Resources for the implementation of total quality management (TQM) : in education, in nonprofits, and in the service sector /

Includes index.

Shear bond strength of self-etch and total-etch bonding systems at different dentin depths

The purpose of this study was to evaluate the dentin shear bond strength of four adhesive systems (Adper Single Bond 2, Adper Prompt L-Pop, Magic Bond DE and Self Etch Bond) in regards to buccal and lingual surfaces and dentin depth. Forty extracted third molars had roots removed and crowns bisected in the mesiodistal direction. The buccal and lingual surfaces were fixed in a PVC/acrylic resin ring and were divided into buccal and lingual groups assigned to each selected adhesive. The same specimens prepared for the evaluation of superficial dentin shear resistance were used to evaluate the different depths of dentin. The specimens were identified and abraded at depths of 0.5, 1.0, 1.5 and 2.0 mm. Each depth was evaluated by ISO TR 11405 using an EMIC-2000 machine regulated at 0.5 mm/min with a 200 Kgf load cell. We performed statistical analyses on the results (ANOVA, Tukey and Scheffé tests). Data revealed statistical differences (p < 0.01) in the adhesive and depth variation as well as adhesive/depth interactions. The Adper Single Bond 2 demonstrated the highest mean values of shear bond strength. The Prompt L-Pop product, a self-etching adhesive, revealed higher mean values compared with Magic Bond DE and Self Etch Bond adhesives, a total and self-etching adhesive respectively. It may be concluded that the shear bond strength of dentin is dependent on material (adhesive system), substrate depth and adhesive/depth interaction.

Prótese total articulada de joelho utilizada no tratamento de osteossarcoma apendicular em cão

O objetivo do trabalho foi reportar o planejamento cirúrgico, a técnica operatória, a instrumentação e os resultados da substituição completa do terço médio distal do fêmur, do platô tibial e da articulação do joelho por prótese em um cão acometido por osteossarcoma no fêmur esquerdo. A prótese foi confeccionada em aço, apresentando três componentes articulados, mantendo o movimento semelhante à articulação do joelho. As porções femorais e tibiais da prótese foram cimentadas aos respectivos ossos, após ostectomia do fêmur e do platô tibial. O animal foi submetido a seis sessões de quimioterapia, com doxorrubicina e carboplatina, intercaladas mensalmente, objetivando inibir o crescimento de possíveis metástases pulmonares. Durante os seis primeiros dias, o animal apresentou neuropraxia e impotência funcional do membro. Aos 10 dias, o cão iniciou leve apoio e aos 30 dias já utilizava o membro pélvico de forma mais efetiva, porém, o ângulo de extensão da articulação foi reduzido de 150° a 100° devido à contratura muscular e à fibrose na região da fossa poplítea. Após um ano de observação, não houve melhora do ângulo de extensão do joelho, porém, o animal fazia uso do membro com claudicação. Aos 425 dias de pós-operatório, o animal veio a óbito por insuficiência renal. Nesse tempo não ocorreram metástases pulmonares ou locais visíveis radiograficamente, mas o proprietário não permitiu a realização da necropsia do paciente, sendo impossível confirmar outros dados que pudessem esclarecer melhor a causa morte. Conclui-se que a substituição total do joelho de cão é uma cirurgia factível, que permite a preservação e a utilização do membro após ressecção da neoplasia, embora outras pesquisas devam ser conduzidas para obtenção de melhores resultados pós-cirúrgicos.

An upflow fixed-bed anaerobic-aerobic reactor for removal of organic matter and nitrogen from L-lysine plant wastewater

This paper reports on the design of a new reactor configuration - an upflow fixed-bed combined anaerobic-aerobic reactor - can operate as a single treatment unit for the removal of nitrogen (approximate to 150 mg N/L) and organic matter (approximate to 1300 mg COD/L) from Lysine plant wastewater. L-Lysine, an essential amino acid for animal nutrition, is produced by fermentation from natural raw materials of agricultural origin, thus generating wastewater with high contents of organic matter and nitrogen. The best operational condition of the reactor was obtained with a hydraulic retention time of 35 h (21 h in the anaerobic zone and 14 h in the aerobic zone) and a recycling ratio (R) of 3.5. In this condition, the COD, total Kjeldahl nitrogen (TKN), and total nitrogen (TN) removal efficiencies were 97%, 96%, and 77%, respectively, with average effluent concentrations of 10 +/- 36 mg COD/L, 2 +/- 1 mg NH(4)(+)-N/L, 8 +/- 3 mg Org-N/L, 1 +/- 1 mg NH(2)(-)-N/L, and 26 +/- 23 mg NH(3)(-)-N/L.

