EXPERIÊNCIA E PARAMETRIZAÇÃO NO PROCESSO DE PROJETO DE APLICAÇÕES DIGITAIS INTERATIVAS

Designers’ experiences are reflected on prototypes developed by them, which are of paramount importance to the formation of concepts, especially in the design and design of computer systems phases. Therefore, this article demonstrates how prototyping can benefit from the parameter in the design of these systems. To make it happen, the design process, exposed in this article, is established methodologically by the understanding of concepts that spread through the experiential and interactive contexts (immersion), in the structuring of ideas (ideation) that delineate one solution liable to implementation (prototype) and its subsequent validation. As a result, a computational solution that consists of an embedded system is proposed, validated by functional tests that show that parametric modeling hold up the establishment of relations and correlations between the components used in prototyping, and demonstrate that the parameter assists both the creation and the redesign of interactive computer systems.Experiências de projetistas se retratam nos protótipos por eles desenvolvidos, os quais são de suma importância para a formação de conceitos, principalmente na fase de projeto e de concepção de sistemas computacionais. Diante disso, o presente artigo tem como objetivo demonstrar como a prototipação pode se beneficiar da parametrização na concepção destes sistemas. Para isso, o processo projetual, exposto neste artigo, é estabelecido metodologicamente pelo entendimento de conceitos que permeiam os contextos experienciais e interacionais (imersão); na estruturação de ideias (ideação) que delineiam uma solução passível de implementação (prototipação) e na sua posterior validação. Como resultado, é proposta uma solução computacional constituída por um sistema embarcado e validada por testes funcionais que retratam que a modelagem paramétrica favorece o estabelecimento de relações e correlações entre os componentes utilizados na prototipação, e demonstram que a parametrização auxilia tanto na criação quanto no redesenho de sistemas computacionais interativos

O PACIENTE COM TRANSTORNO MENTAL: A PERCEPÇÃO DE FAMILIARES CUIDADORES ACERCA DESSA CONDIÇÃO

This is a qualitative and descriptive study, whose objective was to verify the perception of caregivers about patients with mental disorders treated in the public health network in the city of Montes Claros-MG. The work was developed at the Psychosocial Care Center (CAPS). The data were obtained through a focal group and analyzed through the discourse analysis technique. After data collection, categories related to the difficulties and challenges encountered by caregivers, patient behavior and caregiver overload emerged. It was concluded that the family caregiver of the mentally ill person presents suffering and lack of information. This demonstrates the need to bring the health team closer to the caregiver, since this interaction may contribute to the process of mitigating the responsibility of caring.Trata-se de um estudo qualitativo e descritivo, cujo o objetivo foi verificar a percepção de cuidadores acerca de pacientes com transtornos mentais atendidos na rede pública de saúde na cidade de Montes Claros-MG. O trabalho foi desenvolvido no centro de atenção psicossocial (CAPS). Os dados foram obtidos através da realização de um grupo focal e analisados através da técnica de análise do discurso. Após a coleta de dados surgiram categorias relacionadas as dificuldades e desafios encontrados pelos cuidadores, comportamento do paciente e sobrecarga dos cuidadores. Concluiu-se que o familiar cuidador do portador de transtorno mental apresenta sofrimento e carência de informação. Isso demonstra a necessidade da aproximar a equipe de saúde ao cuidador, pois essa interação poderá contribuir no processo de amenização da responsabilidade do ato de cuida

O câncer e a criança: um impacto familiar

The aim of this work is a bibliographic review concerning the children living with cancer and their family, in order to identify the themes that have been already studied and to understand the impact on the family during the phases of childhood cancer. The information acquisition was based on documents from the Ministry of Health and on scientific studies available on the following databases: the Google Scholar, the Health virtual Library, the Scielo, the CAPES Journals, the MEDLINE, the LILACS and the Cochrane. The choice of the documents and journals was mainly justified by its link with the childhood health theme. The systematic of the studies research covered the period from 1999 to 2015. The keywords used for the research’s strategy were: childhood health, childhood cancer, family caregivers and grief. The results were presented in three themes: childhood cancer impact on the family, adaptation process of the family facing the sickness and the mourning regarding the death of the sick child. The review enabled to identify the need for special follow-up of the person, which is in direct contact with the child, usually the mother, since the moment of the diagnostic, until after the death.O objetivo desse estudo é revisar a literatura relativa à criança com câncer e sua família, a fim de identificar temas que têm sido pesquisados, e compreender o impacto causado na família durante as fases do câncer infantil. O levantamento de dados foi embasado em documentos do Ministério da Saúde e em trabalhos científicos disponibilizados no Google Acadêmico, Biblioteca virtual da Saúde, Scielo, Periodicos Capes, MEDLINE, LILACS e Cochrane. A escolha dos documentos e periódicos se deu pela sua relação com os temas Saúde da criança. A busca sistematizada de trabalhos abrangeram o período de 1999 a 2015. A estratégia de busca desse referencial utilizou as seguintes palavras-chave: Saúde da Criança, Câncer Infantil, Cuidadores Familiares e Luto. Os resultados foram apresentados em três temas: impacto do câncer infantil na familiar; processo de adaptação da família diante da doença e o luto diante da morte da criança. A revisão demonstrou que uma necessidade de acompanhamento especial a pessoa em contato direto com a criança, geralmente a mãe, desde o momento do diagnostico, e até após a morte

