O estágio extracurricular remunerado no cuidar da enfermagem nos hospitais de ensino

OLIVEIRA,Jonas Sâmi Albuquerque de; ENDERS, Bertha Cruz; MENEZES, Rejane Maria Paiva de MEDEIROS, Soraya Maria de. O estágio extracurricular remunerado no cuidar da enfermagem nos hospitais de ensino. Revista Gaúcha de Enfermagem, Porto Alegre(RS),v.30,n.2, p.311-8,jun.2009.

Orthogonal persistence in Java supported by aspect- oriented programming and reflection

The persistence concern implemented as an aspect has been studied since the appearance of the Aspect-Oriented paradigm. Frequently, persistence is given as an example that can be aspectized, but until today no real world solution has applied that paradigm. Such solution should be able to enhance the programmer productivity and make the application less prone to errors. To test the viability of that concept, in a previous study we developed a prototype that implements Orthogonal Persistence as an aspect. This first version of the prototype was already fully functional with all Java types including arrays. In this work the results of our new research to overcome some limitations that we have identified on the data type abstraction and transparency in the prototype are presented. One of our goals was to avoid the Java standard idiom for genericity, based on casts, type tests and subtyping. Moreover, we also find the need to introduce some dynamic data type abilities. We consider that the Reflection is the solution to those issues. To achieve that, we have extended our prototype with a new static weaver that preprocesses the application source code in order to introduce changes to the normal behavior of the Java compiler with a new generated reflective code.

A parallel numerical solver using hierarchically tiled arrays

Solving linear systems is an important problem for scientific computing. Exploiting parallelism is essential for solving complex systems, and this traditionally involves writing parallel algorithms on top of a library such as MPI. The SPIKE family of algorithms is one well-known example of a parallel solver for linear systems. The Hierarchically Tiled Array data type extends traditional data-parallel array operations with explicit tiling and allows programmers to directly manipulate tiles. The tiles of the HTA data type map naturally to the block nature of many numeric computations, including the SPIKE family of algorithms. The higher level of abstraction of the HTA enables the same program to be portable across different platforms. Current implementations target both shared-memory and distributed-memory models. In this thesis we present a proof-of-concept for portable linear solvers. We implement two algorithms from the SPIKE family using the HTA library. We show that our implementations of SPIKE exploit the abstractions provided by the HTA to produce a compact, clean code that can run on both shared-memory and distributed-memory models without modification. We discuss how we map the algorithms to HTA programs as well as examine their performance. We compare the performance of our HTA codes to comparable codes written in MPI as well as current state-of-the-art linear algebra routines.

A Visual Analytics Approach to Comparing Cohorts of Event Sequences

Sequences of timestamped events are currently being generated across nearly every domain of data analytics, from e-commerce web logging to electronic health records used by doctors and medical researchers. Every day, this data type is reviewed by humans who apply statistical tests, hoping to learn everything they can about how these processes work, why they break, and how they can be improved upon. To further uncover how these processes work the way they do, researchers often compare two groups, or cohorts, of event sequences to find the differences and similarities between outcomes and processes. With temporal event sequence data, this task is complex because of the variety of ways single events and sequences of events can differ between the two cohorts of records: the structure of the event sequences (e.g., event order, co-occurring events, or frequencies of events), the attributes about the events and records (e.g., gender of a patient), or metrics about the timestamps themselves (e.g., duration of an event). Running statistical tests to cover all these cases and determining which results are significant becomes cumbersome. Current visual analytics tools for comparing groups of event sequences emphasize a purely statistical or purely visual approach for comparison. Visual analytics tools leverage humans' ability to easily see patterns and anomalies that they were not expecting, but is limited by uncertainty in findings. Statistical tools emphasize finding significant differences in the data, but often requires researchers have a concrete question and doesn't facilitate more general exploration of the data. Combining visual analytics tools with statistical methods leverages the benefits of both approaches for quicker and easier insight discovery. Integrating statistics into a visualization tool presents many challenges on the frontend (e.g., displaying the results of many different metrics concisely) and in the backend (e.g., scalability challenges with running various metrics on multi-dimensional data at once). I begin by exploring the problem of comparing cohorts of event sequences and understanding the questions that analysts commonly ask in this task. From there, I demonstrate that combining automated statistics with an interactive user interface amplifies the benefits of both types of tools, thereby enabling analysts to conduct quicker and easier data exploration, hypothesis generation, and insight discovery. The direct contributions of this dissertation are: (1) a taxonomy of metrics for comparing cohorts of temporal event sequences, (2) a statistical framework for exploratory data analysis with a method I refer to as high-volume hypothesis testing (HVHT), (3) a family of visualizations and guidelines for interaction techniques that are useful for understanding and parsing the results, and (4) a user study, five long-term case studies, and five short-term case studies which demonstrate the utility and impact of these methods in various domains: four in the medical domain, one in web log analysis, two in education, and one each in social networks, sports analytics, and security. My dissertation contributes an understanding of how cohorts of temporal event sequences are commonly compared and the difficulties associated with applying and parsing the results of these metrics. It also contributes a set of visualizations, algorithms, and design guidelines for balancing automated statistics with user-driven analysis to guide users to significant, distinguishing features between cohorts. This work opens avenues for future research in comparing two or more groups of temporal event sequences, opening traditional machine learning and data mining techniques to user interaction, and extending the principles found in this dissertation to data types beyond temporal event sequences.

