O mundo privado na UTI: análise da internação de pacientes oncológicos / The private world in the ICU: analysis of the hospitalization of oncology patientes / El mundo privado en la UCI: análisis de la hospitalización de pacientes oncológicos

O presente estudo buscou investigar a percepção que pacientes adultos de uma unidade de terapia intensiva (UTI) oncológica têm acerca da experiência de internação nesse setor. Trata-se de uma pesquisa de abordagem qualitativa e de compreensão. Sete pacientes de um hospital de câncer na região Sul do país foram pesquisados. Eles responderam a uma entrevista semiestruturada, a qual foi gravada e posteriormente transcrita, o que possibilitou o acesso às concepções prévias desses sujeitos acerca da UTI, aspectos psicológicos presentes durante a internação e concepções posteriores à experiência de internamento na unidade. Tais informações foram interpretadas por meio da análise de conteúdo. A partir dos resultados, foi possível verificar que a experiência de internação em contextos de terapia intensiva pode ser afetada, favorável ou desfavoravelmente, pelo conjunto de regras que o paciente traz consigo acerca do que é a UTI. Além disso, foi possível compreender também que os estímulos aversivos existentes nesse ambiente podem ser atenuados pela presença da família e por uma relação acolhedora e sensível com a equipe de saúde, favorecendo, assim, o repertório de enfrentamento do paciente frente a esse momento crítico de saúde.(AU)

This study aims to investigate the perception of adult patients in an oncology intensive care unit (ICU) regarding the experience of hospitalization in this sector. This is a research with a qualitative approach and understanding. Seven patients from a cancer hospital in the southern region of the country were surveyed. They answered a semi-structured interview, which was recorded and later transcribed, on the subjects' previous conceptions about the ICU, psychological aspects present during hospitalization, and conceptions subsequent to the hospitalization experience in the Unit. Such information was interpreted through content analysis. From the results, it was possible to verify that the experience of hospitalization in intensive care contexts can be affected, favorably or unfavorably, by the set of rules that the patient brings with them about what the ICU is. In addition, it was also possible to understand that the aversive stimulus existing in this environment can be attenuated by the presence of the family and by a welcoming and sensitive relationship with the health team, thus favoring the patient's coping repertoire when facing a critical moment of health.(AU)

Este estudio pretendió investigar la percepción que tienen los pacientes adultos sobre la experiencia de hospitalización en una Unidad de Cuidados Intensivos (UCI) de oncología. Se trata de una investigación con enfoque cualitativo y de comprensión. Participaron siete pacientes de un hospital oncológico en la región Sur de Brasil. Se aplicó una entrevista semiestructurada, que fue grabada y, posteriormente, transcrita, lo que permitió acceder a las concepciones previas de los sujetos sobre la UCI, los aspectos psicológicos presentes durante la hospitalización y las concepciones posteriores a la experiencia de internación en la Unidad. Dicha información se interpretó mediante análisis de contenido. A partir de los resultados, fue posible constatar que la experiencia de hospitalización en cuidados intensivos puede ser afectada favorable o desfavorablemente por el conjunto de normas que el paciente trae consigo sobre qué es la UTI. Además, se constató que los estímulos adversos existentes en este ambiente pueden mitigarse mediante la presencia de la familia y la relación acogedora y sensible con el equipo de salud, lo que favorece así el repertorio de afrontamiento del paciente ante este momento crítico de salud.(AU)

Plataformização e o uso da informação para a criação de estímulos de consumo / Platformization and the use of information for the creation of consumption response / La plataformización y el uso de la información para crear estímulos al consumidor

