Preliminary results on the postmortem measurement of 3-beta-hydroxybutyrate in liver homogenates.

The concentrations of 3-beta-hydroxybutyrate (3HB) in blood and two liver samples were retrospectively examined in a series of medicolegal autopsies. These cases included diabetic ketoacidosis, nondiabetic individuals presenting moderate to severe decompositional changes and nondiabetic medicolegal cases privy of decompositional changes. 3HB concentrations in liver sample homogenates correlate well with blood values in all examined groups. Additionally, decompositional changes were not associated with increases in blood and liver 3HB levels. These results suggest that 3HB can be reliably measured in liver homogenates when blood is not available at autopsy. Furthermore, they suggest that metabolic disturbances potentially leading or contributing to death may be objectified through liver 3HB determination even in decomposed bodies.

Dimensionamento informatizado de profissionais de enfermagem: avaliação de um software

A complexidade para operacionalizar o método de dimensionamento de profissionais de enfermagem, diante das inúmeras variáveis relativas à identificação da carga de trabalho, do tempo efetivo de trabalho dos profissionais e do Índice de Segurança Técnica (IST), evidenciou a necessidade de desenvolver um software, denominado: Dimensionamento Informatizado de Profissionais de Enfermagem (DIPE). Este estudo exploratório descritivo teve como objetivo avaliar a qualidade técnica e o desempenho funcional do DIPE. Participaram como sujeitos da pesquisa dezoito avaliadores, sendo dez enfermeiros docentes ou enfermeiros gerentes de unidades de saúde hospitalar e oito especialistas em informática em saúde. A avaliação do software baseou-se na norma NBR ISO/IEC 9126-1, considerando as características funcionalidade, confiabilidade, usabilidade, eficiência e ma­nutenibilidade. A avaliação do software obteve resultados positivos, sobre os quais os avaliadores concordaram em todas as características avaliadas. As sugestões relatadas serão importantes para a proposição de melhorias e aprimoramento do DIPE.

Desenvolvimento e avaliação de um software que verifica a acurácia diagnóstica

Este artigo descreve o desenvolvimento e avaliação de um software que verifica a acurácia diagnóstica de alunos de enfermagem. O software foi baseado num modelo que utiliza conceitos da lógica fuzzy, em PERL, banco de dados MySQL para acesso pela internet e a classificação NANDA-I 2007-2008. Avaliou-se a qualidade técnica e a usabilidade do software utilizando instrumentos específicos. A atividade proposta no software possui quatro etapas nas quais o aluno estabelece valores de relação entre diagnósticos de enfermagem, características definidoras/fatores de risco e casos clínicos. Os valores de relação determinados pelo aluno são comparados aos de especialistas, gerando escores de desempenho para o aluno. Na avaliação, o software atendeu satisfatoriamente as necessidades de qualidade técnica e, segundo os alunos, trouxe benefícios ao aprendizado, podendo transformar-se em uma ferramenta educacional no ensino do diagnóstico de enfermagem.

Software CMAP TOOLS® para a construção de mapas conceituais: a avaliação dos estudantes de enfermagem

O mapeamento conceitual (MC) é uma estratégia de ensino que pode ser utilizada para resoluções de casos clínicos, porém de trabalhosa execução manuscrita. O estudo teve por objetivos descrever os desafios e as contribuições do software Cmap Tools® para a construção de mapas conceituais para resolução de caso clínico. Para isso, utilizou-se método descritivo, qualitativo, com estudantes da 3ª série de Graduação em Enfermagem da Universidade Federal de São Paulo. A estratégia de ensino foi aplicada e os dados foram coletados pela técnica do grupo focal. Os resultados evidenciaram que o software facilita e garante a organização, visualização e correlação dos dados, porém com dificuldades iniciais relacionadas ao manejo das ferramentas que dispõe. Concluiu-se que o software Cmap Tools® favoreceu a construção dos MC por seus recursos de formatação e autoformatação e que estratégias de orientação deveriam ser implantadas para a fase inicial de utilização.

