Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety.

PURPOSE: To develop a consensus opinion regarding capturing diagnosis-timing in coded hospital data. METHODS: As part of the World Health Organization International Classification of Diseases-11th Revision initiative, the Quality and Safety Topic Advisory Group is charged with enhancing the capture of quality and patient safety information in morbidity data sets. One such feature is a diagnosis-timing flag. The Group has undertaken a narrative literature review, scanned national experiences focusing on countries currently using timing flags, and held a series of meetings to derive formal recommendations regarding diagnosis-timing reporting. RESULTS: The completeness of diagnosis-timing reporting continues to improve with experience and use; studies indicate that it enhances risk-adjustment and may have a substantial impact on hospital performance estimates, especially for conditions/procedures that involve acutely ill patients. However, studies suggest that its reliability varies, is better for surgical than medical patients (kappa in hip fracture patients of 0.7-1.0 versus kappa in pneumonia of 0.2-0.6) and is dependent on coder training and setting. It may allow simpler and more precise specification of quality indicators. CONCLUSIONS: As the evidence indicates that a diagnosis-timing flag improves the ability of routinely collected, coded hospital data to support outcomes research and the development of quality and safety indicators, the Group recommends that a classification of 'arising after admission' (yes/no), with permitted designations of 'unknown or clinically undetermined', will facilitate coding while providing flexibility when there is uncertainty. Clear coding standards and guidelines with ongoing coder education will be necessary to ensure reliability of the diagnosis-timing flag.

Terapias no farmacológicas en el manejo del dolor en neonatos pretérmino. revisión sistemática de la literatura

Antecedentes El dolor en neonatos ha sido un problema poco explorado. Se ha propuesto el uso de las terapias no farmacológicas para su tratamiento, sin embargo existen pocas aproximaciones sistemáticas para la evaluación de su eficacia. Objetivos Determinar la eficacia de las terapias no farmacológicas en el manejo del dolor en neonatos pretérmino a través de una revisión sistemática. Metodología Se realizó una revisión sistemática de la literatura para evaluar la eficacia de las terapias no farmacológicas en el manejo del dolor en el recién nacido petérmino. La búsqueda se realizó a través de las bases de datos Embase, Cochrane, Bireme y Embase. Se identificaron estudios publicados inglés y español. Se realizó un análisis cualitativo y cuantitativo. Resultados Se incluyeron 10 ensayos clínicos. La solución de sacarosa administrada por vía oral mostró reducir la intensidad del dolor en el recién nacido. La intubación y toma de muestras facilitada por el cuidador mostró también reducir la intensidad del dolor. Conclusión Se recomienda la administración solución de sacarosa y acompañamiento del cuidador durante los procedimientos como medidas para reducir el dolor en el recién nacido pretérmino.

An effective approach for land-cover classification from airborne lidar fused with co-registered data

Airborne lidar provides accurate height information of objects on the earth and has been recognized as a reliable and accurate surveying tool in many applications. In particular, lidar data offer vital and significant features for urban land-cover classification, which is an important task in urban land-use studies. In this article, we present an effective approach in which lidar data fused with its co-registered images (i.e. aerial colour images containing red, green and blue (RGB) bands and near-infrared (NIR) images) and other derived features are used effectively for accurate urban land-cover classification. The proposed approach begins with an initial classification performed by the Dempster–Shafer theory of evidence with a specifically designed basic probability assignment function. It outputs two results, i.e. the initial classification and pseudo-training samples, which are selected automatically according to the combined probability masses. Second, a support vector machine (SVM)-based probability estimator is adopted to compute the class conditional probability (CCP) for each pixel from the pseudo-training samples. Finally, a Markov random field (MRF) model is established to combine spatial contextual information into the classification. In this stage, the initial classification result and the CCP are exploited. An efficient belief propagation (EBP) algorithm is developed to search for the global minimum-energy solution for the maximum a posteriori (MAP)-MRF framework in which three techniques are developed to speed up the standard belief propagation (BP) algorithm. Lidar and its co-registered data acquired by Toposys Falcon II are used in performance tests. The experimental results prove that fusing the height data and optical images is particularly suited for urban land-cover classification. There is no training sample needed in the proposed approach, and the computational cost is relatively low. An average classification accuracy of 93.63% is achieved.

