereby impacting the overall quality of education and teaching in schools. The reform of China's basic education management system…

  10. Effects of primary care team social networks on quality of care and costs for patients with cardiovascular disease.

    Science.gov (United States)

    Mundt, Marlon P; Gilchrist, Valerie J; Fleming, Michael F; Zakletskaia, Larissa I; Tuan, Wen-Jan; Beasley, John W

    2015-03-01

    Cardiovascular disease is the leading cause of mortality and morbidity in the United States. Primary care teams can be best suited to improve quality of care and lower costs for patients with cardiovascular disease. This study evaluates the associations between primary care team communication, interaction, and coordination (ie, social networks); quality of care; and costs for patients with cardiovascular disease. Using a sociometric survey, 155 health professionals from 31 teams at 6 primary care clinics identified with whom they interact daily about patient care. Social network analysis calculated variables of density and centralization representing team interaction structures. Three-level hierarchical modeling evaluated the link between team network density, centralization, and number of patients with a diagnosis of cardiovascular disease for controlled blood pressure and cholesterol, counts of urgent care visits, emergency department visits, hospital days, and medical care costs in the previous 12 months. Teams with dense interactions among all team members were associated with fewer hospital days (rate ratio [RR] = 0.62; 95% CI, 0.50-0.77) and lower medical care costs (-$556; 95% CI, -$781 to -$331) for patients with cardiovascular disease. Conversely, teams with interactions revolving around a few central individuals were associated with increased hospital days (RR = 1.45; 95% CI, 1.09-1.94) and greater costs ($506; 95% CI, $202-$810). Team-shared vision about goals and expectations mediated the relationship between social network structures and patient quality of care outcomes. Primary care teams that are more interconnected and less centralized and that have a shared team vision are better positioned to deliver high-quality cardiovascular disease care at a lower cost. © 2015 Annals of Family Medicine, Inc.

  11. A reassessment of the indicators of primary education quality in developing countries: Emerging evidence from Tanzania

    Science.gov (United States)

    Mosha, Herme Joseph

    1988-03-01

    This article seeks to identify factors affecting the quality of primary education in five regions of Tanzania by extensively reviewing relevant literature and empirical data. Some of the shortcomings emphasised by the author are: frequent staff turnover, declining financial support for primary education, ineffective curricula, shortage of teachers' guides and textbooks, and unfavourable working conditions for teachers in rural areas. Beyond this, the need for freely available material, efficient school management and regular inspections is stressed by the author.

  12. Improving the quality of nurse clinical documentation for chronic patients at primary care clinics: A multifaceted intervention

    Directory of Open Access Journals (Sweden)

    Ozayr H. Mahomed

    2015-09-01

    Full Text Available Background: Deficiencies in record keeping practices have been reported at primary care level in the public health sector in South Africa. These deficiencies have the potential to negatively impact patient health outcomes as the break in information may hinder continuity of care. This disruption in information management has particular relevance for patients with chronic diseases. Objectives: The aim of this study was to establish if the implementation of a structured clinical record (SCR as an adjunct tool to the algorithmic guidelines for chronic disease management improved the quality of clinical records at primary care level. Method: A quasi-experimental study (before and after study with a comparison group was conducted across 30 primary health care clinics (PHCs located in three districts in South Africa. Twenty PHCs that received the intervention were selected as intervention clinics and 10 facilities were selected as comparison facilities. The lot quality assurance sampling (LQAS method was used to determine the number of records required to be reviewed per diagnostic condition per facility. Results: There was a a statistically significant increase in the percentage of clinical records achieving compliance to the minimum criteria from the baseline to six months post-intervention for both HIV patients on antiretroviral treatment and patients with non-communicable diseases (hypertension and diabetes. Conclusions: A multifaceted intervention using a SCR to supplement the educational outreach component (PC 101 training has demonstrated the potential for improving the quality of clinical records for patients with chronic diseases at primary care clinics in South Africa.

  13. Pedagogical Renewal for Quality Universal Primary Education: Overview of Trends in Sub-Saharan Africa

    Science.gov (United States)

    Dembele, Martial; Lefoka, Pulane

    2007-01-01

    This article assumes that pedagogical renewal and teacher development are two sides of the same coin, and that the achievement of a universal primary education that is equitable and of acceptable quality in Sub-Saharan Africa will depend to a large extent on both. The need for pedagogical renewal stems from the evidence that (i) teaching is…

  14. SERVQUAL Application and Adaptation for Educational Service Quality Assessments in Russian Higher Education

    Science.gov (United States)

    Galeeva, Railya B.

    2016-01-01

    Purpose: The purpose of this study is to demonstrate an adaptation of the SERVQUAL survey method for measuring the quality of higher educational services in a Russian university context. We use a new analysis and a graphical technique for presentation of results. Design/methodology/approach: The methodology of this research follows the classic…

  15. The impact of ethics and work-related factors on nurse practitioners' and physician assistants' views on quality of primary healthcare in the United States.

    Science.gov (United States)

    Ulrich, Connie M; Zhou, Qiuping Pearl; Hanlon, Alexandra; Danis, Marion; Grady, Christine

    2014-08-01

    Nurse practitioners (NPs) and physician assistants (PAs) provide primary care services for many American patients. Ethical knowledge is foundational to resolving challenging practice issues, yet little is known about the importance of ethics and work-related factors in the delivery of quality care. The aim of this study was to quantitatively assess whether the quality of the care that practitioners deliver is influenced by ethics and work-related factors. This paper is a secondary data analysis of a cross-sectional self-administered mailed survey of 1,371 primary care NPs and PAs randomly selected from primary care and primary care subspecialties in the United States. Ethics preparedness and confidence were significantly associated with perceived quality of care (pfactors. Investing in ethics education and addressing restrictive practice environments may improve collaborative practice, teamwork, and quality of care. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Cognition, depression, fatigue, and quality of life in primary Sj?gren's syndrome: correlations

    OpenAIRE

    Ko?er, Belgin; Tezcan, Mehmet Engin; Batur, Hale Zeynep; Haznedaro?lu, ?eminur; G?ker, Berna; ?rke?, Ceyla; ?etinkaya, R?meysa

    2016-01-01

    Abstract Objective The aim of the present study was to investigate the prevalence and pattern of cognitive dysfunction observed in primary Sj?gren's syndrome (PSS) and to examine the relationships between cognitive abilities, depression, fatigue, and quality of life. Materials and Methods Thirty?two subjects with PSS were compared with 19 healthy controls on comprehensive neuropsychological, depression, fatigue, health state, and daily?life activities tests. Results There was low performance ...

  17. Quality of after-hours primary care in the Netherlands: a narrative review.

    Science.gov (United States)

    Giesen, Paul; Smits, Marleen; Huibers, Linda; Grol, Richard; Wensing, Michel

    2011-07-19

    Many Western countries are seeking an organizational model for after-hours primary care that is safe, efficient, and satisfactory for patients and health care professionals. Around the year 2000, Dutch primary care physicians (PCPs) reorganized their after-hours primary care and shifted from small rotation groups to large-scale PCP cooperatives. This article provides a narrative review of studies on a range of issues about after-hours primary care in the Netherlands, including experiences of health care professionals and patients, patient-safety incidents, adherence to practice guidelines, waiting times, and quality of telephone triage. Physicians expressed high satisfaction with PCP cooperatives; their workload decreased, and job satisfaction increased compared with the situation before the reorganization. In general, patients were also satisfied, but areas for improvement included telephone consultations, patient education, and distance to a pharmacy. A study identified patient-safety incidents in 2.4% of all contacts, of which most did not result in harm to patients. The average adherence to clinical guidelines by physicians was 77%, with lowest adherence scores for prescribing antibiotics and treatment in emergency cases. The average waiting time for home visits was 30 minutes. Seventy percent of patients with life-threatening problems were visited within the time target of 15 minutes. Telephone triage by nurses had positive effects on care efficiency by increasing the proportion of telephone consultations and decreasing the proportion of clinic consultations and home visits. The after-hours primary care system in the Netherlands might set an example for other countries struggling to find a good solution for the problems they encounter with after-hours primary care. Future developments in the Netherlands include integration and extensive collaboration with the accident and emergency departments of hospitals, in which PCPs take care of self-referring patients.

  18. [Quality and compliance with Clinical Practice Guidelines of Chronic Noncommunicable Diseases in primary care].

    Science.gov (United States)

    Poblano-Verástegui, Ofelia; Vieyra-Romero, Waldo I; Galván-García, Ángel F; Fernández-Elorriaga, María; Rodríguez-Martínez, Antonia I; Saturno-Hernández, Pedro J

    2017-01-01

    To assess the quality and compliance of clinical practice guidelines (CPG) applicable to chronic non-communicable diseases (CNCD) in primary healthcare (CS), and views of staff on the barriers, facilitators and their use. 18 valued CPG with AGREEII, 3 are selected to develop indicators and assess compliance using lot quality acceptance sample (LQAS, standard 75 / 95% threshold 40 / 75% respectively, α:0. 05, β:0. 10) on 5 CS. 70 professionals surveyed about knowledge and use of CPG. Average quality of the CPG was 57.2%; low rating in domains: "Applicability" (<25%), "Stakeholder involvement" (43.5%) and "Rigour of development" (55.0%). Compliance in CS ranges from 39 to 53.4%. Professionals show uneven knowledge of CPG; 44 to 45% (according to CPG), they declare that they are not used, they identify as main barriers the lack of training, and their difficult accessibility and management. The quality and implementation of evaluated CPG is deficient constituting an opportunity of improvement in health services.

  19. Attributes of patient-centered primary care associated with the public perception of good healthcare quality in Brazil, Colombia, Mexico and El Salvador.

    Science.gov (United States)

    Doubova, Svetlana V; Guanais, Frederico C; Pérez-Cuevas, Ricardo; Canning, David; Macinko, James; Reich, Michael R

    2016-09-01

    This study evaluated primary care attributes of patient-centered care associated with the public perception of good quality in Brazil, Colombia, Mexico and El Salvador. We conducted a secondary data analysis of a Latin American survey on public perceptions and experiences with healthcare systems. The primary care attributes examined were access, coordination, provider-patient communication, provision of health-related information and emotional support. A double-weighted multiple Poisson regression with robust variance model was performed. The study included between 1500 and 1503 adults in each country. The results identified four significant gaps in the provision of primary care: not all respondents had a regular place of care or a regular primary care doctor (Brazil 35.7%, Colombia 28.4%, Mexico 22% and El Salvador 45.4%). The communication with the primary care clinic was difficult (Brazil 44.2%, Colombia 41.3%, Mexico 45.1% and El Salvador 56.7%). There was a lack of coordination of care (Brazil 78.4%, Colombia 52.3%, Mexico 48% and El Salvador 55.9%). Also, there was a lack of information about healthy diet (Brazil 21.7%, Colombia 32.9%, Mexico 16.9% and El Salvador 20.8%). The public's perception of good quality was variable (Brazil 67%, Colombia 71.1%, Mexico 79.6% and El Salvador 79.5%). The primary care attributes associated with the perception of good quality were a primary care provider 'who knows relevant information about a patient's medical history', 'solves most of the health problems', 'spends enough time with the patient', 'coordinates healthcare' and a 'primary care clinic that is easy to communicate with'. In conclusion, the public has a positive perception of the quality of primary care, although it has unfulfilled expectations; further efforts are necessary to improve the provision of patient-centered primary care services in these four Latin American countries. © The Author 2016. Published by Oxford University Press. All rights reserved. For

  20. Unfreezing Higher Education Institutions? Understanding the Introduction of Quality Management in Teaching and Learning in Germany

    Science.gov (United States)

    Seyfried, Markus; Ansmann, Moritz

    2018-01-01

    Quality management (QM) in teaching and learning has strongly "infected" the higher education sector and spread around the world. It has almost everywhere become an integral part of higher education reforms. While existing research on QM mainly focuses on the national level from a macro-perspective, its introduction at the institutional…

  1. Clinical Evaluation of Quality of Obturation and Instrumentation Time using Two Modified Rotary File Systems with Manual Instrumentation in Primary Teeth.

    Science.gov (United States)

    Govindaraju, Lavanya; Jeevanandan, Ganesh; Subramanian, Emg

    2017-09-01

    Pulp therapy in primary teeth has been performed using various instrumentation techniques. However, the conventional instrumentation technique used for root canal preparation in primary teeth is hand instrumentation. Various Nickel-Titanium (Ni-Ti) instruments are available to perform efficient root canal preparation in primary teeth. These Ni-Ti instruments has been designed to aid in better root canal preparation in permanent teeth but are rarely used in primary teeth. It is necessary to assess the feasibility of using these adult rotary files with a modified sequence in primary teeth. To compare the quality of obturation and instrumentation time during root canal preparation using hand files and modified rotary file systems in primary molars. Forty-five primary mandibular molars were randomly assigned to three experimental groups (n=15). Group I was instrumented using k-hand files, Group II with S2 ProTaper universal file and Group III with 0.25 tip 4% taper K3 rotary file. Standardized digital radiographs were taken before and after root canal instrumentation. Root canal preparation time was also recorded. Statistical analysis of the obtained data was done using SPSS Software version 17.0. An intergroup comparison of the instrumentation time and the quality of obturation was done using ANOVA and Chi-square test with the level of significance set at 0.05. No significant differences were noted with regard to the quality of obturation (p=0.791). However, a statistically significant difference was noted in the instrumentation time between the three groups (pProTaper rotary system had significantly lesser instrumentation time when compared to that of K3 rotary system and hand file system. The hand files, S2 ProTaper Universal and K3 0.25 tip 4% taper files systems performed similarly with respect to the quality of obturation. There was a significant difference in instrumentation time with manual instrumentation compared to the modified rotary file systems in primary

  2. Quality Research in Higher Education Institutions in Oman: Some Views of Teacher Researchers

    Directory of Open Access Journals (Sweden)

    Ahmed Ali Saleh Al Ajmi

    2015-06-01

    Full Text Available Academic research remains a prime source of knowledge and innovation for higher education institutions (HEIs that strive to grow, expand and develop their academic reputations and standards. Yet, research informs teaching practices, shapes social changes and it has financial outcomes for HEIs. Therefore, it is imperative to develop institutional policies and strategies for promoting and sustaining quality research in HEIs in Oman. There are a number of international frameworks and models which have been developed to measure research quality in HEIs around the world. For example, bibliometrics were used to assess research quality in HEIs in the UK because bibliometric data can provide a number of component variables. An appropriate bibliometric model may include components such as output volume, diversity of outputs, citation volume, journal impact factor and average citations per publication, etc. Moreover, other popular examples of models for assessing research quality are Multidimensional Research Assessment Matrix (MRAM used in Europe and the UK’s Research Assessment Exercise (RAE. However, neither of the above mentioned models is adopted by HEIs in Oman. Thus, the current study is an attempt to explore some institutional, international, logistic and pragmatic factors that impact academic research and publication quality, review popular international research quality assessment models and explore the possibility of applying them in the Omani context. To achieve the study objectives, 20 teacher researchers were surveyed and the findings and recommendations were presented. Keywords: Quality Research, HEIs in Oman, International Models, Factors, Teacher Researchers' Views

  3. Interobserver agreement between primary graders and an expert grader in the Bristol and Weston diabetic retinopathy screening programme: a quality assurance audit.

    Science.gov (United States)

    Patra, S; Gomm, E M W; Macipe, M; Bailey, C

    2009-08-01

    To assess the quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and to set standards for future interobserver agreement reports. A prospective audit of 213 image sets from six fully trained primary graders in the Bristol and Weston diabetic retinopathy screening programme was carried out over a 4-week period. All the images graded by the primary graders were regraded by an expert grader blinded to the primary grading results and the identity of the primary grader. The interobserver agreement between primary graders and the blinded expert grader and the corresponding Kappa coefficient was determined for overall grading, referable, non-referable and ungradable disease. The audit standard was set at 80% for interobserver agreement with a Kappa coefficient of 0.7. The interobserver agreement bettered the audit standard of 80% in all the categories. The Kappa coefficient was substantial (0.7) for the overall grading results and ranged from moderate to substantial (0.59-0.65) for referable, non-referable and ungradable disease categories. The main recommendation of the audit was to provide refresher training for the primary graders with focus on ungradable disease. The audit demonstrated an acceptable level of quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and provided a standard against which future interobserver agreement can be measured for quality assurance within a screening programme. Diabet. Med. 26, 820-823 (2009).

  4. Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews.

    Science.gov (United States)

    Rethlefsen, Melissa L; Farrell, Ann M; Osterhaus Trzasko, Leah C; Brigham, Tara J

    2015-06-01

    To determine whether librarian and information specialist authorship was associated with better reported systematic review (SR) search quality. SRs from high-impact general internal medicine journals were reviewed for search quality characteristics and reporting quality by independent reviewers using three instruments, including a checklist of Institute of Medicine Recommended Standards for the Search Process and a scored modification of the Peer Review of Electronic Search Strategies instrument. The level of librarian and information specialist participation was significantly associated with search reproducibility from reported search strategies (Χ(2) = 23.5; P Librarian co-authored SRs had significantly higher odds of meeting 8 of 13 analyzed search standards than those with no librarian participation and six more than those with mentioned librarian participation. One-way ANOVA showed that differences in total search quality scores between all three groups were statistically significant (F2,267 = 10.1233; P librarian or information specialist co-authors are correlated with significantly higher quality reported search strategies. To minimize bias in SRs, authors and editors could encourage librarian engagement in SRs including authorship as a potential way to help improve documentation of the search strategy. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Review of the Research Literature on Defining and Demonstrating Quality Teaching and Impact in Higher Education

    Science.gov (United States)

    Strang, Lucy; Bélanger, Julie; Manville, Catriona; Meads, Catherine

    2016-01-01

    In March 2016, the Higher Education Academy (HEA) commissioned RAND Europe to conduct a literature review of research published since 2012, with the aim of identifying and summarising the key trends and issues in the literature on how "quality teaching" and its impact are currently being defined and demonstrated at higher education…

  6. a System Dynamics Model to Study the Importance of Infrastructure Facilities on Quality of Primary Education System in Developing Countries

    Science.gov (United States)

    Pedamallu, Chandra Sekhar; Ozdamar, Linet; Weber, Gerhard-Wilhelm; Kropat, Erik

    2010-06-01

    The system dynamics approach is a holistic way of solving problems in real-time scenarios. This is a powerful methodology and computer simulation modeling technique for framing, analyzing, and discussing complex issues and problems. System dynamics modeling and simulation is often the background of a systemic thinking approach and has become a management and organizational development paradigm. This paper proposes a system dynamics approach for study the importance of infrastructure facilities on quality of primary education system in developing nations. The model is proposed to be built using the Cross Impact Analysis (CIA) method of relating entities and attributes relevant to the primary education system in any given community. We offer a survey to build the cross-impact correlation matrix and, hence, to better understand the primary education system and importance of infrastructural facilities on quality of primary education. The resulting model enables us to predict the effects of infrastructural facilities on the access of primary education by the community. This may support policy makers to take more effective actions in campaigns.

