Реферат
A IEC 62304 fornece requisitos para os fabricantes de sistemas de saúde demonstrarem sua capacidade de fornecer softwares desenvolvidos com processos, atividades e tarefas, associadas aos riscos de segurança, que devem ser demonstrados para atendimento de fins regulatórios em diversos países. Este trabalho apresenta um mapeamento sistemático da literatura envolvendo os trabalhos que reportam utilizações, vantagens e dificuldades no uso da IEC 62304 em seus quase 15 anos de existência.
IEC 62304 provides requirements for manufacturers of healthcare systems to demonstrate their ability to provide software developed with processes, activities, and tasks, associated with safety risks, which must be demonstrated to meet regulatory purposes in several countries. This work presents a systematic literature mapping involving works that report uses, advantages and difficulties in the use of IEC 62304 in its almost 15 years of existence.
IEC 62304 proporciona requisitos para que los fabricantes de sistemas de atención médica demuestren su capacidad para proporcionar software desarrollado con procesos, actividades y tareas, asociadas con riesgos de seguridad, que deben demostrarse para cumplir con los propósitos regulatorios en varios países. Este trabajo presenta un mapeo sistemático de literatura que involucran trabajos que reportan usos, ventajas y dificultades en el uso de IEC 62304 en sus casi 15 años de existencia.
Тема - темы
Humans , Software/standards , Computer Security/standards , Health Information SystemsРеферат
Objetivo: este estudo avaliou a acurácia e confiabilidadedas medidas lineares em exames detomografia computadorizada de feixe cônico(TCFC), em dois softwares, utilizando diferentesvoxels e variando o posicionamento da mandíbula.Material e Métodos: 10 imagens de TCFC demandíbulas humanas com 25 pontos foram obtidas,usando diferentes protocolos de aquisição(0.250, 0.300, 0.400-mm voxels) e orientações damandíbula (centralizada, rotacionada 10° lateralmentepara direita e esquerda, inclinada 10° para cima e para baixo); 14 medidas foram realizadasnas reconstruções multiplanares nos softwares XoranCate OsiriX. Os achados foram comparadoscom as medidas físicas através de um paquímetrodigital. O teste ANOVA e o coeficiente de correlaçãoforam utilizados com p < 0,05. Resultados:não houve diferença estatisticamente significantequando as medidas foram comparadas em aquisiçõescom diferentes tamanhos de voxels emambos os softwares. A posição da mandíbula nãoinfluenciou nas medidas. Nenhuma diferença foiencontrada quando os valores foram comparadosentre os softwares e o paquímetro digital. Conclusão:as medidas lineares em ambos os softwaresforam confiáveis e acurados comparados a mensuraçãofísica em todos os protocolos. A acuráciae a confiabilidade das mensurações não influenciaramde acordo com as variações de posicionamentoda mandíbula.(AU)
Objective: this study evaluated the accuracy and reliability of linear measurements on cone beam CT (CBCT) scans in two software programs, using different voxels and varying mandible positioning. Material and methods: CBCT images of 10 human mandibles with 25 markers were obtained using different acquisition protocols (0.250, 0.300, 0.400-mm voxels) and mandible orientations (centered, rotated 10° laterally to right and left, tilted 10 up and down); fourteen measurements were carried out on the multiplanar reconstructions in XoranCat and OsiriX Lite software programs. The findings were compared to physical measurements using a digital caliper. ANOVA and correlation coefficient tests were used, at α = 0.05. Results: there was no statistically significant difference when the measurements were compared in acquisitions with different voxel sizes analysed in both software programs. Mandibular positioning changes did not influence the measurements. No differences were found when the values were compared between the software programs and the digital caliper. Conclusion: linear measurements in both programs were reliable and accurate compared with physical measurements when using all acquisition protocols. The accuracy and reliability of the measurements were not influenced by variations in the mandible positioning.(AU)
Тема - темы
Humans , Software/standards , Cone-Beam Computed Tomography/standards , Dimensional Measurement Accuracy , Mandible/diagnostic imaging , Reference Values , Reproducibility of Results , Analysis of Variance , Cone-Beam Computed Tomography/methodsРеферат
Técnicas como la Tomografía por Emisión de Positrones y la Tomografía Computarizada permiten determinar la naturaleza maligna o benigna de un tumor y estudiar las estructuras anatómicas del cuerpo con imágenes de alta resolución, respectivamente. Investigadores a nivel internacional han utilizado diferentes técnicas para la fusión de la Tomografía por Emisión de Positrones y la Tomografía Computarizada porque permite observar las funciones metabólicas en correlación con las estructuras anatómicas. La presente investigación se propone realizar un análisis y selección de algoritmos que propicien la fusión de neuroimágenes, basado en la precisión de los mismos. De esta forma contribuir al desarrollo de software para la fusión sin necesidad de adquirir los costosos equipos de adquisición de imágenes de alto rendimiento, los cuales son costosos. Para el estudio se aplicaron los métodos Análisis documental, Histórico lógico e Inductivo deductivo. Se analizaron e identificaron las mejores variantes de algoritmos y técnicas para la fusión según la literatura reportada. A partir del análisis de estas técnicas se identifica como mejor variante el esquema de fusión basado en Wavelet para la fusión de las imágenes. Para el corregistro se propone la interpolación Bicúbica. Como transformada discreta de Wavelet se evidencia el uso de la de Haar. Además, la investigación propició desarrollar el esquema de fusión basado en las técnicas anteriores. A partir del análisis realizado se constataron las aplicaciones y utilidad de las técnicas de fusión como sustitución a los altos costos de adquisición de escáneres multifunción PET/CT para Cuba(AU)
