964 resultados para quality indicator


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Objectives The purpose of this study was to identify the structural quality of care domains and to establish a set of structural quality indicators (SQIs) for the assessment of care of older people with cognitive impairment in emergency departments (EDs). Methods A structured approach to SQI development was undertaken including: 1) a comprehensive search of peer-reviewed and gray literature focusing on identification of evidence-based interventions targeting structure of care of older patients with cognitive impairment and existing SQIs; 2) a consultative process engaging experts in the care of older people and epidemiologic methods (i.e., advisory panel) leading to development of a draft set of SQIs; 3) field testing of drafted SQIs in eight EDs, leading to refinement of the SQI set, and; 4) an independent voting process among the panelists for SQI inclusion in a final set, using preestablished inclusion and exclusion criteria. Results At the conclusion of the process, five SQIs targeting the management of older ED patients with cognitive impairment were developed: 1) the ED has a policy outlining the management of older people with cognitive impairment during the ED episode of care; 2) the ED has a policy outlining issues relevant to carers of older people with cognitive impairment, encompassing the need to include the (family) carer in the ED episode of care; 3) the ED has a policy outlining the assessment and management of behavioral symptoms, with specific reference to older people with cognitive impairment; 4) the ED has a policy outlining delirium prevention strategies, including the assessment of patients' delirium risk factors, and; 5) the ED has a policy outlining pain assessment and management for older people with cognitive impairment. Conclusions This article presents a set of SQIs for the evaluation of performance in caring for older people with cognitive impairment in EDs.

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Purpose The purpose of this research is to examine the concept of “potential quality” – that is, a company's tangible search qualities (such as the physical servicescape and virtual servicescape) – within the context of the real‐estate industry in the USA. Design/methodology/approach This qualitative study collects data by conducting personal in‐depth interviews with 34 respondents who had been recent buyers or renters of property. The data are then coded and themed to identify quality dimensions relevant to this industry. Findings The results indicate that a buyer's perception of the overall service quality of real‐estate service consists of two components: the interaction with a realtor (process quality); and the virtual servicescape, especially the firm's website design and content (potential quality). The study concludes that existing scales (such as SERVQUAL and RESERV) fail to capture the tangible component of service quality sufficiently in the real‐estate industry. Research limitations/implications The study uses data from only one industry (real estate) and from only one demographic segment (professionals in higher education). Practical implications Service providers of intangible, high‐contact services must appreciate the importance of the virtual servicescape as a surrogate quality indicator that can help to reduce information asymmetries and consumers' uncertainty with regard to initiating a business relationship. Real estate firms need to pay attention to the training of agents and the design and content of their e‐service systems. Originality/value This study integrates potential quality, process quality, and outcome quality in a comprehensive proposed model. In particular, the study identifies “potential quality” as a combination of the attributes of the virtual service environment and the physical service environment.

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Displacement estimation is a key step in the evaluation of tissue elasticity by quasistatic strain imaging. An efficient approach may incorporate a tracking strategy whereby each estimate is initially obtained from its neighbours' displacements and then refined through a localized search. This increases the accuracy and reduces the computational expense compared with exhaustive search. However, simple tracking strategies fail when the target displacement map exhibits complex structure. For example, there may be discontinuities and regions of indeterminate displacement caused by decorrelation between the pre- and post-deformation radio frequency (RF) echo signals. This paper introduces a novel displacement tracking algorithm, with a search strategy guided by a data quality indicator. Comparisons with existing methods show that the proposed algorithm is more robust when the displacement distribution is challenging.

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Until now health impact assessment and environmental impact assessment are two different issues, often not addressed together. Both issues have to be dealt with for sustainable building. The aim of this paper is to link healthy and sustainable housing in life cycle assessment. Two strategies are studied: clean air as a functional unity and health as a quality indicator. The strategies are illustrated with an example on the basis of Eco-Quantum, which is a Dutch whole-building assessment tool. It turns out that both strategies do not conflict with the LCA methodology. The LCA methodology has to be refined for this purpose.

