Information systems assessment in pathologic anatomy service

Information technologies changed the way of how the health organizations work, contributing to their effectiveness, efficiency and sustainability. Hospital Information Systems (HIS) are emerging on all of health institutions, helping health professionals and patients. However, HIS are not always implemented and used in the best way, leading to low levels of benefits and acceptance by users of these systems. In order to mitigate this problem, it is essential to take measures able to ensure if the HIS and their interfaces are designed in a simple and interactive way. With this in mind, a study to measure the user satisfaction and their opinion was made. It was applied the Technology Acceptance Model (TAM) on a HIS implemented on various hospital centers (AIDA), being used the Pathologic Anatomy Service. The study identified weakness and strengths features of AIDA and it pointed some solutions to improve the medical record.

Improving quality of medical service with mobile health software

An increasing number of m-Health applications are being developed benefiting health service delivery. In this paper, a new methodology based on the principle of calm computing applied to diagnostic and therapeutic procedure reporting is proposed. A mobile application was designed for the physicians of one of the Portuguese major hospitals, which takes advantage of a multi-agent interoperability platform, the Agency for the Integration, Diffusion and Archive (AIDA). This application allows the visualization of inpatients and outpatients medical reports in a quicker and safer manner, in addition to offer a remote access to information. This project shows the advantages in the use of mobile software in a medical environment but the first step is always to build or use an interoperability platform, flexible, adaptable and pervasive. The platform offers a comprehensive set of services that restricts the development of mobile software almost exclusively to the mobile user interface design. The technology was tested and assessed in a real context by intensivists.

Centrality and rapidity dependence of inclusive jet production in sNN=5.02 TeV proton-lead collisions with the ATLAS detector

Measurements of the centrality and rapidity dependence of inclusive jet production in sNN−−−√=5.02 TeV proton--lead (p+Pb) collisions and the jet cross-section in s√=2.76 TeV proton--proton collisions are presented. These quantities are measured in datasets corresponding to an integrated luminosity of 27.8 nb−1 and 4.0 pb−1, respectively, recorded with the ATLAS detector at the Large Hadron Collider in 2013. The p+Pb collision centrality was characterised using the total transverse energy measured in the pseudorapidity interval −4.9<η<−3.2 in the direction of the lead beam. Results are presented for the double-differential per-collision yields as a function of jet rapidity and transverse momentum (pT) for minimum-bias and centrality-selected p+Pb collisions, and are compared to the jet rate from the geometric expectation. The total jet yield in minimum-bias events is slightly enhanced above the expectation in a pT-dependent manner but is consistent with the expectation within uncertainties. The ratios of jet spectra from different centrality selections show a strong modification of jet production at all pT at forward rapidities and for large pT at mid-rapidity, which manifests as a suppression of the jet yield in central events and an enhancement in peripheral events. These effects imply that the factorisation between hard and soft processes is violated at an unexpected level in proton--nucleus collisions. Furthermore, the modifications at forward rapidities are found to be a function of the total jet energy only, implying that the violations may have a simple dependence on the hard parton--parton kinematics.

Public service culture collections of microorganisms: are they important for biotechnology?

Microbiology as a scientific discipline recognised the need to preserve microorganisms for scientific studies establishing from its very beginning research culture collections (CC). Later on, to better serve different scientific fields and bioindustries with the increasing number of strains of scientific, medical, ecological and biotechnological importance public service CC were established with the specific aims to support their user communities. Currently, the more developed public service CC are recognised as microBiological Resources Centres (mBRC). mBRC are considered to be one of the key elements for sustainable international scientific infrastructure, which is necessary to underpin successful delivery of the benefits of biotechnology, whether within the health sector, the industrial sector or other sectors, and in turn ensure that these advances help drive economic growth. In more detail, mBRCs are defined by Organisation for Economic Co-operation and Development (OECD) as service providers and repositories of the living cells, genomes of organisms, and information relating to heredity and functions of biological systems. mBRCs contain collections of culturable organisms (e.g., microorganisms, plant, animal cells), replicable parts of these (e.g. genomes, plasmids, virus, cDNAs), viable but not yet culturable organisms, cells and tissues, as well as database containing molecular, physiological and structural information relevant to these collections and related bioinformatics. Thus mBRCs are fundamental to harnessing and preserving the world’s microbial biodiversity and genetic resources and serve as an essential element of the infrastructure for research and development. mBRCs serve a multitude of functions and assume a range of shapes and forms. Some are large national centres performing a comprehensive role providing access to diverse organisms. Other centres play much narrower, yet important, roles supplying limited but crucial specialised resources. In the era of the knowledge-based bio-economy mBRCs are recognised as vital element to underpinning the biotechnology.