Techniques such as Positron Emission Tomography and Computed Tomography allow to determine the malignant or benign nature of a tumor and to study the anatomical structures of the body with high resolution images, respectively. International researchers have used different techniques for the fusion of Positron Emission Tomography and Computed Tomography because it allows observing metabolic functions in correlation with anatomical structures. The present investigation proposes to carry out an analysis and selection of algorithms that favor the fusion of neuroimaging, based on their precision. In this way, contribute to the development of fusion software without the need to purchase expensive high-performance imaging equipment, which is expensive. For the study the documentary analysis, logical historical and deductive inductive methods were applied. The best algorithm variants and techniques for fusion were analyzed and identified according to the reported literature. From the analysis of these techniques, the Wavelet-based fusion scheme for image fusion is identified as the best variant. Bicubic interpolation is proposed for co-registration. As a discrete Wavelet transform, the use of Haar's is evidenced. In addition, the research led to the development of the fusion scheme based on the previous techniques. From the analysis carried out, the applications and usefulness of fusion techniques were verified as a substitute for the high costs of acquiring PET / CT multifunction scanners for Cuba(AU)
Тема - темы
Humans , Male , Female , Image Processing, Computer-Assisted/methods , Software/standards , Tomography, X-Ray Computed/methods , Positron-Emission Tomography/methods , Wavelet Analysis , CubaРеферат
La implementación de aplicaciones y servicios informáticos en el sector de la salud es uno de los desafíos de las tecnologías de la información y las comunicaciones. La informática médica como disciplina integradora recibe un importante impacto del enfoque de la ciencia, la tecnología y la sociedad que domina el campo biomédico, las ciencias biotecnológicas y farmacéuticas. La Universidad de Ciencias Informáticas (UCI) desde su fundación ha participado en el desarrollo de aplicaciones y servicios informáticos para el sector sanitario cubano. Esta universidad ha desarrollado e implementado la Plataforma de imágenes médicas, el Sistema de Información Hospitalaria y el Sistema de manejo de datos de Ensayos Clínicos. Estas aplicaciones introducen en la sociedad cubana un valor constituido en beneficios sociales, económicos y culturales-organizacionales. Además, contribuyen a la gestión de las instituciones de salud y la eficiencia económica. Este artículo describe el impacto social, económico y ambiental de las aplicaciones y servicios informáticos desarrollados por la Universidad(AU)
Applications and computer services implementation in the health sector is one of the information and communications technologies challenges. Medical informatics as an integrating discipline receives an important impact from the science, technology and society approach that dominates the biomedical field, biotechnological and pharmaceutical sciences. The Informatics Sciences University (UCI) since the beginnings has participated in the development of applications and computer services for the Cuban health sector. UCI has developed and implemented the Medical Imaging Platform, the Hospital Information System, and the Clinical Trials Data Management System. These applications introduced in the Cuban society a valuable social, economic and cultural-organizational benefit. Additionally those applications contributed to the health institutions management and the economic efficiency. This paper describes the social, economic and environmental impact of the applications and computer services developed by the university(AU)
Тема - темы
Humans , Medical Informatics , Medical Informatics Applications , Software/standardsРеферат
En Cuba la mayoría de los especialistas de seguridad informática tienen un escaso conocimiento sobre las herramientas indispensables del hacking ético. Para realizar la presente investigación se hicieron búsquedas bibliográficas nacionales e internacionales. De la gran cantidad de herramientas disponibles en distribuciones especializadas para la seguridad informática (Parrot Security, Black Arch y Kali Linux), se seleccionaron aquellas que se ajustaban más a las características de las redes cubanas. Este trabajo tuvo como objetivo describir algunas de las herramientas seleccionadas para el escaneo y explotación de vulnerabilidades, y conceptos fundamentales sobre el tema. Consideramos que este estudio puede ser provechoso para los especialistas cubanos en seguridad informática pues les servirá no solo para conocer sobre el hacking ético, sino también cuáles son las herramientas que se pueden emplear, teniendo en cuenta las características de nuestras redes nacionales(AU)
In Cuba, most computer security specialists have little knowledge about the essential tools of ethical hacking. To carry out the present investigation, national and international bibliographic searches were made. From the large number of tools available in specialized distributions for computer security (Parrot Security, Black Arch and Kali Linux), those that best fit the characteristics of Cuban networks were selected. Our research aimed to describe some of the selected tools for scanning and exploiting vulnerabilities, and fundamental concepts on the subject. We believe that this study will be very useful for Cuban specialists in computer security because it will serve them not only to learn about ethical hacking; but also, what are the tools that can be used taking into account the characteristics of our national networks(AU)
Тема - темы
Humans , Software/standards , Computer Security/standards , CubaРеферат
Una de las etapas de un proceso de despliegue de un sistema informático, es la capacitación de los usuarios finales. En algunas ocasiones se subestima la profundidad del impacto de los cambios técnicos en la organización y en los empleados al implantar un sistema informático y no se contrata el servicio de entrenamiento. El presente artículo describe una estrategia de entrenamiento y acompañamiento a usuarios en el proceso de implantación del Sistema de Información Hospitalaria XAVIA HIS. Los principales resultados se relacionan con la definición de acciones, métodos y técnicas que permiten planificar y ejecutar los servicios de entrenamiento y acompañamiento con una mayor eficiencia de las actividades ejecutadas, así como los programas bases de entrenamiento para especialistas informáticos, así como técnicos y profesionales de la salud(AU)
End user training is one of the computer system deployment process stages. The technical changes depth impact on the organization and on employees when implementing a computer system sometimes is underestimated and the training service is not hired. This article describes a training and accompaniment strategy for users in the Hospital Information System XAVIA HIS implementation process. Main results are related to the actions, methods and techniques definition that allow planning and executing the training and accompaniment services with greater efficiency of the activities carried out. Also, the paper present the basic training programs for computer specialists, health technicians and professionals(AU)
Тема - темы
Humans , Technology/methods , Technology Assessment, Biomedical , Software/standards , Medical Informatics ApplicationsРеферат
