Assessment of Quality of Life and Psychologic Aspects in Patients with Gestational Trophoblastic Disease

OBJECTIVE: To assess quality of life (QoL) and psychological aspects in patients with gestational trophoblastic disease (GTD).METHODS: This cross-sectional self-report study was conducted among 54 women. Validated questionnaires assessed QoL (WHO-QOL-bref), symptoms of depression (Beck Depression Inventory [BDI]) and anxiety (State-Trait Anxiety Inventory [STAI]).RESULTS: Most patients rated overall QoL as good (44.44%) anti were satisfied with their health status (42.59%). Mean QoL domain score was lowest for psychologic health (53.86 +/- 21.46) and highest for social relationships (65.74 +/- 22.41). BDI mean was 15.81 +/- 11.15, indicating dysphoria. STAI means were 46 +/- 6.46 for trait-anxiety and 43.72 +/- 4.23 for state-anxiety, both evidencing medium-high anxiety. Among employed patients, environment domain mean was the highest (p = 0.024). Presence of children resulted in lowest means for physical health (p = 0.041) and environment (p = 0.045). Patients desiring children showed significantly higher means for physical health (p = 0.004), psychological health (p = 0.021) and environment (p = 0.003). Chemotherapy had no significant influence on QoL (p > 0.05).CONCLUSION: This study evidenced psychological impact on GTD patients, suggesting specialized care centers should provide psychological interventions during treatment and follow-up of GTD patients, highlighting the importance of a multidisciplinary approach. (J Reprod Med 2009;54:239-244)

The variability and predictors of quality of AIDS care services in Brazil

Background: Since establishing universal free access to antiretroviral therapy in 1996, the Brazilian Health System has increased the number of centers providing HIV/AIDS outpatient care from 33 to 540. There had been no formal monitoring of the quality of these services until a survey of 336 AIDS health centers across 7 Brazilian states was undertaken in 2002. Managers of the services were asked to assess their clinics according to parameters of service inputs and service delivery processes. This report analyzes the survey results and identifies predictors of the overall quality of service delivery.Methods: The survey involved completion of a multiple-choice questionnaire comprising 107 parameters of service inputs and processes of delivering care, with responses assessed according to their likely impact on service quality using a 3-point scale. K-means clustering was used to group these services according to their scored responses. Logistic regression analysis was performed to identify predictors of high service quality.Results: The questionnaire was completed by 95.8% (322) of the managers of the sites surveyed. Most sites scored about 50% of the benchmark expectation. K-means clustering analysis identified four quality levels within which services could be grouped: 76 services (24%) were classed as level 1 (best), 53 (16%) as level 2 (medium), 113 (35%) as level 3 (poor), and 80 (25%) as level 4 (very poor). Parameters of service delivery processes were more important than those relating to service inputs for determining the quality classification. Predictors of quality services included larger care sites, specialization for HIV/AIDS, and location within large municipalities.Conclusion: The survey demonstrated highly variable levels of HIV/AIDS service quality across the sites. Many sites were found to have deficiencies in the processes of service delivery processes that could benefit from quality improvement initiatives. These findings could have implications for how HIV/AIDS services are planned in Brazil to achieve quality standards, such as for where service sites should be located, their size and staffing requirements. A set of service delivery indicators has been identified that could be used for routine monitoring of HIV/AIDS service delivery for HIV/AIDS in Brazil (and potentially in other similar settings).

A longitudinal study of quality of life of elderly with mandibular implant-supported fixed prostheses

Objectives: To verify the consequences of implant-supported fixed oral rehabilitation on the quality of life (QL) of elderly individuals.Material and methods: Fifteen patients were studied, being 10 females and five males; all were aged > 60 years, were completely edentulous, wore removable dentures on both arches, and were treated with implant-supported fixed dentures. Three QL questionnaires were applied, two related to the oral conditions (Oral Impact on Daily Performance - OIDP - and Oral Health Impact Profile, short version - OHIP-14) and one dealing with global aspects (World Health Organization Quality of Life - WHOQOL-BREF), before 3, 6, and 18 months after surgical placement of implants.Results: Scores in the OIDP and OHIP-14 questionnaires were better after dental treatment. The WHOQOL-BREF was less sensitive, confirming the higher reliability of specific questionnaires (focal) compared with general questions in such situations.Conclusion: Treatment with implant-supported fixed prostheses improved QL in the elderly; these effects are better detected by specific instruments focused on the subject.

Analysis of quality in Brazilian e-commerce (B2C)

The business world has changed the way how people think and act on products and services. In this context, the most recent amendment of the scenarios of retail operations has been the use of technology in sales and distribution. The internet has revolutionized the way people communicate, and moreover as they purchase their goods and services. Thus, the e-commerce, specifically the relation business to customer, or simply B2C, has acted so convincingly in this change of paradigm, namely the purchases in the physical location for the virtual site. Quotes online, ease of payment, price, speed of delivery, have become real order winners of applications for companies that compete in this segment. With the focus on quality of services on e-commerce, the research examines the dimension related to the quality of services, and looks for what of these factors are winners of applications. © 2010 IFIP International Federation for Information Processing.

