The need to address the issue of quality in aged care service provision in Australia has received increasing emphasis in recent decades. Particularly since the 1980s, the federal government has played a key role in ensuring that this is the case through the implementation of various reforms and regulatory strategies. In 1998, the national standards monitoring system which had been in place since the mid 1980s was replaced with a new system based on an accreditation model. In contrast to the former system which was wholly controlled by government and involved one-off inspections by government standards monitors, responsibility for managing the new system has been devolved to an independent body, the Aged Care Standards and Accreditation Agency. One of the Agency's primary functions is to assess compliance with the accreditation standards. A key component of the new system is its emphasis on continuous improvement which has been incorporated into the accreditation standards. As a consequence, the new system requires a much greater level of involvement and commitment by providers than previously. In order to continue receiving government funding all facilities had to be accredited by January 1st 2001. This study represents an evaluation of the accreditation system based on the views and experiences of service providers in Western Australia. It explored a number of issues relating to the basic philosophy and principles underlying the new system, the implementation process, the accreditation standards that are used as a basis for assessing service quality and the overall impact of the system on providers. It also sought providers' views about the strengths and limitations of the system and any areas in need of change or improvement. A descriptive design, using in-depth interviews as the method of data collection, was adopted for the study. / Participants from three levels of service provision, namely, facilities, organisations and peak bodies were selected on a stratified purposive basis. A total of 45 informants were interviewed. The findings indicated that, overall, as a regulatory approach the accreditation system was generally supported by providers and was regarded as having a number of positive features, particularly in comparison to the previous system. At the same time a number of concerns were identified. These related in particular to the assessment process, specifically the lack of consistency amongst assessors and the self assessment tool, and to the extent of information and guidance provided by the Agency. Concerns regarding the latter's role in relation to, and extent of independence from, the federal government were also identified. The study also found that the introduction of the system had impacted on providers in a variety of ways, both positive and negative, but particularly in terms of the demands on staff and financial resources. A number of 'broader' level factors, such as funding, nursing shortages and other often competing demands (e.g. assessing residents according to the Resident Classification Scale) were also felt to be impacting on providers' capacity to meet the requirements of the system. These concerns, along with concerns about the way in which the system would develop in the future, appear to have created a degree of uncertainty and in some cases apprehension amongst many providers. Although this study has focused on the experiences of Western Australian service providers, evidence from other reviews of the accreditation system where providers' views have been sought has indicated a widespread similarity in perceptions. This suggests, therefore, that there is a need for further review and refinement of certain aspects of the system as it moves into the second round.

Šio darbo tikslas - pagaminti kvapiųjų rozmarinų etanolines ištraukas (tinktūras, skystuosius ekstraktus) ir įvertinti jų kokybę. Darbo uždaviniai:  Remiantis literatūros duomenimis parinkti žaliavos ir ekstrahento santykį bei ištraukų gamybos metodus.  Įvertinti pagamintų ištraukų kokybę, nustatant sauso likučio ir fenolinių junginių kiekį.  Įvertinti technologinių parametrų daromą įtaką veikliųjų medžiagų išsiskyrimui iš žaliavos.  Įvertinti ištraukų antioksidacinį aktyvumą. Bendras fenolinių junginių kiekis rozmarinų tinktūrose ir ekstraktuose nustatytas spektrofotometriniu metodu (spektrofotometras UNICAM Helios α UV, Didžioji Britanija) pagal rozmarino rūgšties standartą. Antioksidacinis aktyvumas nustatytas spektrofotometriškai, panaudojant DPPH• laisvojo radikalo sujungimo metodą. Sausasis rozmarinų etanolinių ištraukų likutis nustatytas drėgnomačiu MLS 50-3HA160. Maišymo įtaka išsiekstrahavusių fenolinių junginių kiekybei nustatyta, naudojant magnetinę maišyklę. Tiriant etanolio koncentracijos įtaką išsiekstrahavusių veikliųjų junginių kiekybei, nustatyta, kad optimalus ekstrahentas yra 50 % etanolis. Tačiau antioksidacinio aktyvumo priklausomybė nuo etanolio koncentracijos yra nežymi. Rezultatai parodė, kad rozmarinų tinktūrų ir skystųjų ekstraktų antioksidacinis aktyvumas nepriklauso nuo vaisto formos. Ištirta, kad sauso likučio ir fenolinių junginių kiekis yra didesni skystuose ekstraktuose lyginant su rozmarinų tinktūromis. Nustatyta, kad brinkinimo laikas... [toliau žr. visą tekstą] / The aim of this research is to make ethanol extracts (tinctures and liquid extracts) of Rosmarinus officinalis and evaluate their quality. The tasks of this research are:  According to the literature, to select proportion of the substance and extractive solvent and select the method of production of ethanol extracts.  To evaluate the quality of produced extracts by fixing the dry residual and phenol compounds.  To evaluate an impact of technologic parameters for the quantity of active compounds.  To evaluate an antioxidative activity of ethanol extracts. The total amount of phenol compounds in tinctures and extracts of Rosmarinus officinalis is estimated spectrophotometrically (spektrophotometer UNICAM Helios α UV, Great Britain). Rosmarinic acid was used as a standart. Antioxidative activity (AA) was determined spectrophotometrically by free radical DPPH• method. The dry residual of ethanol extracts was determined by hygrometer MLS 50-3HA160. The impact of stirring on the quantity of seperated phenol compounds was evaluated by magnetic stirrer. Searching the impact of ethanol concentration on the quantity of seperated active compounds, it‘s evaluated that optimal extractive solvent is 50 % ethanol. However AA dependence on ethanol concentration is low. The findings confirm that AA of tinctures and extracts of Rosmarinus officinalis doesn‘t depend on drug form. It‘s evaluated that the quantity of dry residual and phenol compounds in liquid extracts is more than in... [to full text]

