Humanização da assistência ao paciente crítico: revisão integrativa da literatura

This study aimed at analyzing the scientific production on health care humanization in intensive-care and emergency units based on publications in national journals. Therefore, this is an integrative review of the national literature. The online database Literatura Latino-Americana do Caribe em Ciências da Saúde - Literature in the Health Sciences in Latin America and the Caribbean (LILACS) based on the Health Virtual Library (BVS) platform was used to select articles. The final sample in this review consisted of 21 articles. The presentation of results and data discussion was descriptively performed and divided into three themes: communication with relatives and the team, caregiver humanization and, finally, the difficulties faced to implement humanization. As regards communication, it is seen by the authors as a fundamental strategy to ensure quality in intensive care, and it is placed as a central axis in the humanization policy. Concerning caregiver humanization, the physical and mental overload resulting from the work process in these units are factors that interfere with personal relations between team members as well as with that between team members and patients. Among the difficulties faced for implementing humanized care for critical patients are the units’s physical and organizational structures, technology and health care professionals’ education, which is centered on the biomedical model. It was concluded that communication is considered to be fundamental for humanization of the care provided to critical patients, since it allows for the development of a network of meanings between patients, the team, families and the establishment. In order to implement care with humanized actions in urgency and emergency sectors, particularly in ICUs, it is necessary to change organizational culture and value health care professionals

Searching and retrieving in content-based repositories of formal mathematical knowledge

In this thesis, the author presents a query language for an RDF (Resource Description Framework) database and discusses its applications in the context of the HELM project (the Hypertextual Electronic Library of Mathematics). This language aims at meeting the main requirements coming from the RDF community. in particular it includes: a human readable textual syntax and a machine-processable XML (Extensible Markup Language) syntax both for queries and for query results, a rigorously exposed formal semantics, a graph-oriented RDF data access model capable of exploring an entire RDF graph (including both RDF Models and RDF Schemata), a full set of Boolean operators to compose the query constraints, fully customizable and highly structured query results having a 4-dimensional geometry, some constructions taken from ordinary programming languages that simplify the formulation of complex queries. The HELM project aims at integrating the modern tools for the automation of formal reasoning with the most recent electronic publishing technologies, in order create and maintain a hypertextual, distributed virtual library of formal mathematical knowledge. In the spirit of the Semantic Web, the documents of this library include RDF metadata describing their structure and content in a machine-understandable form. Using the author's query engine, HELM exploits this information to implement some functionalities allowing the interactive and automatic retrieval of documents on the basis of content-aware requests that take into account the mathematical nature of these documents.

Identification of selective norbornane-type aspartate analogue inhibitors of the glutamate transporter 1 (GLT-1) from the chemical universe generated database (GDB)

A variety of conformationally constrained aspartate and glutamate analogues inhibit the glutamate transporter 1 (GLT-1, also known as EAAT2). To expand the search for such analogues, a virtual library of aliphatic aspartate and glutamate analogues was generated starting from the chemical universe database GDB-11, which contains 26.4 million possible molecules up to 11 atoms of C, N, O, F, resulting in 101026 aspartate analogues and 151285 glutamate analogues. Virtual screening was realized by high-throughput docking to the glutamate binding site of the glutamate transporter homologue from Pyrococcus horikoshii (PDB code: 1XFH ) using Autodock. Norbornane-type aspartate analogues were selected from the top-scoring virtual hits and synthesized. Testing and optimization led to the identification of (1R*,2R*,3S*,4R*,6R*)-2-amino-6-phenethyl-bicyclo[2.2.1]heptane-2,3-dicarboxylic acid as a new inhibitor of GLT-1 with IC(50) = 1.4 ?M against GLT-1 and no inhibition of the related transporter EAAC1. The systematic diversification of known ligands by enumeration with help of GDB followed by virtual screening, synthesis, and testing as exemplified here provides a general strategy for drug discovery.

Prácticas de lectura en bibliotecas virtuales en contextos didácticos diversos

Este trabajo se propone examinar los procesos cognitivos de alumnos de escuelas primaria en las prácticas de lectura en bibliotecas virtuales en el contexto de dos situaciones didácticas contrastantes. La perspectiva teórica adoptada considera los aportes de la tradición socio-histórica vigotskiana y del constructivismo relacional piagetiano. El diseño metodológico se inscribe en un estudio cualitativo de casos en el que se realiza el seguimiento de las prácticas de lectura de los alumnos mediante observaciones de aula donde se registran minuciosamente las acciones de un grupo frente a la pantalla y los intercambios con sus compañeros y el docente. Estos datos se complementan con encuestas realizadas previamente y entrevistas clínicas individuales, administradas a posteriori de la observación. Los resultados evidencian que los estudiantes parten de ideas provenientes de una historia socio-cognitivo-cultural que guían sus representaciones acerca de las bibliotecas virtuales. Estas ideas entran en constante contradicción con las formas organizativas y los contenidos que las bibliotecas les presentan. Las condiciones e intervenciones didácticas tienen un papel constitutivo en el desarrollo de las prácticas y saberes altamente complejos que requieren las búsquedas. La comparación permite avanzar sobre las situaciones que generan una mayor autonomía de los alumnos.