Nature-based tourism and the valuation of its environmental resources: Economic and other aspects

Nature-based tourism has grown in importance in recent decades, and strong links have been established between it and ecotourism. This reflects rising incomes, greater levels of educational attainment and changing values, especially in the Western world. Nature-based tourism is quite varied. Different types of such tourism are identified and their consequences for sustainability of their resource-base are briefly considered. The development and management of nature-based tourism involves many economic aspects, several of which are discussed. For example, one must consider the economics of reserving or protecting land for this type of tourism. What economic factors should be taken into account? Economists stress the importance of taking into account the opportunity costs involved in such a decision. This concept is explained. However, determining the net economic value of an area used for tourism is not straightforward. Techniques for doing this, such as the travel cost method and stated value methods, are introduced. Natural areas reserved for tourism may have economic value not only for tourism but also jointly for other purposes, such as conserving wildlife, maintaining hydrological cycles and so on. These other purposes, should be taken into account when considering the use of land for nature-based tourism. According to one economic point of view, land should be used in a way that maximises its total economic value. While this approach has its merits, it does not take into account the distribution of benefits from land use and its local impacts on income and employment. These can be quite important politically and for nature conservation, and are discussed. Finally, there is some discussion of whether fees charged to tourists for access to environmental resources should discriminate between domestic tourists and foreigners.

An Eight-week, Multicentric, Randomized, Interventional, Open-label, Phase 4, Parallel Comparison of the Efficacy and Tolerability of the Fixed Combination of Timolol Maleate 0.5%/Brimonidine Tartrate 0.2% Versus Fixed Combination of Timolol Maleate 0.5%/Dorzolamide 2% in Patients With Elevated Intraocular Pressure

Purpose: To compare the efficacy and tolerability of the fixed combination of timolol maleate 0.5%/brimonidine tartrate 0.2% versus fixed combination of timolol maleate 0.5%/dorzolamide 2% in patients with elevated intraocular pressure (IOP) over 8 weeks. Patients and Methods: This 8-week, multicentric. interventional, randomized, open-label, parallel group study was conducted Lit 4 centers in Brazil and 1 center in Argentina. Patients with open-angle glaucoma or ocular hypertension were randomized to receive bilaterally fixed combination of brimonidine/timolol maleate 0.5% or fixed combination of dorzolamide 2%/timolol 0.5% twice daily at 8:00 AM and 8:00 PM. A modified diurnal tension curve (8:00 AM 10:30 AM, 02:00 PM, and 4:00 PM) followed by the water drinking test (WDT), which estimates IOP peak of diurnal tension curve, were performed in the baseline and week-8 visits. Adverse events data were recorded at each visit. Results: A total of 210 patients were randomized (brimonidine/timolol, n = 111; dorzolamide/timolol, n = 99). Mean baseline IOP was 23.43 +/- 3.22 mm Hg and 23.43 +/- 4.06 mm Hg in the patients treated with brimonidine/timolol and dorzolamide/timolol, respectively (P = 0.993). Mean diurnal IOP reduction after 8 weeks were 7.02 +/- 3.06 mm Hg and 6.91 +/- 3.67 mm Hg. respectively (P = 0.811). The adjusted difference between groups (analysis of covariance) Lit week 8 was not statistically significant (P = 0.847). Mean baseline WDT peak was 27.79 +/- 4.29 mm Hg in the brimonidine/timolol group and 27.68 +/- 5.46 mm Hg in the dorzolamide/timolol group. After 8 weeks of treatment, mean WDT peaks were 20.94 +/- 3.76 mm Hg (P < 0.001) and 20.98 +/- 4.19 (P < 0.001), respectively. The adjusted difference between groups (analysis of covariance) was not statistically significant (P = 0.469). No statistical difference in terms of adverse events was Found between groups. Conclusions: Both fixed combinations were capable of significantly reducing the mean diurnal IOP, mean diurnal peak, and mean WDT peak after 8 weeks of treatment. Also, both fixed combinations are well tolerated with few side effects.

miRNA analysis of prostate cancer by quantitative real time PCR: Comparison between formalin-fixed paraffin embedded and fresh-frozen tissue