  7. Effects of physiologic testosterone therapy on quality of life, self-esteem, and mood in women with primary ovarian insufficiency.

    Science.gov (United States)

    Guerrieri, Gioia M; Martinez, Pedro E; Klug, Summer P; Haq, Nazli A; Vanderhoof, Vien H; Koziol, Deloris E; Popat, Vaishali B; Kalantaridou, Sophia N; Calis, Karim A; Rubinow, David R; Schmidt, Peter J; Nelson, Lawrence M

    2014-09-01

    Women with primary ovarian insufficiency (POI) display low androgen levels, which could contribute to mood and behavioral symptoms observed in this condition. We examined the effects of physiologic testosterone therapy added to standard estrogen/progestin therapy on quality of life, self-esteem, and mood in women with POI. One hundred twenty-eight women with 46,XX spontaneous POI participated in a 12-month randomized, placebo-controlled, parallel-design investigation of the efficacy of testosterone augmentation of estrogen/progestin therapy. Quality of life, self-esteem, and mood symptoms were evaluated with standardized rating scales and a structured clinical interview. Differences in outcome measures between the testosterone and placebo treatments were analyzed by Wilcoxon rank sum tests. No differences in baseline characteristics, including serum hormone levels (P > 0.05), were found. Baseline mean (SD) Center for Epidemiologic Studies Depression Scale scores were 10.7 (8.6) and 9.2 (7.8) for testosterone and placebo, respectively (P = 0.35). After 12 months of treatment, measures of quality of life, self-esteem, and mood symptoms did not differ between treatment groups. Serum testosterone levels achieved physiologic levels in the testosterone group and were significantly higher compared with placebo (P self-esteem and had minimal effects on mood. Other mechanisms might play a role in the altered mood accompanying this disorder.

  8. Addressing the challenges of improving primary care quality in Uzbekistan: a qualitative study of chronic heart failure management.

    Science.gov (United States)

    Ahmedov, Mohir; Green, Judith; Azimov, Ravshan; Avezova, Guloyim; Inakov, Sherzod; Mamatkulov, Bahrom

    2013-08-01

    Uzbekistan has a well-developed primary care system, with universal access to care, but faces challenges in improving the quality of clinical care provided. This study aimed to identify barriers to quality improvement by focusing on one common condition, Chronic Heart Failure (CHF), for which there are evidence-based international guidelines for management. To identify the challenges to improving the quality of care for CHF in line with such guidelines we took a qualitative approach, interviewing 15 physicians and 30 patients in detail about their experiences of CHF management. Despite recent improvements to the training of primary care physicians, their access to up-to-date information was limited, and they were disproportionately reliant on information from pharmaceutical companies. The main barriers to implementing international standards of care were: reluctance of physicians (and patients) to abandon ineffective interventions; enduring, system-wide incentives for clinically unnecessary hospitalization; and the lack of structural support for evidence-based health services improvement. Patients were in general positive about adherence to medications, but faced some problems in affording drugs and hospital care. Future interventions to strengthen primary care should be implemented with evaluations of their impact on the processes and outcomes of care for chronic conditions.

  9. Determinants of Quality of Life in Primary Care Patients with Diabetes: Implications for Social Workers

    Science.gov (United States)

    Ayalon, Liat; Gross, Revital; Tabenkin, Hava; Porath, Avi; Heymann, Anthony; Porter, Boaz

    2008-01-01

    Using a cross-sectional design of 400 primary care patients with diabetes, the authors evaluated demographics, health status, subjective health and mental health, health behaviors, health beliefs, knowledge of diabetes treatment, satisfaction with medical care, and quality of medical care as potential predictors of QoL and QoL in the hypothetical…

  10. PERCEIVED SERVICE QUALITY AND STUDENTS' SATISFACTION IN HIGHER EDUCATION: THE INFLUENCE OF TEACHING METHODS

    Directory of Open Access Journals (Sweden)

    Eugenia Pedro

    2018-03-01

    Full Text Available The main aim of this research was to study the relationship between perceived quality (PQ and satisfaction in Higher education, and especially to identify if these variables could differ between groups of students exposed to different teaching methods. A quantitative study was conducted at a Portuguese Faculty of Health Sciences, through a survey applied to a final sample of 359 students. Data analysis was performed through a structural equation model, using, for this purpose, the PLS method. Results confirm that PQ is positively related to students' satisfaction in the Higher Education Institutions (HEI context, and that PQ and satisfaction are significantly different when students are exposed to different teaching approaches. Although there is a substantial body of evidence regarding teaching methods in HEI, to our knowledge there is no reliable prior study that explicitly approached the influence of alternative teaching methods on students' satisfaction and their perception of service quality.

  11. Social Anxiety and Friendship Quality over Time.

    Science.gov (United States)

    Rodebaugh, Thomas L; Lim, Michelle H; Shumaker, Erik A; Levinson, Cheri A; Thompson, Tess

    2015-01-01

    High social anxiety in adults is associated with self-report of impaired friendship quality, but not necessarily with impairment reported by friends. Further, prospective prediction of social anxiety and friendship quality over time has not been tested among adults. We therefore examined friendship quality and social anxiety prospectively in 126 young adults (67 primary participants and 59 friends, aged 17-22 years); the primary participants were screened to be extreme groups to increase power and relevance to clinical samples (i.e., they were recruited based on having very high or very low social interaction anxiety). The prospective relationships between friendship quality and social anxiety were then tested using an Actor-Partner Interdependence Model. Friendship quality prospectively predicted social anxiety over time within each individual in the friendship, such that higher friendship quality at Time 1 predicted lower social anxiety approximately 6 months later at Time 2. Social anxiety did not predict friendship quality. Although the results support the view that social anxiety and friendship quality have an important causal relationship, the results run counter to the assumption that high social anxiety causes poor friendship quality. Interventions to increase friendship quality merit further consideration.

  12. Analytical Chemistry in the European Higher Education Area European Higher Education

    DEFF Research Database (Denmark)

    the more specialized degree of the Euromaster. The aim of the process, as a part of the fulfilment of the Bologna Declaration, is to propose a syllabus for education at the highest level of competence in academia. The proposal is an overarching framework that is supposed to promote mobility and quality......A Eurobachelor degree of Chemistry was endorsed by the EuCheMS division of analytical chemistry in 2004, and it has since then been adopted by many European universities. In the second stage of the European Higher Education Area (EHEA) process of harmonization, there is now focus on developing...... hold positions where analytical chemistry is the primary occupation. The education within the EHEA offers subjects related to chemical analysis but not all universities offer courses on analytical chemistry as an independent scientific discipline. Accordingly, the recent development of the analytical...

  13. Manufacturing of High Quality Teachers for Chemistry Education at Higher Secondary Level in Current Era

    OpenAIRE

    R. Azmat

    2013-01-01

    Education is the most influential tool whose efficient use requires the power of determination, devoted work and sacrifice. As teachers are major handler of this tool therefore, they must possess qualities of high education and competency for deliver. Education extends attractive way of life, talent and manners which make an individual a fine civilian. Primary and secondary education is one of the foundation stone of development of children and country. It acts as a vital part in placing the ...

  14. Introducing quality improvement management methods into primary health care services in Uganda.

    Science.gov (United States)

    Omaswa, F; Burnham, G; Baingana, G; Mwebesa, H; Morrow, R

    1996-01-01

    Uganda's National Quality Assurance Program was established in 1994 to monitor the process of decentralization of primary health care services. Guidelines were developed to address problems (e.g., in obtaining health funds channeled through local government) identified at district meetings. Bringing together District Health Teams with local administrators and political leaders to share responsibility for strengthening health services has been a significant program achievement. A smoother functioning referral system from health units to district hospitals has resulted. The response to a measles outbreak in the Arua district in 1993-94 confirmed the utility of the quality management approach. Weaknesses in the district cold chain, problems with diagnostic accuracy, and a poorly functioning information system were identified as key causative factors, and corrective action in these areas led to a subsequent decline in measles cases. Patient dissatisfaction with long waiting times at Masaka Hospital was another concern addressed through the quality assurance approach. Five salient areas were identified for action: low health worker morale, supply shortages, inadequate supervision by hospital management, poor patient flow, and inefficient drug dispensing. As a result, long delays were eliminated and utilization of hospital outpatient services increased by 28%.

  15. Brewing Service Quality in Higher Education: Characteristics of Ingredients that Make up the Recipe

    Science.gov (United States)

    Yeo, Roland K.

    2008-01-01

    Purpose: The paper seeks to explore the influences of service quality in higher education and the perceptions associated with the implementation of a Singapore tertiary institution. It draws on the underpinnings of SERVQUAL, and discusses the dichotomy and interrelation between customer perception and expectation. Design/methodology/approach:…

  16. Comparative study of the Quality Control of x-ray tubes and generators in hospital assistance and primary assistance in Galician autonomous community

    International Nuclear Information System (INIS)

    Pombar Camean, M.; Lobato Busto, R.

    1992-01-01

    The quality guarantee in Diagnostic Radiology is defined as the organized effort of surgical staff to guarantee sufficient quality images, which provide the correct diagnostic information, as cheaply as possible and with the least exposure to radiation for the patient. In this paper a comparative study about the quality control of x-ray tube and generators in hospital assistance and primary assistance is present. In the conclusions, it is confirmed that the antiquity and poor conservation of the primary attendance x-ray equipment, have influence on the studied constants and therefore, influence the doses received by the patients. (author)

  17. Performance study of the primary standard ionization chamber for deployment of the diagnostic radiology qualities

    International Nuclear Information System (INIS)

    Cardoso, Ricardo de Souza; Bossio, Francisco; Quaresma, Daniel da Silva; Peixoto, Jose Guilherme Pereira

    2013-01-01

    Activities radiotherapy, diagnostic radiology and radiation protection, require knowledge of physical and dosimetric parameters, to be applied safely. Aiming to meet demand in Brazil, the National Laboratory of Metrology of Ionising Radiation - LNMRI - is deploying the primary standard for the calibration of secondary standard chambers, used in quality control in hospitals, clinics and industries. (author)

  18. The information system of learning quality control in higher education institutions: achievements and problems of European universities

    Directory of Open Access Journals (Sweden)

    Orekhova Elena

    2016-01-01

    Full Text Available The article deals with the main trends in the development of the system of learning quality control connected with the European integration of higher education and the democratization of education. The authors analyze the state of information systems of learning quality control existing in European higher education and identify their strong and weak points. The authors show that in the learning process universities actively use innovative analytic methods as well as modern means of collecting, storing and transferring information that ensure the successful management of such a complex object as the university of the 21st century.

  19. Physico-chemical quality of drinking water in villages of Primary Health Centre, Waghodia, Gujarat (India).

    Science.gov (United States)

    Desai, Gaurav; Vasisth, Smriti; Patel, Maharshi; Mehta, Vaibhav; Bhavsar, Bharat

    2012-07-01

    16 water samples were collected to study the physical and chemical quality of water of main source of drinking water in the villages of Primary Health Centre, Waghodia of Vadodara district of Gujarat. The values recommended by Indian Standard for Drinking Water (IS 10500:1991) were used for comparison of observed values. The study indicates that the contamination problem in these villages is not alarming at present, but Waghodia being industrial town, ground water quality may deteriorate with passage of time, which needs periodical monitoring. The study provides the local area baseline data which may be useful for the comparison of future study.

  20. Does Internal Quality Management Contribute to More Control or to Improvement of Higher Education?: A Survey on Faculty's Perceptions

    Science.gov (United States)

    Kleijnen, Jan; Dolmans, Diana; Willems, Jos; van Hout, Hans

    2011-01-01

    Purpose: The purpose of this paper is to explore faculty's perceptions of quality management activities (QMA) within their departments, attention being paid to relevant quality aspects and whether quality management contributes to control or improvement of higher education. Furthermore, it examines differences between departments and relationships…

  1. The extent, quality and impact of patient and public involvement in primary care research: a mixed methods study.

    Science.gov (United States)

    Blackburn, Steven; McLachlan, Sarah; Jowett, Sue; Kinghorn, Philip; Gill, Paramjit; Higginbottom, Adele; Rhodes, Carol; Stevenson, Fiona; Jinks, Clare

    2018-01-01

    In the UK, more patients go to primary care than other parts of the health service. Therefore it is important for research into primary care to include the insights and views of people who receive these services. To explore the extent, quality and impact of patient and public involvement (PPI) in primary care research, we examined documents of 200 projects and surveyed 191 researchers.We found that about half of studies included PPI to develop research ideas and during the study itself. Common activities included designing study materials, advising on methods, and managing the research. Some studies did not undertake the PPI activities initially planned and funded for. PPI varied by study design, health condition and study population. We found pockets of good practice: having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However, good practice was lacking in other areas. Few projects offered PPI contributors training, used PPI to develop information for participants about study progress and included PPI to advise on publishing findings.Researchers reported beneficial impacts of PPI. Most impact was reported when the approach to PPI included more indicators of good practice. The main cost of PPI for researchers was their time. Many reported difficulties providing information about PPI.In partnership with PPI contributors, we have used these findings to develop:a new Cost and Consequences Framework for PPI highlighting financial and non-financial costs, benefits and harms of PPIFifteen co-produced recommendations to improve the practice and delivery of PPI. Background: To improve the lives of patients in primary care requires the involvement of service users in primary care research. We aimed to explore the extent, quality and impact of patient and public involvement (PPI) in primary care research. Methods: We extracted information about PPI from grant applications, reports and an electronic survey of researchers of studies funded

  2. The quality of Australian Indigenous primary health care research focusing on social and emotional wellbeing: a systematic review.

    Science.gov (United States)

    Farnbach, Sara; Eades, Anne-Maree; Fernando, Jamie K; Gwynn, Josephine D; Glozier, Nick; Hackett, Maree L

    2017-10-11

    Objectives and importance of the study: Primary health care research focused on Aboriginal and Torres Strait Islander (Indigenous) people is needed to ensure that key frontline services provide evidence based and culturally appropriate care. We systematically reviewed the published primary health care literature to identify research designs, processes and outcomes, and assess the scientific quality of research focused on social and emotional wellbeing. This will inform future research to improve evidence based, culturally appropriate primary health care. Systematic review in accordance with PRISMA and MOOSE guidelines. Four databases and one Indigenous-specific project website were searched for qualitative, quantitative and mixed-method published research. Studies that were conducted in primary health care services and focused on the social and emotional wellbeing of Indigenous people were included. Scientific quality was assessed using risk-of-bias assessment tools that were modified to meet our aims. We assessed community acceptance by identifying the involvement of community governance structures and representation during research development, conduct and reporting. Data were extracted using standard forms developed for this review. We included 32 articles, which reported on 25 studies. Qualitative and mixed methods were used in 18 studies. Twelve articles were judged as high or unclear risk of bias, four as moderate and five as low risk of bias. Another four studies were not able to be assessed as they did not align with the risk-of-bias tools. Of the five articles judged as low risk of bias, two also had high community acceptance and both of these were qualitative. One used a phenomenological approach and the other combined participatory action research with a social-ecological perspective and incorporated 'two-way learning' principles. Of the 16 studies where a primary outcome was identified, eight aimed to identify perceptions or experiences. The

  3. Social Participation and Friendship Quality of Students with Special Educational Needs in Regular Greek Primary Schools

    Science.gov (United States)

    Avramidis, Elias; Avgeri, Georgia; Strogilos, Vasilis

    2018-01-01

    The study addresses the social participation of integrated students with special educational needs (SEN) in upper primary regular classes in Greece alongside their perceptions of best friend quality. Social participation was defined as consisting of four key dimensions: students' acceptance by classmates, friendships, social self-perceptions, and…

  4. The Long Road--How Evolving Institutional Governance Mechanisms Are Changing the Face of Quality in Portuguese Higher Education

    Science.gov (United States)

    Sarrico, Cláudia S.; Veiga, Amélia; Amaral, Alberto

    2013-01-01

    While a lot has been written regarding the changing management and governance arrangements in higher education, less is known about how this progression relates to quality in higher education. The purpose of this article is to describe the context of governance in Portuguese higher education institutions and how institutional governance…

  5. Mentoring Professors: A Model for Developing Quality Online Instructors and Courses in Higher Education

    Science.gov (United States)

    Barczyk, Casimir; Buckenmeyer, Janet; Feldman, Lori

    2010-01-01

    This article presents a four-stage model for mentoring faculty in higher education to deliver high quality online instruction. It provides a timeline that shows the stages of program implementation. Known as the Distance Education Mentoring Program, its major outcomes include certified instructors, student achievement, and the attainment of a…

  6. Strategies of Raising the Quality of Higher Education and Attaining Equality of Educational Opportunities

    Science.gov (United States)

    Petrovskiy, Igor V.; Agapova, Elena N.

    2016-01-01

    The aim of the research is to develop the policy and strategy recommendations to increase the quality of higher education in Russian Federation. The study examines the significance of equal educational opportunities and the influence of this factor on the educational systems of developing countries. Transformational processes in the domain of…

  7. Indicators for continuous quality improvement for otitis media in primary health care for Aboriginal and Torres Strait Islander children.

