Eu, nós… ELAS quilombolas: documentário sobre vacinação contra COVID-19 em quilombolas enquanto dispositivo antirracista / We quilombola women: a documentary about COVID-19 vaccination among quilombolas as an anti-racist device

Resumo Eu, nós... ELAS quilombolas, documentário que aborda a identidade quilombola e o direito à vacinação contra a COVID-19, faz emergir noções como prioridade, direito, privilégio e identidade durante o processo que precisa vincular os números de doses a braços de cidadãos. No Brasil, diante da omissão do governo federal, fundamentada na necropolítica e no negacionismo, a falta de informações levou as comunidades quilombolas a se responsabilizarem pela construção das listas de aptos a receberem a vacina. O objetivo da produção foi utilizar as imagens como linguagem política na área da saúde, documentando e dando visibilidade para essas questões, como ilustração de processos de enfrentamento das desigualdades e iniquidades sociais e de saúde pautadas no racismo estrutural. Ao associar ciência e arte, o método de produção audiovisual, entrelaçado com os referenciais da sociologia das imagens, da antropologia visual e dos dispositivos de produção e estética de Coutinho, emergiram três categorias: o eu, o nós e o elas. Este artigo apresenta as categorias que embasaram a construção narrativa do documentário a partir das potencialidades das imagens, que se apresentaram como dispositivo político-pedagógico antirracista, tanto durante o processo de produção quanto ao longo das exibições públicas.

Abstract We quilombola women, a documentary that considers the quilombola identity and the right to COVID-19 vaccination, evokes notions of priority, rights, privileges and identity during the process of matching the number of vaccine doses available to citizens' arms. Omission by a Brazilian federal government grounded in necro-politics and denial, plus a lack of information, led quilombo communities to take it on themselves to draw up lists of those eligible for vaccination. The production team's aim was to use images as political language in the health field, so as to document and give visibility to these issues as one illustration of combating social and health inequalities and inequities rooted in structural racism. By combining science and art and interlacing references from the sociology of images, visual anthropology, plus the work and aesthetic devices of Eduardo Coutinho, the audiovisual production method brought out three key categories: I, We, and They, quilombola women. This article explores these categories underpinning construction of the documentary narrative, which drew on the potential of images, which in turn served as anti-racist, political and educational devices, both in the course of the production process and during the public screenings.

Qualitative research on thematic interviews and factual records of Kampo medicine based on grounded theory / 国际中医中药杂志

Through literature search and screening, with qualitative research methods and the guidance of the three-level coding framework of grounded theory, literature about interview and factual records with Kampo medicine as theme was analyzed to explore concern areas and key points of Kampo medicine. The included literature mainly showed the modern development prospect of Kampo medicine from the fields of the revival background, laws and regulations, clinical work, education and teaching, scientific research, Kampo medicine industry, periodicals and books, representatives, symbolic events, organization and communication of Kampo medicine. Among them, half or more of the literature involved specific aspects such as clinical diagnosis and treatment methods of Kampo medicine, international communication, drug dosage forms and marketing, scientific research institutions and clinical research, and university education. At the same time, the specific aspects of events, legislation, organizations, periodicals, books and representatives mentioned in the literature provided important indexes for the comparative study of traditional medicine between China and Japan. In the future, the above fields and aspects can be set as starting points and main framework to further obtain and research relevant interviews and documentary literature, so as to promote the communication and development of traditional medicine at home and abroad.

A 25 años de la implementación del identificador de objeto digital / Twenty-five years after the implementation of the Digital Object Identifier

RESUMEN El identificador de objeto digital, conocido en inglés como digital object identifier y abreviado DOI, surgido en 1997, es una cadena alfanumérica única que identifica un contenido electrónico y proporciona un enlace permanente a su ubicación en internet. A 25 años de la implementación de esta herramienta, todavía quedan muchas revistas con un impacto considerable que no cuentan con DOI. Cuba no lo tiene porque le es negado por las grandes agencias registradoras. Fue objetivo de los autores de esta comunicación destacar la importancia del DOI como herramienta básica para el control de la documentación digital. Se concluyó que su principal aporte es asegurar la identificación persistente y unívoca de un documento, a través de un registro sistemático central de sus metadatos. Se recomienda que siempre que esté disponible el DOI en línea, se utilice en la cita bibliográfica, para mejorar la visibilidad de las revistas y los propios investigadores.