On the temperature dependence of the absorption cross section for black holes in string theory

We study the low frequency absorption cross section of spherically symmetric nonextremal d-dimensional black holes. In the presence of α′ corrections, this quantity must have an explicit dependence on the Hawking temperature of the form 1/TH. This property of the low frequency absorption cross section is shared by the D1-D5 system from type IIB superstring theory already at the classical level, without α′ corrections. We apply our formula to the simplest example, the classical d-dimensional Reissner-Nordstr¨om solution, checking that the obtained formula for the cross section has a smooth extremal limit. We also apply it for a d-dimensional Tangherlini-like solution with α′3 corrections.

Critical analyses of the introduction of liquid-based cytology in a public health service of the state of São Paulo, Brazil

OBJECTIVE The aim of this study was to compare the performance of the current conventional Pap smear with liquid-based cytology (LBC) preparations. STUDY DESIGN Women routinely undergoing their cytopathological and histopathological examinations at Fundação Oncocentro de São Paulo (FOSP) were recruited for LBC. Conventional smears were analyzed from women from other areas of the State of São Paulo with similar sociodemographic characteristics. RESULTS A total of 218,594 cases were analyzed, consisting of 206,999 conventional smears and 11,595 LBC. Among the conventional smears, 3.0% were of unsatisfactory preparation; conversely, unsatisfactory LBC preparations accounted for 0.3%. The ASC-H (atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion) frequency did not demonstrate any differences between the two methods. In contrast, the incidence of ASC-US (atypical squamous cells of undetermined significance) was almost twice as frequent between LBC and conventional smears, at 2.9 versus 1.6%, respectively. An equal percentage of high-grade squamous intraepithelial lesions were observed for the two methods, but not for low-grade squamous intraepithelial lesions, which were more significantly observed in LBC preparations than in conventional smears (2.2 vs. 0.7%). The index of positivity was importantly enhanced from 3.0% (conventional smears) to 5.7% (LBC). CONCLUSIONS LBC performed better than conventional smears, and we are truly confident that LBC can improve public health strategies aimed at reducing cervical lesions through prevention programs.

Suicide attempts and substance use in an emergency room sample

OBJECTIVE: Describe suicide attempts assisted in an emergency room (ER) and acute substance consumption or dependence on these individuals. METHODS: Descriptive epidemiologic study was carried out during one year, evaluating suicide attempts assisted at Embu das Artes ER, São Paulo, Brazil. Patients were scheduled to a non structured psychiatric interview. Main outcomes measures were: socio demographic data, suicide attempt method, drugs or alcohol acute use in the six hours prior to attempt, patients with ICD-10 substance dependence diagnosis. The descriptive analyses and chi-square test (p < 0.05) were used to verify associations between the variables studied. RESULTS: sample was formed of 80 patients, mean age of 26.9 years (SD = 8.91), predominantly female (72.5%) and 21.2% adolescents. Most suicide attempts were made through medicine ingestion (62.5%). Approximately 21.2% and 7.5% related to have used alcohol and an illicit drug respectively within 6 hours prior to attempt and 10% were found to be substance dependent. All substance dependents had attempted suicide previously (p-value = 0.4). There was a significant association between suicide attempt through medicine ingestion and psychiatric treatment history (p = 0.02). CONCLUSION: More national studies are necessary to consider the role of alcohol and drug in suicide attempts assisted in ER, especially in chemical dependents whose suicidal behavior is relevant.

Association study of the Ile349val polymorphism of the gene ADH1C and alcohol dependence

OBJECTIVE: The aim of this study was to investigate the polymorphism Ile349Val of the enzyme alcohol dehydrogenase ADH1C gene among individuals with alcohol dependence syndrome (ADS) attending Alcoholics Anonymous (AA) meetings. METHODS: A total of 120 subjects residing in Rio de Janeiro city participated in this study. Subjects were divided into two groups: a group consisting of 54 individuals from the ADS group and 66 individuals that declared not having any alcohol dependence (control group). DNA was extracted from mouth epithelial cells by phenol-chloroform method and further submitted to amplification by polymerase chain reaction (PCR). RESULTS: Our results did not show differences between the genotypes of control individuals and ADS subjects. Nevertheless, we found increased rates of alcoholism in families of ADS subjects as compared to controls. CONCLUSIONS: Our results did not show any genotype difference on the ADH1C gene when control and AA genotypes are compared.