Endemic zoonoses: a one health approach

Endemic zoonotic diseases remain a serious but poorly recognised problem in affected communities in developing countries. Despite the overall burden of zoonoses on human and animal health, information about their impacts in endemic settings is lacking and most of these diseases are continuously being neglected. The non-specific clinical presentation of these diseases has been identified as a major challenge in their identification (even with good laboratory diagnosis), and control. The signs and symptoms in animals and humans respectively, are easily confused with other non-zoonotic diseases, leading to widespread misdiagnosis in areas where diagnostic capacity is limited. The communities that are mostly affected by these diseases live in close proximity with their animals which they depend on for livelihood, which further complicates the understanding of the epidemiology of zoonoses. This thesis reviewed the pattern of reporting of zoonotic pathogens that cause febrile illness in malaria endemic countries, and evaluates the recognition of animal associations among other risk factors in the transmission and management of zoonoses. The findings of the review chapter were further investigated through a laboratory study of risk factors for bovine leptospirosis, and exposure patterns of livestock coxiellosis in the subsequent chapters. A review was undertaken on 840 articles that were part of a bigger review of zoonotic pathogens that cause human fever. The review process involves three main steps: filtering and reference classification, identification of abstracts that describe risk factors, and data extraction and summary analysis of data. Abstracts of the 840 references were transferred into a Microsoft excel spread sheet, where several subsets of abstracts were generated using excel filters and text searches to classify the content of each abstract. Data was then extracted and summarised to describe geographical patterns of the pathogens reported, and determine the frequency animal related risk factors were considered among studies that investigated risk factors for zoonotic pathogen transmission. Subsequently, a seroprevalence study of bovine leptospirosis in northern Tanzania was undertaken in the second chapter of this thesis. The study involved screening of serum samples, which were obtained from an abattoir survey and cross-sectional study (Bacterial Zoonoses Project), for antibodies against Leptospira serovar Hardjo. The data were analysed using generalised linear mixed models (GLMMs), to identify risk factors for cattle infection. The final chapter was the analysis of Q fever data, which were also obtained from the Bacterial Zoonoses Project, to determine exposure patterns across livestock species using generalized linear mixed models (GLMMs). Leptospira spp. (10.8%, 90/840) and Rickettsia spp. (10.7%, 86/840) were identified as the most frequently reported zoonotic pathogens that cause febrile illness, while Rabies virus (0.4%, 3/840) and Francisella spp. (0.1%, 1/840) were least reported, across malaria endemic countries. The majority of the pathogens were reported in Asia, and the frequency of reporting seems to be higher in areas where outbreaks are mostly reported. It was also observed that animal related risk factors are not often considered among other risk factors for zoonotic pathogens that cause human fever in malaria endemic countries. The seroprevalence study indicated that Leptospira serovar Hardjo is widespread in cattle population in northern Tanzania, and animal husbandry systems and age are the two most important risk factors that influence seroprevalence. Cattle in the pastoral systems and adult cattle were significantly more likely to be seropositive compared to non-pastoral and young animals respectively, while there was no significant effect of cattle breed or sex. Exposure patterns of Coxiella burnetii appear different for each livestock species. While most risk factors were identified for goats (such as animal husbandry systems, age and sex) and sheep (animal husbandry systems and sex), there were none for cattle. In addition, there was no evidence of a significant influence of mixed livestock-keeping on animal coxiellosis. Zoonotic agents that cause human fever are common in developing countries. The role of animals in the transmission of zoonotic pathogens that cause febrile illness is not fully recognised and appreciated. Since Leptospira spp. and C. burnetii are among the most frequently reported pathogens that cause human fever across malaria endemic countries, and are also prevalent in livestock population, control and preventive measures that recognise animals as source of infection would be very important especially in livestock-keeping communities where people live in close proximity with their animals.

