Experience Report Research Articles

Generative AI in the Software Modeling Classroom: An Experience Report With ChatGPT and Unified Modeling Language

Generative AI in the Software Modeling Classroom: An Experience Report With ChatGPT and Unified Modeling Language

ETHICAL DILEMMAS IN MEDICAL CARE FOR WOMEN IN SITUATIONS OF SOCIAL VULNERABILITY: EXPANDING THE DEBATE ON MARGINALIZED POPULATIONS IN EDUCATION

This paper addresses reflections and discussions on the female figure in the context of social marginalization, linked to threats to human rights, with a focus on access to health care and quality longitudinal monitoring. This debate analyzes the historical process of marginalization and oppression amplified when women are inserted as street dwellers, enhancing the weaknesses of helplessness and substance abuse, thus aggravating violence and stigma. This is a narrative review of literature, of a reflective nature, associated with a report of an educational experience in the construction of a teaching methodology based on a fictitious case that triggers discussion and resolution of problems linked to human rights violations of marginalized women, in the light of philosophies of law and the study of public policies for undergraduate medical students. The development of the work shows the importance of expanding studies on this topic, focusing on historically invisible people, in a problematizing narrative, using the construction of clinical cases containing not only health needs for a resolution of medicalization, based strictly on biological diagnoses, but that challenge the reflective thinking of social medicine, directing the debate towards human rights lines, in a context of interprofessional dialogues and studies of public policies, as essential in the training of doctors committed to guaranteeing equity and access to the most neglected population segments in Brazil.

A REALIZAÇÃO DO PROGRAMA SAÚDE NA ESCOLA COMO FERRAMENTA PARA PROMOÇÃO DE EDUCAÇÃO EM SAÚDE DURANTE A FORMAÇÃO EM MEDICINA DE FAMÍLIA E COMUNIDADE: UM RELATO DE EXPERIÊNCIA

Introduction: The School Health Program (PSE), announced by the Ministry of Health in 2007, aims to promote health in partnership with educational institutions to improve the quality of life of the population, specifically school-aged children. This involves collaboration between health and education professionals, providing appropriate knowledge to reduce vulnerabilities that may compromise the development and the future of children and adolescents. Objective: To report the experience of a family medicine resident, part of a family health team (eSF) in the Federal District (DF), primarily promoting sexual education for children and adolescents in two public schools within the team's area of coverage. Methodology: This is a descriptive and qualitative study, of the experience report type, conducted during the two years of residency in Family and Community Medicine, from 2023 to 2024, in the satellite city of Sobradinho, Federal District. Results: The students involved, aged between 9 and 12 years, showed great interest in the topics addressed regarding sexuality and hygiene habits, adopting a participatory attitude, engaging in the exchange of experiences, raising questions, and discussing the subjects covered in the meeting and topics detailed in the adolescent health booklet. Conclusion: The necessity of partnership between health teams and education professionals was evident to provide health promotion, especially focused on sexual education, aiming to reduce negative outcomes and minimize future social and health damages in the vulnerable population of the DF.

VALUATION OF ETHNIC-CULTURAL IDENTITY: COMPARATIVE ANALYSIS OF EXPERIENCE REPORTS ON VISITS TO QUILOMBOS IN THE STATE OF PARÁ AND RIO DE JANEIRO

The article "Valorization of Ethnic-Cultural Identity: comparative analysis of experience reports during visits to quilombos in the states of Pará and Rio de Janeiro" analyzes visits to quilombola communities, comparing the realities of two states. In Pará, the quilombola communities of Perpétuo Socorro do Tauerá, São Raimundo do Taperú and Maripí face a lack of cultural appreciation, especially among the younger generations, who tend to reject or be unaware of their Afro-descendant heritage. On the other hand, the quilombo of São José da Serra, in Rio de Janeiro, shows a strong connection with Afro-Brazilian culture and identity, valuing traditions and memory. The research addresses the importance of educational actions in the quilombola communities of Pará to rescue and strengthen ethnic-cultural identity, proposing measures such as teacher training and the inclusion of practical activities based on Afro-Brazilian history and culture, following the National Curricular Guidelines. The technical visits carried out by pedagogy students allowed a detailed analysis of the cultural dynamics and challenges faced, highlighting the need for integration between school and community to rescue these traditions. It is suggested that strengthening relationships between younger and older generations, through discussion groups and cultural practices, could help reverse the process of denying Afro-Brazilian identity. The valorization of emotional intelligence in interpersonal relationships within the school is also highlighted as fundamental to the success of these initiatives, promoting a positive and respectful organizational climate.