ABSTRACT The Digital Object Identifier, abbreviated as DOI and emerged in 1997, is a unique alphanumeric string that identifies electronic content and provides a permanent link to its location on the Internet. Twenty-five years after the implementation of this tool, there are still many journals with a considerable impact which do not have DOIs. Cuba does not have it because it is denied by the big registration agencies. The objective of this article was to highlight the importance of the DOI as a basic tool for the control of digital documentation. We concluded that its main contribution is to ensure the persistent and unique identification of a document, through a central systematic record of its metadata. It is recommended that whenever the DOI is available online, it is used in the bibliographic citation, to improve the visibility of the journals and the researchers themselves.

Hospitalizations and adverse drug events in the Brazilian unified health system: a ten-year retrospective analysis of routine data

ABSTRACT OBJECTIVE To describe the frequency and characteristics of hospitalizations for/with adverse drug events in the Brazilian unified health system routine data. METHODS Nationwide retrospective study using data obtained from a period of ten years from the Brazil Hospital Information System (SIH-SUS), an administrative database that registers hospitalizations in the unified health system. We selected hospitalizations with primary and/or secondary diagnosis related to adverse drug events according to a list of validated International Classification Disease 10th edition (ICD-10) codes. These events were described according to year, age group, sex, length of hospital stay, mortality, hospital costs, Brazilian geographical region, and category of ICD-10 codes. Crude hospitalization rates of adverse drug events per 100,000 inhabitants were obtained and Joinpoint Regression was used to analyze temporal changes in these rates along the years. The most frequent ICD-10 codes were also identified. RESULTS Over ten years, 603,663 hospitalizations in Brazil were found in the database, out of which 2.5% of the patients died. Though 2009 had the highest prevalence of hospitalization per 100,000 inhabitants (32.57), no significant annual change in rates was found for the entire period. All age groups and sexes presented a jointpoint in temporal series; however, only women had a significative increase trend. The most frequent codes were from the chapter of mental and behavioral disorders (F19.2, F19.0, and F19.5 codes). CONCLUSIONS The database methodology can be useful to estimate frequencies of adverse drug events and perform characterization nationwide and to help monitor morbidity along the years.

Database of the alumni performance of the Ophthalmology Stricto sensu Postgraduate Program at Escola Paulista de Medicina, UNIFESP

Abstract Purpose To develop a database with social, demographic and professional information of all graduates of the two post-graduate programs in Ophthalmology of EPM-UNIFESP, including their opinions on quality, application, and contribution of the courses received in their professional careers. Methods The survey was conducted in the digital and physical archives of the University and by telephone contact. When the graduates' e-mails were all collected, the electronic questionnaire was applied. The responses were compiled. Descriptive analysis of the results obtained in this cross-sectional study was performed, and analyzed by the authors and by statistical professionals, through Excel graphs. Results The database suggests that most graduates were born and work in the state of São Paulo. A significant fraction of 66.77% is dedicated to academic work, but only 36.2% hold management positions. Most of them receive amounts of one to 56 minimum wages monthly. The main motivation was to improve their professional careers. Conclusion For post-graduate programs, a database with information of its graduates can elucidate whether the goals were achieved based on the proposed teaching, as well as can generate reflections to improve the quality, the courses expectations and the vision that students have of the University.

Obesidad no morbida y morbida del adulto en el Perú, 1975 - 2013 / Adult non-morbid and morbid obesity in Peru, 1975 - 2013

