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Two-thirds of medical decisions are based on laboratory test results. Therefore, laboratories should practice strict quality control (QC) measures. Traditional QC processes may not accurately reflect the magnitude of errors in clinical laboratories. Six Sigma is a statistical tool which provides opportunity to assess performance at the highest level of excellence. The purpose of this paper is to evaluate performance of the coagulation laboratory utilizing Sigma metrics as the highest level of quality.

Quality indicators of the coagulation laboratory from January 1, 2009, to December 31, 2015, were evaluated. These QIs were categorized into pre-analytical, analytical and post-analytical. Relative frequencies of errors were calculated and converted to Sigma scale to determine the extent of control over each process. The Sigma level of 4 was considered optimal performance.

During the study period, a total of 474,655 specimens were received and 890,535 analyses were performed. These include 831,760 (93.4 percent) routine and 58,775 (6.6 percent) special tests. Stat reporting was requested for 166,921 (18.7 percent). Of 7,535,146 total opportunities (sum of the total opportunities for all indicators), a total of 4,005 errors were detected. There were 2,350 (58.7 percent) pre-analytical, 11 (0.3 percent) analytical and 1,644 (41 percent) post-analytical errors. Average Sigma value obtained was 4.8 with 12 (80 percent) indicators achieving a Sigma value of 4. Three (20 percent) low-performance indicators were: unacceptable proficiency testing (3.8), failure to inform critical results (3.6) and delays in stat reporting (3.9).

This study shows that a small number of errors can decrease Sigma value to below acceptability limits. If clinical laboratories start using Sigma metrics for monitoring their performance, they can identify gaps in their performance more readily and hence can improve their performance and patient safety.

This study provides an opportunity for the laboratorians to choose and set world-class goals while assessing their performance.

To the best of the authors’ knowledge and belief, this study is the first of its kind that has utilized Sigma metrics as a QC tool for monitoring performance of a coagulation laboratory.

This study aims to differentiate crime-related characteristics (such as the number of cases filed against current convictions and criminal history) based on the criminal thinking prevailing among convicts. However, because of the low reliability of subscales and poor structural validity of indigenous and translated versions of international instruments, a new instrument criminal attitude measure (CAM) was extracted to measure criminal thinking patterns among convicts incarcerated in central prisons of Punjab.

A cross-sectional research design was used. Data was collected from 1,949 male convicts (extracting mutually exclusive data from 649 respondents for EFA and 1,300 respondents for confirmatory factor analysis [CFA]). Both data samples were collected from convicts incarcerated in the nine (all) central jails of Punjab, Pakistan.

The results of this study showed poor model fit for both the indigenous criminal thinking scale and the translated version of criminogenic cognition scale. CAM was extracted through principal component analysis and proposed as a 15-item questionnaire with five factors extracted through varimax rotation. Those five factors are power orientation, mollification, entitlement, mistrust toward authorities and short-term orientation. The results of CFA for CAM confirmed the proposed five-factor structure for the construct. Findings based on MANOVA further found that CAM differentiates between the thinking patterns of recidivists, convicts with multiple charges filed against them in current convictions and convicts with a familial criminal record. The findings of this study showed that CAM is a practical, valid and reliable instrument for measuring criminal thinking among convicts.

In this study, using the survey method was inevitable because of the restrictions imposed by the granted permission. However, this time duration was extended because of the courtesy of the Superintendent and Deputy Superintendent of each jail. This study is focused on a male sample only, and the findings cannot be generalized to females. The phenomena proposed (based on large data sets) in this study can further be elaborated using qualitative research designs and methods (using a small sample with an in-depth study). So, it is also suggested to test this new instrument on a comparative study between prisoners and non-prisoners to explore whether scale can differentiate between these two groups.

A short-scale and easy-to-administer instrument was developed for assessing major criminogenic needs among convicts for prison management, i.e. assigning barracks, allocating treatment and also detecting changes in attitude after imprisonment.

To the best of the authors’ knowledge, this study is the first study to explore and validate the construct of criminal attitudes among convicts using both the EFA and CFA. A small and valid instrument facilitates the measurement of criminogenic needs among prisoners. Data was collected from all central jails in Punjab. This study explored comparatively less researched crime characteristics in a relatively large sample.

This study aims to differentiate maladaptive personality domains through crime-related characteristics among convicts incarcerated in central jails of Punjab (CJP). In total, 552 respondents were taken from nine CJP.

Data were collected through the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Short Form (PID-5 SF) (Maples et al., 2015), and forced-choice questions were designed to measure crime-related characteristics.

Confirmatory factor analysis showed that PID-5 SF exhibited a good to excellent construct validity based on the DSM-5 criteria of using three facets to measure a domain (APA, 2013). Multivariate analysis showed that convicts who have committed different crime types and have criminal records exhibit different personality domains.

In addition to the literature, the data from all CJP, Pakistan, was collected and tested so that need for personality-oriented intervention could be identified for the prison setting. This also highlights that the usefulness of PID-5 SF is not only in identifying maladaptive personality among incarcerated convicts but also in differentiating between different crime-related characteristics.

This paper aims to investigate the effect of audit quality and environmental auditing on integrated reporting and the effect of environmental auditing on audit quality.

Data was collected from a sample of 300 international companies during the period 2010–2019. The author collected the data from the Thomson Reuters Eikon database, sustainability reports and annual reports. A multiple regression analysis was performed to test the hypotheses.

The finding of this study confirms a positive and significant relationship between audit quality and integrated reporting. It is also found that environmental auditing has a positive and significant effect on integrated reporting. Thus, this study found a positive and significant relationship between environmental auditing and audit quality.

The findings in this paper identify strategies for improving integrated reporting as a crucial element in the processing of financial and nonfinancial information, to help managers and investors and shareholders take a long-term perspective. Therefore, the results encourage companies to invest in economic, environmental and social aspects. This enables accounting professionals, stock exchange authorities and users of environmental and social information to be aware of the factors associated with environmental reporting, to improve the efficiency of those producing the audit service.

The originality of this study lies in its consideration of a particular aspect of auditing, namely, environmental auditing. However, despite the large body of research on auditing and integrated reporting, to the best of the author’s knowledge, this is the first study to examine the relationship between environmental auditing and integrated reporting. Furthermore, in this research, the author has emphasized the importance of the role played by environmental auditing on audit quality. This design has been neglected in previous studies. Finally, the choice of the field of investigation for the reliability of the data used and the generalization of the results obtained, enables us to make important contributions to the user of the information.