Atividade de morcegos insetívoros (mammalia, chiroptera) no pampa brasileiro: uso de hábitat e sazonalidade

Bats correspond to 20% of the extant mammal species and, with a few exceptions, use echolocation, a spacial orientation system based on emission and analysis of echoes from sound waves, generally ultrasounds. Echolocation was discovered in the 1940 s and since the 1970 s ultrasound detectors have been commercially available, allowing the investigation of several aspects of the natural history and ecology of bats. Passive acoustic monitoring has been frequently used in habitat use studies, predominantly in North America and Europe, by comparing the number of bat passes between different habitat types. This dissertation presents the first evaluation of the spacial and seasonal variation patterns in the activity of insectivorous bats in the Brazilian biome Pampa, in the state of Rio Grande do Sul. Since bat activity can vary according to habitat type, time of year and climatic conditions, the following hypotheses were tested: 1. bat activity varies between different types of habitat; 2. bat activity varies seasonally; 3. bat activity is influenced by temperature, humidity and wind speed. The acoustic samples were taken along fixed transects of 1500 meters, which were monitored monthly from April 2009 to March 2010. Five habitat types were sampled: eucalypts, stream, riparian forest, wetland and grassland. In each sample, the number of bat passes was obtained by using an ultrasound detector Pettersson D230. A total of 1183 bat passes were registered. Greater bat activity levels was observed along large eucalypts (1.93 bat passes/3min) and along a stream (1.61 bat passes/3 min). A riparian forest (0.94 bat passes/3 min) and a wetland area (0.61 bat passes/3 min) exhibited statistically equal levels of activity. Bat passes were fewer in grassland areas (0,16 bat passes/3 min). Bat activity was not correlated with abiotic factors. However, bat activity was significantly low in the colder season, winter, and was similar in autumn, spring and summer. The observed preference for vegetation borders and water courses agrees with reports from other countries and is attributed predominantly to the high prey abundance in these types of environments. Additionally, low activity in the winter is probably a response to the reduced availability of insects, and to lower temperatures. Our results indicate which areas of arboreal vegetation and water courses should be priorities for the conservation of bats and that alterations of these habitat types might negatively influence bat activity in the region

Fisioterapia respiratória e sua aplicabilidade no período pré-operatório de cirurgia cardíaca

Procedimentos cirúrgicos torácicos podem alterar a mecânica respiratória, repercutindo na função pulmonar. A presença de profissionais fisioterapeutas é fundamental no preparo e na reabilitação dos indivíduos que são submetidos à cirurgia cardíaca, visto que dispõem de um grande arsenal de técnicas. O objetivo foi verificar a efetividade de exercícios respiratórios, com e sem a utilização de dispositivos, e o treinamento muscular respiratório pré-cirurgia cardíaca na redução das complicações pulmonares pós-operatórias. Mesmo existindo controvérsias a respeito de qual técnica utilizar, estudos demonstram a eficácia da fisioterapia respiratória pré-cirúrgica na prevenção e na redução de complicações pulmonares pós-operatórias.

Encontro da saúde mental e da saúde pública: estudo analítico-descritivo sobre como pacientes com queixas físicas estabelecem a relação inicial em psicoterapia de orientação psicanalítica

Pós-graduação em Psicologia - FCLAS

Concepções dos estudos de usuários na visão dos professores dos cursos de Biblioteconomia brasileiros

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The effect of offset implant configuration on bone stress distribution: a systematic review