This research is a case study of the quality improvement process in an English further education college. It examines the way that staff involved in the design and operation of the quality system shape the process in a part of the education sector that struggles with issues of performance. The case is placed into the context of an unstable policy environment, where further education colleges have been subjected to frequent bouts of government intervention and a funding regime that is unfavourable when compared to secondary schools and universities. The contribution to knowledge of this thesis is that it addresses an under-researched area of further education by viewing the quality process from the perspective of the governors, managers and professional staff responsible for its design and operation. As such it addresses a problem where a lot of attention has been given to teaching staff who experience the quality process or to macro studies where the focus is on outputs in the sector. However, less attention has been paid to the governors, senior staff and quality teams who assess teaching and learning in colleges. The data for the case study were gathered over a two-year period between 2010-2012 and include interviews with college staff, senior staff from OFSTED and the Department for Business Innovation and Skills and staff from a second college, used to help verify the findings. In addition to this, documentation for the quality system was gathered including inspection documents and policy documents. The data were analysed in order to surface traits of social and organisational practice that address the problem of operating a quality system in an environment that is highly resistant to systemisation and predictability. The findings are presented as 'fuzzy' generalisations supplemented by guidance in the form of design principles. The thesis provides an empirically grounded description of key elements of the relationships and the surrounding sociotechnical system that were found in the case. The design principles augment the case study and provide guidance on how a combination of trust relationships, resilience of processes to disruption and flexibility of application provide a background for the quality improvement process at Stretchford College, which was rated as 'Outstanding' at the time of the research.

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / O presente estudo tem por fim avaliar, sob diversos aspectos, os programas de assentamento agrÃcolas desenvolvidos atualmente no Estado do CearÃ. Tal avaliaÃÃo visa a detectar a efetividade dessas polÃticas pÃblicas na promoÃÃo de avanÃos significativos. A exemplo, na qualidade de vida de seus beneficiÃrios. Para atingir o referido objetivo, foi realizado um levantamento de dados primÃrios, com a aplicaÃÃo de 170 questionÃrios a produtores beneficiÃrios e nÃo beneficiÃrios, nos municÃpios de Russas, Tabuleiro do Norte, Morada Nova e Ibicuitinga. Realizou-se uma extensa revisÃo de literatura, uma detalhada anÃlise tabular complementada pela aplicaÃÃo de testes estatÃsticos tais como t de Student, Qui-quadrado, âUâ de MannâWhitney, entre outros. A anÃlise da efetividade das polÃticas se deu por meio da construÃÃo de Ãndices com dados nÃo pareados e a aplicaÃÃo do modelo Propensity Score Matching, que traz em seu bojo o pareamento dos dados. O estudo resultou numa rica caracterizaÃÃo do perfil socioeconÃmico dos entrevistados e em conclusÃes da anÃlise sem pareamento bastante semelhantes Ãs conclusÃes com pareamento dos dados. Essas apontam a nÃo efetividade das polÃticas em gerar impactos significativos na qualidade de vida, desenvolvimento ambiental, desenvolvimento polÃtico institucional, entre outros, para seus beneficiÃrios em comparaÃÃo com os nÃo contemplados pelas polÃticas. / This study has the goal to evaluate, under many aspects, the agricultural settlement programs presently developed in the State of CearÃ. This evaluation aims to detect the effectiveness of these public politics in the promotion of significant advancement. As an example, in the life quality of their beneficiaries. In order to achieve the aforesaid goal, it was made a research for primary data by the application of 170 questionnaires with beneficiary and non beneficiary rural producers, in the cities of Russas, Tabuleiro do Norte, Morada Nova and Ibicuitinga. It was made an extent revision of the literature, a detailed tabular study complemented by the application of statistic tests such as t Student, Chi-square, âUâ de MannâWhitney, and others. The analysis of political effectiveness was made by the construction of indexes with non matched data and the application of the Propensity Score Matching model, which is based in the matching of data. The study resulted in a rich characterization of the social economic profile of the interviewed and in conclusions of the analyses without matching very similar to the conclusions with data matching. These point to the non effectiveness of the politics in generating significant impacts in life quality, environmental development, politic institutional development, and others, to the beneficiaries when compared to those who are not contemplated by the politics.

