Childhood and adolescence in mental health policy: an analysis through health counselors and conferences. / A infância e a adolescência na política de saúde mental: uma análise por meio dos conselheiros e conferências de saúde.

This qualitative, descriptive, and exploratory documentary and field research aimed to analyze how children and adolescents are included in the formulation of public mental health policies. The document analysis database consisted of reports from Health Conferences (national, state, and municipal), minutes of meetings of the Health Council (national, state, and municipal), and memories of the Thematic Commission on Mental Health (state and municipal). Nine counselors or former health counselors participated in this study through an individual interview with a semi-structured script. Furthermore, the theoretical framework for the analysis of this research was based on the communicative action of Jürgen Habermas. The themes that emerged from the documentary research included the guidelines for intersectoral processes, as well as the expansion of beds for children and adolescents. In addition, the interviews indicated the lack of discussion on the subject, predominance of the punitive perspective, and need for a broader debate. The lack of intersubjective spaces for democratic listening compromises communicative action, resulting in the invisibility of children and adolescents in the policy formulation process and reduced opportunities for participation and social control.

O objetivo do trabalho foi analisar como crianças e adolescentes são contemplados nos processos de participação para a formulação das políticas públicas de saúde mental. Pesquisa qualitativa, descritiva e exploratória de caráter documental e de campo. A base de dados da análise documental consistiu em: relatórios das Conferências de Saúde (nacional, estadual e municipal), atas de reuniões do Conselho de Saúde (nacional, estadual e municipal) e memórias da Comissão Temática de Saúde Mental (estadual e municipal). Participaram deste estudo nove conselheiros ou ex-conselheiros de saúde, por meio de uma entrevista individual com roteiro semiestruturado. Como marco teórico de análise desta pesquisa, foi proposto o agir comunicativo de Jürgen Habermas. Dentre os temas que emergiram da pesquisa documental, encontram-se as diretrizes de processos intersetoriais, bem como a ampliação de leitos para crianças e adolescentes. As entrevistas apontaram a falta de discussão da temática, predomínio da perspectiva punitivista e para a necessidade de um debate mais amplo. A falta de espaços intersubjetivos de escuta democrática compromete o agir comunicativo, ocasionando a invisibilização da criança e do adolescente no processo de formulação da política e enfraquecendo os espaços de participação e controle social.

Overview of the Last 71 Years of Metabolic and Bariatric Surgery: Content Analysis and Meta-analysis to Investigate the Topic and Scientific Evolution.

Obesity is a worldwide epidemic, and bariatric surgery has become increasingly popular due to its effectiveness in treating it. Therefore, understanding this area is of paramount importance. This article aims to provide an understanding of the development of the topic related to procedures, content, data, and status. To achieve this objective, a literature review and a bibliometric analysis were conducted. The methods provided insight into the current state and relevant topics over time. In conclusion, the article provided the identification of the transformation of the research field, initially focused only on physical aspects, to a more complex approach, which also incorporates psychological and social aspects and the correlation between obesity, bariatric surgery, and quality of life.

Fostering Digital Health in Universities: An Experience of the First Junior Scientific Committee of the Brazilian Congress of Health Informatics.

OBJECTIVES: Digital health (DH) is a revolution driven by digital technologies to improve health. Despite the importance of DH, curricular updates in healthcare university programs are scarce, and DH remains undervalued. Therefore, this report describes the first Junior Scientific Committee (JSC) focusing on DH at a nationwide congress, with the aim of affirming its importance for promoting DH in universities. METHODS: The scientific committee of the Brazilian Congress of Health Informatics (CBIS) extended invitations to students engaged in health-related fields, who were tasked with organizing a warm-up event and a 4-hour session at CBIS. Additionally, they were encouraged to take an active role in a workshop alongside distinguished experts to map out the current state of DH in Brazil. RESULTS: The warm-up event focused on the topic "Artificial intelligence in healthcare: is a new concept of health about to arise?" and featured remote discussions by three professionals from diverse disciplines. At CBIS, the JSC's inaugural presentation concentrated on delineating the present state of DH education in Brazil, while the second presentation offered strategies to advance DH, incorporating viewpoints from within and beyond the academic sphere. During the workshop, participants deliberated on the most crucial competencies for future professionals in the DH domain. CONCLUSIONS: Forming a JSC proved to be a valuable tool to foster DH, particularly due to the valuable interactions it facilitated between esteemed professionals and students. It also supports the cultivation of leadership skills in DH, a field that has not yet received the recognition it deserves.