Introducción: El Centro Nacional de Toxicología de Cuba, supervisa y controla la información de eventos atribuibles a la inmunización, vacunación e intoxicaciones con medicamentos y plaguicidas. Los casos que llegan al centro, se justifican mayormente por el uso de plaguicidas que tienen un alto nivel de toxicidad y riesgo de muerte. Los especialistas en toxicología, requieren facilidad para revisar las hojas de seguridad, el listado oficial de plaguicidas autorizados en Cuba y los casos anteriores. Esto permite analizar y emitir un diagnóstico, que salve la vida del afectado. Objetivo: Presentar un sistema para la gestión y el análisis de los casos intoxicados por plaguicidas. Métodos: El desarrollo se sustentó en la metodología de software Extreme Programming, modelado con la herramienta CASE Visual Paradigm 8.0 y lenguaje UML 2.0. Se utilizó Java con NetBeans 8.0.2 y como gestor de base de datos PostgreSQL 9.3. Resultados: Se desarrolló una herramienta de gestión de la información toxicológica, así como una base de casos de los síntomas, plaguicidas y diagnóstico por plaguicida. Los especialistas en toxicología cuentan con una herramienta de apoyo a la toma de decisiones, que reduce la ocurrencia de errores humanos(AU)
Introduction: The Cuban National Toxicology Center supervises and controls the information of events attributable to immunization, vaccination and poisonings with medications and pesticides. The cases that arrive at the center are mainly justified by the use of pesticides that have a high level of toxicity and risk of death. Specialists in toxicology require ease to review the safety sheets, the official list of authorized pesticides in Cuba and the above cases. This allows analyzing and issuing a diagnosis that saves the life of the affected person. Objective: To present a system for the management and analysis of cases poisoned by pesticides. Methods: The development was based on the Extreme Programming software methodology, modeled with the CASE Visual Paradigm 8.0 tool and the UML 2.0 language. Java was used with NetBeans 8.0.2 and as PostgreSQL 9.3 database manager. Results: A toxicological information management tool was developed, as well as a case database of symptoms, pesticides and pesticide diagnosis. Toxicology specialists have a decision support tool that reduces the occurrence of human errors(AU)
Тема - темы
Humans , Male , Female , Pesticides/adverse effects , Pesticides/poisoning , Software/standards , CubaРеферат
Resumen Las infecciones respiratorias agudas (IRA) causadas por virus son una importante causa de morbilidad y mortalidad en el mundo, afectando principalmente a niños y adultos mayores. Se asocian a un alto número de consultas y hospitalizaciones, a una significativa sobrecarga del sistema de salud y a un alto costo económico. La vigilancia de virus respiratorios tiene el potencial de ayudar a optimizar la respuesta sanitaria, garantizar la disponibilidad de recursos humanos, racionalizar los recursos y disminuir los costos asociados a la atención en salud. Con el objetivo de optimizar la recolección y visualización de los datos de nuestro actual sistema de vigilancia de virus respiratorios, se diseñó una plataforma basada en R y sus paquetes Shiny, que permite la creación de una interfase web interactiva y amigable para la recolección, análisis y publicación de los datos. Se ingresaron a esta plataforma los datos de la red de vigilancia metropolitana de virus respiratorios disponibles desde 2006. En esta plataforma, el investigador demora menos de un minuto en registrar los datos. El análisis y publicación es inmediato, llegando a cualquier usuario con un dispositivo conectado a Internet, quien puede elegir las variables a consultar. Con un costo muy bajo, en poco tiempo y utilizando el lenguaje de programación R, se logró crear un sistema simple e interactivo, disminuyendo el tiempo de carga y análisis de datos de forma considerable, posiblemente aumentando el impacto y la disponibilidad de esta vigilancia.
Abstract Acute respiratory infections (ARI) are an important cause of morbidity and mortality worldwide, affecting mainly children and the elderly. They are associated with a high economic burden, increased number of medical visits and hospitalizations. The surveillance of the circulation of respiratory viruses can reduce the health care associated costs, and to optimize the health response. A platform based on R and its package Shiny was designed, to create an interactive and friendly web interface for gathering, analysis and publication of the data. The data from the Chilean metropolitan respiratory viruses surveillance network, available since 2006, was uploaded into the platform. Using this platform, the researcher spends less than 1 minute to upload the data, and the analysis and publication is immediate, available to be seen by any user with a device connected to Internet, who can choose the variables to be displayed. With a very low cost, in a short time, and using the R programming language, it was possible to create a simple, and interactive platform, considerably decreasing the upload and analysis time, and increasing the impact and availability of this surveillance.
Тема - темы
Humans , Child , Aged , Respiratory Tract Infections/economics , Respiratory Tract Infections/epidemiology , Software/economics , Software/standards , Virus Diseases/epidemiology , Health Care Costs , Models, Theoretical , Viruses , Chile/epidemiology , InternetРеферат
Abstract Prevention and health promotion are considered important strategies to control oral diseases. Dental caries is preventable disease and remains the most common chronic disease that affects mainly low income children and still considered the main cause of tooth loss in adulthood in Brazil. The aim of this study is to present a System Dynamics model (SDM) specifically developed with the Stella Architect software to estimate the cost and clinical hours required to control the evolution of dental caries in preschool children in Maringá, Brazil. Two main strategies to control caries were considered in the model: the application of fluoride varnish on teeth presenting white spots, and the use of Atraumatic Restorative Treatment (ART) in cavitated carious lesions without pulp involvement. The parameters used in the model were: number of people covered by a local oral health team = 4,000; number of children up to 5 years = 7% of the population; children's decayed, missing, filled teeth (dmft) index = 2.4; time/cost of 4 applications of fluoride varnish = 5 minutes/US$ 0.716; and time/cost of each ART restoration = 15 minutes/US$ 1.475. The SDM generated an estimated total cost of US$698.00, and a total of 112 clinical hours to treat the population in question. The use of the SDM presented here has the potential to assist decision making by measuring the material and human resources required to prevent and control dental caries at an early age.