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A low-cost test bed was made from a modified heavy vehicle (HV) brake tester. By rotating a test HV’s wheel on an eccentric roller, a known vibration was imparted to the wheel under test. A control case for dampers in good condition was compared with two test cases of ineffective shock absorbers. Measurement of the forces at the bearings of the roller provided an indication of the HV wheel-forces. Where the level of serviceability of the shock absorbers varied, differences in wheel load provided a quality indicator corresponding to a change of damper characteristic. Conclusions regarding the levels of damper maintenance beyond which HV suspensions cause road damage and dynamic wheel forces at the threshold of tyre wear at which HV shock absorbers are normally replaced are presented.

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The paper provides an assessment of the performance of commercial Real Time Kinematic (RTK) systems over longer than recommended inter-station distances. The experiments were set up to test and analyse solutions from the i-MAX, MAX and VRS systems being operated with three triangle shaped network cells, each having an average inter-station distance of 69km, 118km and 166km. The performance characteristics appraised included initialization success rate, initialization time, RTK position accuracy and availability, ambiguity resolution risk and RTK integrity risk in order to provide a wider perspective of the performance of the testing systems. ----- ----- The results showed that the performances of all network RTK solutions assessed were affected by the increase in the inter-station distances to similar degrees. The MAX solution achieved the highest initialization success rate of 96.6% on average, albeit with a longer initialisation time. Two VRS approaches achieved lower initialization success rate of 80% over the large triangle. In terms of RTK positioning accuracy after successful initialisation, the results indicated a good agreement between the actual error growth in both horizontal and vertical components and the accuracy specified in the RMS and part per million (ppm) values by the manufacturers. ----- ----- Additionally, the VRS approaches performed better than the MAX and i-MAX when being tested under the standard triangle network with a mean inter-station distance of 69km. However as the inter-station distance increases, the network RTK software may fail to generate VRS correction and then may turn to operate in the nearest single-base RTK (or RAW) mode. The position uncertainty reached beyond 2 meters occasionally, showing that the RTK rover software was using an incorrect ambiguity fixed solution to estimate the rover position rather than automatically dropping back to using an ambiguity float solution. Results identified that the risk of incorrectly resolving ambiguities reached 18%, 20%, 13% and 25% for i-MAX, MAX, Leica VRS and Trimble VRS respectively when operating over the large triangle network. Additionally, the Coordinate Quality indicator values given by the Leica GX1230 GG rover receiver tended to be over-optimistic and not functioning well with the identification of incorrectly fixed integer ambiguity solutions. In summary, this independent assessment has identified some problems and failures that can occur in all of the systems tested, especially when being pushed beyond the recommended limits. While such failures are expected, they can offer useful insights into where users should be wary and how manufacturers might improve their products. The results also demonstrate that integrity monitoring of RTK solutions is indeed necessary for precision applications, thus deserving serious attention from researchers and system providers.

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The Effective Exponential SNR Mapping (EESM) is an indispensable tool for analyzing and simulating next generation orthogonal frequency division multiplexing (OFDM) based wireless systems. It converts the different gains of multiple subchannels, over which a codeword is transmitted, into a single effective flat-fading gain with the same codeword error rate. It facilitates link adaptation by helping each user to compute an accurate channel quality indicator (CQI), which is fed back to the base station to enable downlink rate adaptation and scheduling. However, the highly non-linear nature of EESM makes a performance analysis of adaptation and scheduling difficult; even the probability distribution of EESM is not known in closed-form. This paper shows that EESM can be accurately modeled as a lognormal random variable when the subchannel gains are Rayleigh distributed. The model is also valid when the subchannel gains are correlated in frequency or space. With some simplifying assumptions, the paper then develops a novel analysis of the performance of LTE's two CQI feedback schemes that use EESM to generate CQI. The comprehensive model and analysis quantify the joint effect of several critical components such as scheduler, multiple antenna mode, CQI feedback scheme, and EESM-based feedback averaging on the overall system throughput.

