Continuous infusion of ticarcillin-clavulanate for home treatment of serious infections: clinical efficacy, safety, pharmacokinetics and pharmacodynamics

Continuous infusion (CI) ticarcillin-clavulanate is a potential therapeutic improvement over conventional intermittent dosing because the major pharmacodynamic (PD) predictor of efficacy of beta-lactams is the time that free drug levels exceed the MIC. This study incorporated a 6-year retrospective arm evaluating efficacy and safety of CI ticarcillin-clavulanate in the home treatment of serious infections and a prospective arm additionally evaluating pharmacokinetics (PK) and PD. In the prospective arm, steady-state serum ticarcillin and clavulanate levels and MIC testing of significant pathogens were performed. One hundred and twelve patients (median age, 56 years) were treated with a CI dose of 9.3-12.4 g/day and mean CI duration of 18.0 days. Infections treated included osteomyelitis (50 patients), septic arthritis (6), cellulitis (17), pulmonary infections (12), febrile neutropenia (7), vascular infections (7), intra-abdominal infections (2), and Gram-negative endocarditis (2); 91/112 (81%) of patients were cured, 14 (13%) had partial response and 7 (6%) failed therapy. Nine patients had PICC line complications and five patients had drug adverse events. Eighteen patients had prospective PK/PD assessment although only four patients had sufficient data for a full PK/PD evaluation (both serum steady-state drug levels and ticarcillin and clavulanate MICs from a bacteriological isolate), as this was difficult to obtain in home-based patients, particularly as serum clavulanate levels were found to deteriorate rapidly on storage. Three of four patients with matched PK/PD assessment had free drug levels exceeding the MIC of the pathogen. Home Cl of ticarcillin-clavulanate is a safe, effective, convenient and practical therapy and is a therapeutic advance over traditional intermittent dosing when used in the home setting. (c) 2005 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

A rheological assessment of the effect of trace level Ni additions on the solidification of Sn-0.7Cu

The influence of trace level Ni additions on the eutectic solidification mode of Sn-0.7Cu has been studied using continuous torque experiments during solidification. The solid fraction at which resistance to paddle rotation at the thermal centre of the sample occurs is related to the spatial distribution of solid during solidification. The results indicate that a transition in solidification mode occurs in the range 0-300 ppm Ni. Growth occurs antiparallel to heat flow from near the mould walls in the Ni-free alloy, while equiaxed growth from distributed centres dominates in alloys containing at least 300 ppm Ni. (c) 2006 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

The mechanics of continuous roller bending of plates

This research initiates a study of the mechanics of four roll plate bending and provides a methodology to investigate the process experimentally. To carry out the research a suitable model bender was designed and constructed. The model bender was comprehensively instrumented with ten load cells, three torquemeters and a tachometer. A rudimentary analysis of the four roll pre-bending mode considered the three critical bending operations. The analysis also gave an assessment of the model bender capacity for the design stage. The analysis indicated that an increase in the coefficient of friction in the contact region of the pinch rolls and the plate would reduce the pinch resultant force required to end a plate to a particular bend radius. The mechanisms involved in the four roll plate bending process were investigated and a mathematical model evolved to determine the mechanics of four roll thin plate bending. A theoretical and experimental investigation was conducted for the bending of HP30 aluminium plates in both single and multipass bending modes. The study indicated that the multipass plate bending mechanics of the process varied according to the number of bending passes executed and the step decrement of the anticipated finished bend radius in any two successive passes (i.e. the bending route). Experimental results for single pass bending indicated that the rollers normally exert a higher bending load for the steady-continous bending with the pre-inactive side roll oper?tive. For the pre-bending mode and the steady-continous bending mode with the pre-active side roll operative, the former exerted the higher loads. The single pass results also indicated that the force on the side roll, the torque and power steadily increased as the anticipated bend radius decreased. Theoretical predictions for the plate internal resistance to accomplish finished bend radii of between 2500mm and 500mm for multipass bending HP30 aluminium plates, suggested that there was a certain bending route which would effectively optimise the bender capacity.