INSERTION OF BADMINTON IN SCHOOL PHYSICAL EDUCATION: EVALUATION AND ANALYSIS

This article is an integrative review that synthesizes and analyzes data from four scientific papers collected from the Scielo database, using the descriptors ‘Methodology,’ ‘Method,’ ‘Badminton as a subject,’ ‘School sport.’ Ten papers were analyzed: one of the studies was carried out in Portuguese public elementary schools; the others in Brazil: in a municipal public school in Natal/RN, Brazil, one that shows badminton as an integral part of the body culture of movement and, the last one, is an experience report of an intervention of the practice of Badminton for primary schools students in Iranduba- AM, with the objectives of synthesizing and analyzing the Insertion of the Net Sport Badminton in School Physical Education Classes. This integrative review enabled the construction of a synthesis of scientific knowledge about a new form of interaction between students and teachers, yielding new attitudinal values for both and inclusion, as well as demonstrating the broad contribution of the Badminton Net Sport in School Physical Education Classes to the improvement and dynamism of School Physical Education classes.

PROMOVENDO O BEM-ESTAR PSICOLÓGICO: ESTRATÉGIAS DE PREVENÇÃO DE DEPRESSÃO EM IDOSOS DE 60 A 80 ANOS

Aging is a normal and natural phase of society's development, deeply linked to health and illness conditions, and influenced by neurobiological, genetic, functional, and sociocultural factors. Quality of life plays a central role in characterizing aging as healthy or pathological, making it clear that an individual's psychological health is a result of the context in which he or she lives. Therefore, this study aimed to analyze the nursing strategies adopted to prevent depression in elderly individuals aged 60 to 80 years. This is a narrative review study, carried out through research in the Virtual Health Library (VHL) and Google Scholar, using the following descriptors: depression AND elderly AND nursing AND prevention. The eligibility criteria adopted were: complete works that addressed the topic between the years 2019 and 2024. Dissertations, theses, theoretical essays, and experience reports were excluded. In the end, eight studies were selected. Among the strategies used by nurses, the following are mentioned: encouraging the maintenance of Activities of Daily Living (ADLs); encouraging the active participation of the social support network; keeping the home environment well ventilated; cleaning and disinfecting frequently touched surfaces, such as bed headboards, remote controls, doorknobs, cell phones and canes, with 70% alcohol; and promoting a healthy diet, accompanied by good fluid intake, as priority measures to reduce the chances of contamination by COVID-19. Thus, it is concluded that health professionals need to redefine the provision of care and attention to the elderly in health services, in addition to promoting the training of the nursing team to meet gerontological needs more adequately.

RELATO DE EXPERIÊNCIA: UM OLHAR HUMANIZADO COM PACIENTES ONCOLÓGICOS PEDIÁTRICOS NO SETOR DA ENFERMARIA

The objective of this work is to report the experience and describe the monitoring of pediatric oncology patients during their hospitalization carried out during the Mandatory Supervised Curricular Internship I. This is a descriptive, qualitative study of the experience report type, about the experience of the student covering the description of the discipline, internship field, activities carried out, challenges and personal and professional impact during the monitoring of pediatric oncology patients during their hospitalization, in the Mandatory Curricular Internship (ECS) l in the ninth period of the Nursing degree. The practice of supervised internship in health is a crucial stage in the academic training and professional development of students. Provides valuable opportunities to develop practical skills and apply theoretical knowledge in real situations. The work experience in the pediatrics sector also contributed to broadening their perspectives for a possible follow-up in the area and improving skills such as critical and reflective reasoning, decision-making and leadership, which are important for success in professional life.

