771 resultados para Quality management in hospitals
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Among the difficulties found in the implementation of ISO 14001 systems, resistance to change can always be found. It is mainly a consequence of the hurry to change, loss of focus, concentration of decision making at the level of top management, arbitrary imposition of objectives and results, faulty communication, and the absence of motivational and financial incentive for change.Therefore, the main objective of this paper is to present best practices with respect to the management of organizational change due to the implementation of ISO 14001 norms in two industrial companies in the Midwest region of the State of São Paulo - Brazil. (C) 2008 Elsevier Ltd. All rights reserved.
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The aim of this study was to evaluate the apical sealing of dentinal tubules after root-end surface cutting by using Er:YAG and Nd:YAG lasers. After root-canal instrumentation and filling, apices of 50 extracted maxillary canine human teeth were resected by Er: YAG with 400 mJ, 10 Hz, for 30 sec. The samples were randomly assigned to five groups (n = 10): (GI) treated without root-end cavity, but with Nd: YAG (1.0W, 10 Hz, 20 sec) for dentinal tubules sealing; (GII) treated with root-end cavity without the use of Nd: YAG; (GIII) treated with root-end cavity and Nd: YAG application; (GIV) treated with root-end cavity made by Er: YAG with no focus and without Nd: YAG application; and (GV) treated without root-end cavity and without Nd: YAG application. The root-end cavities were performed by using Er: YAG at 300 mJ, 10 Hz, for 20 sec. Subsequently, all teeth were waterproofed and immersed in 2% methylene blue for 48 h in a vacuum environment. The samples were longitudinally sectioned, and microleakage was measured. ANOVA and the Fisher LSD test showed that GIV was less susceptible to microleakage than were the other groups (p < 0.05). Interestingly, the use of the Er: YAG with no focus showed superior dentinal tubule sealing in comparison with the other groups, even with or without root-end cavity and Nd: YAG application.
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Winter cover crops can affect N nutrition of the following maize crop. Although legumes have been recommend for maize rotations, in tropical areas grasses may be more interesting because they provide a longer protection of soil surface. Legumes can add N to the system and grasses can compete with maize for the available nutrient. An experiment was conducted in Botucatu, São Paulo State, Brazil, to study N dynamics in the soil surface straw-maize system as affected by N fertilization management and species included in the no-till rotation. Treatments were fallow, black oat (Avena strigosa), pearl millet (Pennisetum glaucum), white lupins (Lupinus albus), black oat fertilized with N. and pearl millet fertilized with N. Maize was grown afterwards in the same plots, receiving 0.0, 60.0 and 120.0 kg ha(-1) of N sidedressed 30 days after plant emergence. Soil, straw and maize samples were taken periodically. The highest corn yields were observed when it was cropped after pearl millet fertilized with N. Nitrogen side dressed application up to 120 kg ha(-1) was not able to avoid corn yield decrease caused by black oat. Grasses can be recommended in maize rotations in tropical areas, provided they receive nitrogen fertilizer and show no allelopathy. Due to its higher ON ratio and dry matter yield they are better than legumes, protecting the soil surface for a longer period. Pearl millet is particularly interesting because it enhances N use efficiency by the following maize crop. For a better N availability/demand synchronism, the cover crops should be desiccated right before maize planting.
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The goal of this work was to establish comparisons among environmental degradation in different areas from Southern Spain (Gulf of Cadiz) and Brazil (Santos and Sao Vicente estuary), by using principal component analyses (PCA) to integrate sediment toxicity (amphipods mortality) and chemical-physical data (Zn, Cd, Pb; Cu, Ni, Co, V, PCBs, PAHs concentrations, OC and fines contents). The results of PCA extraction of Spanish data showed that Bay of Cadiz, CA-1 did not present contamination or degradation; CA-2 exhibited contamination by PCBs, however it was not related to the amphipods mortality. Ria of Huelva was the most impacted site, showing contamination caused principally by hydrocarbons, in HV-1 and HV-2, but heavy metals were also important contaminants at HV-1, HV-2 and HV-3. Algeciras Bay was considered as not degraded in GR-3 and -4, but in GR-3' high contamination by PAHs was found. In the Brazilian area, the most degraded sediments were found in the stations situated at the inner parts of the estuary (SSV-2, SSV-3, and SSV-4), followed by SSV-6, which is close to the Submarine Sewage Outfall of Santos - SSOS. Sediments from SSV-1 and SSV-5 did not present chemical contamination, organic contamination or significant amphipod mortality. The results, of this investigation showed that both countries present environmental degradation related to PAHs: in Spain, at Ria of Huelva and Gudarranque river's estuary areas; and in Brasil, in the internal portion of the Santos and Sao Vicente estuary. The same situation is found for heavy metals, since all of the identified metals are related to toxicity in the studied areas, with few exceptions (V for both Brazil and Spain, and Cd and Co for Brazilian areas). The contamination by PCBs is more serious for Santos and Sao Vicente estuary than for the investigated areas in Gulf of Cadiz, where such compound did not relate to the toxicity. (c) 2006 Elsevier Ltd. All rights reserved.