    Science.gov (United States)

    Sibthorpe, Beverly; Agostino, Jason; Coates, Harvey; Weeks, Sharon; Lehmann, Deborah; Wood, Marianne; Lannigan, Francis; McAullay, Daniel

    2017-04-01

    Otitis media is a common, generally self-limiting childhood illness that can progress to severe disease and have lifelong sequelae, including hearing loss and developmental delays. Severe disease is disproportionately prevalent among Aboriginal and Torres Strait Islander children. Primary health care is at the frontline of appropriate prevention and treatment. Continuous quality improvement in the prevention and management of important causes of morbidity in client populations is accepted best practice in primary health care and now a requirement of Australian Government funding to services providing care for Aboriginal and Torres Strait Islander children. To date, there have been no indicators for continuous quality improvement in the prevention and management of otitis media and its sequelae in primary health care. Through an expert group consensus process, seven evidence-based indicators, potentially extractable from electronic health records, have been developed. The development process and indicators are described.

  8. Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: quantitative examination of variation between practices in recruitment, implementation and effectiveness.

    Science.gov (United States)

    Dreischulte, Tobias; Grant, Aileen; Hapca, Adrian; Guthrie, Bruce

    2018-01-05

    The cluster randomised trial of the Data-driven Quality Improvement in Primary Care (DQIP) intervention showed that education, informatics and financial incentives for general medical practices to review patients with ongoing high-risk prescribing of non-steroidal anti-inflammatory drugs and antiplatelets reduced the primary end point of high-risk prescribing by 37%, where both ongoing and new high-risk prescribing were significantly reduced. This quantitative process evaluation examined practice factors associated with (1) participation in the DQIP trial, (2) review activity (extent and nature of documented reviews) and (3) practice level effectiveness (relative reductions in the primary end point). Invited practices recruited (n=33) and not recruited (n=32) to the DQIP trial in Scotland, UK. (1) Characteristics of recruited versus non-recruited practices. Associations of (2) practice characteristics and 'adoption' (self-reported implementation work done by practices) with documented review activity and (3) of practice characteristics, DQIP adoption and review activity with effectiveness. (1) Recruited practices had lower performance in the quality and outcomes framework than those declining participation. (2) Not being an approved general practitioner training practice and higher self-reported adoption were significantly associated with higher review activity. (3) Effectiveness ranged from a relative increase in high-risk prescribing of 24.1% to a relative reduction of 77.2%. High-risk prescribing and DQIP adoption (but not documented review activity) were significantly associated with greater effectiveness in the final multivariate model, explaining 64.0% of variation in effectiveness. Intervention implementation and effectiveness of the DQIP intervention varied substantially between practices. Although the DQIP intervention primarily targeted review of ongoing high-risk prescribing, the finding that self-reported DQIP adoption was a stronger predictor of

  9. The Continuing Development of Primary Sector Physical Education: Working Together to Raise Quality of Provision

    Science.gov (United States)

    Sloan, Stephen

    2010-01-01

    This paper sets out to provide further insight as to the reasons why many schools within the primary sector continue to find it difficult to ensure quality provision for physical education (PE) and school sport. It examines why class teachers, including the subject coordinator, possess concerns about teaching PE. It asks the question of who is…

  10. Schizophrenia in Malaysian families: A study on factors associated with quality of life of primary family caregivers

    Directory of Open Access Journals (Sweden)

    Yi Eng J

    2011-06-01

    Full Text Available Abstract Background Schizophrenia is a chronic illness which brings detrimental effects in the caregivers' health. This study was aimed at highlighting the socio-demographic, clinical and psychosocial factors associated with the subjective Quality of Life (QOL of Malaysian of primary family caregivers of subjects with schizophrenia attending an urban tertiary care outpatient clinic in Malaysia. Methods A cross-sectional study was performed to study patient, caregiver and illness factors associated with the QOL among 117 individuals involved with caregiving for schizophrenia patients. The study used WHOQOL-BREF to assess caregivers' QOL and Brief Psychiatric Rating Scale (BPRS to assess the severity of patients' symptoms. Social Readjustment Rating Scale (SRRS assessed the stress level due to life events. Results The mean scores of WHOQOL-BREF in physical, psychological, social and environmental domains were 66.62 (14.36, 61.32 (15.52, 62.77 (17.33, 64.02 (14.86 consecutively. From multiple regression analysis, factors found to be significantly associated with higher QOL were higher educational level among caregivers in social and environmental domains; caregivers not having medical problem/s in physical and psychological domains; later onset and longer illness duration of illness in social domains; patients not attending day care program in environmental domain; lower BPRS score in physical and environmental domains. SRRS score of caregivers was also found to have a significant negative correlation with QOL in environmental and psychological domains. Other factors were not significantly associated with QOL. Conclusion Caregivers with more social advantages such as higher educational level and physically healthier and dealing with less severe illness had significantly higher QOL in various aspects. Supporting the caregivers in some of these modifiable factors in clinical practice is important to achieve their higher level QOL.

  11. Just-in-Time Compound Pooling Increases Primary Screening Capacity without Compromising Screening Quality.

    Science.gov (United States)

    Elkin, L L; Harden, D G; Saldanha, S; Ferguson, H; Cheney, D L; Pieniazek, S N; Maloney, D P; Zewinski, J; O'Connell, J; Banks, M

    2015-06-01

    Compound pooling, or multiplexing more than one compound per well during primary high-throughput screening (HTS), is a controversial approach with a long history of limited success. Many issues with this approach likely arise from long-term storage of library plates containing complex mixtures of compounds at high concentrations. Due to the historical difficulties with using multiplexed library plates, primary HTS often uses a one-compound-one-well approach. However, as compound collections grow, innovative strategies are required to increase the capacity of primary screening campaigns. Toward this goal, we have developed a novel compound pooling method that increases screening capacity without compromising data quality. This method circumvents issues related to the long-term storage of complex compound mixtures by using acoustic dispensing to enable "just-in-time" compound pooling directly in the assay well immediately prior to assay. Using this method, we can pool two compounds per well, effectively doubling the capacity of a primary screen. Here, we present data from pilot studies using just-in-time pooling, as well as data from a large >2-million-compound screen using this approach. These data suggest that, for many targets, this method can be used to vastly increase screening capacity without significant reduction in the ability to detect screening hits. © 2015 Society for Laboratory Automation and Screening.

  12. How does higher frequency monitoring data affect the calibration of a process-based water quality model?

    Science.gov (United States)

    Jackson-Blake, Leah; Helliwell, Rachel

    2015-04-01

    Process-based catchment water quality models are increasingly used as tools to inform land management. However, for such models to be reliable they need to be well calibrated and shown to reproduce key catchment processes. Calibration can be challenging for process-based models, which tend to be complex and highly parameterised. Calibrating a large number of parameters generally requires a large amount of monitoring data, spanning all hydrochemical conditions. However, regulatory agencies and research organisations generally only sample at a fortnightly or monthly frequency, even in well-studied catchments, often missing peak flow events. The primary aim of this study was therefore to investigate how the quality and uncertainty of model simulations produced by a process-based, semi-distributed catchment model, INCA-P (the INtegrated CAtchment model of Phosphorus dynamics), were improved by calibration to higher frequency water chemistry data. Two model calibrations were carried out for a small rural Scottish catchment: one using 18 months of daily total dissolved phosphorus (TDP) concentration data, another using a fortnightly dataset derived from the daily data. To aid comparability, calibrations were carried out automatically using the Markov Chain Monte Carlo - DiffeRential Evolution Adaptive Metropolis (MCMC-DREAM) algorithm. Calibration to daily data resulted in improved simulation of peak TDP concentrations and improved model performance statistics. Parameter-related uncertainty in simulated TDP was large when fortnightly data was used for calibration, with a 95% credible interval of 26 μg/l. This uncertainty is comparable in size to the difference between Water Framework Directive (WFD) chemical status classes, and would therefore make it difficult to use this calibration to predict shifts in WFD status. The 95% credible interval reduced markedly with the higher frequency monitoring data, to 6 μg/l. The number of parameters that could be reliably auto

  13. Michigan's fee-for-value physician incentive program reduces spending and improves quality in primary care.

    Science.gov (United States)

    Lemak, Christy Harris; Nahra, Tammie A; Cohen, Genna R; Erb, Natalie D; Paustian, Michael L; Share, David; Hirth, Richard A

    2015-04-01

    As policy makers and others seek to reduce health care cost growth while improving health care quality, one approach gaining momentum is fee-for-value reimbursement. This payment strategy maintains the traditional fee-for-service arrangement but includes quality and spending incentives. We examined Blue Cross Blue Shield of Michigan's Physician Group Incentive Program, which uses a fee-for-value approach focused on primary care physicians. We analyzed the program's impact on quality and spending from 2008 to 2011 for over three million beneficiaries in over 11,000 physician practices. Participation in the incentive program was associated with approximately 1.1 percent lower total spending for adults (5.1 percent lower for children) and the same or improved performance on eleven of fourteen quality measures over time. Our findings contribute to the growing body of evidence about the potential effectiveness of models that align payment with cost and quality performance, and they demonstrate that it is possible to transform reimbursement within a fee-for-service framework to encourage and incentivize physicians to provide high-quality care, while also reducing costs. Project HOPE—The People-to-People Health Foundation, Inc.

  14. [Appraisal of occupational stress and strain in primary and secondary school teachers].

    Science.gov (United States)

    Wang, Z; Lan, Y; Li, J; Wang, M

    2001-09-01

    This study was conducted to assess occupational stress and strain in primary and secondary school teachers. A test of occupational stress and strain was carried out by using Occupational Stress Inventory Revised Edition (OSI-R) in 1460 primary and secondary school teachers (teacher group) and 319 mental workers in non-educational area (non-teacher group as control). The results showed the level of occupational stress in role overload and physical environment in the teacher group was significantly higher than that in the non-teacher group (P < 0.05). In teacher group the level of occupational stress and strain increased with age; the occupational stress and strain in male teachers were significantly higher than those in female teachers (P < 0.01); the occupational stress and strain in secondary school teachers were significantly higher than those in primary school teachers. These results indicate: to protect and promote primary and secondary school teacher's health, particularly male teachers' health, to mitigate their work pressure and to raise the quality of education are important tasks in the area of occupational health.

  15. Educational Quality Differences in a Middle-Income Country: The Urban-Rural Gap in Malaysian Primary Schools

    Science.gov (United States)

    Othman, Mariam; Muijs, Daniel

    2013-01-01

    Shortcomings of educational quality in rural schools remain a key focus in the literature related to developing countries. This paper studies whether rural primary schools in Malaysia, an upper middle-income developing country, are still experiencing lower levels of educational resources, school climate, school leadership, and parental involvement…

  16. Higher Degree Committee Members’ Perceptions of Quality Assurance of Doctoral Education: A South African Perspective

    Directory of Open Access Journals (Sweden)

    Shan Simmonds

    2016-10-01

    Full Text Available In South Africa four key policy discourses underpin doctoral education: growth, capacity, efficiency, and quality discourses. This article contributes to the discourse on quality by engaging with quality assurance from the perspective of the decision makers and implementers of macro policy (national, meso (institutional, and micro (faculty/departmental levels. We explore the perceptions that members of higher degree committees in the field of Education have of the quality assurance of doctoral education. Our data are drawn from a national survey questionnaire completed by these respondents at all public South African institutions that offer a doctorate in Education. The insights gained reside within four categories: positionality, policy, programmes, and people (stakeholders. Thereafter, we problematised the main results using academic freedom in a mode 3 knowledge production environment as a lens, which revealed thought provoking directions for future research about doctoral education.

  17. Counting on commitment; the quality of primary care-led diabetes management in a system with minimal incentives

    Directory of Open Access Journals (Sweden)

    Mc Hugh Sheena

    2011-12-01

    Full Text Available Abstract Background The aim of the present study was to assess the performance of three primary care-led initiatives providing structured care to patients with Type 2 diabetes in Ireland, a country with minimal incentives to promote the quality of care. Methods Data, from three primary care initiatives, were available for 3010 adult patients with Type 2 diabetes. Results were benchmarked against the national guidelines for the management of Type 2 diabetes in the community and results from the National Diabetes Audit (NDA for England (2008/2009 and the Scottish Diabetes Survey (2009. Results The recording of clinical processes of care was similar to results in the UK however the recording of lifestyle factors was markedly lower. Recording of HbA1c, blood pressure and lipids exceeded 85%. Recording of retinopathy screening (71% was also comparable to England (77% and Scotland (90%. Only 63% of patients had smoking status recorded compared to 99% in Scotland while 70% had BMI recorded compared to 89% in England. A similar proportion of patients in this initiative and the UK achieved clinical targets. Thirty-five percent of patients achieved a target HbA1c of 30 kg/m2 in Ireland (50%, n = 1060 compared to Scotland (54%. Conclusions This study has demonstrated what can be achieved by proactive and interested health professionals in the absence of national infrastructure to support high quality diabetes care. The quality of primary care-led diabetes management in the three initiatives studied appears broadly consistent with results from the UK with the exception of recording lifestyle factors. The challenge facing health systems is to establish quality assurance a responsibility for all health care professionals rather than the subject of special interest for a few.

  18. Individual care plans for chronically ill patients within primary care in the Netherlands: Dissemination and associations with patient characteristics and patient-perceived quality of care.

    Science.gov (United States)

    Jansen, Daphne L; Heijmans, Monique; Rijken, Mieke

    2015-06-01

    To examine the use of individual care plans (ICPs) within primary chronic illness care in the Netherlands, and to explore the relationships between ICP use, patient characteristics, and patient-perceived quality of care. Cross-sectional study using survey data from a panel of chronically ill patients and medical registration data provided by their general practices. A sample of 1377 patients with somatic chronic disease(s) randomly selected in general practices throughout the Netherlands, supplemented with a sample of 225 COPD patients, also recruited from general practices. (i) Percentage of ICP use based on self-report by chronically ill patients, and (ii) patient-perceived quality of care as assessed using the Patient Assessment of Chronic Illness Care (PACIC). ICP use among the total generic sample was low (9%), but slightly higher (13%) among patients diagnosed with diabetes or COPD, diseases for which disease management programmes have been set up in the Netherlands. Patients with a low educational level and patients with poor(er) self-rated health were more likely to have an ICP. Compared with patients without an ICP, patients with an ICP more often reported that the care they received was patient-centred, proactive, planned, and included collaborative goal setting, problem-solving, and follow-up support. Findings reveal a discrepancy between practice and policy aspirations regarding ICP use in primary chronic illness care. More research is needed to gain insight into the effectiveness of ICPs to improve the quality of chronic illness care in various patient populations.

  19. 40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

    Science.gov (United States)

    2010-07-01

    ... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data.... Primary and Secondary Ambient Air Quality Standards for Ozone. 2.1 Data Reporting and Handling Conventions... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of...

  20. Providing high-quality care in primary care settings: how to make trade-offs.

    Science.gov (United States)

    Beaulieu, Marie-Dominique; Geneau, Robert; Del Grande, Claudio; Denis, Jean-Louis; Hudon, Eveline; Haggerty, Jeannie L; Bonin, Lucie; Duplain, Réjean; Goudreau, Johanne; Hogg, William

    2014-05-01

    To gain a deeper understanding of how primary care (PC) practices belonging to different models manage resources to provide high-quality care. Multiple-case study embedded in a cross-sectional study of a random sample of 37 practices. Three regions of Quebec. Health care professionals and staff of 5 PC practices. Five cases showing above-average results on quality-of-care indicators were purposefully selected to contrast on region, practice size, and PC model. Data were collected using an organizational questionnaire; the Team Climate Inventory, which was completed by health care professionals and staff; and 33 individual interviews. Detailed case histories were written and thematic analysis was performed. The core common feature of these practices was their ongoing effort to make trade-offs to deliver services that met their vision of high-quality care. These compromises involved the same 3 areas, but to varying degrees depending on clinic characteristics: developing a shared vision of high-quality care; aligning resource use with that vision; and balancing professional aspirations and population needs. The leadership of the physician lead was crucial. The external environment was perceived as a source of pressure and dilemmas rather than as a source of support in these matters. Irrespective of their models, PC practices' pursuit of high-quality care is based on a vision in which accessibility is a key component, balanced by appropriate management of available resources and of external environment expectations. Current PC reforms often create tensions rather than support PC practices in their pursuit of high-quality care. Copyright© the College of Family Physicians of Canada.

  1. Environmental factors associated with primary care access among urban older adults.

    Science.gov (United States)

    Ryvicker, Miriam; Gallo, William T; Fahs, Marianne C

    2012-09-01

    Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors - in particular, the primary care infrastructure - inform older adults' primary care use. Using geographic data on primary care physician supply and surveys from 1260 senior center attendees in New York City, we examined factors that facilitate and hinder primary care use for individuals living in service areas with different supply levels. Supply quartiles varied in primary care use (visit within the past 12 months), racial and socio-economic composition, and perceived neighborhood safety and social cohesion. Primary care use did not differ significantly after controlling for compositional factors. Individuals who used a community clinic or hospital outpatient department for most of their care were less likely to have had a primary care visit than those who used a private doctor's office. Stratified multivariate models showed that within the lowest-supply quartile, public transit users had a higher odds of primary care use than non-transit users. Moreover, a higher score on the perceived neighborhood social cohesion scale was associated with a higher odds of primary care use. Within the second-lowest quartile, nonwhites had a lower odds of primary care use compared to whites. Different patterns of disadvantage in primary care access exist that may be associated with - but not fully explained by - local primary care supply. In lower-supply areas, racial disparities and inadequate primary care infrastructure hinder access to care. However, accessibility and elder-friendliness of public transit, as well as efforts to improve social cohesion and support, may facilitate primary care access for individuals living in low-supply areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Readiness for the Patient-Centered Medical Home: structural capabilities of Massachusetts primary care practices.

