790 resultados para patient safety and quality
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This text extends some ideas presented in a keynote lecture of the 5th Encontro de Tipografia conference, in Barcelos, Portugal, in November 2014. The paper discusses problems of identifying the location and encoding of design decisions, the implications of digital workflows for capturing knowledge generating through design practice, and the consequences of the transformation of production tools into commodities. It concludes with a discussion of the perception of added value in typeface design.
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This case series compares patient experiences and therapeutic processes between two modalities of cognitive behaviour therapy (CBT) for depression: computerized CBT (cCBT) and therapist-delivered CBT (tCBT). In a mixed-methods repeated-measures case series, six participants were offered cCBT and tCBT in sequence, with the order of delivery randomized across participants. Questionnaires about patient experiences were administered after each session and a semi-structured interview was completed with each participant at the end of each therapy modality. Therapy expectations, patient experiences and session impact ratings in this study generally favoured tCBT. Participants typically experienced cCBT sessions as less meaningful, less positive and less helpful compared to tCBT sessions in terms of developing understanding, facilitating problem-solving and building a therapeutic relationship.
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The last 20 years have seen the emergence of a popular climate of antipathy towards occupational health and safety regulation within the UK, particularly within the mainstream British media. The governance of health and safety has thus in recent years become an increasingly visible and contested public and political issue. The extent of this contestation, and its impact on the State’s governance of health and safety in the workplace and beyond, is explained and historicized within this chapter. Why has public rhetoric about health and safety apparently become so important in framing the ways in which the State could legitimately act in recent years? The chapter demonstrates how since 1960 the State remained a significant player – one among many, admittedly – and that while its roles in managing health and safety had long been bounded by a number of factors, a variable that emerged with particular saliency over the last 20 years has been a mediated notion of ‘public opinion’. This focus serves to remind us of the ways in which State action has at certain moments been pushed in particular directions by factors beyond formal mechanisms of rule.
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For the diagnosis and prognosis of the problems of quality of life, a multidisciplinary ecosystemic approach encompasses four dimensions of being-in-the-world, as donors and recipients: intimate, interactive, social and biophysical. Social, cultural and environmental vulnerabilities are understood and dealt with, in different circumstances of space and time, as the conjugated effect of all dimensions of being-in-the-world, as they induce the events (deficits and assets), cope with consequences (desired or undesired) and contribute for change. Instead of fragmented and reduced representations of reality, diagnosis and prognosis of cultural, educational, environmental and health problems considers the connections (assets) and ruptures (deficits) between the different dimensions, providing a planning model to develop and evaluate research, teaching programmes, public policies and field projects. The methodology is participatory, experiential and reflexive; heuristic-hermeneutic processes unveil cultural and epistemic paradigms that orient subject-object relationships; giving people the opportunity to reflect on their own realities, engage in new experiences and find new ways to live better in a better world. The proposal is a creative model for thought and practice, providing many opportunities for discussion, debate and development of holistic projects integrating different scientific domains (social sciences, psychology, education, philosophy, etc.).
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The quality control optimization of medical processes that use ionizing radiation in the treatment of diseases like cancer is a key element for patient safety and success of treatment. The major medical application of radiation is radiotherapy, i.e. the delivery of dose levels to well-defined target tissues of a patient with the purpose of eliminating a disease. The need of an accurate tumour-edge definition with the purpose of preserving healthy surrounding tissue demands rigorous radiation treatment planning. Dosimetric methods are used for dose distribution mapping region of interest to assure that the prescribed dose and the irradiated region are correct. The Fricke gel (FXG) is the main dosimeter that supplies visualization of the three-dimensional (3D) dose distribution. In this work the dosimetric characteristics of the modified Fricke dosimeter produced at the Radiation Metrology Centre of the Institute of Energetic and Nuclear Research (IPEN) such as gel concentration dose response dependence, xylenol orange addition influence, dose response between 5 and 50Gy and signal stability were evaluated by magnetic resonance imaging (MRI). Using the same gel solution, breast simulators (phantoms) were shaped and absorbed dose distributions were imaged by MRI at the Nuclear Resonance Laboratory of the Physics Institute of Sao Paulo University. (C) 2007 Elsevier Ltd. All rights reserved.