Prácticas de lectura en bibliotecas virtuales en contextos didácticos diversos

Este trabajo se propone examinar los procesos cognitivos de alumnos de escuelas primaria en las prácticas de lectura en bibliotecas virtuales en el contexto de dos situaciones didácticas contrastantes. La perspectiva teórica adoptada considera los aportes de la tradición socio-histórica vigotskiana y del constructivismo relacional piagetiano. El diseño metodológico se inscribe en un estudio cualitativo de casos en el que se realiza el seguimiento de las prácticas de lectura de los alumnos mediante observaciones de aula donde se registran minuciosamente las acciones de un grupo frente a la pantalla y los intercambios con sus compañeros y el docente. Estos datos se complementan con encuestas realizadas previamente y entrevistas clínicas individuales, administradas a posteriori de la observación. Los resultados evidencian que los estudiantes parten de ideas provenientes de una historia socio-cognitivo-cultural que guían sus representaciones acerca de las bibliotecas virtuales. Estas ideas entran en constante contradicción con las formas organizativas y los contenidos que las bibliotecas les presentan. Las condiciones e intervenciones didácticas tienen un papel constitutivo en el desarrollo de las prácticas y saberes altamente complejos que requieren las búsquedas. La comparación permite avanzar sobre las situaciones que generan una mayor autonomía de los alumnos.

Prácticas de lectura en bibliotecas virtuales en contextos didácticos diversos

Este trabajo se propone examinar los procesos cognitivos de alumnos de escuelas primaria en las prácticas de lectura en bibliotecas virtuales en el contexto de dos situaciones didácticas contrastantes. La perspectiva teórica adoptada considera los aportes de la tradición socio-histórica vigotskiana y del constructivismo relacional piagetiano. El diseño metodológico se inscribe en un estudio cualitativo de casos en el que se realiza el seguimiento de las prácticas de lectura de los alumnos mediante observaciones de aula donde se registran minuciosamente las acciones de un grupo frente a la pantalla y los intercambios con sus compañeros y el docente. Estos datos se complementan con encuestas realizadas previamente y entrevistas clínicas individuales, administradas a posteriori de la observación. Los resultados evidencian que los estudiantes parten de ideas provenientes de una historia socio-cognitivo-cultural que guían sus representaciones acerca de las bibliotecas virtuales. Estas ideas entran en constante contradicción con las formas organizativas y los contenidos que las bibliotecas les presentan. Las condiciones e intervenciones didácticas tienen un papel constitutivo en el desarrollo de las prácticas y saberes altamente complejos que requieren las búsquedas. La comparación permite avanzar sobre las situaciones que generan una mayor autonomía de los alumnos.

A New Multidisciplinary Home Care Telemedicine System to Monitor Stable Chronic Human Immunodeficiency Virus-Infected Patients: A Randomized Study

BACKGROUND: Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. METHODOLOGY: We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. FINDINGS: Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4+ T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21) and compliance levels >90% (p = 0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. CONCLUSIONS: Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection. TRIAL REGISTRATION: Clinical-Trials.gov: NCT01117675.

Design and synthesis of new multitarget inhibitors of dengue virus replication

Attraverso una combinazione di virtual screening/virtual library generation abbiamo identificato una nuova serie di inibitori della replicazione del virus Dengue, attivi sia su un target virale (NS5) sia su uno cellulare (Src chinasi)

Digitization Projects Carried out by the Mathematical Institute Belgrade

In this paper some current digitization projects carried out by the Mathematical Institute of Serbian Academy of Science and Arts Belgrade and the Faculty of Mathematics Belgrade are described. The projects concern developing of a virtual library of retro-digitized books and an Internet data base and presentation of electronic editions of some leading Serbian journals in science and arts, and the work on the South-Eastern European Digitization Initiative (SEEDI).

GeoPlexo: um material manipulável para o ensino dos números complexos

This study aims to develop a manipulative material to assist the teaching and learning of Complex Numbers. Primarily, It tries to define the status of the current teaching of Complex Numbers, having as guide the bias of the research produced in dissertations and published on the website of Capes and the Virtual Library of Profmat from 2004 to 2014. It presents historical aspects of the theme, a mathematical foundation and a discussion of the use of manipulative materials as teaching resources for the teaching of mathematics. It introduces the manipulative material called GeoPlexo and a sequence of activities of potentiation and settling of complex numbers, explaining its use. It concludes with the importance of manipulative materials as a teaching resource for the teaching of Complex Numbers, especially regarding the geometric visualization of this mathematical object.

