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).

Effects of dietary trace mineral sources and levels fed to layers in their second laying cycle on the quality of eggs stored at different temperatures and for different periods

This study aimed at evaluating the effects of trace mineral levels and sources supplemented to diets fed to semi-heavy layers in their second laying cycle on the quality of eggs stored for 14 days at different temperatures. The experimental diets consisted of the inclusion of inorganic trace minerals (T1 - control: 100% ITM) and five supplementation levels of organic trace minerals (carboaminophopho chelates) (110, 100, 90, 80, and 70% OTM). Trace mineral inclusion levels (mg/kg feed) were: T1: control - 100% ITM: Zn (54), Fe (54), Mn (72), Cu (10), I (0.61) Se (0.3); T2 - 110% OTM: Zn (59.4), Fe (59.4), Mn (79.2), Cu (11.88), I (1.21) Se (0.59); T3 - 100%: OTM: Zn (54), Fe (54), Mn (72), Cu (10.8), I (1.10) Se (0.54); T4 - 90% OTM: Zn (48.6), Fe (48.6), Mn (64.8), Cu (9.72), I (0.99) Se (0.49); T5 - 80% OTM: Zn (43.2), Fe (43.2), Mn (57.6), Cu (8.64), I (0.88), Se (0.43); T6 - 70% OTM: Zn (37.8), Fe (37.8), Mn (50.4), Cu (7.56), I (0.77) Se (0.38). A completely randomized experimental design in a split-plot arrangement with 60 treatments of four replicates each was applied. The combination of six diets versus storage temperature (room or under refrigeration) was randomized in plots, whereas the sub-plots consisted of storage times (0, 3, 7, 10, and 14 days). Data were submitted to analysis of variance of a model in slip-plots in time using the software package SAS (2000) at 5% probability level. It was concluded that 70% OTM supplementation can be used with no damage to egg quality, independently from storage temperature or time. The quality of refrigerated eggs stored up to 14 days is better than those stored at room temperature.

Support Tool to the Validation Process of Functional Requirements

The activity of validating identified requirements for an information system helps to improve the quality of a requirements specification document and, consequently, the success of a project. Although various different support tools to requirements engineering exist in the market, there is still a lack of automated support for validation activity. In this context, the purpose of this paper is to make up for that deficiency, with the use of an automated tool, to provide the resources for the execution of an adequate validation activity. The contribution of this study is to enable an agile and effective follow-up of the scope established for the requirements, so as to lead the development to a solution which would satisfy the real necessities of the users, as well as to supply project managers with relevant information about the maturity of the analysts involved in requirements specification.

Quality of propolis commercialized in the informal market

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Yield and quality of carrot seeds, cv. Brasilia, as a result of plant population, gibberellic acid and stage of maturity

'Brasilia' is a cultivar of carrot with characteristics suiting cultivation under hot conditions but with problems in seed production, arising from the conflicting requirements of root and seed production. One solution is to select cultivars requiring vernalisation and then to use GA(3) to induce flowering where the climate prevents this. There is, however, little information on plant population, seed maturity and harvesting time on which to base such a procedure. Accordingly this research was carried out to study the physiological quality and production of the seeds in plant populations from 25,000 to 800,000 plants/ha, in the seed-to-seed method of cv. Brasilia in Anapolis, GO, Brazil. In each population, two harvest methods (from first and second orders of umbels, or selected harvest, and remaining orders, or total harvest) and two stages of maturity (brownish, or mature seeds, and yellowish, or immature ones) were also evaluated. Two trials were carried out, with and without gibberellic acid. Seed was evaluated for physical characters, germination, vigour, 1000-seed weight, water content, dry matter and productivity. Seed was produced in both experiments (with or without GA3 spraying). Mature seed showed germination at least 30% greater than immature, and seed from the selected harvest showed germination 16% greater than from the total harvest. In increasing plant population to 200,000 plants/ha, seed quality was not affected, but productivity increased.

An hydrochemical answer to a legislative demand involving health risk related to water quality

Effluents and surface waters around an area involved with the inking of tissues at Itatiba municipality, São Paulo State, Brazil, were chemically analyzed with the purpose of evaluating the influence on the water quality of the chemicals released, as well to provide answers to legislative requirements related to the São Paulo State Register 997 published on 31 May 1976.

