Ontology modeling for generation of clinical pathways

Purpose: Increasing costs of health care, fuelled by demand for high quality, cost-effective healthcare has drove hospitals to streamline their patient care delivery systems. One such systematic approach is the adaptation of Clinical Pathways (CP) as a tool to increase the quality of healthcare delivery. However, most organizations still rely on are paper-based pathway guidelines or specifications, which have limitations in process management and as a result can influence patient safety outcomes. In this paper, we present a method for generating clinical pathways based on organizational semiotics by capturing knowledge from syntactic, semantic and pragmatic to social level. Design/methodology/approach: The proposed modeling approach to generation of CPs adopts organizational semiotics and enables the generation of semantically rich representation of CP knowledge. Semantic Analysis Method (SAM) is applied to explicitly represent the semantics of the concepts, their relationships and patterns of behavior in terms of an ontology chart. Norm Analysis Method (NAM) is adopted to identify and formally specify patterns of behavior and rules that govern the actions identified on the ontology chart. Information collected during semantic and norm analysis is integrated to guide the generation of CPs using best practice represented in BPMN thus enabling the automation of CP. Findings: This research confirms the necessity of taking into consideration social aspects in designing information systems and automating CP. The complexity of healthcare processes can be best tackled by analyzing stakeholders, which we treat as social agents, their goals and patterns of action within the agent network. Originality/value: The current modeling methods describe CPs from a structural aspect comprising activities, properties and interrelationships. However, these methods lack a mechanism to describe possible patterns of human behavior and the conditions under which the behavior will occur. To overcome this weakness, a semiotic approach to generation of clinical pathway is introduced. The CP generated from SAM together with norms will enrich the knowledge representation of the domain through ontology modeling, which allows the recognition of human responsibilities and obligations and more importantly, the ultimate power of decision making in exceptional circumstances.

Fish oil fatty acids and vascular reactivity

Endothelial dysfunction and an associated increase in vascular tone are risk factors for cardiovascular disease and highly predictive of future cardiovascular events. A part of the benefits associated with increased intake of the long chain (LC) n-3 polyunsaturated fatty acids (PUFA), eicosapentaenoic acid and docosahexaenoic acid, found in fish oils is a positive impact on cardiovascular health. Here, the recent evidence from human observational and intervention trials are reviewed, and an insight into potential mechanisms underlying the impact of LC n-3 PUFA on vascular reactivity is provided.

Does milk consumption contribute to cardiometabolic health and overall diet quality?

Although milk consumption is recommended in most dietary guidelines around the world, its contribution to overall diet quality remains a matter of debate in the scientific community as well as in the public. This paper summarizes the discussion among experts in the field on the place of milk in a balanced, healthy diet. The evidence to date suggests at least a neutral effect of milk intake on health outcomes. The possibility that milk intake is simply a marker of higher nutritional quality diets cannot be ruled out. This review also identifies a number of key research gaps pertaining to the impact of milk consumption on health. These need to be addressed to better inform future dietary guidelines.

Surgical Site Infection in a University Hospital in Northeast Brazil

We examined prevention of surgical site infection (SSI) in a tertiary teaching hospital in northeast Brazil, from January 1994 to December 2003. The survey included 5,742 patients subjected to thoracic, urologic, vascular and general surgery. The criteria for diagnosing SSI were those of the Centers for Disease Control, USA, and the variables of the National Nosocomial Infection Surveillance risk index were used. Data analysis revealed that anesthetic risk scores, wound class and duration of surgery were significantly associated with SSI. A total of 296 SSIs were detected among the 5,742 patients (5.1%). The overall incidence of SSI was 8.8% in 1994; it decreased to 3.3% in 2003. In conclusion, the use of educational strategies, based on guidelines for SSI prevention reduced SSI incidence. Appropriate management of preoperative, intraoperative, and postoperative incision care, and a surveillance system based on international criteria, were useful in reducing SSI rates in our hospital

Monitoramento das águas da bacia hidrográfica pirangi pela determinação dos índices de qualidade da água-iqa e índice de toxidez-it

The problems of water supply in Northeast Brazil are severe and require more focused studies. This work was intended to assess water quality in the watershed Pirangi, located in the Northeastern state of the newborn using the Water Quality Index, AQI associated with the Index of Toxicity-IT. The data presented in this study were collected in November 2008, June 2009 and March 2010 at eight sampling stations distributed throughout the basin. The study covered nine parameters, based on guidelines established by CETESB, and seven members of Metal Toxicity index-IT. These waters are framed in the classification between GOOD and BAD showing AQI 41.34 minimum and a maximum of 76.23. Virtually all seven metals analyzed were below the detection limits of ICP-OES giving IT a water equal to one when they are absent and 0 when there are levels of trace metals

