179 resultados para Quality Use of Medicines
Resumo:
Parmesan-type cheeses are the most consumed special cheeses in Brazil. It is generally sold in retail shops, either grated or in wedge-shaped pieces, and its quality varies considerably, which is reflected directly in its price. There is lack of processing standardization and, since the ripening period is fundamental for the quality of this hard, semi-fat cooked cheese, this stage seems to be the thin line between low and high quality products. It is important to note that the Italian Parmegiano Reggiano is matured for a period of twelve months, as well as its rival Grana Padano, and this long ripening period causes changes making them gourmet, highly-valued cheeses. In the present study, twelve different Parmesan-type cheeses were purchased from the Brazilian retail market and evaluated for microbiological, physicochemical, and instrumental parameters. Heterogeneous quality was confirmed by microbiological problems detected in the samples and physicochemical composition that did not meet current Brazilian specifications. The use of principal component analysis and hierarchical cluster analysis made it possible to separate the samples into three distinct groups, mainly due to different acidity and moisture levels, water activity, and hardness values. The price per kg was also considered and was correlated with moisture, acidity, and texture.
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The objective of this study was to evaluate the effect of Moringa oleifera Lam. leaf extract on the sedimentation of impurities in the treatment of sugarcane juice and the effects on sugar quality and on the clarified juice. The experimental design used was a 4x2 factorial arrangement with four replications. The main treatments performed included the extracted original sugarcane juice, the synthetic polyelectrolyte (Flomex 9076), the leaf extract, and a control. The secondary treatments consisted of the sugarcane varieties RB92579 and RB867515. The clarification process used was simple defecation, in which the flocculating agents and the juice, limed and heated, were poured simultaneously into a decanter. The microbiological and chemico-technological characteristics of the extracted and clarified juices were evaluated. The clarified juice was concentrated up to 60° Brix (syrup) and subjected to boiling in a pilot pan using seeds to perform the graining: The sugar was recovered by centrifugation and analyzed for microbiological and chemico-technological characteristics. It was concluded that the use of the Moringa oleifera Lam. leaves extract resulted in a better quality of clarified juice and sugar.
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In this study, seven wine samples were prepared varying the amount of pulp of acerola fruits and the sugar content using the simulated annealing technique to obtain the optimal sensory qualities and cost for the wine produced. S. cerevisiae yeast was used in the fermentation process and the sensory attributes were evaluated using a hedonic scale. Acerola wines were classified as sweet, with 11°GL of alcohol concentration and with aroma, taste, and color characteristics of the acerola fruit. The simulated annealing experiments showed that the best conditions were found at mass ratio between 1/7.5-1/6 and total soluble solids between 28.6-29.0 °Brix, from which the sensory acceptance scores of 6.9, 6.8, and 8.8 were obtained for color, aroma, and flavor, respectively, with a production cost 43-45% lower than the cost of traditional wines commercialized in Brazil.
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The most promising microorganisms for use as starter cultures are those isolated from the native microbiota of traditional fermented products. The aim of this study was to evaluate the use of lactic acid bacteria selected from the native microbiota of sausages produced by spontaneous fermentation as starter cultures for the production of sausage. Strains of Lactobacillus plantarum 503 and 341 have the potential for use as starter cultures in the manufacture of Italian sausage type. The population of lactic acid bacteria in sausages was >8 log CFU.g-1 during fermentation, which caused the pH to decrease to <4.5. This decrease in pH and the water activity of < 0.90 of sausages ensures the safety and preservation of this product. Sausages produced with these lactic cultures fulfill the requirements for microbiological quality and composition of Italian sausage type. Our results suggest the possibility of using these starter cultures for the production of sausages with peculiar characteristics that contribute to the identity of the product.
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This study aimed to evaluate the effects of slow (–18 °C) and fast freezing (liquid nitrogen) of pork meat, and the use of exudate released upon thawing, on the physicochemical, color, rheological, microbiological, histological, and sensory characteristics of cooked ham. The meat samples were frozen at –18 °C and thawed after 22 weeks for the production of cooked ham. No significant difference was observed regarding physicochemical, color and microbiological parameters or in sensory acceptance. The hardness and chewiness parameters showed significant differences when compared to the control sample (ham made from chilled meat). Light microscopy of cooked ham samples showed that changes in the tissues were caused by freezing and thawing the meat. The effect of exudate was significant on the sodium content and compression force parameters, but this difference was not perceived in the sensory analysis, confirming that frozen pork meat can be used to produce cooked ham without loss of quality.