Wireless mesh networks planning based on parameters of quality of service

The use of QoS parameters to evaluate the quality of service in a mesh network is essential mainly when providing multimedia services. This paper proposes an algorithm for planning wireless mesh networks in order to satisfy some QoS parameters, given a set of test points (TPs) and potential access points (APs). Examples of QoS parameters include: probability of packet loss and mean delay in responding to a request. The proposed algorithm uses a Mathematical Programming model to determine an adequate topology for the network and Monte Carlo simulation to verify whether the QoS parameters are being satisfied. The results obtained show that the proposed algorithm is able to find satisfactory solutions.

Living kidney donors - a prospective study of quality of life before and after kidney donation

Although the safety of living kidney donation has been well established, prospective studies examining the physical and psychosocial aspects of the donor's quality of life are still scarce. Thus, the purpose of this prospective work was to assess the quality of life of 50 consecutive donors before and after kidney transplantation. All donors were asked to respond to both a donor questionnaire and the short-form 36-item health survey (SF-36). Interviews were individually conducted before, three months after, and over one yr after transplantation. Donation was considered a positive experience by all patients and had no impact on any physical or psychosocial aspect of the donor's life. Improved self-esteem and better quality of life after donation were reported in 52% of the cases. All donors would donate again and encouraged donation. SF-36 data indicated improvement in post-donation mental and physical scores among living donors closely related to recipient. Overall, most donors had a positive experience, felt no changes in quality of life, experienced enhanced self-esteem, would donate again, and recommended donation. © 2012 John Wiley & Sons A/S.

Measuring the impact of quality infrastructure in Latin America: Experiences, achievements and limitations

This document, which is partly based on by the study Impacto de la Infraestructura de la Calidad en América Latina, is a second joint effort by the Economic Commission for Latin America and the Caribbean (ECLAC) and the German National Metrology Institute (PTB) to move towards a more detailed understanding of the role played by the Quality Infrastructure in opening up possibilities for the countries in the region to innovate and compete. Through methodological analysis and the realization of case studies at the national level in certain countries in the region, the document seeks to offer a more comprehensive picture of the impact of the Quality Infrastructure and its importance for the economic and social development of countries. The document analyzes various QI related aspects, with particular emphasis on a review of conceptual elements, the role of the QI in the innovation systems of countries and a brief analysis of a set of case studies in Latin American countries. It also identifies a series of challenges and limitations for carrying out impact studies. These elements are taken up again in the final conclusions of the book, where a number of policy recommendations are outlined.

Analysis of quality indicators of central sterile supply departments at accredited public hospitals

O objetivo do estudo foi descrever e analisar os indicadores de qualidade de Centros de Material e Esterilização de hospitais públicos acreditados do Estado de São Paulo e sua gestão pelos responsáveis do setor. Trata-se de um estudo de casos múltiplos, onde são apresentados os dados interligados de três hospitais acreditados num relatório de casos cruzados. Os dados foram coletados por entrevista semiestruturada com o responsável e por visita técnica com análise documental. Os resultados constatam a dificuldade dos responsáveis em pontuar os indicadores específicos do setor e os referidos foram os de produção e pesquisa de satisfação do cliente que não retratam a qualidade efetiva do serviço, pois são fragmentados, sem consolidação de resultados na busca de melhorias, o que sugere baixa especificidade e baixa sensibilidade dos critérios da Organização Nacional de Acreditação à realidade deste setor.

Tradução e adaptação de The Fall of the House of Usher: um estudo comparativo

The aim of this work is to analyze the short-story The Fall of the House of Usher by Edgar Allan Poe, and two of its versions into Portuguese: A Queda da Casa de Uhser, a translation by Brenno Silveira, published in 1959 by Abril, and the adaptation by Clarice Lispector, with the same title, published in 1975 by Ediouro. The original short-story was first published in 1840, in Tales of the Grotesque and Arabesque, translated into Portuguese as Histórias Extraordinárias. In this work, we will identify the differences between a translation and an adaptation, as well as the construction of the grotesque universe in those different texts. By means of a comparative analysis from the selected corpus, we will deploy the ways each one constructs the effect wanted by Poe, highlighting the main semantic and structural differences present in the translation and the adaptation of the short-story in relation with the original. Lastly, we will try to show the losses and gains of an adaptation

Enhancement of quality and stability of dried papaya by pectin-based coatings as air-drying pretreatment

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Determination of quality parameters for mustard sauces in sealed packets using time-domain nuclear magnetic resonance spectroscopy and chemometrics

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Evaluation of quality of life related to i-131 therapy in patients with well-differentiated thyroid cancer and emphasis in salivary morbidity: a follow up study after treatment

To evaluate the impact of iodine-131 therapy received during childhood and adolescence and correlate it with the quality of life in these patients. Methods: We studied 19 patients diagnosed with cancer in childhood or adolescence who underwent thyroidectomy and supplemental therapy with I-131. We also recruited a control group of healthy subjects with the same demographic parameters. All patients were subjected to a scintigraphy examination of the salivary glands, and were also asked to complete a questionnaire in order to assess their overall quality of life. In addition, a more specific questionnaire for patients with head and neck cancer was also given to all study participants. Results: The quantitative and qualitative analyses of the salivary glands showed functional deficits with greater involvement of the parotid gland for volume, concentration and excretion. The right submandibular gland showed significant changes for volume in the patient group. The questionnaires made it possible to observe significant differences between the patient and control groups for symptoms such as thick saliva, dry mouth and speech problems. Conclusion: In spite of being very effective and widely used, iodine radionuclide therapy is correlated with a lower quality of life in young people.