Effect of daminozide, paclobutrazol and chlormequat on development and quality of potted 'persian carpet' zinnia

In Brazil zinnias have good prospect for the flowering potted plant market, once consumers demand for new forms of products is stimulated by novelty. 'Persian Carpet' is a highly ornamental plant, with fast growth, minimal labor requirements and low cost seeds. The present study evaluated the effect of growth regulators on development and quality of 'Persian Carpet' grown as a potted plant. Growth regulators are commonly used to control growth and produce short and compact plants. Paclobutrazol (0.5, 0.75 and 1.0 mg a.i./pot) and chlormequat (1.0, 2.0 and 3.0 g. L-1) were applied as a single drench, and daminozide (2.5, 3.75 and 5.0 g. L-1) as a single foliar spray to runoff. Regulators were applied at apical flower bud stage. Daminozide (5.0 g. L-1), paclobutrazol (0.5, 0.75 and 1.0 mg a.i./pot) and chlormequat (1.0 g. L-1) significantly reduced plant height and side branches length compared to the control. Plant height showed a negative linear response to the increasing concentration of daminozide or paclobutrazol. Paclobutrazol (1.0 mg a.i./pot) and chlormequat (1.0 g. L-1) increased foliage and flowers harvest index. Plant spread diameter and canopy shape were improved with paclobutrazol (0.75 mg a.i./pot). Chlormequat (2.0 and 3.0 g. L-1) caused phytotoxicity symptoms, turning plants unsuitable for commercialization. Studied regulators concentrations did not affect flower diameter and production cycle. Although regulators controlled height and side branches growth significantly, plants were not short and compact enough to attend market quality.

A bi-objective genetic approach for the selection of sugarcane varieties to comply with environmental and economic requirements

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

SEQUENTIAL SAMPLING AND MICROSATELLITES FOR EVALUATION OF THE GENETIC QUALITY IN CORN SEEDS LOTS

In the seed production system, genetic purity is one of the fundamental requirements for its commercialization. The present work had the goal of determined the sample size for genetic purity evaluation, in order to protect the seed consumer and the producer and to evaluate the sensitivity of microsatellite technique for discriminating hybrids from their respective relatives and for detecting mixtures when they are present in small amounts in the samples. For the sequential sampling, hybrid seeds were marked and mixed in with the seed lots, simulating the following levels of contamination: 0.25, 0.5, 1.0, 2.0, 4.0, and 6.0%. After this, groups of 40 seeds were taken in sequence, up to a maximum of 400 seeds, with the objective of determining the quantity of seeds necessary to detect the percentage of mixture mentioned above. The sensitivity of microsatellite technique was evaluated by mixing different proportions of DNA from the hybrids with their respective seed lines. For the level of mixture was higher than 1:8 (1P1:8P2; 8P1:1P2), the sensitivity of the marker in detecting different proportions of the mixture varied according to the primer used. In terms of the sequential sampling, it was verified that in order to detect mixture levels higher than 1% within the seed lot- with a risk level for both the producer and the consumer of 0.05- the size of the necessary sample was smaller than the size needed for the fixed sample size. This also made it possible to reduce costs, making it possible to use microsatellites to certify the genetic purity of corn seeds lots.

CRITICAL APPLICATIONS OF SW 846 US EPA METHODS TO EVALUATION OF MARINE SAMPLES QUALITY

Technical evaluation of analytical data is of extreme relevance considering it can be used for comparisons with environmental quality standards and decision-making as related to the management of disposal of dredged sediments and the evaluation of salt and brackish water quality in accordance with CONAMA 357/05 Resolution. It is, therefore, essential that the project manager discusses the environmental agency`s technical requirements with the laboratory contracted for the follow-up of the analysis underway and even with a view to possible re-analysis when anomalous data are identified. The main technical requirements are: (1) method quantitation limits (QLs) should fall below environmental standards; (2) analyses should be carried out in laboratories whose analytical scope is accredited by the National Institute of Metrology (INMETRO) or qualified or accepted by a licensing agency; (3) chain of custody should be provided in order to ensure sample traceability; (4) control charts should be provided to prove method performance; (5) certified reference material analysis or, if that is not available, matrix spike analysis, should be undertaken and (6) chromatograms should be included in the analytical report. Within this context and with a view to helping environmental managers in analytical report evaluation, this work has as objectives the discussion of the limitations of the application of SW 846 US EPA methods to marine samples, the consequences of having data based on method detection limits (MDL) and not sample quantitation limits (SQL), and present possible modifications of the principal method applied by laboratories in order to comply with environmental quality standards.

