Desvio de posicionamento em radioterapia para patologias de cabeça e pescoço e próstata: revisão de literatura

Introdução – Numa era em que os tratamentos de Radioterapia Externa (RTE) exigem cada vez mais precisão, a utilização de imagem médica permitirá medir, quantificar e avaliar o impacto do erro provocado pela execução do tratamento ou pelos movimentos dos órgãos. Objetivo – Analisar os dados existentes na literatura acerca de desvios de posicionamento (DP) em patologias de cabeça e pescoço (CP) e próstata, medidos com Cone Beam Computed Tomography (CBCT) ou Electronic Portal Image Device (EPID). Metodologia – Para esta revisão da literatura foram pesquisados artigos recorrendo às bases de dados MEDLINE/PubMed e b-on. Foram incluídos artigos que reportassem DP em patologias CP e próstata medidos através de CBCT e EPID. Seguidamente foram aplicados critérios de validação, que permitiram a seleção dos estudos. Resultados – Após a análise de 35 artigos foram incluídos 13 estudos e validados 9 estudos. Para tumores CP, a média (μ) dos DP encontra-se entre 0,0 e 1,2mm, com um desvio padrão (σ) máximo de 1,3mm. Para patologias de próstata observa-se μDP compreendido entre 0,0 e 7,1mm, com σ máximo de 7,5mm. Discussão/Conclusão – Os DP em patologias CP são atribuídos, maioritariamente, aos efeitos secundários da RTE, como mucosite e dor, que afetam a deglutição e conduzem ao emagrecimento, contribuindo para a instabilidade da posição do doente durante o tratamento, aumentando as incertezas de posicionamento. Os movimentos da próstata devem-se principalmente às variações de preenchimento vesical, retal e gás intestinal. O desconhecimento dos DP afeta negativamente a precisão da RTE. É importante detetá-los e quantificá-los para calcular margens adequadas e a magnitude dos erros, aumentando a precisão da administração de RTE, incluindo o aumento da segurança do doente. - ABSTRACT - Background and Purpose – In an era where precision is an increasing necessity in external radiotherapy (RT), modern medical imaging techniques provide means for measuring, quantifying and evaluating the impact of treatment execution and movement error. The aim of this paper is to review the current literature on the quantification of setup deviations (SD) in patients with head and neck (H&N) or prostate tumors, using Cone Beam Computed Tomography (CBCT) or Electronic Portal Image Device (EPID). Methods – According to the study protocol, MEDLINE/PubMed and b-on databases were searched for trials, which were analyzed using selection criteria based on the quality of the articles. Results – After assessment of 35 papers, 13 studies were included in this analysis and nine were authenticated (6 for prostate and 3 for H&N tumors). The SD in the treatment of H&N cancer patients is in the interval of 0.1 to 1.2mm, whereas in prostate cancer this interval is 0.0 to 7.1mm. Discussion – The reproducibility of patient positioning is the biggest barrier for higher precision in RT, which is affected by geometrical uncertainty, positioning errors and inter or intra-fraction organ movement. There are random and systematic errors associated to patient positioning, introduced since the treatment planning phase or through physiological organ movement. Conclusion – The H&N SD are mostly assigned to the Radiotherapy adverse effects, like mucositis and pain, which affect swallowing and decrease secretions, contributing for the instability of patient positioning during RT treatment and increasing positioning uncertainties. Prostate motion is mainly related to the variation in bladder and rectal filling. Ignoring SD affects negatively the accuracy of RT. Therefore, detection and quantification of SD is crucial in order to calculate appropriate margins, the magnitude of error and to improve accuracy in RTE and patient safety.

Probabilistic linkage in household survey on hospital care usage

OBJECTIVE: To evaluate the potential advantages and limitations of the use of the Brazilian hospital admission authorization forms database and the probabilistic record linkage methodology for the validation of reported utilization of hospital care services in household surveys. METHODS: A total of 2,288 households interviews were conducted in the county of Duque de Caxias, Brazil. Information on the occurrence of at least one hospital admission in the year preceding the interview was obtained from a total of 10,733 household members. The 130 records of household members who reported at least one hospital admission in a public hospital were linked to a hospital database with 801,587 records, using an automatic probabilistic approach combined with an extensive clerical review. RESULTS: Seventy-four (57%) of the 130 household members were identified in the hospital database. Yet only 60 subjects (46%) showed a record of hospitalization in the hospital database in the study period. Hospital admissions due to a surgery procedure were significantly more likely to have been identified in the hospital database. The low level of concordance seen in the study can be explained by the following factors: errors in the linkage process; a telescoping effect; and an incomplete record in the hospital database. CONCLUSIONS: The use of hospital administrative databases and probabilistic linkage methodology may represent a methodological alternative for the validation of reported utilization of health care services, but some strategies should be employed in order to minimize the problems related to the use of this methodology in non-ideal conditions. Ideally, a single identifier, such as a personal health insurance number, and the universal coverage of the database would be desirable.

