Performance evaluation of hospitals that provide care in the public health system, Brazil

OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System.METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction.RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed.CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

Performance evaluation of primary care services for the treatment of tuberculosis

Objective Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. Method An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). Results The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. Conclusion The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.



Performance evaluation of hydrocyclone filter for microirrigation

In this study a hydrocyclone filter of 20 cm was selected and its performance was evaluated by studying the variation of discharge, pressure drop, influent concentration, and filtration efficiency with elapsed time of operation. The filter was tested with clean water to determine clean pressure drop and later it was tested with four concentrations of solid suspension, viz. 300; 600; 900 and 1,200 mg L-1. In the concentration of 300 mg L-1, the variation of pressure drop was low. But for the other concentrations of solid suspension, the variation was significant. The maximum pressure drops obtained were 41.19, 45.11, 50.01 and 52.95 kPa at 350, 390, 280 and 190 minutes of elapsed time, respectively. The maximum efficiency of solid suspension was 30.3, 32.96, 43.89 and 52.5% where as the minimum efficiencies were 9.91, 9.93, 9.62 and 9.9%, respectively. The hydrociclone tested presented inefficiency to filter small particles as clay. The initial removal efficiency of higher concentration was bigger than for lower concentration but, the final efficiency are almost the same irrespective of the concentration of solid suspension. The present tested hydrocyclone could be used as a pre-filter microirrigation to prevent emitter clogging.

Performance evaluation of 3D computer vision techniques

This work presents the implementation and comparison of three different techniques of three-dimensional computer vision as follows: • Stereo vision - correlation between two 2D images • Sensorial fusion - use of different sensors: camera 2D + ultrasound sensor (1D); • Structured light The computer vision techniques herein presented took into consideration the following characteristics: • Computational effort ( elapsed time for obtain the 3D information); • Influence of environmental conditions (noise due to a non uniform lighting, overlighting and shades); • The cost of the infrastructure for each technique; • Analysis of uncertainties, precision and accuracy. The option of using the Matlab software, version 5.1, for algorithm implementation of the three techniques was due to the simplicity of their commands, programming and debugging. Besides, this software is well known and used by the academic community, allowing the results of this work to be obtained and verified. Examples of three-dimensional vision applied to robotic assembling tasks ("pick-and-place") are presented.

Challenges and perspectives of academic evaluation

Academic evaluation has been an essential component of modern science since its inception, as science has moved away from personalized patronage toward its contemporary role as an essential enterprise of contemporary, democratic societies. In recent years, Brazil has experienced sustained growth in its scientific output, which is nowadays fully compatible with its status as a high middle-income country striving to become a fully developed, more equitable country in the years to come. Growth usually takes place amidst challenges and dilemmas and, in Brazil as elsewhere, academic evaluation is not exempt from such difficulties. In a large, profoundly heterogeneous country with a national evaluation system and nationwide on-line platforms disseminating information on the most disparate fields of knowledge, the main challenges refer to how to pay attention to detail without losing sight of comprehensiveness and how to handle social and regional diversity while preserving academic excellence as the fundamental benchmark.

A comparison of four DNA extraction protocols for the analysis of urine from patients with visceral leishmaniasis

Introduction Polymerase chain reaction (PCR) may offer an alternative diagnostic option when clinical signs and symptoms suggest visceral leishmaniasis (VL) but microscopic scanning and serological tests provide negative results. PCR using urine is sensitive enough to diagnose human visceral leishmaniasis (VL). However, DNA quality is a crucial factor for successful amplification. Methods A comparative performance evaluation of DNA extraction methods from the urine of patients with VL using two commercially available extraction kits and two phenol-chloroform protocols was conducted to determine which method produces the highest quality DNA suitable for PCR amplification, as well as the most sensitive, fast and inexpensive method. All commercially available kits were able to shorten the duration of DNA extraction. Results With regard to detection limits, both phenol: chloroform extraction and the QIAamp DNA Mini Kit provided good results (0.1 pg of DNA) for the extraction of DNA from a parasite smaller than Leishmania (Leishmania) infantum (< 100fg of DNA). However, among 11 urine samples from subjects with VL, better performance was achieved with the phenol:chloroform method (8/11) relative to the QIAamp DNA Mini Kit (4/11), with a greater number of positive samples detected at a lower cost using PCR. Conclusion Our results demonstrate that phenol:chloroform with an ethanol precipitation prior to extraction is the most efficient method in terms of yield and cost, using urine as a non-invasive source of DNA and providing an alternative diagnostic method at a low cost.