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The context: Soil biodiversity and sustainable agriculture; Abstracts - Theme 1: Monitoring and assessment: Bioindicators of soil health: assessment and monitoring for sustainable agriculture; Practical tools to measure soil health and their use by farmers; Biological soil quality from biomass to biodiversity - importance and resilience to management stress and disturbance; Integrated management of plant-parasitic nematodes in maize-bean cropping systems; Microbial quantitative and qualitative changes in soils under different crops and tillage management systems in Brazil; Diversity in the rhizobia associated with Phaseolus vulgaris L: in Ecuador and comparisons with Mexican bean rhizobia; Sistemas integrados ganadería-agricultura en Cuba; Soil macrofauna as bioindicator of soil quality; Biological functioning of cerrado soils; Hydrolysis of fluorescein diacetate as a soil quality indicator in different pasture systems; Soil management and soil macrofauna communities at Embrapa Soybean, Londrina, Brazil; Soil macrofauna in a 24 - year old no-tillage system in Paraná, Brazil; Invertebrate macrofauna of soils inpastures under different forms of management in the cerrado (Brazil); Soil tillage modifies the invertebrate soil macrofauna community; Soil macrofauna in various tillage and land use systems on an oxisols near Londrina, Paraná, Brazil; Interference of agricultural systems on soil macrofauna; Scarab beetle-grub holes in various tillage and crop management systems at Embrapa Soybean, Londrina, Brazil; Biological management of agroecosystems; Soil biota and nutrient dynamics through litterfall in agroforestry system in Rondônia, Amazônia, Brazil; Soil-C stocks and earthworm diversity of native and introduced pastures in Veracruz, Mexico; Theme 2 : Adaptive management: Some thoughts on the effects and implications of the transition from weedy multi-crop to wead-free mono-crop systems in Africa; Towards sustainable agriculture with no-tillage and crop rotation systems in South Brazil; Effect of termites on crusted soil rehabilitation in the Sahel; Management of macrofauna in traditional and conventional agroforestry systems from India with special reference to termites and earthworms; Adaptive management for redeveloping traditional agroecosystems; Conservation and sustainable use of soil biodiversity: learning with master nature!; Convergence of sciences: inclusive technology innovation processes for better integrated crop/vegetation, soil and biodiversity management; Potential for increasing soil biodiversity in agroecosystems; Biological nitrogen fixation and sustainability in the tropics; Theme 3: Research and innovation: Plant flavonoids and cluster roots as modifiers of soil biodiversity; The significance of biological diversity in agricultural soil for disease suppressiveness and nutrient retention; Linking above - and belowground biodiversity: a comparison of agricultural systems; Insect-pests in biologically managed oil and crops: the experience at ICRISAT; Sistemas agricolas micorrizados en Cuba; The effect of velvetbean (Mucuna pruriens) on the tropical earthworm Balanteodrilus pearsei: a management option for maize crops in the Mexican humid tropics; The potential of earthworms and organic matter quality in the rehabilitation of tropical soils; Research and innovation in biological management of soil ecosystems; Application of biodynamic methods in the Egyptian cotton sector; Theme 4: Capacity building and mainstreaming: Soil ecology and biodiversity: a quick scan of its importance for government policy in The Netherlands; Agrotechnological transfer of legume inoculants in Eastern and Southern Africa; Agricultura urbana en Cuba; Soil carbon sequestration for sustaining agricultural production and improving the environment; Conservation and sustainable management of below-ground biodiversity: the TSBF-BGBD network project; The tropical soil biology and fertility institute of CIAT (TSBF); South-South initiative for training and capacity building for the management of soil biology/biodiversity; Strategies to facilititate development and adoption of integrated resource management for sustainable production and productivity improvement; The challenge program on biological nitrogen fixation (CPBNF); Living soil training for farmers: improving knowledge and skills in soil nutrition management; Do we need an inter-governmental panel on land and soil (IPLS)? Protection and sustainable use of biodiversity of soils; Cases Studies -- Plant parasitic nematodes associated with common bean (Phaseolus vulgaris L.) and integrated management approaches; Agrotechnological transfer of legume inoculants in Eastern and Southern Africa; Restoring soil fertility and enhancing productivity in Indian tea plantations with earthworms and organic fertilizers; Managing termites and organic resources to improve soil productivity in the Sahel; Overview and case studies on biological nitrogen fixation: perspectives and limitations; Soil biodiversity and sustainable agriculture: an overview.

