785 resultados para quality of healthcare


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Dhaka cheese is a semihard artisanal variety made mainly from bovine milk, using very simple pressing methods. Experimental cheeses were pressed at gauge pressures up to 31 kPa for 12 h at 24 °C and 70% RH. These cheeses were subsequently examined for their compositional, textural and rheological properties plus their microstructures investigated by confocal laser microscopy. The cheese pressed at 15.6 kPa was found to have the best compositional and structural properties.

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Postharvest quality of Alphonso mangoes (Mangifera indica L) is vital to ensure proper ripening and good quality. 500 g mature green mangoes, were subjected to three pre- packaging hot water dips (20, 30 & 40°C) for 40 min, two packaging films (OPP unperforated and perforated), using three levels of gas concentrations of 25,50 and 75% v/v CO2 treatments (balance N2) and stored at 10°C for 21 days. During the storage period headspace gas composition, weight loss, ascorbic acid, pulp firmness, external fruit colour and overall quality score were measured to determine optimum storage conditions. The most effective postharvest condition was found to be dipping in water maintained at 40°C for 40 min, followed by packaging under 50% CO2 in bags made of unperforated film when compared to mangoes packed under 25 and 75% CO2 which showed deteriorated quality including spoilage and mould. Good keeping quality of at least 21 days was achieved under these conditions, which was much superior to the control samples that showed deterioration after 12 days of storage.

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Three-dimensional computational simulations are performed to examine indoor environment and micro-environment around human bodies in an office in terms of thermal environment and air quality. In this study, personal displacement ventilation (PDV), including two cases with all seats taken and two middle seats taken, is compared with overall displacement ventilation (ODV) of all seats taken under the condition that supply temperature is 24℃ and air change rate is 60 l/s per workstation. When using PDV, temperature stratification, the characteristic of displacement ventilation, is obviously observed at the position of occupant’s head and clearer in the case with all seats taken. Verticalertical ertical temperature temperature temperature temperature temperature differences below height of the head areare under under under 2℃ in two cases in two cases in two cases in two cases in two cases in two cases in two cases in two cases with all seats taken,and the temperature with PDV is higher than that with ODV. Verticalertical ertical temperature temperature temperature temperature temperature temperature difference is under 3 under 3under 3 under 3℃ in the case in the case in the case in the case in the case in the case in the case with two middle seats taken. CO2 concentration is lower th is lower th is lower this lower this lower than 2 g/man 2 g/m an 2 g/man 2 g/man 2 g/man 2 g/m 3 in the breath zone. in the breath zone. in the breath zone. in the breath zone. in the breath zone. in the breath zone. in the breath zone. in the breath zone. in the breath zone. The results indicate that PDV can be used in the room with big change of occupants’ number to satisfy the need of thermal comfort and air quality. When not all seats are taken, designers should increase supply air requirement or reduce its temperature for thermal comfort. INDEX TERMS

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This paper analyses the quality of debate surrounding the UK’s 2011 electoral reform referendum as represented in the print media. It first considers how debate quality in the context of a referendum campaign may best be conceptualized. It then uses content analysis of media coverage to investigate three aspects of that debate: its quantity; the balance between Yes and No arguments, and the quality of reason-giving. It finds that the quantity of debate was comparable to other recent electoral reform referendums. Coverage was predominantly, but not overwhelmingly, hostile to change. The different indicators of the quality of reason-giving present a mixed picture. The paper concludes by considering how the analysis could be extended through further comparison with other cases.

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Purpose: Increasing costs of health care, fuelled by demand for high quality, cost-effective healthcare has drove hospitals to streamline their patient care delivery systems. One such systematic approach is the adaptation of Clinical Pathways (CP) as a tool to increase the quality of healthcare delivery. However, most organizations still rely on are paper-based pathway guidelines or specifications, which have limitations in process management and as a result can influence patient safety outcomes. In this paper, we present a method for generating clinical pathways based on organizational semiotics by capturing knowledge from syntactic, semantic and pragmatic to social level. Design/methodology/approach: The proposed modeling approach to generation of CPs adopts organizational semiotics and enables the generation of semantically rich representation of CP knowledge. Semantic Analysis Method (SAM) is applied to explicitly represent the semantics of the concepts, their relationships and patterns of behavior in terms of an ontology chart. Norm Analysis Method (NAM) is adopted to identify and formally specify patterns of behavior and rules that govern the actions identified on the ontology chart. Information collected during semantic and norm analysis is integrated to guide the generation of CPs using best practice represented in BPMN thus enabling the automation of CP. Findings: This research confirms the necessity of taking into consideration social aspects in designing information systems and automating CP. The complexity of healthcare processes can be best tackled by analyzing stakeholders, which we treat as social agents, their goals and patterns of action within the agent network. Originality/value: The current modeling methods describe CPs from a structural aspect comprising activities, properties and interrelationships. However, these methods lack a mechanism to describe possible patterns of human behavior and the conditions under which the behavior will occur. To overcome this weakness, a semiotic approach to generation of clinical pathway is introduced. The CP generated from SAM together with norms will enrich the knowledge representation of the domain through ontology modeling, which allows the recognition of human responsibilities and obligations and more importantly, the ultimate power of decision making in exceptional circumstances.

