Using the dual-level modeling approach to develop applications for pervasive healthcare

Health information technology is the area of IT involving the design, development, creation, use and maintenance of information systems for the healthcare industry. Automated and interoperable healthcare information systems are expected to lower costs, improve efficiency and reduce error, while also providing better consumer care and service. Pervasive Healthcare focuses on the use of new technologies, tools, and services, to help patients play a more active role in the treatment of their conditions. Pervasive Healthcare environments demand a huge amount of information exchange, and specific technologies have been proposed to provide interoperability between the systems that comprise such environments. However, the complexity of these technologies makes it difficult to fully adopt them and to migrate Centered Healthcare Environments to Pervasive Healthcare Environments. Therefore, this paper proposes an approach to develop applications in the Pervasive Healthcare environment, through the use of dual-level modeling based on Archetypes. This approach was demonstrated and evaluated in a controlled experiment that we conducted in the cardiology department of a hospital located in the city of Marilia (São Paulo, Brazil). An application was developed to evaluate this approach, and the results showed that the approach is suitable for facilitating the development of healthcare systems by offering generic and powerful capabilities

Towards a reusable architecture for message exchange in pervasive healthcare

The main objective of this paper is to present a reusable architecture for message exchange in pervasive healthcare environments meant to be generally applicable to different applications in the healthcare domain. This architecture has been designed by integrating different concepts and technologies of ubiquitous computing, software agents, and openEHR archetypes, in order to provide interoperability between healthcare systems. The architecture was demonstrated and evaluated in controlled experiments that we conducted at three cardiology clinics, an analysis laboratory, and the cardiology sector of a hospital located in Marília (São Paulo, Brazil). Three applications were developed to evaluate this architecture, and the results showed that the architecture is suitable to facilitate the development of healthcare systems by offering generic and powerful message exchange capabilities. The reusable architecture speeds up the development of new applications, reducing the number of mistakes and the development time. The proposed architecture facilitates message exchanging between caregivers, contributing in this way to the development of pervasive healthcare systems that allow healthcare to be available anywhere, anytime, and to anyone

A list of land plants of Parque Nacional do Caparaó, Brazil, highlights the presence of sampling gaps within this protected area

Brazilian protected areas are essential for plant conservation in the Atlantic Forest domain, one of the 36 global biodiversity hotspots. A major challenge for improving conservation actions is to know the plant richness, protected by these areas. Online databases offer an accessible way to build plant species lists and to provide relevant information about biodiversity. A list of land plants of “Parque Nacional do Caparaó” (PNC) was previously built using online databases and published on the website "Catálogo de Plantas das Unidades de Conservação do Brasil." Here, we provide and discuss additional information about plant species richness, endemism and conservation in the PNC that could not be included in the List. We documented 1,791 species of land plants as occurring in PNC, of which 63 are cited as threatened (CR, EN or VU) by the Brazilian National Red List, seven as data deficient (DD) and five as priorities for conservation. Fifity-one species were possible new ocurrences for ES and MG states

COMPLEXIDADE RACIAL: mitos e realidades em duas freguesias de Salvador em 1775

A partir da análise minuciosa dos dados do Censo de 1775 sobre duas freguesias de Salvador (São Pedro e Penha), são colocados em questão cinco mitos dominantes sobre a escravidão no imaginário nacional: (1) o domínio total do trabalho escravo na sociedade; (2) uma sociedade formada apenas por senhores e escravos; (3) uma sociedade constituída, por um lado, por um segmento de dominantes e exploradores e, por outro, por dominados e explorados; (4) uma sociedade urbana segregada; (5) uma sociedade patriarcal, em que as mulheres eram submissas e economicamente subordinadas. Os resultados do censo, portanto, levantam novas questões para o entendimento da complexidade do nosso passado, o que ajuda a entender a manutenção das extremas desigualdades atuais, além de evidenciar a existência de diferenciações espaciais na cidade. PALAVRAS-CHAVE: escravos, libertos, agregados, freguesias, Salvador.RACIAL COMPLEXITY: myth and reality in two Salvador freguesias in 1775 Pedro de Almeida Vasconcelos The meticulous analysis of data from the Census of 1775 on two freguesias of Salvador (São Pedro and Penha), bring doubt to five dominant myths on slavery in the national imaginary: (1) the exclusivity of slave work in the society; (2) a society just formed by slave owners and slaves; (3) a society where, on one side, live a segment of dominant exploiters and, on the other, dominated explored people; (4) a segregated urban society; (5) a patriarchal society, in which women were submissive and economically subordinates. The results of the census, therefore, bring new subjects to understanding the complexity of our past, what helps to understand the maintenance of the extreme current inequalities, besides showing the existence of space differentiations in the city. KEYWORDS: slaves, freed men, agregados, freguesias, Salvador.COMPLEXITÉ RACIALE: mythes et réalités dans deux paroisses de Salvador en 1775 Pedro de Almeida Vasconcelos A partir de l’analyse minutieuse des données du recensement de 1775 concernant deux paroisses de Salvador (São Pedro et Penha) sont remis en question cinq mythes dominants à propos de l’esclavage dans l’imaginaire national: (1) l’exclusivité du travail esclave dans la société; (2) une société formée uniquement de seigneurs et d’esclaves; (3) une société constituée d’une part par un segment de dominants et d’exploiteurs et d’autre part de dominés et d’exploités; (4) une société urbaine ségréguée; (5) une société patriarcale où les femmes étaient soumises et subordonnées économiquement. Les résultats de ce recensement soulèvent donc de nouvelles questions pour la compréhension de la complexité de notre passé, ceci permet de comprendre le maintien d’extrêmes inégalités actuelles et de mettre aussi en évidence l’existence de différenciations spatiales dans la ville. MOTS-CLÉS: esclaves, personnes libres, domestiques, paroisses, Salvador. Publicação Online do Caderno CRH: http://www.cadernocrh.ufba.b