Тема - темы
Humans , Male , Female , Child, Preschool , Systems Analysis , Dental Caries/economics , Dental Caries/therapy , Dental Atraumatic Restorative Treatment/economics , Time Factors , Software/standards , Brazil , DMF Index , Fluorides, Topical/economics , Dental Materials/economics , Dental Atraumatic Restorative Treatment/methodsРеферат
ABSTRACT Objectives: to report the user experience of the webQDA software in the support of qualitative data analysis about health literacy of older adults. Methods: quasi-experimental research developed from January 2014 to January 2015, with 118 older adults, all of whom were interviewed to assess the level of health literacy. Interviews were carried out before and after four educational interventions, according to Freire's method named Culture Circle. The interviews were transcribed and entered in the software, which highlighted the analytical categories. Results: the systems of sources, interpretative encoding and questioning of the data available in the software allowed the construction of three categories for the literacy levels and four categories for their dimensions. Final considerations: We concluded that the webQDA software enables the structured encoding of qualitative materials, ensuring faster and effective management of data with systematization and analytical transparency.
RESUMEN Objetivos: relatar la experiencia con la utilización del software webQDA como base al análisis de los datos cualitativos sobre literacidad en salud de ancianos. Métodos: investigación cuasiexperimental realizada en el período de enero de 2014 a enero de 2015, en la cual participaron 118 ancianos mediante entrevistas para evaluar el nivel de literacidad en salud. Se realizaron entrevistas antes y después de cuatro intervenciones educativas, de acuerdo con el método problematizador freireano titulado Círculo de Cultura. Se transcribieron las entrevistas y las insertaron en el software, lo que permitió obtener las categorías analíticas. Resultados: los sistemas de fuentes, de codificación interpretativa y de cuestionamiento de los datos disponibles en el software permitieron elaborar tres categorías sobre los niveles de literacidad y cuatro categorías sobre sus dimensiones. Consideraciones finales: Se concluyó que el software webQDA permite la codificación estructurada de los materiales cualitativos, lo que promueve una gestión más rápida y eficaz de los datos a partir de la sistematización y transparencia analítica.
RESUMO Objetivos: relatar a experiência de uso do software webQDA no apoio à análise dos dados qualitativos acerca do letramento em saúde de idosos. Métodos: pesquisa quase experimental desenvolvida no período de janeiro de 2014 a janeiro de 2015, com 118 idosos, os quais foram entrevistados para avaliar o nível de letramento em saúde. Foram realizadas entrevistas antes e após quatro intervenções educativas, segundo o método problematizador freireano denominado Círculo de Cultura. As entrevistas foram transcritas e inseridas no software, o que permitiu evidenciar as categorias analíticas. Resultados: os sistemas de fontes, codificação interpretativa e questionamento dos dados disponíveis no software permitiram a construção de três categorias para os níveis do letramento e de quatro categorias para as suas dimensões. Considerações finais: Conclui-se que o software webQDA permite a codificação estruturada dos materiais qualitativos, assegurando gestão mais rápida e eficaz dos dados a partir da sistematização e transparência analítica.
Тема - темы
Humans , Research Personnel/psychology , Software/standards , Nursing Research/methods , Qualitative Research , Data Management/instrumentation , Research Design , Software/trends , Nursing Research/trends , Data Management/methods , Life Change EventsРеферат
RESUMO Introdução: O aplicativo para smartphone AtestaDO foi desenvolvido para auxiliar o médico na certificação da causa de morte. Neste estudo se propõe avaliar a aceitabilidade desse aplicativo. Métodos: Médicos foram convidados para participar de reuniões sobre certificação correta da causa da morte e avaliar o aplicativo em três etapas dessas reuniões, realizadas em Natal e em dois grandes hospitais de Belo Horizonte. Resultados: Em Natal, 82% dos 38 médicos participantes tinham mais de 20 anos de graduação, e em Belo Horizonte, mais de 67% dos 58 médicos tinham menos de 5 anos de graduação. As seções "Interface do aplicativo", "Como atestar as causas de morte", "Prática com exercícios" e "Outras informações para o médico" foram bem avaliadas por mais de 50% dos médicos de Belo Horizonte. Em Natal, todas as seções foram bem avaliadas por pelo menos 80% dos médicos. Mais de 70% dos participantes de Natal e da segunda etapa de Belo Horizonte usariam o aplicativo para preencher a causa de morte. A probabilidade de usar o AtestaDO para dar aulas sobre preenchimento da Declaração de Óbito foi de 83% para médicos de Natal, mas inferior a 60% em Belo Horizonte. Nas três etapas, a maioria dos médicos recomendaria o uso do aplicativo para outros colegas. Conclusão: A avaliação do aplicativo AtestaDO mostrou boa aceitabilidade. Espera-se que o uso dessa ferramenta permita alcançar melhorias na certificação médica da causa do óbito.
ABSTRACT Introduction: A smartphone application named AtestaDO was developed to support physicians with medical certification of the cause of death. The objective of this study is to evaluate the acceptability of the app. Methods: Physicians were invited to attend meetings on the proper certification of cause of death, and to evaluate the application in a national workshop in Natal (first stage) and in two large hospitals in Belo Horizonte (second and third stages). Results: In Natal, 82% of 38 physicians had more than 20 years of experience and in Belo Horizonte, more than 67% of 58 physicians had less than 5 years of experience. The sections "Application interface", "How to certify the causes of death", "Practice with exercises" and "Other information for physicians" were positively evaluated by more than 50% of physicians in Belo Horizonte. In Natal, all sections were positively evaluated by at least 80% of participants. More than 70% of the participants in both Natal and the second stage of Belo Horizonte indicated they would possibly use AtestaDO to guide filling of a death certificate. The probability of using AtestaDO to teach classes on filling death certificates was 83.3% for Natal's physicians but less than 60% in Belo Horizonte. In the three stages, most physicians would recommend using the application to other colleagues. Conclusion: The evaluation of AtestaDO showed good acceptability. We expect that the use of this tool enables improvements in medical certification of causes of death.