Is it possible to automate the discovery of process maps for the time-driven activity-based costing method? A systematic review.

OBJECTIVES: The main objective of this manuscript was to identify the methods used to create process maps for care pathways that utilized the time-driven activity-based costing method. METHODS: This is a systematic mapping review. Searches were performed in the Embase, PubMed, CINAHL, Scopus, and Web of Science electronic literature databases from 2004 to September 25, 2022. The included studies reported practical cases from healthcare institutions in all medical fields as long as the time-driven activity-based costing method was employed. We used the time-driven activity-based costing method and analyzed the created process maps and a qualitative approach to identify the main fields. RESULTS: A total of 412 studies were retrieved, and 70 articles were included. Most of the articles are related to the fields of orthopedics and childbirth-related to hospital surgical procedures. We also identified various studies in the field of oncology and telemedicine services. The main methods for creating the process maps were direct observational practices, complemented by the involvement of multidisciplinary teams through surveys and interviews. Only 33% of the studies used hospital documents or healthcare data records to integrate with the process maps, and in 67% of the studies, the created maps were not validated by specialists. CONCLUSIONS: The application of process mining techniques effectively automates models generated through clinical pathways. They are applied to the time-driven activity-based costing method, making the process more agile and contributing to the visualization of high degrees of variations encountered in processes, thereby making it possible to enhance and achieve continual improvements in processes.

Validation of targeted selective treatment (TST) methodology for gastrointestinal parasites of adult sheep in different physiological states.

We aimed to validate a targeted selective treatment (TST) methodology for treating parasitic gastrointestinal infections in ewes in different physiological states using parasitological and hematological parameters. Forty ewes were monitored from December 2021 to June 2022 and evaluated during various physiological stages in their life cycle. Before starting the experiment, a fecal egg count (FEC) reduction test was performed to evaluate the efficacy of the anthelmintic (AH) treatment. Weekly assessments were performed based on the Famacha© (F) system and body condition score (BCS), and ewes were subjected to AH treatment when necessary, with their physiological states recorded. Ewes were treated when they presented F ≥ 3, BCS ≤ 2.0 (when F = 2), or submandibular edema. Parasitological, i.e., FEC, and hematological, i.e., hematocrit (Ht), parameters were evaluated monthly to determine the efficiency of the TST methodology. Comparisons between the mean Ht and FEC values in ewes subjected to AH treatment and untreated ewes were performed using analysis of variance, followed by Tukey's test. Spearman's correlation was performed to determine the correlation between the variables, i.e., F scores, BCS, Ht, and FEC. All tests were performed at a significance level of 5 %. During the experimental period, 1138 evaluations were performed. The main reason for AH treatment was F ≥ 3. Ewes in early pregnancy, lactation and late pregnancy received comparatively more AH treatments than the other physiological states. Ewes in late pregnancy and lactation exhibited lower mean Ht values (23.5 % and 22.9 %) and higher mean FEC values (3269 and 1426) compared with those in early pregnancy (30.2 % and 727 EPG). In addition, a statistically significant difference was observed in the Ht and FEC values of ewes that presented submandibular edema (P < 0.001) compared with those that did not exhibit submandibular edema. The genus Haemonchus sp. showed a 96.4 % prevalence in coprocultures. A positive correlation existed between F scores and FEC (r = 0.3819) and a negative correlation between F scores and Ht (r = -0.4728). Ewes that needed AH treatment had lower mean Ht values than ewes that did not need the treatment (19.2 % × 29.3 %; P < 0.001) and higher mean FEC values (8747 × 1163; P < 0.001), confirming that these ewes needed AH treatment. The TST methodology based on F scores, BCS, and submandibular edema could effectively identify individuals in the herd needing AH treatment, identifying 13 % additional cases requiring treatment than using only the F score criterion.