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Methodological support to develop interoperable applications for pervasive healthcare

The healthcare model currently being used in most countries will soon be inadequate, due to the increasing care costs of a growing population of elderly people, the rapid increase of chronic diseases, the growing demand for new treatments and technologies, and the relative decrease in the number of healthcare professionals with respect to the population increase. This healthcare model, which is centered on highly specialized people, located in large hospitals, needs to change into a distributed model, in order to produce faster responses and to allow patients to manage their own health. A distributed healthcare model that pervades the daily lives of the citizens is more appropriate to provide less expensive and more effective and timely healthcare, and characterizes Pervasive Healthcare.\ud \ud This thesis aims at demonstrating the feasibility of using healthcare standards, ubiquitous computing technologies, service-oriented architecture principles, and software agents, to develop interoperable applications for exchanging messages in Pervasive Healthcare environments. This thesis presents a Reusable Architecture and a Message Generator that employ these technologies for achieving its aim.\ud \ud In this work, a case study was performed in a realistic distributed healthcare environment, where three usage scenarios were defined in the cardiology domain: delivery of laboratory analysis results, schedule of an appointment for pacemaker evaluation, and support of a medical staff meeting to prepare for a cardiac surgery. The experiments were conducted in a distributed environment at the Santa Casa Hospital of Marília (Brazil). The evaluation of these applications was carried out using the Technology Acceptance Model, since this model is generally considered as appropriate to explain technology acceptance.\ud \ud We showed that the methodology proposed in this thesis truly facilitates the development of Pervasive Healthcare. The proposed methodology preserves the investment in the legacy healthcare information systems and allows developers to add new features to them, aiming to fill the automation gap and satisfying the need for increased user mobility, while providing smart assistance to the end-users. The results obtained so far are highly promising, and encourage us to continue exploring our methodology to develop communication services that are suitable for other healthcare scenarios

A methodology based on openEHR archetypes and software agents for developing e-health applications reusing legacy systems

Background and objective In Pervasive Healthcare, novel information and communication technologies are applied to support the provision of health services anywhere, at anytime and to anyone. Since health systems may offer their health records in different electronic formats, the openEHR Foundation prescribes the use of archetypes for describing clinical knowledge in order to achieve semantic interoperability between these systems. Software agents have been applied to simulate human skills in some healthcare procedures. This paper presents a methodology, based on the use of openEHR archetypes and agent technology, which aims to overcome the weaknesses typically found in legacy healthcare systems, thereby adding value to the systems. Methods This methodology was applied in the design of an agent-based system, which was used in a realistic healthcare scenario in which a medical staff meeting to prepare a cardiac surgery has been supported. We conducted experiments with this system in a distributed environment composed by three cardiology clinics and a center of cardiac surgery, all located in the city of Marília (São Paulo, Brazil). We evaluated this system according to the Technology Acceptance Model. Results The case study confirmed the acceptance of our agent-based system by healthcare professionals and patients, who reacted positively with respect to the usefulness of this system in particular, and with respect to task delegation to software agents in general. The case study also showed that a software agent-based interface and a tools-based alternative must be provided to the end users, which should allow them to perform the tasks themselves or to delegate these tasks to other people. Conclusions A Pervasive Healthcare model requires efficient and secure information exchange between healthcare providers. The proposed methodology allows designers to build communication systems for the message exchange among heterogeneous healthcare systems, and to shift from systems that rely on informal communication of actors to a more automated and less error-prone agent-based system. Our methodology preserves significant investment of many years in the legacy systems and allows developers to extend them adding new features to these systems, by providing proactive assistance to the end-users and increasing the user mobility with an appropriate support