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The central goal of this paper is thinking about the Brazilian military power and its linking to the international ambitions of the country in the 21st century. After a comparative analysis to other BRICs and with a historical one about Brazil's strategic irrelevance, we aim to establish what the minimum military capacity Brazil would need in order to meet the country's latest international interests. Similarly, it will be discussed if the National Strategy of Defense, approved in 2008, and the recent strategic agreements signed with France represent one more step toward this minimum military capacity.
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With the purpose of at lowering costs and reendering the demanded information available to users with no access to the internet, service companies have adopted automated interaction technologies in their call centers, which may or may not meet the expectations of users. Based on different areas of knowledge (man-machine interaction, consumer behavior and use of IT) 13 propositions are raised and a research is carried out in three parts: focus group, field study with users and interviews with experts. Eleven automated service characteristics which support the explanation for user satisfaction are listed, a preferences model is proposed and evidence in favor or against each of the 13 propositions is brought in. With balance scorecard concepts, a managerial assessment model is proposed for the use of automated call center technology. In future works, the propositions may become verifiable hypotheses through conclusive empirical research.
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An alternative vector control method, using lambda-cyhalothrin impregnated wide-mesh gauze covering openings in the walls of the houses was developed in an area in the Eastern part of the interior of Suriname. Experimental hut observations showed that Anopheles darlingi greatly reduced their biting activity (99-100%) during the first 5 months after impregnation. A model assay showed high mortality both of mosquitoes repelled by the gauze as well as of those that succeeded in getting through it. A field application test in 270 huts showed good acceptance by the population and good durability of the applied gauze. After introducing the method in the entire working area, replacing DDT residual housespraying, the malaria prevalence, of 25-37% before application dropped and stabilized at between 5 and 10% within one year. The operational costs were less than those of the previously used DDT housespraying program, due to a 50% reduction in the cost of materials used. The method using widemesh gauze impregnated with lambdacyhalothrin strongly affects the behavior of An. darlingi. It is important to examine the effect of the method on malaria transmission further, since data indirectly obtained suggest substantial positive results.
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INTRODUCTION: Population aging in Brazil has increased the prevalence of neurodegenerative diseases (Parkinson's and Alzheimer's disease) and affective disorders (anxiety, depression), all common in old age. A retrospective study was carried out with the purpose of ascertaining if there is an association between falls and psychoactive medication use among older residents of a community in Brazil. METHODS: All residents aged 65+ (n=161) of one neighborhood of Campo Belo, Brazil (population of 48,000) were evaluated regarding the use of psychoactive drugs and the occurrence of falls in the 12 months preceding the study. Vision and hearing screenings were also performed. RESULTS: From the study population, 9.3% were taking prolonged half-life benzodiazepines, 4.4% anticonvulsants (mostly barbiturates), 2.5% antidepressants (all cyclics) and 8.1% alpha-methyldopa. No subject reported use of hypnotics, neuroleptics or drugs to treat Alzheimer's or Parkinson's diseases (except biperiden). As a whole, drugs that increase the risk of falls were used by 1/5 of this population. In the 12-month period preceding the study, 27 residents (16.8%) experienced falls and, of those, 4 (14.8%) had fracture(s). There was an independent association between psychoactive drug use and falls when variables such as age, gender, vision and hearing were controlled (p=0.02). CONCLUSIONS: Although the population of this neighborhood must be considered young (only 4% are 65 years old or more), there are already problems related to the use of psychoactive drugs among people. Prescribed anxiolytics, anticonvulsants, antidepressants and antihypertensives are not appropriate for this age group and their use is associated with falls.
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OBJECTIVE: To estimate the direct costs of schizophrenia for the public sector. METHODS: A study was carried out in the state of São Paulo, Brazil, during 1998. Data from the medical literature and governmental research bodies were gathered for estimating the total number of schizophrenia patients covered by the Brazilian Unified Health System. A decision tree was built based on an estimated distribution of patients under different types of psychiatric care. Medical charts from public hospitals and outpatient services were used to estimate the resources used over a one-year period. Direct costs were calculated by attributing monetary values for each resource used. RESULTS: Of all patients, 81.5% were covered by the public sector and distributed as follows: 6.0% in psychiatric hospital admissions, 23.0% in outpatient care, and 71.0% without regular treatment. The total direct cost of schizophrenia was US$191,781,327 (2.2% of the total health care expenditure in the state). Of this total, 11.0% was spent on outpatient care and 79.2% went for inpatient care. CONCLUSIONS: Most schizophrenia patients in the state of São Paulo receive no regular treatment. The study findings point out to the importance of investing in research aimed at improving the resource allocation for the treatment of mental disorders in Brazil.
