Desenvolvimento de um sistema de captura de baixo custo destinado a determinação da cinemática humana

The motion capture is a main tool for quantitative motion analyses. Since the XIX century, several motion caption systems have been developed for biomechanics study, animations, games and movies. The biomechanics and kinesiology involves and depends on knowledge from distinct fields, the engineering and health sciences. A precise human motion analysis requires knowledge from both fields. It is necessary then the use of didactics tools and methods for research and teaching for learning aid. The devices for analysis and motion capture currently that are found on the market and on educational institutes presents difficulties for didactical practice, which are the difficulty of transportation, high cost and limited freedom for the user towards the data acquisition. Therefore, the motion analysis is qualitatively performed or is quantitatively performed in highly complex laboratories. Based is these problems, this work presents the development of a motion capture system for didactic use hence a cheap, light, portable and easily used device with a free software. This design includes the selection of the device, the software development for that and tests. The developed system uses the device Kinect, from Microsoft, for its low cost, low weight, portability and easy use, and delivery tree-dimensional data with only one peripheral device. The proposed programs use the hardware to make motion captures, store them, reproduce them, process the motion data and graphically presents the data.

Classificação de atividade eletromiográfia facial de indivíduos saudáveis e com hanseníese por meio de máquina de vetores de suporte

A number of studies in the areas of Biomedical Engineering and Health Sciences have employed machine learning tools to develop methods capable of identifying patterns in different sets of data. Despite its extinction in many countries of the developed world, Hansen’s disease is still a disease that affects a huge part of the population in countries such as India and Brazil. In this context, this research proposes to develop a method that makes it possible to understand in the future how Hansen’s disease affects facial muscles. By using surface electromyography, a system was adapted so as to capture the signals from the largest possible number of facial muscles. We have first looked upon the literature to learn about the way researchers around the globe have been working with diseases that affect the peripheral neural system and how electromyography has acted to contribute to the understanding of these diseases. From these data, a protocol was proposed to collect facial surface electromyographic (sEMG) signals so that these signals presented a high signal to noise ratio. After collecting the signals, we looked for a method that would enable the visualization of this information in a way to make it possible to guarantee that the method used presented satisfactory results. After identifying the method's efficiency, we tried to understand which information could be extracted from the electromyographic signal representing the collected data. Once studies demonstrating which information could contribute to a better understanding of this pathology were not to be found in literature, parameters of amplitude, frequency and entropy were extracted from the signal and a feature selection was made in order to look for the features that better distinguish a healthy individual from a pathological one. After, we tried to identify the classifier that best discriminates distinct individuals from different groups, and also the set of parameters of this classifier that would bring the best outcome. It was identified that the protocol proposed in this study and the adaptation with disposable electrodes available in market proved their effectiveness and capability of being used in different studies whose intention is to collect data from facial electromyography. The feature selection algorithm also showed that not all of the features extracted from the signal are significant for data classification, with some more relevant than others. The classifier Support Vector Machine (SVM) proved itself efficient when the adequate Kernel function was used with the muscle from which information was to be extracted. Each investigated muscle presented different results when the classifier used linear, radial and polynomial kernel functions. Even though we have focused on Hansen’s disease, the method applied here can be used to study facial electromyography in other pathologies.

Classificação de atividade eletromiográfia facial de indivíduos saudáveis e com hanseníase por meio de máquina de vetores de suporte