Introducción: La obesidad es una enfermedad considerada como problema de salud pública que afecta a un gran número de personas y que requiere políticas de gobierno que enfrenten esta situación. Objetivo: Determinar las variaciones en las frecuencias de obesidad no mórbida (ONM) y obesidad mórbida (OM) de acuerdo a diferentes encuestas nacionales en función de variables socio-demográficas. Métodos: Estudio descriptivo secundario de datos de cinco encuestas nacionales: Evaluación Nutricional del Poblador Peruano (ENPPE 1975), Encuesta Nacional de Indicadores Nutricionales, Bioquímicos, Socio-económicos y Culturales (CENAN 2005), Encuesta Nacional de Hogares (ENAHO 2009-2010) y Encuesta Nacional de Hogares (ENAHO 2012-2013). La ONM se identificó por un IMC de 30 a 39,99 kg/m² y para la OM con un IMC igual o mayor de 40 kg/m². Resultados: La frecuencia de la ONM se incrementó de 8,5% en 1975 a 18,5% en el 2013, mientras la OM de 0,5 a 0,9% en el mismo periodo. La presencia de OM fue mayor en el género femenino (1,3%) frente al masculino (0,4%), con un incremento promedio en mujeres de 0,6% (0,7% en 1975 y 1,3% en 2013) y en varones de 0,2%. La presencia de obesidad fue mayor en el grupo de 50 a 59 años, en quienes viven en regiones costeras, áreas urbanas y ciudades ubicadas por debajo de 1000 msnm. Conclusiones: La ONM y la OM, presentes desde hace muchos años en nuestro país, tuvieron tendencia al incremento progresivo en los años de estudio, a predominio del género femenino.

Introduction: Obesity is a chronic disease, which is considered as a public health problem. It affects a large number of people and requires governmental policies that encourage this situation. Objective: To determine the variations in the frequencies of non-morbid obesity (NMO) and morbid obesity (MO) according with different national surveys, and in function of socio-demographic variables. Methods: A descriptive study with data of five national surveys: Nutritional Evaluation of the Peruvian Population (ENPPE 1975), National Survey of Nutritional, Biochemical, Socio-economic and Cultural Indicators (CENAN 2005), National Household Survey (ENAHO 2009-2010) and National Household Survey (ENAHO 2012-2013). NMO was identified by a BMI of 30 to 39.99 kg/m² and MO was defined by a BMI equal to or greater than 40 kg/m². Results: The frequency of NMO has increased from 8,5% in 1975 to 18,5% in 2013, and the MO increased from 0,5 to 0,9% in the same period. OM is most presented in females (1,3%) with an average increasing of 0,6% (0,7% in 1975 and 1,3% in 2013) while in men it was 0,2%. Similarly, the frequency of MO was higher in the age group of 50 to 59 years, in those who live in coastal regions, urban areas and cities located below 1000 meters above sea level. Conclusions: ONM and OM, present for many years in our country, had a tendency to the progressive increase in the years of study, with a predominance of the female gender.

Establishment of neonatal homogeneity platform for clinical and scientific research / 中华围产医学杂志

Neonatal medicine in China has been developing rapidly in recent years,but there is a considerable gap in clinical statistics and studies between China and developed countries.Since 1990s,some international neonatal homogeneity platforms such as the Vermont-Oxford Network and the Canadian Neonatal Network,in which a unified collaboration network database was applied,have been established to share the homogeneous data of all network databases in neonatal clinical and scientific research.These platforms have greatly promoted the progress of neonatal clinical studies in both Europe and America.Yet,we have not seen great breakthroughs in clinical big data analysis in neonatal medicine in China.Here,we discussed the critical role of establishing neonatal homogeneity platform in clinical and scientific research.

Educación continua: bases de datos biomédicas II: Medline/PubMed / Continuing education: biomedical databases II: Medline/PubMed

MEDLINE/PubMed es una de las bases de datos de bibliografía biomédica más grandes e importantes y el principal componente de PUbMed que cubre las áreas de medicina, enfermería, odontología, veterinaria, sistemas de salud y ciencias preclínicas. La interfaz de PubMed permite realizar búsquedas, no solamente en Medline, sino también en otras 35 bases de datos del NCBI (Centro Nacional para la Información Biotecnológica). Medline fue desarrollado por la Biblioteca Nacional de Medicina de los Estados Unidos (NLM), que forma parte del Instituto Nacional de Salud (NIH). En esta sexta entrega de educación continua se describen la estructura, el funcionamiento y las características de los principales componentes de Medline/PubMed que permitirán al usuario realizar una búsqueda bibliográfica más eficiente.

MEDLINE / PubMed is one of the largest and most important biomedical bibliographic databases and the main component of PUbMed that covers the areas of medicine, nursing, dentistry, veterinary, health systems and preclinical sciences. The PubMed interface allows searching not only of Medline, but also of another 35 NCBI (National Center for Biotechnology Information) databases. Medline was developed by the National Library of Medicine of the United States (NLM), which is part of the National Institute of Health (NIH). This sixth edition of continuing education describes the structure, operation and characteristics of the main components of Medline / PubMed that will allow the user to perform a more efficient bibliographic search.