Resumo Vivemos numa sociedade em que a existência está diretamente associada a visibilidade dos indivíduos. As construções narrativas que validam este processo trabalham com imagens e vídeos que projetam e constroem as nossas vivências em múltiplas plataformas digitais. Através delas é possível mapear boa parte de nossas ações e interações. Esses dados são valiosos indicativos de nosso comportamento social e emocional diante de variados temas e situações. As plataformas digitais utilizam essas informações na dinâmica do capitalismo de dados, extraindo valor a partir de mecanismos automatizados de coleta e operados por sujeitos algorítmicos. Por meio da organização de Big Data novos padrões de consumo são estimulados através de entregas customizadas para determinados grupos de pessoas interconectadas. Este estudo mostra as características deste processo operado em ambientes heterotópicos em que o espaço-tempo é formatado pela lógica das plataformas. Além disso, será apresentado um panorama sobre como esse artifício se tornou possível por causa da necessidade de relevância em que a autonomia do indivíduo nas redes é proporcional a sua submissão as regras de vigilância e exploração econômica. Através desta premissa este estudo apresenta dados recentes sobre a relação de confiança dos brasileiros nestas plataformas digitais que, paradoxalmente, ocupam lugar de destaque como fonte de informação primordial para boa parte da população no Brasil.

Abstract We live in a society in which the existence is directly associated with the visibility of the individuals. The narrative constructions that validate these processes work with images and videos that project and build our experiences on multiple digital platforms. Through them it is possible to map part of our actions and interactions. These data are valuable indicators of our social and emotional behavior in the face of many themes and situations. Digital platforms use this information in the dynamic of data capitalism, extracting value from automated collection mechanisms operated by algorithmic subjects. Through the Big Data organization, consumption patterns are stimulated through customized deliveries for certain groups of interconnected people. This study shows the characteristics of this process operated in heterotopic environments in which space-time is operated by the platform logic. In addition to that, an overview will be presented on how this artifice became possible because of the need for relevance in which the individuals autonomy in networks is proportional to their submission to the rules of surveillance and economic exploitation. Through this premise, this study also presents recent data on the trust relationship of Brazilians in these digital platforms that, paradoxically, occupy a prominent place as a primary source of information for a large part of the population in Brazil.

Resumen Vivimos en una sociedad en la que la existencia está directamente asociada a la visibilidad de los individuos. Las construcciones narrativas que validan este proceso funcionan con imágenes y vídeos que proyectan y construyen nuestras experiencias en múltiples plataformas digitales. A través de ellos es posible mapear la mayoría de nuestras acciones e interacciones. Estos datos son valiosos indicadores de nuestro comportamiento social y emocional ante diversos temas y situaciones. Las plataformas digitales utilizan esta información en la dinámica del capitalismo de datos, extrayendo valor de los mecanismos de recogida automatizada operados por sujetos algorítmicos. A través de la organización de Big Data se estimulan nuevos patrones de consumo mediante entregas personalizadas a determinados grupos de personas interconectadas. Este estudio muestra las características de este proceso operado en entornos heterotópicos en los que el espacio-tiempo está formateado por la lógica de las plataformas. Además, se presentará una visión general de cómo este artificio fue posible debido a la necesidad de relevancia en la que la autonomía del individuo en las redes es proporcional a su sometimiento a las reglas de vigilancia y explotación económica. A través de esta premisa, este estudio presenta datos recientes sobre la relación de confianza de los brasileños en estas plataformas digitales que, paradójicamente, ocupan un lugar destacado como fuente primaria de información para gran parte de la población en Brasil.

NLM and the IAIMS Initiative: Cross-Institutional Academic/Advanced Systems Contributing to the Evolution of Networked Information and Resources.

The Integrated Academic/Advanced Information Systems (IAIMS) program began in 1983 and was based on a study by the Association of American Medical Colleges (AAMC). Donald A.B. Lindberg M.D. was a member of the AAMC Advisory Committee. The U.S. National Library of Medicine (NLM) grants for IAIMS were initiated in 1984 the same year Dr. Lindberg became Director of the NLM. This chapter presents an overview of IAIMS and its progression through three stages with Dr. Lindberg's leadership.

Norma técnica de salud para la gestión de la historia clínica / Technical health standard for the management of medical records

La norma los procedimientos para la gestión de la Historia Clínica, a fin de contribuir a mejorar la calidad de atención a los usuarios de los servicios de salud, a través de un adecuado manejo, conservación y eliminación de las Historias Clínicas, así como a proteger los intereses legales de los usuarios, del personal de la salud y de las Instituciones Prestadoras de Servicios de Salud - IPRESS del Sector Salud.