A qualidade da assistência médica e dos serviços de saúde é uma questão que nas últimas décadas passou a ser motivo de crescente interesse tanto nos meios científicos e políticos, como na sociedade como um todo. À medida que foram se tornando conhecidos uma grande quantidade de problemas que afetam a prestação de serviços de saúde, a questão da avaliação da qualidade de cuidados médicos passou a ser não apenas um motivo de interesse, mas também uma prioridade entre os responsáveis pela formulação de políticas sociais e de saúde. Enquanto que em vários países a avaliação da qualidade de serviços vem ocorrendo de forma sistemática, no Brasil isso não tem ocorrido, principalmente no que diz respeito à avaliação qualitativa. O estudo desenvolvido nesta tese se propõe a avaliar qualitativamente um serviço ambulatorial de saúde mental. Os principais objetivos deste trabalho são: 1) avaliar o grau de satisfação dos pacientes com o tratamento recebido no serviço estudado; 2) analisar a interrelação entre o processo de prestação de serviços e os resultados finais do tratamento para se avaliar a qualidade da atenção prestada; e 3) determinar o peso que diferentes fatores, tais como processo de prestação de serviço, características individuais dos pacientes, e fatores relacionados à doença, podem ter na determinação de que o resultado final do tratamento possa ser considerado positivo ou negativo. Foram sujeitos deste estudo os pacientes atendidos no Ambulatório de Saúde Mental da Faculdade de Medicina de Botucatu como \"casos novos\" (1a consulta) de Psiquiatria durante os anos de 1989 e 1990, procedentes de Botucatu e São Manoel e portadores dos diagnósticos da \"CID\"-9 (1975) \"Transtornos neuróticos\", \"Reações de ajustamento\" e diagnósticos do \"Código V\" (V.61, V.62 e V.ll). Os dados sobre o tratamento dos pacientes foram coletados das fichas de agendamento de consultas, dos prontuários médicos e de questionários aplicados aos pacientes em entrevistas domiciliares. Dos 1155 pacientes atendidos como \"casos novos\" foram incluídos nesta pesquisa 289 pacientes. Em função dos pacientes que não puderam responder às entrevistas domiciliares, contamos com um total de 211 pacientes dos quais obtivemos informações tanto dos prontuários médicos, como das entrevistas domiciliares. A análise estatística realizada pode ser dividida em duas fases: 1) onde foram obtidas informações através da distribuição de freqüências e associações entre variáveis, e 2), onde foram utilizados métodos de análise multivariada. Em 66.5 por cento dos casos os pacientes referiram sentir-se \"melhor\" como resultado do tratamento recebido, índice bastante similar ao da percepção do médico de \"melhora com o tratamento\" (65,7 por cento). Em 70,1 por cento dos casos os pacientes referiam estar satisfeitos com o tratamento. Neste estudo, as pessoas relacionadas com o tratamento como o médico e funcionários da recepção foram avaliados positivamente enquanto que alguns fatores organizativos foram avaliados mais negativamente. Como em outros estudos, a satisfação geral esteve altamente associada com a percepção de melhora do paciente. Diferentemente de outros trabalhos, neste, a satisfação também esteve fortemente associada à percepção de melhora por parte do médico. São apresentados e discutidos vários aspectos do processo de assistência que estiveram associados aos resultados finais do tratamento. Analisando-se a interrelação de muitas das variáveis do processo com os resultados obtidos, podemos chegar à algumas conclusões \"aproximadas\" sobre a qualidade do serviço, que poderão servir para que se possam tomar ·decisões pragmáticas sobre a organização do serviço, ainda que em última instância não nos permitam responder de forma precisa à pergunta contida em um de nossos objetivos: \"qual foi o nível de qualidade da assistência prestada?\". Isso porque nos faltam critérios e \"standards\" explícitos aplicáveis a nosso meio. O desenvolvimento desses critérios e padrões explícitos de qualidade deveriam ser um objetivo prioritário de futuras pesquisas na área da avaliação qualitativa em Saúde Mental. Com relação ao \"peso que diferentes fatores podem ter na determinação do resultado final do tratamento\", pode-se dizer que algumas características da doença tiveram pouco peso na determinação dos resultados, enquanto que certas características do paciente como sexo e renda per-cápita estiveram associadas de forma significante com os resultados do tratamento. Comentamos com detalhes esses dados, e salientamos que tais achados são válidos no contexto \"deste\" estudo. Além dessas duas características, também descrevemos outras variáveis ligadas ao processo, que estiveram altamente associadas à determinação dos resultados, através da análise multivariada. A \"satisfação com o tratamento\" foi a variável que mais fortemente esteve associada aos resultados finais. Do referido acima poderíamos concluir que atingimos o objetivo de verificarmos em que extensão, certos fatores podem interferir nos resultados finais. Para finalizar, pudemos avaliar o grau de satisfação