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Amazonian oils and fats display unique triacylglycerol (TAG) profiles and, because of their economic importance as renewable raw materials and use by the cosmetic and food industries, are often subject to adulteration and forgery. Representative samples of these oils (andiroba, Brazil nut, buriti, and passion fruit) and fats (cupuacu, murumuru, and ucuba) were characterized without pre-separation or derivatization via dry (solvent-free) matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Characteristic profiles of TAG were obtained for each oil and tat. Dry MALDI-TOF MS provides typification and direct and detailed information, via TAG profiles, of their variable combinations of fatty acids. A database from spectra could be developed and may be used for their fast and reliable typification, application screening, and quality control.
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GPS technology has been embedded into portable, low-cost electronic devices nowadays to track the movements of mobile objects. This implication has greatly impacted the transportation field by creating a novel and rich source of traffic data on the road network. Although the promise offered by GPS devices to overcome problems like underreporting, respondent fatigue, inaccuracies and other human errors in data collection is significant; the technology is still relatively new that it raises many issues for potential users. These issues tend to revolve around the following areas: reliability, data processing and the related application. This thesis aims to study the GPS tracking form the methodological, technical and practical aspects. It first evaluates the reliability of GPS based traffic data based on data from an experiment containing three different traffic modes (car, bike and bus) traveling along the road network. It then outline the general procedure for processing GPS tracking data and discuss related issues that are uncovered by using real-world GPS tracking data of 316 cars. Thirdly, it investigates the influence of road network density in finding optimal location for enhancing travel efficiency and decreasing travel cost. The results show that the geographical positioning is reliable. Velocity is slightly underestimated, whereas altitude measurements are unreliable.Post processing techniques with auxiliary information is found necessary and important when solving the inaccuracy of GPS data. The densities of the road network influence the finding of optimal locations. The influence will stabilize at a certain level and do not deteriorate when the node density is higher.
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BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated. RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs). SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.
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Purpose – This case study presents an impact assessment of Corporate Social Responsibility (CSR) programs of the TFM Company in order to understand how they contribute to the sustainable development of communities in areas in which they operate. Design/Methodology/Approach - Data for this study was collected using qualitative data methods that included semi-structured interviews and Focus Group Discussions most of them audio and video recorded. Documentary analysis and a field visit were also undertaken for the purpose of quality analysis of the CSR programs on the terrain. Data collected was analyzed using the Seven Questions to sustainability (7Qs) framework, an evaluation tool developed by the Mining, Minerals and Sustainable Development (MMSD) North America chapter. Content analysis method was on the other hand used to examine the interviews and FGDs of the study participants. Findings - Results shows that CSR programs of TFM SA do contribute to community development, as there have been notable changes in the communities’ living conditions. But whether they have contributed to sustainable development is not yet the case as programs that enhance the capacity of communities and other stakeholders to support these projects development beyond the implementation stage and the mines operation lifetime need to be considered and implemented. Originality/Value – In DRC, there is paucity of information of research studies that focus on impact assessment of CSR programs in general and specifically those of mining companies and their contribution to sustainable development of local communities. Many of the available studies cover issues of minerals and conflict or conflict minerals as mostly referred to. This study addressees this gap.
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Compounded medicines have been reported by the ANVISA due to decreased of the therapeutic response or toxicity of these formulations. The aim of this work was to investigate the physicochemical quality control among naproxen sodium oral suspensions 25 mg/mL obtained from six compounding pharmacies (A, B, C, D, E and F) and the manufactured suspension (R). In the quality control test, the tests of pH, content, homogeneity, volume and physical and organoleptic characteristics were performed according to the Brazilian Pharmacopoeia. The analytical method for determination of naproxen in suspensions was validate. This method showed excellent precision, accuracy, linearity and specificity. In the content test the suspensions B, C and E showed lower value and the F suspension showed a high value of the content. The products C and E were disapproved in the description of the physical and organoleptic characteristics test. In the pH test, three suspensions were outside specifications (C, E and F). Only the products R, A and D showed satisfactory results in these tests and therefore they were approved for relative bioavailability test. The R, A and D suspensions were orally