    Science.gov (United States)

    Friedberg, Mark W; Safran, Dana G; Coltin, Kathryn L; Dresser, Marguerite; Schneider, Eric C

    2009-02-01

    The Patient-Centered Medical Home (PCMH), a popular model for primary care reorganization, includes several structural capabilities intended to enhance quality of care. The extent to which different types of primary care practices have adopted these capabilities has not been previously studied. To measure the prevalence of recommended structural capabilities among primary care practices and to determine whether prevalence varies among practices of different size (number of physicians) and administrative affiliation with networks of practices. Cross-sectional analysis. One physician chosen at random from each of 412 primary care practices in Massachusetts was surveyed about practice capabilities during 2007. Practice size and network affiliation were obtained from an existing database. Presence of 13 structural capabilities representing 4 domains relevant to quality: patient assistance and reminders, culture of quality, enhanced access, and electronic health records (EHRs). Three hundred eight (75%) physicians responded, representing practices with a median size of 4 physicians (range 2-74). Among these practices, 64% were affiliated with 1 of 9 networks. The prevalence of surveyed capabilities ranged from 24% to 88%. Larger practice size was associated with higher prevalence for 9 of the 13 capabilities spanning all 4 domains (P < 0.05). Network affiliation was associated with higher prevalence of 5 capabilities (P < 0.05) in 3 domains. Associations were not substantively altered by statistical adjustment for other practice characteristics. Larger and network-affiliated primary care practices are more likely than smaller, non-affiliated practices to have adopted several recommended capabilities. In order to achieve PCMH designation, smaller non-affiliated practices may require the greatest investments.

  3. Primary care quality and safety systems in the English National Health Service: a case study of a new type of primary care provider.

    Science.gov (United States)

    Baker, Richard; Willars, Janet; McNicol, Sarah; Dixon-Woods, Mary; McKee, Lorna

    2014-01-01

    Although the predominant model of general practice in the UK National Health Service (NHS) remains the small partnership owned and run by general practitioners (GPs), new types of provider are emerging. We sought to characterize the quality and safety systems and processes used in one large, privately owned company providing primary care through a chain of over 50 general practices in England. Senior staff with responsibility for policy on quality and safety were interviewed. We also undertook ethnographic observation in non-clinical areas and interviews with staff in three practices. A small senior executive team set policy and strategy on quality and safety, including a systematic incident reporting and investigation system and processes for disseminating learning with a strong emphasis on customer focus. Standardization of systems was possible because of the large number of practices. Policies appeared generally well implemented at practice level. However, there was some evidence of high staff turnover, particularly of GPs. This caused problems for continuity of care and challenges in inducting new GPs in the company's systems and procedures. A model of primary care delivery based on a corporate chain may be useful in standardizing policies and procedures, facilitating implementation of systems, and relieving clinical staff of administrative duties. However, the model also poses some risks, including those relating to stability. Provider forms that retain the long term, personal commitment of staff to their practices, such as federations or networks, should also be investigated; they may offer the benefits of a corporate chain combined with the greater continuity and stability of the more traditional general practice.

  4. Palliative care in the home: a scoping review of study quality, primary outcomes, and thematic component analysis.

    Science.gov (United States)

    Hofmeister, Mark; Memedovich, Ally; Dowsett, Laura E; Sevick, Laura; McCarron, Tamara; Spackman, Eldon; Stafinski, Tania; Menon, Devidas; Noseworthy, Tom; Clement, Fiona

    2018-03-07

    The aim of palliative care is to improve the quality of life of patients and families through the prevention and relief of suffering. Frequently, patients may choose to receive palliative care in the home. The objective of this paper is to summarize the quality and primary outcomes measured within the palliative care in the home literature. This will synthesize the current state of the literature and inform future work. A scoping review was completed using PRISMA guidelines. PubMed, Embase, CINAHL, Web of Science, Cochrane Library, EconLit, PsycINFO, Centre for Reviews and Dissemination, Database of Abstracts of Reviews of Effects, and National Health Service Economic Evaluation Database were searched from inception to August 2016. Inclusion criteria included: 1) care was provided in the "home of the patient" as defined by the study, 2) outcomes were reported, and 3) reported original data. Thematic component analysis was completed to categorize interventions. Fifty-three studies formed the final data set. The literature varied extensively. Five themes were identified: accessibility of healthcare, caregiver support, individualized patient centered care, multidisciplinary care provision, and quality improvement. Primary outcomes were resource use, symptom burden, quality of life, satisfaction, caregiver distress, place of death, cost analysis, or described experiences. The majority of studies were of moderate or unclear quality. There is robust literature of varying quality, assessing different components of palliative care in the home interventions, and measuring different outcomes. To be meaningful to patients, these interventions need to be consistently evaluated with outcomes that matter to patients. Future research could focus on reaching a consensus for outcomes to evaluate palliative care in the home interventions.

  5. Academics\\' perceptions of `quality in higher education\\' and quality ...

    African Journals Online (AJOL)

    academics. The article discusses various perceptions of QHE as well as the concern for quality nationally and internationally and distils out some general QP, QA, QC and QM strategies. This research was a case study. The sample consisted of 28 academics from the Faculty of Science. Data were gathered mainly through

  6. QUALITY-RELATED FUNDING IN ROMANIAN HIGHER EDUCATION THROUGHOUT 2003 – 2011: A GLOBAL ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Gabriel-Alexandru Vîiu

    2015-12-01

    Full Text Available The article explores quality-related funding and its global outcomes in the context of Romanian higher education by focusing on the funding allocations provided to public universities throughout a period of nine years based on their institutional performance on the quality indicators integrated in the funding algorithm. Global funding allocations between universities are analysed and a summative appraisal for the entire nine-year window is provided. The article also explores the relation between quality- related funding, institutional disciplinary profiles and the results of a comprehensive evaluation conducted in 2011 by the Ministry of Education to complete a classification of the universities. The main findings indicate a low overall impact of qualityrelated funding for many institutions, but also a clear pattern in which universities focused on science, technology, engineering and mathematics overwhelmingly outperformed mixed institutions, as well as those focused on humanities, arts and social sciences. Furthermore, the global quality-related funding outcomes of the 2003 – 2011 period studied in the paper are shown to be significantly associated with the results of the 2011 classification

  7. Expansion vs. Quality: Emerging Issues of For-Profit Private Higher Education Institutions in Ethiopia

    Science.gov (United States)

    Alemu, Daniel S.

    2010-02-01

    Private for-profit higher education has been rapidly expanding in developing countries worldwide since the early 1990s. This global trend has been particularly evident in Ethiopia, where only three public universities existed until 1996. By 2005, about 60 private for-profit higher education institutions had been founded in Ethiopia. This has led to mixed feelings among the Ethiopian public. While some laud the opportunities and advantages these new institutions bring, others are apprehensive that the quality of education might be compromised by an expansion motivated by monetary gain. This article sheds light on these paradoxes and provides suggestions for policy and practices.

  8. Leveraging quality improvement through use of the Systems Assessment Tool in Indigenous primary health care services: a mixed methods study.

    Science.gov (United States)

    Cunningham, Frances C; Ferguson-Hill, Sue; Matthews, Veronica; Bailie, Ross

    2016-10-18

    Assessment of the quality of primary health care health delivery systems is a vital part of continuous quality improvement (CQI) processes. The Systems Assessment Tool (SAT) was designed to support Indigenous PHC services in assessing and improving their health care systems. It was based on the Assessment of Chronic Illness Care scale, and on practical experience with applying systems assessments in quality improvement in Indigenous primary health care. We describe the development and application of the SAT, report on a survey to assess the utility of the SAT and review the use of the SAT in other CQI research programs. The mixed methods approach involved a review of documents and internal reports relating to experience with use of the SAT since its development in 2002 and a survey of key informants on their experience with using the SAT. The paper drew from documents and internal reports to describe the SAT development and application in primary health care services from 2002 to 2014. Survey feedback highlighted the benefit to the whole primary health care team from participating in the SAT, bringing to light issues that might not emerge with separate individual tool completion. A majority of respondents reported changes in their health centres as a result of using the SAT. Good organisational and management support assisted with ensuring allocation of time and resources for SAT conduct. Respondents identified the importance of having a skilled, external facilitator. Originally designed as a measurement tool, the SAT rapidly evolved to become an important development tool, assisting teams in learning about primary health care system functioning, applying best practice and contributing to team strengthening. It is valued by primary health care centres as a lever in implementing improvements to strengthen centre delivery systems, and has potential for further adaptation and wider application in Australia and internationally.

  9. Equality adds quality: On upgrading higher education and research in the field of law

    Directory of Open Access Journals (Sweden)

    Baer Susanne

    2017-01-01

    Full Text Available Much has been attempted, and many projects are still underway aimed at achieving equality in higher education and research. Today, the key argument to demand and support the integration of gender in academia is that equality is indeed about the quality on which academic work is supposed to be based. Although more or less national political, social and cultural contexts matter as much as academic environments, regarding higher education and research, the integration of gender into the field of law seems particularly interesting. Faculties of law enjoy a certain standing and status, are closely connected to power and politics, and are likely to feature resistance to equality efforts, both in the law itself and in the curriculum and research agenda. However, a multidimensional, intersectional gender analysis helps to reframe cases and doctrines, rulings and regulations far beyond the law that evidently affects women, which the headscarf controversies illustrate. In addition to gender competence, team diversity is a procedural device for success, and non-discrimination is a key requirement when diversity is meant to work. After all, such efforts - to expose bias and educate about gender in an academic field, to insist and integrate it continuously, and to not only demand but also do it - produce quality. Thus, gender equality is crucial for the achievement of the best possible results in higher education and research.

  10. [Quantified research about the effects of sleep quality on attention in class and acadamic achievements in primary school children].

    Science.gov (United States)

    Wang, Xiang-Yun; Qian, Yan-Fei; Gong, Sheng-Cheng; Tan, Mo; Tan, Xin; Yang, Yan; Li, Ling-Di; Huang, Chao-Quan

    2011-12-01

    To study the adverse effects of sleep problems and sleep insufficiency on attention in class and pupils' acadamic achievements. A total of 1138 students from four primary schools at ages of 6-12 years were randomly sampled from four districts of Changsha city, Hunan Province June 2009 to April 2010. The inquired items included sleep problems, sleep time, sleep quality, attention in class and academic achievements. Teachers and parents observed the pupils according to the unified requirements for 3 months and then filled out the questionnaires. The total valid inquiry tables were 1091 with the answering rate of 95.87%, including 549 boys and 542 girls. The sleep quality was more poor in children with sleep problems or sleep insufficiency than in children with normal sleep. The sleep quality was reduced and aggravated along with the increasing sleep problems and the reducing sleep time. The attention in class and academic achievements in children with sleep problems or sleep insufficiency were more poor than in children with normal sleep. The sleep quality index was negatively correlated with attention in class and academic achievements. The attention in class was positively correlated with academic achievements. The decline in sleep quality directly affects the attention in class and reduce the academic achievements in primary school children.

  11. Comparison of quality of obturation and instrumentation time using hand files and two rotary file systems in primary molars: A single-blinded randomized controlled trial.

    Science.gov (United States)

    Govindaraju, Lavanya; Jeevanandan, Ganesh; Subramanian, E M G

    2017-01-01

    In permanent dentition, different rotary systems are used for canal cleaning and shaping. Rotary instrumentation in pediatric dentistry is an emerging concept. A very few studies have compared the efficiency of rotary instrumentation for canal preparation in primary teeth. Hence, this study was performed to compare the obturation quality and instrumentation time of two rotary files systems - Protaper, Mtwo with hand files in primary molars. Forty-five primary mandibular molars were randomly allotted to one of the three groups. Instrumentation was done using K-files in Group 1; Protaper in Group 2; and Mtwo in Group 3. Instrumentation time was recorded. The canal filling quality was assessed as underfill, optimal fill, and overfill. Statistical analysis was done using Chi-square, ANOVA, and post hoc Tukey test. No significant difference was observed in the quality of obturation among three groups. Intergroup comparison of the instrumentation time showed a statistically significant difference between the three groups. The use of rotary instrumentation in primary teeth results in marked reduction in the instrumentation time and improves the quality of obturation.

  12. Creation of a synthetic indicator of quality of care as a clinical management standard in primary care.

    Science.gov (United States)

    Coma, Ermengol; Ferran, Manel; Méndez, Leonardo; Iglesias, Begoña; Fina, Francesc; Medina, Manuel

    2013-12-01

    The development of electronic medical records has allowed the creation of new quality indicators in healthcare. Among them, synthetic indicators facilitate global interpretation of results and comparisons between professionals. A healthcare quality standard (EQA, the Catalan acronym for Estàndard de Qualitat Assistencial) was constructed to serve as a synthetic indicator to measure the quality of care provided by primary care professionals in Catalonia (Spain). The project phases were to establish the reference population; select health problems to be included; define, select and deliberate about subindicators; and construct and publish the EQA. Construction of the EQA involved 107 healthcare professionals, and 91 health problems were included. In addition, 133 experts were consulted, who proposed a total of 339 indicators. After systematic paired comparison, 61 indicators were selected to create the synthetic indicator. The EQA is now calculated on a monthly basis for more than 8000 healthcare professionals using an automated process that extracts data from electronic medical records; results are published on a follow-up website. Along with the use of the online EQA results tool, there has been an ongoing improvement in most of the quality of care indicators. Creation of the EQA has proven to be useful for the measurement of the quality of care of primary care services. Also an improvement trend over 5 years is shown across most of the measured indicators. The online version of this article (doi:10.1186/2193-1801-2-51) contains supplementary material, which is available to authorized users.

  13. Designing a multifaceted quality improvement intervention in primary care in a country where general practice is seeking recognition: the case of Cyprus

    Directory of Open Access Journals (Sweden)

    Stoffers Henri E

    2008-08-01

    Full Text Available Abstract Background Quality Improvement Interventions require significant financial investments, and therefore demand careful consideration in their design in order to maximize potential benefits. In this correspondence we present the methodological approach of a multifaceted quality improvement intervention aiming to improve quality of care in primary care, properly tailored for a country such as Cyprus where general practice is currently seeking recognition. Methods Our methodological approach was focused on the design of an open label, community-based intervention controlled trial using all patients from two urban and two rural public primary care centers diagnosed with hypertension and type II diabetes mellitus. The design of our intervention was grounded on a strong theoretical framework that included the Unified Theory of Acceptance and Use of Technology, and the Chronic Care Model, which synthesize evidence-based system changes in accordance with the Theory of Planned Behavior and the Theory of Reasoned Action. The primary outcome measure was improvement in the quality of care for two chronic diseases evaluated through specific clinical indicators, as well as the patient satisfaction assessed by the EUROPEP questionnaire and additional personal interviews. Results We designed a multifaceted quality improvement intervention model, supported by a varying degree of scientific evidence, tailored to local needs and specific country characteristics. Overall, the main components of the intervention were the development and adoption of an electronic medical record and the introduction of clinical guidelines for the management of the targeted chronic diseases facilitated by the necessary model of organizational changes. Conclusion Health planners and policy makers need to be aware of the potential use of certain theoretical models and applied methodology as well as inexpensive tools that may be suitably tailored to the local needs, in order to

  14. Designing a multifaceted quality improvement intervention in primary care in a country where general practice is seeking recognition: the case of Cyprus.

    Science.gov (United States)

    Samoutis, George A; Soteriades, Elpidoforos S; Stoffers, Henri E; Zachariadou, Theodora; Philalithis, Anastasios; Lionis, Christos

    2008-08-27

    Quality Improvement Interventions require significant financial investments, and therefore demand careful consideration in their design in order to maximize potential benefits. In this correspondence we present the methodological approach of a multifaceted quality improvement intervention aiming to improve quality of care in primary care, properly tailored for a country such as Cyprus where general practice is currently seeking recognition. Our methodological approach was focused on the design of an open label, community-based intervention controlled trial using all patients from two urban and two rural public primary care centers diagnosed with hypertension and type II diabetes mellitus. The design of our intervention was grounded on a strong theoretical framework that included the Unified Theory of Acceptance and Use of Technology, and the Chronic Care Model, which synthesize evidence-based system changes in accordance with the Theory of Planned Behavior and the Theory of Reasoned Action. The primary outcome measure was improvement in the quality of care for two chronic diseases evaluated through specific clinical indicators, as well as the patient satisfaction assessed by the EUROPEP questionnaire and additional personal interviews. We designed a multifaceted quality improvement intervention model, supported by a varying degree of scientific evidence, tailored to local needs and specific country characteristics. Overall, the main components of the intervention were the development and adoption of an electronic medical record and the introduction of clinical guidelines for the management of the targeted chronic diseases facilitated by the necessary model of organizational changes. Health planners and policy makers need to be aware of the potential use of certain theoretical models and applied methodology as well as inexpensive tools that may be suitably tailored to the local needs, in order to effectively design quality improvement interventions in primary care

  15. 40 CFR 50.11 - National primary and secondary ambient air quality standards for oxides of nitrogen (with...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient air quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). 50.11 Section 50.11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL...