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Anisotropic conductive film (ACF) which consists of an adhesive epoxy matrix and randomly distributed conductive particles are widely used as the connection material for electronic devices with high I/O counts. However, for the semiconductor industry the reliability of the ACF is still a major concern due to a lack of experimental reliability data. This paper reports the investigations into the moisture-induced failures in Flip-Chip-on-Flex interconnections with Anisotropic Conductive Films (ACFs). Both experimental and modeling methods were applied. In the experiments, the contact resistance was used as a quality indicator and was measured continuously during the accelerated tests (autoclave tests). The temperature, relative humidity and the pressure were set at 121°C, 100%RH, and 2atm respectively. The contact resistance of the ACF joints increased during the tests and nearly 25% of the joints were found to be open after 168 hours’ testing time. Visible conduction gaps between the adhesive and substrate pads were observed. Cracks at the adhesive/flex interface were also found. For a better understanding of the experimental results, 3-D Finite Element (FE) models were built and a macro-micro modeling method was used to determine the moisture diffusion and moisture-induced stresses inside the ACF joints. Modeling results are consistent with the findings in the experimental work.

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This paper reports the investigations into the moisture induced failures in flip-chip-on-flex interconnections with anisotropic conductive films (ACF). Both experimental and modeling methods were applied. In the experiments, the contact resistance was used as a quality indicator and was measured continuously during the accelerated tests (autoclave tests). The temperature, relative humidity and the pressure were set at 121°C, 100%RH, 1atm respectively. The contact resistance of the ACF joints increased during the tests and nearly 25% of the joints were found to be open after 168 hours' testing time. Visible conduction gaps between the adhesive and substrate pads were observed. Cracks at the adhesive/flex interface were also found. It is believed that the swelling effect of the adhesive and the water penetration along the adhesive/flex interface are the main causes of this contact degradation. Another finding from the experimental work was that the ACF interconnections that had undergone the reflow treatment were more sensitive to the moisture and showed worse reliability during the tests. For a better understanding of the experimental results, 3D finite element (FE) models were built and a macro-micro modeling method was used to determine the moisture diffusion and moisture-induced stresses inside the ACF joints. Modeling results are consistent with the findings in the experimental work.

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Dissertação de Mestrado apresentado ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Auditoria, sob orientação de: Doutora Alcina Dias e coorientação de: Doutora Ana Paula Lopes