Adaptive tool for automatic data collection of real electricity markets

The study of electricity markets operation has been gaining an increasing importance in last years, as result of the new challenges that the electricity markets restructuring produced. This restructuring increased the competitiveness of the market, but with it its complexity. The growing complexity and unpredictability of the market’s evolution consequently increases the decision making difficulty. Therefore, the intervenient entities are forced to rethink their behaviour and market strategies. Currently, lots of information concerning electricity markets is available. These data, concerning innumerous regards of electricity markets operation, is accessible free of charge, and it is essential for understanding and suitably modelling electricity markets. This paper proposes a tool which is able to handle, store and dynamically update data. The development of the proposed tool is expected to be of great importance to improve the comprehension of electricity markets and the interactions among the involved entities.

A data-mining based methodology for wind forecasting

In many countries the use of renewable energy is increasing due to the introduction of new energy and environmental policies. Thus, the focus on the efficient integration of renewable energy into electric power systems is becoming extremely important. Several European countries have already achieved high penetration of wind based electricity generation and are gradually evolving towards intensive use of this generation technology. The introduction of wind based generation in power systems poses new challenges for the power system operators. This is mainly due to the variability and uncertainty in weather conditions and, consequently, in the wind based generation. In order to deal with this uncertainty and to improve the power system efficiency, adequate wind forecasting tools must be used. This paper proposes a data-mining-based methodology for very short-term wind forecasting, which is suitable to deal with large real databases. The paper includes a case study based on a real database regarding the last three years of wind speed, and results for wind speed forecasting at 5 minutes intervals.

Power systems reliability calculation based on fuzzy data mining

This paper presents a methodology supported on the data base knowledge discovery process (KDD), in order to find out the failure probability of electrical equipments’, which belong to a real electrical high voltage network. Data Mining (DM) techniques are used to discover a set of outcome failure probability and, therefore, to extract knowledge concerning to the unavailability of the electrical equipments such us power transformers and high-voltages power lines. The framework includes several steps, following the analysis of the real data base, the pre-processing data, the application of DM algorithms, and finally, the interpretation of the discovered knowledge. To validate the proposed methodology, a case study which includes real databases is used. This data have a heavy uncertainty due to climate conditions for this reason it was used fuzzy logic to determine the set of the electrical components failure probabilities in order to reestablish the service. The results reflect an interesting potential of this approach and encourage further research on the topic.

Towards the wide implementation of standards IEC 61968/70 (CIM) and IEC 61850 in the distribution system (CIGRÉ C6-105_2010)

Currently, power systems (PS) already accommodate a substantial penetration of distributed generation (DG) and operate in competitive environments. In the future, as the result of the liberalisation and political regulations, PS will have to deal with large-scale integration of DG and other distributed energy resources (DER), such as storage and provide market agents to ensure a flexible and secure operation. This cannot be done with the traditional PS operational tools used today like the quite restricted information systems Supervisory Control and Data Acquisition (SCADA) [1]. The trend to use the local generation in the active operation of the power system requires new solutions for data management system. The relevant standards have been developed separately in the last few years so there is a need to unify them in order to receive a common and interoperable solution. For the distribution operation the CIM models described in the IEC 61968/70 are especially relevant. In Europe dispersed and renewable energy resources (D&RER) are mostly operated without remote control mechanisms and feed the maximal amount of available power into the grid. To improve the network operation performance the idea of virtual power plants (VPP) will become a reality. In the future power generation of D&RER will be scheduled with a high accuracy. In order to realize VPP decentralized energy management, communication facilities are needed that have standardized interfaces and protocols. IEC 61850 is suitable to serve as a general standard for all communication tasks in power systems [2]. The paper deals with international activities and experiences in the implementation of a new data management and communication concept in the distribution system. The difficulties in the coordination of the inconsistent developed in parallel communication and data management standards - are first addressed in the paper. The upcoming unification work taking into account the growing role of D&RER in the PS is shown. It is possible to overcome the lag in current practical experiences using new tools for creating and maintenance the CIM data and simulation of the IEC 61850 protocol – the prototype of which is presented in the paper –. The origin and the accuracy of the data requirements depend on the data use (e.g. operation or planning) so some remarks concerning the definition of the digital interface incorporated in the merging unit idea from the power utility point of view are presented in the paper too. To summarize some required future work has been identified.

