Estrés psicológico y problemática musculoesquelética. Revisión sistemática / Psychological stress and musculoskeletal problems. Systematic review

Objetivo. Analizar los diseños epidemiológicos más utilizados en el estudio de la relación entre estrés psicológico y problemática musculoesquelética. Metodología. Búsqueda bibliográfica con criterios de inclusión y exclusión específicos, en PubMed/Medline, EBSCOhost y revistas electrónicas de diversas disciplinas siguiendo las recomendaciones del estándar PRISMA. Se extrajeron 2782 artículos de los cuales fueron seleccionados 41 para la revisión. Resultados. Más del 80% de los estudios confirmaron la relación entre estrés psicológico y problemática musculoesquelética, determinando que los niveles de estrés mantenidos aumentan el riesgo de aparición de sintomatología, sobre todo en lumbares y cervicales. Del total de estudios, más del 50% fueron de diseño transversal y 77% sobre temática laboral. La población más vulnerable fue la femenina, especialmente funcionarios y trabajadores de oficina. Las “Demandas laborales” constituyeron el estresor psicosocial más descrito. Respecto a los instrumentos de medición más usados, destacan el “Stress Energy Questionnaire”, el “Job Content Questionnaire” y el “Standardized Nordic Musculoskeletal Questionnaire”. Conclusión: Los estudios sobre estrés psicológico y problemática musculoesquelética tienen diseños y resultados heterogéneos. Los hallazgos resaltaron múltiples estresores psicosociales y áreas corporales afectadas, siendo escasos los consensos en diagnósticos e instrumentos de medida. Aunque aparece una asociación entre estrés psicológico y problemas musculo esqueléticos, no se vislumbran relaciones causales claras. Dado el elevado coste de estos problemas, se considera necesario realizar más estudios con diseños y metodologías rigurosas (AU)

Objective: Analyze the epidemiological approach more used in the study of the relationship between psychological stress and musculoskeletal problems. Methodology: Bibliographic research with specific inclusion and exclusion criteria on PubMed / Medline, EBSCOhost and electronic journals from diverse disciplines following the recommendations of PRISMA standards. 2782 articles were extracted, of which 41 were selected for the revision. Results: More than 80% of the articles confirmed that maintained stress levels increase the risk of developing musculoskeletal symptoms, especially in the lower back and neck. Over 50% of the studies followed a transversal design, and 77% of them dealt with labour issues. The most vulnerable population were women working in civil service or white collars, and labour demands was the most described psychosocial stressor. Regarding measurement instruments, the most used were the Energy Stress Questionnaire, the Job Content Questionnaire, and the Standardized Nordic Musculoskeletal Questionnaire. Conclusion: Studies on psychological stress and musculoskeletal problems had heterogeneous results and designs. The findings highlight multiple psychosocial stressors and body areas affected and there was little consensus on diagnosis and measuring instruments. Although there was an association between psychological stress and musculoskeletal problems, their causal relationships are unclear. Given the higher cost of this problem, it is necessary to develop more studies with designs and rigorous methodologies (AU)

MeSH Up: effective MeSH text classification for improved document retrieval.

MOTIVATION: Controlled vocabularies such as the Medical Subject Headings (MeSH) thesaurus and the Gene Ontology (GO) provide an efficient way of accessing and organizing biomedical information by reducing the ambiguity inherent to free-text data. Different methods of automating the assignment of MeSH concepts have been proposed to replace manual annotation, but they are either limited to a small subset of MeSH or have only been compared with a limited number of other systems. RESULTS: We compare the performance of six MeSH classification systems [MetaMap, EAGL, a language and a vector space model-based approach, a K-Nearest Neighbor (KNN) approach and MTI] in terms of reproducing and complementing manual MeSH annotations. A KNN system clearly outperforms the other published approaches and scales well with large amounts of text using the full MeSH thesaurus. Our measurements demonstrate to what extent manual MeSH annotations can be reproduced and how they can be complemented by automatic annotations. We also show that a statistically significant improvement can be obtained in information retrieval (IR) when the text of a user's query is automatically annotated with MeSH concepts, compared to using the original textual query alone. CONCLUSIONS: The annotation of biomedical texts using controlled vocabularies such as MeSH can be automated to improve text-only IR. Furthermore, the automatic MeSH annotation system we propose is highly scalable and it generates improvements in IR comparable with those observed for manual annotations.

Visualizations for taxonomic and phylogenetic trees.