dos pacientes com o tratamento recebido. Tal avaliação foi de extrema importância nesta pesquisa, no sentido da complementaridade de informações que possibilitou, ao proporcionar a visão subjetiva do usuário que pôde ser somada aos dados obtidos do prontuário. Levando-se em consideração a situação atual das pesquisas qualitativas em nosso meio, sugere-se os estudos na linha da avaliação da satisfação com a assistência recebida sejam os que se mostrem mais factíveis de serem realizados, e em termos de resultados produzidos, poderiam ser tão bons quanto outros métodos para a avaliação da qualidade de serviços de saúde mental. / The interest in the quality of medical care and health services has been an issue that, in the last decades, has grown not only in the scientific and political arenas, but in the society as a whole. As the problems concerning the quality of health care delivery were known, the issue of their evaluation has been not only an issue of interest, but also a priority among the decision makers in the field of social and health policy. While in several countries the evaluation of health services is being sistematically developed, this has not been so in Brazil, and with special emphasis in qualitative evaluation. The aim of this thesis is to develop a qualitative evaluation of a mental health outpatient service. The main objectives of this dissertation are: 1) to evaluate the patients satisfaction level with the treatment that they received in the service; 2) to analyze the relationship between the health care delivery process and the final treatment outcome in order to evaluate the health care delivery quality; and 3) to determine the weight that several factors, such as the health delivery process, the patients individual characteristics, and factors related to the illness, can have in the final positive or negative treatment outcome. The subjects of this study were the patients treated in the outpatient mental health service of the Botucatu Medical School as \"New Patients\" (1st visit) during the years 1989 and 1990, coming from Botucatu and São Manoel Municipalities, and with the ICD-9 (1975) diagnosis \"neurotic disorders\", \"adjustment reactions\" and some \"V Code\" diagnosis (V.61, V.62, V.ll). The patients\' treatment data were collected from the scheduling records, medical records and home interviews applied to the patients. Among the 1155 patients that were examined as \"new patients\" 289 were included. From these, we obtained data from both, home interviews and the medical record with a final total of 211 patients. The statistical analysis can be divided into two phases: 1) when the information was obtained from the frequency distribution and correlations among variables, and 2) from multivariate analysis techniques. From all the patients, 66.5 per cent of them said to feel \"better\" after receiving treatment, a percentage quite similar to that o f the physician\'s perception of \"improvement with the treatment\" (65.7 per cent). In 70,1 per cent of the cases the patients said to be satisfied with the treatment. In our case, while people related with treatment such as the physicians and the reception employees were positively evaluated, some organizational factors related to the service were evaluated negatively. As in other studies, the overall satisfaction was highly correlated to the patients\' perception of improvement. Contrary to other studies, in this one, satisfaction was also highly correlated to the perception of improvement by the physician. Several aspects of the health delivery process related to treatment outcomes are presented and discussed. Analysing the relationship of several process variables with the outcomes, we obtained some conclusions about the service quality. These conclusions can be used to make decisions about the service organization, although these cannot be used to answer in a strict sense the question: \"what was the quality level of health care achieved?\". This is due to the lack of explicit crieteria and standards that can be used in our cultural context. The development of these explicit crieteria should be a prioritary goal of further research in the area of quality evaluation in mental health care. With regards to the \"weight that different factors can have in the treatment outcome\", while some illnesses\' characteristics had a relatively low weight in the outcome, some patients characteristics such as sex and personal income were highly weighted. These results are extensively presented, and we stress that our conclusions are valid within the context of this study. Besides these two characteristics, we also describe other variables related to the process that we found to be highly related to the outcome using multivariate analysis. The \"treatment satisfaction\" was the most significant variable related to the final outcome. From these results we concluded that the objective of verifying that some factors can interfere in the final results has been achieved. Finally, we were able to fully evaluate the patients\' satisfaction level with the treatment received. Such evaluation was quite important for our research, because the subjective point of view of the patient provided complementary information to the data obtained from medical records. If we take into account the actual state of the art of the research on quality in our country, possibly the studies based on the evaluation of patients\' satisfaction with the treatment received are the most feasible and, in terms of the results obtained, as good as other methods of mental health service quality valuation.