Development of a technological innovation capability assessment model:a case study of manufacturing SMEs in Sialkot, Pakistan

Small and Medium Enterprises (SMEs) play an important part in the economy of any country. Initially, a flat management hierarchy, quick response to market changes and cost competitiveness were seen as the competitive characteristics of an SME. Recently, in developed economies, technological capabilities (TCs) management- managing existing and developing or assimilating new technological capabilities for continuous process and product innovations, has become important for both large organisations and SMEs to achieve sustained competitiveness. Therefore, various technological innovation capability (TIC) models have been developed at firm level to assess firms‘ innovation capability level. These models output help policy makers and firm managers to devise policies for deepening a firm‘s technical knowledge generation, acquisition and exploitation capabilities for sustained technological competitive edge. However, in developing countries TCs management is more of TCs upgrading: acquisitions of TCs from abroad, and then assimilating, innovating and exploiting them. Most of the TIC models for developing countries delineate the level of TIC required as firms move from the acquisition to innovative level. However, these models do not provide tools for assessing the existing level of TIC of a firm and various factors affecting TIC, to help practical interventions for TCs upgrading of firms for improved or new processes and products. Recently, the Government of Pakistan (GOP) has realised the importance of TCs upgrading in SMEs-especially export-oriented, for their sustained competitiveness. The GOP has launched various initiatives with local and foreign assistance to identify ways and means of upgrading local SMEs capabilities. This research targets this gap and developed a TICs assessment model for identifying the existing level of TIC of manufacturing SMEs existing in clusters in Sialkot, Pakistan. SME executives in three different export-oriented clusters at Sialkot were interviewed to analyse technological capabilities development initiatives (CDIs) taken by them to develop and upgrade their firms‘ TCs. Data analysed at CDI, firm, cluster and cross-cluster level first helped classify interviewed firms as leader, follower and reactor, with leader firms claiming to introduce mostly new CDIs to their cluster. Second, the data analysis displayed that mostly interviewed leader firms exhibited ‗learning by interacting‘ and ‗learning by training‘ capabilities for expertise acquisition from customers and international consultants. However, these leader firms did not show much evidence of learning by using, reverse engineering and R&D capabilities, which according to the extant literature are necessary for upgrading existing TIC level and thus TCs of firm for better value-added processes and products. The research results are supported by extant literature on Sialkot clusters. Thus, in sum, a TIC assessment model was developed in this research which qualitatively identified interviewed firms‘ TIC levels, the factors affecting them, and is validated by existing literature on interviewed Sialkot clusters. Further, the research gives policy level recommendations for TIC and thus TCs upgrading at firm and cluster level for targeting better value-added markets.

Natura 2000 erdők közgazdasági környezetének elemzése (Assessment of the economic environment of Natura 2000 forests)

Ebben a tanulmányban a Natura 2000 erdők közgazdasági kérdéseit jártuk körül az ökoszisztéma-szolgáltatások koncepciójának segítségével, nemzetközi és hazai szakirodalomra építve. Emellett a természetközeli erdőgazdálkodás fogalomkörét, s azon belül a folyamatos erdőborítást szolgáló erdőgazdálkodást vettük alapul. A következőkben néhány összegző megállapítást teszünk, és kijelölünk további kutatási irányokat. _____ This study has been prepared within the LIFEinFORESTS – Improved communication, cooperation and capacity building for preserving biodiversity in Natura 2000 forests (B2 action, LIFE13 INF/HU/001163) – project in the framework of LIFE+ Information and Communication under the contract signed with the Duna-Ipoly National Park Directorate. The main aim of the study is to summarize the international and Hungarian economic and environmental economic literature related to the Natura 2000 forests, and serve as a background study for the communication with and training of forest owners and users operating at Natura 2000 sites. The concept of ecosystem services (ESs) is used as an overall framework for the study. In our opinion it is able to show all the benefits provided by forests and can also help to reveal that the benefits of nature-oriented, continuous cover forest management (CCF) can exceed the benefits of traditional rotation forest management (RFM). The definition and the classification of the Millennium Ecosystem Assessment (MA, 2003, 2005) is used throughout the study, so provisioning, cultural, regulating and supporting services are distinguished.

Assessment of the Spatial and Temporal Distribution of Functional Connectivity in Resting-State BOLD fMRI

Recent research into resting-state functional magnetic resonance imaging (fMRI) has shown that the brain is very active during rest. This thesis work utilizes blood oxygenation level dependent (BOLD) signals to investigate the spatial and temporal functional network information found within resting-state data, and aims to investigate the feasibility of extracting functional connectivity networks using different methods as well as the dynamic variability within some of the methods. Furthermore, this work looks into producing valid networks using a sparsely-sampled sub-set of the original data.

In this work we utilize four main methods: independent component analysis (ICA), principal component analysis (PCA), correlation, and a point-processing technique. Each method comes with unique assumptions, as well as strengths and limitations into exploring how the resting state components interact in space and time.