  16. The quality of Australian Indigenous primary health care research focusing on social and emotional wellbeing: a systematic review

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    Sara Farnbach

    2017-10-01

    Full Text Available Objectives and importance of the study: Primary health care research focused on Aboriginal and Torres Strait Islander (Indigenous people is needed to ensure that key frontline services provide evidence based and culturally appropriate care. We systematically reviewed the published primary health care literature to identify research designs, processes and outcomes, and assess the scientific quality of research focused on social and emotional wellbeing. This will inform future research to improve evidence based, culturally appropriate primary health care. Study type: Systematic review in accordance with PRISMA and MOOSE guidelines. Methods: Four databases and one Indigenous-specific project website were searched for qualitative, quantitative and mixed-method published research. Studies that were conducted in primary health care services and focused on the social and emotional wellbeing of Indigenous people were included. Scientific quality was assessed using risk-of-bias assessment tools that were modified to meet our aims. We assessed community acceptance by identifying the involvement of community governance structures and representation during research development, conduct and reporting. Data were extracted using standard forms developed for this review. Results: We included 32 articles, which reported on 25 studies. Qualitative and mixed methods were used in 18 studies. Twelve articles were judged as high or unclear risk of bias, four as moderate and five as low risk of bias. Another four studies were not able to be assessed as they did not align with the risk-of-bias tools. Of the five articles judged as low risk of bias, two also had high community acceptance and both of these were qualitative. One used a phenomenological approach and the other combined participatory action research with a social–ecological perspective and incorporated ‘two-way learning’ principles. Of the 16 studies where a primary outcome was identified, eight aimed

  17. The role of the primary care team in the rapid response system.

    Science.gov (United States)

    O'Horo, John C; Sevilla Berrios, Ronaldo A; Elmer, Jennifer L; Velagapudi, Venu; Caples, Sean M; Kashyap, Rahul; Jensen, Jeffrey B

    2015-04-01

    The purpose of the study is to evaluate the impact of primary service involvement on rapid response team (RRT) evaluations. The study is a combination of retrospective chart review and prospective survey-based evaluation. Data included when and where the activations occurred and the patient's code status, primary service, and ultimate disposition. These data were correlated with survey data from each event. A prospective survey evaluated the primary team's involvement in decision making and the overall subjective quality of the interaction with primary service through a visual analog scale. We analyzed 4408 RRTs retrospectively and an additional 135 prospectively. The primary team's involvement by telephone or in person was associated with significantly more transfers to higher care levels in retrospective (P team involvement, with more frequent changes seen in the retrospective analysis (P = .01). Subjective ratings of communication by the RRT leader were significantly higher when the primary service was involved (P team involvement influences RRT activation processes of care. The RRT role should be an adjunct to, but not a substitute for, an engaged and present primary care team. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Quality assessment of child care services in primary health care settings of Central Karnataka (Davangere District

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    Rashmi

    2010-01-01

    Full Text Available Background: Infectious disease and malnutrition are common in children. Primary health care came into being to decrease the morbidity. Quality assessment is neither clinical research nor technology assessment. It is primarily an administrative device used to monitor performance to determine whether it continues to remain within acceptable bounds. Aims and Objectives: To assess the quality of service in the delivery of child health care in a primary health care setting. To evaluate client satisfaction. To assess utilization of facilities by the community. Materials and Methods: Study Type: Cross-sectional community-based study. Quality assessment was done by taking 30-50%, of the service provider. Client satisfaction was determined with 1 Immunization and child examination-90 clients each. Utilization of services was assessed among 478 households. Statistical Analysis: Proportions, Likert′s scale to grade the services and Chi-square. Results: Immunization service: Identification of needed vaccine, preparation and care was average. Vaccination technique, documentation, EPI education, maintenance of cold chain and supplies were excellent. Client satisfaction was good. Growth monitoring: It was excellent except for mother′s education andoutreach educational session . Acute respiratory tract infection care: History, physical examination, ARI education were poor. Classification, treatment and referral were excellent. Client satisfaction was good. Diarrheal disease care: History taking was excellent. But examination, classification, treatment, ORT education were poor. Conclusion: Mothers education was not stressed by service providers. Service providers′ knowledge do not go with the quality of service rendered. Physical examination of the child was not good. Except for immunization other services were average.

  19. Do Electronic Technologies Increase or Narrow Differences in Higher Education Quality between Low- and High-Income Countries?

    Science.gov (United States)

    Capshaw, Norman Clark

    2008-01-01

    The disruptive technologies of the Internet and computers are changing our world in myriad ways. These technologies are also increasingly being employed in higher education but to what effect? Are the effects on higher education quality measurable, and if so, what is the effect on the traditional gap between high-income and low- to middle-income…

  20. Longer guts and higher food quality increase energy intake in migratory swans.

    Science.gov (United States)

    van Gils, Jan A; Beekman, Jan H; Coehoorn, Pieter; Corporaal, Els; Dekkers, Ten; Klaassen, Marcel; van Kraaij, Rik; de Leeuw, Rinze; de Vries, Peter P

    2008-11-01

    1. Within the broad field of optimal foraging, it is increasingly acknowledged that animals often face digestive constraints rather than constraints on rates of food collection. This therefore calls for a formalization of how animals could optimize food absorption rates. 2. Here we generate predictions from a simple graphical optimal digestion model for foragers that aim to maximize their (true) metabolizable food intake over total time (i.e. including nonforaging bouts) under a digestive constraint. 3. The model predicts that such foragers should maintain a constant food retention time, even if gut length or food quality changes. For phenotypically flexible foragers, which are able to change the size of their digestive machinery, this means that an increase in gut length should go hand in hand with an increase in gross intake rate. It also means that better quality food should be digested more efficiently. 4. These latter two predictions are tested in a large avian long-distance migrant, the Bewick's swan (Cygnus columbianus bewickii), feeding on grasslands in its Dutch wintering quarters. 5. Throughout winter, free-ranging Bewick's swans, growing a longer gut and experiencing improved food quality, increased their gross intake rate (i.e. bite rate) and showed a higher digestive efficiency. These responses were in accordance with the model and suggest maintenance of a constant food retention time. 6. These changes doubled the birds' absorption rate. Had only food quality changed (and not gut length), then absorption rate would have increased by only 67%; absorption rate would have increased by only 17% had only gut length changed (and not food quality). 7. The prediction that gross intake rate should go up with gut length parallels the mechanism included in some proximate models of foraging that feeding motivation scales inversely to gut fullness. We plea for a tighter integration between ultimate and proximate foraging models.

  1. Development of Quality Assurance System in Culture and Nation Character Education in Primary Education in Indonesia

    Science.gov (United States)

    Susilana, Rudi; Asra

    2013-01-01

    The purpose of national education is to develop skills and build dignified national character and civilization in educating nation life (Act No. 20, 2003). The paper describes a system of quality assurance in culture and character education in primary education. This study employs the six sigma model which consists of the formula DMAIC (Define,…

  2. Quality of nutrition services in primary health care facilities: Implications for integrating nutrition into the health system in Bangladesh.

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    Sk Masum Billah

    Full Text Available In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC and management of sick children younger than five years.Service delivery quality was assessed across three dimensions; structural readiness, process and outcome. Structural readiness was assessed by observing the presence of equipment, guidelines and register/reporting forms in ANC rooms and consulting areas for sick children at 37 primary healthcare facilities in 12 sub-districts. In addition, the training and knowledge relevant to nutrition service delivery of 95 healthcare providers was determined. The process of nutrition service delivery was assessed by observing 381 ANC visits and 826 sick children consultations. Satisfaction with the service was the outcome and was determined by interviewing 541 mothers/caregivers of sick children.Structural readiness to provide nutrition services was higher for ANC compared to management of sick children; 73% of ANC rooms had >5 of the 13 essential items while only 13% of the designated areas for management of sick children had >5 of the 13 essential items. One in five (19% healthcare providers had received nutrition training through the NNS. Delivery of the nutrition services was poor: <30% of women received all four key antenatal nutrition services, 25% of sick children had their weight checked against a growth-chart and <1% had their height measured. Nevertheless, most mothers/caregivers rated their satisfaction of the service above average.Strengthening the provision of equipment and increasing the coverage of training are imperative to improve nutrition services. Inherent barriers to implementing nutrition services in primary health care, especially high caseloads during the management of sick under-five children, should

  3. Information Support of the Higher Education Quality Management System

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    Murat K. Baymuldin

    2013-01-01

    Full Text Available The article deals with the quality management system (QMS of a university as a combination of organizational structure, procedures, processes and resources needed to implement quality policy with the help of quality planning, management, control and improvement, the need for automated information system of the university quality management system control

  4. Design and implementation of pay-for-quality in primary healthcare: A case study from Iran

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    Jafar Sadegh Tabrizi

    2017-06-01

    Full Text Available Background The common methods of payment to healthcare providers such as capitation and salary are not designed to be stimulation for high quality healthcare. The pay-for -quality (P4Q programs are designed to provide the financial incentives to the service providers in order to improve quality of services based on specified criteria. Aims This study describes the design and implementation of a P4Q program in the primary healthcare (PHc in East Azerbaijan Province, Iran. Methods The present study is a case study that describes the process of designing and implementing the P4Q program in PHC in East-Azerbaijan province in 2015. To design the P4Q program, after identifying core components of the program through literature review and Focus Group Discussion (FGD, final decision about each component was made by achieving consensus from a panel of recognised experts in the area of PHc. Altogether two FGD and seven expert panel sessions were hold in EAPHC in order to design the P4Q program. Results Key components of P4Q program were selected by qualitative studies and the results were categorized in five headings including P4Q formula, quality measures, payment strategy, data reporting and performance evaluation. The formula consists of five elements including fixed payment, individual, team and organization performance and managerial appraisal. A total of 37 measures, which covers the domains of quality of PHc, human resource development and responsibility were selected. ‘Improvement’ and ‘absolute level of measures’ were selected as the payment strategy. The methods of data reporting included valid questionnaire, organization’s documents and medical records. The final P4Q program was used for paying incentives to all primary health care providers in public health centres affiliated to Tabriz University of Medical Sciences. Conclusion Designing and implementing the P4Q program led to a shift in paying the incentives to healthcare providers

  5. 05. Abbreviated Mindfulness Intervention for Job Satisfaction, Quality of Life, and Compassion in Primary Care Clinicians: A Pilot Study

    OpenAIRE

    Fortney, Luke; Luchterhand, Charlene; Zakletskaia, Larissa; Zgierska, Aleksandra; Rakel, David

    2013-01-01

    Focus Area: Integrative Algorithms of Care Purpose: Burnout, attrition, and low work satisfaction of primary care physicians are growing concerns and can have a negative influencee on health care. Interventions for clinicians that improve work-life balance are few and poorly understood. We undertook this study as a first step in investigating whether an abbreviated mindfulness intervention could increase job satisfaction, quality of life, and compassion among primary care clinicians. Methods:...

  6. Team climate and quality of care in primary health care: a review of studies using the Team Climate Inventory in the United Kingdom

    OpenAIRE

    Goh, Teik T; Eccles, Martin P

    2009-01-01

    Abstract Background Attributes of teams could affect the quality of care delivered in primary care. The aim of this study was to systematically review studies conducted within the UK NHS primary care that have measured team climate using the Team Climate Inventory (TCI), and to describe, if reported, the relationship between the TCI and measures of quality of care. Findings The databases MEDLINE, EMBASE, and CINAHL were searched. The reference lists of included article were checked and one re...

  7. The quality of learning in Nigerian primary education. The UPE programme 1976 - 1982

    Science.gov (United States)

    Kelly, George; Lassa, Peter

    1983-06-01

    The speed with which UPE was introduced to Nigeria has meant enormous problems of both a logistical and educational nature. After six years many have proved all but impossible to overcome. While generalising may be wrong, it is questionable whether the government's objectives for UPE can be achieved. Vast regional discrepancies of implementation have meant that the reduction in the previous imblance of opportunity is unlikely. A high rate of unemployment and disaffection among terminal primary leavers will offset the concept of UPE as an investment. Grassroots support will weaken if primary schooling offers no tangible returns. A further problem is present. The curriculum of UPE has been inappropriate for a system which is terminal for the majority. Basic skills are often unlearned. The national curriculum has not been sufficiently localised and, with staff and material shortages, has been impossible to teach. In current conditions it is academic and certificate-orientated. There is an urgent need to review the structure of primary education before it is too late. A community base might be considered in the face of weakening government funding but the redesign of the curriculum is an essential prerequisite. The content and quality of education is as important as the logistics of its provision.

  8. Effects of Feiji Decoction for Soothing the Liver Combined with Psychotherapy 
on Quality of Life in Primary Lung Cancer Patients

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    Yilin YAO

    2012-01-01

    Full Text Available Background and objective Primary lung cancer is one of the most common malignant tumors. It causes great pain and mood disorders to patients, and significantly reduces their quality of life. The aim of the current study is to evaluate the effect of Feiji Decoction for soothing the liver combined with psychotherapy on quality of life (QoL and physical status of patients with primary lung cancer. Methods A total of 118 patients with primary non-small cell lung cancer were randomly divided into two groups. The 57 patients in the combined therapy group were treated with Feiji Decoction for soothing the liver and psychotherapy combined with chemotherapy, whereas the 61 patients in the control group were treated with chemotherapy only. Both groups were observed for the two treatment courses. The European Organization for Research and Treatment of Cancer QoL Questionnaire LC-43 (EORTC QLQ-LC43 was used to assess the QoL of every patient in both groups before and after treatment scales. At the same time, physical status was assessed using the Karnofsky performance status (KPS and East Cooperative Oncology Group performance status (ECOG. Results The scores of physiology function, role function, emotion function, cognize function, society function, and general health in the therapy group were higher than that of the control group. The therapy group also showed better QoL results than the contol group. Significant differences were observed between the two groups (P<0.01. Meanwhile, the scores of fatigue, vomit, pain, polypnea, insomnia, anorexia, constipation, and specific manifestation of lung cancer in the therapy group were obviously lower than that of the control group; more patients were observed to be relieved. Significant differences between the two groups were observed (P<0.01. The KPS and ECOG scores of the patients were observed to have improved and stabilized in the therapy group than that of the control group; the differences were statistically

  9. [Job stress and quality of life of primary care health-workers: evidence of validity of the PECVEC questionnaire].

    Science.gov (United States)

    Fernández-López, Juan Antonio; Fernández-Fidalgo, María; Martín-Payo, Rubén; Rödel, Andreas

    2007-08-01

    To evaluate the relationship between Health-Related Quality of Life (HRQL) and stress at work among Primary Care workers, as evidence of the construct validity of the Spanish version (PECVEC) of the profile of quality of life in the chronically ill (PLC) questionnaire. In addition, to check its other psychometric properties. Cross-sectional study. Eighteen primary care centres in Health Area IV, Asturias (Oviedo), Spain, sharing similar socio-demographic conditions. Two hundred and thirty-three primary care nurses and physicians. HRQL was evaluated by the 6 general dimensions of the Spanish version of the PLC. Stress at work was evaluated by the three scales of the Effort-Reward Imbalance (ERI) questionnaire. The construct validity of the PECVEC was assessed by testing the inverse associations of QoL dimensions and job stress ones, when the most important confuser variables were monitored. The non-response rate was low (effects and only small ceiling effects were observed. Internal consistency analysis and exploratory and confirmatory factor analysis demonstrated high reliability, factorial validity and convergent/divergent validity of the PECVEC. The PECVEC demonstrates adequate psychometric properties for evaluating HRQL in healthy subjects.

  10. Coverage and quality of antenatal care provided at primary health care facilities in the 'Punjab' province of 'Pakistan'.

    Directory of Open Access Journals (Sweden)

    Muhammad Ashraf Majrooh

    Full Text Available BACKGROUND: Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In 'Pakistan' antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to 'Divisions' and 'Districts'. By population 'Punjab' is the largest province of Pakistan having 36 districts. This study was conducted to assess the coverage and quality antenatal care in the primary health care facilities in 'Punjab' province of 'Pakistan'. METHODS: Quantitative and Qualitative methods were used to collect data. Using multistage sampling technique nine out of thirty six districts were selected and 19 primary health care facilities of public sector (seventeen Basic Health Units and two Rural Health Centers were randomly selected from each district. Focus group discussions and in-depth interviews were conducted with clients, providers and health managers. RESULTS: The overall enrollment for antenatal checkup was 55.9% and drop out was 32.9% in subsequent visits. The quality of services regarding assessment, treatment and counseling was extremely poor. The reasons for low coverage and quality were the distant location of facilities, deficiency of facility resources, indifferent attitude and non availability of the staff. Moreover, lack of client awareness about importance of antenatal care and self empowerment for decision making to seek care were also responsible for low coverage. CONCLUSION: The coverage and quality of the antenatal care services in 'Punjab' are extremely compromised. Only half of the expected pregnancies are enrolled and

  11. Determining Perceptual Gaps of Service Quality and Value in Higher Education: A Midwestern Bible College

    Science.gov (United States)

    McIntosh, Benjamin T.

    2017-01-01

    This doctoral research project examined perceptual gaps of service quality and value in the context of higher education. The researcher performed quantitative analysis of survey data gathered from students at a small, Midwestern Bible college. Students self-selected to participate in this research project and, using class status as an independent…

  12. Variations in the service quality of medical practices.

    Science.gov (United States)

    Ly, Dan P; Glied, Sherry A

    2013-11-01

    To examine regional variation in the service quality of physician practices and to assess the association of this variation with the supply and organization of physicians. Secondary analyses of the Community Tracking Study (CTS) household and physician surveys. A total of 40,339 individuals who had seen a primary care physician because of an illness or injury and 17,345 generalist physicians across 4 survey time periods in 60 CTS sites were included. Service quality measures used were lag between making an appointment and seeing a physician, and wait time at the physician's office. Our supply measure was the physician-to-population ratio. Our organizational measure was the percentage of physicians in group practices. Multivariate regressions were performed to examine the relationship between service quality and the supply and organization of physicians. There was substantial variation in the service quality of physician visits across the country. For example, in 2003, the average wait time to see a doctor was 16 minutes in Milwaukee but more than 41 minutes in Miami; the average appointment lag for a sick visit in 2003 was 1.2 days in west-central Alabama but almost 6 days in Northwestern Washington. Service quality was not associated with the primary care physician-to-population ratio and had varying associations with the organization of practices. Cross-site variation in service quality of care in primary care has been large, persistent, and associated with the organization of practices. Areas with higher primary care physician-to-population ratios had longer, not shorter, appointment lags.