Co-creation and urban transformation: the application of design thinking for participatory solutions in Rio Tavares, Florianópolis

Cities face increasingly complex challenges that demand innovative and collaborative solutions. The lack of participatory urban planning and the need for more humanized approaches have generated negative impacts on the quality of life, including the loss of cultural identity, inadequate urban mobility, and environmental damage. This article analyzes the application of Design Thinking, focusing on the immersion and analysis stages, within a participatory urban transformation process in the Rio Tavares neighborhood of Florianópolis, Brazil. This growing neighborhood faces challenges such as the lack of urban infrastructure and the need for preserving cultural and environmental heritage. This study investigates how Design Thinking can engage the community in identifying and understanding these problems, promoting empathy, and gaining a clear understanding of local needs. The research employed an experience report methodology with data collection through a participatory mural at two cultural events held in the neighborhood. The results revealed the main challenges faced by the neighborhood and highlighted the importance of citizen participation in the urban transformation process.

Sentiment analysis in medication adherence: using ruled-based and artificial intelligence-driven algorithms to understand patient medication experiences.

Studies are exploring ways to improve medication adherence, with sentiment analysis (SA) being an underutilized innovation in pharmacy. This technique uses artificial intelligence (AI) and natural language processing to assess text for underlying feelings and emotions. This study aimed to evaluate the use of two SA models, Valence Aware Dictionary for Sentiment Reasoning (VADER) and Emotion English DistilRoBERTa-base (DistilRoBERTa), for the identification of patients' sentiments and emotions towards their pharmacotherapy. A dataset containing 320,095 anonymized patients' reports of experiences with their medication was used. VADER assessed sentiment polarity on a scale from - 1 (negative) to + 1 (positive). DistilRoBERTa classified emotions into seven categories: anger, disgust, fear, joy, neutral, sadness, and surprise. Performance metrics for the models were obtained using the sklearn.metrics module of scikit-learn in Python. VADER demonstrated an overall accuracy of 0.70. For negative sentiments, it achieved a precision of 0.68, recall of 0.80, and an F1-score of 0.73, while for positive sentiments, it had a precision of 0.73, recall of 0.59, and an F1-score of 0.65. The AUC for the ROC curve was 0.90. DistilRoBERTa analysis showed that higher ratings for medication effectiveness, ease of use, and satisfaction corresponded with more positive emotional responses. These results were consistent with VADER's sentiment analysis, confirming the reliability of both models. VADER and DistilRoBERTa effectively analyzed patients' sentiments towards pharmacotherapy, providing valuable information. These findings encourage studies of SA in clinical pharmacy practice, paving the way for more personalized and effective patient care strategies.

Microaggressions among staff in higher education: Examining differences by social identities, and the association with job satisfaction

Microaggressions are everyday slights or insults directed toward members of marginalized groups; microaggressions are harmful, even if unintentional, and they occur in various contexts including the workplace. However, there is limited research on microaggressions among staff in higher education. The first aim of this study was to obtain systematic reports of experiences of microaggressions and other forms of discrimination among staff at a large public university. The second aim was to test for differences in these experiences as a function of staff members’ race/ethnicity, gender identity, sexual orientation, and disability status. A third aim was to examine whether microaggression and discrimination predicted job satisfaction. Web-based survey data were collected from a diverse sample of 680 university staff members. The survey included adapted versions of two scales on microaggressions and standard measures of everyday and workplace discrimination. Results indicated that experiences of microaggressions and discrimination were common among staff, and differed by race/ethnicity, gender identity, sexual orientation, and disability status, with those of marginalized identities reporting significantly more negative experiences. Finally, more frequent experiences of microaggressions and workplace discrimination predicted lower job satisfaction. These findings indicate a need for education on microaggressions pertaining to campus climate improvement in institutions of higher education.

