A Clinical Support System Based on Quality of Life Estimation

Quality of life is a concept influenced by social, economic, psychological, spiritual or medical state factors. More specifically, the perceived quality of an individual's daily life is an assessment of their well-being or lack of it. In this context, information technologies may help on the management of services for healthcare of chronic patients such as estimating the patient quality of life and helping the medical staff to take appropriate measures to increase each patient quality of life. This paper describes a Quality of Life estimation system developed using information technologies and the application of data mining algorithms to access the information of clinical data of patients with cancer from Otorhinolaryngology and Head and Neck services of an oncology institution. The system was evaluated with a sample composed of 3013 patients. The results achieved show that there are variables that may be significant predictors for the Quality of Life of the patient: years of smoking (p value 0.049) and size of the tumor (p value < 0.001). In order to assign the variables to the classification of the quality of life the best accuracy was obtained by applying the John Platt's sequential minimal optimization algorithm for training a support vector classifier. In conclusion data mining techniques allow having access to patients additional information helping the physicians to be able to know the quality of life and produce a well-informed clinical decision.

Animal helminths in human archaeological remains: a review of zoonoses in the past

The authors present a review of records of intestinal parasitic helminths from animals in human archaeological remains, reported since the emergence of paleopathological studies. The objective was to relate paleoparasitological findings to geographic, biotic, and abiotic factors from the environment in which the prehistoric populations lived, and understand some aspects related to the process of human dispersion and biological and cultural evolution. Modification of eating habits and the incorporation of new cultural practices are analyzed from the perspective of zoonoses from prehistory to the present day, especially in Brazilian indigenous populations. Three tables identifying the helminths, their natural hosts, dates, and sites of archaeological findings complete this review. In conclusion, various zoonoses known today have occurred since antiquity, and these data, combined with studies on the emergence and reemergence of diseases, could make possible to compose scenarios for the future.

Risk-factors for non-adherence to antiretroviral therapy

Cross-sectional study analyzed as case-control to identify risk factors for non-adherence to antiretroviral therapy. We studied 412 out-clinics HIV infected subjects of three public hospitals of Recife, Pernambuco. The objective was to examine the association between non-adherence to the antiretroviral therapy and biological, social-behavior and demographics and economic factors, factors related to the disease and/or treatment, factors related to life habits and depression symptoms. Variables significantly associated with non-adherence to antiretroviral therapy were: time elapsed since HIV diagnosis (p = 0.002), daily dose (p = 0.046), use of alcohol (p = 0.030) and past drug use (p = 0.048), and borderline p-values were found for educational level (p = 0.093) and family monthly income (p = 0.08). In the multivariable analysis, the factors that remained in the final model were family monthly income, time period with HIV infection and use of alcohol. No association was observed between non-adherence to antiretroviral therapy and gender, age, sexual orientation, marital status, educational level and place of residence. Based on our results and the local situation we suggest: assessment of social needs; training of partners and/or families on supporting adherence, creation of "adherence groups" to motivate and to reassure patients on the benefits of treatment; counseling and/or psychotherapy for alcohol drinkers.

Summer Vacations not Only a Memory for Life, but Also a Rare Infection

Introduction: Rhinoscleroma is a rare, chronic, granulomatous disease that most frequently affects the upper respiratory tract, especially the nasal cavity and sometimes extends through the lower respiratory tract. Is associated with Klebsiella rhinoscleromatis, which is endemic in certain geographic regions namely Central America. The pathogenesis and risk factors remain unclear. Clinical case: We report a five years Old Portuguese boy, previously healthy, brought to the Emergency Department with epistaxis, without other accompanying signs or symptoms. The Otorhinolaryngologist (ORL) performed rhinoscopy and identified an intranasal bleeding mass. The MRI revealed an intranasal mass with extension to the ethmoid bone sinus, and performed biopsy. The histopathology was vital, making the diagnosis of Rhinoscleroma. The child had traveled abroad for the first time on vacations a year before to Dominican Republic. The bacteriologic exam identified a Klebsiella spp. sensible to the association of amoxicillin and clavulanic acid. Blood test performed excluded association of immunodeficiency. Since it’s a rare disease genetic study are under course. Monthly evaluation by ORL and pediatrician was performed which documented progressive reduction until total disappearing of the macro and microscopic lesion, and negative bacteriologic exam. Six months of antibiotic therapy were completed without any known secondary effects. The child remained asymptomatic up to the last visit, 3 months following treatment and has shown no evidence of recurrence. Conclusion: Globalization and free transit of people to areas far from origin countries here some rare diseases are endemic brings a new challenge to modern medicine. Sometimes vacations bring more than memories.