Pacote de sincronização de réplicas de bases de dados

A replicação de base de dados tem como objectivo a cópia de dados entre bases de dados distribuídas numa rede de computadores. A replicação de dados é importante em várias situações, desde a realização de cópias de segurança da informação, ao balanceamento de carga, à distribuição da informação por vários locais, até à integração de sistemas heterogéneos. A replicação possibilita uma diminuição do tráfego de rede, pois os dados ficam disponíveis localmente possibilitando também o seu acesso no caso de indisponibilidade da rede. Esta dissertação baseia-se na realização de um trabalho que consistiu no desenvolvimento de uma aplicação genérica para a replicação de bases de dados a disponibilizar como open source software. A aplicação desenvolvida possibilita a integração de dados entre vários sistemas, com foco na integração de dados heterogéneos, na fragmentação de dados e também na possibilidade de adaptação a várias situações. ABSTRACT: Data replication is a mechanism to synchronize and integrate data between distributed databases over a computer network. Data replication is an important tool in several situations, such as the creation of backup systems, load balancing between various nodes, distribution of information between various locations, integration of heterogeneous systems. Replication enables a reduction in network traffic, because data remains available locally even in the event of a temporary network failure. This thesis is based on the work carried out to develop an application for database replication to be made accessible as open source software. The application that was built allows for data integration between various systems, with particular focus on, amongst others, the integration of heterogeneous data, the fragmentation of data, replication in cascade, data format changes between replicas, master/slave and multi master synchronization.

Field and petrographic data of 1.90 to 1.88 Ga I- and A-type granitoids from the central region of the Amazonian Craton, NE Amazonas State, Brazil

O SW do município de Presidente Figueiredo, localizado no Estado do Amazonas, Nordeste do Cráton Amazônico Central, Brasil, hospeda granitoides do tipo I de idade entre 1890 a 1898 Ma (Terra Preta Granito, Suíte Água Branca), hornblenda-sienogranitos do tipo A (Sienogranito Canoas da Suíte Mapuera), rochas vulcânicas ácidas à intermediárias (Grupo Iricoumé) e granitos rapakivi de idades entre 1883 a 1889 Ma (Granito São Gabriel da Suíte Mapuera), e rochas afins (quartzo-gabro-anortosito e diorito), além de quartzo-monzonito Castanhal, milonitos e hornfels. A fácies quartzo-diorito do granito Terra Preta foi formada por processos de mistura entre um dique quartzo-gabro sinplutônico e um granodiorito hornblenda. Glóbulos parcialmente assimilados de sienogranitos hornblenda Canoas e seus contatos com o granodiorito hornblenda Terra Preta sugerem que o sienogranito Canoas é um pouco mais jovem do que o Granito Terra Preta. Xenólitos do sienogranito Canoas no interior do Granito São Gabriel mostram que o granito é mais jovem do que o sienogranito Canoas. Novas evidências geológicas e petrográficas avançam na compreensão petrológica destas rochas e sugerem que, além de cristalização fracionada, assimilação e mistura de magma, desempenharam um papel importante, pelo menos em escala local, na evolução e variação composicionais dos plutons. Tal evidência é encontrada no Granito Terra Preta misturado com materiais quartzo-diorito, félsico associado ao sienogranito Canoas e nos enclaves microgranulares intermediários, que apresentam biotita e hornblenda primárias, além de dissolução plagioclásio, corrosão de feldspatos, mantos feldspatos alcalinos, segunda geração de apatita, e elevados teores xenocristais em enclaves intermediários formados a partir da fragmentação de intrusões máficas. Análises petrográficas mostram que um evento deformacional registrado na parte Ocidental da área de estudo (com deformação progressiva de E para W) é estimado entre o magmatismo pós-colisional de 1,90 Ga e as invasões do Granito São Gabriel e rochas afins máficas/intermediárias (intraplaca). No entanto, torna-se extremamente necessário obter idades absolutas para este evento metamórfico.