A number of studies in the areas of Biomedical Engineering and Health Sciences have employed machine learning tools to develop methods capable of identifying patterns in different sets of data. Despite its extinction in many countries of the developed world, Hansen’s disease is still a disease that affects a huge part of the population in countries such as India and Brazil. In this context, this research proposes to develop a method that makes it possible to understand in the future how Hansen’s disease affects facial muscles. By using surface electromyography, a system was adapted so as to capture the signals from the largest possible number of facial muscles. We have first looked upon the literature to learn about the way researchers around the globe have been working with diseases that affect the peripheral neural system and how electromyography has acted to contribute to the understanding of these diseases. From these data, a protocol was proposed to collect facial surface electromyographic (sEMG) signals so that these signals presented a high signal to noise ratio. After collecting the signals, we looked for a method that would enable the visualization of this information in a way to make it possible to guarantee that the method used presented satisfactory results. After identifying the method's efficiency, we tried to understand which information could be extracted from the electromyographic signal representing the collected data. Once studies demonstrating which information could contribute to a better understanding of this pathology were not to be found in literature, parameters of amplitude, frequency and entropy were extracted from the signal and a feature selection was made in order to look for the features that better distinguish a healthy individual from a pathological one. After, we tried to identify the classifier that best discriminates distinct individuals from different groups, and also the set of parameters of this classifier that would bring the best outcome. It was identified that the protocol proposed in this study and the adaptation with disposable electrodes available in market proved their effectiveness and capability of being used in different studies whose intention is to collect data from facial electromyography. The feature selection algorithm also showed that not all of the features extracted from the signal are significant for data classification, with some more relevant than others. The classifier Support Vector Machine (SVM) proved itself efficient when the adequate Kernel function was used with the muscle from which information was to be extracted. Each investigated muscle presented different results when the classifier used linear, radial and polynomial kernel functions. Even though we have focused on Hansen’s disease, the method applied here can be used to study facial electromyography in other pathologies.

Avaliação de tecnologias em saúde, qualidade em saúde, segurança do doente

Tecnologia em saúde: Aplicação de conhecimento e competências sob a forma de dispositivos médicos, medicamentos, vacinas, procedimentos e sistemas desenvolvidos para resolver um problema de saúde e melhorar a qualidade de vida. Classificação das TS - 1. Natureza material: medicamentos, equipamentos, procedimentos médicos e cirúrgicos, sistemas de suporte, sistemas organizacionais e de gestão. 2. Propósito: prevenção, diagnóstico, tratamento, reabilitação. 3. Estadio de difusão: futura, experimental, investigacional, estabelecida, obsoleta. Como sabemos que uma tecnologia tem melhores resultados clínicos ou se causa mais danos do que benefícios? Efetividade clínica e económica.

Adesão dos enfermeiros à notificação de eventos nos serviços de internamento e unidades de cuidados intensivos de um hospital central

Introdução: A notificação de eventos tornou-se um importante instrumento para a melhoria da qualidade no sistema de saúde. Partilhar a ocorrência de eventos na área dos cuidados de saúde é fundamental para a implementação de mecanismos de prevenção que aumentem a segurança do doente. Objetivo: Conhecer a adesão dos enfermeiros à notificação de eventos nos serviços de internamento e unidades de cuidados intensivos de um hospital central. Metodologia: Estudo exploratório descritivo, com abordagem quantitativa. Resultados: Relativamente aos eventos em que o dano é trágico, a grande maioria das vezes são notificados. Em relação à queda, todos os profissionais com quem ocorreu este evento, notificaram. Os enfermeiros apontam como principais barreiras à notificação de eventos: o esquecimento decorrente do excesso de trabalho; a evolução do evento tornar desnecessária a notificação e a aplicação informática para notificação ser complicada, não ser intuitiva. Conclusões: Após a recolha de dados verificamos, que quando ocorrem eventos, os enfermeiros notificam-nos poucas vezes. Os resultados obtidos apontam algumas orientações para a melhoria da cultura de segurança na instituição, ressalvando-se a necessidade de formação na área da segurança e da notificação antes de o evento acontecer.

Efeitos do processo de acreditação nas práticas profissionais dos assistentes sociais em contexto hospitalar: perspectiva de um painel Delphi