Viver mais... Pensar o passado, viver o presente e sonhar o futuro Projeto de Investigação e Intervenção em Educação Social

Este relatório é o resultado descritivo e reflexivo de um Projeto de Educação e Intervenção Social, "Viver mais... Pensar o passado, viver o presente e sonhar o futuro", desenvolvido com um grupo de idosos do Centro de Caridade Nossa Senhora do Perpetuo Socorro. O projeto de investigação e de intervenção social seguiu as linhas metodológicas da Investigação Ação Participativa, em que os sujeitos são atores participativos e interventivos. Para o desenvolvimento deste projeto foi necessário recorrer a algumas técnicas de investigação, como a observação participante, conversas intencionais e análise documental, que facilitaram a recolha de informações, a análise da realidade e a intervenção desenvolvida. A partir da análise da realidade emergiram alguns problemas e necessidades que foram priorizados pelos sujeitos, daí surgiu o projeto de intervenção que aqui se apresenta com a finalidade de “Melhorar a qualidade de vida dos idosos do Centro de Dia do Centro de Caridade Nossa Senhora do Perpetuo Socorro, através da valorização das suas histórias de vida e melhoria das relações interpessoais”. Este projeto teve três grandes focos importantes que foi a recolha e construção das narrativas de vida de alguns participantes, a realização de vários encontros intergeracionais entre os idosos do Centro de Dia e as crianças do Jardim de Infância e o processo de consciencialização por parte dos idosos sobre a importância do grupo para o bem-estar pessoal, a gestão de conflitos e a melhoria das dinâmicas relacionais. Os resultados do projeto foram relevantes porque foram o produto de um processo reflexivo e de partilha entre os indivíduos, que favoreceu o desenvolvimento de um sentimento de utilidade e de valorização pessoal nos sujeitos, melhorando e fortalecendo assim as relações interpessoais entre eles.

Cardmobili: innovation technology in everyday life

The developments of the internet, the proliferation of the use of Web 2.0 tools, and of the technology in general, are leveraging new ways of people to communicate, collaborate, and interact. This new world and new markets, in a daily change, are enabling the emergence of new innovative enterprises and services, taking advantage of the new technologies and of the global network. Cardmobili is a Portuguese start-up company working in the area of mobile services. This company provides a mobile service to manage rewards and membership cards, enabling users to store them in the cloud, while using mobile applications to present them in store, collecting and using the rewards, sharing cards and information with other users and friends in social networks. Cardmobili is linked to merchants’ loyalty management systems, enabling users to access exclusive offers, delivered to their mobile application and web account. The company provides complete services to make any loyalty or membership program mobile: branding, new customer registration, integration of customer account balance, mobile vouchers, coupons and offers, and mobile communication.

Health-Related Quality of Life of Pediatric Intensive Care Survivors

Objetivo: Avaliar a qualidade de vida relacionada à saúde (QVRS)de crianças sobreviventes à alta da terapia intensiva pediátrica. Métodos: Foi realizada uma avaliação prospectiva da QVRS na admissão e após 6 meses em crianças com idade igual ou superior a 6 anos, internadas em três unidades de terapia intensiva pediátricas (UTIPs) terciárias de maio de 2002 a junho de 2004. A QVRS foi avaliada com o questionário Health Utilities Index Mark 3 (HUI3), aplicado a um representante da criança. Resultados: Das 517 admissões elegíveis, 44 crianças faleceram na UTIP (8,5%) e 320 casos foram avaliados na admissão; entre eles, foi possível realizar o seguimento de 252 casos. Não foram encontradas diferenças estatisticamente significativas entre os escores globais do HUI3 antes da admissão e no seguimento [medianas (intervalo interquartil) de 0,86 (0,42-1,00) e 0,83 (0,45-1,00); p = 0,674, respectivamente]. No âmbito individual, 21% das crianças não apresentaram mudanças na QVRS, foi observada melhora em 40% e agravamento em 38% dos casos. Deficiência grave antes da admissão (escore global do HUI3 < 0,70)esteve presente em 36% dos casos, com melhora no seguimento aos 6 meses em 60% deles. Entre aqueles que apresentaram agravamento da QVRS no seguimento, 45% eram vítimas de trauma. Conclusões: Embora a QVRS seja globalmente semelhante nas duas avaliações, foram encontradas várias diferenças no âmbito individual. As crianças com baixa QVRS antes da admissão (deficiência grave) podem se beneficiar da terapia intensiva pediátrica, visto que muitas dessas crianças melhoraram a QVRS, em comparação com seu estado pré-admissão.