Carga de enfermedad en años de vida ajustados por discapacidad del cáncer gástrico en Colombia / Disease Burden of Gastric Cancer in Disability-Adjusted Life Years in Colombia

Resumen Objetivo: el cáncer gástrico es la segunda causa de muerte por cáncer y la quinta neoplasia más frecuente en el mundo. En Colombia, es la primera causa de mortalidad por cáncer. La incidencia y mortalidad anuales son 16,3 y 14,2/100 000 habitantes, respectivamente. El objetivo de este estudio fue estimar su carga de enfermedad, medida en años de vida ajustados por discapacidad (AVAD), en Colombia. Métodos: se desarrolló un estudio con enfoque en prevalencia para el año 2014. Para estimar la prevalencia, se realizó una búsqueda en los registros del Sistema de Información en Protección Social (SISPRO) y el Departamento Administrativo Nacional de Estadística (DANE). La duración promedio de los casos prevalentes y la sobrevida estimada se obtuvieron de la literatura local. Los AVAD fueron calculados sumando los años de vida perdidos por muerte prematura (AVPM) y los años de vida vividos con discapacidad (AVVD), según la metodología de la Organización Mundial de la Salud (OMS). Resultados: las prevalencias estimadas para 5 años en población mayor de 15 años fueron 40,9/100 000 en mujeres y 62,5/100 000 en hombres. El total de AVAD fue 293,418, con una tasa de 623/100 000 habitantes, de los cuales el 97,4% corresponde a AVPM. La tasa de AVVD y AVPM para Colombia fue 16 y 607/100 000, respectivamente. Conclusiones: los datos obtenidos de SISPRO y el DANE estiman una alta carga de enfermedad en Colombia. Es necesaria la implementación de estrategias de detección temprana del cáncer para disminuir la carga de la enfermedad y mejorar el pronóstico de los pacientes.

Abstract Objective: Gastric cancer is the second most common cause of cancer death and the fifth most common neoplasm in the world. In Colombia, it is the leading cause of cancer mortality. The annual incidence and mortality are 16.3/100,000 and 14.2/100,000 inhabitants respectively. The aim of this study was to estimate the disease burden in Colombia as measured in disability-adjusted life years (DALYs). Methods: This study focuses on prevalence in 2014. To estimate prevalence, a search was made in the registries of the Social Protection Information System (SISPRO) and the National Administrative Department of Statistics (DANE). The average duration of cases and estimated survival were obtained from the local literature. DALYs were calculated by adding the years of life lost due to premature death (YLLs) and years of life lived with disability (YLD) according to the methodology of the World Health Organization (WHO). Results: Prevalences estimated for five years in the population older than 15 years were 40.9/100,000 for women and 62.5/100,000 for men. The total DALY was 293,418, with a rate of 623/100,000 inhabitants; 97.4% correspond to YLL. The YLD and YLL for Colombia were 16/100,000 and 607/100,000, respectively. Conclusions: Data obtained from SISPRO and DANE estimate a high disease burden in Colombia. It is necessary to implement early cancer detection strategies to reduce the burden of disease and improve patient prognosis.

The status quo and future prospects of the next generation sequencing technologies in clinical diagnostics / 中华检验医学杂志

During the past decade, tremendous progress has been made in terms of speed, read length, and throughput, along with a sharp reduction in per-base cost.Together, these advances democratized next generation sequence (NGS) and paved the way for the development of a large number of novel NGS applications in clinical diagnostics, especially in the field of non-invasive prenatal detection, rare genetic disease and cancer companion diagnostics.As technology advances, long-read single molecule sequencing began to emerge.Single cell, long-reads, transcriptome, and low cost will be the NGS direction.Due to the special nature of clinical testing, the current NGS clinical application system,including genetic counseling, testing standards, quality control, supervision, database construction etc, does not match the national conditions well and still faces a few challenges, needs to be constantly improved through the routine clinical practice in the future.