Correlation is perhaps the simplest technique. Using this technique, resting-state patterns can be identified based on how similar the time profile is to a seed region’s time profile. However, this method requires a seed region and can only identify one resting state network at a time. This simple correlation technique is able to reproduce the resting state network using subject data from one subject’s scan session as well as with 16 subjects.

Independent component analysis, the second technique, has established software programs that can be used to implement this technique. ICA can extract multiple components from a data set in a single analysis. The disadvantage is that the resting state networks it produces are all independent of each other, making the assumption that the spatial pattern of functional connectivity is the same across all the time points. ICA is successfully able to reproduce resting state connectivity patterns for both one subject and a 16 subject concatenated data set.

Using principal component analysis, the dimensionality of the data is compressed to find the directions in which the variance of the data is most significant. This method utilizes the same basic matrix math as ICA with a few important differences that will be outlined later in this text. Using this method, sometimes different functional connectivity patterns are identifiable but with a large amount of noise and variability.

To begin to investigate the dynamics of the functional connectivity, the correlation technique is used to compare the first and second halves of a scan session. Minor differences are discernable between the correlation results of the scan session halves. Further, a sliding window technique is implemented to study the correlation coefficients through different sizes of correlation windows throughout time. From this technique it is apparent that the correlation level with the seed region is not static throughout the scan length.

The last method introduced, a point processing method, is one of the more novel techniques because it does not require analysis of the continuous time points. Here, network information is extracted based on brief occurrences of high or low amplitude signals within a seed region. Because point processing utilizes less time points from the data, the statistical power of the results is lower. There are also larger variations in DMN patterns between subjects. In addition to boosted computational efficiency, the benefit of using a point-process method is that the patterns produced for different seed regions do not have to be independent of one another.

This work compares four unique methods of identifying functional connectivity patterns. ICA is a technique that is currently used by many scientists studying functional connectivity patterns. The PCA technique is not optimal for the level of noise and the distribution of the data sets. The correlation technique is simple and obtains good results, however a seed region is needed and the method assumes that the DMN regions is correlated throughout the entire scan. Looking at the more dynamic aspects of correlation changing patterns of correlation were evident. The last point-processing method produces a promising results of identifying functional connectivity networks using only low and high amplitude BOLD signals.

Brazilian Social Segurity and Social Work: reflections on the Continuous Cash Benefit Programme

Guaranteed under the Federal Constitution of 1988, Brazilian social security covers rights relating to health, social welfare and social care. The Continuous Cash Benefit Programme (BPC) was approved as part of social care policy and is regulated under the Social Care Act (Ley Orgánica de Asistencia Social) of 1993. This benefit guarantees a minimum monthly income for persons with disabilities and for older adults. Certain requirements must be satisfied in order to obtain the assistance: medical and social assessment of disabled persons, a minimum age of 65 years for older adults, and, in both cases, the value of per capita income for the nuclear family in question, which must be lower than a quarter of the minimum wage. Regulation of the BPC has incorporated advances and setbacks in terms of legislation and implementation. In this framework, this article presents a theoretical reflection, an analysis of the legislation on the matter, and some reflections on the challenges that it poses for social workers.

Aged embankment imaging and assessment using surface waves

Rapid, non-intrusive surface wave surveys provide depth profiles from which ground models can be generated for use in earthwork condition assessment. Stiffness throughout earthworks controls the behaviour under static and dynamic loads, and characterising heterogeneity is of interest in relation to the stability of engineered backfill and life-cycle deterioration in aged utility and transportation infrastructure. Continuous surface wave methods were used to identify interfaces between fine- and coarse-grained fill in an end-tipped embankment along the Great Central Railway in Nottinghamshire, UK. Multichannel analysis of surface wave (MASW) methods were used to characterise subsurface voiding in a canal embankment along the Knottingley and Goole canal near Eggborough, Yorkshire. MASW methods are currently being used to study extreme weather impacts on the stability of a highplasticity clay embankment along the Gloucestershire–Warwickshire railway near Laverton. Optimal results were obtained using equipment capable of generating and detecting over wide frequency ranges.