Age of Child, More than HPV Type, Is Associated with Clinical Course in Recurrent Respiratory Papillomatosis

Background: RRP is a devastating disease in which papillomas in the airway cause hoarseness and breathing difficulty. The disease is caused by human papillomavirus (HPV) 6 or 11 and is very variable. Patients undergo multiple surgeries to maintain a patent airway and in order to communicate vocally. Several small studies have been published in which most have noted that HPV 11 is associated with a more aggressive course. Methodology/Principal Findings: Papilloma biopsies were taken from patients undergoing surgical treatment of RRP and were subjected to HPV typing. 118 patients with juvenile-onset RRP with at least 1 year of clinical data and infected with a single HPV type were analyzed. HPV 11 was encountered in 40% of the patients. By our definition, most of the patients in the sample (81%) had run an aggressive course. The odds of a patient with HPV 11 running an aggressive course were 3.9 times higher than that of patients with HPV 6 (Fisher's exact p = 0.017). However, clinical course was more closely associated with age of the patient (at diagnosis and at the time of the current surgery) than with HPV type. Patients with HPV 11 were diagnosed at a younger age (2.4y) than were those with HPV 6 (3.4y) (p = 0.014). Both by multiple linear regression and by multiple logistic regression HPV type was only weakly associated with metrics of disease course when simultaneously accounting for age. Conclusions/Significance Abstract: The course of RRP is variable and a quarter of the variability can be accounted for by the age of the patient. HPV 11 is more closely associated with a younger age at diagnosis than it is associated with an aggressive clinical course. These data suggest that there are factors other than HPV type and age of the patient that determine disease course.

Kinematic constraints to the transition redshift from supernovae type Ia union data

The kinematic approach to cosmological tests provides direct evidence to the present accelerating stage of the Universe that does not depend on the validity of general relativity, as well as on the matter-energy content of the Universe. In this context, we consider here a linear two-parameter expansion for the decelerating parameter, q(z)=q(0)+q(1)z, where q(0) and q(1) are arbitrary constants to be constrained by the union supernovae data. By assuming a flat Universe we find that the best fit to the pair of free parameters is (q(0),q(1))=(-0.73,1.5) whereas the transition redshift is z(t)=0.49(-0.07)(+0.14)(1 sigma) +0.54-0.12(2 sigma). This kinematic result is in agreement with some independent analyses and more easily accommodates many dynamical flat models (like Lambda CDM).

Modelo de data mining para detecção de tumores em exames de rastreio

Dissertação para obtenção do grau de Mestre em Engenharia Informática

Modelo de data mining para deteção de embolias pulmonares

Trabalho de Projeto para obtenção do grau de Mestre em Engenharia Informática e de Computadores

Two-type heterogeneous multiprocessor scheduling: Is there a phase transition? (Extended Abstract)

Consider the problem of non-migratively scheduling a set of implicit-deadline sporadic tasks to meet all deadlines on a two-type heterogeneous multiprocessor platform. We ask the following question: Does there exist a phase transition behavior for the two-type heterogeneous multiprocessor scheduling problem? We also provide some initial observations via simulations performed on randomly generated task sets.

Evaluation of long term persistence of Diabetes Mellitus Type II treatment newly diagnosed patients in Lisbon and Tagus health administration region : a three year follow up study