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Baiting studies performed in large, medium and small hospitals in Brazil revealed the presence of 14 ant species, with up to nine recorded in one hospital. Dominant species were exotic ants, and in the large hospital, Tapinoma melanocephalum was the most prevalent. Ants were not uniformly spread through the hospitals, but tended to be found in the more critical areas, particularly in nursery, intensive care, obstetrics, neurology and dermatology units. Bacteriological studies using specific media for bacteria associated with intra-hospital infections indicated the potential for the mechanical vectoring of species of Staphylococcus, Serratia, Klebsiella, Acinetobacter, Enterobacter, Candida and Enterococcus by ants. Although T. melanocephalum did not have the highest rate of association with these bacteria, its ubiquitous occurrences resulted in the highest overall potential as a vector of these bacteria. Because of a large number of ant species occurring in Brazilian hospitals, ants pose a potential problem to the spread of diseases in hospitals. Because of the number of associated ant species in hospitals, the control of this potential problem is much more difficult than in registered temperate areas.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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The search for competitive advantage in a global environment must consider the use of tacit and explicit knowledge circulating inside companies. Differential factors can be easily replicated nowadays. Due to the great volume of knowledge and information, it is necessary to create a system that allows the management of important knowledge. Existing models for Knowledge Management are based on the reality at large companies. In Brazil, most of the companies are smaller ones. This work presents a simplified model to implement Knowledge Management in Small and Medium Companies in Brazil, based on a unique case study with limited scope. Despite some human and financial restrictions, Knowledge Management can help smaller companies, preserving organizational memory and increasing process efficiency. Observing a unique case prevented any generalization of the model. But the recommendations can be references to other companies, because projects like this must address the specific issues of each organization. The objective of this study is to introduce a simplified model for planning Knowledge Management at small companies in Brazil, considering their restrictions and also seeking to create a competitive advantage. Human aspects are very important in Knowledge Management, but that is not the focus of this study. The model was conceived presuming the participation of all people involved.
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Marker assisted selection depends on the identification of tightly linked association between marker and the trait of interest. In the present work, functional (EST-SSRs) and genomic (gSSRs) microsatellite markers were used to detect putative QTLs for sugarcane yield components (stalk number, diameter and height) and as well as for quality parameters (Brix, Pol and fibre) in plant cane. The mapping population (200 individuals) was derived from a bi-parental cross (IACSP95-3018 x IACSP93-3046) from the IAC Sugarcane Breeding Program. As the map is under construction, single marker trait association analysis based on the likelihood ratio test was undertaken to detect the QTLs. Of the 215 single dose markers evaluated (1:1 and 3:1), 90 (42%) were associated with putative QTLs involving 43 microsatellite primers (18 gSSRs and 25 EST-SSRs). For the yield components, 41 marker/trait associations were found: 20 for height, 6 for diameter and 15 for stalk number. An EST-SSRs marker with homology to non-phototropic hypocotyls 4 (NPH4) protein was associated with a putative QTL with positive effect for diameter as also with a negative effect for stalk number. In relation to the quality parameters, 18 marker trait associations were found for Brix, 19 for Pol, and 12 for fibre. For fibre, 58% of the QTLs detected showed a negative effect on this trait. Some makers associated with QTLs with a negative effect for fibre showed a positive effect for Pol, reflecting the negative correlation generally observed between these traits.
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This article aims to present proposals for improvement of key standards and resolutions concerned about the methodology for calculating the indicator of total harmonic voltage distortion, and should contribute to the process of examining the compatibility of potentially disturbing loads in electric power quality in distribution systems. These proposals were drawn from the analysis of results from measurement campaigns conducted in a case study including analysis of the connection of a new induction furnace in a foundry served by a distributor of São Paulo state. A general historical situating the quality of electric energy in the electricity sector is presented, and methodological guidelines and procedures used in experimental trials are shown. The analysis and discussion of results are prepared to answer the main questions that arise during the implementation of standards, resolutions and procedures. © 2011 IEEE.