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The research outlined in this paper highlights the importance of the early nutrition of vegetable crops, and its long-term effects on their subsequent growth and development. Results are also presented to demonstrate how the nutrient supply during the establishment stages of young seedlings and transplants can be enhanced by targeting fertiliser to a zone close to their developing roots. Three different precision fertiliser placement techniques are compared for this purpose: starter, band or side-injected fertiliser. The use of each of these methods consistently produced the same (or greater) yields at lower application rates than those from conventional broadcast applications, increasing the apparent recovery of N, P and K, and the overall efficiency of nutrient use, while reducing the levels of residual nutrients in the soil. Starter fertilisers also advanced the maturity of some crops, and enhanced produce quality by increasing the proportions of the larger and/or more desirable marketable grades. The benefits of the different placement techniques are illustrated with selected examples from research at Warwick HRI using different vegetable crops, including lettuce, onion and carrot.

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Objective: To investigate the sociodemographic determinants of diet quality of the elderly in four EU countries. Design: Cross-sectional study. For each country, a regression was performed of a multidimensional index of dietary quality v. sociodemographic variables. Setting In Finland, Finnish Household Budget Survey (1998 and 2006); in Sweden, SNAC-K (2001–2004); in the UK, Expenditure & Food Survey (2006–07); in Italy, Multi-purpose Survey of Daily Life (2009). Subjects: One- and two-person households of over-50s (Finland, n 2994; UK, n 4749); over-50 s living alone or in two-person households (Italy, n 7564); over-60 s (Sweden, n 2023). Results: Diet quality among the EU elderly is both low on average and heterogeneous across individuals. The regression models explained a small but significant part of the observed heterogeneity in diet quality. Resource availability was associated with diet quality either negatively (Finland and UK) or in a non-linear or non-statistically significant manner (Italy and Sweden), as was the preference for food parameter. Education, not living alone and female gender were characteristics positively associated with diet quality with consistency across the four countries, unlike socio-professional status, age and seasonality. Regional differences within countries persisted even after controlling for the other sociodemographic variables. Conclusions: Poor dietary choices among the EU elderly were not caused by insufficient resources and informational measures could be successful in promoting healthy eating for healthy ageing. On the other hand, food habits appeared largely set in the latter part of life, with age and retirement having little influence on the healthiness of dietary choices.

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Background Patients do not adhere to their medicines for a host of reasons which can include their underlying beliefs as well as the quality of their interactions with healthcare professionals. One way of measuring the outcome of pharmacy adherence services is to assess patient satisfaction but no questionnaire exists that truly captures patients' experiences with these relatively new services. Objective Our objective was to develop a conceptual framework specific to patient satisfaction with a community pharmacy adherence service based on criteria used by patients themselves. Setting The study was based in community pharmacies in one large geographical area of the UK (Surrey). All the work was conducted between October 2008 and September 2010. Methods This study involved qualitative non-participant observation and semi-structured interviewing. We observed the recruitment of patients to the Medicines Use Review (MUR) service and also actual MUR consultations (7). We also interviewed patients (15). Data collection continued until no new themes were identified during analysis. We analysed interviews to firstly create a comprehensive account of themes which had significance within the transcripts, then created sub-themes within super-ordinate categories. We used a structure-process-outcome approach to develop a conceptual framework relating to patient satisfaction with the MUR. Favourable ethical opinion for this study was received from the NHS Surrey Research Ethics Committee on 2nd June 2008. Results Five super-ordinate themes linked to patient satisfaction with the MUR service were identified, including relationships with healthcare providers; attitudes towards healthcare providers; patients' experience of health, healthcare and medicines; patients' views of the MUR service; the logistics of the MUR service. In the conceptual framework, structure was conceptualised as existing relationships, environment, and time; process was conceptualised as related to recruitment and consultation stages; and outcome as two concepts of immediate patient outcomes and satisfaction on reflection. Conclusion We identified and highlighted factors that can influence patient satisfaction with the MUR service and this led to the development of a conceptual framework of patient satisfaction with the MUR service. This can form the basis for developing a questionnaire for measuring patient satisfaction with this and similar pharmacy adherence services. Impact of findings on practice * Pharmacists and researchers can access the relevant ideas presented here in relation to patient satisfaction with pharmacy adherence services. * Researcher can use the conceptual framework as a basis for measuring the quality of pharmacy adherence services. * Community pharmacists can improve the quality of healthcare they provide by realizing concepts relevant to patient satisfaction with adherence services.

