What impact did a Paediatric Early Warning system have on emergency admissions to the paediatric intensive care unit? An observational cohort study

Summary The ideology underpinning Paediatric Early Warning systems (PEWs) is that earlier recognition of deteriorating in-patients would improve clinical outcomes. Objective To explore how the introduction of PEWs at a tertiary children's hospital affects emergency admissions to the Paediatric Intensive Care Unit (PICU) and the impact on service delivery. To compare ‘in-house’ emergency admissions to PICU with ‘external’ admissions transferred from District General Hospitals (without PEWs). Method A before-and-after observational study August 2005–July 2006 (pre), August 2006–July 2007 (post) implementation of PEWs at the tertiary children's hospital. Results The median Paediatric Index of Mortality (PIM2) reduced; 0.44 vs 0.60 (p < 0.001). Fewer admissions required invasive ventilation 62.7% vs 75.2% (p = 0.015) for a shorter median duration; four to two days. The median length of PICU stay reduced; five to three days (p = 0.002). There was a non-significant reduction in mortality (p = 0.47). There was no comparable improvement in outcome seen in external emergency admissions to PICU. A 39% reduction in emergency admission total beds days reduced cancellation of major elective surgical cases and refusal of external PICU referrals. Conclusions Following introduction of PEWs at a tertiary children's hospital PIM2 was reduced, patients required less PICU interventions and had a shorter length of stay. PICU service delivery improved

Adaptación transcultural y validación del contenido del Delaware School Climate Survey-Student (DSCS-S) en Brasil

El clima escolar evalúa las dimensiones: social, emocional, ética, académica y ambiental de la vida escolar, tales como normas, metas, valores, relaciones interpersonales, prácticas de enseñanza y aprendizaje y estructuras institucionales. El presente artículo pretende presentar el proceso de traducción, adaptación cultural y de investigación de la validación del contenido del instrumento de clima escolar del Delaware School Climate Survey-Student (DSCS-S) en Brasil, especialmente la investigación de la validad del contenido del instrumento a través del coeficiente de validad de contenido (CVC). El proceso consistió en etapas de traducción y retraducción, estudio piloto con público albo, evaluaciones con especialistas y minuciosos ajustes en el instrumento. El análisis apunta a la importancia de seguir un riguroso método de adaptación transcultural de instrumentos para garantizar la validez del contenido, así como la existencia de evidencias de validez de contenido (CVC > 0,8 para todas las escalas del instrumento) del DSCS-S para la lengua portuguesa de Brasil. Este instrumento puede ayudar a las escuelas brasileñas a evaluar el clima escolar y desarrollar estrategias, programas y políticas escolares más eficacesSchool climate assessments aim to evaluate the social, emotional, ethical, academic and environmental aspects of school life, such as rules, goals, values, interpersonal relationships, teaching and learning practices as well as institutional structures. This paper presents the process of cross-cultural adaptation and content validity investigation of the Delaware School Climate Survey Student (DSCS-S) in Brazil. A content validity research was conducted through the content validity coefficient (CVC). The process consisted in translations and back-translation steps, pilot study with the target population, evaluations by an expert committee and rigorous revisions of the instrument. The analysis suggest the importance of a thorough method of cross-cultural adaptation to ensure its content validity, and the existence of content validity evidence (CVC > 0.8 for all instrument's scales) of the DSCS-S in Brazil. This instrument can support Brazilian schools to assess its climate in order to develop more effective school strategies, programs and policies

Seasonal fluctuations of the airborne pollen in Guarda (Portugal)

Airborne pollen calendars are useful to estimate the flowering season of the different plants as well as to indicate the allergenic potential present in the atmosphere at a given time. In this study, a 1-year survey (from January 2013 to February 2014) is presented of the atmospheric concentration of pollen types in Guarda (Portugal), using a 7-day Hirst volumetric trap. The daily mean concentration of both the number of pollen grains and the main pollen season was determined as well as the bi-hourly variations. The highest airborne pollen concentration was found during early spring and early summer. Contrastingly, December was the month with the lowest pollen concentration. The major pollens sampled were Quercus, Pinaceae, Poaceae, Cupressaceae, Urticaceae, Apiaceae, Oleaceae and Polygonaceae. Some differences were found in the intradiurnal distribution patterns of the pollen types studied, with some taxa types being predominantly sampled in the morning (8:00-10:00 a.m.) while others were more evident in the late evening hours (8-10 p.m.). Finally, these results were compared with the forecast made by the Portuguese Aerobiology Network for the central region of Portugal, revealing some significant differences in the pollination periods

Erosive potential of rains in the climate change scenarios in the upper Taquari River Basin, MS, Brazil.

