Validity and reliability of a health care service evaluation instrument for tuberculosis

OBJECTIVE To evaluate the validity and reliability of an instrument that evaluates the structure of primary health care units for the treatment of tuberculosis.METHODS This cross-sectional study used simple random sampling and evaluated 1,037 health care professionals from five Brazilian municipalities (Natal, state of Rio Grande do Norte; Cabedelo, state of Paraíba; Foz do Iguaçu, state of Parana; Sao José do Rio Preto, state of Sao Paulo, and Uberaba, state of Minas Gerais) in 2011. Structural indicators were identified and validated, considering different methods of organization of the health care system in the municipalities of different population sizes. Each structure represented the organization of health care services and contained the resources available for the execution of health care services: physical resources (equipment, consumables, and facilities); human resources (number and qualification); and resources for maintenance of the existing infrastructure and technology (deemed as the organization of health care services). The statistical analyses used in the validation process included reliability analysis, exploratory factor analysis, and confirmatory factor analysis.RESULTS The validation process indicated the retention of five factors, with 85.9% of the total variance explained, internal consistency between 0.6460 and 0.7802, and quality of fit of the confirmatory factor analysis of 0.995 using the goodness-of-fit index. The retained factors comprised five structural indicators: professionals involved in the care of tuberculosis patients, training, access to recording instruments, availability of supplies, and coordination of health care services with other levels of care. Availability of supplies had the best performance and the lowest coefficient of variation among the services evaluated. The indicators of assessment of human resources and coordination with other levels of care had satisfactory performance, but the latter showed the highest coefficient of variation. The performance of the indicators “training” and “access to recording instruments” was inferior to that of other indicators.CONCLUSIONS The instrument showed feasibility of application and potential to assess the structure of primary health care units for the treatment of tuberculosis.

Information technology service management: an experimental approach towards IT service prediction

Dissertation presented to obtain a Masters degree in Computer Science

Remote experimentation network - yielding an inter-university peer-to-peer e-service

The goal of this paper is to discuss the benefits and challenges of yielding an inter-continental network of remote laboratories supported and used by both European and Latin American Institutions of Higher Education. Since remote experimentation, understood as the ability to carry out real-world experiments through a simple Web browser, is already a proven solution for the educational community as a supplement to on-site practical lab work (and in some cases, namely for distance learning courses, a replacement to that work), the purpose is not to discuss its technical, pedagogical, or economical strengths, but rather to raise and try to answer some questions about the underlying benefits and challenges of establishing a peer-to-peer network of remote labs. Ultimately, we regard such a network as a constructive mechanism to help students gain the working and social skills often valued by multinational/global companies, while also providing awareness of local cultural aspects.

On the analysis of compensation correctness

One fundamental idea of service-oriented computing is that applications should be developed by composing already available services. Due to the long running nature of service interactions, a main challenge in service composition is ensuring correctness of transaction recovery. In this paper, we use a process calculus suitable for modelling long running transactions with a recovery mechanism based on compensations. Within this setting, we discuss and formally state correctness criteria for compensable processes compositions, assuming that each process is correct with respect to transaction recovery. Under our theory, we formally interpret self-healing compositions, that can detect and recover from faults, as correct compositions of compensable processes. Moreover, we develop an automated verification approach and we apply it to an illustrative case study.

Acute renal failure after rifampicin

A patient with miliary tuberculosis and a chronic urogenital focus is described, who had a borderline renal function at diagnosis and developed overt renal failure upon daily treatment with rifampin (RMP), isoniazid (INH) and ethambutol (EMB). This is the first Brazilian report of BMP induced renal damage. A renal biopsy taken on the third day of oliguria showed recent tubular necrosis with acute interstitial inflammation and granuloma formation. The aspect of the granulomatous lesion hightly suggested drug etiology because of the lack of palisading, high incidence of neutrophils and absence of facid-fast bacilli. This is the first presentation of an acute granulomatous interstitial nephritis probably due to RMP. Furthermore the pathogenesis of the renal damage caused by tuberculosis and RMP are discussed.

Mechanical behavior and localized failure modes in a porous basalt from the Azores

Basaltic rocks are the main component of the oceanic upper crust, thus of potential interest for water and geothermal resources, storage of CO2 and volcanic edifice stability. In this work, we investigated experimentally the mechanical behavior and the failure modes of a porous basalt, with an initial connected porosity of 18%. Results were acquired under triaxial compression experiments at confining pressure in the range of 25-200 MPa on water saturated samples. In addition, a purely hydrostatic test was also performed to reach the pore collapse critical pressure P*. During hydrostatic loading, our results show that the permeability is highly pressure dependent, which suggests that the permeability is mainly controlled by pre-existing cracks. When the sample is deformed at pressure higher than the pore collapse pressure P*, some very small dilatancy develops due to microcracking, and an increase in permeability is observed. Under triaxial loading, two modes of deformation can be highlighted. At low confining pressure (Pc < 50 MPa), the samples are brittle and shear localization occurs. For confining pressure > 50 MPa, the stress-strain curves are characterized by strain hardening and volumetric compaction. Stress drops are also observed, suggesting that compaction may be localized. The presence of compaction bands is confirmed by our microstructure analysis. In addition, the mechanical data allows us to plot the full yield surface for this porous basalt, which follows an elliptic cap as previously observed in high porosity sandstones and limestones.