  13. Is the quality of brief motivational interventions for drug use in primary care associated with subsequent drug use?

    Science.gov (United States)

    Palfai, Tibor P; Cheng, Debbie M; Bernstein, Judith A; Palmisano, Joseph; Lloyd-Travaglini, Christine A; Goodness, Tracie; Saitz, Richard

    2016-05-01

    Although a number of brief intervention approaches for drug use are based on motivational interviewing (MI), relatively little is known about whether the quality of motivational interviewing skills is associated with intervention outcomes. The current study examined whether indices of motivational interviewing skill were associated with subsequent drug use outcomes following two different MI-based brief interventions delivered in primary care; a 15 min Brief Negotiated Interview (BNI) and a 45 min adaptation of motivational interviewing (MOTIV). Audio recordings from 351 participants in a randomized controlled trial for drug use in primary care were coded using the Motivational Interviewing Treatment Integrity Scale, (MITI Version 3.1.1). Separate negative binomial regression analyses, stratified by intervention condition, were used to examine the associations between six MITI skill variables and the number of days that the participant used his/her main drug 6 weeks after study entry. Only one of the MITI variables (% reflections to questions) was significantly associated with the frequency of drug use in the MOTIV condition and this was opposite to the hypothesized direction (global p=0.01, adjusted IRR 1.50, 95%CI: 1.03-2.20 for middle vs. lowest tertile [higher skill, more drug use]. None were significantly associated with drug use in the BNI condition. Secondary analyses similarly failed to find consistent predictors of better drug outcomes. Overall, this study provides little evidence to suggest that the level of MI intervention skills are linked with better drug use outcomes among people who use drugs and receive brief interventions in primary care. Findings should be considered in light of the fact that data from the study are from negative trial of SBI and was limited to primary care patients. Future work should consider alternative ways of examining these process variables (i.e., comparing thresholds of proficient versus non-proficient skills) or

  14. Space Shuttle Program Primary Avionics Software System (PASS) Success Legacy - Quality and Reliability Date

    Science.gov (United States)

    Orr, James K.; Peltier, Daryl

    2010-01-01

    Thsi slide presentation reviews the avionics software system on board the space shuttle, with particular emphasis on the quality and reliability. The Primary Avionics Software System (PASS) provides automatic and fly-by-wire control of critical shuttle systems which executes in redundant computers. Charts given show the number of space shuttle flights vs time, PASS's development history, and other charts that point to the reliability of the system's development. The reliability of the system is also compared to predicted reliability.

  15. ASPECTS REGARDING THE ORGANIZATIONAL STRUCTURE, QUALITY AND PERFORMANCE OF SPORT IN HIGHER EDUCATION IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Sorin BUHAȘ

    2017-12-01

    Full Text Available This study addresses sport in higher education in rel ation to its organization structure, quality and sports performance. We have studied documents, normative acts and the way in which certain decisional factors involved in higher education sports activities are organized. The lack of a concrete strategy inthis respect, renders the information sources to be relatively limited. Particularly, our research was based on scientific documentation, historical method and document analysis. There is a small number of legitimated athletes related to the number of higher education students. Higher education sport is a non-functional system, it cannot generate a representative number of participants in the National University Championships, and the international representation is not a natural consequence of the internal competition. Therefore, it is imperative for higher education sports to be the foundation of performance sports. This involves changing both the approach to this phenomenon and its organizational structure. Also, the development of human resources and sports infrastructure are essential conditions for the development ofsports activity.

  16. Perceptions of primary care staff on a regional data quality intervention in Australian general practice: a qualitative study.

    Science.gov (United States)

    Ghosh, Abhijeet; McCarthy, Sandra; Halcomb, Elizabeth

    2016-04-26

    Technological advances in clinical data capturing and storage systems have led to recent attempts at disease surveillance and region specific population health planning through regularly collected primary care administrative clinical data. However the accuracy and comprehensiveness of primary care health records remain questionable. We aimed to explore the perceptions and experiences of general practice staff in maintaining accurate patient health data within clinical software used in primary care settings of regional NSW. Focus groups were conducted with general practitioners, practice nurses and practice administrative staff from 17 practices in the Illawarra-Shoalhaven region of the state of New South Wales (NSW) in Australia that had participated in the Sentinel Practices Data Sourcing (SPDS) project - a general practice based chronic disease surveillance and data quality improvement study. A total of 25 respondents that included 12 general practitioners (GPs) and 13 practice staff participated in the 6 focus groups. Focus groups were audio-recorded and transcribed verbatim. Thematic analysis of the data was undertaken. Five key themes emerged from the data. Firstly, the theme of resourcing data management raised issues of time constraints, the lack of a dedicated data management role and the importance of multidisciplinary involvement, including a data champion. The need for incentives was identified as being important to motivate ongoing commitment to maintaining data quality. However, quality of software packages, including coding issues and software limitations and information technology skills were seen as key barriers. The final theme provided insight into the lessons learnt from the project and the increased awareness of the importance of data quality amongst practice staff. The move towards electronic methods of maintaining general practice patient records offers significant potential benefits in terms of both patient care and monitoring of health

  17. Quality Primary Care and Family Planning Services for LGBT Clients: A Comprehensive Review of Clinical Guidelines.

    Science.gov (United States)

    Klein, David A; Malcolm, Nikita M; Berry-Bibee, Erin N; Paradise, Scott L; Coulter, Jessica S; Keglovitz Baker, Kristin; Schvey, Natasha A; Rollison, Julia M; Frederiksen, Brittni N

    2018-04-01

    LGBT clients have unique healthcare needs but experience a wide range of quality in the care that they receive. This study provides a summary of clinical guideline recommendations related to the provision of primary care and family planning services for LGBT clients. In addition, we identify gaps in current guidelines, and inform future recommendations and guidance for clinical practice and research. PubMed, Cochrane, and Agency for Healthcare Research and Quality electronic bibliographic databases, and relevant professional organizations' websites, were searched to identify clinical guidelines related to the provision of primary care and family planning services for LGBT clients. Information obtained from a technical expert panel was used to inform the review. Clinical guidelines meeting the inclusion criteria were assessed to determine their alignment with Institute of Medicine (IOM) standards for the development of clinical practice guidelines and content relevant to the identified themes. The search parameters identified 2,006 clinical practice guidelines. Seventeen clinical guidelines met the inclusion criteria. Two of the guidelines met all eight IOM criteria. However, many recommendations were consistent regarding provision of services to LGBT clients within the following themes: clinic environment, provider cultural sensitivity and awareness, communication, confidentiality, coordination of care, general clinical principles, mental health considerations, and reproductive health. Guidelines for the primary and family planning care of LGBT clients are evolving. The themes identified in this review may guide professional organizations during guideline development, clinicians when providing care, and researchers conducting LGBT-related studies.

  18. The PAMINO-project: evaluating a primary care-based educational program to improve the quality of life of palliative patients

    Directory of Open Access Journals (Sweden)

    Engeser Peter

    2007-05-01

    Full Text Available Abstract Background The care of palliative patients challenges the health care system in both quantity and quality. Especially the role of primary care givers needs to be strengthened to provide them with the knowledge and the confidence of applying an appropriate end-of-life care to palliative patients. To improve health care services for palliative patients in primary care, interested physicians in and around Heidelberg, Germany, are enabled to participate in the community-based program 'Palliative Medical Initiative North Baden (PAMINO' to improve their knowledge in dealing with palliative patients. The impact of this program on patients' health and quality of life remains to be evaluated. Methods/Design The evaluation of PAMINO is a non-randomized, controlled study. Out of the group of primary care physicians who took part in the PAMINO program, a sample of 45 physicians and their palliative patients will be compared to a sample of palliative patients of 45 physicians who did not take part in the program. Every four weeks for 6 months or until death, patients, physicians, and the patients' family caregivers in both groups answer questions to therapy strategies, quality of life (QLQ-C15-PAL, POS, pain (VAS, and burden for family caregivers (BSFC. The inclusion of physicians and patients in the study starts in March 2007. Discussion Although participating physicians value the increase in knowledge they receive from PAMINO, the effects on patients remain unclear. If the evaluation reveals a clear benefit for patients' quality of life, a larger-scale implementation of the program is considered. Trial registration: The study was registered at ‘current controlled trials (CCT’, registration number: ISRCTN78021852.

  19. Quality of Life After Stereotactic Body Radiation Therapy for Primary and Metastatic Liver Tumors

    International Nuclear Information System (INIS)

    Mendez Romero, Alejandra; Wunderink, Wouter; Os, Rob M. van; Nowak, Peter J.C.M.; Heijmen, Ben J.M.; Nuyttens, Joost J.; Brandwijk, Rene P.; Verhoef, Cornelis; IJzermans, Jan N.M.; Levendag, Peter C.

    2008-01-01

    Purpose: Stereotactic body radiation therapy (SBRT) provides a high local control rate for primary and metastatic liver tumors. The aim of this study is to assess the impact of this treatment on the patient's quality of life. This is the first report of quality of life associated with liver SBRT. Methods and Materials: From October 2002 to March 2007, a total of 28 patients not suitable for other local treatments and with Karnofsky performance status of at least 80% were entered in a Phase I-II study of SBRT for liver tumors. Quality of life was a secondary end point. Two generic quality of life instruments were investigated, EuroQol-5D (EQ-5D) and EuroQoL-Visual Analogue Scale (EQ-5D VAS), in addition to a disease-specific questionnaire, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ C-30). Points of measurement were directly before and 1, 3, and 6 months after treatment. Mean scores and SDs were calculated. Statistical analysis was performed using paired-samples t-test and Student t-test. Results: The calculated EQ-5D index, EQ-5D VAS and QLQ C-30 global health status showed that mean quality of life of the patient group was not significantly influenced by treatment with SBRT; if anything, a tendency toward improvement was found. Conclusions: Stereotactic body radiation therapy combines a high local control rate, by delivering a high dose per fraction, with no significant change in quality of life. Multicenter studies including larger numbers of patients are recommended and under development

  20. Cost to primary care practices of responding to payer requests for quality and performance data.

    Science.gov (United States)

    Halladay, Jacqueline R; Stearns, Sally C; Wroth, Thomas; Spragens, Lynn; Hofstetter, Sara; Zimmerman, Sheryl; Sloane, Philip D

    2009-01-01

    We wanted to determine how much it costs primary care practices to participate in programs that require them to gather and report data on care quality indicators. Using mixed quantitative-qualitative methods, we gathered data from 8 practices in North Carolina that were selected purposively to be diverse by size, ownership, type, location, and medical records. Formal practice visits occurred between January 2008 and May 2008. Four quality-reporting programs were studied: Medicare's Physician Quality Reporting Initiative (PQRI), Community Care of North Carolina (CCNC), Bridges to Excellence (BTE), and Improving Performance in Practice (IPIP). We estimated direct costs to the practice and on-site costs to the quality organization for implementation and maintenance phases of program participation. Major expenses included personnel time for planning, training, registry maintenance, visit coding, data gathering and entry, and modification of electronic systems. Costs per full-time equivalent clinician ranged from less than $1,000 to $11,100 during program implementation phases and ranged from less than $100 to $4,300 annually during maintenance phases. Main sources of variation included program characteristics, amount of on-site assistance provided, experience and expertise of practice personnel, and the extent of data system problems encountered. The costs of a quality-reporting program vary greatly by program and are important to anticipate and understand when undertaking quality improvement work. Incentives that would likely improve practice participation include financial payment, quality improvement skills training, and technical assistance with electronic system troubleshooting.

  1. Patient satisfaction is biased by renovations to the interior of a primary care office: a pretest-posttest assessment.

    Science.gov (United States)

    Tièche, Raphaël; da Costa, Bruno R; Streit, Sven

    2016-08-11

    Measuring quality of care is essential to improve primary care. Quality of primary care for patients is usually assessed by patient satisfaction questionnaires. However, patients may not be able to judge quality of care without also reflecting their perception of the environment. We determined the effect that redesigning a primary care office had on patient satisfaction. We hypothesized that renovating the interior would make patients more satisfied with the quality of medical care. We performed a Pretest-Posttest analysis in a recently renovated single-practice primary care office in Grenchen, Switzerland. Before and after renovation, we distributed a questionnaire to assess patient satisfaction in four domains. We chose a Likert scale (1 = very poor to 6 = very good), and 12 quality indicators, and included two consecutive samples of patients presenting at the primary care office before (n = 153) and after (n = 153) interior design renovation. Response rate was high (overall 85 %). The sample was similar to the enlisted patient collective, but the sample population was older (60 years) than the collective (52 years). Patient satisfaction was higher for all domains after the office was renovated (p patient satisfaction, including satisfaction in domains otherwise unchanged. Physician skills and patient satisfaction sometimes depend on surrounding factors that may bias the ability of patients to assess the quality of medical care. These biases should be taken into account when quality assessment instruments are designed for patients.

  2. Improvement in quality of lifesix months after primary total hip arthroplasty in a Pakistani population.

    Science.gov (United States)

    Zubairi, Akbar Jaleel; Bin Mahmood, Syed Usman; Ali, Moiz; Noordin, Shahryar

    2016-10-01

    This prospective, cohort study was carried out to assess the improvement in quality of life of patients undergoing elective primary total hip arthroplasty (THA). It was conducted at the orthopaedic department of the Aga Khan University Hospital, Karachi, from June 2014 to May 2015, and comprised patients who had undergone THA. A total of 89 patients having a mean age of 41.5±12.0 years with a baseline core outcomes measure index (COMI)-hip score of > 3.5 were included. A decrease in COMI-hip score by >3 points six months post-operatively was considered improvement in quality of life. Patient satisfaction with restriction to squatting was assessed separately. The mean reduction in COMI-hip was 4.9±1.3 with 83(93%) patients experiencing significant improvement in quality of life. Age >50 years and American Society of Anaesthesiologists (ASA) level >III was significantly associated with no improvement in quality of life. Most patients were satisfied with their disability to squat irrespective of COMI-hip score. THA was found to be associated with significant improvement in quality of life and COMI-hip score was applicable in our population despite its inability to assess disability with restriction in squatting.

  3. An assessment of routine primary care health information system data quality in Sofala Province, Mozambique

    Directory of Open Access Journals (Sweden)

    Cuembelo Fatima

    2011-05-01

    Full Text Available Abstract Background Primary health care is recognized as a main driver of equitable health service delivery. For it to function optimally, routine health information systems (HIS are necessary to ensure adequate provision of health care and the development of appropriate health policies. Concerns about the quality of routine administrative data have undermined their use in resource-limited settings. This evaluation was designed to describe the availability, reliability, and validity of a sample of primary health care HIS data from nine health facilities across three districts in Sofala Province, Mozambique. HIS data were also compared with results from large community-based surveys. Methodology We used a methodology similar to the Global Fund to Fight AIDS, Tuberculosis and Malaria data verification bottom-up audit to assess primary health care HIS data availability and reliability. The quality of HIS data was validated by comparing three key indicators (antenatal care, institutional birth, and third diptheria, pertussis, and tetanus [DPT] immunization with population-level surveys over time. Results and discussion The data concordance from facility clinical registries to monthly facility reports on five key indicators--the number of first antenatal care visits, institutional births, third DPT immunization, HIV testing, and outpatient consults--was good (80%. When two sites were excluded from the analysis, the concordance was markedly better (92%. Of monthly facility reports for immunization and maternity services, 98% were available in paper form at district health departments and 98% of immunization and maternity services monthly facility reports matched the Ministry of Health electronic database. Population-level health survey and HIS data were strongly correlated (R = 0.73, for institutional birth, first antenatal care visit, and third DPT immunization. Conclusions Our results suggest that in this setting, HIS data are both reliable and

  4. Evaluation of the Quality of Life and Psychiatric Symptoms of Patients with Primary Coxarthrosis after Total Hip Arthroplasty.

    Science.gov (United States)

    Balik, M S; Hocaoğlu, Ç; Erkut, A; Güvercin, Y; Keskin, D

    2017-01-01

    PURPOSE OF THE STUDY In this study, it was aimed to examine the preoperative and postoperative quality of life and psychiatric symptoms of the patients with primary coxarthrosis after total hip arthroplasty. MATERIAL AND METHODS 150 patients undergone total hip arthroplasty were involved in this study. The socio-demographical data form prepared by the researchers was utilized before and after the operation in order to demonstrate disease-related socio-demographical characteristics of the patient. The Quality of Life Scale Short Form (SF-36), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Harris Hip Score (HHS) and Visual Analog Scale (VSA) were implemented in the preoperative period and at 6th and 12th week after the operation. RESULTS Of the patients involved in study, 28.7% were male and 71.3% were female. Their mean age was 58.34±11.92 year. While statistically significant differences were found between the preoperative and postoperative periods in terms of physical function, physical role limitation, emotional role limitation, energy, social function, pain, and general health subscales of SF-36, no significant differences were found relating mental health subscale. In BAI, BDI, VAS, and HHS comparison, statistically significant differences were found between the preoperative and postoperative periods, except for BAI. CONCLUSIONS In this study, it was determined that primary coxarthrosis affects significantly the quality of the patients' lives in a negative way and can be accompanied by mental symptoms. After total hip arthroplasty, significant improvement was observed in quality of life, depression and pain scores. Key words: total hip prosthesis, quality of life, mental symptoms.

  5. Achievements and Lessons Learned from Vietnam's Higher Education Quality Assurance System after a Decade of Establishment

    Science.gov (United States)

    Nguyen, Huu Cuong; Ta, Thi Thu Hien; Nguyen, Thi Thu Huong

    2017-01-01

    Higher education quality assurance and accreditation were officially implemented in Vietnam over twelve years ago. From a totally centralized model, Vietnam's accreditation system has been becoming more independent, especially with the establishment of accrediting agencies. The first accreditation certificates were also awarded to universities…

  6. The role of higher education in transforming the quality of dementia care: dementia studies at the University of Bradford.

    Science.gov (United States)

    Downs, M; Capstick, A; Baldwin, P C; Surr, C; Bruce, E

    2009-04-01

    There is now widespread concern about the inadequate care and support provided to people with dementia from diagnosis to death. It is acknowledged that while there is a range of effective ways to care for and support people with dementia and their families from diagnosis to death, these have yet to become integral to practice. In England, for example, the National Dementia Strategy seeks to transform the quality of dementia care. One of the key components to transforming the quality of care is to ensure we have an informed and effective workforce. We argue here that in order to transform the quality of care we need to distinguish between the aims of training and education. Whilst there is a place for skills-based workplace training, Higher Education in dementia studies has a key role to play in the provision of specialist knowledge and skills in dementia care emphasizing as it does the development of critical thinking, reflection and action. In this paper we describe dementia studies at Bradford University available at both undergraduate and postgraduate levels. We outline their aims and learning outcomes, curricula, approach to teaching, learning and assessment. We describe the nature of students who study with us, noting their fit with the Higher Education Funding Council in England's agenda for widening participation in higher education. Higher Education in dementia studies has a unique role to play in equipping practitioners and professionals with the information, skills and attitudes to realize the potential for quality of life for people with dementia and their families.

  7. Costs associated with data collection and reporting for diabetes quality improvement in primary care practices: a report from SNOCAP-USA.