A qualidade da assistência médica e dos serviços de saúde é uma questão que nas últimas décadas passou a ser motivo de crescente interesse tanto nos meios científicos e políticos, como na sociedade como um todo. À medida que foram se tornando conhecidos uma grande quantidade de problemas que afetam a prestação de serviços de saúde, a questão da avaliação da qualidade de cuidados médicos passou a ser não apenas um motivo de interesse, mas também uma prioridade entre os responsáveis pela formulação de políticas sociais e de saúde. Enquanto que em vários países a avaliação da qualidade de serviços vem ocorrendo de forma sistemática, no Brasil isso não tem ocorrido, principalmente no que diz respeito à avaliação qualitativa. O estudo desenvolvido nesta tese se propõe a avaliar qualitativamente um serviço ambulatorial de saúde mental. Os principais objetivos deste trabalho são: 1) avaliar o grau de satisfação dos pacientes com o tratamento recebido no serviço estudado; 2) analisar a interrelação entre o processo de prestação de serviços e os resultados finais do tratamento para se avaliar a qualidade da atenção prestada; e 3) determinar o peso que diferentes fatores, tais como processo de prestação de serviço, características individuais dos pacientes, e fatores relacionados à doença, podem ter na determinação de que o resultado final do tratamento possa ser considerado positivo ou negativo. Foram sujeitos deste estudo os pacientes atendidos no Ambulatório de Saúde Mental da Faculdade de Medicina de Botucatu como \"casos novos\" (1a consulta) de Psiquiatria durante os anos de 1989 e 1990, procedentes de Botucatu e São Manoel e portadores dos diagnósticos da \"CID\"-9 (1975) \"Transtornos neuróticos\", \"Reações de ajustamento\" e diagnósticos do \"Código V\" (V.61, V.62 e V.ll). Os dados sobre o tratamento dos pacientes foram coletados das fichas de agendamento de consultas, dos prontuários médicos e de questionários aplicados aos pacientes em entrevistas domiciliares. Dos 1155 pacientes atendidos como \"casos novos\" foram incluídos nesta pesquisa 289 pacientes. Em função dos pacientes que não puderam responder às entrevistas domiciliares, contamos com um total de 211 pacientes dos quais obtivemos informações tanto dos prontuários médicos, como das entrevistas domiciliares. A análise estatística realizada pode ser dividida em duas fases: 1) onde foram obtidas informações através da distribuição de freqüências e associações entre variáveis, e 2), onde foram utilizados métodos de análise multivariada. Em 66.5 por cento dos casos os pacientes referiram sentir-se \"melhor\" como resultado do tratamento recebido, índice bastante similar ao da percepção do médico de \"melhora com o tratamento\" (65,7 por cento). Em 70,1 por cento dos casos os pacientes referiam estar satisfeitos com o tratamento. Neste estudo, as pessoas relacionadas com o tratamento como o médico e funcionários da recepção foram avaliados positivamente enquanto que alguns fatores organizativos foram avaliados mais negativamente. Como em outros estudos, a satisfação geral esteve altamente associada com a percepção de melhora do paciente. Diferentemente de outros trabalhos, neste, a satisfação também esteve fortemente associada à percepção de melhora por parte do médico. São apresentados e discutidos vários aspectos do processo de assistência que estiveram associados aos resultados finais do tratamento. Analisando-se a interrelação de muitas das variáveis do processo com os resultados obtidos, podemos chegar à algumas conclusões \"aproximadas\" sobre a qualidade do serviço, que poderão servir para que se possam tomar ·decisões pragmáticas sobre a organização do serviço, ainda que em última instância não nos permitam responder de forma precisa à pergunta contida em um de nossos objetivos: \"qual foi o nível de qualidade da assistência prestada?