1000 resultados para quality


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The objective of this work was to evaluate the effects of alkaline solution marinades on the characteristics of pork subjected to post-mortem pH decrease in pig muscle. The pH of carcasses was measured in a commercial slaughterhouse (n = 526), 45 min after slaughtering (pH45) and, then, the carcasses were divided into the groups with pH45<5.7 or pH45>5.7. Ten samples of the longissimus dorsi muscles of each group were collected and distributed in an entirely randomized design, in a 2x4 factorial arrangement, with two conditions (pH45<5.7 or pH45>5.7), and four marinade solutions: TC, no marinade; TM1, sodium bicarbonate and sodium chloride; TM2, sodium tripolyphosphate and sodium chloride; TM3, sodium bicarbonate, sodium tripolyphosphate and sodium chloride. There was no interaction between pH45 of the meat and the marinade treatments. Meat with pH45<5.7 showed higher values for lightness, and for purge loss (PL), exudate loss (EL), cooking loss (CL) and shear force (SF). Marinating increased the pH, reduced the lightness, EL, CL and SF, and improved tenderness, juiciness and flavor of meat. Marinades with solutions containing chloride, bicarbonate, and sodium tripolyphosphate are effective in the improvement of pork quality, making physical characteristics of marinated meat similar to those of fresh pork, as a consequence of accelerated postmortem glycolysis.

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Introduction New evidence from randomized controlled and etiology of fever studies, the availability of reliable RDT for malaria, and novel technologies call for revision of the IMCI strategy. We developed a new algorithm based on (i) a systematic review of published studies assessing the safety and appropriateness of RDT and antibiotic prescription, (ii) results from a clinical and microbiological investigation of febrile children aged <5 years, (iii) international expert IMCI opinions. The aim of this study was to assess the safety of the new algorithm among patients in urban and rural areas of Tanzania.Materials and Methods The design was a controlled noninferiority study. Enrolled children aged 2-59 months with any illness were managed either by a study clinician using the new Almanach algorithm (two intervention health facilities), or clinicians using standard practice, including RDT (two control HF). At day 7 and day 14, all patients were reassessed. Patients who were ill in between or not cured at day 14 were followed until recovery or death. Primary outcome was rate of complications, secondary outcome rate of antibiotic prescriptions.Results 1062 children were recruited. Main diagnoses were URTI 26%, pneumonia 19% and gastroenteritis (9.4%). 98% (531/541) were cured at D14 in the Almanach arm and 99.6% (519/521) in controls. Rate of secondary hospitalization was 0.2% in each. One death occurred in controls. None of the complications was due to withdrawal of antibiotics or antimalarials at day 0. Rate of antibiotic use was 19% in the Almanach arm and 84% in controls.Conclusion Evidence suggests that the new algorithm, primarily aimed at the rational use of drugs, is as safe as standard practice and leads to a drastic reduction of antibiotic use. The Almanach is currently being tested for clinician adherence to proposed procedures when used on paper or a mobile phone

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The reason for this study is to propose a new quantitative approach on how to assess the quality of Open Access University Institutional Repositories. The results of this new approach are tested in the Spanish University Repositories. The assessment method is based in a binary codification of a proposal of features that objectively describes the repositories. The purposes of this method are assessing the quality and an almost automatically system for updating the data of the characteristics. First of all a database was created with the 38 Spanish institutional repositories. The variables of analysis are presented and explained either if they are coming from bibliography or are a set of new variables. Among the characteristics analyzed are the features of the software, the services of the repository, the features of the information system, the Internet visibility and the licenses of use. Results from Spanish universities ARE provided as a practical example of the assessment and for having a picture of the state of the development of the open access movement in Spain.

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OBJECTIVE: Critically ill patients are at high risk of malnutrition. Insufficient nutritional support still remains a widespread problem despite guidelines. The aim of this study was to measure the clinical impact of a two-step interdisciplinary quality nutrition program. DESIGN: Prospective interventional study over three periods (A, baseline; B and C, intervention periods). SETTING: Mixed intensive care unit within a university hospital. PATIENTS: Five hundred seventy-two patients (age 59 ± 17 yrs) requiring >72 hrs of intensive care unit treatment. INTERVENTION: Two-step quality program: 1) bottom-up implementation of feeding guideline; and 2) additional presence of an intensive care unit dietitian. The nutrition protocol was based on the European guidelines. MEASUREMENTS AND MAIN RESULTS: Anthropometric data, intensive care unit severity scores, energy delivery, and cumulated energy balance (daily, day 7, and discharge), feeding route (enteral, parenteral, combined, none-oral), length of intensive care unit and hospital stay, and mortality were collected. Altogether 5800 intensive care unit days were analyzed. Patients in period A were healthier with lower Simplified Acute Physiologic Scale and proportion of "rapidly fatal" McCabe scores. Energy delivery and balance increased gradually: impact was particularly marked on cumulated energy deficit on day 7 which improved from -5870 kcal to -3950 kcal (p < .001). Feeding technique changed significantly with progressive increase of days with nutrition therapy (A: 59% days, B: 69%, C: 71%, p < .001), use of enteral nutrition increased from A to B (stable in C), and days on combined and parenteral nutrition increased progressively. Oral energy intakes were low (mean: 385 kcal*day, 6 kcal*kg*day ). Hospital mortality increased with severity of condition in periods B and C. CONCLUSION: A bottom-up protocol improved nutritional support. The presence of the intensive care unit dietitian provided significant additional progression, which were related to early introduction and route of feeding, and which achieved overall better early energy balance.

