A system for the management of clinical tasks throughout the clinical process with notification features

Computer-Interpretable Guidelines have been associated with a higher integration of standard practices in the daily context of health care institutions. The Clinical Decision Support Systems that deliver these machine-interpretable recommendations usually follow a Q & A style of communication, retrieving information from the user or a clinical repository and performing reasoning upon it, based on the rules from Clinical Practice Guidelines. However, these systems are limited in the reach they are capable of achieving as they were initially conceived for use in very specific moments of the clinical process, namely in physician appointments. The purpose of this work is thus to present a system that, in addition to Q & A reasoning, is equipped with other functionalities such as the scheduling and temporal management of clinical tasks, the mapping of these tasks onto an agenda of activities to allow an easy consultation by health care professionals, and notifications that let health care professionals know of task enactment times and information collection times. In this way, the system ensures the delivery of procedures. The main components of the system, which reflect a different perspective on the delivery of CIG advice that we call guideline as a service, are disclosed, and they include a health care Personal Assistant Web Application, a health care assistant mobile application, and the integration with the private calendar services of the user.(POCI-01-0145-)info:eu-repo/semantics/publishedVersio

Atenção ao idoso na estratégia de Saúde da Família: atuação do enfermeiro

Este estudo objetivou descrever a consulta de enfermagem ao idoso realizada na ESF; identificar possíveis dificuldades na atenção à saúde do idoso, bem como os cursos de qualificação profissional realizados e as necessidades de aprendizagem. Os dados foram coletados por meio da entrevista semiestruturada e submetidos à análise descritiva e temática. Foram entrevistadas 12 enfermeiras, a maioria estando na faixa etária de anos de formada (41%) em instituição particular (75%). Emergiram duas categorias temáticas: consulta de enfermagem ao idoso na ESF e qualificação profissional para a atenção à saúde do idoso. Foi considerado como desafio na realização da consulta de enfermagem a obtenção de dados fidedignos, a resolutividade e o apoio familiar. Os cursos para qualificar a atenção ao idoso ocorreram durante o período de graduação, destacando a falta de oportunidade, a pouca oferta e a necessidade de se aprofundar sobre o processo de envelhecimento.Este estudio tuvo como objetivo describir la consulta de enfermería realizada por el anciano en la ESF; identificar posibles dificultades en la atención a la salud del anciano, así como los cursos de calificación profesional realizados y las necesidades de aprendizaje. Los datos fueron recogidos a través de la entrevista semiestructurada y sometidos al análisis descriptivo temático. Fueron entrevistadas doce enfermeras, estando la mayoría situadas en la faja etaria de 23 a 28 años (66%), con 1-2 años de graduadas (41%) en instituciones particulares (75%). Emergieron dos categorías temáticas: consulta de enfermería del anciano en la ESF y calificación profesional para la atención de la salud del anciano. Fue considerado como desafío en la realización de la consulta de enfermería la obtención de datos fidedignos, la resolutividad y el apoyo familiar. Los cursos para calificar la atención al anciano, tuvieron lugar durante el período de graduación, destacándose la falta de oportunidad, la poca oferta y la necesidad de profundizar sobre el proceso de envejecimiento.This study aimed to describe the nursing consultation for the elderly provided at the Family Health Strategy (ESF, acronym in Portuguese); identify possible difficulties in delivering health care to the elderly, as well as the professional qualification courses performed and the learning needs. Data were collected through semi-structured interviews and submitted to descriptive and thematic analysis. Interviews were performed with 12 nurses, most with ages between years since graduation (41%) in private institutions (75%). Two thematic categories emerged from the analysis: nursing consultation for the elderly performed at ESF and professional qualification in health care for the elderly. Obtaining reliable data in the nursing consultation, resolution and family support were considered as challenges. The courses to qualify professionals for elderly care occurred during their graduation course, highlighting the lack of opportunity, the short supply and the need for deeper studies about the aging process

Modeling the quantum evolution of the universe through classical matter

It is well known that the canonical quantization of the Friedmann-Lema\^itre-Robertson-Walker (FLRW) filled with a perfect fluid leads to nonsingular universes which, for later times, behave as their classical counterpart. This means that the expectation value of the scale factor $(t)$ never vanishes and, as $t\to\infty$, we recover the classical expression for the scale factor. In this paper, we show that such universes can be reproduced by classical cosmology given that the universe is filled with an exotic matter. In the case of a perfect fluid, we find an implicit equation of state (EoS). We then show that this single fluid with an implict EoS is equivalent to two non-interacting fluids, one of them representing stiff matter with negative energy density. In the case of two non-interacting scalar fields, one of them of the phantom type, we find their potential energy. In both cases we find that quantum mechanics changes completely the configuration of matter for small values of time, by adding a fluid or a scalar field with negative energy density. As time passes, the density of negative energy decreases and we recover the ordinary content of the classical universe. The more the initial wave function of the universe is concentrated around the classical big bang singularity, the more it is necessary to add negative energy, since this type of energy will be responsible for the removal of the classical singularity.Comment: updated version as accepted by Gen. Relativ. Gravi