Usefulness of methadone plasma concentration measurement in patients receiving nevirapine or efavirenz.

Objective: To determine methadone plasma trough and peak concentrations in patients presenting opiate withdrawal symptoms after introduction of nevirapine or efavirenz. To describe the disappearance of these symptoms after methadone titration based on plasma concentrations rather than on the symptoms. Methods: Nine patients undergoing highly active antiretroviral therapy (HAART) and either nevirapine or efavirenz treatment were monitored daily for opiate withdrawal in a specialized drug addiction center. Methadone dose was titrated daily, and plasma concentrations were measured. The data are retrospective (case series). Results: Several patients complained of symptoms such as nausea, vomiting, accelerated intestinal transit, or insomnia. Even after methadone titration based on clinical symptoms, patients and health-care providers trained in infectious disease did not classify these as withdrawal symptoms and considered them as the side effects of HAART or anxiety. Methadone plasma trough concentration showed low levels of (R)- and (R,S)-methadone. Further methadone dose adjustment according to plasma level resulted in the disappearance of these withdrawal symptoms. The daily methadone dose was split when the peak/trough (R)-methadone ratio was more than 2. Conclusions: When introducing efavirenz or nevirapine to patients undergoing methadone treatment, withdrawal symptoms should be monitored, especially those such as insomnia, vomiting, or nausea. Methadone plasma trough and peak measurements can be of value in preventing unnecessary side effects of HAART.

Measurement with Some Theory: a New Approach to Evaluate Business Cycle Models

We propose a method to evaluate cyclical models which does not require knowledge of the DGP and the exact empirical specification of the aggregate decision rules. We derive robust restrictions in a class of models; use some to identify structural shocks and others to evaluate the model or contrast sub-models. The approach has good size and excellent power properties, even in small samples. We show how to examine the validity of a class of models, sort out the relevance of certain frictions, evaluate the importance of an added feature, and indirectly estimate structural parameters.

Measurement of nurses' workload in an oncology outpatient clinic

The growing demand and the degree of patient care in oncological outpatient services, as well as the complexity of treatment have had an impact on the workload of nurses. This study aimed at measuring the workload and productivity of nurses in an oncological outpatient service. An observational study using a work sampling technique was conducted and included seven nurses working in an oncological outpatient service in the south-eastern region of Brazil. A total of 1,487 intervention or activity samples were obtained. Nurses used 43.2% of their time on indirect care, 33.2% on direct care, 11.6% on associated activities, and 12% on personal activities. Their mean productivity was 88.0%. The findings showed that nurses in this service spend most of their time in indirect care activities. Moreover, the productivity index in this study was above that recommended in the literature.

Activity assays and immunoassays for plasma Renin and prorenin: information provided and precautions necessary for accurate measurement.

BACKGROUND: Measurement of plasma renin is important for the clinical assessment of hypertensive patients. The most common methods for measuring plasma renin are the plasma renin activity (PRA) assay and the renin immunoassay. The clinical application of renin inhibitor therapy has thrown into focus the differences in information provided by activity assays and immunoassays for renin and prorenin measurement and has drawn attention to the need for precautions to ensure their accurate measurement. CONTENT: Renin activity assays and immunoassays provide related but different information. Whereas activity assays measure only active renin, immunoassays measure both active and inhibited renin. Particular care must be taken in the collection and processing of blood samples and in the performance of these assays to avoid errors in renin measurement. Both activity assays and immunoassays are susceptible to renin overestimation due to prorenin activation. In addition, activity assays performed with peptidase inhibitors may overestimate the degree of inhibition of PRA by renin inhibitor therapy. Moreover, immunoassays may overestimate the reactive increase in plasma renin concentration in response to renin inhibitor therapy, owing to the inhibitor promoting conversion of prorenin to an open conformation that is recognized by renin immunoassays. CONCLUSIONS: The successful application of renin assays to patient care requires that the clinician and the clinical chemist understand the information provided by these assays and of the precautions necessary to ensure their accuracy.