A acreditação de um hospital revela-se um instrumento de extrema importância na melhoria da qualidade dos cuidados de saúde. Subjacente a este processo, estão inerentes alterações ao nível organizacional e individual. Este artigo tem como objetivo, identificar os efeitos do processo de acreditação nas práticas profissionais dos assistentes sociais em contexto hospitalar. Neste sentido, realizou-se um painel de peritos, com recurso à técnica Delphi, no qual participaram 12 peritos multidisciplinares e internacionais, tendo sido conseguida obtenção de consenso em três rondas. Dos resultados obtidos emergiram consensos que permite considerar cinco dimensões de ação relevantes face aos efeitos da acreditação nas práticas profissionais dos assistentes sociais, quanto: 1) especificidades da prática; 2) interação de equipas; 3) eficácia profissional; 4) avaliação e monitorização; 5) ganhos em saúde. São dimensões que correspondem a mudanças e que sugerem uma linha de ação que é influenciada, e determinada pelo processo de acreditação no desenvolvimento de uma cultura de melhoria contínua da qualidade da actividade do Serviço Social e do agir profissional. Os resultados obtidos evidenciam que um processo de acreditação tem efeitos diretos e positivos nas práticas dos assistentes sociais.

Common fish diseases and parasites affecting wild and farmed tilapia and catfish in central and western Uganda

Intensification of aquaculture production in Uganda is likely to result into disease out-breaks leading to economic losses to commercial fish farms and associated natural aquatic ecosystems. This survey assessed health profiles of selected commercial fish farms and adjacent natural aquatic ecosystemsto identify fish diseases and parasites affecting Nile tilapia (Oreochromis niloticus) and African catfish (Clarias gariepinus) in aquaculture systems in Uganda. Fish farms encounter disease out-breaks that cause low survival rates (0 - 30%), especially catfish hatcheries. Health management issues are not well understood by fish farmers, with some unable to detect diseased fish. Current control strategies to control aquatic pathogens include use of chemotherapeutants and antibiotics. Bacterial pathogens isolated included Flavobacterium columnare, Aeromonas sp., Edwardsiella sp., Psuedomonus sp., Steptococcus sp., Staphylococcus sp., Proteus sp., and Vibrio sp. A high occurrence of Flavobacterium columnare exists in both asymptomatic and symptomatic fish was observed. Parasites included protozoans (Ichthyopthirius multiphilis, Trichodina sp. and Icthyobodo sp.) and trematodes (Cleidodiscus sp. and Gyrodactylus sp.). Diagnosis and control of diseases and parasites in aquaculture production systems requires adoption of a regional comprehensive biosecurity strategy: the East African (EAC) region unto which this study directly contributes.

An exploratory study of the relationship between psychosocial hazard and ambulatory physiological response in higher education employees.

Purpose: as exposure to psychosocial hazard at work represents a substantial risk factor for employee health in many modern occupations, being able to accurately assess how employees cope with their working environment is crucial. As the workplace is generally accepted as being a dynamic environment consideration should be given to the interaction between employees and the acute environmental characteristics of their workplace. The aim of this study was to investigate the effects of both acute demand and chronic work-related psychosocial hazard upon employees through ambulatory assessment of heart rate variability and blood pressure. Design: a within-subjects repeated measures design was used to investigate the relationship between exposure to work-related psychosocial hazard and ambulatory heart rate variability and blood pressure in a cohort of higher education employees. Additionally the effect of acute variation in perceived work-related demand was investigated. Results: two dimensions of the Management Standards were found to demonstrate an association with heart rate variability; more hazardous levels of “demand” and “relationships” were associated with decreased SDNN. Significant changes in blood pressure and indices of heart rate variability were observed with increased acute demand.

PREVALÊNCIA E PERFIL DAS PESSOAS COM DIABETES CADASTRADAS NO SISTEMA DE INFORMAÇÃO DA ATENÇÃO BÁSICA (SIAB)