Abordagem histórica e institucional da mudança em contabilidade de gestão: o caso da normalização nos hospitais públicos portugueses

A teoria institucional constituiu o enquadramento no qual foi suportada a pergunta geral desta investigação: como e porquê a Normalização da Contabilidade de Gestão (NCG) nos hospitais públicos portugueses surgiu e evoluiu? O objetivo geral foi compreender de forma profunda o surgimento e a mudança nas regras de NCG dos hospitais públicos portugueses no período histórico 1954-2011. Face ao enquadramento institucional que justificou uma investigação interpretativa, foi usado como método de investigação um estudo de caso explanatório. A evidência sobre o caso da NCG nos hospitais públicos portugueses foi recolhida em documentos e através de 58 entrevistas realizadas em 47 unidades de análise (nos serviços centrais de contabilidade do Ministério da Saúde e em 46 hospitais públicos, num total de 53 existentes). Quanto aos principais resultados obtidos, no período 1954-1974, as regras criadas pelo poder político para controlo dos gastos públicos e a contabilidade orçamental de base de caixa estiveram na génese dos primeiros conceitos de Contabilidade de Gestão (CG) para os serviços públicos de saúde portugueses. A transição de um regime ditatorial para um regime democrático (25 de Abril de 1974), a criação do Plano Oficial de Contabilidade (POC/77) e a implementação de um estado social com Serviço Nacional de Saúde (SNS) criaram a conjuntura crítica necessária para o surgimento de um Plano Oficial de Contabilidade para os Serviços de Saúde (POCSS/80) que incluiu regras de CG. A primeira edição do Plano de Contabilidade Analítica dos Hospitais (PCAH), aprovada em 1996, não foi uma construção de raiz, mas antes uma adaptação para os hospitais das regras de CG incluídas no POCSS/91 que havia revisto o POCSS/80. Após o início da implementação do PCAH, em 1998, ocorreram sequências de autorreforço institucionalizadoras destas normas, no período 1998-2011, por influência de pressões isomórficas coercivas que delinearam um processo de evolução incremental cujo resultado foi uma reprodução por adaptação, num contexto de dependência de recursos. Vários agentes internos e externos pressionaram, no período 2003-2011, através de sequências reativas para a desinstitucionalização do PCAH em resposta ao persistente fenómeno de loose coupling. Mas o PCAH só foi descontinuado nos hospitais com privatização da governação e rejeição dos anteriores sistemas de informação. Ao nível da extensão da teoria, este estudo de caso adotou o institucionalismo histórico na investigação em CG, quanto se sabe pela primeira vez, que se mostra útil na interpretação dos processos e dos resultados da criação e evolução de instituições de CG num determinado contexto histórico. Na condição de dependência de recursos, as sequências de autorreforço, via isomorfismo coercivo, tendem para uma institucionalização com fenómeno de loose coupling. Como resposta a este fenómeno, ocorrem sequências reativas no sentido da desinstitucionalização. Perante as pressões (políticas, funcionais, sociais e tecnológicas) desinstitucionalizadoras, o fator governação privada acelera o processo de desinstitucionalização, enquanto o fator governação pública impede ou abranda esse processo.