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Self-reported clinical history of misdiagnosed leprosy cases in the State of Mato Grosso, Brzil, 2016-2019

This study aimed to analyze the self-reported clinical history of patients misdiagnosed with leprosy in the State of Mato Grosso, Brazil. This is a cross-sectional study of new leprosy cases diagnosed in the State of Mato Grosso from 2016 to 2019, with individuals who were released from multidrug therapy due to misdiagnosis after starting treatment. Data were collected via telephone interviews. Over the study period, 354 leprosy cases were released from treatment due to misdiagnosis, of which 162 (45.8%) could be interviewed. All interviewees expressed dissatisfaction with their treatment, which prompted them to seek a reevaluation of their diagnosis before they were released due to "misdiagnosis". Among them, 35.8% received a final diagnosis of a musculoskeletal or connective tissue disease - mainly fibromyalgia and degenerative changes in the spine - followed by 13.6% with diagnoses of skin and subcutaneous tissue diseases. For 23.5% of the respondents, no alternative diagnosis was established, whereas 7.4% were later re-diagnosed with leprosy. Fibromyalgia and spinal problems were the most common alternative diagnoses for erroneous leprosy. Although the diagnosis of leprosy is usually clinical and does not require access to technical infrastructure in most cases, some more complex situations require diagnostic support via complementary tests, as well as close collaboration between primary care and reference services

Panorama espaço - temporal de fatores de mudança economica, scoial e ambiental na Amazônia: estudo de caso Flona Tapajós.

Políticas públicas voltadas para integrar a Amazônia a outras regiões do Brasil na década de 1970 incluíram a instalação de portos, hidrelétricas e abertura de rodovias como a Transamazônica (BR 230) Cuiabá-Santarém (BR 163) e Belém - Brasília (BR 316), desencadeando um processo intenso de transformações na paisagem, principalmente pelo desflorestamento. Porém, neste mesmo período, também foram delimitadas áreas legalmente protegidas na região, como foi o caso da Floresta Nacional do Tapajós, criada em 1974. O objetivo do trabalho foi avaliar temporal e espacialmente forçantes promotoras de alterações na paisagem. Para tanto, foram utilizados dados secundários analíticos disponíveis em bases do IBGE, bem como informações espaciais disponibilizadas por órgãos públicos em âmbito federal, estadual e municipal. Variáveis topoclimáticas foram utilizadas nas avaliações da dinâmica espaço-temporal com auxílio de análises geoestísticas e modelagem. Os resultados reforçaram o modelo de ocupação denominado "espinha de peixe", tendo as rodovias como eixo de antropização e do aumento progressivo da pressão em Áreas Protegidas. Ao avaliar os cenários para 2030, observa-se os efeitos aos longo dos rios, a oeste do estado do Pará, pelas instalação de portos para escoamento da produção em mercado nacional e internacional

Bioinformatics and Medicine in the Era of Deep Learning

Many of the current scientific advances in the life sciences have their origin in the intensive use of data for knowledge discovery. In no area this is so clear as in bioinformatics, led by technological breakthroughs in data acquisition technologies. It has been argued that bioinformatics could quickly become the field of research generating the largest data repositories, beating other data-intensive areas such as high-energy physics or astroinformatics. Over the last decade, deep learning has become a disruptive advance in machine learning, giving new live to the long-standing connectionist paradigm in artificial intelligence. Deep learning methods are ideally suited to large-scale data and, therefore, they should be ideally suited to knowledge discovery in bioinformatics and biomedicine at large. In this brief paper, we review key aspects of the application of deep learning in bioinformatics and medicine, drawing from the themes covered by the contributions to an ESANN 2018 special session devoted to this topic

COPA DO MUNDO DE FUTEBOL DA/NA GLOBO: UM ESTUDO SOBRE O AGENDAMENTO DE 2014 NO JORNAL NACIONAL

Artico decorrente de pesquisa coletiva relizada pelo LABOMIDIA/UFSC, integrandes da rede CEDES.Este trabalho apresenta uma pesquisa em andamento cujo objetivo é o de investigar o agendamento midiático-esportivo realizado na Copa do Mundo de Futebol/2010 projetando a Copa de 2014 que será realizada no Brasil. Apoiados em bases teóricas sobre o conceito de agenda-setting e reflexões em torno do jornalismo e da publicidade, observou-se o Jornal Nacional da Rede Globo durante a Copa da África do Sul, além da observação do mesmo durante a realização dos amistosos preparatórios da seleção brasileira. Os dados foram analisados quantitativamente e qualitativamente, através da análise de conteúdo e da análise crítica do discurso e demonstram que, em específico, o referido programa telejornalístico utiliza este fenômeno esportivo particular como “espelho da imagem do próprio país”, lançando, para isso, valores estéticos, apelos emocionais e táticas sensacionalistas, auxiliando empresas divulgadoras de produtos a fortalecer ou posicionar suas marcas ao valor que o esporte, e sobretudo o futebol se prestam.Rede CEDE