Review of the Registration in the Clinical Research Information Service

Clinical research registration is required in many countries to improve transparency of clinical research and to ensure subject safety. Developed in February 2010, the Clinical Research Information Service (CRIS) is an online registration system for clinical studies in Korea and one of the primary registries of the World Health Organization (WHO) International Clinical Trials Registry Platform. The present analysis investigated the characteristics of studies registered in the CRIS between February 2010 and December 2014. Data for the analysis were extracted from the CRIS database. As of December 31, 2014, 1,323 clinical studies were registered. Of these, 938 (70.9%) were interventional studies and 385 (29.1%) were observational studies. A total of 248 (18.7%) studies were funded by government sources, 1,051 (79.4%) by non-government sources, and 24 (1.8%) by both. The most frequently studied disease category based on the ICD-10 classification was the digestive system (13.1%), followed by the nervous system (9.4%) and musculoskeletal system (9.1%). Only 17.8% of the studies were registered prior to enrollment of the first subject. Comparing the number of registered or approved clinical studies between the CRIS, the Ministry of Food and Drug Safety, and ClinicalTrials.gov suggests that a considerable number of clinical studies are not registered with the CRIS; therefore, we would suggest that such registration should be the mandatory legal requirement.

Os dois vetores temporais de Nachtrãglichkeit no desenvolvimento da organização do ego: a importância do conceito para a simbolização dos traumas e ansiedades sem nome / The two vectors of Nachtrãglichkeit in the development of ego organizations: significance of the concept for the symbolization of nameless traumas and anxieties

O autor descreve o conceito freudiano de Nachtrãglichkeit como processo ativo que, por meio do significado, preenche a lacuna entre vicissitudes afetivas passadas e o presente cognitivo. Assim, confere-se simbolização posteriormente [nachtrãglich] a eventos traumáticos anteriores, que se tornam suscetíveis ao controle onipotente. Discutem-se os dois vetores temporais de Nachtrãglichkeit: o primeiro é um processo causal que opera em direção ao avanço do tempo contra o pano de fundo da realidade factual, enquanto o segundo é um movimento regressivo que permite a compreensão de cenas e fantasias inconscientes que ocorrem no nível do processo primário. Esse movimento temporal em duas partes foi observado e descrito por Freud anteriormente. Contudo, sua importância permaneceu por vezes oculta antes do estudo do Moisés. Foi ignorado principalmente nas traduções para francês e inglês, dando assim origem a uma compreensão unilateral do conceito, nas diversas culturas psicanalíticas, como deferred action ou après-coup. O estudo de Freud sobre Moisés aborda tanto os aspectos temporais de Nachtrãglichkeit, procurando não só reconstruir o evento passado em base causal determinista, mas também compreender a verdade subjetiva desse evento na transferência segundo a linha retroativa do tempo. O critério decisivo para a separação conceitual e clínica dos dois vetores temporais é o desenvolvimento da organização de ego e a capacidade de simbolização. Os dois vetores não devem ser separados em nível factual, assim como ambos os aspectos de Nachtrãglichkeit são essenciais para a compreensão dos processos inconscientes, combinando-se como fazem em uma relação de complementaridade circular.

The author describes Freud’s conception of Nachtrãglichkeit as an active process that bridges the gap between past affective vicissitudes and the cognitive present by way of meaning. Symbolization is thereby subsequently [nachtrãglich] conferred on early traumatic events, which thus become susceptible to omnipotent control. The two time vectors of Nachtrãglichkeit are discussed: the first is a causal process operating in the forward direction of time against the background of a factual reality, while the second is a backward movement that permits an understanding of unconscious scenes and phantasies taking place at primary-process level. This twofold temporal motion was observed and described by Freud early on. However, its significance often remained hidden prior to his study of Moses. It was mostly overlooked in English and French translations, thus giving rise to a one-sided understanding of the concept in the various psychoanalytic cultures, as either deferred action or après-coup. Freud’s Moses study addresses both temporal aspects of Nachtrãglichkeit, seeking not only to reconstruct a past event on a causal, deterministic basis, but also to understand the subjective truth of that event in the transference along the retrograde time line. The decisive criterion for the conceptual and clinical separation of the two time vectors is the development of ego organization and the capacity for symbolization. The two vectors should not be separated on the factual level, as both aspects of Nachtrãglichkeit are essential to the understanding of unconscious processes, combining as they do in a relationship of circular complementarity.