\". Isso porque nos faltam critérios e \"standards\" explícitos aplicáveis a nosso meio. O desenvolvimento desses critérios e padrões explícitos de qualidade deveriam ser um objetivo prioritário de futuras pesquisas na área da avaliação qualitativa em Saúde Mental. Com relação ao \"peso que diferentes fatores podem ter na determinação do resultado final do tratamento\", pode-se dizer que algumas características da doença tiveram pouco peso na determinação dos resultados, enquanto que certas características do paciente como sexo e renda per-cápita estiveram associadas de forma significante com os resultados do tratamento. Comentamos com detalhes esses dados, e salientamos que tais achados são válidos no contexto \"deste\" estudo. Além dessas duas características, também descrevemos outras variáveis ligadas ao processo, que estiveram altamente associadas à determinação dos resultados, através da análise multivariada. A \"satisfação com o tratamento\" foi a variável que mais fortemente esteve associada aos resultados finais. Do referido acima poderíamos concluir que atingimos o objetivo de verificarmos em que extensão, certos fatores podem interferir nos resultados finais. Para finalizar, pudemos avaliar o grau de satisfação dos pacientes com o tratamento recebido. Tal avaliação foi de extrema importância nesta pesquisa, no sentido da complementaridade de informações que possibilitou, ao proporcionar a visão subjetiva do usuário que pôde ser somada aos dados obtidos do prontuário. Levando-se em consideração a situação atual das pesquisas qualitativas em nosso meio, sugere-se os estudos na linha da avaliação da satisfação com a assistência recebida sejam os que se mostrem mais factíveis de serem realizados, e em termos de resultados produzidos, poderiam ser tão bons quanto outros métodos para a avaliação da qualidade de serviços de saúde mental. / The interest in the quality of medical care and health services has been an issue that, in the last decades, has grown not only in the scientific and political arenas, but in the society as a whole. As the problems concerning the quality of health care delivery were known, the issue of their evaluation has been not only an issue of interest, but also a priority among the decision makers in the field of social and health policy. While in several countries the evaluation of health services is being sistematically developed, this has not been so in Brazil, and with special emphasis in qualitative evaluation. The aim of this thesis is to develop a qualitative evaluation of a mental health outpatient service. The main objectives of this dissertation are: 1) to evaluate the patients satisfaction level with the treatment that they received in the service; 2) to analyze the relationship between the health care delivery process and the final treatment outcome in order to evaluate the health care delivery quality; and 3) to determine the weight that several factors, such as the health delivery process, the patients individual characteristics, and factors related to the illness, can have in the final positive or negative treatment outcome. The subjects of this study were the patients treated in the outpatient mental health service of the Botucatu Medical School as \"New Patients\" (1st visit) during the years 1989 and 1990, coming from Botucatu and São Manoel Municipalities, and with the ICD-9 (1975) diagnosis \"neurotic disorders\", \"adjustment reactions\" and some \"V Code\" diagnosis (V.61, V.62, V.ll). The patients\' treatment data were collected from the scheduling records, medical records and home interviews applied to the patients. Among the 1155 patients that were examined as \"new patients\" 289 were included. From these, we obtained data from both, home interviews and the medical record with a final total of 211 patients. The statistical analysis can be divided into two phases: 1) when the information was obtained from the frequency distribution and correlations among variables, and 2) from multivariate analysis techniques. From all the patients, 66.5 per cent of them said to feel \"better\" after receiving treatment, a percentage quite similar to that o f the physician\'s perception of \"improvement with the treatment\" (65.7 per cent). In 70,1 per cent of the cases the patients said to be satisfied with the treatment. In our case, while people related with treatment such as the physicians and the reception employees were positively evaluated, some organizational factors related to the service were evaluated negatively. As in other studies, the overall satisfaction was highly correlated to the patients\' perception of improvement. Contrary to other studies, in this one, satisfaction was also highly correlated to the perception of improvement by the physician. Several aspects of the health delivery process related to treatment outcomes are presented and discussed. Analysing the relationship of several process variables with the outcomes, we obtained some conclusions about the service quality. These conclusions can be used to make decisions about the service organization, although these cannot be used to answer in a strict sense the question: \"what was the quality level of health care achieved?\". This is due to the lack of explicit crieteria and standards that can be used in our cultural context. The development of these explicit crieteria should be a prioritary goal of further research in the area of quality evaluation in mental health care. With regards to the \"weight that different factors can have in the treatment outcome\", while some illnesses\' characteristics had a relatively low weight in the outcome, some patients characteristics such as sex and personal income were highly weighted. These results are extensively presented, and we stress that our conclusions are valid within the context of this study. Besides these two characteristics, we also describe other variables related to the process that we found to be highly related to the outcome using multivariate analysis. The \"treatment satisfaction\" was the most significant variable related to the final outcome. From these results we concluded that the objective of verifying that some factors can interfere in the final results has been achieved. Finally, we were able to fully evaluate the patients\' satisfaction level with the treatment received. Such evaluation was quite important for our research, because the subjective point of view of the patient provided complementary information to the data obtained from medical records. If we take into account the actual state of the art of the research on quality in our country, possibly the studies based on the evaluation of patients\' satisfaction with the treatment received are the most feasible and, in terms of the results obtained, as good as other methods of mental health service quality valuation.

Research object: information systems for accounting data processing. Research aim: to analyse the aspects, criteria and indices of the quality of integrated accounting data processing and to evaluate the quality of integrated data processing in four information systems of accounting data processing. Objectives: • To analyze the theoretical aspects of integrated accounting data. • To analyze the types of information systems used for accounting data processing. • To choose the methods for the quality analysis of information systems of integrated data processing and to form evaluation system of criteria. • To choose the matrices of information systems of integrated data processing indices and to identify their meaning. • To determine the meanings of indices of the four information systems of integrated accounting data processing and evaluate their ability to manage data. Research methods: monographic, comparing, logical analysis and generalization, data analysis and systemizing, graphical representation, observing, questionnaire, statistic managing of data, evaluation, generalizing and other scientific research methods. After the analysis of foreign and Lithuanian references, the conception of integrated accounting data processing was defined and the evaluation aspects were determined. The model of evaluation of integrated data processing quality has also been created. The system of criteria and indices was created and the methods of denoting the meaning were chosen. On the... [to full text]

La qualité de l’enseignement supérieur en Afrique est une notion très évoquée, pour en relever la dégradation, ou la nécessité d’en voir pourvus les institutions et systèmes d’enseignement.Pourtant le cadre de la transposition du processus de Bologne interroge quant au contenu et à la pertinence de cette notion dans nos pays.Au plan théorique, en rappelant l’importance de l’enseignement supérieur dans le développement socio-économique, puis le contexte de création du processus de Bologne, ainsi que l’analyse de ses principaux textes, nous avons souligné les conditions de déroulement de la transposition du processus de Bologne dans l’enseignement supérieur. Nous terminons cette partie en disséquant l’aspect de la qualité dans l’enseignement supérieur, ainsi que son évaluation en Europe et dans le monde.Dans cette étude, en approchant les acteurs de l’enseignement supérieur, par les méthodes d’entretien et de questionnaires, nous tentons de mettre en lumière la notion de la qualité et son évaluation selon le point de vue de ceux-ci. Ce sont principalement les universités publiques et l’INP-HB qui ont constitué notre terrain d’étude.Les résultats de l’étude nous montrent une qualité de l’enseignement supérieur, en particulier avec les intrants (compétences des enseignants, infrastructures et équipements) comme principales caractéristiques mais également l’insertion professionnelle et l’employabilité, marqueurs de cette qualité. / The quality of Higher Education in Africa is a very evocated word, to say its fallings or the need to see institutions and education systems with it. However, the framework of Bologna Process transposition questions about content and relevance of this notion in our countries.From the theoretical viewpoint, remembering the importance of Higher Education in socio-economic growing, then the context of Bologna Process creation, as well as the analysis of Bologna mains texts, we emphasize the circumstances of Bologna Process transposition in Higher Education. We complete this part dissecting the issue of quality in Higher Education, as well as its assessment in Europe and in the world.In this study, approaching higher education stakeholders, with interviews and questionnaires, we try to put the light on this issue and its assessment according to their view points. It’s mainly the public’s universities and INP-HB, our ground studies.Results shows us a quality of Higher Education, in particular with entrants (teacher’s abilities, infrastructures and equipment’s) as mains characteristics but equally the professional insertion and employability, clue of this quality