Objective: Micro RNA (miRNA) is a class of small noncoding RNA that plays a major role in the regulation of gene expression, which has been related to cancer behavior. The possibility of analyzing miRNA from the archives of pathology laboratories is exciting, as it allows for large retrospective studies. Formalin is the most common fixative used in the surgical pathology routine, and its promotion of nucleic acid degradation is well known. Our aim is to compare miRNA profiles from formalin-fixed paraffin embedded (FFPE) tissues with fresh-frozen prostate cancer tissues. Methods: The expression of 14 miRNAs was determined by quantitative real time polymerase chain reaction (qRT-PCR) in 5 paired fresh-frozen and FFPE tissues, which were representative of prostate carcinoma. Results: There was a very good correlation of the miRNA expression of miR-let7c and miR-32 between the fresh-frozen and FFPE tissues, with Pearson`s correlation coefficients of 0.927 (P = 0.023) and 0.960 (P = 0.010), respectively. For the remaining miRNAs, the correlation was good with Spearman correlation coefficient of 0.638 (P < 0.001). Conclusion: Analysis of miRNAs from routinely processed and stored FFPE prostate tissue is feasible for some miRNAs using qRT-PCR. Further studies should be conducted to confirm the reliability of using stock tissues for miRNA expression determination. (C) 2011 Elsevier Inc. All rights reserved.

Valuation of tourism's natural resources

Discusses the implications of the economic valuation of natural resources used for tourism and relates this valuation to the concept of total economic valuation. It demonstrates how applications of the concept of total economic valuation can be supportive of the conservation of natural resources used for tourism. Techniques for valuing tourism’s natural resources are then outlined and critically evaluated. Consideration is given to travel cost methods, contingent valuation methods, and hedonic pricing approaches before concentrating on current developments of valuation techniques, such as choice modelling. The general limitations of existing methods are considered and it is argued that more attention should be given to developing guidelines that will identify ‘optimally imperfect methods’. An overall assessment concludes this article.

The role of illness, resources, appraisal, and coping strategies in adjustment to HIV/AIDS: The direct and buffering effects

This study examined the utility of a stress and coping model of adjustment to HIV/AIDS. A total of 114 HN-infected gay or bisexual men were interviewed and they completed self-administered scales. Predictors included illness variables (disease stage and number of symptoms), coping resources (optimism and social support), appraisal (threat, challenge, and controllability), and coping strategies (problem-and emotion-focused). Adjustment outcomes were depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that better adjustment was related to an asymptomatic illness stage, fewer HN-related symptoms, greater social support, challenge and controllability appraisals, problem-focused coping, and lower threat appraisals and reliance on emotion focused coping. There was limited support for the stress-buffering effects of optimism. Findings support the utility of a stress and coping model of adjustment to HIV/AIDS.

Kangaroos and feral goats as economic resources for graziers: Some views from south-west Queensland

Fifteen years ago it was proposed that the conversion of kangaroos from a pest to an economically valuable resource would allow graziers to reduce the numbers of domestic stock and thereby lower total grazing pressure. Since then, little progress towards this goal has been achieved. This is believed to be due mainly to the low prices obtained for kangaroo products. A survey of graziers in south-west Queensland was carried out to discover their opinions on kangaroos as a potential economic resource. Questions on the harvesting of feral goats were also included in the survey because of the contrast this industry provides to kangaroo harvesting in terms of grazier involvement. The results of the survey are discussed in relation to resource ownership rights; kangaroo product prices and marketing; and competition within the kangaroo harvesting industry. They show that while low kangaroo product prices do act as a disincentive to graziers, other administrative, legal and institutional factors are also important impediments to their entry to the industry. It is concluded that until the focus of attention widens to include consideration of these as well as just market factors, little progress will be made towards integrating graziers into the kangaroo harvesting industry.

Mental health research in Brazil: policies, infrastructure, financing and human resources

The objective of this descriptive study was to map mental health research in Brazil, providing an overview of infrastructure, financing and policies mental health research. As part of the Atlas-Research Project, a WHO initiative to map mental health research in selected low and middle-income countries, this study was carried out between 1998 and 2002. Data collection strategies included evaluation of governmental documents and sites and questionnaires sent to key professionals for providing information about the Brazilian mental health research infrastructure. In the year 2002, the total budget for Health Research was US$101 million, of which US$3.4 million (3.4) was available for Mental Health Research. The main funding sources for mental health research were found to be the São Paulo State Funding Agency (Fapesp, 53.2%) and the Ministry of Education (CAPES, 30.2%). The rate of doctors is 1.7 per 1,000 inhabitants, and the rate of psychiatrists is 2.7 per 100,000 inhabitants estimated 2000 census. In 2002, there were 53 postgraduate courses directed to mental health training in Brazil (43 in psychology, six in psychiatry, three in psychobiology and one in psychiatric nursing), with 1,775 students being trained in Brazil and 67 overseas. There were nine programs including psychiatry, neuropsychiatry, psychobiology and mental health, seven of them implemented in Southern states. During the five-year period, 186 students got a doctoral degree (37 per year) and 637 articles were published in Institute for Scientic Information (ISI)-indexed journals. The investment channeled towards postgraduate and human resource education programs, by means of grants and other forms of research support, has secured the country a modest but continuous insertion in the international knowledge production in the mental health area.