Serviço de visualização de informação geográfica na WEB - A publicação do atlas de Portugal utilizando a especificação WEB MAP SERVICE

Dissertação apresentada como requisito parcial para obtenção do grau de Mestre em Ciência e Sistemas de Informação Geográfica

Integrating the LMS in service oriented e-learning systems

Learning management systems are routinely used for presenting, solving and grading exercises with large classes. However, teachers are constrained to use questions with pre-defined answers, such as multiple-choice, to automatically correct the exercises of their students. Complex exercises cannot be evaluated automatically by the LMS and require the coordination of a set of heterogeneous systems. For instance, programming exercises require a specialized exercise resolution environment and automatic evaluation features, each provided by a different type of system. In this paper, the authors discuss an approach for the coordination of a network of eLearning systems supporting the resolution of exercises. The proposed approach is based on a pivot component embedded in the LMS and has two main roles: 1) provide an exercise resolution environment, and 2) coordinate communication between the LMS and other systems, exposing their functions as web services. The integration of the pivot component in the LMS relies on Learning Tools Interoperability (LTI). This paper presents an architecture to coordinate a network of eLearning systems and validate the proposed approach by creating such a network integrated with LMS from two different vendors.

CrimsonHex: a service oriented repository of specialised learning objects

The corner stone of the interoperability of eLearning systems is the standard definition of learning objects. Nevertheless, for some domains this standard is insufficient to fully describe all the assets, especially when they are used as input for other eLearning services. On the other hand, a standard definition of learning objects in not enough to ensure interoperability among eLearning systems; they must also use a standard API to exchange learning objects. This paper presents the design and implementation of a service oriented repository of learning objects called crimsonHex. This repository is fully compliant with the existing interoperability standards and supports new definitions of learning objects for specialized domains. We illustrate this feature with the definition of programming problems as learning objects and its validation by the repository. This repository is also prepared to store usage data on learning objects to tailor the presentation order and adapt it to learner profiles.

Tuberculosis in patients with chronic renal failure

Nine cases of tuberculosis (TB) were diagnosed among 800 uremic patients, followed-up during 11 years, a prevalence of 1125%, 2.5 times higher than that in the general population. Six patients (66.7%) had lymph node involvement (4 cervical and 2 mediastinal). Three patients (33.3%) had pulmonary involvement (2 pleuro-pulmonary and 1 bilateral apical pulmonary). Eight patients were undergoing dialysis and 1 was pre-dialytic. The duration of dialysis ranged from 1 to 60 months. Three patients had previously received immunosuppressive drugs for unsuccessful renal transplantation. Daily fever was present in all but one patient; he was asymptomatic and TB was suspected after routine chest radiography. Biopsy was the diagnostic procedure in 7 patients (77.8%), four by direct cervical lymph node biopsy, 2 by mediastinal, performed by mediastinoscopy and 1 by pleural biopsy. In 2 other patients TB was confirmed by the presence of tubercle bacilli; in sputum (1 patient) and in a bronchial flushing specimen (the other patient). Triple therapy was used in all patients (isoniazid and ethambutol in all), plus rifampicin in 8 and streptomycin in 1. One patient had jaundice and another had optical neuritis. Five patients were cured. The other four died during treatment of causes unrelated to TB or its treatment.

A contribution to the e-framework: a specification of a programming exercise evaluation service

This work is a contribution to the e-Framework, arguably the most prominent e-learning framework today, and consists of the definition of a service for the automatic evaluation of programming exercises. This evaluation domain differs from trivial evaluations modelled by languages such as the IMS Question & Test Interoperability (QTI) specification. Complex evaluation domains justify the development of specialized evaluators that participate in several business processes. These business processes can combine other type of systems such as Programming Contest Management Systems, Learning Management Systems, Integrated Development Environments and Learning Object Repositories where programming exercises are stored as Learning Objects. This contribution describes the implementation approaches used, more precisely, behaviours & requests, use & interactions, applicable standards, interface definition and usage scenarios.

Specifying a programming exercises evaluation service on the e-Framework

The e-Framework is arguably the most prominent e-learning framework currently in use. For this reason it was selected as basis for modelling a programming exercises evaluation service. The purpose of this type of evaluator is to mark and grade exercises in computer programming courses and in programming contests. By exposing its functions as services a programming exercise evaluator is able to participate in business processes integrating different system types, such as Programming Contest Management Systems, Learning Management Systems, Integrated Development Environments and Learning Object Repositories. This paper formalizes the approaches to be used in the implementation of a programming exercise evaluator as a service on the e-Framework.

Using the learning tools interoperability framework for LMS integration in service oriented architectures

The LMS plays an indisputable role in the majority of the eLearning environments. This eLearning system type is often used for presenting, solving and grading simple exercises. However, exercises from complex domains, such as computer programming, require heterogeneous systems such as evaluation engines, learning objects repositories and exercise resolution environments. The coordination of networks of such disparate systems is rather complex. This work presents a standard approach for the coordination of a network of eLearning systems supporting the resolution of exercises. The proposed approach use a pivot component embedded in the LMS with two roles: provide an exercise resolution environment and coordinate the communication between the LMS and other systems exposing their functions as web services. The integration of the pivot component with the LMS relies on the Learning Tools Interoperability. The validation of this approach is made through the integration of the component with LMSs from two vendors.

An internet DGPS service for precise outdoor navigation

The goal of the work presented in this paper is to provide mobile platforms within our campus with a GPS based data service capable of supporting precise outdoor navigation. This can be achieved by providing campus-wide access to real time Differential GPS (DGPS) data. As a result, we designed and implemented a three-tier distributed system that provides Internet data links between remote DGPS sources and the campus and a campus-wide DGPS data dissemination service. The Internet data link service is a two-tier client/server where the server-side is connected to the DGPS station and the client-side is located at the campus. The campus-wide DGPS data provider disseminates the DGPS data received at the campus via the campus Intranet and via a wireless data link. The wireless broadcast is intended for portable receivers equipped with a DGPS wireless interface and the Intranet link is provided for receivers with a DGPS serial interface. The application is expected to provide adequate support for accurate outdoor campus navigation tasks.