Prediction of the occurrence of leprosy reactions based on Bayesian networks.

Introduction: Leprosy reactions (LR) are severe episodes of intense activation of the host inflammatory response of uncertain etiology, today the leading cause of permanent nerve damage in leprosy patients. Several genetic and non-genetic risk factors for LR have been described; however, there are limited attempts to combine this information to estimate the risk of a leprosy patient developing LR. Here we present an artificial intelligence (AI)-based system that can assess LR risk using clinical, demographic, and genetic data. Methods: The study includes four datasets from different regions of Brazil, totalizing 1,450 leprosy patients followed prospectively for at least 2 years to assess the occurrence of LR. Data mining using WEKA software was performed following a two-step protocol to select the variables included in the AI system, based on Bayesian Networks, and developed using the NETICA software. Results: Analysis of the complete database resulted in a system able to estimate LR risk with 82.7% accuracy, 79.3% sensitivity, and 86.2% specificity. When using only databases for which host genetic information associated with LR was included, the performance increased to 87.7% accuracy, 85.7% sensitivity, and 89.4% specificity. Conclusion: We produced an easy-to-use, online, free-access system that identifies leprosy patients at risk of developing LR. Risk assessment of LR for individual patients may detect candidates for close monitoring, with a potentially positive impact on the prevention of permanent disabilities, the quality of life of the patients, and upon leprosy control programs.

Gestational and congenital syphilis: gaps to be elucidated.

Congenital and gestational syphilis are increasingly prevalent multisystemic infections in Brazil. This study aimed to present a case series of three children diagnosed with congenital syphilis even though their mother had unreactive treponemal tests. The VDRL (Venereal Disease Research Laboratory) titers of a 22-year-old mother with three pregnancies decreased after treatment. The mother did not have a reactive treponemal test, but all the three children were diagnosed with early congenital syphilis. This case series highlights the difficulty in diagnosing gestational and congenital syphilis in Brazil.

Deception detection with machine learning: A systematic review and statistical analysis.

Several studies applying Machine Learning to deception detection have been published in the last decade. A rich and complex set of settings, approaches, theories, and results is now available. Therefore, one may find it difficult to identify trends, successful paths, gaps, and opportunities for contribution. The present literature review aims to provide the state of research regarding deception detection with Machine Learning. We followed the PRISMA protocol and retrieved 648 articles from ACM Digital Library, IEEE Xplore, Scopus, and Web of Science. 540 of them were screened (108 were duplicates). A final corpus of 81 documents has been summarized as mind maps. Metadata was extracted and has been encoded as Python dictionaries to support a statistical analysis scripted in Python programming language, and available as a collection of Jupyter Lab Notebooks in a GitHub repository. All are available as Jupyter Lab Notebooks. Neural Networks, Support Vector Machines, Random Forest, Decision Tree and K-nearest Neighbor are the five most explored techniques. The studies report a detection performance ranging from 51% to 100%, with 19 works reaching accuracy rate above 0.9. Monomodal, Bimodal, and Multimodal approaches were exploited and achieved various accuracy levels for detection. Bimodal and Multimodal approaches have become a trend over Monomodal ones, although there are high-performance examples of the latter. Studies that exploit language and linguistic features, 75% are dedicated to English. The findings include observations of the following: language and culture, emotional features, psychological traits, cognitive load, facial cues, complexity, performance, and Machine Learning topics. We also present a dataset benchmark. Main conclusions are that labeled datasets from real-life data are scarce. Also, there is still room for new approaches for deception detection with Machine Learning, especially if focused on languages and cultures other than English-based. Further research would greatly contribute by providing new labeled and multimodal datasets for deception detection, both for English and other languages.

Gestational and congenital syphilis: gaps to be elucidated

ABSTRACT Congenital and gestational syphilis are increasingly prevalent multisystemic infections in Brazil. This study aimed to present a case series of three children diagnosed with congenital syphilis even though their mother had unreactive treponemal tests. The VDRL (Venereal Disease Research Laboratory) titers of a 22-year-old mother with three pregnancies decreased after treatment. The mother did not have a reactive treponemal test, but all the three children were diagnosed with early congenital syphilis. This case series highlights the difficulty in diagnosing gestational and congenital syphilis in Brazil.