Trends in child and adolescent obesity prevalence according to socioeconomic position: protocol for a systematic review

BACKGROUND: Obesity is a significant public health issue and is socially patterned, with greater prevalence of obesity observed in the most socioeconomically disadvantaged groups. Recent evidence suggests that the prevalence of childhood obesity is levelling off in some countries. However, this may not be the case across all socioeconomic strata. The aim of this review is to examine whether trends in child and adolescent obesity prevalence since 1990 differ according to socioeconomic position in developed countries.

METHODS: An electronic search will be conducted via Ovid Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus and Cochrane Collaboration to identify articles that report trends in obesity prevalence in children and adolescents according to socioeconomic position. We will also search grey literature databases including the Virtual Library for Public Health and the System for Information on Grey Literature, as well as websites from relevant organisations. Articles that report on a series of cross sectional studies; describe one or more measure of obesity with data recorded at two or more time points since 1990; and report trends by at least one indicator of socioeconomic position will be included. Quality of included studies will be evaluated according to criteria that consider both internal and external validity. Descriptive analysis will be performed to examine trends since 1990 in childhood obesity prevalence according to socioeconomic position.

DISCUSSION: The review will provide a picture of change over time in developed countries of childhood obesity prevalence across socioeconomic strata and identify whether changes in childhood obesity prevalence are experienced equally across socioeconomic groups.

Tratamiento del rechazo mediado por anticuerpos en pacientes trasplantados renales revisión sistemática

Antecedentes: El trasplante renal es la mejor alternativa terapéutica para la enfermedad renal crónica terminal. Los medicamentos inmunosupresores previenen el rechazo. El rechazo mediado por anticuerpos es frecuente y disminuye la función y duración del injerto. Objetivo: Evaluar sistemáticamente la evidencia disponible relacionada con la eficacia y seguridad del tratamiento para el rechazo mediado por anticuerpos en pacientes trasplantados renales. Metodologia: Revisión sistemática en bases de datos MEDLINE, EMBASE, Scopus y Biblioteca virtual de la salud. Literatura gris google scholar, google academico, www.clinicaltrialsregister.eu, and https://clinicaltrials.gov/. Búsqueda manual referencias artículos pre-seleccionados así como de revisiones previamente publicadas. Se siguieron las recomendacioes guia PRISMA para la identificacion de artículos potenciales, tamizaje y selección teniendo en cuenta los criterios de inclusion. Extracción datos de acuerdo a las variables, revisión calidad de los artículos elegidos utilizando evaluación riesgo de segos de Cochrane. Resultados: Se seleccionaron 9 ensayos clínicos publicados entre 1980 y 2016, incluyeron 222 pacientes (113 brazo de intervención y 109 en el control), seguimiento promedio 16 meses. Intervenciones evaluadas plasmaféresis, inmunoadsorción y rituximab. Hubo una amplia heterogeneidad en la definición de criterios de inclusión, criterios diagnósticos de rechazo y medidas de evaluación de eficacia de las intervenciones. Tres estudios encontraron diferencias estadísticamente significativas entre los grupos de tratamiento. Conclusiones: La evidencia sobre la eficacia de los tratamientos del rechazo mediado por anticuerpos en injertos renales es de baja calidad. Son necesarios ensayos clínicos controlados para poder definir el tratamiento óptimo de estos pacientes.

University library virtual reference services : best practices and continuous improvement

The inclusion or not of chat services within Virtual Reference (VR) is an important topic for university libraries. Increasingly, email supported by a Frequently Asked Questions (FAQ) database is suggested in the scholarly literature as the preferred, cost-effective means for providing university VR services. This paper examines these issues and identifies some best practices for university library VR services relating to chat and email service, collaborative service provision, services staffing, and staff training. Further studies are required to more completely identify best practices for the complete range of VR services.

Moving Communities of Practice forward: the challenge for the National electronic Library for Health and its Virtual Branch Libraries

Yeoman, A., Urquhart, C. & Sharp, S. (2003). Moving Communities of Practice forward: the challenge for the National electronic Library for Health and its Virtual Branch Libraries. Health Informatics Journal, 9(4), 241-252. Previously appeared as a conference paper for the iSHIMR2003 conference (Proceedings of the Eighth International Symposium on Health Information Management Research, June 1-3, 2003, Boras, Sweden) Sponsorship: NHS Information Authority/National electronic Library for Health