JOB SATISFACTION: A QUALITY INDICATOR IN NURSING HUMAN RESOURCE MANAGEMENT

This descriptive study addresses the job satisfaction of nurse managers and clinical nurses working at the Hematology and Hemotherapy Services of a public hospital in Sao Paulo. The study objectives were to identify the factors that caused job satisfaction among nurse managers and clinical nurses, and support the results in the development of indicators to evaluate the quality of nursing human resource management. The components of the study were: autonomy, interaction, professional status, job requirements, organizational norms and remuneration. Participants were 44 nurses. Data were collected using a Job Satisfaction Index (JSI) questionnaire. In conclusion, this study permitted the identification of the clinical nurse group, which was the most satisfied, with a JSI of 10.5; the managerial group scored 10.0. Regarding the satisfaction levels in regards to the current activity, 88.9% of the nurse managers reported feeling satisfied, as did 90.9% of clinical nurses. For both groups, autonomy was the component with the highest level of professional satisfaction.

Pet food: quality and quality improvement

Today’s pet food industry is growing rapidly, with pet owners demanding high-quality diets for their pets. The primary role of diet is to provide enough nutrients to meet metabolic requirements, while giving the consumer a feeling of well-being. Diet nutrient composition and digestibility are of crucial importance for health and well being of animals. A recent strategy to improve the quality of food is the use of “nutraceuticals” or “Functional foods”. At the moment, probiotics and prebiotics are among the most studied and frequently used functional food compounds in pet foods. The present thesis reported results from three different studies. The first study aimed to develop a simple laboratory method to predict pet foods digestibility. The developed method was based on the two-step multi-enzymatic incubation assay described by Vervaeke et al. (1989), with some modification in order to better represent the digestive physiology of dogs. A trial was then conducted to compare in vivo digestibility of pet-foods and in vitro digestibility using the newly developed method. Correlation coefficients showed a close correlation between digestibility data of total dry matter and crude protein obtained with in vivo and in vitro methods (0.9976 and 0.9957, respectively). Ether extract presented a lower correlation coefficient, although close to 1 (0.9098). Based on the present results, the new method could be considered as an alternative system of evaluation of dog foods digestibility, reducing the need for using experimental animals in digestibility trials. The second parte of the study aimed to isolate from dog faeces a Lactobacillus strain capable of exert a probiotic effect on dog intestinal microflora. A L. animalis strain was isolated from the faeces of 17 adult healthy dogs..The isolated strain was first studied in vitro when it was added to a canine faecal inoculum (at a final concentration of 6 Log CFU/mL) that was incubated in anaerobic serum bottles and syringes which simulated the large intestine of dogs. Samples of fermentation fluid were collected at 0, 4, 8, and 24 hours for analysis (ammonia, SCFA, pH, lactobacilli, enterococci, coliforms, clostridia). Consequently, the L. animalis strain was fed to nine dogs having lactobacilli counts lower than 4.5 Log CFU per g of faeces. The study indicated that the L animalis strain was able to survive gastrointestinal passage and transitorily colonize the dog intestine. Both in vitro and in vivo results showed that the L. animalis strain positively influenced composition and metabolism of the intestinal microflora of dogs. The third trail investigated in vitro the effects of several non-digestible oligosaccharides (NDO) on dog intestinal microflora composition and metabolism. Substrates were fermented using a canine faecal inoculum that was incubated in anaerobic serum bottles and syringes. Substrates were added at the final concentration of 1g/L (inulin, FOS, pectin, lactitol, gluconic acid) or 4g/L (chicory). Samples of fermentation fluid were collected at 0, 6, and 24 hours for analysis (ammonia, SCFA, pH, lactobacilli, enterococci, coliforms). Gas production was measured throughout the 24 h of the study. Among the tested NDO lactitol showed the best prebiotic properties. In fact, it reduced coliforms and increased lactobacilli counts, enhanced microbial fermentation and promoted the production of SCFA while decreasing BCFA. All the substrates that were investigated showed one or more positive effects on dog faecal microflora metabolism or composition. Further studies (in particular in vivo studies with dogs) will be needed to confirm the prebiotic properties of lactitol and evaluate its optimal level of inclusion in the diet.

