Performance of the Alice PDx Device With the Somnolyzer Automated Scoring Algorithm for the Diagnosis of Obstructive Sleep Apnea.

Objective Automated scoring of respiratory events could allow a swifter obstructive sleep apnea (OSA) identification. We assessed the accuracy of the Alice PDx device with the Somnolyzer automated scoring algorithm, compared to the manually reviewed scoring by a trained sleep technician, for the diagnosis of OSA. Methods A prospective study was conducted between March 2021 and March 2022 in Centro Hospitalar do Baixo Vouga, a level 2 hospital in Aveiro, Portugal. Patients with high pre-test probability for OSA performed a type III home sleep apnea testing with the Alice PDx device. Data were scored automatedly by the Sleepware G3 with the Somnolyzer digital system and manually by a trained sleep technician. Correlation and dependent t-tests were used. Sensitivity, specificity, positive predictive values (PPVs), negative predictive values (NPVs), and area under the receiver operating characteristic curve (AUROC) of automated scoring were calculated. Data were analyzed using the Stata Statistical Software (Release 17, StataCorp., 2023, College Station, TX: StataCorp LLC). Results In 150 participants (mean age 57.8 ± 13.9 years), the mean apnea-hypopnea index (AHI) was 21.9 ± 21.8 events/hour by manual scoring and 25.4 ± 21.6 events/hour by automated scoring. The mean difference was 3.4 ± 4.4 events/hour, and a strong, positive, linear correlation was found between the two scores (r = 0.98). At the altered AHI (AHI ≥ 5 events/hour), mild, moderate, and severe OSA, the automated scoring sensitivity/specificity values were 91.2%/100.0%, 80.0%/68.6%, 91.6%/41.9%, and 98.1%/80.9%, respectively. The PPVs/NPVs for the same categories were 100.0%/69.4%, 89.3%/51.1%, 79.7%/66.7%, and 91.8%/95.0%, respectively. Finally, the AUROC was 0.85, 0.70, 0.73, and 0.93, respectively. Conclusion The automated scoring obtained from the Alice PDx portable device, using Sleepware G3 with the Somnolyzer digital system, seems accurate enough to diagnose OSA and validate the initiation of PAP therapy in the correct clinical setting. Nevertheless, it does not replace manual reviewing by a trained sleep technician in the case of mild and moderate OSA, to obtain a correct severity classification. With this valuable time-saving tool, we expect to hasten OSA diagnosis and treatment and thus tackle the underdiagnosis problem.

Uncertainty deconstructed: conceptual analysis and state-of-the-art review of the ERP correlates of risk and ambiguity in decision-making.

Risk and uncertainty are central concepts of decision neuroscience. However, a comprehensive review of the literature shows that most studies define risk and uncertainty in an unclear fashion or use both terms interchangeably, which hinders the integration of the existing findings. We suggest uncertainty as an umbrella term that comprises scenarios characterized by outcome variance where relevant information about the type and likelihood of outcomes may be somewhat unavailable (ambiguity) and scenarios where the likelihood of outcomes is known (risk).These conceptual issues are problematic for studies on the temporal neurodynamics of decision-making under risk and ambiguity, because they lead to heterogeneity in task design and the interpretation of the results. To assess this problem, we conducted a state-of-the-art review of ERP studies on risk and ambiguity in decision-making. By employing the above definitions to 16 reviewed studies, our results suggest that: (a) research has focused more on risk than ambiguity processing; (b) studies assessing decision-making under risk often implemented descriptive-based paradigms, whereas studies assessing ambiguity processing equally implemented descriptive- and experience-based tasks; (c) descriptive-based studies link risk processing to increased frontal negativities (e.g., N2, N400) and both risk and ambiguity to reduced parietal positivities (e.g., P2, P3); (d) experience-based studies link risk to increased P3 amplitudes and ambiguity to increased frontal negativities and the LPC component; (e) both risk and ambiguity processing seem to be related with cognitive control, conflict monitoring, and increased cognitive demand; (f) further research and improved tasks are needed to dissociate risk and ambiguity processing.

Usability Assessment of Moodle by Brazilian and Portuguese Nursing Students.