Behavioural stress responses predict environmental perception in European sea bass (Dicentrarchus labrax)

Individual variation in the response to environmental challenges depends partly on innate reaction norms, partly on experience-based cognitive/emotional evaluations that individuals make of the situation. The goal of this study was to investigate whether pre-existing differences in behaviour predict the outcome of such assessment of environmental cues, using a conditioned place preference/avoidance (CPP/CPA) paradigm. A comparative vertebrate model (European sea bass, Dicentrarchus labrax) was used, and ninety juvenile individuals were initially screened for behavioural reactivity using a net restraining test. Thereafter each individual was tested in a choice tank using net chasing as aversive stimulus or exposure to familiar conspecifics as appetitive stimulus in the preferred or non preferred side respectively (called hereafter stimulation side). Locomotor behaviour (i.e. time spent, distance travelled and swimming speed in each tank side) of each individual was recorded and analysed with video software. The results showed that fish which were previously exposed to appetitive stimulus increased significantly the time spent on the stimulation side, while aversive stimulus led to a strong decrease in time spent on the stimulation side. Moreover, this study showed clearly that proactive fish were characterised by a stronger preference for the social stimulus and when placed in a putative aversive environment showed a lower physiological stress responses than reactive fish. In conclusion, this study showed for the first time in sea bass, that the CPP/CPA paradigm can be used to assess the valence (positive vs. negative) that fish attribute to different stimuli and that individual behavioural traits is predictive of how stimuli are perceived and thus of the magnitude of preference or avoidance behaviour.European Commission [265957]; Portuguese Fundacao para a Ciencia e Tecnologia (FCT) [FRH/BPD/72952/2010]; FCT [SFRH/BD/80029/2011

A highly efficacious pediculicide based on dimeticone: Randomized observer blinded comparative trial

BACKGROUND: Infestation with the human head louse (Pediculus humanus capitis) occurs worldwide. Existing treatment options are limited, and reports of resistance to commonly used pediculicides have been increasing. In this trial we assessed the efficacy of a product containing a high (92%) concentration of the silicone oil dimeticone (identical in composition to NYDA(R)), as compared to a 1% permethrin lotion. METHODS: Randomized, controlled, observer blinded clinical trial. Participants were recruited from a poor urban neighbourhood in Brazil where pediculosis capitis was highly prevalent. To minimize reinfestation during the trial, participants (145 children aged 5-15 years with head lice infestations) were transferred to a holiday resort outside the endemic area for a period of 9 days. Two applications of dimeticone or 1% permethrin were done, seven days apart. Outcome measures were defined as cure (absence of vital head lice) after first application and before and after second applications, degree of itching, cosmetic acceptability, and clinical pathology. RESULTS: Overall cure rates were: day 2 - dimeticone 94.5% (95% CI: 86.6% - 98.5%) and permethrin 66.7% (95% CI: 54.6% - 77.3%; p < 0.0001); day 7 - dimeticone 64.4% (95% CI: 53.3% - 75.3%) and permethrin 59.7% (95% CI: 47.5% - 71.1%; p = 0.5); day 9 - dimeticone 97.2% (95% CI: 90.3% - 99.7%) and permethrin 67.6% (95% CI: 55.4%-78.2%); p < 0.0001). Itching was reduced similarly in both groups. Cosmetic acceptability was significantly better in the dimeticone group as compared to the permethrin group (p = 0.01). Two mild product-related incidents occurred in the dimeticone group. CONCLUSION: The dimeticone product is a safe and highly efficacious pediculicide. Due to its physical mode of action (interruption of the lice's oxygen supply of the central nervous system), development of resistance is unlikely. TRIAL REGISTRATION: Current Controlled Trials ISRCTN15117709

Superparamagnetic properties of hemozoin

We report that hemozoin nanocrystals demonstrate superparamagnetic properties, with direct measurements of the synthetic hemozoin magnetization. The results show that the magnetic permeability constant varies from mu = 4585 (at -20 degrees C) to 3843 (+20 degrees C), with the values corresponding to a superparamagnetic system. Similar results were obtained from the analysis of the diffusion separation of natural hemozoin nanocrystals in the magnetic field gradient, with mu = 6783 exceeding the value obtained in direct measurements by the factor of 1.8. This difference is interpreted in terms of structural differences between the synthetic and natural hemozoin. The ab initio analysis of the hemozoin elementary cell showed that the Fe3+ ion is in the high-spin state (S = 5/2), while the exchange interaction between Fe3+ electron-spin states was much stronger than k(B)T at room temperature. Thus, the spin dynamics of the neighboring Fe3+ ions are strongly correlated, lending support to the superparamagnetism