MOTIVATION: Despite substantial efforts to develop and populate the back-ends of biological databases, front-ends to these systems often rely on taxonomic expertise. This research applies techniques from human-computer interaction research to the biodiversity domain. RESULTS: We developed an interactive node-link tool, TaxonTree, illustrating the value of a carefully designed interaction model, animation, and integrated searching and browsing towards retrieval of biological names and other information. Users tested the tool using a new, large integrated dataset of animal names with phylogenetic-based and classification-based tree structures. These techniques also translated well for a tool, DoubleTree, to allow comparison of trees using coupled interaction. Our approaches will be useful not only for biological data but as general portal interfaces.

A knowledge discovery object model API for Java.

BACKGROUND: Biological data resources have become heterogeneous and derive from multiple sources. This introduces challenges in the management and utilization of this data in software development. Although efforts are underway to create a standard format for the transmission and storage of biological data, this objective has yet to be fully realized. RESULTS: This work describes an application programming interface (API) that provides a framework for developing an effective biological knowledge ontology for Java-based software projects. The API provides a robust framework for the data acquisition and management needs of an ontology implementation. In addition, the API contains classes to assist in creating GUIs to represent this data visually. CONCLUSIONS: The Knowledge Discovery Object Model (KDOM) API is particularly useful for medium to large applications, or for a number of smaller software projects with common characteristics or objectives. KDOM can be coupled effectively with other biologically relevant APIs and classes. Source code, libraries, documentation and examples are available at http://www.bcgsc.ca/bioinfo/software.

Concept-match medical data scrubbing. How pathology text can be used in research.

CONTEXT: In the normal course of activity, pathologists create and archive immense data sets of scientifically valuable information. Researchers need pathology-based data sets, annotated with clinical information and linked to archived tissues, to discover and validate new diagnostic tests and therapies. Pathology records can be used for research purposes (without obtaining informed patient consent for each use of each record), provided the data are rendered harmless. Large data sets can be made harmless through 3 computational steps: (1) deidentification, the removal or modification of data fields that can be used to identify a patient (name, social security number, etc); (2) rendering the data ambiguous, ensuring that every data record in a public data set has a nonunique set of characterizing data; and (3) data scrubbing, the removal or transformation of words in free text that can be used to identify persons or that contain information that is incriminating or otherwise private. This article addresses the problem of data scrubbing. OBJECTIVE: To design and implement a general algorithm that scrubs pathology free text, removing all identifying or private information. METHODS: The Concept-Match algorithm steps through confidential text. When a medical term matching a standard nomenclature term is encountered, the term is replaced by a nomenclature code and a synonym for the original term. When a high-frequency "stop" word, such as a, an, the, or for, is encountered, it is left in place. When any other word is encountered, it is blocked and replaced by asterisks. This produces a scrubbed text. An open-source implementation of the algorithm is freely available. RESULTS: The Concept-Match scrub method transformed pathology free text into scrubbed output that preserved the sense of the original sentences, while it blocked terms that did not match terms found in the Unified Medical Language System (UMLS). The scrubbed product is safe, in the restricted sense that the output retains only standard medical terms. The software implementation scrubbed more than half a million surgical pathology report phrases in less than an hour. CONCLUSIONS: Computerized scrubbing can render the textual portion of a pathology report harmless for research purposes. Scrubbing and deidentification methods allow pathologists to create and use large pathology databases to conduct medical research.

Gestión clínica de la lista de espera en un servicio de cirugía general / Management of the hospital waiting list in a general surgery department

Introducción. Presentamos nuestra experiencia en la gestión clínica de la lista de espera del Servicio de Cirugía General del Hospital de Viladecans (hospital público del Institut Català de la Salut).Objetivos. Diseño de una base de datos para la gestión clínica de la lista de espera del servicio de cirugía general, y evaluación de los resultados tras su diseño y aplicación.Material y método. Base de datos creada a tal fin, y que recoge todos los pacientes incluidos en lista de espera para intervención quirúrgica electiva durante un período de 5 años (desde el 1 de enero de 1996 al 31 de diciembre de 2000).Resultados. El número de intervenciones quirúrgicas electivas año tras año se ha mantenido por debajo de la demanda, creando un déficit que equivaldría a incrementar nuestra actividad en un 23,8 por ciento para adecuarla a la demanda. La lista de espera para la cirugía electiva ha estado condicionada a la presión de urgencias, que ha ido progresivamente en aumento. El criterio establecido de prioridad se ha demostrado útil, habiendo operado el 60,8 por ciento de los pacientes preferentes antes de 3 meses, y el 65,2 por ciento de los pacientes no preferentes entre 3 y 9 meses.Conclusiones. 1) Existe un progresivo incremento de la demanda de servicios quirúrgicos en nuestra área de influencia. 2) Se ha logrado una mejor gestión clínica, con un progresivo descenso en el número de anulaciones y un incremento en la actividad quirúrgica. 3) Se ha reducido el número de reprogramaciones de un 32 a un 14,3 por ciento. 4). Calculamos un déficit de recursos (horas de quirófano) que equivaldría a un 23,8 por ciento de nuestra actividad quirúrgica actual para poder adecuarnos a la demanda. 5) La base de datos diseñada por nosotros ha demostrado ser un instrumento útil de gestión de nuestra lista de espera (AU)

What, when and how to back up your data.