Тема - темы
Humans , Physicians/standards , Software/standards , Death Certificates , Cause of Death , Smartphone/standards , Physicians/statistics & numerical data , Time Factors , Practice Patterns, Physicians'/standards , Brazil , Surveys and Questionnaires , Reproducibility of Results , Quality ImprovementРеферат
RESUMO Objetivo: descrever de maneira prática e detalhada a criação de uma plataforma totalmente informatizada para coleta, armazenamento e análise de dados, inicialmente proposta para cirurgia cardiovascular, com interfaces reprodutíveis e aplicáveis a outras especialidades cirúrgicas, bem como, apresentar a experiência inicial de trabalho com esta ferramenta e os resultados preliminares obtidos após sua implementação em um hospital universitário terciário brasileiro. Métodos: a plataforma foi desenvolvida com base nas ferramentas Google, gratuitas, de fácil utilização e amplamente acessíveis. Desde o início desta iniciativa, em maio de 2015, até a análise preliminar, em fevereiro de 2017, dados de 271 pacientes, consecutivos, submetidos à cirurgia cardiovascular foram prospectivamente recordados e analisados. Resultados: a iniciativa foi implementada com pleno sucesso, com 100% dos pacientes incluídos e sem perda de qualquer variável em um banco de dados composto por mais de 500 variáveis. As complicações pós-operatórias imediatas mais frequentes foram: fibrilação atrial (22,5%), broncopneumonia (10,7%), delirium (10,3%), insuficiência renal aguda (10%), acidente vascular encefálico (5%) e morte (7%). Comparando-se as taxas de mortalidade no primeiro e segundo anos da iniciativa, uma redução de 10,8% para 4% (p=0,042), respectivamente, foi evidenciada. Conclusão: a nova proposta de coleta e armazenamento de dados apresentada neste trabalho mostrou-se plenamente factível e efetiva. Por serem gratuitas, de fácil manuseio e universalmente acessíveis, estas ferramentas podem ser úteis a outras especialidades cirúrgicas que desejem desenvolver métodos de avaliação de sucesso e complicações pós-operatórios, bem como, programas de melhoria de qualidade.
ABSTRACT Objective: to describe, in a practical and step-by-step manner, the construction of a fully electronic platform for data collection, storage, and analysis, initially proposed for cardiovascular surgery, with interfaces that are reproducible and applicable to other surgical specialties, as well as to present the initial work experience with this instrument in cardiac surgery and the preliminary results obtained after its implementation in a Brazilian tertiary university hospital. Methods: the platform was developed based on Google tools, which are free, easy to use, and widely accessible. From the beginning of this initiative, in May 2015, to the preliminary analysis, in February 2017, data from 271 consecutive patients submitted to cardiovascular surgery were prospectively recorded and preliminarily analyzed. Results: the initiative was implemented with full success, with 100% of patients included and without loss of any variable, in a database composed of more than 500 variables. The most frequent immediate postoperative complications were: atrial fibrillation (22.5%), bronchopneumonia (10.7%), delirium (10.3%), acute renal failure (10%), stroke (5%), and death (7%). Comparing mortality rates in the first and second years of the initiative, a reduction from 10.8% to 4% (p=0.042), respectively, was evidenced. Conclusion: the new proposal of data collection and storage presented in this work was fully feasible and effective. It may be useful to other surgical specialties that wish to develop methods to evaluate success and postoperative complication rates, as well as quality improvement programs.
Тема - темы
Humans , Male , Female , Aged , Cardiovascular Surgical Procedures , Software/standards , Databases, Factual/standards , Forms as Topic , Outcome and Process Assessment, Health Care , Brazil , Reproducibility of Results , Internet , Quality Improvement , Hospitals, University , Middle AgedРеферат
Introducción: La generación de mecanismos de aplicación del conocimiento en el desarrollo de nuevos productos y procesos e incluso de nuevas formas de organización social es el recurso fundamental en la Sociedad de la Información -Conocimiento. Objetivo: Proponer tareas para concertar, a través de IMIA-LAC, los atributos de las herramientas informáticas y los procesos que caracterizan la Gestión del Conocimiento. Método: Se revisaron los sitios de IMIA e IMIA-LAC para obtener información sobre el desarrollo de esa organización en el mundo. Utilizando estrategias de búsqueda se obtuvo la información necesaria para vincular la estrategia gerencial de gestión del conocimiento con el desarrollo alcanzado, de las aplicaciones informáticas y de los procesos de informatización de los servicios de salud. Resultados: Se argumenta una propuesta de Planes de Acción para potenciar el desarrollo a través de IMIA-LAC: a) Estrategias dirigidas desde la organización, por ejemplo mejorar la identidad corporativa de esta b) Estrategias dirigidas a la búsqueda de mejoras en los servicios de salud, usando los vínculos efectivos con organizaciones claves en el sector Conclusiones: Se proponen un conjunto de acciones para concertar los procesos que caracterizan la Gestión del Conocimiento a través de IMIA-LAC utilizando las herramientas informáticas(AU)
Introduction: Generating mechanisms for applying knowledge in the development of new products, processes and new forms of social organization is the fundamental resource in the Information-Knowledge Society. Objective: Propose tasks to arrange, through IMIA-LAC, the attributes of IT tools and processes that characterize Knowledge Management. Methods: The IMIA and IMIA-LAC sites were reviewed to obtain information about the work of that organization in the world. Using search strategies the necessary information was obtained to link the managerial strategy of knowledge management with the development achieved of the computer applications and of the computerization processes of the health services. Results: A proposal of Plans of Action is argued to promote the development through IMIA-LAC: a) Strategies directed from the organization, for example to improve the corporate identity of this b) Strategies directed to the search of improvements in the health services, using effective links with key organizations in the sector. Conclusions: A set of actions are proposed to coordinate the processes that characterize the Knowledge Management through IMIA-LAC using the computer tools(AU)
Тема - темы
Humans , Male , Female , Quality of Health Care , Medical Informatics Applications , Software/standards , Knowledge ManagementРеферат
ABSTRACT Objective: To describe the development of a software prototype to apply the nursing process in clinical units of a general hospital, and assess its usefulness. Method: Applied methodological research of technological production of a program based on prototyping software engineering developed in three stages: specification, development, and validation. Results: Produced under the name of INFOSAE, the system represents a set of stages (history, diagnosis, expected outcomes, and nursing intervention) providing guidance to nurses to direct and guarantee the necessary care to patients, also allowing an assessment of this care. Conclusion: The INFOSAE software prototype, an easy-to-use computerized technology, obtained a favorable assessment by the user nurses that participated in the whole development process, from the specification to the validation of the system.