Cost of schizophrenia: direct costs and use of resources in the State of São Paulo

OBJECTIVE: To estimate the direct costs of schizophrenia for the public sector. METHODS: A study was carried out in the state of São Paulo, Brazil, during 1998. Data from the medical literature and governmental research bodies were gathered for estimating the total number of schizophrenia patients covered by the Brazilian Unified Health System. A decision tree was built based on an estimated distribution of patients under different types of psychiatric care. Medical charts from public hospitals and outpatient services were used to estimate the resources used over a one-year period. Direct costs were calculated by attributing monetary values for each resource used. RESULTS: Of all patients, 81.5% were covered by the public sector and distributed as follows: 6.0% in psychiatric hospital admissions, 23.0% in outpatient care, and 71.0% without regular treatment. The total direct cost of schizophrenia was US$191,781,327 (2.2% of the total health care expenditure in the state). Of this total, 11.0% was spent on outpatient care and 79.2% went for inpatient care. CONCLUSIONS: Most schizophrenia patients in the state of São Paulo receive no regular treatment. The study findings point out to the importance of investing in research aimed at improving the resource allocation for the treatment of mental disorders in Brazil.

Forest resources in Graciosa Island (Azores) : biomass availability for sustainable energetic use

Dissertação de Mestrado em Ambiente, Saúde e Segurança.

Produção de hidrogénio por fotoeletrólise da água – aproveitamento do subproduto oxigénio

A noção de Economia relativa ao Hidrogénio no vocabulário dos líderes políticos e empresariais tem vindo a mudar sobretudo pela preocupação da poluição global, segurança energética e mudanças climáticas, para além do crescente domínio técnico dos cientistas e engenheiros. O interesse neste composto, que é o elemento mais simples e abundante no universo, está a crescer, devido aos avanços tecnológicos das células de combustível – as potenciais sucessoras das baterias dos aparelhos portáteis eletrónicos, centrais elétricas e motores de combustão interna. Existem métodos já bem desenvolvidos para produzir o hidrogénio. Contudo, destacase a eletrólise da água, não só por ser um método simples mas porque pode utilizar recursos energéticos renováveis, tais como, o vento ou os painéis fotovoltaicos, e aumentar a sua eficiência. Os desafios para melhorar a utilização deste método consistem em reduzir o consumo, a manutenção e os custos energéticos e aumentar a confiança, a durabilidade e a segurança. Mais ainda, consistem em rentabilizar o subproduto oxigénio pois é um gás industrial e medicinal muito importante. Neste trabalho, estudou-se a viabilidade económica da instalação de uma unidade de produção de hidrogénio e oxigénio puros por eletrólise da água, utilizando como fonte energética a energia solar, na empresa Gasoxmed – Gases Medicinais S.A., pretendendo num futuro próximo, comercializar o hidrogénio como fonte de energia, e por outro lado, aproveitar o subproduto oxigénio para utilização industrial. Projetou-se assim uma unidade utilizando um eletrolisador da marca Proton, modelo C30, com capacidade de produção gasosa de 3 kg/h (30 m3/h) de hidrogénio e 20 kg/h (15 m3/h) de oxigénio. Os gases produzidos são comprimidos num compressor da marca RIX a 200 bares para posterior armazenamento em cilindros pressurizados. Dimensionou-se ainda um sistema de miniprodução fotovoltaico com potência 250 kW para alimentar eletricamente a instalação. A realização do projeto na nova área de produção necessitará de 1.713.963€, os quais serão adquiridos por empréstimo bancário. Definiram-se todos os custos fixos associados ao projeto que perfazem um total de 62.554€/mês para os primeiros 5 anos (duração do crédito bancário) findo o qual diminuirão para 21.204€/mês. Da comercialização do hidrogénio, do oxigénio industrial e da eletricidade produzida no sistema de miniprodução de 250 kW, prevê-se um lucro mensal de 117.925€, perfazendo assim um total líquido mensal positivo de 55.371€ durante os primeiros 5 anos e a partir daí de 96.721€/mês, resultando uma amortização do investimento inicial no final do 3º ano.

Resource sharing in global fixed-priority preemptive multiprocessor scheduling

In this paper we consider global fixed-priority preemptive multiprocessor scheduling of constrained-deadline sporadic tasks that share resources in a non-nested manner. We develop a novel resource-sharing protocol and a corresponding schedulability test for this system. We also develop the first schedulability analysis of priority inheritance protocol for the aforementioned system. Finally, we show that these protocols are efficient (based on the developed schedulability tests) for a class of priority-assignments called reasonable priority-assignments.