Linking customer satisfaction, quality, and strategic planning

By acknowledging and dissecting the interconnected roles of customer satisfaction, quality, and strategic planning, this paper provides an analytical framework for creating a customer-driven organization and culture. It shows how quality starts and ends with the customer. Companies that are achieving long-term continuous improvement in quality tailored to customer satisfaction possess lasting characteristics such as customer orientation, customer consciousness, and customer responsiveness. In doing so, they liberate the quality concept from the narrow product or service focus to encompass total conformance to customer requirements in spite of the existing functionalization and departmentalization of modern complex structures. In addition to these key components, a customer-driven organization demands building and nurturing a customer satisfaction culture and value system that makes quality improvement and heightened concern for customer satisfaction a permanent aspect of organizational life.

Payment for performance in the Family Health Programme: lessons from the UK Quality and Outcomes Framework

OBJECTIVE: Payment for performance financial incentive schemes reward doctors based on the quality and the outcomes of their treatment. In Brazil, the Ministry of Health is looking to scale up its use in public hospitals and some municipalities are developing payment for performance schemes even for the Family Health Programme. In this article the Quality and Outcomes Framework used in the UK since 2004 is discussed, as well as its experience to elaborate some important lessons that Brazilian municipalities should consider before embarking on payment for performance scheme in primary care settings.

Association between sleep quality and quality of life in nursing professionals working rotating shifts

OBJECTIVE To analyze the association between sleep quality and quality of life of nursing professionals according to their work schedules.METHODS A prospective, cross-sectional, observational study was conducted between January and December 2010, with 264 nursing professionals, drawn from 989 subjects at Botucatu General Hospital and stratified by professional category. The Pittsburg Sleep Quality Index and the WHOQOL-bref were administered to evaluate sleep quality and quality of life, respectively. Self-reported demographic data were collected with a standard form. Continuous variables were reported as means and standard deviations, and categorical variables were expressed as proportions. Associations were evaluated using Spearman’s correlation coefficient. The association of night-shift work and gender with sleep disturbance was evaluated by logistic regression analysis using a model adjusted for age and considering sleep disturbance the dependent variable. The level of significance was p < 0.05.RESULTS Night-shift work was associated with severe worsening of at least one component of sleep quality in the model adjusted for age (OR = 1.91; 95%CI 1.04;3.50; p = 0.036). Female gender was associated with sleep disturbance (OR = 3.40; 95%CI 1.37;8.40; p = 0.008). Quality of life and quality of sleep were closely correlated (R = -0.56; p < 0.001).CONCLUSIONS Characteristics of the nursing profession affect sleep quality and quality of life, and these two variables are associated.

New species and records of Psocoptera (Insecta) from Roraima State, Brazil.

Psocoptera. from Ilha de Marcica and Pacaraima, Roraima State, Brazil, representing 103 species are recorded. Sixty-two are new to science. and are described and figured, representing genera Echmepteryx(2), Tapinella(3), Musapsocus, (1), Seopsocus(3),Isth-mopsocis(3), Dolabellopsocus(6), Epipsocus(5), Neurostigma.(1), Nctiopscus(1), Cae-cilius (6) , Enderluinella (1), Xanthocarcilius(1) , Polypsocus(3) , Scytopsocus(1), ar-chipsocus(1), Lachesilla(4), Notolachesilla(1) , Perispsocus(4), Dactylopsocus (1) , Metylophorus(3), Blaste.(4), Lichenomiae(3), Myopsocus (3). Genus Notarchispsu. gen. is erected for Archipsocus macrurusNew and a new species. Genus MonocladellusEu-derlein in placed in synonymy of, PolypsocusHagen. South American species assigned to genus LophopterygllaEnderlein by New (1979) are. reassigned to Myopscus and represent a parallel development in the latter genus.