Applied immuno-epidemiological research: an approach for integrating existing knowledge into the statistical analysis of multiple immune markers.

BACKGROUND: Immunologists often measure several correlated immunological markers, such as concentrations of different cytokines produced by different immune cells and/or measured under different conditions, to draw insights from complex immunological mechanisms. Although there have been recent methodological efforts to improve the statistical analysis of immunological data, a framework is still needed for the simultaneous analysis of multiple, often correlated, immune markers. This framework would allow the immunologists' hypotheses about the underlying biological mechanisms to be integrated. RESULTS: We present an analytical approach for statistical analysis of correlated immune markers, such as those commonly collected in modern immuno-epidemiological studies. We demonstrate i) how to deal with interdependencies among multiple measurements of the same immune marker, ii) how to analyse association patterns among different markers, iii) how to aggregate different measures and/or markers to immunological summary scores, iv) how to model the inter-relationships among these scores, and v) how to use these scores in epidemiological association analyses. We illustrate the application of our approach to multiple cytokine measurements from 818 children enrolled in a large immuno-epidemiological study (SCAALA Salvador), which aimed to quantify the major immunological mechanisms underlying atopic diseases or asthma. We demonstrate how to aggregate systematically the information captured in multiple cytokine measurements to immunological summary scores aimed at reflecting the presumed underlying immunological mechanisms (Th1/Th2 balance and immune regulatory network). We show how these aggregated immune scores can be used as predictors in regression models with outcomes of immunological studies (e.g. specific IgE) and compare the results to those obtained by a traditional multivariate regression approach. CONCLUSION: The proposed analytical approach may be especially useful to quantify complex immune responses in immuno-epidemiological studies, where investigators examine the relationship among epidemiological patterns, immune response, and disease outcomes.

Mechanisms and mediation in survival analysis: towards an integrated analytical framework.

BACKGROUND: A wide-ranging debate has taken place in recent years on mediation analysis and causal modelling, raising profound theoretical, philosophical and methodological questions. The authors build on the results of these discussions to work towards an integrated approach to the analysis of research questions that situate survival outcomes in relation to complex causal pathways with multiple mediators. The background to this contribution is the increasingly urgent need for policy-relevant research on the nature of inequalities in health and healthcare. METHODS: The authors begin by summarising debates on causal inference, mediated effects and statistical models, showing that these three strands of research have powerful synergies. They review a range of approaches which seek to extend existing survival models to obtain valid estimates of mediation effects. They then argue for an alternative strategy, which involves integrating survival outcomes within Structural Equation Models via the discrete-time survival model. This approach can provide an integrated framework for studying mediation effects in relation to survival outcomes, an issue of great relevance in applied health research. The authors provide an example of how these techniques can be used to explore whether the social class position of patients has a significant indirect effect on the hazard of death from colon cancer. RESULTS: The results suggest that the indirect effects of social class on survival are substantial and negative (-0.23 overall). In addition to the substantial direct effect of this variable (-0.60), its indirect effects account for more than one quarter of the total effect. The two main pathways for this indirect effect, via emergency admission (-0.12), on the one hand, and hospital caseload, on the other, (-0.10) are of similar size. CONCLUSIONS: The discrete-time survival model provides an attractive way of integrating time-to-event data within the field of Structural Equation Modelling. The authors demonstrate the efficacy of this approach in identifying complex causal pathways that mediate the effects of a socio-economic baseline covariate on the hazard of death from colon cancer. The results show that this approach has the potential to shed light on a class of research questions which is of particular relevance in health research.