This article defines and describes the process of backing up data files, which should be undertaken by anyone who routinely uses a computer. The important points to be considered when developing a backup strategy are explained and a résumé given of the backup devices currently available.

DataFoundry: information management for scientific data.

Data warehouses and data marts have been successfully applied to a multitude of commercial business applications. They have proven to be invaluable tools by integrating information from distributed, heterogeneous sources and summarizing this data for use throughout the enterprise. Although the need for information dissemination is as vital in science as in business, working warehouses in this community are scarce because traditional warehousing techniques do not transfer to scientific environments. There are two primary reasons for this difficulty. First, schema integration is more difficult for scientific databases than for business sources, because of the complexity of the concepts and the associated relationships. While this difference has not yet been fully explored, it is an important consideration when determining how to integrate autonomous sources. Second, scientific data sources have highly dynamic data representations (schemata). When a data source participating in a warehouse changes its schema, both the mediator transferring data to the warehouse and the warehouse itself need to be updated to reflect these modifications. The cost of repeatedly performing these updates in a traditional warehouse, as is required in a dynamic environment, is prohibitive. This paper discusses these issues within the context of the DataFoundry project, an ongoing research effort at Lawrence Livermore National Laboratory. DataFoundry utilizes a unique integration strategy to identify corresponding instances while maintaining differences between data from different sources, and a novel architecture and an extensive meta-data infrastructure, which reduce the cost of maintaining a warehouse.

Extracting knowledge from large medical databases: an automated approach.

Tools which can uncover patterns in patients' records and then make predictions based on that knowledge are and will continue to be high priority in many medical informatics groups. These tools are impacting the performance of outcome studies by discovering patterns which can then be verified with standard statistical tools. This paper demonstrates INC2.5, a general classification system, as a tool for assisting physicians in the decision making process. INC2.5 gathers information from patient records and builds a decision tree which is used to assist physicians in predicting the outcome of new patients. The decision tree will also reveal any patterns which the system found in the data. Successful results of such a system can be used to enhance outcome studies as well as to spread clinical information to areas with fewer resources.

The role of the UMLS in 'storing' and 'sharing' across systems.

We will argue that 'sharing', 're-use', 're-purposing', and 'addition' of health care information is difficult, intrinsically; that the best way to overcome the difficulty is to start doing it, as soon as possible, and that the UMLS Knowledge Sources provide the best place to start. We recommend that the UMLS be used as a default source of biomedical concept names and relationships, as a comprehensive, data-based, 'reference model', and as an example of a large, ecumenical, evolving, continuously updated source of re-usable health care information.

HERMES: a health care workstation integration architecture.

An architecture is described that facilitates integration of existing databases and applications without modifying them. By means of this architecture, data from different sources dispersed in a network can be combined and directly used in existing applications or applications that have been developed specially for integration. This feature of combining data from different sources into one workstation is viewed as the enabling technology on which computer-based patient records can be built. The abstraction of computer-, network- and application-specific details is completely dealt with by the integration architecture. This integration architecture has been developed with extendibility and flexibility in mind, and allows for a growth-path towards application of the open system paradigm in medicine.

Base de datos del personal con item que trabaja en la Secretaria Nacional de Salud por municipio y niveles de atención / sss

El presente base de datos, ofrece información relevante para la primera linea de acción de la política de recursos humanos en el nuevo modelo Sanitario, tendiente a asignar el personal de atención primaria en función de población y necesidades. Fuentes de información: planilla matriz presupuestaria 1995 del Ministerio de Desarrollo Humano, Secretaria Nacional de Salud; sectores, áreas y distritos por municipio, secretarias regionales de: La Paz, Oruro, Cochabamba, Santa Cruz, Chuquisaca, Tarija, Beni, Riberalta, Pando, Potosí y Tupiza. El personal administrativo engloba tanto a nutricionistas, trabajadoras sociales, bioquímicos, personal administrativo, trabajadores manuales, etc.