I Brazilian Registry of Heart Failure - Clinical Aspects, Care Quality and Hospitalization Outcomes

Background:Heart failure (HF) is one of the leading causes of hospitalization in adults in Brazil. However, most of the available data is limited to unicenter registries. The BREATHE registry is the first to include a large sample of hospitalized patients with decompensated HF from different regions in Brazil.Objective:Describe the clinical characteristics, treatment and prognosis of hospitalized patients admitted with acute HF.Methods:Observational registry study with longitudinal follow-up. The eligibility criteria included patients older than 18 years with a definitive diagnosis of HF, admitted to public or private hospitals. Assessed outcomes included the causes of decompensation, use of medications, care quality indicators, hemodynamic profile and intrahospital events.Results:A total of 1,263 patients (64±16 years, 60% women) were included from 51 centers from different regions in Brazil. The most common comorbidities were hypertension (70.8%), dyslipidemia (36.7%) and diabetes (34%). Around 40% of the patients had normal left ventricular systolic function and most were admitted with a wet-warm clinical-hemodynamic profile. Vasodilators and intravenous inotropes were used in less than 15% of the studied cohort. Care quality indicators based on hospital discharge recommendations were reached in less than 65% of the patients. Intrahospital mortality affected 12.6% of all patients included.Conclusion:The BREATHE study demonstrated the high intrahospital mortality of patients admitted with acute HF in Brazil, in addition to the low rate of prescription of drugs based on evidence.

Use and records of child health handbook focused on growth and development

Objective To evaluate the use and records of the Child Health Handbook (CHH), especially growth and development. Method Cross-sectional study with 358 mother-child pairs registered in 12 Primary Health Centers (PHCs) of a small municipality. Mothers were interviewed at the PHC from February to April 2013 using a questionnaire. Data analysis was done using WHO Anthro software, Epi InfoTM and Stata. Results Fifty-three percent of the mothers were carrying the CHH at the time of the interview, similar to the proportion of mothers who were instructed to bring the CHH to health appointments. Annotations in the CHH during the visits were reported by 49%. The vaccination schedule was completed in 97% of the CHH, but only 9% and 8% of the CHH, respectively, contained growth charts and properly completed developmental milestones. Conclusion Low rates of use and unsatisfactory record-keeping in the CHH reinforce the need for investment in professional training and community awareness for the CHH to become an effective instrument of promotion of child health.

The quality and characteristics of sleep of hypertensive patients

OBJECTIVEAnalyzing the quality of sleep of hypertensive patients registered in the national registration system and monitoring of hypertensive patients.METHODSA cross-sectional study of quantitative and descriptive analyses with 280 hypertensive patients registered in the National Program of Hypertension and Diabetes of the Federal Government in the months from August to October 2011. Questionnaires were used which allowed for tracking sociodemographic data on hypertension and Pittsburgh Sleep Quality Index (PSQI).RESULTSThe prevalence of poor sleep quality among respondents (156 hypertensive patients) and high rates of using medication for sleeping (106 hypertensive patients) was observed. Other relevant data refers to the quality of sleep among hypertensive patients using sleep medication compared to those who do not use it (p≤0.01).CONCLUSIONIndividuals with high blood pressure have a negative association with sleep quality.

New species and records of Chimarra Stephens (Trichoptera, Philopotamidae) from Central Amazonia, Brazil

Chimarra (Curgia) paucispina sp. nov., of the aurivittata group Flint, 1998 is described and illustrated from specimens collected in Amazonas State. The key to species of Chimarra (Curgia) Walker, 1860 presented by Flint was modified to include the new species. Chimarra (Chimarrita) chela Blahnik, 1997 and Chimarra (Curgia) jugescens Flint, 1998 are for first time reported for the Amazonas State. This is the first record of C. chela in Brazil.

Organic matter quality and dynamics in tropical soils amended with sugar industry residue

Soil organic matter depletion caused by agricultural management systems have been identified as a critical problem in most tropical soils. The application of organic residues from agro-industrial activities can ameliorate this problem by increasing soil organic matter quality and quantity. Humic substances play an important role in soil conservation but the dynamics of their transformations is still poorly understood. This study evaluated the effect of compost application to two contrasting tropical soils (Inceptisol and Oxisol) for two years. Soil samples were incubated with compost consisting of sugarcane filter cake, a residue from the sugar industry, at 0, 40, 80, and 120 Mg ha-1. Filter cake compost changed the humic matter dynamics in both content and quality, affecting the soil mineralogical composition. It was observed that carbon mineralization was faster in the illite-containing Inceptisol, whereas humic acids were preserved for a longer period in the Oxisol. In both soils, compost application increased fulvic acid contents, favoring the formation of small hydrophilic molecules. A decrease in fluorescence intensity according to the incubation time was observed in the humic acids extracted from amended soils, revealing important chemical changes in this otherwise stable C pool.