Applying process mining in health technology assessment.

Objective: Propose a process mining-based method for Health Technology Assessment. Methods: Articles dealing with prior studies in Health Technology Assessment using Process Mining were identified. Five research questions were defined to investigate these studies and present important points and desirable characteristics to be addressed in a proposal. The was defined method with five steps and was submitted to a case study for evaluation. Results: The Literature search identified six main characteristics. As a result, the five-step method proposed was applied in the radical prostatectomy surgical procedure between the robot assisted technique and laparoscopy. Conclusion: It was demonstrated in this article the creation of the proposal of an efficient method with its replication for other health technologies, coupled with the good interpretation of the specialists in terms of comprehensibility of the discovered patterns and their correlation with clinical protocols and guidelines.

SemClinBr - a multi-institutional and multi-specialty semantically annotated corpus for Portuguese clinical NLP tasks.

BACKGROUND: The high volume of research focusing on extracting patient information from electronic health records (EHRs) has led to an increase in the demand for annotated corpora, which are a precious resource for both the development and evaluation of natural language processing (NLP) algorithms. The absence of a multipurpose clinical corpus outside the scope of the English language, especially in Brazilian Portuguese, is glaring and severely impacts scientific progress in the biomedical NLP field. METHODS: In this study, a semantically annotated corpus was developed using clinical text from multiple medical specialties, document types, and institutions. In addition, we present, (1) a survey listing common aspects, differences, and lessons learned from previous research, (2) a fine-grained annotation schema that can be replicated to guide other annotation initiatives, (3) a web-based annotation tool focusing on an annotation suggestion feature, and (4) both intrinsic and extrinsic evaluation of the annotations. RESULTS: This study resulted in SemClinBr, a corpus that has 1000 clinical notes, labeled with 65,117 entities and 11,263 relations. In addition, both negation cues and medical abbreviation dictionaries were generated from the annotations. The average annotator agreement score varied from 0.71 (applying strict match) to 0.92 (considering a relaxed match) while accepting partial overlaps and hierarchically related semantic types. The extrinsic evaluation, when applying the corpus to two downstream NLP tasks, demonstrated the reliability and usefulness of annotations, with the systems achieving results that were consistent with the agreement scores. CONCLUSION: The SemClinBr corpus and other resources produced in this work can support clinical NLP studies, providing a common development and evaluation resource for the research community, boosting the utilization of EHRs in both clinical practice and biomedical research. To the best of our knowledge, SemClinBr is the first available Portuguese clinical corpus.

Environment type and storage period on eggshell quality of laying hens at different ages / Tipos de ambiente e período de armazenamento sobre a qualidade de casca de ovos de poedeiras comerciais em diferentes idades

ABSTRACT: Eggshell quality is directly linked to the good acceptability of the product by consumers, whereas the industry is concerned with economic losses. Prolonged periods of laying, diseases, nutrition, bird age and genetics can influence egg quality. This study aimed to examine the influence of the environment, bird age and storage period on the physical characteristics of the shell of eggs from commercial laying hens. The experiment involved 288 eggs from Hy-line hens, which were distributed in a completely randomized design with a triple 3×2×4 factorial arrangement represented by three ages (31, 62 or 88 weeks), two storage temperatures (ambient or refrigerated), and four storage periods (one, 10, 20 or 30 days), totaling 24 treatments. Four replications were used with three eggs each. Eggshell strength, percentage and thickness were measured. Differences were observed, with the eggs stored at room temperature exhibiting lower shell strength. Laying eggs at an advanced age (88 weeks) resulted in decreased eggshell strength as compared with the other ages, whereas the eggs from young layers (31 weeks) had a thicker shell. The advancing age of the laying hens reduced eggshell quality, regardless of the storage environment. Nonetheless, the eggs stored in the refrigerator showed better eggshell quality and integrity than those stored at ambient temperature.

RESUMO: A qualidade da casca está diretamente ligada à boa aceitabilidade do produto pelos consumidores, enquanto a indústria se preocupa com as perdas econômicas. Períodos prolongados de postura, doenças, nutrição, idade da ave e genética podem influenciar a qualidade dos ovos. Objetivou-se avaliar a influência do ambiente, idade da ave e período de armazenamento nas características físicas da casca de ovos de poedeiras comerciais. Foram utilizados 288 ovos de poedeiras Hy-line, distribuídos em um delineamento inteiramente casualizado em fatorial triplo 3x2x4, sendo os fatores: três idades (31, 62 e 88 semanas), temperatura de armazenamento (ambiente e refrigerado), e quatro períodos de armazenamento (um, 10, 20 e 30 dias), totalizando 24 tratamentos, com quatro repetições de três ovos. Avaliou-se a resistência, percentual e espessura da casca. Foram observadas diferenças, uma vez que os ovos armazenados em temperatura ambiente apresentaram diminuição na resistência de casca. Ovos de poedeiras em idade avançada (88 semanas) apresentaram pior resistência de casca em relação às demais idades, enquanto ovos provenientes de poedeiras jovens (31 semanas) apresentaram maior espessura de casca. A idade avançada da poedeira reduziu a qualidade de casca dos ovos, independentemente do ambiente de armazenamento. Ainda, os ovos armazenados em geladeira apresentaram melhor qualidade e integridade da casca em comparação com os armazenados ao ambiente.

Análise de itinerário dos usuários para atendimento de serviços Básicos de Saúde, por meio de Mineração de Processos / Analysis of users' itinerary to service Basic Health services, through Process Mining / Análisis del itinerario de usuarios para el servicio de servicios Básicos de Salud, mediante Minería de Procesos

Objetivo: O objetivo deste trabalho foi analisar o itinerário e o perfil dos usuários, com demandas por atendimentos de saúde nas unidades básicas e de pronto atendimento, por meio da mineração de processos. Método: A base de dados foi extraída do Sistema Informatizado e-Saúde ­ Município de Curitiba, correspondente ao período entre janeiro e dezembro de 2019. Quatro distritos sanitários foram selecionados a partir de critérios de polarização. Para a descoberta do itinerário, foi adotado o software Disco®. Resultado: Foram identificadas situações que não seguem o preconizado pela atenção primária à saúde, desde a consulta médica como sendo o serviço básico de saúde mais frequente realizado nas unidades de pronto atendimento, bem como sendo o primeiro local de busca por atendimento. Conclusão: O critério de polarização para a seleção dos distritos, contribui para que o gestor reveja o processo de trabalho estabelecido para a atenção básica, conforme o respectivo perfil.

Objective: The objective of this study was to analyze the itinerary and profile of users, with demands for health care in primary and emergency care units, through process mining. Method: The database was extracted from the e-Saúde Computerized System ­ Municipality of Curitiba, corresponding to January and December 2019. Four health districts were selected based on polarization criteria. For the discovery of the itinerary, the Disco® software was adopted. Result: Situations that do not follow what is recommended by primary health care were identified since the medical consultation is the most frequent basic health service performed in emergency care units and the first place to seek care. Conclusion: The polarization criterion for selecting districts helps the manager review the work process established for primary care, according to the respective profile.

Objetivo: El objetivo de este estudio fue analizar el itinerario y perfil de los usuarios, con demandas de atención a la salud en las unidades de atención primaria y urgencias, a través de la minería de procesos. Método: La base de datos se extrajo del Sistema Computarizado e-Saúde - Municipio de Curitiba (enero a diciembre de 2019). Se seleccionaron cuatro distritos de salud con base en criterios de polarización. Para el descubrimiento del itinerario se adoptó el software Disco®. Resultado: Se identificaron situaciones que no siguen lo recomendado por la atención primaria de salud, ya que la consulta médica es el servicio básico de salud más frecuente que se realiza en las unidades de atención de emergencia y el primer lugar para buscar atención. Conclusión: El criterio de polarización para la selección de distritos ayuda al gestor a revisar el proceso de trabajo establecido para la atención primaria, según el perfil respectivo.

Clinical applicability of the terminological subset of palliative care for dignified dying.