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

EXPERIÊNCIA E PARAMETRIZAÇÃO NO PROCESSO DE PROJETO DE APLICAÇÕES DIGITAIS INTERATIVAS

Experiências de projetistas se retratam nos protótipos por eles desenvolvidos, os quais são de suma importância para a formação de conceitos, principalmente na fase de projeto e de concepção de sistemas computacionais. Diante disso, o presente artigo tem como objetivo demonstrar como a prototipação pode se beneficiar da parametrização na concepção destes sistemas. Para isso, o processo projetual, exposto neste artigo, é estabelecido metodologicamente pelo entendimento de conceitos que permeiam os contextos experienciais e interacionais (imersão); na estruturação de ideias (ideação) que delineiam uma solução passível de implementação (prototipação) e na sua posterior validação. Como resultado, é proposta uma solução computacional constituída por um sistema embarcado e validada por testes funcionais que retratam que a modelagem paramétrica favorece o estabelecimento de relações e correlações entre os componentes utilizados na prototipação, e demonstram que a parametrização auxilia tanto na criação quanto no redesenho de sistemas computacionais interativos

In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil.

BackgroundWe evaluated in-hospital mortality and outcomes incidence after hospital discharge due to COVID-19 in a Brazilian multicenter cohort.MethodsThis prospective multicenter study (RECOVER-SUS, NCT04807699) included COVID-19 patients hospitalized in public tertiary hospitals in Brazil from June 2020 to March 2021. Clinical assessment and blood samples were performed at hospital admission, with post-hospital discharge remote visits. Hospitalized participants were followed-up until March 31, 2021. The outcomes were in-hospital mortality and incidence of rehospitalization or death after hospital discharge. Kaplan-Meier curves and Cox proportional-hazard models were performed.Findings1589 participants [54.5% male, age=62 (IQR 50-70) years; BMI=28.4 (IQR,24.9-32.9) Kg/m² and 51.9% with diabetes] were included. A total of 429 individuals [27.0% (95%CI,24.8-29.2)] died during hospitalization (median time 14 (IQR,9-24) days). Older age [vs<40 years; age=60-69 years-aHR=1.89 (95%CI,1.08-3.32); age=70-79 years-aHR=2.52 (95%CI,1.42-4.45); age≥80-aHR=2.90 (95%CI 1.54-5.47)]; noninvasive or mechanical ventilation at admission [vs facial-mask or none; aHR=1.69 (95%CI 1.30-2.19)]; SAPS-III score≥57 [vs<57; aHR=1.47 (95%CI 1.13-1.92)] and SOFA score≥10 [vs <10; aHR=1.51 (95%CI 1.08-2.10)] were independently associated with in-hospital mortality. A total of 65 individuals [6.7% (95%CI 5.3-8.4)] had a rehospitalization or death [rate=323 (95%CI 250-417) per 1000 person-years] in a median time of 52 (range 1-280) days post-hospital discharge. Age ≥ 60 years [vs <60, aHR=2.13 (95%CI 1.15-3.94)] and SAPS-III ≥57 at admission [vs <57, aHR=2.37 (95%CI 1.22-4.59)] were independently associated with rehospitalization or death after hospital discharge.InterpretationHigh in-hospital mortality rates due to COVID-19 were observed and elderly people remained at high risk of rehospitalization and death after hospital discharge.FundingFundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Programa INOVA-FIOCRUZ

Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial

IMPORTANCE: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. OBJECTIVE: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. INTERVENTIONS: An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory-system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. RESULTS: A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. CONCLUSIONS AND RELEVANCE: In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01374022

Núcleos de Ensino da Unesp: artigos 2007

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq