917 resultados para Telephone quality nursing
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Background: Universities worldwide are seeking objective measures for the assessment of their faculties` research products to evaluate them and to attain prestige. Despite concerns, the impact factors (IF) of journals where faculties publish have been adopted. Research objective: The study aims to explore conditions created within five countries as a result of policies requiring or not requiring faculty to publish in high IF journals, and the extent to which these facilitated or hindered the development of nursing science. Design: The design was a multiple case study of Brazil, Taiwan, Thailand (with IF policies, Group A), United Kingdom and the United States (no IF policies, Group B). Key informants from each country were identified to assist in subject recruitment. Methods: A questionnaire was developed for data collection. The study was approved by a human subject review committee. Five faculty members of senior rank from each country participated. All communication occurred electronically. Findings: Groups A and B countries differed on who used the policy and the purposes for which it was used. There were both similarities and differences across the five countries with respect to hurdles, scholar behaviour, publishing locally vs. internationally, views of their science, steps taken to internationalize their journals. Conclusions: In group A countries, Taiwan seemed most successful in developing its scholarship. Group B countries have continued their scientific progress without such policies. IF policies were not necessary motivators of scholarship; factors such as qualified nurse scientists, the resource base in the country, may be critical factors in supporting science development.
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To analyse the sensitivity and specificity of clinical indicators of ineffective airway clearance in children with congenital heart disease and to identify the indicators that have high predictive power. The precise establishment of nursing diagnoses has been found to be one of the factors contributing to higher quality of care and cost reduction in healthcare institutions. The use of indicators to diagnose ineffective airway clearance could improve care of children with congenital heart disease. Longitudinal study. Participants consisted of 45 children, <= 1 year of age, with congenital heart disease, who had not had definitive or palliative surgical correction. Six assessments were made at 2-day intervals. Each clinical indicator was defined based on previously established operational criteria. Sensitivity, specificity and positive and negative predictive values of each indicator were calculated based on a model for the longitudinal data. A nursing diagnosis of ineffective airway clearance was made in 31% of patients on the first assessment, rising to 71% on the last assessment, for a 40% increase. Sensitivity was highest for Changes in Respiratory Rates/Rhythms (0.99), followed by Adventitious Breath Sounds (0.97), Sputum Production (0.85) and Restlessness (0.53). Specificity was higher for Sputum Production (0.92), followed by Restlessness (0.73), Adventitious Breath Sounds (0.70) and Changes in Respiratory Rates/Rhythms (0.17). The best positive predictive values occurred for Sputum Production (0.93) and Adventitious Breath Sounds (0.80). Adventitious Breath Sounds followed by Sputum Production were the indicators that had the best overall sensitivity and specificity as well as the highest positive predictive values. The use of simple indicators in nursing diagnoses can improve identification of ineffective airway clearance in children with congenital heart disease, thus leading to early treatment of the problem and better care for these children.
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Objective The study analyzes the possibility of incorporating health promotion measures into the work processes of Family Health Program teams at a primary health care clinic in Brazil. Design and Sample We used the participatory research concept developed in 1968 by Freire. The study sample comprised the end-users of the health care system, together with 3 multidisciplinary teams. A total of 77 health care users and 55 health professionals participated in the study. Measures Culture circles composed of health care professionals, and users from different areas investigated generative topics, encoded/decoded topics, and engaged in critical probing for clarification. Topics affecting quality of life and health were heuristically evaluated. Results Although most topics were related to changing the focus of health care facilities, some were related to subsidizing community-based interventions, improving environmental strategies, individual skills, and public policies. Incorporating the novel health promotion measures and creating an expanded full-treatment clinic are important steps toward that goal. Conclusions Topics that can stimulate dialogue among the members of the culture circles include creating an environment of closer cultural contact, with repercussions for work processes, family health models, and general health models, as well as the inclusion of social aspects in the decision-making processes related to health issues that affect the living conditions of the population.
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Purpose. This study was designed to explore the cultural meaning and dimensions of quality of life from the perspective of Brazilian burn patients. Method. A qualitative research approach was used. Nineteen burn patients and their close relatives participated in this ethnographic study. Data were collected by means of direct observation and semi-structured interviews, conducted in a hospital outpatient clinic and during visits to patients` homes. The following inter-related phases guided the analysis process: reading of the material and data reduction, data display, conclusion outlining and verification. Results. Participants reported that the quality of life is related to autonomy and the ability to work. The dimensions of quality of life included: resuming work and functional ability, body image, having leisure and interpersonal relationships. Their descriptions revealed their feelings and attitudes about resuming their previous activities and social lives, particularly concerning the work. Conclusion. For burn patients, quality of life is associated with the concept of normality, the satisfactory performance of social roles in the context of family life and the social world. The results showed the importance of the sociocultural dimension in the concept of quality of life for persons undergoing burn rehabilitation.