Purpose: The aim of this systematic review was to compare straight-line and offset implant configurations for three-element implant-retained prostheses. Materials and Methods: Two independent reviewers conducted a review on PubMed/Medline, EMBASE, and Cochrane Library for studies published in English, from January 1, 1995 to January 17, 2014. A systematic review was conducted following the PRISMA statement. All relevant titles were selected according to inclusion/exclusion criteria. From this pool of titles, abstracts and full texts were reviewed. Results: A total of 6080 titles were identified with the initial search. Twenty-one were selected based on title and abstract. Of these, after discussion and complete reading, 12 studies were selected according to the inclusion and exclusion criteria, all of which were in vitro studies. Conclusions: A systematic review of the current literature showed only in vitro evidence that there is no consensus on the advantage of using an offset configuration implant compared to those in straight-line configuration, even though some studies present a slight improvement of bone stress distribution when an offset implant is under oblique loading (PICO).

Os caminhos movediços de Bandeira

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Selection criteria for selective dorsal rhizotomy in children with spastic cerebral palsy: a systematic review of the literature

AIM Information regarding the selection procedure for selective dorsal rhizotomy (SDR) in children with spastic cerebral palsy (CP) is scarce. Therefore, the aim of this study was to summarize the selection criteria for SDR in children with spastic CP. METHOD A systematic review was carried out using the following databases: MEDLINE, CINAHL, EMBASE, PEDro, and the Cochrane Library. Additional studies were identified in the reference lists. Search terms included 'selective dorsal rhizotomy', 'functional posterior rhizotomy', 'selective posterior rhizotomy', and 'cerebral palsy'. Studies were selected if they studied mainly children (<18y of age) with spastic CP, if they had an intervention of SDR, if they had a detailed description of the selection criteria, and if they were in English. The levels of evidence, conduct of studies, and selection criteria for SDR were scored. RESULTS Fifty-two studies were included. Selection criteria were reported in 16 International Classification of Functioning, Disability and Health model domains including 'body structure and function' (details concerning spasticity [94%], other movement abnormalities [62%], and strength [54%]), 'activity' (gross motor function [27%]), and 'personal and environmental factors' (age [44%], diagnosis [50%], motivation [31%], previous surgery [21%], and follow-up therapy [31%]). Most selection criteria were not based on standardized measurements. INTERPRETATION Selection criteria for SDR vary considerably. Future studies should describe clearly the selection procedure. International meetings of experts should develop more uniform consensus guidelines, which could form the basis for selecting candidates for SDR.

Guide to data for health systems planners /

Mode of access: Internet.

Solar thermal electric power information user study /

This report describes the results of a series of telephone interviews with groups of users of information on solar thermal electric power. These results, part of a larger study on many different solar technologies, identify types of information each group needed and the best ways to get information to each group. The report is one of ten discussing study results. Results from five solar thermal electric power groups of respondents are analyzed in this report: DOE-funded researchers, non-DOE-funded researchers, representatives of utilities, electric power engineers, and educators.

Using books and libraries /

"Originally written for the freshman course in library use at Louisiana State University ... All statements applying specifically to the Louisiana State University libraries have been removed and generalized material substituted."--Foreword.

La gestión de proyectos en la formación de los profesionales de la información: análisis internacional de la materia en los estudios universitarios de Información y Documentación

Se presentan los resultados de un estudio sobre la formación universitaria que reciben los profesionales de la información sobre la materia gestión de proyectos, tras el análisis de las titulaciones en Información y Documentación a nivel internacional. Para ello, se han utilizado fuentes y directorios sobre la educación internacional en Library and Information Science y se ha creado una base de datos con 106 registros de asignaturas sobre gestión de proyectos incluidas en las titulaciones en Información y Documentación. Como resultado de este proceso, los parámetros de análisis de la investigación han sido la ubicación geográfica, las instituciones de educación superior, las titulaciones académicas y las propias asignaturas sobre gestión de proyectos. Entre las conclusiones más notables, destaca la obligatoriedad de las asignaturas, la enseñanza de las mismas en modo presencial y el caso de las universidades públicas de Estados Unidos, Alemania y Francia.