A review of Parkinson’s disease cardinal and dyskinetic motor symptoms assessment methods using sensor systems

This paper is reviewing objective assessments of Parkinson’s disease(PD) motor symptoms, cardinal, and dyskinesia, using sensor systems. It surveys the manifestation of PD symptoms, sensors that were used for their detection, types of signals (measures) as well as their signal processing (data analysis) methods. A summary of this review’s finding is represented in a table including devices (sensors), measures and methods that were used in each reviewed motor symptom assessment study. In the gathered studies among sensors, accelerometers and touch screen devices are the most widely used to detect PD symptoms and among symptoms, bradykinesia and tremor were found to be mostly evaluated. In general, machine learning methods are potentially promising for this. PD is a complex disease that requires continuous monitoring and multidimensional symptom analysis. Combining existing technologies to develop new sensor platforms may assist in assessing the overall symptom profile more accurately to develop useful tools towards supporting better treatment process.

Giving Peru a productivity boost : towards a system of continuous education and training

In spite of impressive rates of economic growth, the quality of the labor force’s human capital is considered a major challenge for sustaining medium term economic growth in Peru. This note reviews the skills of the Peruvian labor force, and the status of the continuous education and training system. Based on such an assessment and on learnings from international best practices, it proposes a system of continuous education and training that draws from international best practices, but that addresses local capacity and institutional issues.

Exploring complex chemical systems: insights from mass spectrometry, electrochemistry and continuous cell culture

The work presented herein covers a broad range of research topics and so, in the interest of clarity, has been presented in a portfolio format. Accordingly, each chapter consists of its own introductory material prior to presentation of the key results garnered, this is then proceeded by a short discussion on their significance. In the first chapter, a methodology to facilitate the resolution and qualitative assessment of very large inorganic polyoxometalates was designed and implemented employing ion-mobility mass spectrometry. Furthermore, the potential of this technique for ‘mapping’ the conformational space occupied by this class of materials was demonstrated. These claims are then substantiated by the development of a tuneable, polyoxometalate-based calibration protocol that provided the necessary platform for quantitative assessments of similarly large, but unknown, polyoxometalate species. In addition, whilst addressing a major limitation of travelling wave ion mobility, this result also highlighted the potential of this technique for solution-phase cluster discovery. The second chapter reports on the application of a biophotovoltaic electrochemical cell for characterising the electrogenic activity inherent to a number of mutant Synechocystis strains. The intention was to determine the key components in the photosynthetic electron transport chain responsible for extracellular electron transfer. This would help to address the significant lack of mechanistic understanding in this field. Finally, in the third chapter, the design and fabrication of a low-cost, highly modular, continuous cell culture system is presented. To demonstrate the advantages and suitability of this platform for experimental evolution investigations, an exploration into the photophysiological response to gradual iron limitation, in both the ancestral wild type and a randomly generated mutant library population, was undertaken. Furthermore, coupling random mutagenesis to continuous culture in this way is shown to constitute a novel source of genetic variation that is open to further investigation.

Rapid continuous chemical analysis of meat chicken shed emissions by SIFT–MS

Assessing and addressing odour impacts from poultry production is extremely difficult and subjective because the odorants involved and their dynamics over time and space are poorly understood. This knowledge gap is due, in part, to the lack of suitable analytical tools for measuring and monitoring odorants in the field. The emergence of Selected Ion Flow Tube – Mass Spectrometry (SIFT–MS) and similar instruments is changing that. These tools can rapidly quantify targeted odorants in ambient air in real time, even at very low concentrations. Such data is essential for developing better odour abatement strategies, assessment methods and odour dispersion models. This project trialled a SIFT–MS to determine its suitability for assessing the odorants in meat chicken shed emissions over time and space. This report details evaluations in New Zealand and Australia to determine the potential of SIFT–MS as a tool for the chicken meat industry, including odour measurement (as a proxy for dynamic olfactometry). The report is specifically targeted at those funding and conducting poultry odour research. It will be of interest to those involved with environmental odour monitoring and assessment in general. The high upfront cost of SIFT–MS will lead to potential users wanting compelling evidence that SIFT–MS will meet their needs before they invest in one.