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Selostus: Kalkituksen vaikutus piparmintun ja Sachalinin mintun satoon Pohjois-Suomessa

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The objective of this work was to quantify the genetic diversity of elite genotypes of irrigated barley in the Brazilian savanna. Thirty elite barley genotypes from Embrapa Cerrados' collection were evaluated using 160 RAPD markers, 12 agronomic traits related to yield components, and 10 malting quality parameters. The genetic dissimilarity matrices based on molecular markers, quantitative traits, and malting quality characters were calculated and a cluster analysis was performed using the unweighted pair-group method with arithmetic mean (UPGMA) as grouping criterion. High genetic diversity among accessions were observed. The estimated genetic dissimilarities were weakly correlated, showing the complementarity of the different character groups. Selection indices and graphical dispersion analysis allowed the selection of promising genotypes and the indication of suitable crosses for maximizing the heterotic effects in breeding programs for irrigated barley in the Brazilian savanna.

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Modern multimedia communication tools must have high security, high availability and high quality of service (QoS). Any security implementation will directly impact on QoS. This paper will investigate how end-to-end security impacts on QoS in Voice over Internet Protocol (VoIP). The QoS is measured in terms of lost packet ratio, latency and jitter using different encryption algorithms, no security and just the use of IP firewalls in Local and Wide Area Networks (LAN and WAN). The results of laboratory tests indicate that the impact on the overall performance of VoIP depends upon the bandwidth availability and encryption algorithm used. The implementation of any encryption algorithm in low bandwidth environments degrades the voice quality due to increased loss packets and packet latency, but as bandwidth increases encrypted VoIP calls provided better service compared to an unsecured environment.

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Introduction: Within the framework of the «Programme cantonal Diabète», we aimed at collecting data to 1) describe the population of diabetic patients in the canton of Vaud, and 2) assess the quality of their care. Methods: A cross-sectional study was conducted in the fall of 2011. Out of 140 randomly selected community pharmacies registered in the canton of Vaud, 56 accepted to participate in patients' recruitment. Noninstitutionalized adult diabetic patients (disease duration >12 months) visiting a pharmacy with a prescription for oral anti-diabetic drugs, insulin, glycemic strips or glucose meter were eligible. Patients not residing in the canton of Vaud, not speaking and understanding French well enough, presenting obvious cognitive impairment, and women with gestational diabetes, were excluded. Using a self-administered questionnaire, data was collected on patients' characteristics and diabetes as well as various process (e.g. recommended annual screenings) and outcomes quality of care indicators. Descriptive analyses were performed. Results: A total of 406 patients with diabetes participated. Mean age was 64 years, 41% were women and 63% were married. Patients reported type 1, 2 and other types of diabetes in 13%, 69% and 19%, respectively. They were treated with oral anti-diabetic drugs, insulin or both in 50%, 23% and 27% of the cases. Half of the patients did not report any diabetes-related complication. Glucose self-monitoring was reported by 82% of the patients. Of those who were aware of HbA1C (n = 218), 98% reported at least one HbA1C control during the last 12 months. During that same time frame, 97% and 95% reported at least one blood pressure and weight measure, 94% reported having had a cholesterol check, 74%, 68% and 64% had eyes, feet and urine screening respectively. 62% of the patients had been immunized against influenza. At least 76% of the patients had a minimum of 5 of the 7 described process indicators performed during the last 12 months. Among patients who knew the value (n = 145), mean HbA1C was 7.4 (SD 1.2). Conclusion: This study targeting community-based diabetic patients shows that while routine clinical and laboratory tests were annually performed in the vast majority of patients, feet and urine screening, as well as influenza immunization, were less often reported by patients. The proportion of patients with diabetes having had at least 5 out of the 7 annual screenings performed was nevertheless very high.