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OBJECTIVE: Use of analgesics has been increasingly recognized as a major public health issue with important consequences in Turkey. The objective of the study was to determine the prevalence and patterns of analgesics usage and associated factors in adults with pain complaints. METHODS: A cross-sectional study was conducted in 15 cities selected from five demographic regions in Turkey. The study sample population comprised 1.909 adults 18-65 age groups suffering from pain. The sampling method was multi-step stratified weighted quota-adjusted sampling. Data were collected by face-to-face interviews using a semi-structured survey questionnaire consisting of 28 questions. Odds ratios were produced by logistic regression analyses. RESULTS: The prevalence of analgesic use was 73.1%, and it was higher in females (75.7%; p<0.05), in subjects 45-54 years (81.4%; p<0.05), in subjects in rural areas (74.6%; p<0.05), in subjects in northern region (84.3%; p<0.05), in illiterate subjects (79.1%; p>0.05), and in subjects of lower socioeconomic status (74.1%; p>0.05). One in ten of the participants used non-prescription analgesics. Non-prescription analgesics were more prevalent among the 55-65 age groups (18.1%; p<0.05), among female (11.6%; p>0.05), among the urban population (10.7%; p>0.05), and in subjects of lower middle socioeconomic status (13.2%; p<0.05). Logistic regression showed statistically significant ORs only for age groups, duration of education, socioeconomic status, and demographic regions (p<0.05). CONCLUSIONS: The results showed that the prevalence of analgesic use and prescription analgesic use is high in Turkey, and their use is related to sociodemographic characteristics.
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OBJECTIVE: To review the use of accelerometry as an objective measure of physical activity in adults and elderly people. METHODS: A systematic review of studies on the use of accelerometty as an objective measure to assess physical activity in adults were examined in PubMed Central, Web of Knowledge, EBSCO and Medline databases from March 29 to April 15, 2010. The following keywords were used: "accelerometry," "accelerometer," "physical activity," "PA," "patterns," "levels," "adults," "older adults," and "elderly," either alone or in combination using "AND" or "OR." The reference lists of the articles retrieved were examined to capture any other potentially relevant article. Of 899 studies initially identified, only 18 were fully reviewed, and their outcome measures abstracted and analyzed. RESULTS: Eleven studies were conducted in North America (United States), five in Europe, one in Africa (Cameroon) and one in Australia. Very few enrolled older people, and only one study reported the season or time of year when data was collected. The articles selected had different methods, analyses, and results, which prevented comparison between studies. CONCLUSIONS: There is a need to standardize study methods for data reporting to allow comparisons of results across studies and monitor changes in populations. These data can help design more adequate strategies for monitoring and promotion of physical activity.
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OBJECTIVE Develop an index to evaluate the maternal and neonatal hospital care of the Brazilian Unified Health System.METHODS This descriptive cross-sectional study of national scope was based on the structure-process-outcome framework proposed by Donabedian and on comprehensive health care. Data from the Hospital Information System and the National Registry of Health Establishments were used. The maternal and neonatal network of Brazilian Unified Health System consisted of 3,400 hospitals that performed at least 12 deliveries in 2009 or whose number of deliveries represented 10.0% or more of the total admissions in 2009. Relevance and reliability were defined as criteria for the selection of variables. Simple and composite indicators and the index of completeness were constructed and evaluated, and the distribution of maternal and neonatal hospital care was assessed in different regions of the country.RESULTS A total of 40 variables were selected, from which 27 single indicators, five composite indicators, and the index of completeness of care were built. Composite indicators were constructed by grouping simple indicators and included the following variables: hospital size, level of complexity, delivery care practice, recommended hospital practice, and epidemiological practice. The index of completeness of care grouped the five variables and classified them in ascending order, thereby yielding five levels of completeness of maternal and neonatal hospital care: very low, low, intermediate, high, and very high. The hospital network was predominantly of small size and low complexity, with inadequate child delivery care and poor development of recommended and epidemiological practices. The index showed that more than 80.0% hospitals had a low index of completeness of care and that most qualified heath care services were concentrated in the more developed regions of the country.CONCLUSIONS The index of completeness proved to be of great value for monitoring the maternal and neonatal hospital care of Brazilian Unified Health System and indicated that the quality of health care was unsatisfactory. However, its application does not replace specific evaluations.