Fatores associados ao tempo de internação de idosos em um hospital de ensino / Factors associated with the length of stay of the elderly in a teaching hospital

Objetivou-se identificar os fatores associados ao tempo de internação em idosos de um hospital universitário. Estudo quantitativo, transversal de caráter descritivo e inferencial realizado com 144 idosos em um hospital, localizado no Estado do Paraná. A coleta de dados foi realizada através de ligação telefônica com questionário estruturado contendo a situação de informação sobre a hospitalização, situação sociodemográfica, estilo de vida e utilização de serviços hospitalares. Os dados foram analisados pelo teste qui-quadrado. Os resultados apontam que, 40% (n=57) permaneceram até 3 dias internados; 32% (n=28) de 3 a 7 dias e 28% (n=41) mais de 7 dias. Estiveram associados ao tempo de internação: sexo masculino; presença de multimorbidade; internação em UTI; tempo de internação em UTI; internação hospitalar anterior; necessidade de atendimento do serviço social durante a internação; agendamento de retorno ao hospital, pós alta e; necessidade de ajuda de alguém (familiar/cuidador) para seguir as recomendações médicas no pós alta (p<0,05). Conclui-se que a maioria dos idosos permaneceu internado por até uma semana, sendo que os fatores associados a esta permanência perpassam desde condição demográfica as condições clínicas de saúde e de internamento e necessidade de auxílio. Denotando a importância da equipe de saúde um monitoramento adequado destes fatores para o direcionamento na assistência à saúde dos idosos no âmbito hospitalar

Prevalência de multimorbidade e fatores associados em trabalhadores de uma instituição de ensino superior

Justification and Objective: multimorbidity can generate disabilities, when associated with work, it affects the reduction of participation in the workforce, job turnover and early retirement. Thus, the objective was to estimate the prevalence and identify factors associated with multimorbidity in higher education institution workers. Method: this is a cross-sectional, quantitative study carried out with workers from a higher education institution (n=629) in the city of Ponta Grossa, PR, Brazil. For data collection, questionnaires with instruments from the Ministry of Health were used. The dependent variable referred to the presence of multimorbidity, and the independent variable referred to sociodemographic and work characteristics, use of health services, self-perceived health, presence of symptoms, lifestyle and eating habits. Chi-square test and logistic regression were performed. Results: the prevalence of multimorbidity was 53%, and it was associated with age (OR=2.99), overweight (OR=1.77), pain (OR=4.54), self-rated general health (OR=2 .08) and self-rated oral health (OR=2.30) (p<0.05). Individuals with multimorbidity seek more follow-up by a Basic Health Unit (OR=0.54) and perform routine medical consultations more frequently (OR=0.83) (p<0.05). Conclusion: a high prevalence of multimorbidity was observed in the assessed workers, with a statistical association with biological factors, lifestyle, self-perceived health and access to health services. In this way, it is possible to outline strategies aimed at reestablishing workers’ health, improving their quality of life.Justificación y Objetivos: la multimorbilidad puede generar discapacidades, cuando asociada al trabajo, centrándose en la reducción de la participación en la población activa, la rotación laboral y la jubilación anticipada. Así, el objetivo fue estimar la prevalencia y identificar los factores asociados a la multimorbilidad en trabajadores de una institución de Educación Superior. Método: estudio transversal, cuantitativo, realizado con trabajadores de una institución de educación superior (n=629) en la ciudad de Ponta Grossa, PR, Brasil. Para la recolección de datos se utilizaron cuestionarios con instrumentos del Ministerio de Salud. La variable dependiente se refirió a la presencia de multimorbilidad, e independiente de las características sociodemográficas, laborales, uso de los servicios de salud, percepción de salud, presencia de síntomas, estilo de vida y hábitos alimentarios. Se realizaron pruebas de chi-cuadrado y regresión logística. Resultados: la prevalencia de multimorbilidad fue del 53%, y se asoció con la edad (OR=2,99), sobrepeso (OR=1,77), dolor (OR=4,54), salud general autoevaluada (OR=2,08) y salud bucal (OR= 2,30) (p<0,05). Las personas con multimorbilidad buscan mayor seguimiento por parte de una Unidad Básica de Salud (OR=0,54) y realizan consultas médicas de rutina con mayor frecuencia (OR=0,83) (p<0,05). Conclusión: hubo alta prevalencia de multimorbilidad en los trabajadores evaluados, con asociación estadística con factores biológicos, estilo de vida, percepción de salud y acceso a servicios de salud. Así, es posible delinear estrategias encaminadas a restaurar la salud de los trabajadores, mejorando su calidad de vida.Justificativa e Objetivo: a multimorbidade pode gerar incapacidades, quando associada ao trabalho, afetando a redução de participação na força de trabalho, rotatividade de empregos e aposentadoria precoce. Dessa forma, objetivou-se estimar a prevalência e identificar fatores associados à multimorbidade em trabalhadores de uma instituição de ensino superior. Método: estudo transversal, quantitativo, realizado com trabalhadores de uma instituição de ensino superior (n=629) na cidade de Ponta Grossa, PR, Brasil. Para coleta de dados, utilizaram-se questionários com instrumentos do Ministério da Saúde. A variável dependente se referiu à presença de multimorbidade, e independentes, às características sociodemográficas, de trabalho, utilização de serviços de saúde, percepção de saúde, presença de sintomas, estilo de vida e hábitos alimentares. Realizou-se Teste do Qui-Quadrado e regressão logística. Resultados: a prevalência de multimorbidade foi de 53%, estando associada à idade (OR=2,99), excesso de peso (OR=1,77), dor (OR=4,54), autoavaliação de saúde geral (OR=2,08) e saúde bucal (OR=2,30) (p<0,05). Indivíduos com multimorbidade buscam mais o acompanhamento por uma Unidade Básica de Saúde (OR=0,54) e realizam consultas médicas de rotina de forma mais frequente (OR=0,83) (p<0,05). Conclusão: observou-se alta prevalência de multimorbidade nos trabalhadores avaliados, com associação estatística aos fatores biológicos, de estilo de vida, percepção de saúde e acesso a serviços de saúde. Dessa forma, é possível traçar estratégias visando reestabelecimento de saúde dos trabalhadores, melhorando sua qualidade de vida