The Singular Therapeutic Project As A Learning And Comprehensive Care Tool: Experience Report On The Management Of Chronic Pain In An Elderly Patient

Background: Chronic pain is a complex condition that affects patients physically, emotionally, and socially. Addressing it effectively in primary care requires a holistic approach that integrates non-pharmacological and pharmacological strategies. The Singular Therapeutic Project (STP) enables personalized, patient-centered care through multidisciplinary collaboration. Aim: This experience report aims to describe the practical learning experience of medical students implementing a STP for a patient with chronic pain, highlighting the impact on care and medical education. Experience Report: During the second semester of 2024, medical students from Bragança, Pará, engaged in home visits through the STP framework under faculty supervision. These visits facilitated an expanded understanding of the patient’s clinical and psychosocial context using tools such as genograms, ecomaps, and functional assessments. Students applied interventions to manage chronic pain and address barriers to medication adherence. Additionally, collaboration with the healthcare team ensured adjustments to care based on the patient’s evolving needs, promoting reintegration into physical activities. Conclusion: The implementation of the STP fostered practical and humanized learning by emphasizing empathy, teamwork, and communication skills. This approach strengthened the students' understanding of primary healthcare, enabling the development of professional competencies essential for managing complex patient cases and contributing to the patient’s improved quality of life.

Applying SOLID principles for the refactoring of legacy code: An experience report

The presence of technical debt in legacy systems is an inevitable consequence of years of development. Metrics play a significant role in informing the prioritisation process of maintenance activities to reduce this debt. However, it is important to note that not all metrics are equally important or readily available in real industrial settings.This paper summarises an experience report of refactoring activities performed at a Dutch partnering company, aimed at identifying, prioritising and repaying parts of the architectural technical debt accumulated in two decades of development.Given the size of the refactoring task, a data-driven prioritisation was necessary, and based on the impact that the maintenance activity would have on the base system. However, the metrics available from the monitoring of the system formed a limited set, and were not always focused on architectural aspects. Even so, the impact analysis was performed and resulted in the selection of a subset of components that needed urgent maintenance.The refactoring of the identified components was centred around the well-known SOLID design principles, particularly the Dependency Inversion (DI) principle. Additionally, a set of recurring actions was established into ‘refactoring patterns’ and systematically applied to more than 5,000 source, header and custom domain language files.This work, albeit limited to the period where the activity was planned for, was well received by the industrial collaborator. The patterns have proven very valuable in the process of maintaining such a large project scope. The data-driven approach and the identified patterns have helped the team navigate this large space and consistently refactor similar architectural issues that fall under the same category.

207P Mobile muscle clinics operating from a UK centre of excellence: report of patient experience and quality of care

207P Mobile muscle clinics operating from a UK centre of excellence: report of patient experience and quality of care

Supporting evidence-based judicial decisions on health care in Brazil: an experience report

Objective: The main objective of this study is to report on the implementation and results of the “Supporting Health-Related Judicial Decisions in Brazil” project conducted at the Health Technology Assessment Center, Hospital Sírio-Libanês through the “Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde”, in Brazil. Methods: This study is an experience report of a project conducted at the Health Technology Assessment Center, Hospital Sírio-Libanês. Results: The activities of the project occurred in 2023 and included two online training courses on primary studies and systematic reviews, 11 one-day workshops with technical-scientific content for members of the Technical Support Centers for the Judiciary (NATJus), 40 online technical-scientific consultations for magistrates on a digital platform, 11 technical-scientific reports addressing the most legally claimed technologies in Brazil; two methodological tools, a national forum (hybrid event), 10 chat-based mentorships for NATJus members; and the maintenance of an open-access blog, by publishing news on relevant topics on law and health. Discussion and conclusion: This project has contributed to the improvement of the judicial decision-making process by providing a range of activities aimed at aiding the prioritization of health technologies that are clearly effective and safe over those that are ineffective, harmful, or have uncertain effects. Submission: 04/09/24| Review: 06/29/24| Approval: 08/18/24

Accelerating a learning public health system: Opportunities, obstacles, and a call to action.