Ontologies for reusing data cleaning knowledge

The emergence of new business models, namely, the establishment of partnerships between organizations, the chance that companies have of adding existing data on the web, especially in the semantic web, to their information, led to the emphasis on some problems existing in databases, particularly related to data quality. Poor data can result in loss of competitiveness of the organizations holding these data, and may even lead to their disappearance, since many of their decision-making processes are based on these data. For this reason, data cleaning is essential. Current approaches to solve these problems are closely linked to database schemas and specific domains. In order that data cleaning can be used in different repositories, it is necessary for computer systems to understand these data, i.e., an associated semantic is needed. The solution presented in this paper includes the use of ontologies: (i) for the specification of data cleaning operations and, (ii) as a way of solving the semantic heterogeneity problems of data stored in different sources. With data cleaning operations defined at a conceptual level and existing mappings between domain ontologies and an ontology that results from a database, they may be instantiated and proposed to the expert/specialist to be executed over that database, thus enabling their interoperability.

Quality of life of the caregivers of people with aphasia. A systematic review.

Purpose: Systematic review to identify the factors associated to the quality of life (QOL) of the caregivers of people with aphasia (PWA). Methods: Studies were searched using Medline, Pubmed, Cochrane Library, CINAHL, PsycINFO and Web of Science databases. Peer-reviewed papers that studied the QOL of PWA’s caregivers or the consequences of aphasia in caregivers’ life were included. Findings were extracted from the studies that met the inclusion criteria. Results: No data is available reporting particularly the QOL of PWA caregivers’ or their QOL predictors. Nevertheless, it was possible to extract aspects related to QOL from the studies that report the consequences of aphasia, and life changes in PWA’s caregivers. Nine (9) studies including PWA’s caregivers were found, but only 5 reported data separately on them. Methodological heterogeneity impedes cross-study comparisons, although some considerations can be made. PWA’s caregivers reported life changes such as: loss of freedom; social isolation; new responsibilities; anxiety; emotional loneliness; need for support and respite. Conclusions: Changes in social relationships, in emotional status, increased burden and need for support and respite were experienced by PWA’s caregivers. Stroke QOL studies need to include PWA caregivers’ and report separately on them. Further research is needed in this area in order to determine their QOL predictors and identify what interventions and referrals better suit their needs.

Divulgação online da religião católica - estudo de caso: análise do website da Diocese do Porto

Dissertação de Mestrado apresentada ao Instituto Superior de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Marketing Digital, sob orientação de Mestre António da Silva Vieira

Motivations in volunteer work

The objective of this paper is to review and discuss the literature about volunteers’ motivations to donate their time to NGOs (Non Governmental Organisations). According to Parboteeah, Cullenb & Lim (2004) management research has not paid much attention to voluntarism, however, voluntarism is a substantial part of productive work for many societies. Wilson & Pimm (1996) show that in Great Britain about 39% of the adult population has been involved in some volunteer activity for some period of time. In the U.S.A. these values reach 50% (Wilson & Pimm, 1996). Considering the benefits that voluntarism can bring to an organisation, we understand that more attention must be devoted to this phenomenon. The more an organisation knows volunteers, the better this organisation will be able to meet the needs and expectations of these individuals. We present a literature review that illustrates and compares the different motivations associated with volunteer work. The paper includes a bibliographical databases search in specialised journals. The search used the key words “motivations” and “voluntarism” (in the heading and text body) and covered all numbers between 2000 and 2007. We identify the existence of repeated motivations (Holmberg & Söderlung, 2005; Prouteau & Wolff, 2008; Soupourmas & Ironmonger, 2001; Yavas & Riecken, 1997), which allow the establishment of a typology of volunteers’ motivations, based on four categories: altruism, social needs, self-esteem, learning and self-development. Finally we identify three main gaps in the literature that justify further research. First, research focusing on the differences between motivations related to volunteers’ "Attraction" versus "Retention" in NGO’s is nil. Second, the great majority of the studies rely on north American (USA and Canada) and Australian context, which demands for further research in European countries. Third, the majority of NGOs researched are related to sport, art or the environment, and it would be interesting to explore the relationship between motivation and NGO type. These questions may obtain interesting answers for NGO management, in particular with regard to volunteer attraction and retention.