Objetivo: Avaliar a prevalência e o perfil das pessoas com diabetes mellitus (DM), autorreferidas. Métodos: Estudo transversal, retrospectivo, realizado com os dados secundários extraídos do Sistema de Informação da Atenção Básica (SIAB). Os dados foram obtidos junto à Secretaria Municipal de Saúde nos meses de março a abril de 2014. Coletaram-se os dados do SIAB referentes à população com diabetes autorreferidas (com 15 anos ou mais) do município de Lajeado-RS, no período de 2011 a 2013, analisados através de estatística descritiva, utilizando-se o programa SPSS versão 21. Resultados: Verificou-se que a prevalência das pessoas com DM se manteve equiparada nos anos estudados (3,0% em 2011, 3,1% em 2012 e 3,0% em 2013). Essa população, na sua maioria, estava acima de 60 anos (60% em 2011, 58% em 2012 e 60% em 2013), é alfabetizada (88% em 2011, 89,9% em 2012 e 90,7% em 2013), com predominância do sexo feminino (63,2% em 2011, 62,9% em 2012 e 63,7% em 2013) e hipertensa (77,5% em 2011, 76,1% em 2012 e 76,9% em 2013). A prevalência de gestantes com diabetes foi de 0,5% em 2012 e 0,3% em 2013, não havendo casos em 2011. Conclusão: A prevalência de DM autorreferida no município é em torno de 3% nos anos analisados, abaixo da média nacional. Constatou-se que a maioria da população com DM é idosa, feminina, alfabetizada, hipertensa, além de haver baixa prevalência de DM em gestantes.

Survey on gill parasites of sturgeon fishes (Acipenseridae) in southern part of Caspian Sea with emphasis on Nitzschia sturionis Ablidgaard, 1794

Sturgeons are important because of producing the expensive caviar. With regard to decreasing of natural stocks of these fishes, cultured sturgeons farms are expanding, so infectious or non-infectious agents can cause problems in this industry. One of the most important infectious diseases, are parasitic diseases, like gill parasites. In this study from March 2007 to June 2008, gills of 122 sturgeons of south west of Caspian Sea, 44 samples of juveniles from freshwater farms and 25 samples of cultured fishes in freshwater were collected and examined. Parasites were separated and determination of species and prevalence of them were done. Nitzschia sturionis and Diclybothrium armatum (monogenea) with general prevalence 8.7% in Acipenser persicus and 25.6% in Acipenser stellatus from sea sturgeons and Trichodina (sp.1, sp.2) and Ichthyophthirius multifiliis from freshwater sturgeons, were separated. Statistical analysis was done according to species, sex, length and weight of fishes. Pathology, morphometric and morphological characters of Nitzschia sturionis were also studied. At the end, we have suggested ways for health management of farms for prevention of parasites entry.

Calidad de atención científico humanístico que presta el personal de enfermería y su relación con el nivel de satisfacción del usuario del Centro de Salud Cojitambo. Azogues, 2014

Antecedentes: el tema de calidad de la atención en salud hoy en día es clave, y urgente de conocer, entender y aplicar por el personal de salud y en particular para el profesional de Enfermería, para lograr la calidad en los servicios de salud es necesario el control, la evaluación objetiva y sistemática de la atención de enfermería ya que se han convertido en una prioridad dentro de la profesión, debido a que el consumidor demanda atención de calidad, existiendo un mayor compromiso con la responsabilidad directa ante él público. Objetivo: determinar la calidad de atención que presta el personal de enfermería del centro de salud “Cojitambo” y su relación con el nivel de satisfacción del usuario. Metodología: se trata de un estudio descriptivo de corte transversal que permitirá determinar la calidad de atención que presta el personal de enfermería del centro de salud “Cojitambo” y su relación con el nivel de satisfacción del usuario. Universo: para el tamaño de la muestra se considera una población infinita con una proporción de insatisfacción del 20% con un nivel de confianza del 96% y una precisión del 4%. Con estos valores el tamaño de la muestra a estudiar es de 385 pacientes. Como técnicas se utilizará la entrevista, observación directa e indirecta, como instrumento el formulario avalado por la Universidad Técnica Particular de Loja en la investigación realizada por el Dr. Carlos Arévalo previa a la obtención de la maestría en gerencias en salud para el desarrollo local, para procesar la información se utilizará los programas Excel, Word y SPSS, los datos serán analizados con estadística descriptiva y presentadas en tablas y gráficas. Uso de resultados: la presente investigación pretenderá obtener datos relacionados con la medición de la calidad de atención que brinda el personal de enfermería y el nivel de satisfacción del usuario que acude al centro de salud Cojitambo.