Mobile TuCSoN: theoretical and technological requirements for TuCSoN's porting over Android mobile devices

Communication and coordination are two key-aspects in open distributed agent system, being both responsible for the system’s behaviour integrity. An infrastructure capable to handling these issues, like TuCSoN, should to be able to exploit modern technologies and tools provided by fast software engineering contexts. Thesis aims to demonstrate TuCSoN infrastructure’s abilities to cope new possibilities, hardware and software, offered by mobile technology. The scenarios are going to configure, are related to the distributed nature of multi-agent systems where an agent should be located and runned just on a mobile device. We deal new mobile technology frontiers concerned with smartphones using Android operating system by Google. Analysis and deployment of a distributed agent-based system so described go first to impact with quality and quantity considerations about available resources. Engineering issue at the base of our research is to use TuCSoN against to reduced memory and computing capability of a smartphone, without the loss of functionality, efficiency and integrity for the infrastructure. Thesis work is organized on two fronts simultaneously: the former is the rationalization process of the available hardware and software resources, the latter, totally orthogonal, is the adaptation and optimization process about TuCSoN architecture for an ad-hoc client side release.

Export Supply Chain Organization and Food Safety and Quality Standards: a case study of the Moroccan Fruit and Vegetable Sector

Agri-food supply chains extend beyond national boundaries, partially facilitated by a policy environment that encourages more liberal international trade. Rising concentration within the downstream sector has driven a shift towards “buyer-driven” global value chains (GVCs) extending internationally with global sourcing and the emergence of multinational key economic players that compete with increase emphasis on product quality attributes. Agri-food systems are thus increasingly governed by a range of inter-related public and private standards, both of which are becoming a priori mandatory, especially in supply chains for high-value and quality-differentiated agri-food products and tend to strongly affect upstream agricultural practices, firms’ internal organization and strategic behaviour and to shape the food chain organization. Notably, increasing attention has been given to the impact of SPS measures on agri-food trade and notably on developing countries’ export performance. Food and agricultural trade is the vital link in the mutual dependency of the global trade system and developing countries. Hence, developing countries derive a substantial portion of their income from food and agricultural trade. In Morocco, fruit and vegetable (especially fresh) are the primary agricultural export. Because of the labor intensity, this sector (especially citrus and tomato) is particularly important in terms of income and employment generation, especially for the female laborers hired in the farms and packing houses. Hence, the emergence of agricultural and agrifood product safety issues and the subsequent tightening of market requirements have challenged mutual gains due to the lack of technical and financial capacities of most developing countries.

Enhancing quality of service in software-defined networks

Resource management is of paramount importance in network scenarios and it is a long-standing and still open issue. Unfortunately, while technology and innovation continue to evolve, our network infrastructure system has been maintained almost in the same shape for decades and this phenomenon is known as “Internet ossification”. Software-Defined Networking (SDN) is an emerging paradigm in computer networking that allows a logically centralized software program to control the behavior of an entire network. This is done by decoupling the network control logic from the underlying physical routers and switches that forward traffic to the selected destination. One mechanism that allows the control plane to communicate with the data plane is OpenFlow. The network operators could write high-level control programs that specify the behavior of an entire network. Moreover, the centralized control makes it possible to define more specific and complex tasks that could involve many network functionalities, e.g., security, resource management and control, into a single framework. Nowadays, the explosive growth of real time applications that require stringent Quality of Service (QoS) guarantees, brings the network programmers to design network protocols that deliver certain performance guarantees. This thesis exploits the use of SDN in conjunction with OpenFlow to manage differentiating network services with an high QoS. Initially, we define a QoS Management and Orchestration architecture that allows us to manage the network in a modular way. Then, we provide a seamless integration between the architecture and the standard SDN paradigm following the separation between the control and data planes. This work is a first step towards the deployment of our proposal in the University of California, Los Angeles (UCLA) campus network with differentiating services and stringent QoS requirements. We also plan to exploit our solution to manage the handoff between different network technologies, e.g., Wi-Fi and WiMAX. Indeed, the model can be run with different parameters, depending on the communication protocol and can provide optimal results to be implemented on the campus network.