OBJECTIVE: To evaluate the clinical applicability of the terminological subset of the international classification for the nursing practice of palliative care for a dignified dying, in oncology. METHOD: Prospective study evaluating the clinical applicability of 33 nursing diagnoses/outcomes and 220 nursing interventions. It used case studies of 20 cancer patients undergoing palliation. The nursing process steps were operated by two nurses. Descriptive statistics was used to present, according to the theoretical model, the nursing diagnoses/outcomes and interventions identified in the patients. All statements identified in patients at some point during care were considered applicable in clinical practice. RESULTS: Twenty-nine nursing diagnoses/outcomes and 197 nursing interventions from the subset were identified. CONCLUSION: In the context of palliative care in patients with cancer, the clinical applicability of 87.8% of the diagnoses/outcomes and 89.5% of the interventions that make up the palliative care terminological subset for dignified dying is affirmed.

Representation of Diagnosis and Nursing Interventions in OpenEHR Archetypes.

OBJECTIVE: The study aimed to represent the content of nursing diagnosis and interventions in the openEHR standard. METHODS: This is a developmental study with the models developed according to ISO 18104: 2014. The Ocean Archetype Editor tool from the openEHR Foundation was used. RESULTS: Two archetypes were created; one to represent the nursing diagnosis concept and the other the nursing intervention concept. Existing archetypes available in the Clinical Knowledge Manager were reused in modeling. CONCLUSION: The representation of nursing diagnosis and interventions based on the openEHR standard contributes to representing nursing care phenomena and needs in health information systems.

Atuação de psicólogos nos CRAS do nordeste: uma revisão sistemática / Psychologist performance in brazilian northeast social assistance reference centers (CRAS): a systematic review / Actuación de psicólogos en los centros de referencia de asistencia social (CRAS) del nordeste: un revisión sistemática

RESUMO O artigo apresenta uma revisão sistemática sobre a atuação de psicólogos nos CRAS no Nordeste brasileiro, de 2009 a 2018. O levantamento realizou-se nas bases de dados: Periódicos CAPES, REDALYC, LILACS, SciELO e PEPSIC, selecionando 12 artigos. O estado do Rio Grande do Norte se destacou nas publicações com os estudos apontando um interesse pela interiorização da atuação e assumindo preferência pela metodologia da pesquisa qualitativa, com prevalência da análise de conteúdo. Sobre as atuações descritas, embora algumas ações essenciais ainda sejam incipientes, como no caso da territorialização e da vigilância social, as práticas corroboram com as orientações normativas. Assim, entende-se que as práticas vêm se transformando, porém é preciso investir na formação para o trabalho social e no compromisso ético-político para uma atuação verdadeiramente transformadora.

ABSTRACT The article presents a systematic review about the performance of psychologists in CRAS in the Brazilian Northeast region, from 2009 to 2018. The survey was carried out in the databases Periódicos CAPES, REDALYC, LILACS, SciELO and PEPSIC, selecting 12 articles. The state of Rio Grande do Norte stood out in the publications, showing an interest for the internalization of the performance, and assuming a preference for qualitative methodology and content analysis. The studies showed that some essential actions are still incipient, as in the case of territorialization and social vigilance, but practices seek to follow normative guidelines. Thus, it is understood that the practices have been transforming, but there is a need for investing in a social work qualification and in the ethical-political commitment for a truly transforming professional performance.

RESUMEN Resumen El artículo presenta una revisión sistemática sobre la actuación de psicólogos en los CRAS en el Nordeste brasileño, de 2009 a 2018. El levantamiento se realizó en las bases de datos: Periódicos CAPES, REDALYC, LILACS, SciELO y PEPSIC, seleccionando 12 artículos. El estado del Rio Grande do Norte se destacó en las publicaciones, con los estudios apuntando un interés por la interiorización de la actuación y la investigación cualitativa asume la preferencia metodológica con prevalencia del análisis de contenido. Sobre las actuaciones descritas, aunque algunas acciones esenciales aún son incipientes, en el caso de la territorialización y vigilancia social, las prácticas corroboran con las orientaciones normativas. Así, se entiende que las prácticas se vienen transformando, pero hay que invertir en la formación para el trabajo social y en el compromiso ético-político para una actuación verdaderamente transformadora.

Domestic violence: a Rodger's evolutionist conceptual analysis.