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study aimed to evaluate the quality of the Family Health Strategy (ESF) through the measurement of users' satisfaction regarding services provided by the program , seeking to identify the link between satisfaction and perceived quality of services by program staff . For this purpose, questionnaires were based on SERVQUAL Scale, which has as a feature comparison between the expectations of the client with regard to provision of service and their perception on it. Thus, this research used the case study method, characterizing it as a descriptive study with cross sectional and quantitative approach. The study was conducted with 606 users of the ESF and 39 professionals from the Health Teams in five units of the ESF in Santa Maria-RS. The data from the application of the SERVQUAL Scale adjusted result showed a negative evaluation of the ESF for both actors: the users show up unhappy and professionals characterized as unacceptable the quality of services. It is important to emphasize that no point was assessed as satisfactory or excellent quality by the actors. However, note that the professionals assigned to all the issues, values higher than those reported by characterizing users, therefore, a slightly better evaluation of officials. This study also identified points of improvement in the environment studied, contributing to the practices currently used by the ESF in the provision of its services are reviewed and reconsidered, using the issues identified here as guiding actions of improvement. / A presente pesquisa teve como objetivo avaliar a qualidade da Estratégia Saúde da Família (ESF) através da mensuração da satisfação dos usuários em relação aos serviços prestados pelo Programa , buscando identificar a relação existente entre esta satisfação e a percepção da qualidade dos serviços pelos funcionários do Programa . Para tal, utilizaram-se questionários baseados na Escala SERVQUAL, que apresenta como característica a comparação entre as expectativas do cliente com relação à prestação do serviço e a sua percepção sobre o mesmo. Dessa forma, a presente pesquisa utilizou o método de estudo de caso, caracterizando-se como uma pesquisa descritiva, com corte transversal e abordagem quantitativa. O estudo foi desenvolvido junto a 606 usuários da ESF e 39 profissionais pertencentes às Equipes de Saúde em cinco unidades da ESF no município de Santa Maria-RS. Os dados provenientes da aplicação da Escala SERVQUAL adaptada mostram como resultado uma avaliação negativa da ESF por ambos os atores: os usuários mostram-se insatisfeitos e os profissionais caracterizam como inaceitável a qualidade dos serviços. Torna-se importante destacar que nenhum ponto foi avaliado como satisfatório ou de qualidade excelente pelos atores. Porém, nota-se que os profissionais atribuíram, em todas as questões, valores superiores aos informados pelos usuários caracterizando, portanto, uma avaliação ligeiramente melhor dos funcionários. Este estudo possibilitou identificar pontos de melhoria no ambiente pesquisado, contribuindo para que as práticas utilizadas atualmente pela ESF na prestação de seus serviços sejam analisadas e repensadas, utilizando os aspectos aqui identificados como norteadores de ações de melhoria.

There is a growing research interest into investigating why NICE (National Institute for Health and Care Excellence) guidelines are not consistently followed in UK mental health services. The current study utilised grounded theory methodology to investigate clinical psychologists’ use of NICE guidelines. Eleven clinical psychologists working in routine practice in the NHS were interviewed. A theoretical framework was produced conceptualising the participants’ beliefs, decision making processes and clinical practices. The overall emerging theme was “considering NICE guidelines to have benefits but to be fraught with dangers”. Participants were concerned that guidelines can create an unhelpful illusion of neatness. They managed the tension between the helpful and unhelpful aspects of guidelines by relating to them in a flexible manner. The participants reported drawing on specialist skills such as idiosyncratic formulation and integration. However, as a result of pressure, and also the rewards that follow from being seen to comply with NICE guidelines, they tended to practice in ways that prevent these skills from being recognised. This led to fears that their professional identity was threatened, which impacted upon perceptions of the guidelines. This is the first theoretical framework that attempts to explain why NICE guidelines are not consistently utilised in UK mental health services. Attention is drawn to the proposed benefits and limitations of guidelines and how these are managed. This study highlights the importance of clinical psychologists articulating and advertising their specialist skills. The findings are integrated with existing theory and research, and clinical and research implications are presented.