Mesurer l'amplitude articulaire du genou: goniométre universel ou smartphone [Measurement of the knee range of motion: standard goniometer or smartphone?].

Universal standard goniometer is an essential tool to measure articulations' range of motion (ROM). In this time of technological advances and increasing use of smartphones, new measurement's tools appear as specific smartphone applications. This article compares the iOS application "Knee Goniometer" with universal standard goniometer to assess knee ROM. To our knowledge, this is the first study that uses a goniometer application in a clinical context. The purpose of this study is to determine if this application could be used in clinical practice.

Biana: a software framework for compiling biological interactions and analyzing networks

Background: The analysis and usage of biological data is hindered by the spread of information across multiple repositories and the difficulties posed by different nomenclature systems and storage formats. In particular, there is an important need for data unification in the study and use of protein-protein interactions. Without good integration strategies, it is difficult to analyze the whole set of available data and its properties.Results: We introduce BIANA (Biologic Interactions and Network Analysis), a tool for biological information integration and network management. BIANA is a Python framework designed to achieve two major goals: i) the integration of multiple sources of biological information, including biological entities and their relationships, and ii) the management of biological information as a network where entities are nodes and relationships are edges. Moreover, BIANA uses properties of proteins and genes to infer latent biomolecular relationships by transferring edges to entities sharing similar properties. BIANA is also provided as a plugin for Cytoscape, which allows users to visualize and interactively manage the data. A web interface to BIANA providing basic functionalities is also available. The software can be downloaded under GNU GPL license from http://sbi.imim.es/web/BIANA.php.Conclusions: BIANA's approach to data unification solves many of the nomenclature issues common to systems dealing with biological data. BIANA can easily be extended to handle new specific data repositories and new specific data types. The unification protocol allows BIANA to be a flexible tool suitable for different user requirements: non-expert users can use a suggested unification protocol while expert users can define their own specific unification rules.

Análise de riscos e dificuldades no desenvolvimento de software

O trabalho que ora apresentamos tem como tema “ O Ensino da Expressão e Educação Físico-Motora nas Escolas do Ensino Básico de São Lourenço dos Órgãos – Pós – Reforma.” O mesmo tem como horizonte temporal o ano lectivo 2006/07 e abarca as Escolas Básicas do novel Município de São Lourenço dos Órgãos. O ensino da Expressão e Educação Físico – Motora (E.E.F.M.) reveste-se de enorme importância e, nos últimos anos, tem-se emprestado muita atenção a esta área, quer seja a nível planetário, quer seja a nível nacional. Hoje, muitos estudiosos preocupam-se com o ensino desta área e, em consequência procuram fazer algo que permita a promoção da mesma e seja vista como as outras ditas académicas, isto porque todos estão cientes da sua importância e pertinência dentro do sistema escolar. Diante de tudo o que já foi dito e na possibilidade de poder dar um contributo a bem da educação no nosso pais, em geral, e no Município de São Lourenço dos Órgãos, em particular, pretendemos compreender, entretanto, porque é que muitos professores não leccionam ou raras vezes leccionam a área da Expressão e Educação Físico – Motora.

Resolving inconsistencies in utility measurement under risk: Tests of generalizations of expected utility

This paper explores biases in the elicitation of utilities under risk and the contribution that generalizations of expected utility can make to the resolution of these biases. We used five methods to measure utilities under risk and found clear violations of expected utility. Of the theories studies, prospect theory was most consistent with our data. The main improvement of prospect theory over expected utility was in comparisons between a riskless and a risky prospect(riskless-risk methods). We observed no improvement over expected utility in comparisons between two risky prospects (risk-risk methods). An explanation why we found no improvement of prospect theory over expected utility in risk-risk methods may be that there was less overweighting of small probabilities in our study than has commonly been observed.