Foraging Behavior and Mortality of Ectatomma brunneum (Hymenoptera, Formicidae) in Simultaneous Exposure to Ant Baits and Conventional Diet in Laboratory

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Teores de poliaminas em alguns alimentos da dieta básica do povo brasileiro

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Impactos da restrição nutricional em cabritos Saanen dos 5 aos 15 Kg de peso corporal

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeitos da alimentação artificial protéica em colônias de uruçu-cinzenta (Melípona fasciculata, Smith 1858) (Apidae, Meliponini) e adaptação em casa-de-vegetaçao

O trabalho teve como objetivo desenvolver uma alimentação artificial protéica a base de extrato de soja (saburá artificial), e avaliar o seu efeito sobre a razão sexual, longevidade de operárias e desenvolvimento de colônias recém-divididas de Melipona fasciculata além de verificar a adaptação da espécie dentro de casas de vegetação. O saburá artificial aqui desenvolvido é constituído de 50g de extrato de soja, 20g de saburá fresco e 60ml de xarope de açúcar invertido (60%). Foi utilizado anilina para colorir o saburá artificial na tentativa de rastrear e verificar o consumo pelas operárias dentro das colônias. Foram utilizadas cinco colônias, das quais três receberam somente saburá e duas o saburá artificial. Não houve diferença significativa entre a produção de rainhas e operárias nos dois tratamentos e nos dois casos não houve produção de machos. As operárias que nasceram de caixas alimentadas com saburá artificial apresentaram maior longevidade e menor peso ao nascer. Estas caixas ainda iniciaram o processo de construção de células e postura mais cedo que as caixas alimentadas com saburá, contudo, suas rainhas apresentaram menor taxa de oviposição diária. O alimento a base de extrato de soja (saburá artificial) não afetou negativamente colônias recém divididas de M. fasciculata. Nos primeiros dias, as abelhas passaram a maior parte do seu tempo no topo da casa-de-vegetação tentando fugir, somente após o terceiro dia houve redução na mortalidade das operárias. Não houve diferença significativa, ao longo de cinco dias, entre a mortalidade de operárias em caixas transferidas, durante a noite e durante o dia, para dentro da casa-de-vegetação. A anilina se mostrou uma excelente ferramenta para controlar os alimentos manuseados e consumidos pela colônia.

Caracterização, confirmação diagnóstica e avaliação da gravidade dos pacientes com DPOC internados em hospital geral com recursos adequados para o geenciamneto da doença

Pós-graduação em Saúde Coletiva - FMB

A educação ambiental presente nos programas de uso público em parques estaduais localizados no município de São Paulo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estado nutricional de pré-escolares e consumo alimentar de suas famílias no Município de Ponta Grossa-Pr: a influência das condições socioeconômicas e das políticas públicas

Pós-graduação em Alimentos e Nutrição - FCFAR

Padrões de dieta em gestantes: estudo de coorte em município paulista

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Development and evolution of caste dimorphism in honeybees - a modeling approach

The difference in phenotypes of queens and workers is a hallmark of the highly eusocial insects. The caste dimorphism is often described as a switch-controlled polyphenism, in which environmental conditions decide an individual's caste. Using theoretical modeling and empirical data from honeybees, we show that there is no discrete larval developmental switch. Instead, a combination of larval developmental plasticity and nurse worker feeding behavior make up a colony-level social and physiological system that regulates development and produces the caste dimorphism. Discrete queen and worker phenotypes are the result of discrete feeding regimes imposed by nurses, whereas a range of experimental feeding regimes produces a continuous range of phenotypes. Worker ovariole numbers are reduced through feeding-regime-mediated reduction in juvenile hormone titers, involving reduced sugar in the larval food. Based on the mechanisms identified in our analysis, we propose a scenario of the evolutionary history of honeybee development and feeding regimes.

Development of cassava cake enriched with its own bran and Spirulina platensis

The cassava cake was developed enriching it with a biomass of Spirulina platensis and a type of bran made out of its own starch. This biomass, a part from being rich in protein, also contains vitamins, essential fatty acids and minerals. Around Umuarama, in the State of Parana, there is an agricultural/industrial complex annually producing and processing tons of cassava. Baked goods can be elaborated based in cassava as a way to expand the use of this raw material and to produce food free of gluten to celiac people. In this complex a solid byproduct is generated, which is rich in starch and fibres, and because of its low commercial value it is used for animal feed or discarded. The bran was dehydrated and analysed microbiologically as well as physically and chemically so as to be used in applied research. Developed energetic food based on cassava lacks protein, but this can be supplied by adding the biomass of Spirulina platensis. Different formulations of this cassava cake were developed varying the concentration of Spirulina platensis and cassava bran. The formulation that presented the best features received chocolate before being submitted to sensory tests by children in the public education system. The results show an excellent acceptance which made viable the development of this product because of aspects like nutrition, technology and sensorial.