Distance education has turned into an important tool for nursing education. The virtual learning environments contribute toward an interactive and attractive educational process. In this study, we assess the usability of a virtual learning environment that was developed to teach nursing students how to care for patients with urinary retention. A multicenter and descriptive study was undertaken, which involved nursing students from the University of São Paulo at Ribeirão Preto College of Nursing, Brazil, and the Escola Superior de Enfermagem de Coimbra, Portugal. The participants were 79 students, mostly female, between 20 and 24 years of age. The virtual learning environment revealed good properties in terms of usability on most criteria. Future research will help to confirm the results.

Análise comparativa entre a Terapia Cognitivo-Comportamental e a Terapia do Esquema / Comparative analysis between Cognitive-Behavioral Therapy and Scheme Therapy

O presente estudo objetiva prover uma análise comparativa entre duas abordagens terapêuticas com o intuito de clarificar suas semelhanças e diferenças. Uma das características fundamentais das primeiras abordagens da Terapia Cognitivo-Comportamental (TCC) é basicamente o trabalho com estruturas mais racionais da cognição, tornando-se, dessa forma, menos eficaz frente a pacientes com problemas caracterológicos mais complexos ou com transtornos de personalidade. A Terapia do Esquema (TE) foi desenvolvida por Jeffrey Young, considerada uma expansão da teoria inicial da TCC de curto prazo, a qual compartilha diversos elementos que caracterizam a TCC. A proposta da TE é de aperfeiçoar o modelo cognitivo com o objetivo de ampliar e criar novas estratégias de tratamento para pacientes crônicos, mais rígidos, e que não respondem satisfatoriamente ao tratamento cognitivo padrão. A TE foca no desenvolvimento e manutenção dos esquemas, principalmente naqueles formados na primeira infância. Dada a carência de textos acadêmicos, nos quais a TCC e a TE são comparadas e analisadas, propõe-se este artigo visando ao esclarecimento de dúvidas diferenciais entre as duas abordagens. Levando em consideração o que foi exposto acima, a presente revisão bibliográfica de artigos publicados em bases de dados e livros técnicos teve como objetivo desenvolver uma análise comparativa entre a TCC e a TE e as suas aplicações ao longo dos tempos, avaliando o desenvolvimento histórico com uma investigação da aplicabilidade de ambas as terapias e os transtornos psicológicos que melhor aderem aos seus tratamentos.(AU)

The present study aims to provide a comparative analysis between two therapeutic approaches in order to clarify their similarities and differences. One of the fundamental characteristics of the first approaches of Cognitive-Behavioral Therapy (CBT) is basically the work with more rational structures of cognition, thus becoming less effective in patients with more complex characterological problems or with personality disorders. Schema Therapy (TE) was developed by Jeffrey Young as an expansion of the early theory of short-term CBT, which shares several elements that characterize CBT. The ET proposal is to improve the cognitive model with the objective of broadening and creating new treatment strategies for chronic patients, which are more rigid and do not respond satisfactorily to standard cognitive treatment. TE has a focus on the development and maintenance of schemes, especially those formed in early childhood. Given the lack of academic texts in which CBT and TE are compared and analyzed, this article is proposed in order to clarify the differential doubts between the two approaches. Taking into account the above, this bibliographic review of articles published in databases and technical books aimed to develop a comparative analysis between CBT and ET and its applications over time evaluating the historical development with an investigation The applicability of both therapies and the psychological disorders that best adhere to their treatments.(AU)

Development of the e-Baby serious game with regard to the evaluation of oxygenation in preterm babies: contributions of the emotional design.