Dispositivo móvel para registro eletrônico multiprofissional do atendimento pré-hospitalar no SAMU / A mobile device application for the use of multidisplinary eletronic records by SAMU's first responders

OBJETIVOS: Descrever o processo de desenvolvimento de software para registro de informações multiprofissionais relevantes sobre os diferentes casos traumáticos e não traumáticos que podem ser atendidos e desenvolver um registro único para a equipe pré-hospitalar móvel de suporte avançado. MÉTODOS: Desenvolvimento de aplicativo para dispositivos móveis utilizando várias ferramentas de informática com requisitos levantados por meio de material disponibilizado em fichas e das entrevistas com equipe multiprofissional (médico, enfermeiro e condutor). RESULTADOS: Foi definido um conjunto de informações que abrangem dados a serem preenchidos pela equipe multiprofissional, bem como requisitos que foram implementados para suprir a necessidade dos profissionais em saúde, auxiliando com melhorias sobre como o registro em saúde é realizado através de uma organização de maneira lógica e sequencial para facilitar seu entendimento. CONCLUSÃO: Através deste estudo foi possível integrar atividades de diferentes profissionais do atendimento pré-hospitalar móvel com um sistema único de registro de informações em saúde.

OBJECTIVES: To describe the procedure of software development in order to store relevant information for a multidisciplinary team, which consists of doctors, nurses and ambulance`s operators who work with various traumatic and non-traumatic cases and to develop accessible records for the first responder team. METHODS: Applications (apps)development for mobile devices using computing software with its requirements acquired from data available on file sand interviews with the multidisciplinary team. RESULTS: A data set that need to be completed by the multidisciplinary team was defined as well as the requirements that have been implemented in order to supply the needs of health professionals, offering improvements on how the health records are usually accomplished throughout a logical and sequential system facilitating the service. CONCLUSION: It was possible to integrate different professional activities of the first responder swith a unique system to record health related information.

Diseño de un sistema de gestión documental para organizaciones cubanas / Design of a document management system for Cuban organizations

Proponer el diseño de un sistema de gestión documental para organizaciones cubanas, en el territorio de Camagüey, teniendo en cuenta la importancia de la conservación del patrimonio documental en las organizaciones. Métodos: se incluyeron como muestra 42 empresas del territorio camagüeyano que se encuentran en perfeccionamiento empresarial. Se aplicaron encuestas para evaluar la situación sobre el dominio y el conocimiento de la gestión documental en estas organizaciones. Resultados: los datos obtenidos en las encuestas aplicadas en las diferentes entidades empresariales sirvieron de base para desarrollar la propuesta del sistema de gestión documental, el cual se realizó a partir de la programación de 4 etapas, donde se definieron los objetivos a alcanzar en cada una de ellas. Conclusiones: el sistema de gestión documental diseñado cumple con las normas internacionales y con los requisitos establecidos en el decreto ley 265, que establece las disposiciones generales para la protección del patrimonio documental de la nación...

Propose the design of a documentary management system for Cuban organizations in the territory of Camagüey, bearing in mind the importance of the preservation of the documentary heritage in the organizations. Methods: the sample was composed of 42 organizations undergoing enterprise improvement in the territory of Camagüey. Surveys were applied to evaluate the current status of knowledge about and command of document management in these organizations. Results: the data obtained from the surveys applied in the various enterprises served as basis for developing the proposal of document management system, which was structured into four stages with specific objectives defined for each of them. Conclusions: the document management system designed complies with international standards and the requirements included in Decree Law 265, where general provisions are established for the protection of the country's documentary heritage...

Criterios, clasificaciones y tendencias de los indicadores bibliométricos en la evaluación de la ciencia / Criteria, classifications and tendencies of bibliometric indicators in the evaluation of the science

El presente trabajo se realiza con el objetivo de enunciar los referentes teóricos sobre clasificación de indicadores bibliométricos en la literatura científica a partir de criterios, clasificaciones y tendencias que se manifiestan en el contexto internacional. Se enfatiza en el desarrollo de los indicadores de impacto en los sistemas de información científica a través de valoraciones respecto al uso del factor de impacto y sus derivados, así como en la normalización y ponderación matemática para establecer comparación entre diferentes disciplinas científicas. Se abordan conceptualmente las nuevas tendencias de la medición del impacto científico en la Web: los llamados altmetrics...

The objective of this work is to state the theoretical framework about the classification of bibliometric indicators in the scientific literature from the criteria, classifications and trends emerging in the international context. The emphasis is on the development of impact indicators in systems of scientific information through assessments regarding the use of impact factor and its derivatives, as well as standardization and mathematical weighting to establish comparisons between different scientific disciplines. New trends to measure the scientific impact on the Web, called almetrics, are conceptually addressed...