RESUMEN Objetivo: Describir el desarrollo de un software prototipo para aplicar el Proceso de Enfermería en unidades de clínica médica de un hospital general y evaluar su utilidad. Método: Investigación metodológica aplicada de producción tecnológica de un software, basada en la ingeniería de software piloto, desarrollada en tres fases: especificación, desarrollo y validación. Resultado: Programado bajo la denominación de INFOSAE, el sistema representa un conjunto de etapas (Histórico, Diagnóstico, Resultados esperados e Intervención de enfermería), que brinda orientación a los enfermeros para dirigir y garantizar la atención necesaria al paciente, permitiendo también evaluar dicha atención. Conclusión: El software prototipo INFOSAE, tecnología informática de fácil aplicación, contó con evaluación favorable por parte de los enfermeros usuarios que participaron de todo el proceso de desarrollo, desde la especificación hasta la validación del sistema.
RESUMO Objetivo: Descrever o desenvolvimento de um software protótipo para aplicar o Processo de Enfermagem em unidades de clínica médica de um hospital geral e avaliar sua utilidade. Método: Pesquisa metodológica aplicada de produção tecnológica de um software, baseada na engenharia de software de prototipação, desenvolvida em três fases: especificação, desenvolvimento e validação. Resultado: Produzido com a denominação de INFOSAE, o sistema representa um conjunto de etapas (Histórico, Diagnóstico, Resultados esperados e Intervenção de enfermagem) que fornece orientação aos enfermeiros para direcionar e garantir a assistência necessária ao paciente, possibilitando ainda avaliar essa assistência. Conclusão: O software protótipo INFOSAE, tecnologia informatizada de fácil aplicação, teve avaliação favorável dos enfermeiros usuários que participaram de todo o processo de desenvolvimento, desde a especificação até a validação do sistema.
Тема - темы
Humans , Reference Standards , Software/standards , Nursing Care/methods , Patients' Rooms/trends , Software/trends , Nursing CareРеферат
ABSTRACT Objective: To compare the distributions of measurements of the Dutch Fatigue Scale (DUFS), Dutch Exertion Fatigue Scale (DEFS), and Fatigue Pictogram tools, according to the New York Heart Association (NYHA) Functional Classification and left ventricular ejection fraction (LVEF). Method: Methodological, cross-sectional study with 118 patients with heart failure. Variance analysis, Pearson's correlation, and Fisher's exact tests were carried out, with a significance level of 0.05. Results: There was an increase in the DUFS and DEFS means with worsening of the NYHA-FC (p<0.001, for both tools). Correlations among the LVEF resulted in positive and weak magnitude for the DEFS (r=0.18; p=0.05) and for the DUFS (r=0.16; p=0.08). Just the item A on the Fatigue Pictogram had an association with the NYHA-FC (p<0.001) and the LVEF (p=0.03). Conclusion: Three tools detected worsening in fatigue levels according to the illness severity assessed by the NYHA-FC.
RESUMEN Objetivo: Comparar las distribuciones de medidas de los instrumentos Dutch Fatigue Scale (DUFS), Dutch Exertion Fatigue Scale (DEFS) y Pictograma de Fatiga, según la Clase Funcional de la New York Heart Association (CF-NYHA), y la fracción de eyección del ventrículo izquierdo (FEVE). Método: Estudio metodológico, transversal, con 118 pacientes con insuficiencia cardíaca. Fueron realizados los tests Análisis de Varianza, Correlación de Pearson y Exacto de Fisher, nivel de significatividad de 0,05. Resultados: Hubo aumentos en los promedios del DUFS y del DEFS, empeorando la CF-NYHA (p<0,001 en ambos instrumentos). Las correlaciones entre FEVE fueron de magnitud positiva a débil para DEFS (r=0,18; p=0,05) y para DUFS (r=0,16; p=0,08). Solo el ítem A del Pictograma de Fatiga tuvo asociación con la CF-NYHA (p<0,001) y con la FEVE (p=0,03). Conclusión: Los tres instrumentos detectaron empeoramiento de niveles de fatiga de acuerdo con la enfermedad evaluada por la CF-NYHA.
RESUMO Objetivo: Comparar as distribuições das medidas dos instrumentos Dutch Fatigue Scale (DUFS), Dutch Exertion Fatigue Scale (DEFS) e Pictograma de Fadiga, segundo a Classe Funcional da New York Heart Association (CF-NYHA) e a Fração de Ejeção do Ventrículo Esquerdo (FEVE). Método: Estudo metodológico, transversal, com 118 pacientes com insuficiência cardíaca. Foram realizados os testes Análise de Variância, Correlação de Pearson e Exato de Fisher, com nível de significância de 0,05. Resultados: Houve aumento nas médias do DUFS e do DEFS com a piora da CF-NYHA (p<0,001, para ambos os instrumentos). As correlações entre a FEVE foram de positiva e fraca magnitude para o DEFS (r=0,18; p=0,05) e para o DUFS (r=0,16; p=0,08). Somente o item A do Pictograma de Fadiga teve associação com a CF-NYHA (p<0,001) e com a FEVE (p=0,03). Conclusão: Os três instrumentos detectaram piora nos níveis de fadiga, de acordo com a gravidade da doença avaliada pela CF-NYHA.