    Science.gov (United States)

    West, David R; Radcliff, Tiffany A; Brown, Tiffany; Cote, Murray J; Smith, Peter C; Dickinson, W Perry

    2012-01-01

    Information about the costs and experiences of collecting and reporting quality measure data are vital for practices deciding whether to adopt new quality improvement initiatives or monitor existing initiatives. Six primary care practices from Colorado's Improving Performance in Practice program participated. We conducted structured key informant interviews with Improving Performance in Practice coaches and practice managers, clinicians, and staff and directly observed practices. Practices had 3 to 7 clinicians and 75 to 300 patients with diabetes, half had electronic health records, and half were members of an independent practice association. The estimated per-practice cost of implementation for the data collection and reporting for the diabetes quality improvement program was approximately $15,552 per practice (about $6.23 per diabetic patient per month). The first-year maintenance cost for this effort was approximately $9,553 per practice ($3.83 per diabetic patient per month). The cost of implementing and maintaining a diabetes quality improvement effort that incorporates formal data collection, data management, and reporting is significant and quantifiable. Policymakers must become aware of the financial and cultural impact on primary care practices when considering value-based purchasing initiatives.

  8. Community health centers and primary care access and quality for chronically-ill patients - a case-comparison study of urban Guangdong Province, China.

    Science.gov (United States)

    Shi, Leiyu; Lee, De-Chih; Liang, Hailun; Zhang, Luwen; Makinen, Marty; Blanchet, Nathan; Kidane, Ruth; Lindelow, Magnus; Wang, Hong; Wu, Shaolong

    2015-11-30

    Reform of the health care system in urban areas of China has prompted concerns about the utilization of Community Health Centers (CHC). This study examined which of the dominant primary care delivery models, i.e., the public CHC model, the 'gate-keeper' CHC model, or the hospital-owned CHC models, was most effective in enhancing access to and quality of care for patients with chronic illness. The case-comparison design was used to study nine health care organizations in Guangzhou, Dongguan, and Shenzhen cities within Guangdong province, China. 560 patients aged 50 or over with hypertension or diabetes who visited either CHCs or hospitals in these three cities were surveyed by using face-to-face interviews. Bivariate analyses were performed to compare quality and value of care indicators among subjects from the three cities. Multivariate analyses were used to assess the association between type of primary care delivery and quality as well as value of chronic care after controlling for patients' demographic and health status characteristics. Patients from all three cities chose their current health care providers primarily out of concern for quality of care (both provider expertise and adequate medical equipment), patient-centered care, and insurance plan requirement. Compared with patients from Guangzhou, those from Dongguan performed significantly better on most quality and value of care indicators. Most of these indicators remained significantly better even after controlling for patients' demographic and health status characteristics. The Shenzhen model (hospital-owned and -managed CHC) was generally effective in enhancing accessibility and continuity. However, coordination suffered due to seemingly duplicating primary care outpatients at the hospital setting. Significant associations between types of health care facilities and quality of care were also observed such that patients from CHCs were more likely to be satisfied with traveling time and follow-up care by

  9. Organization Complexity and Primary Care Providers' Perceptions of Quality Improvement Culture Within the Veterans Health Administration.

    Science.gov (United States)

    Korom-Djakovic, Danijela; Canamucio, Anne; Lempa, Michele; Yano, Elizabeth M; Long, Judith A

    2016-01-01

    This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers' (PCPs') perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohio. PCPs in community-based outpatient clinics reported an improvement in established processes for QI, and communication and cooperation from 2010 to 2012. However, their peers in hospital-based clinics did not report any significant improvements in QI culture. In both years, compared with high-complexity facilities, medium- and low-complexity facilities had better scores on the scales assessing established processes for QI, and communication and cooperation. © The Author(s) 2014.

  10. Exploring Diet Quality between Urban and Rural Dwelling Women of Reproductive Age.

    Science.gov (United States)

    Martin, Julie C; Moran, Lisa J; Teede, Helena J; Ranasinha, Sanjeeva; Lombard, Catherine B; Harrison, Cheryce L

    2017-06-08

    Health disparities, including weight gain and obesity exist between urban and rural dwelling women. The primary aim was to compare diet quality in urban and rural women of reproductive age, and secondary analyses of the difference in macronutrient and micronutrient intake in urban and rural women, and the predictors of diet quality. Diet quality was assessed in urban ( n = 149) and rural ( n = 394) women by a modified version of the Dietary Guideline Index (DGI) energy, macronutrient and micronutrient intake from a food frequency questionnaire (FFQ) and predictors of diet quality. Diet quality did not significantly differ between urban and rural women (mean ± standard deviation (SD), 84.8 ± 15.9 vs. 83.9 ± 16.5, p = 0.264). Rural women reported a significantly higher intake of protein, fat, saturated fat, monounsaturated fat, cholesterol and iron and a higher score in the meat and meat alternatives component of the diet quality tool in comparison to urban women. In all women, a higher diet quality was associated with higher annual household income (>$Australian dollar (AUD) 80,000 vs. urban and rural women; however, a higher macronutrient consumption pattern was potentially related to a higher lean meat intake in rural women. Women who are unemployed and on a lower income are an important target group for future dietary interventions aiming to improve diet quality.

  11. Effects of lanreotide Autogel primary therapy on symptoms and quality-of-life in acromegaly: data from the PRIMARYS study.

    Science.gov (United States)

    Caron, Philippe J; Bevan, John S; Petersenn, Stephan; Houchard, Aude; Sert, Caroline; Webb, Susan M

    2016-04-01

    To evaluate the effects of lanreotide Autogel on patient-reported outcomes and association with biochemical control, using PRIMARYS data. PRIMARYS was a 1-year, open-label study of lanreotide Autogel (Depot in USA) 120 mg every 4 weeks in 90 treatment-naïve patients with acromegaly. Symptoms were assessed using Patient-assessed Acromegaly Symptom Questionnaire (PASQ) and health-related quality of life (HRQoL) using the AcroQoL questionnaire. Correlations between PASQ and AcroQoL scores, and between PASQ/AcroQoL and growth hormone (GH)/insulin-like growth factor-1 (IGF-1) levels were also evaluated (post hoc). Acromegaly symptoms and HRQoL significantly improved from week 12 to week 48, with modest correlations at week 48 between PASQ total score (R = -0.55, p 50% of baseline standard deviation) in PASQ total score and >40% achieved a MID in AcroQoL global score (post hoc). Changes in PASQ scores were similar in biochemically controlled (GH levels ≤2.5 μg/L and normal IGF-1 levels) and uncontrolled groups, while changes in global and psychological AcroQoL scores were greater in the controlled group. There was no correlation between changes in PASQ or AcroQoL scores and changes in GH or IGF-1 levels. Primary treatment with lanreotide Autogel over 1 year was associated with rapid and sustained improvements in clinical signs and symptoms and HRQoL in patients with acromegaly. Improvements in HRQoL, but not symptoms, were greater in those achieving biochemical control (ClinicalTrials.gov: NCT00690898; EudraCT: 2007-000155-34).

  12. A systematic tale of two differing reviews: evaluating the evidence on public and private sector quality of primary care in low and middle income countries.

    Science.gov (United States)

    Coarasa, Jorge; Das, Jishnu; Gummerson, Elizabeth; Bitton, Asaf

    2017-04-12

    Systematic reviews are powerful tools for summarizing vast amounts of data in controversial areas; but their utility is limited by methodological choices and assumptions. Two systematic reviews of literature on the quality of private sector primary care in low and middle income countries (LMIC), published in the same journal within a year, reached conflicting conclusions. The difference in findings reflects different review methodologies, but more importantly, a weak underlying body of literature. A detailed examination of the literature cited in both reviews shows that only one of the underlying studies met the gold standard for methodological robustness. Given the current policy momentum on universal health coverage and primary health care reform across the globe, there is an urgent need for high quality empirical evidence on the quality of private versus public sector primary health care in LMIC.

  13. Methological quality of systematic reviews and meta-analyses on acupuncture for stroke: A review of review.

    Science.gov (United States)

    Chen, Xin-Lin; Mo, Chuan-Wei; Lu, Li-Ya; Gao, Ri-Yang; Xu, Qian; Wu, Min-Feng; Zhou, Qian-Yi; Hu, Yue; Zhou, Xuan; Li, Xian-Tao

    2017-11-01

    To assess the methodological quality of systematic reviews and meta-analyses regarding acupuncture intervention for stroke and the primary studies within them. Two researchers searched PubMed, Cumulative index to Nursing and Allied Health Literature, Embase, ISI Web of Knowledge, Cochrane, Allied and Complementary Medicine, Ovid Medline, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang and Traditional Chinese Medical Database to identify systematic reviews and meta-analyses about acupuncture for stroke published from the inception to December 2016. Review characteristics and the criteria for assessing the primary studies within reviews were extracted. The methodological quality of the reviews was assessed using adapted Oxman and Guyatt Scale. The methodological quality of primary studies was also assessed. Thirty-two eligible reviews were identified, 15 in English and 17 in Chinese. The English reviews were scored higher than the Chinese reviews (P=0.025), especially in criteria for avoiding bias and the scope of search. All reviews used the quality criteria to evaluate the methodological quality of primary studies, but some criteria were not comprehensive. The primary studies, in particular the Chinese reviews, had problems with randomization, allocation concealment, blinding, dropouts and withdrawals, intent-to-treat analysis and adverse events. Important methodological flaws were found in Chinese systematic reviews and primary studies. It was necessary to improve the methodological quality and reporting quality of both the systematic reviews published in China and primary studies on acupuncture for stroke.

  14. Evaluating quality management systems for HIV rapid testing services in primary healthcare clinics in rural KwaZulu-Natal, South Africa.

    Directory of Open Access Journals (Sweden)

    Ziningi Jaya

    between 64.4% (CI: 44%- 84% and 89.2% (CI: 74%- 100%.Ten out of eleven of the clinics were rated as moderate (70-89%. All clinic have scored highest for the following audit component: equipment; process control and specimen management; and facility ad safety, with 100%. Clinics obtained the lowest scores for the assessment audit component followed by process improvement and organisation, with 40.9% (CI: 15.7-66.1%, 45.5% (CI: 10.4-80.5% and 56.8% (CI: 31.8 81.8%, respectively. A statistically significant correlation was observed between the following: category of staff performing the HIV rapid tests in the audited clinics and service and satisfactory audit component; weekly average number of patients using the audited PHC clinics and service and satisfactory audit component; number of HIV lay counsellors in the audited clinics and quality control audit component with p<0.05.In the small audit of primary healthcare clinics located within the rural part of KwaZulu-Natal, results revealed an overall moderate rating of the quality management system for rapid HIV testing. Improvements in the organisation, quality control, process improvement and assessment components could enable a higher quality assurance rating for rural HIV testing in KwaZulu-Natal.

  15. Evaluating quality management systems for HIV rapid testing services in primary healthcare clinics in rural KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Jaya, Ziningi; Drain, Paul K; Mashamba-Thompson, Tivani P

    2017-01-01

    : 44%- 84%) and 89.2% (CI: 74%- 100%).Ten out of eleven of the clinics were rated as moderate (70-89%). All clinic have scored highest for the following audit component: equipment; process control and specimen management; and facility ad safety, with 100%. Clinics obtained the lowest scores for the assessment audit component followed by process improvement and organisation, with 40.9% (CI: 15.7-66.1%), 45.5% (CI: 10.4-80.5%) and 56.8% (CI: 31.8 81.8%), respectively. A statistically significant correlation was observed between the following: category of staff performing the HIV rapid tests in the audited clinics and service and satisfactory audit component; weekly average number of patients using the audited PHC clinics and service and satisfactory audit component; number of HIV lay counsellors in the audited clinics and quality control audit component with paudit of primary healthcare clinics located within the rural part of KwaZulu-Natal, results revealed an overall moderate rating of the quality management system for rapid HIV testing. Improvements in the organisation, quality control, process improvement and assessment components could enable a higher quality assurance rating for rural HIV testing in KwaZulu-Natal.

  16. A Research on Patient Satisfaction with Primary Health Care in the Center of Afyonkarahisar

    Directory of Open Access Journals (Sweden)

    Nazli Sensoy

    2013-10-01

    Full Text Available Aim: Patient satisfaction is an important indicator to evaluate the quality of primary health care service. It is also significant to improve the quality of medical care, expectation from health staff, priority of patient needs, views and feedbacks about medical services in primary health care. Our objective in this study is to determine the patient satisfaction and the factors effecting this aspect in the evaluation of primary health care quality. Material and Method: This research was carried out in one Mother and Child Health and Family Planning Centre and nine Health Centers in January 2009 at Afyonkarahisar center. The questionnaire was performed to investigate the degree of satisfaction about health services, and socio-demographic characteristics of patients admitted to primary health care by face to face interview method. The data was evaluated by SPSS 15.00.Results: 1227 patients participating in the study, 809 women and 418 were male, married 878, 290 were single.Their education level was 408 graduated from primary school. At the same time, their job distributions were 596 housewives, 133 retired. When the patients had health problems, the most preferable institutione was health center, the choice of the reasons they were satisfied with the services in general, determined as to obtain quick results and confidence in solving problems.75% of the patients waiting time for admission and registration procedures were 0-5minutes. The admission reasons were mostly physical examination and prescription. Patients who are male, aged above 50 years and low educated had much higher satisfaction levels. Discussion: As a result, decreased satisfaction with higher education level, satisfaction increased with increasing age and a short waiting period for the application-registration and examination procedures were being influenced patient satisfaction.

  17. Teacher evaluation system, institutions of technology higher education: quality guidelines

    Directory of Open Access Journals (Sweden)

    Laura Belkis Parada Romero

    2016-01-01

    Full Text Available Due to the globalization of education, it has become prevalent to strengthen the quality systems to ensure that educational actors in higher education institutions are the best. In this context teachers are given a main role since they are cornerstones in educational processes. Currently, teacher quality is assessed through an assessment or evaluation system. Almost every university evaluates its teachers, but there is no legal regulation on how to do it, in most institutions there is a professional in charge of designing and applying assessment instruments according to the authors he/she prefers. In most universities, on the one hand, it is used a traditional questionnaire aiming to collect data about dimensions associated with teaching, on the other hand, there is another option in which assessment models include self-evaluation, as in some cases in Chile. That’s why one of the concerns of this research is to propose guidelines for a more qualitative and formative assessment not exclusively following political parameters –based on administrative decisions–, but following emerging proposals with a deeper analysis. Nowadays the main actors in teacher evaluation are teachers, students and administrative staff, every six months these actors are evaluated by using an assessment tool that they usually do not know. The research investigates the perception actors in teacher evaluation have regarding its objectives, methods and stages, so they put forward ideas on how to restructure the current institutional assessment and propose improvements aiming at both the quantitative aspect and the qualitative analysis of performances and skills.

  18. in primary care

    African Journals Online (AJOL)

    Claire van Deventer

    Keywords: child HIV, doctor involvement, primary health care, quality improvement ... expertise increased, PHC facilities are now expected to be able to .... organised patient documentation were revisited. .... Review: what can we learn from quality ... South Pacific: Review of evidence and lessons from an innovative.

  19. Variations in Student Perceptions of Service Quality of Higher Education Institutions in Brazil: A Longitudinal Study

    Science.gov (United States)

    Campos, Domingos Fernandes; dos Santos, Guido Salvi; Castro, Felipe Nalon

    2017-01-01

    Purpose: The purpose of this paper is to examine, through a longitudinal study, undergraduate student perceptions of service expectations, priorities and quality of the higher education institution that they attend, using an importance-performance rating matrix. Design/methodology/approach: This research was carried out with students exposed to a…

  20. Social support network, mental health and quality of life: a cross-sectional study in primary care

    Directory of Open Access Journals (Sweden)

    Flávia Batista Portugal

    Full Text Available The objective of this study was to identify the association between emotional distress and social support networks with quality of life in primary care patients. This was a cross-sectional study involving 1,466 patients in the cities of São Paulo and Rio de Janeiro, Brazil, in 2009/2010. The General Health Questionnaire, the Hospital Anxiety and Depression Scale and the brief version of the World Health Organization Quality of Life Instrument were used. The Social Support Network Index classified patients with the highest and lowest index as socially integrated or isolated. A bivariate analysis and four multiple linear regressions were conducted for each quality of life outcome. The means scores for the physical, psychological, social relations, and environment domains were, respectively, 64.7; 64.2; 68.5 and 49.1. In the multivariate analysis, the psychological domain was negatively associated with isolation, whereas the social relations and environment domains were positively associated with integration. Integration and isolation proved to be important factors for those in emotional distress as they minimize or maximize negative effects on quality of life.

  1. Serum heme oxygenase-1 levels in patients with primary dysmenorrhea.

    Science.gov (United States)

    Aksoy, Ayse Nur; Laloglu, Esra; Ozkaya, Alev Lazoglu; Yilmaz, Emsal Pınar Topdagi

    2017-04-01

    Primary dysmenorrhea effects the life-quality of women negatively. The aim of this study was to evaluate heme oxygenase-1 (HO1) activity together with malondialdehyde (MDA) and nitric oxide (NO) levels in patients with primary dysmenorrhea. A total of 28 nulliparous women with the diagnosis of primary dysmenorrhea and 26 healthy controls were included in this study. On the first day of menstruation, all patients underwent ultrasound examination to exclude pelvic pathology and the visual analogue scale was applied to patients. Patient's visual analogue scale (VAS) scores, age, body mass index (BMI), menstrual cycle length (day), length of bleeding (day) were recorded. In the same day, fasting blood samples were taken from each patient for biochemical analysis. Serum MDA, NO and HO1 levels were found to be higher in women with primary dysmenorrhea compared to healthy controls (p = 0.012, p = 0.009, p dysmenorrhea. Antioxidant support might be helpful to reduce pain severity in primary dysmenorrhea.