Revisiting the S-index for soil physical quality and its use in Brazil

The S-index was introduced in 2004 in a publication by A.R. Dexter. S was proposed as an indicator of soil physical quality. A critical value delimiting soils with rich and poor physical quality was proposed. At present, Brazil is world leader in citations of Dexter's publication. In this publication the S-theory is mathematically revisited and extended. It is shown that S is mathematically correlated to bulk density and total porosity. As an absolute indicator, the value of S alone has proven to be incapable of predicting soil physical quality. The critical value does not always hold under boundary conditions described in the literature. This is to be expected because S is a static parameter, therefore implicitly unable to describe dynamic processes. As a relative indicator of soil physical quality, the S-index has no additional value over bulk density or total porosity. Therefore, in the opinion of the author, the fact that bulk density or total porosity are much more easily determined than the water retention curve for obtaining S disqualifies S as an advantageous indicator of relative soil physical quality. Among the several equations available for the fitting of water retention curves, the Groenevelt-Grant equation is preferable for use with S since one of its parameters and S are linearly correlated. Since efforts in soil physics research have the purpose of describing dynamic processes, it is the author's opinion that these efforts should shift towards mechanistic soil physics as opposed to the search for empirical correlations like S which, at present, represents far more than its reasonable share of soil physics in Brazil.

Effects of traffic control on the soil physical quality and the cultivation of sugarcane

The cultivation of sugarcane with intensive use of machinery, especially for harvest, induces soil compaction, affecting the crop development. The control of agricultural traffic is an alternative of management in the sector, with a view to preserve the soil physical quality, resulting in increased sugarcane root growth, productivity and technological quality. The objective of this study was to evaluate the physical quality of an Oxisol with and without control traffic and the resulting effects on sugarcane root development, productivity and technological quality. The following managements were tested: no traffic control (NTC), traffic control consisting of an adjustment of the track width of the tractor and sugarcane trailer (TC1) and traffic control consisting of an adjustment of the track width of the tractor and trailer and use of an autopilot (TC2). Soil samples were collected (layers 0.00-0.10; 0.10-0.20 and 0.20-0.30 m) in the plant rows, inter-row center and seedbed region, 0.30 m away from the plant row. The productivity was measured with a specific weighing scale. The technological variables of sugarcane were measured in each plot. Soil cores were collected to analyze the root system. In TC2, the soil bulk density and compaction degree were lowest and total porosity and macroporosity highest in the plant row. Soil penetration resistance in the plant row, was less than 2 MPa in TC1 and TC2. Soil aggregation and total organic carbon did not differ between the management systems. The root surface and volume were increased in TC1 and TC2, with higher productivity and sugar yield than under NTC. The sugarcane variables did not differ between the managements. The soil physical quality in the plant row was preserved under management TC1 and TC2, with an improved root development and increases of 18.72 and 20.29 % in productivity and sugar yield, respectively.

Soil Physical Quality and Soybean Yield as Affected by Chiseling and Subsoiling of a No-Till Soil