RESUMO: Raional: A persistência à terapêutica é o tempo em qualquer antidiabético oral, desde o seu início até à descontinuação de todas as medicações ou até ao fim do período do estudo. Os objetivos deste estudo foi a análise da persistência à terapêutica no segundo e terceiro anos após início do tratamento em doentes adultos diagnosticados na região de Lisboa e Vale do Tejo e determinar o efeito de determinadas variáveis na persistência a longo prazo. Métodos: Um estudo retrospetivo não interventivo foi desenhado com base nos dados a obter do SIARS (prescrições e aquisições na farmácia) e Pordata. A persistência foi quantificada como a percentagem de doentes que continuam a adquirir pelo menos um antidiabético oral ao segundo e terceiro anos após a compra da primeira receita. A associação entre a persistência e o segundo e terceiro anos com cada uma das co-variáveis foi aferido pelo teste qui-quadrado e os odd ratios foram calculados com recurso a um modelo de regressão logística. Resultados: A persistência à terapêutica obtida foi de 80% e 62% para o segundo e terceiro anos após início da terapêutica. Odd ratios para primeiro e segundo ano: número de grupos farmacoterapêuticos diferentes (OR = 2.167, 1.807 – 2.598, p = 0.000 / OR = 1.863, 1.621 – 2.142, p = 0.000); idade (OR = 0.914, 0.772 – 1.081, p = 0.294 / OR = 0.875, 0.764 – 1.002, p = 0.054); sexo (OR = 1.163, 0.983 – 1.377, p = 0.079); número de diferentes prescritores (OR = 3.594, 3.030 – 4.262, p = 0.000 / OR = 2.167, 1.886 – 2.491, p = 0.000); instituição de prescrição (OR = 0.725, 0.698 – 0.753, p = 0.000 / OR = 0.683, 0.650 – 0.717, p = 0.000); grupo farmacoterapêutico (OR = 1.056, 1.043 – 1.069, p = 0.000 / OR = 1.077, 1.060 – 1.095, p = 0.000); relação com o médico (OR = 0.834, 0.816 – 0.852, p = 0.000 / OR = 0.799, 0.777 – 0.821, p = 0.000) e custo médio mensal por grupo farmacoterapêutico (OR = 0.954, 0.942 – 0.968, p = 0.000 / OR = 0.930, 0.914 – 0.947, p = 0.000). Conclusões: O valor da persistência à terapêutica no segundo ano é ligeiramente acima do que é mencionado na literatura e não existem dados para comparar os resultados do terceiro ano. Relativamente ao efeito das co-variáveis no segundo e terceiro anos após o início do tratamento, os resultados são sobreponíveis, sendo que o sexo não está associado à persistência ao terceiro ano.----------------------------------ABSTRACT: Background: Therapy persistence is the time on any antidiabetic medication, from initiation of therapy to discontinuation of all medications or the end of the study period. The aim of the study was to analyse the therapy persistence in the second and third years after treatment initiation in newly diagnosed adult patients in the Lisbon and Tagus Valley region and to determine the effect of several co-variables in the long term persistence. Methods: A retrospective non-interventional study based on SIARS data (drug prescriptions and acquisitions) and Pordata was designed. Persistence was quantified as the percentage of patients that continued to purchase at least one type of antidiabetic at year 2 and 3 after the date of first prescription acquisition. Association between persistence at second and third years with each of the other co-variables were verified by using the Chi-Square test and odds ratio were calculated using a regression logistic model. Results: Therapy persistence obtained was 80% and 62% for the second and third years after treatment initiation. Odd ratios for second and third years: number of different pharmacotherapeutic groups (OR = 2.167, 1.807 – 2.598, p = 0.000 / OR = 1.863, 1.621 – 2.142, p = 0.000); age (OR = 0.914, 0.772 – 1.081, p = 0.294 / OR = 0.875, 0.764 – 1.002, p = 0.054); gender (OR = 1.163, 0.983 – 1.377, p = 0.079); number of different prescribers (OR = 3.594, 3.030 – 4.262, p = 0.000 / OR = 2.167, 1.886 – 2.491, p = 0.000); institution of prescription (OR = 0.725, 0.698 – 0.753, p = 0.000 / OR = 0.683, 0.650 – 0.717, p = 0.000); pharmacotherapeutic group (OR = 1.056, 1.043 – 1.069, p = 0.000 / OR = 1.077, 1.060 – 1.095, p = 0.000); relationship with the physician (OR = 0.834, 0.816 – 0.852, p = 0.000 / OR = 0.799, 0.777 – 0.821, p = 0.000) and average cost per month and per pharmacotherapeutic group (OR = 0.954, 0.942 – 0.968, p = 0.000 / OR = 0.930, 0.914 – 0.947, p = 0.000). Conclusions: Second year therapy persistence value is slightly above of what is referenced in literature and no data was found to compare the third year value. Regarding the effect of the co-variables analysed at second and third years after treatment initiation, the results were overlapping with gender being not associated with persistence at the third year.

Predicting type of delivery by identification of obstetric risk factors through data mining

In Maternity Care, a quick decision has to be made about the most suitable delivery type for the current patient. Guidelines are followed by physicians to support that decision; however, those practice recommendations are limited and underused. In the last years, caesarean delivery has been pursued in over 28% of pregnancies, and other operative techniques regarding specific problems have also been excessively employed. This study identifies obstetric and pregnancy factors that can be used to predict the most appropriate delivery technique, through the induction of data mining models using real data gathered in the perinatal and maternal care unit of Centro Hospitalar of Oporto (CHP). Predicting the type of birth envisions high-quality services, increased safety and effectiveness of specific practices to help guide maternity care decisions and facilitate optimal outcomes in mother and child. In this work was possible to acquire good results, achieving sensitivity and specificity values of 90.11% and 80.05%, respectively, providing the CHP with a model capable of correctly identify caesarean sections and vaginal deliveries.