administered to Wistar rats and the blood samples were taken at time intervals of 10, 20, 40, 60 min, 3, 4, 6, 24 and 48 h. The plasma samples were immediately stored at 80 ºC until analysis of HPLC. The bioanalytical method validation showed specificity, linearity (R2 0.9987), precision, accuracy, good recovery and stability. The chromatographic conditions were: flow rate of 1.2 mL.min-1 with a mobile phase of acetonitrile : sodium phosphate buffer pH 4.0 (50:50, v/v) at 280 nm, using a C18 column. The confidence interval of 90% for the Cmax and AUCt ratio was within the range of 80 - 125% proposed by the FDA. Only one suspension, obtained from the compounding pharmacy D, was considered bioequivalent to the rate of absorption under the conditions proposed by this study. Thus, the results indicate the need for strict supervision from the relevant authorities to ensure the patient safety and the quality of compounded drugs by pharmacies
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Citrus sudden death (CSD) has greatly affected sweet orange cultivars grafted on Rangpur lime in São Paulo and Minas Gerais States, Brazil. To characterize and quantify CSD damage, fruit yield and quality were assessed in each combination of sweet orange cultivar (Hamlin, Pera, Natal, and Valencia), age class (3 to 5, 6 to 10, and 11 to 15 years old), and CSD severity class (0 = no symptom, 1 = initial symptoms, and 2 = severe symptoms). For each combination, 10 trees were harvested and 20 fruit were taken for quality analysis. Damage was characterized by reduc_ tion of: (i) total weight of fruit/tree (36 and 67% for severity class 1 and 2, respectively), (ii) number of fruit/tree (27 and 55%), (iii) fruit size (13 and 25% in diameter and height [stem to styler distance]), (iv) fruit weight (32 and 56%), (v) total soluble solids (TSS)/fruit (18 and 42%), and increase of (vi) Brix (14 and 34%), (vii) acidity (16 and 41%), and (viii) TSS/90-1b. box (21 and 33%). There was no alteration on Brix/acidity ratio and percentage of juice on fruit of affected trees. Sweet orange cultivars did not differ in percentage of reduction or increase of all yield and quality variables, with the exception of Pera, which expressed increases of Brix and acidity. For more severe affected trees, the youngest plants showed a higher reduction in fruit number/tree, whereas plants 6 to 10 years old showed a higher increase in fruit acidity and TSS/box. However, no differences in percentage of reduction or increase for other variables were observed among different age classes. The damage to the above probably was associated with reduced water absorption capacity of CSD-affected trees.
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European corn borer (ECB) [Ostrinia nubilalis (Hubner)] (Lepidoptera: Crambidae) is known to infest Irish potato (Solanum tuberosum L.) but only causes economic damage during the first generation in East Coast potato producing areas. However, in Nebraska, second generation ECB infest potato plants during the bulking period and may reduce yield and/or potato quality. Experiments were conducted in 2001, 2002, and 2003 to examine physiological and yield effects of second generation ECB injury to potato in Nebraska. Pike, Atlantic, and three Frito Lay proprietary varieties (FL1867, FL1879, and FL1833) were used. Experimental plots were infested with four ECB egg masses per plant to simulate ECB infestation by second-generation larvae; controls received no egg masses. Photosynthetic rates, tuber weights, tuber size grades, solids, and fry quality were measured. Potato plants with ECB infestation had significantly reduced photosynthetic rates on ECB-infested stems and on uninfested stems on the same plant when larvae were in the fifth instar. When insects were in the fourth instar, photosynthetic rates were reduced only on ECB-infested stems. In 2001, ECB infestation reduced the average mass of large tubers and increased the amount of small tubers in FL1867 and FL1879. In 2002, significant yield reductions were not observed. Across both years, ECB-infested plots produced fewer large (65- to 100-mm diam.) tubers than control plots. Other tuber properties and chip qualities were unaffected. This study indicates that second generation ECB infestation of approximately 30% infested plants results in economic loss for some chipping varieties and affects tuber bulking. In contrast to east coast growers, Midwest potato farmers must be concerned with second generation ECB.
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An experiment was conducted on guava trees Psidium guajava L. (cv. Paluma) grown in the Experimental Citrus Culture Station of Bebedouro, SP, on dystrophic, acid Typical Hapludox in order to assess the effects of application of increasing lime doses to the soil on the quality of guava fruits on the basis of the physicochemical changes observed in the fruits after harvesting. The treatments consisted of increasing lime doses applied before planting, considering 0, 1.85, 3.79, 5.56 and 7.41 t ha(-1), applied in August 1999. Leaf calcium content was assessed at flowering time. After fruit harvesting, calcium content in the pulp, total weight, transverse diameter, length, pulp weight, % pulp, Brix degrees (degrees Brix), titratable acidity, and fruit ratio were determined. Loss of fruit fresh mass, firmness and color were determined daily during a period of 8 days of storage. Lime application to an acid Red Latosol before guava tree planting did not affect the physical characteristics of the fruits but provided a lower loss of fresh matter and greater fruit firmness when the fruits presented Ca levels close to 0.99 g kg(-1). It is important to conduct new studies of the effects of liming on guava fruit quality under different edaphic-climatic conditions and on different guava tree genotypes. (c) 2005 Elsevier B.V. All rights reserved.