Exploring the potential role of allostatic load biomarkers in risk assessment of patients presenting with depressive symptoms

Background: Depression is a major health problem worldwide and the majority of patients presenting with depressive symptoms are managed in primary care. Current approaches for assessing depressive symptoms in primary care are not accurate in predicting future clinical outcomes, which may potentially lead to over or under treatment. The Allostatic Load (AL) theory suggests that by measuring multi-system biomarker levels as a proxy of measuring multi-system physiological dysregulation, it is possible to identify individuals at risk of having adverse health outcomes at a prodromal stage. Allostatic Index (AI) score, calculated by applying statistical formulations to different multi-system biomarkers, have been associated with depressive symptoms. Aims and Objectives: To test the hypothesis, that a combination of allostatic load (AL) biomarkers will form a predictive algorithm in defining clinically meaningful outcomes in a population of patients presenting with depressive symptoms. The key objectives were: 1. To explore the relationship between various allostatic load biomarkers and prevalence of depressive symptoms in patients, especially in patients diagnosed with three common cardiometabolic diseases (Coronary Heart Disease (CHD), Diabetes and Stroke). 2 To explore whether allostatic load biomarkers predict clinical outcomes in patients with depressive symptoms, especially in patients with three common cardiometabolic diseases (CHD, Diabetes and Stroke). 3 To develop a predictive tool to identify individuals with depressive symptoms at highest risk of adverse clinical outcomes. Methods: Datasets used: ‘DepChron’ was a dataset of 35,537 patients with existing cardiometabolic disease collected as a part of routine clinical practice. ‘Psobid’ was a research data source containing health related information from 666 participants recruited from the general population. The clinical outcomes for 3 both datasets were studied using electronic data linkage to hospital and mortality health records, undertaken by Information Services Division, Scotland. Cross-sectional associations between allostatic load biomarkers calculated at baseline, with clinical severity of depression assessed by a symptom score, were assessed using logistic and linear regression models in both datasets. Cox’s proportional hazards survival analysis models were used to assess the relationship of allostatic load biomarkers at baseline and the risk of adverse physical health outcomes at follow-up, in patients with depressive symptoms. The possibility of interaction between depressive symptoms and allostatic load biomarkers in risk prediction of adverse clinical outcomes was studied using the analysis of variance (ANOVA) test. Finally, the value of constructing a risk scoring scale using patient demographics and allostatic load biomarkers for predicting adverse outcomes in depressed patients was investigated using clinical risk prediction modelling and Area Under Curve (AUC) statistics. Key Results: Literature Review Findings. The literature review showed that twelve blood based peripheral biomarkers were statistically significant in predicting six different clinical outcomes in participants with depressive symptoms. Outcomes related to both mental health (depressive symptoms) and physical health were statistically associated with pre-treatment levels of peripheral biomarkers; however only two studies investigated outcomes related to physical health. Cross-sectional Analysis Findings: In DepChron, dysregulation of individual allostatic biomarkers (mainly cardiometabolic) were found to have a non-linear association with increased probability of co-morbid depressive symptoms (as assessed by Hospital Anxiety and Depression Score HADS-D≥8). A composite AI score constructed using five biomarkers did not lead to any improvement in the observed strength of the association. In Psobid, BMI was found to have a significant cross-sectional association with the probability of depressive symptoms (assessed by General Health Questionnaire GHQ-28≥5). BMI, triglycerides, highly sensitive C - reactive 4 protein (CRP) and High Density Lipoprotein-HDL cholesterol were found to have a significant cross-sectional relationship with the continuous measure of GHQ-28. A composite AI score constructed using 12 biomarkers did not show a significant association with depressive symptoms among Psobid participants. Longitudinal Analysis Findings: In DepChron, three clinical outcomes were studied over four years: all-cause death, all-cause hospital admissions and composite major adverse cardiovascular outcome-MACE (cardiovascular death or admission due to MI/stroke/HF). Presence of depressive symptoms and composite AI score calculated using mainly peripheral cardiometabolic biomarkers was found to have a significant association with all three clinical outcomes over the following four years in DepChron patients. There was no evidence of an interaction between AI score and presence of depressive symptoms in risk prediction of any of the three clinical outcomes. There was a statistically significant interaction noted between SBP and depressive symptoms in risk prediction of major adverse cardiovascular outcome, and also between HbA1c and depressive symptoms in risk prediction of all-cause mortality for patients with diabetes. In Psobid, depressive symptoms (assessed by GHQ-28≥5) did not have a statistically significant association with any of the four outcomes under study at seven years: all cause death, all cause hospital admission, MACE and incidence of new cancer. A composite AI score at baseline had a significant association with the risk of MACE at seven years, after adjusting for confounders. A continuous measure of IL-6 observed at baseline had a significant association with the risk of three clinical outcomes- all-cause mortality, all-cause hospital admissions and major adverse cardiovascular event. Raised total cholesterol at baseline was associated with lower risk of all-cause death at seven years while raised waist hip ratio- WHR at baseline was associated with higher risk of MACE at seven years among Psobid participants. There was no significant interaction between depressive symptoms and peripheral biomarkers (individual or combined) in risk prediction of any of the four clinical outcomes under consideration. Risk Scoring System Development: In the DepChron cohort, a scoring system was constructed based on eight baseline demographic and clinical variables to predict the risk of MACE over four years. The AUC value for the risk scoring system was modest at 56.7% (95% CI 55.6 to 57.5%). In Psobid, it was not possible to perform this analysis due to the low event rate observed for the clinical outcomes. Conclusion: Individual peripheral biomarkers were found to have a cross-sectional association with depressive symptoms both in patients with cardiometabolic disease and middle-aged participants recruited from the general population. AI score calculated with different statistical formulations was of no greater benefit in predicting concurrent depressive symptoms or clinical outcomes at follow-up, over and above its individual constituent biomarkers, in either patient cohort. SBP had a significant interaction with depressive symptoms in predicting cardiovascular events in patients with cardiometabolic disease; HbA1c had a significant interaction with depressive symptoms in predicting all-cause mortality in patients with diabetes. Peripheral biomarkers may have a role in predicting clinical outcomes in patients with depressive symptoms, especially for those with existing cardiometabolic disease, and this merits further investigation.