  2. Students as Stakeholders in the Policy Context of the European Standards and Guidelines for Quality Assurance in Higher Education Institutions

    NARCIS (Netherlands)

    Logermann, Frauke; Leisyte, Liudvika; Curaj, Adrian; Matei, Liviu; Pricopie, Remus; Salmi, Jamil; Scott, Peter

    2015-01-01

    The European Standard and Guidelines for Quality Assurance (ESG) of 2005 can be defined as one of the major Bologna documents aimed at furthering the role of students as stakeholders in internal quality assurance processes at higher education institutions (HEIs). Still little is known about

  3. Adopting Self-Accreditation in Response to the Diversity of Higher Education: Quality Assurance in Taiwan and Its Impact on Institutions

    Science.gov (United States)

    Chen, Karen Hui-Jung; Hou, Angela Yung-Chi

    2016-01-01

    In 2012, Taiwan implemented a dual-track quality assurance system comprising accreditation and self-accreditation in higher education institutions. Self-accrediting institutions can accredit their programs without requiring approval from external quality assurance agencies. In contrast to other countries, the Ministry of Education of Taiwan…

  4. Which journals do primary care physicians and specialists access from an online service?

    Science.gov (United States)

    McKibbon, K Ann; Haynes, R Brian; McKinlay, R James; Lokker, Cynthia

    2007-07-01

    The study sought to determine which online journals primary care physicians and specialists not affiliated with an academic medical center access and how the accesses correlate with measures of journal quality and importance. Observational study of full-text accesses made during an eighteen-month digital library trial was performed. Access counts were correlated with six methods composed of nine measures for assessing journal importance: ISI impact factors; number of high-quality articles identified during hand-searches of key clinical journals; production data for ACP Journal Club, InfoPOEMs, and Evidence-Based Medicine; and mean clinician-provided clinical relevance and newsworthiness scores for individual journal titles. Full-text journals were accessed 2,322 times by 87 of 105 physicians. Participants accessed 136 of 348 available journal titles. Physicians often selected journals with relatively higher numbers of articles abstracted in ACP Journal Club. Accesses also showed significant correlations with 6 other measures of quality. Specialists' access patterns correlated with 3 measures, with weaker correlations than for primary care physicians. Primary care physicians, more so than specialists, chose full-text articles from clinical journals deemed important by several measures of value. Most journals accessed by both groups were of high quality as measured by this study's methods for assessing journal importance.

  5. Quality and accreditation in higher education: integration and internationalization of Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    Jorge González González

    2013-10-01

    Full Text Available The paper discusses the concepts of «quality» and «accreditation» in education with different meanings, and proposes comprehensive definitions that have been put into practice by the Union of Universities of Latin America and the Caribbean and the International Network of Evaluators through model «V» evaluation planningfor continuous improvement, integration and internationalization of higher education.

  6. Health-Related Quality of Life in Primary Care: Which Aspects Matter in Multimorbid Patients with Type 2 Diabetes Mellitus in a Community Setting?

    Science.gov (United States)

    Kamradt, Martina; Krisam, Johannes; Kiel, Marion; Qreini, Markus; Besier, Werner; Szecsenyi, Joachim; Ose, Dominik

    2017-01-01

    Knowledge about predictors of health-related quality of life for multimorbid patients with type 2 diabetes mellitus in primary care could help to improve quality and patient-centeredness of care in this specific group of patients. Thus, the aim of this study was to investigate the impact of several patient characteristics on health-related quality of life of multimorbid patients with type 2 diabetes mellitus in a community setting. A cross-sectional study with 32 primary care practice teams in Mannheim, Germany, and randomly selected multimorbid patients with type 2 diabetes mellitus (N = 495) was conducted. In order to analyze associations of various patient characteristics with health-related quality of life (EQ-5D index) a multilevel analysis was applied. After excluding patients with missing data, the cohort consisted of 404 eligible patients. The final multilevel model highlighted six out of 14 explanatory patient variables which were significantly associated with health-related quality of life: female gender (r = -0.0494; p = .0261), school education of nine years or less (r = -0.0609; p = .0006), (physical) mobility restrictions (r = -0.1074; p = .0003), presence of chronic pain (r = -0.0916; p = .0004), diabetes-related distress (r = -0.0133; p diabetes-related distress, chronic pain, restrictions in (physical) mobility, female gender, as well as lower education and, increased BMI have a noteworthy impact on health-related quality of life in multimorbid patients with type 2 diabetes mellitus seen in primary care practices in a community setting. The highlighted aspects should gain much more attention when treating multimorbid patients with type 2 diabetes mellitus.

  7. Software requirements elicitation to support internal monitoring of quality assurance system for higher education in Indonesia

    Science.gov (United States)

    Amalia, A.; Gunawan, D.; Hardi, S. M.; Rachmawati, D.

    2018-02-01

    The Internal Quality Assurance System (in Indonesian: SPMI (Sistem Penjaminan Mutu Internal) is a systemic activity of quality assurance of higher education in Indonesia. SPMI should be done by all higher education or universities in Indonesia based on the Regulation of the Minister of Research, Technology and Higher Education of the Republic of Indonesia Number 62 of 2016. Implementation of SPMI must refer to the principle of SPMI that is independent, standardize, accurate, well planned and sustainable, documented and systematic. To assist the SPMI cycle properly, universities need a supporting software to monitor all the activities of SPMI. But in reality, many universities are not optimal in building this SPMI monitoring system. One of the obstacles is the determination of system requirements in support of SPMI principles is difficult to achieve. In this paper, we observe the initial phase of the engineering requirements elicitation. Unlike other methods that collect system requirements from users and stakeholders, we find the system requirements of the SPMI principles from SPMI guideline book. The result of this paper can be used as a choice in determining SPMI software requirements. This paper can also be used by developers and users to understand the scenario of SPMI so that could overcome the problems of understanding between this two parties.

  8. Addressing long-term physical healthcare needs in a forensic mental health inpatient population using the UK primary care Quality and Outcomes Framework (QOF): an audit

    OpenAIRE

    Ivbijaro, GO; Kolkiewicz, LA; McGee, LSF; Gikunoo, M

    2008-01-01

    Objectives This audit aims to evaluate the effectiveness of delivering an equivalent primary care service to a long-term forensic psychiatric inpatient population, using the UK primary care national Quality and Outcomes Framework (QOF).

  9. An Evaluation of Service Quality in Higher Education: Marmara and Nigde Omer Halisdemir Universities' Department of Education Students

    Science.gov (United States)

    Ada, Sefer; Baysal, Z. Nurdan; Erkan, Senem Seda Sahenk

    2017-01-01

    The purpose of this research is to evaluate the quality service in higher education in Marmara and Nigde Omer Halisdemir Universities' department of education students. This study was prepared using a screening model from quantitative research methods. The sample of this research comprised 886 university students attending the higher education…

  10. Use of automated reminder letters to improve diabetes management in primary care: outcomes of a quality improvement initiative.

    Science.gov (United States)

    Berryman, Sally H; Sick, Brian T; Wang, Qi; Swan, Paul J; Weber-Main, Anne Marie

    2013-01-01

    Effective management of patients with diabetes mellitus (DM) can be time-consuming and costly. One patient-centred quality improvement strategy is to generate reminder letters to prompt patient action(s), but this strategy's effect on DM outcomes is uncertain. To determine whether using the electronic medical record to automatically generate reminder letters for patients not meeting recommended DM targets is associated with improvement in practice level quality metrics for DM management. Over 15 months, letters were sent monthly to all patients with DM in a large, urban, primary care teaching practice whose records for haemoglobin A1c (HbA1c), low-density lipoprotein (LDL) or blood pressure (BP) indicated non-compliance with recommended levels and testing intervals. Logistic regression was used to analyse cross-sectional, practice-level differences in the proportion of patients meeting DM quality metrics (HbA1c < 7%, LDL < 100 mg/dl and BP < 130/80 mmHg; rates of checking each value within the last 12 months; and a composite of these five measures) across four time points: six months before the intervention, start of the intervention, end of the 15-month intervention period and six months after the intervention. The number of letters sent per month ranged from 284 to 392, representing 28-38% of all patients with DM. At the end of the intervention, patients' odds of being at goal were higher than before the intervention began for LDL < 100 mg/dl, and for HbA1c and LDL tested once within the last 12 months (or 1.24, P = 0.005; or 1.35, P = 0.03; or 1.48, P < 0.001, respectively). Post intervention, declines were seen in LDL checked within the last 12 months (or 0.76, P = 0.003) and in the composite endpoint (or 0.78, P = 0.005). The automated patient-reminder letter intervention was associated with modest improvements in several, but not all DM measures. This approach may be an effective tool for improving quality of care for patients with DM.

  11. Type D personality is a predictor of poor emotional quality of life in primary care heart failure patients independent of depressive symptoms and New York Heart Association functional class.

    Science.gov (United States)

    Pedersen, Susanne S; Herrmann-Lingen, Christoph; de Jonge, Peter; Scherer, Martin

    2010-02-01

    Quality of life is an important patient-centered outcome and predictor of mortality in heart failure, but little is known about the role of personality as a determinant of quality of life in this patient group. We examined the influence of Type D personality (i.e., increased negative emotions paired with emotional non-expression) on quality of life in primary care heart failure patients, using a prospective study design. Heart failure patients (n = 251) recruited from 44 primary care practices in Germany completed standardized questionnaires at baseline and 9 months. The prevalence of Type D was 31.9%. Type D patients experienced poorer emotional (P emotional (P = .78) nor physical quality of life (P = .74) over time; neither the interaction for time by Type D for emotional (P = .31) nor physical quality of life (P = .91) was significant, indicating that Type D exerted a stable effect on quality of life over time. Adjusting for demographics, New York Heart Association functional class, and depressive symptoms, Type D remained an independent determinant of emotional (P = .03) but not physical quality of life (P = .29). Primary care heart failure patients with a Type D personality experienced poorer emotional but not physical quality of life compared to non-Type D patients. Patients with this personality profile should be identified in primary care to see if their treatment is optimal, as both Type D and poor quality of life have been associated with increased morbidity and mortality.

  12. Functioning of primary health care in opinion of managers of primary health care units.

    Science.gov (United States)

    Bojar, I; Wdowiak, L; Kwiatosz-Muc, M

    2006-01-01

    The aim of the research is to get to know opinions of primary health care managers concerning working of primary health care and concerning quality of medical services offered by family doctors out-patient clinics. The research among managers of primary health care units took place in all out-patient clinics in Lublin province. Research instrument was survey questionnaire of authors own construction. Results were statistically analyzed. From 460 surveys sent, 108 questionnaires were accepted to analysis. Majority of managers of out-patient clinics of primary health care is satisfied with the way and the quality of work of employed staff. In opinion of 71.3% of managers access to family doctor services is very good. Availability of primary health care services is better estimated by managers of not public units. The occupied local provide comfortable work for the staff in opinion of 78.5% of surveyed managers of out-patient clinics. Managers estimate the level of their services as very good (37.96%) and good (37.96%) comparing to other such a subjects present in the market. Internal program of improving quality is run in 22% of out-patient clinics, which were investigated. Managers of primary health care units assess the quality of their services as good and very good. They estimate positively the comfort and politeness in serving patients as well as technical status of equipment and the lodging. They assess availability of their services as very good. Large group of managers of family doctors practices recognizes neighborhood practices as a competitors.

  13. Automatic Assessment of Pathological Voice Quality Using Higher-Order Statistics in the LPC Residual Domain

    Directory of Open Access Journals (Sweden)

    JiYeoun Lee

    2009-01-01

    Full Text Available A preprocessing scheme based on linear prediction coefficient (LPC residual is applied to higher-order statistics (HOSs for automatic assessment of an overall pathological voice quality. The normalized skewness and kurtosis are estimated from the LPC residual and show statistically meaningful distributions to characterize the pathological voice quality. 83 voice samples of the sustained vowel /a/ phonation are used in this study and are independently assessed by a speech and language therapist (SALT according to the grade of the severity of dysphonia of GRBAS scale. These are used to train and test classification and regression tree (CART. The best result is obtained using an optima l decision tree implemented by a combination of the normalized skewness and kurtosis, with an accuracy of 92.9%. It is concluded that the method can be used as an assessment tool, providing a valuable aid to the SALT during clinical evaluation of an overall pathological voice quality.

  14. Patient satisfaction with quality of primary health care in Benghazi, Libya.

    Science.gov (United States)

    Salam, Asharaf Abdul; Alshekteria, Amina Abdulla; Abd Alhadi, Hana; Ahmed, Mariam; Mohammed, Anees

    2010-10-21

    The Libyan National Health System (LNHS) is debated for the paradox of its performance versus impact. It has poor performance, but the national health statistics are good and competitive. There are concerted efforts to manage health care services and to regain the lost trust. A primary health care (PHC) system that focuses on preventive and promotive care is the core focus of LNHS efforts. To assess patient satisfaction with quality of PHC assessed in terms of (a) customer profile, (b) patient satisfaction, and (c) health care-seeking behavior. A sample of nine health centers and seven polyclinics from various locations in Benghazi, Libya were selected for gathering information by structured face-to-face interviews. A total of 310 beneficiaries were interviewed by using an Arabic translation of the Charleston Psychiatric Outpatient Satisfaction Scale. The beneficiaries appear to be quite satisfied with the quality of services. Geographical zone, marital status of beneficiary, and type of facility are satisfaction-related factors. There are preferences for facilities located within the City Centre over those located elsewhere. There is also an interaction effect of the geographical zone and the type of facility in creating differences in satisfaction. A customer-friendly facility concept that emphasizes reception, physician interaction, and cordiality shall add value. Polyclinics require more attention as does the Al Slawy area. A few utility services might also be considered.

  15. Potable water quality monitoring of primary schools in Magura district, Bangladesh: children's health risk assessment.

    Science.gov (United States)

    Rahman, Aminur; Hashem, Abul; Nur-A-Tomal, Shahruk

    2016-12-01

    Safe potable water is essential for good health. Worldwide, school-aged children especially in the developing countries are suffering from various water-borne diseases. In the study, drinking water supplies for primary school children were monitored at Magura district, Bangladesh, to ensure safe potable water. APHA standard analytical methods were applied for determining the physicochemical parameters of the water samples. For determination of the essential physicochemical parameters, the samples were collected from 20 randomly selected tube wells of primary schools at Magura. The metal contents, especially arsenic (As), iron (Fe), and manganese (Mn), in the water samples were analyzed by atomic absorption spectroscopy. The range of physicochemical parameters found in water samples were as follows: pH 7.05-9.03, electrical conductivity 400-2340 μS/cm, chloride 10-640 mg/L, hardness 200-535 mg/L as CaCO 3 , and total dissolved solids 208-1216 mg/L. The level of metals in the tube well water samples were as follows: As 1 to 55 μg/L, Fe 40 to 9890 μg/L, and Mn 10 to 370 μg/L. Drinking water parameters of Magura district did not meet the requirement of the World Health Organization drinking water quality guideline, or the Drinking Water Quality Standards of Bangladesh.

  16. The Pedagogy of Higher Education: How to Evaluate the Quality of Training in Morocco to Improve it

    Directory of Open Access Journals (Sweden)

    Sara Riahi

    2018-02-01

    Full Text Available This paper is devoted to the profession of higher education. It aims to characterize the profession of teaching and objectively draw the portrait of the Moroccan teacher to identify the business improvement routes, so the education system. This paper deals with the teaching profession in all cycles of education and training: a detailed analysis of the state of the trade is proposed for primary and secondary education, supplemented by the results of the survey, opinion on these cycles; for higher education and vocational training, a brief description of the state of business is provided in this paper.

  17. Relationship Quality Time: The Validation of a Relationship Quality Scale in Higher Education

    Science.gov (United States)

    Snijders, Ingrid; Rikers, Remy M. J. P.; Wijnia, Lisette; Loyens, Sofie M. M.

    2018-01-01

    This study investigated the overall "quality" of the interpersonal relationship students have with faculty and staff, that is, relationship quality (RQ). In relationship management research, RQ is paramount for the creation of bonds with customers, which in turn is necessary for the sustainability of organizations, that is, continuity…

  18. Case Study on Quality Education

    Science.gov (United States)

    Habib, Zahida

    2011-01-01

    Quality of Education, especially at Primary level, is an important issue to be discussed at the International Forum. This study highlights the quality of primary education through a comparison of the quality of Community Model Schools and Govt. Girls Primary Schools in Pakistan. Community Model Schools were established under Girls Primary…

  19. Implementation of a Quality Improvement Process Aimed to Deliver Higher-Value Physical Therapy for Patients With Low Back Pain: Case Report.

    Science.gov (United States)

    Karlen, Emily; McCathie, Becky

    2015-12-01

    The current state of health care demands higher-value care. Due to many barriers, clinicians routinely do not implement evidence-based care even though it is known to improve quality and reduce cost of care. The purpose of this case report is to describe a theory-based, multitactic implementation of a quality improvement process aimed to deliver higher-value physical therapy for patients with low back pain. Patients were treated from January 2010 through December 2014 in 1 of 32 outpatient physical therapy clinics within an academic health care system. Data were examined from 47,755 patients (mean age=50.3 years) entering outpatient physical therapy for management of nonspecific low back pain, with or without radicular pain. Development and implementation tactics were constructed from adult learning and change management theory to enhance adherence to best practice care among 130 physical therapists. A quality improvement team implemented 4 tactics: establish care delivery expectations, facilitate peer-led clinical and operational teams, foster a learning environment focused on meeting a population's needs, and continuously collect and analyze outcomes data. Physical therapy utilization and change in functional disability were measured to assess relative cost and quality of care. Secondarily, charge data assessed change in physical therapists' application of evidence-based care. Implementation of a quality improvement process was measured by year-over-year improved clinical outcomes, decreased utilization, and increased adherence to evidence-based physical therapy, which was associated with higher-value care. When adult learning and change management theory are combined in quality improvement efforts, common barriers to implementing evidence-based care can be overcome, creating an environment supportive of delivering higher-value physical therapy for patients with low back pain. © 2015 American Physical Therapy Association.

  20. Measurement of Perceived Service Quality in Higher Education Institutions: A Review of HEdPERF Scale Use

    Science.gov (United States)

    Silva, Danilo Soares; de Morales, Gustavo Hermínio Salati Marcondes; Makiya, Ieda Kanashiro; Cesar, Francisco Ignácio Giocondo

    2017-01-01

    Purpose: This study aims to find evidence of the HEdPERF scale use for measuring the perceived service quality from the perspective of students in higher education institutions (HEIs) worldwide. Design/methodology/approach: A systematic review of the literature was conducted to find evidence of the scale use in articles published between January…