Controlo de acesso móvel

O mercado de smartphones tem vindo a crescer massivamente nos últimos anos, bem como a diversi cação das suas funcionalidades no dia-a-dia de cada pessoa. O mercado aberto de aplicações para estes equipamentos também tem sofrido uma forte evolução o que permite uma maior qualidade e competitividade pela apresentação de produtos. O conceito de casas inteligentes está cada vez mais presente e é algo que as pessoas se estão a acomodar de forma gradual. Para acompanhar tal feito, é necessário desenvolver as capacidades dos equipamentos que estas pessoas mais usam para que estes possam dar resposta a estas necessidades. Para o caso atual irão ser estudadas as fechaduras inteligentes. Os sistemas comercializados atualmente, são tipicamente sistemas proprietários e apresentam algumas limitações ou faltas (ex: ao nível da segurança, incapacidade de abranger um largo número de dispositivos móveis ou mesmo ao nível do preço). Neste contexto, e com base na caracterização das soluções de controlo de acesso atuais, foi estudada a viabilidade de, usando uma abordagem assente em tecnologias não proprietárias (i.e., abertas), desenvolver soluções de controlo de acesso com características comparáveis com os sistemas proprietários actuais e, eventualmente, ultrapassando os limites e falhas identi cados. Dadas estas premissas o sistema de controlo de acesso móvel pensado envolve um computador BeagleBone Black e a tecnologia sem os Bluetooth. Este sistema permite a fácil integração do computador com qualquer smartphone atual e é dotado de fortes características de segurança e privacidade. O sistema foi concebido inicialmente para ser implementado em fechaduras de portas mas com possibilidade de expansão para outros equipamentos. Além disso, o sistema permitirá também o acesso a terceiros após a devida autorização do dono.

Sustainability of systems interoperability in dynamic business networks

Dissertação para obtenção do Grau de Doutor em Engenharia Electrotécnica e de Computadores

EVALUATION OF SUBLETHAL EFFECTS OF Ipomoea cairica LINN. EXTRACT ON LIFE HISTORY TRAITS OF DENGUE VECTORS

Plant derived insecticides have considerable potential for mosquito control because these products are safer than conventional insecticides. This study aimed to investigate sublethal activities of Ipomoea carica or railway creeper crude acethonilic extract against life history trait of dengue vectors, Aedes albopictus and Aedes aegypti. The late third instar larvae of Ae. albopictus and Ae. aegypti were exposed to a sublethal dose at LC50 and larvae that survived were further cultured. Overall, Ipomea cairica crude extracts affected the whole life history of both Aedes species. The study demonstrated significantly lower egg production (fecundity) and eggs hatchability (fertility) in Ae. albopictus. The sublethal dose of crude extracts reduced significantly the width of larval head capsule and the wing length of both sexes in both Aedes species. The significance of sublethal effects of I. cairica against Aedes mosquitoes was an additional hallmark to demonstrate further activity of this plant despite its direct toxicity to the larvae. The reduced reproductive capacity as well as morphological and physiological anomalies are some of the effects that make I. cairica a potential candidate to be used as a new plant-based insecticide to control dengue vectors.

Analysis of the intranuclear life of nonsense transcripts

Dissertação para obtenção do Grau de Doutor em Biologia, Especialidade de Biologia Molecular

Mental Health and Quality of Life in Alcoholic Liver Disease Patients After Liver Transplantation: a Prospective Controlled Study

OBJECTIVE: Alcoholic liver disease (ALD) is one of the most important indications for liver transplantation. Discordant conclusions have been found concerning quality of life and mental health after transplantation in this particular group. The aim of this work was to investigate improvements in mental health and quality of life among transplanted patients for ALD. METHODS: We studied 45 consecutive transplant candidates with ALD, attending the outpatient clinics. Among these patients we transplanted 24 with the control candidates remaining in wait for transplantation. RESULTS: There was a significant improvement in all mental health and quality of life dimensions among the transplanted ALD group. We also observed a favorable evolution of coping mechanisms (CM) in this group. CONCLUSION: There is a favorable adjustment of ALD patients after transplantation as shown in CM evolution, which might explain the improved mental health and quality-of-life dimensions.

When Does Quality of Life Improve After Liver Transplantation? A Longitudinal Prospective Study

OBJECTIVES: We sought to investigate the improvement in quality of life (mental and physical components) at 1 and 6 months after liver transplantation. METHODS: A sample of liver transplant candidates (n = 60), comprising consecutive patients attending outpatient clinics of a liver transplantation central unit (25% of the patients had familial amyloid polyneuropathy [FAP] and the remaining patents had chronic liver diseases), was assessed by means of the Short Form (SF)-36, Portuguese-validated version, a self-rating questionnaire developed by the Medical Outcome Trust, to investigate certain primary aspects of quality of life, at 3 times: before, and at 1 and 6 months after transplantation. RESULTS: We observed a significant improvement in quality of life (both mental and physical components) by 1 month after transplantation. Between the first month and the sixth month after transplantation, there also was an improvement in the quality of life (both mental and physical components), although only the physical components of quality of life was significantly improved. CONCLUSIONS: Our findings suggested that quality of life improved early after liver transplantation (1 month). Between the first and the sixth months, there only was a significant improvement in the physical quality of life.