Тема - темы
Humans , Male , Female , Adult , Aged , Software/standards , Fatigue/classification , Heart Failure/complications , Cross-Sectional Studies , Surveys and Questionnaires , Fatigue/diagnosis , Middle AgedРеферат
ABSTRACT Objective: Validate the content of an instrument that assesses the quality of a software applied to the risk classification of patients. Method: Methodological study, conducted in three stages: adaptation of the instrument, content validation through Delphi technique and pre-test. The results were analyzed through Content Validity Index, Overall Content Validity Index and Inter-rater Reliability. Results: The final version of the instrument comprises 8 characteristics and 28 sub-characteristics, being 37 general questions to computer experts and nurse and 7 specific questions to computer experts, including 1 question and excluding 3 questions of the original instrument. We obtained Overall Content Validity of 92% and Inter-rater Reliability of 100% in the second Delphi round. Final considerations: The instrument has content validity, allowing to assess the technical quality and functional performance of the software applied to the risk classification of patients.
RESUMEN Objetivo: Validar el contenido de instrumento que evalúa la cualidad de un programa (software) aplicado a la clasificación de riesgo de pacientes. Método: Estudio metodológico, realizado en tres etapas: la adaptación del instrumento, la validación de contenido por medio de la técnica Delphi y la prueba previa. Los resultados fueron analizados por medio del Índice de Validez de Contenido, Índice de Validez de Contenido Global e Índice de Concordancia Interevaluadores. Resultados: La versión final del instrumento contempla ocho características, 28 subcaracteristicas, siendo 37 cuestiones generales a los expertos en informática y enfermero y siete cuestiones específicas a los expertos en informática, con inclusión de una cuestión y exclusión de tres cuestiones del instrumento original. Se obtuvo porcentual de Validez de Contenido Global del 92% e Índice de Concordancia Interevaluadores del 100% en la segunda ronda Delphi. Consideraciones finales: El instrumento posee validez de contenido permitiendo evaluar la cualidad técnica y el desempeño funcional de programa (software) aplicado a la clasificación de riesgo de pacientes.
RESUMO Objetivo: Validar o conteúdo de instrumento que avalia a qualidade de um software aplicado à classificação de risco de pacientes. Método: Estudo metodológico, realizado em três fases: adaptação do instrumento, validação de conteúdo por meio da técnica Delphi e pré-teste. Os resultados foram analisados por meio do Índice de Validade de Conteúdo, Índice de Validade de Conteúdo global e Índice de Concordância Interavaliadores. Resultados: A versão final do instrumento contempla oito características, 28 subcaracterísticas, sendo 37 questões gerais aos especialistas em informática e enfermeiro e sete questões específicas aos especialistas em informática, com inclusão de uma questão e exclusão de três questões do instrumento original. Obteve-se percentual de Validade de Conteúdo Global de 92% e Índice de Concordância Interavaliadores de 100% na segunda rodada Delphi. Considerações finais: O instrumento possui validade de conteúdo permitindo avaliar a qualidade técnica e desempenho funcional de software aplicado à classificação de risco de pacientes.
Тема - темы
Humans , Male , Female , Adult , Psychometrics/standards , Software Design , Software/standards , Risk Assessment/standards , Psychometrics/instrumentation , Psychometrics/methods , Brazil , Reproducibility of Results , Delphi Technique , Risk Assessment/methodsРеферат
La detección oportuna de fallas y el monitoreo de los elementos que conforman una red de computadoras son actividades de gran relevancia para brindar un buen servicio a los usuarios. De esto se deriva la importancia de contar con un esquema capaz de notificar las fallas en la red y de mostrar su comportamiento mediante el análisis y recolección de tráfico. En el presente trabajo se aborda el monitoreo de redes, describiendo los diferentes enfoques y técnicas que se deben tener en consideración para implementar este servicio, los elementos a tomar en cuenta en un esquema de monitoreo, así como un resumen de algunas herramientas para su implementación(AU)
The timely detection of failures and the monitoring of the elements that make up a computer network are highly relevant activities to provide a good service to users. From this the importance of having a scheme capable of notifying of faults in the network and of showing their behavior through the analysis and collection of traffic is derived. In the present work the monitoring of networks is approached, describing the different approaches and techniques that must be taken into consideration to implement this service, the elements to be taken into accountin a monitoring scheme, as well as a summary of some tools for its implementation(AU)
Тема - темы
Humans , Medical Informatics Applications , Software/standards , Science and Technology Information NetworksРеферат
Se presenta la existencia de soluciones de la Inteligencia Artificial en la enseñanza aprendizaje inteligente mediante tutores, gestión del aprendizaje o video juegos. Se expone la capacidad de adaptación dinámica de los mismos al desarrollo del aprendizaje del estudiante. Se observa ausencia de los mismos u otros en ámbitos de formación reglamentada, lo cual constituye ya una desventaja inobjetable. Se define el objetivo del presente trabajo como: caracterizar el estado de la aplicación de la Inteligencia Artificial en la pedagogía, y considerar la importancia y factibilidad práctica de la técnica de Inteligencia Artificial para la mejora de los procesos de aprendizaje. Se analizan los métodos Sistemas Expertos, Redes Neurales Artificiales, Algoritmos Genéticos, Razonamiento Basado en Casos, así como se declaran las herramientas informáticas: Servidor Web Apache, Lenguajes Java Script, PHP para servidor y de Gestión MySql de Bases de Datos, requeridas para la utilización de estos métodos de Inteligencia Artificial en entorno multiplataforma. Los resultados se sintetizan en relaciones de inconvenientes al emplear cada una de las varias técnicas de Inteligencia Artificial mencionadas, resultando el Razonamiento Basado en Casos más prometedor y el de mayor perspectiva. Consecuentemente, igualmente la Inteligencia Artificial lo es respecto a la enseñanza, así como también lo es el disponer de esta técnica para el desarrollo de este campo. Se concluye que se cumple el objetivo planteado, el análisis de las técnicas más conocidas, la factibilidad de aplicación del Razonamiento Basado en Casos, y la definición de herramientas informáticas para la aplicación multiplataforma de la técnica de Inteligencia Artificial seleccionada, desde este enfoque preliminar(AU)