As motivações no trabalho voluntário

Este trabalho revê e discute a literatura sobre as motivações dos voluntários para doarem o seu tempo às ONG’s. Quanto melhor uma organização conhecer os voluntários, mais essa organização poderá ir de encontro às necessidades e expectativas desses mesmos indivíduos. Por isso, compreender as motivações que podem levar um indivíduo a doar o seu tempo a uma determinada organização é relevante na gestão das ONG’s. Primeiro, o artigo discute o estado da arte do voluntariado formal e as motivações dos indivíduos voluntários não dirigentes. Apresenta-se uma pesquisa a bases de dados bibliográficas, que inclui revistas especializadas na investigação de voluntariado. Depois, o artigo mostra e compara os diferentes tipos de motivações associadas ao trabalho voluntário e propõe uma tipologia que agrupa as motivações dos voluntários em quatro tipos: altruísmo, pertença, ego e reconhecimento social e aprendizagem e desenvolvimento. Por fim, efectua-se uma análise que indica três lacunas na literatura das motivações dos voluntários que justificam investigação adicional: (i) a omissão de diferenças entre as motivações relacionadas com a “Atracção” versus a “Retenção” dos voluntários; (ii) a focalização das investigações no contexto norte-americano e australiano; e (iii) a ausência de análises comparativas que relacionem as motivações por tipos de ONG’s.

Processing XML with Java – a performance benchmark

Over time, XML markup language has acquired a considerable importance in applications development, standards definition and in the representation of large volumes of data, such as databases. Today, processing XML documents in a short period of time is a critical activity in a large range of applications, which imposes choosing the most appropriate mechanism to parse XML documents quickly and efficiently. When using a programming language for XML processing, such as Java, it becomes necessary to use effective mechanisms, e.g. APIs, which allow reading and processing of large documents in appropriated manners. This paper presents a performance study of the main existing Java APIs that deal with XML documents, in order to identify the most suitable one for processing large XML files

Performance analysis of Java APIS for XML processing

Over time, XML markup language has acquired a considerable importance in applications development, standards definition and in the representation of large volumes of data, such as databases. Today, processing XML documents in a short period of time is a critical activity in a large range of applications, which imposes choosing the most appropriate mechanism to parse XML documents quickly and efficiently. When using a programming language for XML processing, such as Java, it becomes necessary to use effective mechanisms, e.g. APIs, which allow reading and processing of large documents in appropriated manners. This paper presents a performance study of the main existing Java APIs that deal with XML documents, in order to identify the most suitable one for processing large XML files.

Relação existente entre as exportações e as restrições financeiras das empresas industriais do setor têxtil

Dissertação de Mestrado em Finanças Empresariais

Mental health and psychiatry research in Brazil: scientific production from 1999 to 2003

OBJECTIVE: To assess the extent of mental health scientific production in Brazil from 1999 to 2003, and to identify the nature of the publications generated, their sources of finance and the ways of publicly disseminating the research findings. METHODS: Searches for publications were conducted in the Medline and PsychInfo databases for the period 1999-2003. A semi-structured questionnaire developed by an international team was applied to 626 mental health researchers, covering each interviewee's educational background, research experience, access to funding sources, public impact and research priorities. The sample was composed by 626 mental health researchers identified from 792 publications indexed on Medline and PsychInfo databases for the period above, and from a list of reviewers of Revista Brasileira de Psiquiatria. RESULTS: In Brazil, 792 publications were produced by 525 authors between 1999 and 2003 (441 indexed in Medline and 398 in the ISI database). The main topics were: depression (29.1%), substance misuse (14.6%), psychoses (10%), childhood disorders (7%) and dementia (6.7%). Among the 626 Brazilian mental health researchers, 329 answered the questionnaire. CONCLUSIONS: There were steadily increasing numbers of Brazilian articles on mental health published in foreign journals from 1999 to 2003: the number of articles in Medline tripled and it doubled in the ISI database. The content of these articles corresponded to the priorities within mental health, but there is a need for better interlinking between researchers and mental health policymakers.