A qualidade e o modelo common assessment framework: O caso dos Serviços Académicos da Universidade de Évora

Uma das condições que mais influencia a competitividade entre instituições de ensino é a Qualidade. Sendo a sociedade cada vez mais exigente, é necessário medir e avaliá-la. A utilização de uma ferramenta de autoavaliação, desenvolvida ao nível da União Europeia, a Common Assessment Framework (CAF), que teve como modelo de origem o European Foundation for Quality Management (EFQM), veio permitir a medição da qualidade dos serviços prestados na administração pública. Este estudo apresenta os diversos aspectos referentes à temática da qualidade, o modelo CAF e os principais resultados obtidos num inquérito por questionário, junto dos alunos, colaboradores internos e gestores dos Serviços Académicos da Universidade de Évora, com o objectivo de avaliar o grau de satisfação com a qualidade do serviço prestado, o desempenho de todas as partes interessadas e, consequentemente, a sustentabilidade desse serviço. Desses resultados retiraram-se alguns pontos fortes, enunciaram-se diversos pontos fracos e evidenciaram-se sugestões de melhoria para o serviço em estudo. Neste sentido, este trabalho serviu de diagnóstico e apresenta uma ferramenta que permite aos Serviços académicos da Universidade de Évora conhecerem-se melhor e poderem mover-se no caminho da qualidade. ABSTRACT: One of the conditions that most influences the competitiveness among institutions of education is quality. As society increasingly demanding in terms of professional skills, it is necessary to measure and assess the quality of education, through continuous improvement to achieve excellence. Currently, the quality must be measured and seen as a competitive advantage. The use of a tool for self-evaluation of the quality, developed at EU level, the Common Assessment Framework (CAF) that has had its origin on European Foundation for Quality Management (EFQM), carne allow the measurement of quality of services provided to the clients, based on an internal guidance for quality in the organization and on the adoption of quality ratings as a routine in their work. This study presents the various aspects relating to the issue of quality and the Common Assessment Framework (CAF) and presents the main results obtained through a survey by questionnaire. These questionnaires were applied to the students, staff and internal managers from the Academic Services of the University of Évora with the aim of assessing the grade of satisfaction with the quality of the services provided, the performance of all interested parties and therefore the sustainability of this service in this institution of higher education. As results obtained on this research there are some strengths, several weaknesses and suggestions for improvement that can benefit the service under study. This work can be used as a diagnosis and gives a tool that allows Academic Services of the University of Évora know themselves better and to be able to move on the path of quality.

Applicability of an assessment model for healthcare information systems in a public hospital

Assessment processes are essential to guarantee quality and continuous improvement of software in healthcare, as they measure software attributes in their lifecycle, verify the degree of alignment between the software and its objectives and identify unpredicted events. This article analyses the use of an assessment model based on software metrics for three healthcare information systems from a public hospital that provides secondary and tertiary care in the region of Ribeirão Preto. Compliance with the metrics was investigated using questionnaires in guided interviews of the system analysts responsible for the applications. The outcomes indicate that most of the procedures specified in the model can be adopted to assess the systems that serves the organization, particularly in the attributes of compatibility, reliability, safety, portability and usability.