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.

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.

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...

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...

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.

An ontology based method to solve query identifier heterogeneity in post-genomic clinical trials.

The increasing amount of information available for biomedical research has led to issues related to knowledge discovery in large collections of data. Moreover, Information Retrieval techniques must consider heterogeneities present in databases, initially belonging to different domains-e.g. clinical and genetic data. One of the goals, among others, of the ACGT European is to provide seamless and homogeneous access to integrated databases. In this work, we describe an approach to overcome heterogeneities in identifiers inside queries. We present an ontology classifying the most common identifier semantic heterogeneities, and a service that makes use of it to cope with the problem using the described approach. Finally, we illustrate the solution by analysing a set of real queries.

Association studies on cervical cancer facilitated by inference and semantic technologies: the assist approach.

Cervical cancer (CxCa) is currently the second leading cause of cancer-related deaths, for women between 20 and 39 years old. As infection by the human papillomavirus (HPV) is considered as the central risk factor for CxCa, current research focuses on the role of specific genetic and environmental factors in determining HPV persistence and subsequent progression of the disease. ASSIST is an EU-funded research project that aims to facilitate the design and execution of genetic association studies on CxCa in a systematic way by adopting inference and semantic technologies. Toward this goal, ASSIST provides the means for seamless integration and virtual unification of distributed and heterogeneous CxCa data repositories, and the underlying mechanisms to undertake the entire process of expressing and statistically evaluating medical hypotheses based on the collected data in order to generate medically important associations. The ultimate goal for ASSIST is to foster the biomedical research community by providing an open, integrated and collaborative framework to facilitate genetic association studies.

Use of epidemiologic data in Integrated Risk Information System (IRIS) assessments.

In human health risk assessment, information from epidemiologic studies is typically utilized in the hazard identification step of the risk assessment paradigm. However, in the assessment of many chemicals by the Integrated Risk Information System (IRIS), epidemiologic data, both observational and experimental, have also been used in the derivation of toxicological risk estimates (i.e., reference doses [RfD], reference concentrations [RfC], oral cancer slope factors [CSF] and inhalation unit risks [IUR]). Of the 545 health assessments posted on the IRIS database as of June 2007, 44 assessments derived non-cancer or cancer risk estimates based on human data. RfD and RfC calculations were based on a spectrum of endpoints from changes in enzyme activity to specific neurological or dermal effects. There are 12 assessments with IURs based on human data, two assessments that extrapolated human inhalation data to derive CSFs and one that used human data to directly derive a CSF. Lung or respiratory cancer is the most common endpoint for cancer assessments based on human data. To date, only one chemical, benzene, has utilized human data for derivation of all three quantitative risk estimates (i.e., RfC, RfD, and dose-response modeling for cancer assessment). Through examples from the IRIS database, this paper will demonstrate how epidemiologic data have been used in IRIS assessments for both adding to the body of evidence in the hazard identification process and in the quantification of risk estimates in the dose-response component of the risk assessment paradigm.

Sistemas de información para la prensa: la gestión de la información y el conocimiento en el contexto de los sistemas integrados de información / Systems of information for the press: the administration of the information and the knowledge in the context of the integrated systems of information

Se abordan los sistemas de información para la prensa; la gestión de los recursos de información y de los ambientes propicios para potenciar el conocimiento. Se analizan los sistemas integrados de información con ambientes que estimulan el conocimiento y las organizaciones, como sistemas de información; el tránsito de los modelos lineales hacia los modelos interactivos multidireccionales en la comunicación; así como los procesos de virtualización y la formación de comunidades virtuales.

Consideraciones teóricas sobre los sistemas de información, los sistemas de información para la prensa y los sistemas integrados de información / Theoretical considerations on the systems of information, the systems of information for the press and the integrated systems of information

Se abordan los sistemas de información, sus cualidades esenciales y tendencias desde una perspectiva interdisciplinar. Se estudian los sistemas complejos de información; los sistemas de información de la prensa y para la prensa; así como las implicaciones de la introducción de las nuevas tecnologías de la información y la comunicación para los sistemas de información. A continuación, se tratan los sistemas de información en línea y los sistemas integrados de información.

Duke Surgery Research Central: an open-source Web application for the improvement of compliance with research regulation.

BACKGROUND: Although regulatory compliance in academic research is enforced by law to ensure high quality and safety to participants, its implementation is frequently hindered by cost and logistical barriers. In order to decrease these barriers, we have developed a Web-based application, Duke Surgery Research Central (DSRC), to monitor and streamline the regulatory research process. RESULTS: The main objective of DSRC is to streamline regulatory research processes. The application was built using a combination of paper prototyping for system requirements and Java as the primary language for the application, in conjunction with the Model-View-Controller design model. The researcher interface was designed for simplicity so that it could be used by individuals with different computer literacy levels. Analogously, the administrator interface was designed with functionality as its primary goal. DSRC facilitates the exchange of regulatory documents between researchers and research administrators, allowing for tasks to be tracked and documents to be stored in a Web environment accessible from an Intranet. Usability was evaluated using formal usability tests and field observations. Formal usability results demonstrated that DSRC presented good speed, was easy to learn and use, had a functionality that was easily understandable, and a navigation that was intuitive. Additional features implemented upon request by initial users included: extensive variable categorization (in contrast with data capture using free text), searching capabilities to improve how research administrators could search an extensive number of researcher names, warning messages before critical tasks were performed (such as deleting a task), and confirmatory e-mails for critical tasks (such as completing a regulatory task). CONCLUSION: The current version of DSRC was shown to have excellent overall usability properties in handling research regulatory issues. It is hoped that its release as an open-source application will promote improved and streamlined regulatory processes for individual academic centers as well as larger research networks.

Bio-nano-informatics: an integrated information management system for personalized oncology.

The Emory-Georgia Tech Nanotechnology Center for Personalized and Predictive Oncology is one of the eight national centers funded by the National Cancer Institute (NCI). Its overall goal is to combine nanotechnology and biocomputing with clinical oncology for personalized detection, diagnosis and treatment of human cancer. Within this large-scale and multifaceted center, a key challenge is how to integrate and manage data and resources. Here we have developed an "intelligent" information system for data management, interpretation, and for translation of new results to clinical applications.