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Contexte De nombreuses études, utilisant des indicateurs de qualité variés, ont démontré que la qualité des soins pour la dépression n’est pas optimale en première ligne. Peu de ces études ont examiné les facteurs associés à la réception d’un traitement adéquat, en particulier en tenant compte simultanément des caractéristiques individuelles et organisationnelles. L'association entre un traitement adéquat pour un épisode dépressif majeur (EDM) et une amélioration des symptômes dépressifs n'est pas bien établie dans des conditions non-expérimentales. Les objectifs de cette étude étaient de : 1) réaliser une revue systématique des indicateurs mesurant la qualité du traitement de la dépression en première ligne ; 2) estimer la proportion de patients souffrant d’EDM qui reçoivent un traitement adéquat (selon les guides de pratique clinique) en première ligne ; 3) examiner les caractéristiques individuelles et organisationnelles associées à l’adéquation du traitement pour la dépression ; 4) examiner l'association entre un traitement minimalement adéquat au cours des 12 mois précédents et l'évolution des symptômes dépressifs à 6 et 12 mois. Méthodes La littérature sur la qualité du traitement de la dépression a été examinée en utilisant un ensemble de mots-clés (« depression », « depressive disorder », « quality », « treatment », « indicator », « adequacy », « adherence », « concordance », « clinical guideline » et « guideline ») et « 360search », un moteur de recherche fédérée. Les données proviennent d'une étude de cohorte incluant 915 adultes consultant un médecin généraliste, quel que soit le motif de consultation, répondant aux critères du DSM-IV pour l’EDM dans la dernière année, nichés dans 65 cliniques de première ligne au Québec, Canada. Des analyses multiniveaux ont été réalisées. Résultats Bien que majoritairement développés à partir de guides de pratique clinique, une grande variété d'indicateurs a été observée dans la revue systématique de littérature. La plupart des études retenues ont utilisé des indicateurs de qualité rudimentaires, surtout pour la psychothérapie. Les méthodes utilisées étaient très variées, limitant la comparabilité des résultats. Toutefois, quelque soit la méthode choisie, la plupart des études ont révélé qu’une grande proportion des personnes souffrant de dépression n’ont pas reçu de traitement minimalement adéquat en première ligne. Dans notre échantillon, l’adéquation était élevée (> 75 %) pour un tiers des indicateurs de qualité mesurés, mais était faible (< 60 %) pour près de la moitié des mesures. Un peu plus de la moitié de l'échantillon (52,2 %) a reçu au moins un traitement minimalement adéquat pour la dépression. Au niveau individuel, les jeunes adultes (18-24 ans) et les personnes de plus de 65 ans avaient une probabilité moins élevée de recevoir un traitement minimalement adéquat. Cette probabilité était plus élevée pour ceux qui ont un médecin de famille, une assurance complémentaire, un trouble anxieux comorbide et une dépression plus sévère. Au niveau des cliniques, la disponibilité de la psychothérapie sur place, l'utilisation d'algorithmes de traitement, et le mode de rémunération perçu comme adéquat étaient associés à plus de traitement adéquat. Les résultats ont également montré que 1) la réception d'au moins un traitement minimalement adéquat pour la dépression était associée à une plus grande amélioration des symptômes dépressifs à 6 et à 12 mois; 2) la pharmacothérapie adéquate et la psychothérapie adéquate étaient toutes deux associées à de plus grandes améliorations dans les symptômes dépressifs, et 3) l'association entre un traitement adéquat et l'amélioration des symptômes dépressifs varie en fonction de la sévérité des symptômes au moment de l'inclusion dans la cohorte, un niveau de symptômes plus élevé étant associé à une amélioration plus importante à 6 et à 12 mois. Conclusions Nos résultats suggèrent que des interventions sont nécessaires pour améliorer la qualité du traitement de la dépression en première ligne. Ces interventions devraient cibler des populations spécifiques (les jeunes adultes et les personnes âgées), améliorer l'accessibilité à la psychothérapie et à un médecin de famille, et soutenir les médecins de première ligne dans leur pratique clinique avec des patients souffrant de dépression de différentes façons, telles que le développement des connaissances pour traiter la dépression et l'adaptation du mode de rémunération. Cette étude montre également que le traitement adéquat de la dépression en première ligne est associé à une amélioration des symptômes dépressifs dans des conditions non-expérimentales.

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Na passagem para o século XX, a agricultura sofreu transformações no modelo de produção. Atualmente, a maior parte dos alimentos são produzidos no modelo da agricultura convencional baseada na utilização intensiva de insumos químicos e alta produtividade, em contraponto, a agricultura orgânica está alicerçada na independência de insumos externos e na qualidade dos alimentos. O morango (Fragaria x Ananassa Duch), reconhecido por suas vitaminas e compostos quimioprotetores, tais como o ácido ascórbico e licopeno, é uma cultura produzida tanto no sistema orgânico, quanto no convencional. Entretanto, não existem informações sobre os tipos de sistemas existentes dentro destas duas formas de fazer agricultura e nem dados sobre os conteúdos de ácido ascórbico e de licopeno. Os objetivos deste trabalho foram: tipificar os sistemas de cultivo praticados e identificar as características básicas da produção de morango em Porto Alegre; quantificar os indicadores nutricionais licopeno e ácido ascórbico em morangos cv. Vila Nova, oriundos de diferentes sistemas de cultivo e avaliar a possibilidade dessas substâncias servirem como descritores da qualidade biológica dos frutos produzidos nestas diferentes formas de fazer agricultura. Foram escolhidos cinco sistemas de produção de morangos no bairro Lami, Porto Alegre/RS, sendo duas propriedades orgânicas (OJ, OS) e três convencionais (CN, CP, CB) Para a tipificação foi usada à observação participativa com registro dos dados sobre a intensidade dos componentes de cultivo (manejos, adubação, controle fitossanitário, técnicas de irrigação) e sócio-econômicos. Para medir os teores de licopeno e ácido ascórbico foram cultivados morangos cv. Vila Nova, os quais foram colhidos maduros e analisados. Dentro do sistema convencional existe uma intensidade variada na utilização de insumos. No sistema orgânico um foi tipificado como agroecológico e outro como em final de transição para o orgânico. Os sistemas convencionais têm alta demanda por produtos externos, principalmente em relação à adubação (adubos minerais de alta solubilidade), irrigação (mangueiras, etc) e controle fitossanitário (produtos químicos de síntese) e os sistemas orgânicos apresentam uma baixa dependência externa em relação ao controle fitossanitários, irrigação e manejo. Eles apresentaram dependência de adubos orgânico de origem animal. Os resultados demonstraram que o conteúdo de licopeno variou de 0,033 a 0,063 mg/100g de peso fresco e que ele não foi eficiente como descritor da qualidade hortícola de morangos cultivados em sistemas orgânicos e convencionais. O conteúdo de ácido ascórbico foi de 30,05 a 69,39 mg/100g de peso fresco. Esta vitamina não discrimina diferenças entre os sistemas, e não pode ser considerada como um descritor de qualidade biológica de morangos cultivados em sistemas orgânicos e convencionais.