The present study aimed to describe the development process of a serious game that enables users to evaluate the respiratory process in a preterm infant based on an emotional design model. The e-Baby serious game was built to feature the simulated environment of an incubator, in which the user performs a clinical evaluation of the respiratory process in a virtual preterm infant. The user learns about the preterm baby's history, chooses the tools for the clinical evaluation, evaluates the baby, and determines whether his/her evaluation is appropriate. The e-Baby game presents phases that contain respiratory process impairments of higher or lower complexity in the virtual preterm baby. Included links give the user the option of recording the entire evaluation procedure and sharing his/her performance on a social network. e-Baby integrates a Clinical Evaluation of the Preterm Baby course in the Moodle virtual environment. This game, which evaluates the respiratory process in preterm infants, could support a more flexible, attractive, and interactive teaching and learning process that includes simulations with features very similar to neonatal unit realities, thus allowing more appropriate training for clinical oxygenation evaluations in at-risk preterm infants. e-Baby allows advanced user-technology-educational interactions because it requires active participation in the process and is emotionally integrated.

[Virtual learning environment: script structure of an online course]. / Ambiente virtual de aprendizagem: estruturação de roteiro para curso online.

This study describes the steps for developing a course and its structure in the Virtual Learning Environment Moodle. It consisted of an application of nursing content offered in an online course included in an international workshop directed to a group of nursing students from a bachelor and a teaching diploma program in Brazil and Portugal. Distinct stages were identified during the study: planning, construction and transformation of content as well as availability of such content to students. The interactive activities and context were developed by professors with the participation of the technical team. The specific procedures and roles performed by professors, specialists, students and technicians are presented. The results of the development and offering of the online course appointed some aspects to be improved in the work process such as the format of content and use of tools.

Ambiente virtual de aprendizagem: estruturação de roteiro para curso online / Virtual learning environment: script structure of an online course / Ambiente virtual de aprendizaje: estructuración de guión para curso online

O presente trabalho visa descrever os passos para desenvolvimento de um curso e sua estrutura em ambiente virtual de aprendizagem Moodle. Para tanto, a pesquisa consistiu na aplicação de conteúdos de enfermagem para oferecimento de curso online em workshop internacional para grupo de estudantes de graduação e licenciatura em enfermagem do Brasil e de Portugal. Durante a pesquisa foram registradas etapas distintas, desde o planejamento do curso passando pela construção e transformação dos conteúdos, até a disponibilização aos estudantes. As atividades interativas e conteúdos foram elaborados pelos professores com participação de equipe técnica. No trabalho são apresentados procedimentos específicos e papéis a serem desempenhados por professores, especialistas, estudantes e técnicos. Os resultados do desenvolvimento e oferecimento do curso online apontaram alguns aspectos a serem aperfeiçoados no processo de trabalho, no formato dos conteúdos e na utilização das ferramentas.

This study describes the steps for developing a course and its structure in the Virtual Learning Environment Moodle. It consisted of an application of nursing content offered in an online course included in an international workshop directed to a group of nursing students from a bachelor and a teaching diploma program in Brazil and Portugal. Distinct stages were identified during the study: planning, construction and transformation of content as well as availability of such content to students. The interactive activities and context were developed by professors with the participation of the technical team. The specific procedures and roles performed by professors, specialists, students and technicians are presented. The results of the development and offering of the online course appointed some aspects to be improved in the work process such as the format of content and use of tools.

La finalidad de este trabajo es describir los pasos para desarrollo de un curso y su estructura en ambiente virtual de aprendizaje Moodle. Para eso, la investigación comprendió la aplicación de contenidos de enfermería para ofrecimiento de curso online en oficina internacional para grupo de alumnos de pregrado y licenciatura en enfermería de Brasil y Portugal. Durante la investigación fueron registradas etapas distintas, desde la planificación del curso, incluyendo la construcción y transformación de contenidos, hasta su disponibilidad para los alumnos. Las actividades interactivas y contenidos fueron elaborados por los profesores con participación de equipo técnico. En el trabajo son presentados procedimientos y papeles que deben desempeñar los profesores, especialistas, alumnos y técnicos. Los resultados del desarrollo y ofrecimiento del curso online indicaron algunos aspectos que se debe perfeccionar en el proceso de trabajo, formato de los contenidos y en la utilización de las herramientas.

Development of educational software for teaching nursing management.