Sugarcane crop efficiency in two growing seasons in São Paulo State, Brazil

A conceptual framework for crop production efficiency was derived using thermodynamic efficiency concept, in order to generate a tool for performance evaluation of agricultural systems and to quantify the interference of determining factors on this performance. In Thermodynamics, efficiency is the ratio between the output and input of energy. To establish this relationship in agricultural systems, it was assumed that the input energy is represented by the attainable crop yield, as predicted through simulation models based on environmental variables. The method of FAO's agroecological zones was applied to the assessment of the attainable sugarcane yield, while Instituto Brasileiro de Geografia e Estatística (IBGE) data were used as observed yield. Sugarcane efficiency production in São Paulo state was evaluated in two growing seasons, and its correlation with some physical factors that regulate production was calculated. A strong relationship was identified between crop production efficiency and soil aptitude. This allowed inferring the effect of agribusiness factors on crop production efficiency. The relationships between production efficiency and climatic variables were also quantified and indicated that solar radiation, annual rainfall, water deficiency, and maximum air temperature are the main factors affecting the sugarcane production efficiency.

Hydrological simulation using SWAT model in headwater basin in Southeast Brazil

Hydrological models are important tools that have been used in water resource planning and management. Thus, the aim of this work was to calibrate and validate in a daily time scale, the SWAT model (Soil and Water Assessment Tool) to the watershed of the Galo creek , located in Espírito Santo State. To conduct the study we used georeferenced maps of relief, soil type and use, in addition to historical daily time series of basin climate and flow. In modeling were used time series corresponding to the periods Jan 1, 1995 to Dec 31, 2000 and Jan 1, 2001 to Dec 20, 2003 for calibration and validation, respectively. Model performance evaluation was done using the Nash-Sutcliffe coefficient (E NS) and the percentage of bias (P BIAS). SWAT evaluation was also done in the simulation of the following hydrological variables: maximum and minimum annual daily flowsand minimum reference flows, Q90 and Q95, based on mean absolute error. E NS and P BIAS were, respectively, 0.65 and 7.2% and 0.70 and 14.1%, for calibration and validation, indicating a satisfactory performance for the model. SWAT adequately simulated minimum annual daily flow and the reference flows, Q90 and Q95; it was not suitable in the simulation of maximum annual daily flows.

An evaluation of manual and mechanical methods to identify Candida spp. from human and animal sources

To compare two yeast identification methods, i. e, the manual and the VITEK mechanical methods, 62 clinical samples from hemocultures and animal sources were analyzed. After identification as Candida yeasts by the VITEK method, the strains were recharacterized using manual assimilation methods and sugar fermentation tests. Our findings reveal 58% concurrent identification between the two methods for animal strains, and 51% for human hemoculture strains.

Performance of the Vitek 2 system software version 5.03 in the bacterial identification and antimicrobial susceptibility test: evaluation study of clinical and reference strains of Gram-positive cocci

Introduction. The genera Enterococcus, Staphylococcus and Streptococcus are recognized as important Gram-positive human pathogens. The aim of this study was to evaluate the performance of Vitek 2 in identifying Gram-positive cocci and their antimicrobial susceptibilities. Methods. One hundred four isolates were analyzed to determine the accuracy of the automated system for identifying the bacteria and their susceptibility to oxacillin and vancomycin. Results. The system correctly identified 77.9% and 97.1% of the isolates at the species and genus levels, respectively. Additionally, 81.8% of the Vitek 2 results agreed with the known antimicrobial susceptibility profiles. Conclusion. Vitek 2 correctly identified the commonly isolated strains; however, the limitations of the method may lead to ambiguous findings.