NoSQL data model for semi-automatic integration of ethnomedicinal plant data from multiple sources.

INTRODUCTION: Sharing traditional knowledge with the scientific community could refine scientific approaches to phytochemical investigation and conservation of ethnomedicinal plants. As such, integration of traditional knowledge with scientific data using a single platform for sharing is greatly needed. However, ethnomedicinal data are available in heterogeneous formats, which depend on cultural aspects, survey methodology and focus of the study. Phytochemical and bioassay data are also available from many open sources in various standards and customised formats. OBJECTIVE: To design a flexible data model that could integrate both primary and curated ethnomedicinal plant data from multiple sources. MATERIALS AND METHODS: The current model is based on MongoDB, one of the Not only Structured Query Language (NoSQL) databases. Although it does not contain schema, modifications were made so that the model could incorporate both standard and customised ethnomedicinal plant data format from different sources. RESULTS: The model presented can integrate both primary and secondary data related to ethnomedicinal plants. Accommodation of disparate data was accomplished by a feature of this database that supported a different set of fields for each document. It also allowed storage of similar data having different properties. CONCLUSION: The model presented is scalable to a highly complex level with continuing maturation of the database, and is applicable for storing, retrieving and sharing ethnomedicinal plant data. It can also serve as a flexible alternative to a relational and normalised database.

Produção científica da área da saúde sobre a sexualidade humana / Health scientific production on human sexuality

Embasamento: A sexualidade humana é frequentemente tratada de forma limitada na formação acadêmica, prejudicando a construção do conhecimento. A análise da produção científica facilita a compreensão da identidade da área de pesquisa e aponta perspectivas futuras. Objetivo: analisar a produção científica da área da saúde sobre sexualidade humana e discutir focos de atenção e lacunas de conhecimento. Método: três bases de dados eletrônicas foram consultadas: LILACS, SCIELO e PUBMED, utilizando-se os descritores “conhecimento/knowledge”, “atitude/attitude”, “conforto/confort” e “formação acadêmica/curriculum”. Todos esses foram combinados com o termo “sexualidade humana”. Incluíram-se artigos científicos publicados em inglês e português no período entre 2000 e 2010. Resultados: Selecionaram-se 20 artigos dos 2.022 analisados. Do total, 50% foram escritos na área da enfermagem, 45% eram da área de medicina e 5% da Terapia Ocupacional. Dentre os artigos analisados, 65% foram publicados em inglês e 35% em português. Conclusão : Enfermagem e medicina produzem maior número de artigos relacionados à sexualidade humana. Apesar de maior parte dos artigos analisados terem sido produzidos fora do Brasil, o País vem aumentando sua produção, demonstrando crescente preocupação por uma área que cada vez mais evidencia sua importância na prática clínica do profissional da área da saúde...

Background: Human sexuality is often treated in a limited way during academic formation, harming knowledge building. The analysis of scientific production facilitates the understanding of the identity of the research field and points the way forward. Objective: To analyze health scientific production on human sexuality and discuss foci of attention and knowledge gaps. Method: Three electronic databases were consulted: LILACS, PUBMED, SCIELO; and using the keywords “knowledge”, “attitude”, “comfort” and “curriculum” in Portuguese and english. All these were combined with the term “human sexuality”. It included papers published in English and Portuguese in the period between 2000 and 2010. Results: We selected 20 articles from 2022 analyzed. Of the total 50% came from nursing, 45% from medicine and 5% from occupational therapy. 65% of the analyzed articles were published in English and 35% in Portuguese. Conclusion : nursing and medicine produce the largest number of articles related to human sexuality. Although most of the articles analyzed were produced outside of Brazil, the country is increasing its production, showing a growing concern over an area that more and more reveals its importance in health professionals clinical practice...

The next challenge to interoperability? A first look at robotic system wireless interoperability in emergency response.