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The conventional radiographic technique using industrial radiographic films is with the days finishing. The Digital Radiography is taking place in several sectors, e.g., the medical, aerospace, security, automotive, etc. In addition to representing a technological trend, it has been demonstrated that digital radiography offers a series of benefits in terms of productivity, sensitivity, environmental aspects, image treatment tools, cost reduction, etc. If one weld seam to be inspected is from a serried product, as example a pipe, the best option to be implemented is the Flat Panel Detector with this equipment is possible to reduce the obtaining digital radiographic images in place of films and reducing the inspection cycle time due to its high degree of automation. In the experiments described in this paper this new technique was tested and the results were compared with those obtained by the conventional radiography. The welded specimens were prepared using the submerged-arc welding process and small artificial cracks of the most varied dimensions, present in the specimens, were used to establish a comparison of the sensitivities presented by the techniques employed After conducting several experiments, the digital method presented the highest sensitivity to the wire-type Image Quality Indicator (IQI) and in the detection of small defects, leading to the conclusion that the use of digital radiography using the flat-panel detector offers advantages over the conventional technique [1, 2]. This work was carried out based on the API 5L Edition 2004 [3] and ISO 3183 Edition 2007 [4] specifications.

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A utilização incorreta dos solos vem causando alterações neles, tornando-os cada vez menos produtivos, aumentando as áreas com solos degradados. O presente trabalho teve por objetivos estudar ações para acelerar a formação do horizonte A de um Latossolo Vermelho degradado, via uso de adubos verdes, lodo de esgoto e cultivo de uma espécie arbórea nativa de Cerrado, e selecionar indicadores para detectar alterações da camada superficial do solo. O monitoramento das alterações do solo foi realizado anualmente. O delineamento experimental foi o de blocos casualizados com seis tratamentos, em cinco repetições. Os tratamentos foram: testemunha - solo exposto (sem manejo); vegetação nativa (Cerrado); espécie arbórea Astronium fraxinifolium; Astronium fraxinifolium + Canavalia ensiformis; Astronium fraxinifolium + Raphanus sativus; e Astronium fraxinifolium + Brachiaria decumbens + lodo de esgoto (60 t ha-1). Avaliou-se no solo: porosidade, densidade do solo, cátions trocáveis, pH, acidez potencial (H + Al), soma de bases (SB), saturação por bases (V), CTC e macrorganismos. Nos adubos verdes, foi avaliada a massa seca e, para a espécie arbórea, a altura e o diâmetro de caule. A mobilização do solo e a mobilização mais a adubação verde e o lodo de esgoto estão recuperando as propriedades do solo degradado, com comportamento semelhante entre elas após um ano de adoção. O melhor indicador físico das alterações do solo foi sua densidade. Os tratamentos adotados são semelhantes quanto à população de macrorganismos do solo e contribuindo positivamente para recuperação da macrofauna. A presença de larva e besouro foi indicadora da melhoria da macrofauna do solo.