Evaluation of the performance of a castor-oil based formulation in limiting pesticide residues in strawberry crops

A study was made to evaluate the effect of a castor oil-based detergent on strawberry crops treated with different classes of pesticides, namely deltamethrin, folpet, tebuconazole, abamectin and mancozeb, in a controlled environment. Experimental crops of greenhouse strawberries were cultivated in five different ways with control groups using pesticides and castor oil-based detergent. The results showed that the group 2, which was treated with castor oil-based detergent, presented the lowest amount of pesticide residues and the highest quality of fruit produced.

Evaluation of tractive performance of four agricultural tractors in laterally inclined terrain

The present work aimed to evaluate the tractive performance of four agricultural tractors with auxiliary front traction in function of six lateral inclinations in a lateral track of trials, which belongs to the Agronomic Sciences Faculty from the São Paulo State University, Campus of Botucatu. The lateral inclinations were 0; 5; 10; 15; 20 and 25 degrees. In all of these situations, the tractors operated with predetermined load of an imposed traction to the pulled tractor of 40 kN in the inclination of 0 degrees. Hence a delineation in random blocks was used, considering six inclinations and four tractors, and with three repetitions for each treatment. The analyzed variables were slippage, tractive force, hourly fuel consumption, and speed. It was concluded that the pneumatic tire configurations influenced in the tractive performance of the tractors, as they increased the lateral inclinations of the terrain.

Evaluation of covering materials in individual shelters and its effects on physiological responses and performance of dairy calves

In Tropical regions, the animal performance is often affected by climate conditions. This study aimed to evaluate covering materials in individual shelters, normally used to house dairy calves, and its influence on the calves physiology and performance. The design used was completely randomized, with a 2x3 factorial arrangement to compare the averages of 5% through the Tukey's test, i.e., both genders- and three types of covering in the shelters (Z - zinc; AC - asbestos cement; and WPAC - white-painted asbestos cement). Parameters evaluated included daily weight gain (DWG), dry matter intake (DMI), feed conversion (FC), rectal temperature (RT), and respiratory frequency (RF). Results showed significant differences (P < 0.05) among males (1.04kg/day) and females (0.74kg/day) for DWG and interaction between gender and treatment (P < 0.05) for zinc covering (0.562kg/day for females and 1.120kg/day for males). Significant differences were also observed in FI of animals housed under shelters with the covering of zinc (48.35kgDM/day for females and 96.91 kgDM/day for males). There were no significant differences (P > 0.05) in the FC and the RT, and there were significant differences (P < 0.05) for RF in the Z treatments (56.9 mov.min-1), WPAC (62.2 mov.min-1) and FC (70.25 mov.min-1). It was concluded that different covering materials did not affect performance and dry matter intake of dairy calves. However, the animals' physiology of thermoregulation was altered by the different covering materials used in individual shelters.

Experimental evaluation of the performance of a wireless sensor network in agricultural environments

The aim of this study was to perform an experimental study to evaluate the proper operation distance between the nodes of a wireless sensor network available on the market for different agricultural crops (maize, physic nut, eucalyptus). The experimental data of the network performance offers to farmers and researchers information that might be useful to the sizing and project of the wireless sensor networks in similar situations to those studied. The evaluation showed that the separation of the nodes depends on the type of culture and it is a critical factor to ensure the feasibility of using WSN. In the configuration used, sending packets every 2 seconds, the battery life was about four days. Therefore, the autonomy may be increased with a longer interval of time between sending packets.