Exercise Dependence Scale: adaptação e evidências de validade e precisão

RESUMO Objetivo O presente estudo teve como objetivo conhecer evidências de validade e precisão da Exercise Dependence Scale-Revised (EDS-R). Métodos Contou-se com uma amostra não probabilística de 709 praticantes de exercício físico de todo o Brasil, com idades variando entre 12 e 73 anos (M = 25,7; DP = 8,43), a maioria do sexo masculino (55,1%) e apresentando o estado civil solteiro (75,5%). Os participantes responderam a EDS-R e questões demográficas. Procurando conhecer a estrutura fatorial, foram utilizados procedimentos de análise fatorial exploratória e confirmatória. Adicionalmente, a fim de avaliar a precisão do instrumento, efetuaram-se cálculos de alfa de Cronbach (consistência interna) e correlações de r de Pearson. Resultados A partir das análises exploratórias (principal axis factoring), foi observada uma variância explicada de 62,7% para uma estrutura de sete fatores. A consistência interna total da escala foi de 0,88, com índices de alfa de Cronbach variando de 0,68 a 0,89 entre os fatores. Os coeficientes de correlação variaram de 0,10 a 0,65, apontando para uma inter-relação entre as dimensões. Os procedimentos de análise fatorial confirmatória corroboraram a estrutura heptafatorial a partir de indicadores satisfatórios de bondade de ajuste do modelo [χ2 (168) = 288,21; p < 0,001, χ2/gl = 1,78, GFI = 0,93, CFI = 0,95 e RMSEA = 0,04 (IC90% = 0,037-0,055)]. Conclusões Os achados apoiaram a adequação psicométrica da EDS-R, a partir das análises exploratórias e confirmatórias, em consonância com o modelo teórico de dependência de exercício físico.

A quantitative research about attitudes of pre-service teachers on inclusive education

In this paper we propose to characterize the inclusive philosophy in Thailand as well as to present and discuss results from a quantitative research carried out within the teacher pre-service context, viewed as one of the components that should be addressed by school systems that seek to be inclusive.

Impact of nutritional counseling in reducing serum cholesterol in public health service patients

OBJECTIVE: To assess the impact of nutritional attention on the lipid profile and nutritional status of hypercholesterolemic patients attended in health centers of Belo Horizonte. METHODS: Using nutritional attendance patient record cards from two health units, the evolution of the lipid profile and the nutritional state (BMI) was monitored of 96 hypercholesterolemic patients who received diet. The patients were appraised at the following moments: initial (1st consultation), after 3 months (2nd consultation) and last consultation (variable for each patient). RESULTS: On the first attendance, 44,4% of the patients presented not only high total cholesterol and LDL-c, but also hypertriglyceridemia and 70.3% were overweight or obese, but most patients (75.6%) presented adequate HDL-c levels. There was significant reduction in the BMI, total cholesterol, LDL-c values (p < 0.01) and also in the triglyceride levels (p < 0.05) in the first three months, without alteration in the HDL-c levels. A significant reduction (p < 0.01) was observed in the frequency of individuals with high cholesterol (from 89.6% down to 47.9%), high and very high LDL-c (from 82.6% down to 45.7%), as well as high and very high triglyceride (from 43.6% down to 16.7%). The observed reduction in frequency of the low HDL-c was statistically meaningless. CONCLUSION: This study evidences the effect of the nutritional attention on lipid profile in hypercholesterolemic patients, reinforcing the need for a multiprofessional team to attend them at the public health services.

Mission du Service Geographique de l'Armée pour la mesure d'un arc de méridien équatorial en Amérique du Sud sous le contrôle scientifique de l'Académie des Sciences, 1899-1906

T. 10, Fasc. 1

Socially integrative customer service (SICS) : identification of a symbiotic link with corporate social responsibility

The aim of this study is to answer the research question "can customer service be revitalised through identification of a symbiotic relationship with social responsibility, linked by people-centricity?" The concept of customer service remains weak and there has been a lack of attention to the underlying purpose: "to serve". To strengthen the theory the humanistic nature of the concept should be revised. Fundamental to this argument is the question of who is a customer? To fully discover the scope of the concept requires a broader or more specifically a societal view. Herein the theme of social corporate responsibility is critical to the recognition of the customer service network (CSN). This suggestion in isolation is useful but structural. Another aspect must be identified to validate the "service" ethos. Through this reasoning the relational theme (RT) provides for a mechanism for this to be achieved. Therefore the theory of socially integrative customer service is based on broadening and deepening the customer service concept. This study is illustrated in the context of the grocery retail sector in the Republic of Ireland. Four case studies are presented, three based on company-wide and in-store research and a fourth is a cross-company study. Results across companies indicate acceptance of the research question and show evidence to validate SICS. There is scope to further develop SICS and to build on the CSN and the RT. Finally the concept of SICS provides for a diverse basis for further research. This theory does no purport to cause a paradigm shift but does add innovation to the body of knowledge. As is the hallmark of good theoretical development, the author has aimed to keep the philosophy simple.