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Line converters have become an attractive AC/DC power conversion solution in industrial applications. Line converters are based on controllable semiconductor switches, typically insulated gate bipolar transistors. Compared to the traditional diode bridge-based power converters line converters have many advantageous characteristics, including bidirectional power flow, controllable de-link voltage and power factor and sinusoidal line current. This thesis considers the control of the lineconverter and its application to power quality improving. The line converter control system studied is based on the virtual flux linkage orientation and the direct torque control (DTC) principle. A new DTC-based current control scheme is introduced and analyzed. The overmodulation characteristics of the DTC converter are considered and an analytical equation for the maximum modulation index is derived. The integration of the active filtering features to the line converter isconsidered. Three different active filtering methods are implemented. A frequency-domain method, which is based on selective harmonic sequence elimination, anda time-domain method, which is effective in a wider frequency band, are used inharmonic current compensation. Also, a voltage feedback active filtering method, which mitigates harmonic sequences of the grid voltage, is implemented. The frequency-domain and the voltage feedback active filtering control systems are analyzed and controllers are designed. The designs are verified with practical measurements. The performance and the characteristics of the implemented active filtering methods are compared and the effect of the L- and the LCL-type line filteris discussed. The importance of the correct grid impedance estimate in the voltage feedback active filter control system is discussed and a new measurement-based method to obtain it is proposed. Also, a power conditioning system (PCS) application of the line converter is considered. A new method for correcting the voltage unbalance of the PCS-fed island network is proposed and experimentally validated.

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The objective of this work was to estimate the allele polymorphism frequencies of genes in Nellore cattle and associate them with meat quality and carcass traits. Six hundred males were genotyped for the following polymorphisms: DGAT1 (VNTR with 18 nucleotides at the promoter region); ANK1, a new polymorphism, identified and mapped here at the gene regulatory region NW_001494427.3; TCAP (AY428575.1:g.346G>A); and MYOG (NW_001501985:g.511G>C). In the association study, phenotype data of hot carcass weight, ribeye area, backfat thickness, percentage of intramuscular fat, shear force, myofibrillar fragmentation index, meat color (L*, a*, b*), and cooking losses were used. Allele B from the ANK1 gene was associated with greater redness (a*). Alleles 5R, 6R, and 7R from the DGAT1 VNTR gene were associated with increased intramuscular fat, reduced cooking losses and increased ribeye area, respectively. The single nucleotide polymorphism (SNP) of the TCAP gene was not polymorphic, and MYOG alleles were not associated with any of the evaluated characteristics. These results indicate that ANK1 and DGAT1 genes can be used in the selection of Nellore cattle for carcass and meat quality.

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BACKGROUND: Intensification of pharmacotherapy in persons with poorly controlled chronic conditions has been proposed as a clinically meaningful process measure of quality. OBJECTIVE: To validate measures of treatment intensification by evaluating their associations with subsequent control in hypertension, hyperlipidemia, and diabetes mellitus across 35 medical facility populations in Kaiser Permanente, Northern California. DESIGN: Hierarchical analyses of associations of improvements in facility-level treatment intensification rates from 2001 to 2003 with patient-level risk factor levels at the end of 2003. PATIENTS: Members (515,072 and 626,130; age >20 years) with hypertension, hyperlipidemia, and/or diabetes mellitus in 2001 and 2003, respectively. MEASUREMENTS: Treatment intensification for each risk factor defined as an increase in number of drug classes prescribed, of dosage for at least 1 drug, or switching to a drug from another class within 3 months of observed poor risk factor control. RESULTS: Facility-level improvements in treatment intensification rates between 2001 and 2003 were strongly associated with greater likelihood of being in control at the end of 2003 (P < or = 0.05 for each risk factor) after adjustment for patient- and facility-level covariates. Compared with facility rankings based solely on control, addition of percentages of poorly controlled patients who received treatment intensification changed 2003 rankings substantially: 14%, 51%, and 29% of the facilities changed ranks by 5 or more positions for hypertension, hyperlipidemia, and diabetes, respectively. CONCLUSIONS: Treatment intensification is tightly linked to improved control. Thus, it deserves consideration as a process measure for motivating quality improvement and possibly for measuring clinical performance.

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Few studies have examined the combined effect of implementing quality and environmental management within the service sector. This void is more evident if we focus on segments in which small businesses predominate and even more so if we look for highly competitive sectors that are very variable and that have high business mortality. After analysing 198 surveys of Spanish travel agency managers using structural equations, it can be concluded that practices of quality management have a significant direct impact on business competitiveness but not on this business's financial results, at least directly. However, there is a significant relationship between environmental management practices and economic benefits. This article suggests that commitment to quality and the environment can allow small businesses in the service sector to have a competitive advantage that will separate surviving and ceased operations, particularly in sectors that are rapidly evolving and highly competitive.