The quality of care of diabetic patients in rural Malawi: A case of Mangochi district

Background Diabetes mellitus is a global public health problem. In Malawi, the prevalence of diabetes is 5.6% but the quality of care has not been well studied. Objective The aim of this study was to assess the quality of care offered to diabetic patients in Mangochi district. Methods This was a cross sectional descriptive study. Quantitative data were collected using a questionnaire from a sample of 75 diabetic patients (children and adults) who attended the Diabetes Clinic at Mangochi District Hospital between 20012 and 2013. Qualitative data were also collected using semi-structured interviews with eight Key Informants from among the District Health Management Team. Frequencies and cross-tabulation were obtained from the quantitative data. Patients’ master cards were checked to validate results. Clinical knowledge about diabetes, care practices and resources were the themes analysed from the qualitative data. Results Among the 75 participants interviewed, 46 were females and 29 males. The overall mean age was 48.3 years (45.6 for females and 53.3 for males). More than half of patients had little or no information about diabetes (40.0 % (n=30) and 22.7 (n=17) respectively. The majority of patients were taking their medicines regularly 98.7% (n=74). Only 17.3% (n=13) reported having their feet inspected regularly. Fifty-six percent of patients were satisfied about services provision. Some nurses and clinicians were trained on diabetes care but most of them left. Guidelines on diabetes management were not accessible. There were shortages in medicines (e.g. soluble insulin) and reagents. Information Education and Communication messages were offered through discussions, experiences sharing and posters. Conclusion Quality of diabetes care provided to diabetic patients attended to Mangochi hospital was sub-optimal due to lack of knowledge among patients and clinicians and resources. More efforts are needed towards retention of trained staff, provision of pharmaceutical and laboratory resources and health education.

The French Polynesian experience

French Polyncsia is currently the world's largest producer of cultured black pearls with exports worth US$150 millions annually. The activity has become of prime socio-economic importance the archipelagos with strong support and control of the government. In the mid-1980s, mass mortality of the black-lipped pearl oyster, Pinctada margaritifera, has occurred in several atolls and challenged the development of pearl farming activity. Consequent Studies and surveys have described severa! pathologica! conditions. None of those is considered to pose significant threat to the industry. However, they are monitored by a surveillance program in order to prevent and control emerging diseases. The governmemt of French Polynesia has developed efforts to maintain high quality of the pearls and sustain demand of the markets. This paper reviews a successful model of development based on proactive policy and cooperation among stakeholders.

Manual/Instruções de Trabalho para a Integração de Enfermeiros e Alunos no Programa de Saúde Infantil e Juvenil

Atualmente a melhoria da qualidade nos cuidados de saúde implica a passagem de uma prática baseada na experiência para uma baseada na evidência científica; na melhoria tendo por premissa não só o desempenho profissional, mas também os cidadãos como parceiros; de uma qualidade mono-disciplinar, para cuidados partilhados; de uma educação profissional contínua e avaliações de qualidade, para uma gestão da saúde, num contexto de melhoria contínua da qualidade. À Ordem dos Enfermeiros é imputada a defesa da qualidade dos cuidados de enfermagem à população. Cabe a cada enfermeiro, individualmente e em coletivo no contexto do seu exercício, refletir, analisar e prosseguir diariamente na procura da excelência do exercício. A gestão da qualidade parte do empenhamento dos profissionais que funcionando como um todo dentro de um núcleo específico com o objetivo de atingirem o mesmo fim, estabelecem estratégias que visem alcançar esse fim. Neste contexto surge a elaboração do Manual / Instruções de Trabalho para a integração e prestação de cuidados dos enfermeiros e alunos de enfermagem no Programa de Saúde Infantil e Juvenil na Unidade de Cuidados de Saúde Personalizados da Baixa da Banheira. Visando a melhoria da articulação, comunicação, continuidade de cuidados, entre a equipa de Enfermagem, pois só em conjunto se poderá desenvolver ações que visem a aquisição dessa qualidade e que contribuam para o desenvolvimento / harmonioso da criança / jovem e sua família.