Covid-19 and pulmonary thromboembolism: a case report

COVID-19 is an acute viral infection caused by SARS-CoV-2 coronavirus. This pandemic disease stands out for the marked variation in the clinical characteristics of patients, ranging from asymptomatic cases to severe organ dysfunction and death. Serious complications occur in the late phase of the disease or even after viral infection, and thrombotic events are one of these complications. In this context, this study aimed to report a case of an obese, young adult female patient with a complication of pulmonary thromboembolism after infection by COVID-19

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Immersion in scientific and technical documents : units, theoretical models and processes

Cette thèse aborde la problématique de l'accès à l'information scientifique et technique véhiculée par de grands ensembles documentaires. Pour permettre à l'utilisateur de trouver l'information qui lui est pertinente, nous avons oeuvré à la définition d'un modèle répondant à l'exigence de souplesse de notre contexte applicatif industriel ; nous postulons pour cela la nécessité de segmenter l'information tirée des documents en plans ontologiques. Le modèle résultant permet une immersion documentaire, et ce grâce à trois types de processus complémentaires : des processus endogènes (exploitant le corpus pour analyser le corpus), exogènes (faisant appel à des ressources externes) et anthropogènes (dans lesquels les compétences de l'utilisateur sont considérées comme ressource) sont combinés. Tous concourent à l'attribution d'une place centrale à l'utilisateur dans le système, en tant qu'agent interprétant de l'information et concepteur de ses connaissances, dès lors qu'il est placé dans un contexte industriel ou spécialisé.This thesis adresses the issue of accessing scientific and technical information conveyed by large sets of documents. To enable the user to find his own relevant information, we worked on a model meeting the requirement of flexibility imposed by our industrial application context ; to do so, we postulated the necessity of segmenting information from documents into ontological facets. The resulting model enables a documentary immersion, thanks to three types of complementary processes : endogenous processes (exploiting the corpus to analyze the corpus), exogenous processes (using external resources) and anthropogenous ones (in which the user's skills are considered as a resource) are combined. They all contribute to granting the user a fundamental role in the system, as an interpreting agent and as a knowledge creator, provided that he is placed in an industrial or specialised context

Immersion dans des documents scientifiques et techniques : unités, modèles théoriques et processus