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A hybrid system to automatically detect, locate and classify disturbances affecting power quality in an electrical power system is presented in this paper. The disturbances characterized are events from an actual power distribution system simulated by the ATP (Alternative Transients Program) software. The hybrid approach introduced consists of two stages. In the first stage, the wavelet transform (WT) is used to detect disturbances in the system and to locate the time of their occurrence. When such an event is flagged, the second stage is triggered and various artificial neural networks (ANNs) are applied to classify the data measured during the disturbance(s). A computational logic using WTs and ANNs together with a graphical user interface (GU) between the algorithm and its end user is then implemented. The results obtained so far are promising and suggest that this approach could lead to a useful application in an actual distribution system. (C) 2009 Elsevier Ltd. All rights reserved.
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This paper presents a novel adaptive control scheme. with improved convergence rate, for the equalization of harmonic disturbances such as engine noise. First, modifications for improving convergence speed of the standard filtered-X LMS control are described. Equalization capabilities are then implemented, allowing the independent tuning of harmonics. Eventually, by providing the desired order vs. engine speed profiles, the pursued sound quality attributes can be achieved. The proposed control scheme is first demonstrated with a simple secondary path model and, then, experimentally validated with the aid of a vehicle mockup which is excited with engine noise. The engine excitation is provided by a real-time sound quality equivalent engine simulator. Stationary and transient engine excitations are used to assess the control performance. The results reveal that the proposed controller is capable of large order-level reductions (up to 30 dB) for stationary excitation, which allows a comfortable margin for equalization. The same holds for slow run-ups ( > 15s) thanks to the improved convergence rate. This margin, however, gets narrower with shorter run-ups (<= 10s). (c) 2010 Elsevier Ltd. All rights reserved.
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Active control solutions appear to be a feasible approach to cope with the steadily increasing requirements for noise reduction in the transportation industry. Active controllers tend to be designed with a target on the sound pressure level reduction. However, the perceived control efficiency for the occupants can be more accurately assessed if psychoacoustic metrics can be taken into account. Therefore, this paper aims to evaluate, numerically and experimentally, the effect of a feedback controller on the sound quality of a vehicle mockup excited with engine noise. The proposed simulation scheme is described and experimentally validated. The engine excitation is provided by a sound quality equivalent engine simulator, running on a real-time platform that delivers harmonic excitation in function of the driving condition. The controller performance is evaluated in terms of specific loudness and roughness. It is shown that the use of a quite simple control strategy, such as a velocity feedback, can result in satisfactory loudness reduction with slightly spread roughness, improving the overall perception of the engine sound. (C) 2008 Elsevier Ltd. All rights reserved.
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The Pirapo river watershed (Parana State, Brazil) compounds a relatively industrialized and urbanized region, undergoing great pressure from the discharge of industrial, agricultural and domestic wastes. We evaluated the environmental quality of ten streams belonging to this watershed in April and June 2008 by performing acute and chronic toxicity tests with Daphnia similis and Ceriodaphnia silvestrii from water and sediment samples. We tested the hypothesis that the streams located in urban areas are more exposed to the influence of pollutants, than those outside the city limits. In addition, we obtained the measures of physical and chemical parameters, and identified the main polluted sources. Contrary to what was expected, the rural streams were more toxic than those located in urban area. These results demonstrate that the water bodies located in rural areas are being affected by the pollution of aquatic ecosystems as far as those found in urban areas, requiring the same attention of environmental managers in relation to its monitoring.
Quality of martensitic stainless steel type AISI-420 utilized in the manufacture surgical implements
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Until now the martensitic stainless steel type AISI-420 is widely used in the manufacture of surgical implements. These implements present premature corrosion problems identified after cleaning, sterilization and cutting edge loss and/or rupture during the surgical processes.. This study evaluates the steel as to the chemical composition, hardness, microstructure and pitting corrosion resistance in a solution of enzyme detergent diluted in water by anodic cyclic polarization. This mixture is used in the cleaning of surgical implements that are submerged in this solution for 2 h before cleaning and sterilization. The results show steels with martensite microstructures in the ferrite phase, together with impurities. These presented low pitting potential values in compariston to steels with a fully martensitic microstructure.