OBJECTIVE: to analyze the concept of domestic violence based on its use in health sciences, humanities, and exact sciences according to Rodgers' evolutionary model. METHODS: this is a concept analysis based on Rodgers' evolutionary conceptual model. Ninety-six articles were included in Portuguese, English, Spanish, and French, which had a definition of domestic violence, having identified the antecedents, attributes and consequences and produced a model case. RESULTS: twenty-two attributes, ten antecedents and eight consequences were identified. FINAL CONSIDERATIONS: from antecedents, attributes and consequences, it was possible to identify the connection between domestic violence and gender issues, especially patriarchal, being seen in a normalized way by society and causing consequences to the victims' physical and psychological health.

Early Identification of Patients at Risk of Sepsis in a Hospital Environment

Abstract Sepsis is a systematic response to an infectious disease, being a concerning factor because of the increase in the mortality ratio for every delayed hour in the identification and start of patient's treatment. Studies that aim to identify sepsis early are valuable for the healthcare domain. Further, studies that propose machine learning-based models to identify sepsis risk are scarce for the Brazilian scenario. Hence, we propose the early identification of sepsis considering data from a Brazilian hospital. We developed a temporal series based on LSTM to predict sepsis in patients considering a three-day timestep. The patients were selected using both criteria, ICD-10, and qSOFA, where we supplemented qSOFA with the additional identification of words referring to infections in the clinical texts. Additionally, we tested a Random Forest classifier to classify patients with sepsis with a single timestep before the sepsis event, evaluating the most relevant features. We achieved an accuracy of 0.907, a sensitivity of 0.912, and a specificity of 0.971 when considering a three-day timestep with LSTM. The Random Forest classifier achieved an accuracy of 0.971, a sensitivity of 0.611, and a specificity of 0.998. The features age, blood glucose, systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, and admission days had the most influence over the algorithm classification, with age being the most relevant feature. We achieved satisfactory results compared with the literature considering a scenario of spaced measures and a high amount of missing data.

Clinical applicability of the terminological subset of palliative care for dignified dying / Aplicabilidad clínica del subconjunto terminológico cuidados paliativos para un morir con dignidad / Aplicabilidade clínica do subconjunto terminológico cuidados paliativos para um morrer com dignidade

ABSTRACT Objective: To evaluate the clinical applicability of the terminological subset of the international classification for the nursing practice of palliative care for a dignified dying, in oncology. Method: Prospective study evaluating the clinical applicability of 33 nursing diagnoses/outcomes and 220 nursing interventions. It used case studies of 20 cancer patients undergoing palliation. The nursing process steps were operated by two nurses. Descriptive statistics was used to present, according to the theoretical model, the nursing diagnoses/outcomes and interventions identified in the patients. All statements identified in patients at some point during care were considered applicable in clinical practice. Results: Twenty-nine nursing diagnoses/outcomes and 197 nursing interventions from the subset were identified. Conclusion: In the context of palliative care in patients with cancer, the clinical applicability of 87.8% of the diagnoses/outcomes and 89.5% of the interventions that make up the palliative care terminological subset for dignified dying is affirmed.

RESUMEN Objetivo: Evaluar la aplicabilidad clínica del subconjunto terminológico de la CIPE para la práctica de enfermería cuidados paliativos para un morir con dignidad, en oncología. Método: Estudio prospectivo, para evaluar la aplicabilidad clínica de 33 diagnósticos/resultados y 220 intervenciones de enfermería. Fueron utilizados estudios de caso de 20 pacientes oncológicos sometidos a paliación. Las etapas del proceso de enfermería fueron operacionalizadas por dos enfermeras. Se utilizó la estadística descriptiva para presentar, de acuerdo con el modelo teórico, los diagnósticos/resultados e intervenciones de enfermería identificados en los pacientes. Fueron considerados aplicables en la práctica clínica todos los enunciados identificados en los pacientes en algún momento de la asistencia. Resultados: Se identificaron 29 diagnósticos/resultados de enfermería y 197 intervenciones de enfermería del subconjunto. Conclusión: En el contexto de los cuidados paliativos en pacientes con enfermedad oncológica se puede afirmar la aplicabilidad clínica de 87,8% de los diagnósticos/resultados y 89,5% de las intervenciones que componen el subconjunto terminológico cuidados paliativos para un morir con dignidad.