This thesis adresses the issue of accessing scientific and technical information conveyed by large sets of documents. To enable the user to find his own relevant information, we worked on a model meeting the requirement of flexibility imposed by our industrial application context ; to do so, we postulated the necessity of segmenting information from documents into ontological facets. The resulting model enables a documentary immersion, thanks to three types of complementary processes : endogenous processes (exploiting the corpus to analyze the corpus), exogenous processes (using external resources) and anthropogenous ones (in which the user's skills are considered as a resource) are combined. They all contribute to granting the user a fundamental role in the system, as an interpreting agent and as a knowledge creator, provided that he is placed in an industrial or specialised context.Cette thèse aborde la problématique de l'accès à l'information scientifique et technique véhiculée par de grands ensembles documentaires. Pour permettre à l'utilisateur de trouver l'information qui lui est pertinente, nous avons oeuvré à la définition d'un modèle répondant à l'exigence de souplesse de notre contexte applicatif industriel ; nous postulons pour cela la nécessité de segmenter l'information tirée des documents en plans ontologiques. Le modèle résultant permet une immersion documentaire, et ce grâce à trois types de processus complémentaires : des processus endogènes (exploitant le corpus pour analyser le corpus), exogènes (faisant appel à des ressources externes) et anthropogènes (dans lesquels les compétences de l'utilisateur sont considérées comme ressource) sont combinés. Tous concourent à l'attribution d'une place centrale à l'utilisateur dans le système, en tant qu'agent interprétant de l'information et concepteur de ses connaissances, dès lors qu'il est placé dans un contexte industriel ou spécialisé

Immersion dans des documents scientifiques et techniques (unités, modèles théoriques et processus)

Cette thèse aborde la problématique de l'accès à l'information scientifique et technique véhiculée par de grands ensembles documentaires. Pour permettre à l'utilisateur de trouver l'information qui lui est pertinente, nous avons oeuvré à la définition d'un modèle répondant à l'exigence de souplesse de notre contexte applicatif industriel ; nous postulons pour cela la nécessité de segmenter l'information tirée des documents en plans ontologiques. Le modèle résultant permet une immersion documentaire, et ce grâce à trois types de processus complémentaires : des processus endogènes (exploitant le corpus pour analyser le corpus), exogènes (faisant appel à des ressources externes) et anthropogènes (dans lesquels les compétences de l'utilisateur sont considérées comme ressource) sont combinés. Tous concourent à l'attribution d'une place centrale à l'utilisateur dans le système, en tant qu'agent interprétant de l'information et concepteur de ses connaissances, dès lors qu'il est placé dans un contexte industriel ou spécialisé.This thesis adresses the issue of accessing scientific and technical information conveyed by large sets of documents. To enable the user to find his own relevant information, we worked on a model meeting the requirement of flexibility imposed by our industrial application context ; to do so, we postulated the necessity of segmenting information from documents into ontological facets. The resulting model enables a documentary immersion, thanks to three types of complementary processes : endogenous processes (exploiting the corpus to analyze the corpus), exogenous processes (using external resources) and anthropogenous ones (in which the user's skills are considered as a resource) are combined. They all contribute to granting the user a fundamental role in the system, as an interpreting agent and as a knowledge creator, provided that he is placed in an industrial or specialised context.SAVOIE-SCD - Bib.électronique (730659901) / SudocGRENOBLE1/INP-Bib.électronique (384210012) / SudocGRENOBLE2/3-Bib.électronique (384219901) / SudocSudocFranceF

Natural language processing for categorisation of feedback reports

Pour favoriser l’efficacité et la facilité d’exploration des retours d’expérience collectés suite à des événements indésirables, l’expert est généralement invité à décrire les faits en langue naturelle et à sélectionner dans des listes prédéfinies la ou les valeurs correspondant par exemple au type d’événement de l’incident. Afin d’aider les experts dans ce travail de catégorisation, Safety Data-CFH a développé un module de catégorisation automatique dynamique et totalement autonome intégré à l’application PLUS. Ce module a été testé par les experts R&D d’EDF sur des fiches d’incidents issus des parcs de production nucléaire et hydraulique.In order to ease the efficiency and comfort of feedback reports exploration, experts have generally to describe facts in natural language, but also to select in predefined lists the appropriate value(s), for instance matching the incident’s type of event. In order to help experts in their categorization task, Safety Data-CFH developed an automatic categorization module, which is dynamic and entirely autonomous, integrated to the application PLUS. This module was tested by EDF’s R&D experts on incident reports from nuclear and hydraulic power plants