In Brazil, the first experiences using informatics in nursing education was in 1985. In spite of the time, this area still continues lacking in relation to initiatives using the computer as a pedagogic instrument. This study aim to demonstrate the development of an educational software for teaching nursing management using interactive multimedia. The methodology was based in the three stages Model for development of CAI system. The software was developed in four modules using the Macromedia Authorware Professional v.7. As conclusion, the educational software was well accepted by the faculty members, emerging positive comments on the developed product. The texts, graphs, sound and images favoring the teach-learning process. Since the educational software is developed for educating nursing students, the next step will be to sample students to measure their satisfaction.

Implantação de sistema de videoconferência aplicado a ambientes de pesquisa e de ensino de enfermagem / Implantación de sistema de videoconferencia aplicado a ambientes de investigación y de enseñanza de enfermería / Implantation of a videoconferencing system applied to nursing research and teaching environments

Descreve o caminho percorrido por um grupo de pesquisadores da Escola de Enfermagem de Ribeirão Preto-USP para implantação de um projeto de pesquisa/ensino/educação permanente baseado em tecnologia de videoconferência. Apresenta as características técnicas dos sistemas disponíveis no mercado e a descrição da solução tecnológica adotada no projeto, com vistas a atender as necessidades para o ambiente acadêmico e de investigação bem como no ambiente hospitalar.

Describes the trajectory followed by a research group at the Ribeirão Preto College of Nursing-USP to implant a research/teaching/continuous education project based on videoconferencing technology. The technical characteristics of the available systems are discussed, as well as the technological solution that was adopted in this project to attend to the needs of the academic and research environment as well as in the hospital context.

Describe el camino recorrido por un grupo de investigadores de la Escuela de Enfermería de Ribeirão Preto - USP para implantar un proyecto de investigación/enseñanza/educación permanente basado en la tecnología de videoconferencia. Fueron presentadas las características técnicas de los sistemas disponibles en el mercado y la descripción de la solución tecnológica adoptada en el proyecto con vistas a atender a las necesidades para el ambiente académico y de investigación y también para el ambiente hospitalario.

[Implantation of a videoconferencing system applied to nursing research and teaching environments]. / Implantação de sistema de videoconferência aplicado a ambientes de pesquisa e de ensino de enfermagem.

Describes the trajectory followed by a research group at the Ribeirão Preto College of Nursing-USP to implant a research/teaching/continuous education project based on videoconferencing technology. The technical characteristics of the available systems are discussed, as well as the technological solution that was adopted in this project to attend to the needs of the academic and research environment as well as in the hospital context.

Enseñar la administración de medicamentos con ayuda de la informática / To teach how to administrate medicines using computers as an aide

Se presenta el desarrollo de un programa instructivo computarizado (software educativo) sobre administración de medicamentos. Se describe la ayuda del ordenador como un recurso educativo en enfermería y las fases empleadas en el desarrollo y en la evaluación del programa. El programa presenta cinco módulos: 1. Instrucción general, 2. Evitando errores, 3. Vías, materiales e intervenciones, 4. Posibles complicaciones, 5. Orientaciones a los profesionales, además del módulo de cierre. El sistema tiene en total 27 tópicos de estudio, 7 tests de conocimiento, 17 vídeos y 34 fotos. La evaluación fue efectuada por 24 alumnos del curso de Pre-grado en Enfermería. Los resultados fueron positivos con algunas sugerencias para el perfeccionamiento del programa. Se concluyó que este estudio representó un salto en la enseñanza, en la medida en que propone una innovación tecnológica, por la posibilidad de desarrollo futuro y por la actualidad del tema y del instrumento para el área (AU)

Diagnóstico, prevençäo e tratamento precoce para hábitos bucais deletérios / Diagnosis, prevention and premature treatment for harmful mouth habits

O presente artigo tem por objetivo descrever os Hábitos Bucais Deletérios e os modos como eles se instalam, a fim de fornecer ao ortodontista melhores meios de diagnosticá-los, previni-los e tratá-los precocemente

Diagnóstico, prevenção e tratamento precoce para hábitos bucais deletérios / Diagnosis, prevention and premature treatment for harmful mouth habits

O presente artigo, tem por objetivo descrever os hábitos deletérios bucais e os modos como eles se instalam, a fim de fornecer ao ortodontista melhores meios de diagnosticá-los, preveni-los e tratá-los precocemente