Public health systems worldwide face increasing challenges in addressing complex health issues and improving population health outcomes. This experience report introduces the concept of a Learning Public Health System (LPHS) as a potential solution to transform public health practice. Building upon the framework of a Learning Health System (LHS) in healthcare, the LPHS aims to create a dynamic, data-driven ecosystem that continuously improves public health interventions and policies. This report explores the definition, benefits, challenges, and implementation strategies of an LPHS, highlighting its potential to revolutionize public health practice. This report employs a comparative analysis approach, examining the similarities and differences between an LPHS and an LHS. It also identifies and elaborates on the potential benefits, challenges, and barriers to implementing an LPHS. Additionally, the study investigates promising national initiatives that exemplify elements of an LPHS in action. An LPHS integrates data from diverse sources to inform knowledge generation, policy development, and operational improvements. Key benefits of implementing an LPHS include improved disease prevention, evidence-informed policy-making, and enhanced health outcomes. However, several challenges were identified, such as interoperability issues, governance concerns, funding limitations, and cultural factors that may impede the widespread adoption of an LPHS. Implementation of an LPHS has the potential to significantly transform public health practice. To realize this potential, a call to action is issued for stakeholders across the public health ecosystem. Recommendations include investing in informatics infrastructure, prioritizing workforce development, establishing robust data governance frameworks, and creating incentives to support the development and implementation of a LPHS. By addressing these key areas, public health systems can evolve to become more responsive, efficient, and effective in improving population health outcomes.

Clinical outcomes of peripherally inserted central catheters in patients with gastroenterological diseases: Report of a 9-year experience.

Peripherally inserted central catheters (PICCs) are safe and useful alternatives to centrally inserted central catheters (CICCs). Several studies have investigated the effectiveness and safety of PICCs; however, few have focused on their use in patients with gastroenterological diseases. In the present study, we evaluated the outcomes of patients with gastroenterological diseases who received PICCs and identified the risk factors associated with central line-associated blood stream infection (CLABSI). We retrospectively examined hospitalized patients at our institution who received PICCs between 2015 and 2023. We evaluated the data on their clinical characteristics, complications, and outcomes. Furthermore, we investigated the risk factors for CLABSIs. A total of 405 patients were included (262 men and 143 women). The median age was 71 (range, 15-94) years. The vessels were inserted in the basilic, cephalic, and brachial veins in 366 (90%), 22 (6%), and 17 (4%) patients, respectively. The median procedure time was 32 [6-149] min. The median dwell time was 16 [0-188] days. CLABSI, catheter occlusions, phlebitis, and exit-site skin infection occurred in 14 (3.5%; 1.77/1000 catheter days), 6 (1.5%; 0.76/1000 catheter days), 3 (0.7%; 0.38/1000 catheter days), and 1 (0.2%; 0.13/1000 catheter days) patients, respectively. There was no case of deep vein thrombosis or pulmonary thrombosis due to PICC placement. Multivariate analysis performed using a Cox's proportional hazard regression model revealed that patients with gastroenterological malignancies had an independently higher risk for CLABSIs (odds ratio [OR]: 3.25, 95% confidence interval [CI]: 1.05-10.05, p = 0.041) and that older age (⩾70 years) tended to be associated with CLABSIs (OR: 3.61, 95% CI: 0.98-13.32, p = 0.054). Gastroenterological malignancies and older age were associated with a higher risk of CLABSIs. Rigorous catheter management is crucial for preventing complications, particularly in vulnerable patient subgroups.

Bridging Ecologies through Contemplative Technologies: Existential Relevance of Huatou 話頭 and the Huayan sanmei men 華嚴三昧門 for Oxytocin and Environmentally Sustainable Behavior