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This paper reports the results of a 2-year study of water quality in the River Enborne, a rural river in lowland England. Concentrations of nitrogen and phosphorus species and other chemical determinands were monitored both at high-frequency (hourly), using automated in situ instrumentation, and by manual weekly sampling and laboratory analysis. The catchment land use is largely agricultural, with a population density of 123 persons km−2. The river water is largely derived from calcareous groundwater, and there are high nitrogen and phosphorus concentrations. Agricultural fertiliser is the dominant source of annual loads of both nitrogen and phosphorus. However, the data show that sewage effluent discharges have a disproportionate effect on the river nitrogen and phosphorus dynamics. At least 38% of the catchment population use septic tank systems, but the effects are hard to quantify as only 6% are officially registered, and the characteristics of the others are unknown. Only 4% of the phosphorus input and 9% of the nitrogen input is exported from the catchment by the river, highlighting the importance of catchment process understanding in predicting nutrient concentrations. High-frequency monitoring will be a key to developing this vital process understanding.

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Model quality assessment programs (MQAPs) aim to assess the quality of modelled 3D protein structures. The provision of quality scores, describing both global and local (per-residue) accuracy are extremely important, as without quality scores we are unable to determine the usefulness of a 3D model for further computational and experimental wet lab studies.Here, we briefly discuss protein tertiary structure prediction, along with the biennial Critical Assessment of Techniques for Protein Structure Prediction (CASP) competition and their key role in driving the field of protein model quality assessment methods (MQAPs). We also briefly discuss the top MQAPs from the previous CASP competitions. Additionally, we describe our downloadable and webserver-based model quality assessment methods: ModFOLD3, ModFOLDclust, ModFOLDclustQ, ModFOLDclust2, and IntFOLD-QA. We provide a practical step-by-step guide on using our downloadable and webserver-based tools and include examples of their application for improving tertiary structure prediction, ligand binding site residue prediction, and oligomer predictions.

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OBJECTIVE: The aim of this study was to compare the knowledge and views of nursing staff on both acute elderly care and rehabilitation wards regarding elderly persons' oral care with that of carers in nursing homes. SUBJECTS: One hundred nurses working on acute, sub-acute and rehabilitation wards for elderly people (Group 1) and 75 carers in nursing homes (Group 2) were surveyed. DESIGN: A semi-structured questionnaire. RESULTS: Similar percentages of each group of nurses were registered with a dentist (86% and 88% respectively), although more hospital-based nurses were anxious about dental treatment compared with the nursing home group (40% and 28% respectively). More carers in nursing homes gave regular advice about oral care than the hospital-based nurses (54% and 43% respectively). Eighteen per cent of each group thought that edentulous individuals did not require regular oral care. Eighty-five per cent of hospital-based nurses and 95% of nursing home carers incorrectly thought that dentures were 'free' on the NHS. Although trends were observed between the two groups, no comparisons were statistically significant (Chi-square; level p < 0.05). CONCLUSIONS: Deficiencies exist in the knowledge of health care workers both in hospital and in the community setting, although the latter were less knowledgeable but more likely to give advice to older people.

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Epidemic protocols are a bio-inspired communication and computation paradigm for large and extreme-scale networked systems. This work investigates the expansion property of the network overlay topologies induced by epidemic protocols. An expansion quality index for overlay topologies is proposed and adopted for the design of epidemic membership protocols. A novel protocol is proposed, which explicitly aims at improving the expansion quality of the overlay topologies. The proposed protocol is tested with a global aggregation task and compared to other membership protocols. The analysis by means of simulations indicates that the expansion quality directly relates to the speed of dissemination and convergence of epidemic protocols and can be effectively used to design better protocols.

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Wireless video sensor networks have been a hot topic in recent years; the monitoring capability is the central feature of the services offered by a wireless video sensor network can be classified into three major categories: monitoring, alerting, and information on-demand. These features have been applied to a large number of applications related to the environment (agriculture, water, forest and fire detection), military, buildings, health (elderly people and home monitoring), disaster relief, area and industrial monitoring. Security applications oriented toward critical infrastructures and disaster relief are very important applications that many countries have identified as critical in the near future. This paper aims to design a cross layer based protocol to provide the required quality of services for security related applications using wireless video sensor networks. Energy saving, delay and reliability for the delivered data are crucial in the proposed application. Simulation results show that the proposed cross layer based protocol offers a good performance in term of providing the required quality of services for the proposed application.