System interoperability enables public safety agencies to communicate and share information. Past failures have demonstrated that systems of different agencies are not inherently interoperable. Therefore, as efforts continue toward the resolutions of these problems, it is incumbent on technology developers to assess the interoperability of new systems. Robotic systems can offer new capabilities to public safety personnel; however, these systems also include new communication technology to share and distribute information. Research has been initiated to examine the interoperability of public safety robotic systems. Definitions for robotic communication interoperability types are introduced.

Integration of data systems and technology improves research and collaboration for a superfund research center.

Large collaborative centers are a common model for accomplishing integrated environmental health research. These centers often include various types of scientific domains (e.g., chemistry, biology, bioinformatics) that are integrated to solve some of the nation's key economic or public health concerns. The Superfund Research Center (SRP) at Oregon State University (OSU) is one such center established in 2008 to study the emerging health risks of polycyclic aromatic hydrocarbons while using new technologies both in the field and laboratory. With outside collaboration at remote institutions, success for the center as a whole depends on the ability to effectively integrate data across all research projects and support cores. Therefore, the OSU SRP center developed a system that integrates environmental monitoring data with analytical chemistry data and downstream bioinformatics and statistics to enable complete "source-to-outcome" data modeling and information management. This article describes the development of this integrated information management system that includes commercial software for operational laboratory management and sample management in addition to open-source custom-built software for bioinformatics and experimental data management.

High-content screening data management for drug discovery in a small- to medium-size laboratory: results of a collaborative pilot study focused on user expectations as indicators of effectiveness.

High-content screening (HCS) technology provides a powerful vantage point to approach biological problems; it allows analysis of cell parameters, including changes in cell or protein movement, shape, or texture. As part of a collaborative pilot research project to improve bioscience research data integration, we identified HCS data management as an area ripe for advancement. A primary goal was to develop an integrated data management and analysis system suitable for small- to medium-size HCS programs that would improve research productivity and increase work satisfaction. A system was developed that uses Labmatrix, a Web-based research data management platform, to integrate and query data derived from a Cellomics STORE database. Focusing on user expectations, several barriers to HCS productivity were identified and reduced or eliminated. The impact of the project on HCS research productivity was tested through a series of 18 lab-requested integrated data queries, 7 of which were fully enabled, 7 partially enabled, and 4 enabled through data export to standalone data analysis tools. The results are limited to one laboratory, but this pilot suggests that through an "implementation research" approach, a network of small- to medium-size laboratories involved in HCS projects could achieve greater productivity and satisfaction in drug discovery research.

Architectural approach for providing relations in biomedical terminologies and ontologies.

The representation of multiple relations is one of the main criteria of ontologies. In formalizing both ontologies and terminologies in biomedicine relations are used to code axioms for the classes of the ontology. However, a huge number of relations represented in medical ontologies and terminologies are derived from language and formal definition is omitted. We present a strategy based on an architectural approach to facility formal analysis of relations for use in ontology systems in biomedicine and in general.

Characterization of lead in US workplaces using data from OSHA's integrated management information system.

BACKGROUND: Lead hazards continue to be encountered in the workplace. OSHA's Integrated Management Information System (IMIS) is the largest available database containing sampling results in US workplaces. METHODS: Personal airborne lead sampling results in IMIS were extracted for years 1979-2008. Descriptive analyses, geographical mapping, and regression modeling of results were performed. RESULTS: Seventy-nine percent of lead samples were in the manufacturing sector. Lead sample results were highest in the construction sector (median = 0.03 mg/m(3) ). NORA sector, year, OSHA region, number of employees at the worksite, federal/state OSHA plan, unionization, advance notification, and presence of an employee representative were statistically associated with having a lead sample result exceed the PEL. CONCLUSIONS: Lead concentrations within construction have been higher than any other industry. Lead hazards have been most prevalent in the north and northeastern US. IMIS data can be useful as a surveillance tool and for targeting prevention efforts toward hazardous industries.

[Research on SOA for hospital information system].

Integration of heterogeneous systems in hospital is an important subject. The loose-coupling and efficient data interaction can be realized with SOA, the complexity of cross-point can be avoided with ESB and Service-Oriented when system integration, the unified control can come for information management. Finally it will meet a variety of needs related with management and business in hospital, adapting quickly to changes.