El autor describe el concepto freudiano de Nachtrãglichkeit como un proceso activo que por medio del significado rellena las lagunas entre vicisitudes afectivas pasadas y el presente cognitivo. De esta manera, la simbolización se confiere con posterioridad [Nachtrãglich] a los sucesos traumáticos anteriores, pasando a ser susceptibles al control omnipotente. Se debate sobre dos vectores temporales de Nachtrãglichkeit: el primero se refiere a un proceso causal que opera en dirección al avance del tiempo contra la tela de fondo de la realidad factual, mientras que el segundo alude a un movimiento regresivo que permite la comprensión de escenas y fantasías inconscientes que ocurren en un nivel de proceso primario. Ese movimiento temporal que ocurre en dos partes fue anteriormente observado y descripto por Freud. Mientras tanto, su importancia permaneció oculta antes del estudio de Moisés. Principalmente fue ignorado en las traducciones para el francés e inglés, originando una comprensión unilateral del concepto en las diversas culturas psicoanalíticas, como deferred action o après-coup. El estudio de Freud sobre Moisés aporta tanto los aspectos temporales del Nachtrãglichkeit, buscando no solamente reconstruir los sucesos del pasado con una base causal determinista, sino comprender la verdad subjetiva de este acontecimiento en la transferencia según la línea retroactiva del tiempo. El criterio decisivo para la separación conceptual y clínica de los dos vectores temporales es el desarrollo de la organización del yo y la capacidad de simbolización. Los dos vectores no deben ser separados en nivel factual, así como los dos aspectos del Nachtrãglichkeit son esenciales para la comprensión de los procesos inconscientes, combinándose como sucede en una relación de complementariedad circular.

Classificação de microáreas de risco com uso de mineração de dados / Classification of risk micro-areas using data mining

Objetivo: Identificar, com o auxílio de técnicas computacionais, regras referentes às condições do ambiente físico para a classificação de microáreas de risco. Métodos: Pesquisa exploratória, desenvolvida na cidade de Curitiba, PR, em 2007, dividida em três etapas: identificação de atributos para classificar uma microárea; construção de uma base de dados; e aplicação do processo de descoberta de conhecimento em base de dados, por meio da aplicação de mineração de dados. O conjunto de atributos envolveu as condições de infra- estrutura, hidrografia, solo, área de lazer, características da comunidade e existência de vetores. A base de dados foi construída com dados obtidos em entrevistas com agentes comunitários de saúde, sendo utilizado um questionário com questões fechadas, elaborado com os atributos essenciais, selecionados por especialistas. Resultados: Foram identificados 49 atributos, sendo 41 essenciais e oito irrelevantes. Foram obtidas 68 regras com a mineração de dados, as quais foram analisadas sob a perspectiva de desempenho e qualidade e divididas em dois conjuntos: as inconsistentes e as que confirmam o conhecimento de especialistas. A comparação entre os conjuntos mostrou que as regras que confirmavam o conhecimento, apesar de terem desempenho computacional inferior, foram consideradas mais interessantes. Conclusões: A mineração de dados ofereceu um conjunto de regras úteis e compreensíveis, capazes de caracterizar microáreas, classificando-as quanto ao grau do risco, com base em características do ambiente físico. A utilização das regras propostas permite que a classificação de uma microárea possa ser realizada de forma mais rápida, menos subjetiva, mantendo um padrão entre as equipes de saúde, superando a influência da percepção particular de cada componente da equipe.

Como realizar ensaios clínicos em terapia intensiva utilizando base de dados de alta qualidade: [revisão] / How to conduct clinical research studies using high quality-clinical databases in the critical care: [review]

As fontes de informação relacionadas à terapia intensiva e os meios de comunicá-la aumentam rapidamente. Neste artigo, apresentamos um panorama geral sobre o que deve ser feito para obter dados de alta qualidade nas unidades de terapia intensiva. Os princípios para a escolha da questão clínica da pesquisa, os desfechos, as variáveis explanatórias e os métodos estatísticos a serem utilizados para abordar a questão são comentados de forma geral, com ênfase nos erros e ciladas mais freqüentes que devem ser evitados.

The sources of intensive care-related information and the means of communication increase rapidly. We presented here an overview of what should be done to collect high quality database. In a second part, the principle of the choice of the research question, the outcome, the explanatory variables and the statistical methods to address the question are overviewed, emphasizing major and frequent pitfalls which should be avoided.