RESUMO Objetivo: Avaliar a aplicabilidade clínica do subconjunto terminológico da classificação internacional para a prática de enfermagem cuidados paliativos para um morrer com dignidade, em oncologia. Método: Estudo prospectivo, de avaliação de aplicabilidade clínica de 33 diagnósticos/resultados e 220 intervenções de enfermagem. Usou estudos de caso de 20 pacientes oncológicos em paliação. As etapas do processo de enfermagem foram operacionalizadas por duas enfermeiras. Utilizou-se estatística descritiva para apresentar, conforme o modelo teórico, os diagnósticos/resultados e intervenções de enfermagem identificados nos pacientes. Foram considerados aplicáveis na prática clínica todos os enunciados identificados nos pacientes em algum momento da assistência. Resultados: Foram identificados 29 diagnósticos/resultados de enfermagem e 197 intervenções de enfermagem do subconjunto. Conclusão: No contexto dos cuidados paliativos em pacientes com doença oncológica afirma-se a aplicabilidade clínica de 87,8% dos diagnósticos/resultados e 89,5% das intervenções que compõem o subconjunto terminológico cuidados paliativos para um morrer com dignidade.

Knowledge discovery in databases para apoio à decisão em atividades vinculadas à enfermagem / Knowledge discovery in databases para apoyar la decisión en actividades relacionadas con la enfermería / Knowledge discovery in databases for the support to decision-making in nursing-related activities

RESUMO Objetivo: relatar experiências de estratégias do uso da mineração de dados em dois cenários de práticas de Enfermagem. Descrição da experiência: em ambas as experiências foi utilizado o algoritmo Apriori para descoberta de regras de associação e identificado as situações de exceção. A primeira experiência utilizou dados provenientes de óbitos infantis da região metropolitana de Curitiba - PR. Na segunda experiência utilizaram-se prontuários de pacientes atendidos por enfermeiros na classificação de risco em um hospital particular de Curitiba - PR. O primeiro estudo identificou 374 regras gerais e o segundo, 108 regras gerais, ambos com suas respectivas regras de exceção. Conclusão: a aplicação do Knowledge Discovery in Databases pode ser demonstrada e efetivada em dois cenários distintos, a fim de contribuir para a tomada de decisão pelo gestor. Espera-se que o relato reforce a importância do ensino da informática em Enfermagem como ferramenta de apoio à decisão.

RESUMEN Objetivo: reportar experiencias de estrategias de uso de minería de datos en dos escenarios de prácticas de enfermería. Descripción del experimento: en ambos experimentos se utilizó el algoritmo Apriori para descubrir reglas de asociación e identificar situaciones excepcionales. El primer experimento utilizó datos de muertes infantiles en la región metropolitana de Curitiba-PR. En el segundo experimento, se utilizaron los registros médicos de los pacientes atendidos por enfermeros en la clasificación de riesgo en un hospital privado de Curitiba-PR. El primer estudio identificó 374 reglas generales y el segundo 108 reglas generales, ambas con sus respectivas reglas de excepción. Conclusión: la aplicación del Knowledge Discovery in Databases se puede demostrar e implementar en dos escenarios diferentes, con el fin de contribuir a la toma de decisiones por parte del gerente. Se espera que el informe refuerce la importancia de la enseñanza de la informática en enfermería como herramienta de apoyo a la toma de decisiones.

ABSTRACT Objective: to report experiences of data mining use strategies in two Nursing practice settings. Description of the experience: in both experiences, the Apriori algorithm was used to discover association rules and to identify exception situations. The first experience used data from infant deaths in the metropolitan region of Curitiba, PR. In the second experience, medical records of patients assisted by nurses were used in the risk classification at a private hospital in Curitiba -PR. The first study identified 374general rules and the second, 108, both with their respective exception rules. Conclusion: the application of Knowledge Discovery in Databases can be demonstrated and carried out in two different settings, in order to contribute to decision-making by the manager. It is expected that the report reinforces the importance of teaching Nursing Informatics as a decision-making support tool.