Contemplative technologies in the form of Buddhist practices that challenge the sense of self and thereby enhance the experience of interrelationality are viable strategies for addressing existential concerns such as the environmental crisis. Much of the existing research on Buddhism and ecology neglects to measure environmentally sustainable behavior or engage with empirical research. Likewise, experiments measuring the effects of contemplative practice on oxytocin, a neuropeptide hormone often implicated in interrelational contexts, are scarce. This study explores the existential relevance of Chan and Huayan practices for oxytocin and environmentally sustainable behavior. Using empirical methods, it reports on an experimental fieldwork study among international participants in a one-month retreat at a Buddhist monastery in Taiwan. Salivary oxytocin, recycling, and food waste were measured, while phenomenological reports of experiences during contemplative practice were also obtained. Results of enzyme-linked immunosorbent assay indicate a marginal increase in oxytocin following Chan practice of the huatou “Who recites the Buddha’s name?” which targets the sense of self, consistent with phenomenological reports reflecting an interrelational, ecological sense of self through huatou. Results also indicate increased recycling and decreased food waste by mass as a function of time on retreat. While the precise mechanisms explaining why participants exhibited more environmentally sustainable behaviors are currently unclear, the discussion proposes an empirically testable framework for bridging ecologies that links emotion, sense of self, and behavior. Contemplative practices may contribute to changes in oxytocin and environmentally sustainable behavior through activation of existential, aesthetic emotions such as doubt and awe, thereby inducing changes in the practitioner’s sense of self, which they may then experience as interrelated with broader ecologies, a possibility awaiting further research. The huatou fieldwork and proposed follow-up study on the Huayan sanmei men thus shed light on the relevance of contemplative technologies from Chinese Buddhism for bridging ecologies in the existentially relational sense.

Moving from crisis response to a learning health system: Experiences from an Australian regional primary care network

AbstractIntroductionThe COVID‐19 pandemic challenged primary care to rapidly innovate. In response, the Western Victorian Primary Health Network (WVPHN) developed a COVID‐19 online Community of Practice comprising general practitioners (GPs), practice nurses, pharmacists, aged care and disability workers, health administrators, public health experts, medical specialists, and consumers. This Experience Report describes our progress toward a durable organizational learning health system (LHS) model through the COVID‐19 pandemic crisis and beyond.MethodsIn March 2020, we commenced weekly Community of Practice sessions, adopting the Project ECHO (Extension of Community Health Outcomes) model for a virtual information‐sharing network that aims to bring clinicians together to develop collective knowledge. Our work was underpinned by the LHS framework proposed by Menear et al. and aligned with Kotter's eight‐step change model.ResultsThere were four key phases in the development of our LHS: build a Community of Practice; facilitate iterative change; develop supportive organizational infrastructure; and establish a sustainable, ongoing LHS. In total, the Community of Practice supported 83 unique COVID‐19 ECHO sessions involving 3192 h of clinician participation and over 10 000 h of organizational commitment. Six larger sessions were run between March 2020 and September 2022 with 3192 attendances. New models of care and care pathways were codeveloped in sessions and network leaders contributed to the development of guidelines and policy advice. These innovations enabled WVPHN to lead the Australian state of Victoria on rates of COVID vaccine uptake and GP antiviral prescribing.ConclusionThe COVID‐19 pandemic created a sense of urgency that helped stimulate a regional primary care‐based Community of Practice and LHS. A robust theoretical framework and established change management theory supported the purposeful implementation of our LHS. Reflection on challenges and successes may provide insights to support the implementation of LHS models in other primary care settings.

Indigenous Voices in the Knowledge Production

In Brazil, in recent years, we have observed an increase in the access of indigenous people in Higher Education and Postgraduate Studies. They demand recognition as producers of scientific knowledge, overcoming the colonial paradigms that objectify them in the production of knowledge. However, in the case of Public Health, persists a very low visibility of indigenous participation in academia. This experience report presents the project “Indigenous Voices in the Production of Knowledge”, carried out through a partnership between a collective of indigenous researchers from different regions of the country and researchers from “Academic Institution”. A network of 20 indigenous researchers was organized, who met in 2019 and highlighted the need to “give recognition to indigenous knowledge” as a scientific expression; the difficulties of mastering the Portuguese language; the collective character of indigenous authorship and the need to make indigenous identities visible in authorship in scientific productions. An Indigenous Editorial Board was formed and prepared a public call for indigenous authors, which resulted in an open access publication with 21 texts. The editorial process sought to qualify the editorial board in the editorial production process; indigenous researchers carried out the peer review of the submitted texts; and virtual meetings were held with the authors to discuss the opinions. In addition to a quality academic production by indigenous authors, the project strengthened the network of indigenous researchers in collective health area, involving them in other events and initiatives, and triggered institutional changes at “Academic Institution”.

Towards effective gamification of existing systems: method and experience report

Towards effective gamification of existing systems: method and experience report