Relationship between discomfort experience and factual recollection in patients of intensive care unit / 中国实用护理杂志

Objective To analyze the correlation of discomfort experience and factual recollection (FR) in patients of intensive care unit (ICU). Methods Fifty-five ICU patients and 63 ward patients par-ticipated in the study. Standardized questionnaires were used to evaluate all patients" FR and the results underwent analysis. Results The prevalence of recollection of any type of discomfort in the ICU patients was 64%. The presence of an endotracheal tube, pain and hallucinations were identified as sources of dis-comfort.The median score for FR in the ICU patients was 7.25. The median score for FR in the ward pa-tients was 13.50. The difference between them was highly significant (t =3.34, P < 0.01 ). Logistic analysis revealed that discomfort, especially discomfort caused by the presence of an endotracheal tube, pain and hallucinations, was positively related to FR, 0R95%CI (1.2～2.1), P < 0.01. Conclusions The presence of an endotracheal tube, pain and hallucinations were most frequently reported as sources of discomfort in ICU patients and their memory was often impaired. FR and recollection of discomfort appear to be related significantly in ICU patients.

Analysis of the Effect of Dietitians' Work Behavior and Organizational Environment on Quality of Hospital Dietary Services

The purpose of this study was to explore the variables affecting the quality of hospital dietary services. The quality of hospital dietary services was inverstigated in two ways, which can be named by factual quality and perceived quality The variables affecting hospital dietary services were classified into two categories [organizational environment variables] and [work behavior variables]. Quality readiness survey was conducted to investigate [organizational environment variables] and [Work behavior variables] on 225 dietitians working in dietary departments of 45 general hospitals which had more than 400 beds. [organizational environment variables] were categorized into four variable group:'organizational work design', 'organizational culture', 'department head leadership' and 'top management leadership'. [work behavior variables] were categorized into three variable group: 'individual behavior', 'peer group behavior', and 'behavior toward supervisor'. Top management leadership (p< 0.01)' in the [organizational environment variables] had significant impacts on the factual quality of hospital dietary services.

Desenvolvimento e implementação de um Banco de Dados Informatizado em nefrologia pediátrica / Development an d implementation database system in pediatric nephrology

Advances in computer technology have made possible to store large amounts of data concerning management of patients with chronic medical disorders. This article describes our experience in the development and implementation database system specif- ically designed for the Division of Pediatric Nephrology. Its basic structure and main functions are related. Until now 17.5 percent (1,090/6,200) of the patients of the Pediatric Nephrology Unit have been inserted in it. Most frequent caus- es for the forwarding were the evaluation of urinary infection (410 - 37,6 percent) and Glomerulopathies (350 - 32.1 percent). From the urinary infection cases, 311 (76 percent) were confirmed, out of them 255 (72 percent) had some abnormalities of the urinary tract. From the glomerulopathy cases, 300 (85.7 percent) were confirmed, being minimal lesions nephrotic syndrome the most frequent cause. Database can be easily deal with. Specific skills in computer programming and systern handling are nor needed. The pro- gram has proved effective to proposed objectives, allowing an analysis of casuisty under many aspecrs concerned to Pediatric Nephrology.

Os avanços na tecnologia em informática têm permitido o armazena- mento de imensa quantidade de dados relacionados ao manuseio de pacientes portadores de doenças crônicas. Esse artigo descreve nossa experiência no desenvolvimentoe implementação de banco de dados especificamente elaborado para uma Unidade de Nefrologia Pediátrica. O sistema básico e suas principais funções são inscritos na Unidade. Até o presente momento foram inseridos 17,5 por cento (1.090/6.200) dos pacientes inscritos na Unidade. Os motivos mais freqüentes de encaminhamento na amostra estudada foram: avaliação de infecção urinária - 410 (37,6 por cento), seguida de glomerulopatias - 350 (32,1 por cento). Dos casos de infecção urinária, 311 (76 por cento) foram confirma- dos, sendo 255 (72 por cento) portadores de uropatias. Dos casos de glome- rulopatia, 300 (85,7 por cento) foram confirmados, a causa mais crescente foi a síndrome nefrótica por lesões mínimas. O banco de dados descrito pode ser facilmente manipulado, não exigindo habilidade em programação e tão pouco grande experiência em informática. O programa tem se demonstrado eficaz para os objetivos propostos, permitindo uma análise da casuística sob os mais diversos aspectos referentes a Nefrologia Pediátrica.