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This paper presents a proposal for a Quality Management System for a generic GNSS Surveying Company as an alternative for management and service quality improvements. As a result of the increased demand for GNSS measurements, a large number of new or restructured companies were established to operate in that market. Considering that GNSS surveying is a new process, some changes must be performed in order to accommodate the old surveying techniques and the old fashioned management to the new reality. This requires a new management model that must be based on a well-described procedure sequence aiming at the Total Management Quality for the company. The proposed Quality Management System was based on the requirements of the Quality System ISO 9000:2000, applied to the whole company, focusing on the productive process of GNSS surveying work.
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This paper discusses the need to simultaneously monitor voltage unbalance and harmonic distortions in addition to root-mean-square voltage values. An alternative way to obtain the parameters related to voltage unbalance at fundamental frequency as well as voltage harmonic distortions is here proposed, which is based on the representation of instantaneous values at the axes and at the instantaneous Euclidean norm. A new power-quality (PQ) index is then proposed to combine the effects of voltage unbalance and harmonic distortions. This new index is easily implemented into existing electronic power meters. This PQ index is determined from the analysis of temperature rise in induction motor windings, which were tested for long periods of time. This paper also shows that these voltage disturbances, which are harmful to the lifetime expectancy of motors, can be measured by alternative ways in relation to conventional methods. Although this paper deals with induction motors only, the results show the relevance for further studies on other pieces of equipment.
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This work presents a case study on technology assessment for power quality improvement devices. A system compatibility test protocol for power quality mitigation devices was developed in order to evaluate the functionality of three-phase voltage restoration devices. In order to validate this test protocol, the micro-DVR, a reduced power development platform for DVR (dynamic voltage restorer) devices, was tested and the results are discussed based on voltage disturbances standards. (C) 2011 Elsevier B.V. All rights reserved.
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The aim of this work was evaluate the effect of citric acid at 1% and 2% in the maintenance of the quality of minimally processed `Regis` peaches, during 9 days storage under refrigeration (5+/-1 degrees C, 85-87% RU) and passive modified atmospheres. The following analyses were realized: color, firmness, texture, soluble solids, titratable acidity, pH, CO(2) and O(2). Increasing in a value and decreasing in b and L values on minimally processed peaches were observed, independent of the citric acid treatment, indicating a browning on the product mainly on the 9(th) day of storage. Overall, the levels of titratable acidity and pH changed at the storage period and at the concentrations studied, unlike the content of soluble solids that remained unchanged. The texture, CO(2) and O(2) changed only for the storage period unlike texture that was higher with the treatment of citric acid 2%. It can be concluded that neither tested concentration of citric acid was effective in preventing enzymatic browning of minimally processed peaches stored the 5+/-1 degrees C and 85-87% RU and passive modified atmosphere.
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Color, pH, shear force, water-holding capacity, chemical composition, cholesterol content, and fatty acid profile from conventional, free-range and alternative broiler breast meat were determined in order to evaluate differences in the quality of broiler meat produced under different systems. Broilers reared in a conventional system had the highest lipid content (1.3%) but lower proportions of polyunsaturated (17.3%) and omega-3 fatty acids (0.3%) (p<0.05) compared to free-range and alternative broilers. On the other hand, free-range broilers had a lower cholesterol content (48.6 mg center dot 100 g(-1)) and lower pH (5.7 1) while broilers raised in an alternative system had a higher shear force (2.33 kgf) and lower yellowness value (b* value = 3.15) when compared to the other rearing systems (p<0.05).
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This work analysed the influence of storage in the quality of forest biomass for energy generation in the region of Lages, Brazil. Logs of Pinus taeda L. and Eucalyptus dunnii Maiden were harvested and piled during the four different seasons: spring, summer, fall and winter. The analyses were performed immediately after harvesting (without being stored), after two, four and six months of storage. The evaluated properties were: moisture content, gross and net calorific value, ash content and solubility in cold water, hot water and sodium hydroxide. The species composition, storage span, harvesting season and storage season influenced the forest biomass characteristics. In general, eucalyptus presented better results than pine, losing moisture faster, having less alteration in the chemical composition and producing greater energetic gain over storage time. For both species, the ideal storage time was four months. Furthermore, spring and summer were the best harvesting seasons. Thus, if the forest biomass is harvested at the end of winter or beginning of spring with subsequent storage during the summer, this biomass will have the best performance for energy production. (C) 2011 Elsevier Ltd. All rights reserved.