ABSTRACT The concept of soil physical quality (SPQ) is currently under discussion, and an agreement about which soil physical properties should be included in the SPQ characterization has not been reached. The objectives of this study were to evaluate the ability of SPQ indicators based on static and dynamic soil properties to assess the effects of two loosening treatments (chisel plowing to 0.20 m [ChT] and subsoiling to 0.35 m [DL]) on a soil under NT and to compare the performance of static- and dynamic-based SPQ indicators to define soil proper soil conditions for soybean yield. Soil sampling and field determinations were carried out after crop harvest. Soil water retention curve was determined using a tension table, and field infiltration was measured using a tension disc infiltrometer. Most dynamic SPQ indicators (field saturated hydraulic conductivity, K0, effective macroporosity, εma, total connectivity and macroporosity indexes [CwTP and Cwmac]) were affected by the studied treatments, and were greater for DL compared to NT and ChT (K0 values were 2.17, 2.55, and 4.37 cm h-1 for NT, ChT, and DL, respectively). However, static SPQ indicators (calculated from the water retention curve) were not capable of distinguishing effects among treatments. Crop yield was significantly lower for the DL treatment (NT: 2,400 kg ha-1; ChT: 2,358 kg ha-1; and DL: 2,105 kg ha1), in agreement with significantly higher values of the dynamic SPQ indicators, K0, εma, CwTP, and Cwmac, in this treatment. The results support the idea that SPQ indicators based on static properties are not capable of distinguishing tillage effects and predicting crop yield, whereas dynamic SPQ indicators are useful for distinguishing tillage effects and can explain differences in crop yield when used together with information on weather conditions. However, future studies, monitoring years with different weather conditions, would be useful for increasing knowledge on this topic.

Grafted eggplant yield, quality and growth in infested soil with Verticillium dahliae and Meloidogyne incognita

The objective of this work was to evaluate the effect of grafting (onto Solanum torvum Sw.) on plant growth, yield and fruit quality of the Pala and Faselis eggplant (Solanum melongena L.) cultivars, grown in a soil infested with Verticillium dahliae Kleb. and Meloidogyne incognita, or in noninfested soil. Soil infestation decreased yield, plant height, final above-ground biomass, and also reduced fruit mean weight and shoot dry weight depending on cultivar or grafting. Grafting decreased fruit oxalic acid and the soluble solid contents, and increased mean fruit weight, depending on cultivar and soil infestation. Grafting also reduced the negative effects of the pathogens on disease index, plant height and shoot dry weight. Cultivar Pala was more vigorous than Faselis, and S. torvum was a vigorous rootstock. The combination of a vigorous rootstock with a weak cultivar (Faselis) is more profitable than that of a vigorous rootstock and a vigorous cultivar (Pala). Using S. torvum as a rootstock for cultivar Faselis, grown in soil infested with the pathogens, is most likely to be useful in conventional and low-input sustainable horticulture, since grafting increases protection against the pathogens, and reduces the losses in quality and yield.

Spittlebug impacts on sugarcane quality and ethanol production

The objective of this work was to evaluate the impacts of spittlebug (Mahanarva fimbriolata) attack on sugarcane quality and ethanol production. Technological and microbiological parameters of juice and fermentation process were evaluated in ten fermentation cycles and two harvest seasons. Treatments consisted of different spittlebug stalk damage levels: control, with 100% of apparently healthy stalks; medium, with 15% of damaged or dry stalks (DDS); high, with 30% of DDS; and very high, with 60% of DDS. Spittlebug attack caused significant losses in cane quality, reducing total soluble solids, sucrose content, total reducing sugars, and pH, and increasing total phenolic compounds, and total and volatile juice acidity. The fermentation process was also significantly affected, resulting in lower ethanol content in wine. There was an increase in acetaldehyde concentration in the distillate. The spittlebug attack caused negative impacts on sugarcane quality and fermentation process, and these impacts are stronger in late season harvests.

Effect of preharvest spraying with thidiazuron on fruit quality and maturity of apples

Apple trees, cultivars Gala and Fuji, were sprayed at full bloom with thidiazuron (TDZ) at the doses of 0, 5, 10, or 20 g (a.i.) ha-1 and fruit were assessed for quality and maturity. In both cultivars, the increase of TDZ dose had detrimental effects on fruit quality, causing a reduction of fruit red surface and an increase of percentage of fruit that was asymmetrical and with calyx-end rot. TDZ caused an increment of calyx-end aperture that might have increased calyx-end rot. TDZ increased density and the length : diameter (L : D) ratio of the fruit. The number of viable seeds was not affected by TDZ. TDZ resulted in a substantial delay of fruit maturity in 'Gala' but not in 'Fuji'. TDZ also reduced soluble solids content (SSC) in 'Gala' and reduced titratable acidity in both cultivars.