Existing Artificial Intelligence solutions for teaching- learning processes by means of tutors, learning management or video games are presented here. Their capacity for dynamic adaptation to student's learning development is detected. Absence of the same or others in areas of regulated training is observed, what constitutesan undeniable disadvantage. The objective of this paper is to characterize the state of application of Artificial Intelligence in pedagogy and to consider the importance and practical feasibility of the Artificial Intelligence techniquefor improving the learning processes. We analyze the Expert Systems, Artificial Neural Networks, Genetic Algorithms and Cases Based Reasoning methods, as well as the computer tools: Apache Web Server and the Java Script, PHP for Serversand MySql Database Management Languages, which all of them are required for using these Artificial Intelligence methods and tools in multiplatform environment. Results sum up as disadvantages when employing several mentioned Artificial intelligence techniques, but Cases Based Reasoning technique turns out to be the most perspective and promising one. Consequently the state of Artificial Intelligence turns out equally so for the teaching process, as well as forhaving this technique available for development in this field. It is concluded that the outlined objective, the analysis of the best known techniques, the feasibility of application of the Cases Based Reasoning, and the definition of the Computer Tools are met for multiplatform application of the selected Artificial Intelligence technique from this preliminary approach(AU)
Тема - темы
Humans , Male , Female , Algorithms , Programming Languages , Software/standards , Artificial Intelligence , Instructional Film and Video , Education, MedicalРеферат
Introdução: Mensurações por antropometria indireta são importantes na área de pesquisa, mas também podem se tornar significativas na área jurídica, como instrumento quantitativo de avaliação pré e pós-operatória. O tipo de arquivo utilizado determina variações na manipulação das imagens. O objetivo é evidenciar tipos de arquivos de imagens utilizados na fotografia digital que será utilizada na pesquisa. Métodos: Foram realizadas mensurações das mamas em 80 hemitórax de 40 mulheres voluntárias. Foram demarcados pontos sobre a região mamária e braços em posição frontal. A união destes pontos em cada hemicorpo formou sete segmentos lineares, uma medida angular e um segmento mediano comum a ambos os hemicorpos. Essas fotografias foram avaliadas em arquivos RAW e JPEG de alta definição, por 3 observadores, com auxílio do software Adobe Photoshop CS6®. Resultados: Os arquivos RAW e JPEG demonstraram serem eficazes na mensuração das mamas. Conclusão: Os arquivos RAW e JPEG apresentaram medidas semelhantes na mensuração das mamas femininas.
Introduction: Indirect anthropometric measurements are important in research but may also be significant in the legal area as a quantitative instrument for pre- and post-operative evaluation. The type of file used determines variations in the manipulation of the images. The objective is to study the types of image files used in digital photography that will find utility in research. Methods: The breasts of 40 women volunteers were measured in 80 hemithoraces, and the mammary region and arms were marked in the frontal position. The union of these points in each hemithorax formed seven linear segments, an angular measure, and a median segment common to both hemithoraces. These photographs were evaluated as high definition RAW and JPEG files by three observers using Adobe Photoshop CS6® software. Results: RAW and JPEG files were shown to be effective in breast measurement. Conclusion: RAW and JPEG files presented similar results in the measurement of female breasts.
Тема - темы
Humans , Female , Adolescent , Adult , Middle Aged , History, 21st Century , Thorax , Body Weights and Measures , Software , Breast , Anthropometry , Journal Article , Mammaplasty , Photograph , Dimensional Measurement Accuracy , Thorax/diagnostic imaging , Body Weights and Measures/instrumentation , Body Weights and Measures/methods , Software/standards , Breast/abnormalities , Breast/diagnostic imaging , Anthropometry/instrumentation , Anthropometry/methods , Mammaplasty/instrumentation , Mammaplasty/methodsРеферат
El desarrollo extraordinario de la tecnología, los resultados de la innovación tecnológica y más aún en el campo de las ciencias informáticas y las telecomunicaciones, hacen de la realización de proyectos de investigación algo cotidiano en las organizaciones empresariales e instituciones públicas. La mayoría de las veces los resultados de estas investigaciones, así como otras informaciones de carácter general son presentados en plataformas web, haciendo uso de gestores de contenido por las ventajas que ofrecen estos con respecto a su alcance y fácil manipulación para mantenerlos actualizados, evidenciándose en una mayor productividad de la entidad al emplearlos. Es por esta razón que se hace imprescindible que las instituciones se interesen por las redes de computación, el mantenimiento y la seguridad requerida para la utilización de los gestores de contenido. Con el fin de prestar atención a este último aspecto (la seguridad), es que el presente trabajo aborda una serie de aspectos que tanto programadores, como administradores de red deben manejar para mejorar la toma de decisiones a la hora de proteger la información expuesta en Web basadas en sistemas gestores de contenido, y en específico aquellas basadas en Joomla!(AU)
The extraordinary development of technology, the results of technological innovation and even more in the field of computer science and telecommunications, make the realization of research projects something every day in business organizations and public institutions. Most of the time the results of this research, as well as other general information are presented in web platforms, making use of content managers because of the advantages they offer with respect to their scope and easy manipulation to keep them updated, evidenced in greater productivity of the entity when using them. It is for this reason that it is essential that institutions are interested in the computer networks, maintenance and security required for the use of content managers. In order to pay attention to this last aspect (security), it is that the present work shows a series of aspects that both programmers and network administrators must manage to improve decision making in protecting the information exposed in Web-based content management systems, and specifically those based on Joomla!(AU)