37 resultados para Quality improvement methodologies


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Background Health-related quality of life (HRQOL) among long-term survivors of coronary artery bypass surgery is an important outcome that has been little studied at the population level. Methods A postal survey was conducted in 1999 to 2000 in patients 6 to 20 years after coronary artery bypass graft (CABG) surgery in Western-Australia. A random stratified sample of 2500 was drawn from 8910 patients who had their first CABG surgery in 1980 to 1993. Health-related quality of life was measured with Short Form 36 and EuroQol visual analogue scale. Results Response was 82% (n = 2061). Health-related quality of life declined with age and was similar for men and women, although scores for women were worse for physical functioning. Compared with Australian population norms, the age- and sex-standardized scores of survivors of CABG were generally worse, mainly in the physical domain. Reported angina at the time of follow-up (33%), symptoms of heart failure equivalent to New York Heart Association (NYHA) classes II to IV (34%), and comorbidities such as diabetes and hypertension were associated with poorer HRQOL. For both men and women without angina or heart failure at follow-up, HRQOL was no different from that of the general population. Conclusion Overall, the quality of life among long-term survivors of CABG is worse than that of the general population, the difference being mainly attributable to recurrent symptoms and comorbidities. Quality of life for those without angina or heart failure at follow-up was equivalent to the population norms, providing an incentive to maximize efforts to abolish angina and ameliorate heart failure symptoms.

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Inconsistent internal fruit quality in Hass avocados affects consumer confidence. To determine the influence of individual trees on fruit quality, Hass avocado fruit were harvested from adjacent trees of similar external appearance in 3 commercial orchards in 1998 and 1 orchard in 1999. The trees in each orchard were grown with similar commercial practices and in similar soil types. Within each location, there were significant (P < 0.05) differences in the mean ripe fruit quality between trees with respect to fruit body rot severity ( mainly anthracnose) with and without cold storage, internal disorders severity due to diffuse discolouration and vascular browning ( after cold storage), days to ripen, percentage dry matter, and the percentage of the skin area with purple-black colour when ripe. These effects were also noted in the same orchard in 1999. There were significant (P < 0.05) differences in fruit flesh calcium, magnesium, potassium, boron and zinc concentrations between trees. Significant (P < 0.05) correlations were observed between average fruit mineral concentrations in each tree ( particularly calcium, magnesium and potassium) and body rot severity, percentage dry matter and fruit mass. There was little conclusive evidence that characteristics such as the growth of the non-suberised roots or the degree of scion under- or overgrowth was involved in these tree effects; however, differences between trees with respect to other rootstock characteristics may be involved. The inconsistency of the correlations across sites and years suggested that other factors apart from tree influences could also affect the relationship between fruit minerals and fruit quality.