Nursing documentation is currently still very hot topic. Perhaps because they are still many health workers (physicians and non-physicians) sufficiently understand the importance and seriousness of this document. The documentation not only provides valid information about the client and his health, but also ensures continuous flow its nursing care and ultimately became a piece of evidence in case of litigation. Documentation can also be used for education and research purposes. Home care is a field that has recently rapidly growing and gaining in popularity. As part of primary and community care nursing provides clients in its natural, familiar and domestic environment, which is a big advantage for him, he does not spend his days in hospital, which is economically difficult anyway. Home Care provides health care services indicated by the treating physician or practitioner and are paid for by health insurance. This thesis deals with the nursing documentation in home care agencies, which aims to describe the demographic impacts on the use of nursing documentation, check the attitude of nurses from selected agencies of home care to nursing documentation and analyze the nursing documentation in selected home care agencies. The thesis is composed of two parts, theoretical and empirical. The theoretical part deals with the history of home care, statistical data shows the growth of agencies, their employees and clients, providing comprehensive home care and medical documentation. The empirical part was realized in the form of qualitative research. The information was gathered in-depth interview technique, which was compiled from 1 identification questions and 11 open-ended questions that formed the framework for the entire interview. In fact, respondents to individually comment on the issue to the extent that they saw fit. The research group consisted of seven sisters of different age, education and length of experience, currently working from home care. Due to fears nurses were promised total anonymity, so you can just tell that they were sisters from ADP capital city of Prague and Central Bohemia. Complementary research was conducted in seven home care agencies for the same regions, but any of nurses does not belong to the Agency from the second survey. In the first phase of the research we examined the influence of nurses' demographic factors such as age, education or length of experience in the management of nursing documentation and own attitudes of nurses from selected agencies in the management of nursing documentation. The research sample consisted of seven nurses working in home care agencies that were selected purposefully and were willing to cooperate in research. In the second phase of the research we tried to analyze individual nursing documentation of selected home care agencies. For this part, we chose seven agencies, which have been their leadership under the promise of anonymity willing to cooperate. The research investigation set up three goals and three research questions. The first objective was to describe the demographic impacts on the use of nursing documentation. The second objective was to determine the attitude of nurses from selected agencies of home care to nursing documentation. The third objective was to analyze the nursing documentation in selected home care agencies. At the outset of the investigation, we asked the following questions: they influence the management of the nursing documentation demographic factors such as age, education or length of practice nurses? What attitudes toward nursing documentation occupy the sisters from selected home care agencies? Correspond to different parts of the nursing documentation with the phases of the nursing process? Results of the research can be an inspiration not only for the nursing management ADP, but also for the nurses working in home care agencies throughout the Czech Republic, only selected agencies.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The steady advance of digital technology and its strong presence in school settings point to a new way of using technology in this environment. Traditionally, digital technology is used by teachers and students as a source of researches and, moreover, by the teacher as an alternative methodology that helps in the classroom. This dissertation aims about digital technology as a basic tool in conducting evaluations and performance, especially in the discipline of Mathematics. Thus, its research question is: there are differences in Mathematics performance when activities are performed on the computer? From this, the overall aim of this work is to compare the performance of students in the discipline of Mathematics, when conducting tests based on paper (PPT) and computer-based (CBT). To support the discussion, we will also address issues related to large-scale assessments, which indicate the performance of students, schools and systems. For this, we divide the dissertation into three articles, in order to address in more detail the different subjects that make up this work. The first paper investigated if previous studies have found differences in performance in Mathematics in digital and printed tests in materials published in journals Portal CAPES. The second article provides an overview of the different evaluations that occur in Brazil and focuses on the National Assessment System (SAEB). The text analyzes the mean performance in Mathematics, systems obtained in Rio Grande do Sul, in the editions 2005, 2007, 2009 and 2011 of SAEB, to try to understand possible trends and fluctuations in average. The third and final article presents the construction and application of a Mathematics test performance, confronted the results between the digital version and the printed version. In addition, also compared performance on the test paper with the results of the national assessment, since the instrument constructed was based on evaluations SAEB. The set of three articles showed us that although the research in this field are recent, it is possible to think about large-scale assessments performed on the computer. Both performances, PPT and CBT, were different: the strategies for resolution of the issues are modified according to the means of achievement. Furthermore, the use of technology can be a more effective way to school gets its results, so that modifications can be made within the same school year. Finally, using computer for this new purpose, it is possible explore different abilities of students, motivate the use of this tool in the school environment and streamline the process of national evaluation. / O contínuo avanço das tecnologias digitais e a sua forte presença nos contextos escolares sinalizam para um novo modo de uso da tecnologia neste ambiente. Tradicionalmente, a tecnologia digital é utilizada por professores e alunos como uma fonte de buscas e pesquisas e, além disso, pelo docente como uma metodologia alternativa que o auxilia em sala de aula. Nesta dissertação de mestrado veremos a tecnologia digital como uma ferramenta base na realização de avaliações e testes de desempenho, em especial na disciplina de matemática. Dessa maneira, nossa questão de pesquisa é: há diferenças no desempenho em matemática quando as atividades são realizadas no computador? A partir disso, o objetivo geral da dissertação é comparar o desempenho de alunos, na disciplina de matemática, quando realizam testes baseado em papel (PPT) e baseado em computador (CBT). Para embasar a discussão, abordaremos também questões relacionadas às avaliações em larga escala, voltadas a diagnosticar o desempenho dos estudantes, escolas e sistemas. Para isso, dividimos a dissertação em três artigos, com o objetivo de abordar de maneira mais detalhada os diferentes assuntos que compõem este trabalho. O primeiro artigo investigou, junto a materiais publicados no Portal de periódicos da CAPES, se pesquisas já realizadas encontraram diferença de desempenho, em matemática, em testes digitais e impressos. O segundo artigo apresenta um panorama das diferentes avaliações que ocorrem no Brasil e foca no Sistema Nacional de Avaliação da Educação Básica (SAEB). O texto analisa as médias de desempenho em matemática, obtidas pelos sistemas do Rio Grande do Sul, nas edições 2005, 2007, 2009 e 2011 do SAEB, para tentar compreender possíveis oscilações e tendências nas médias. O terceiro e último artigo apresenta a construção e aplicação de um teste de desempenho de matemática, confrontado os resultados entre a versão digital e a versão impressa. Além deste viés, também comparamos os desempenhos do teste em papel com os resultados da avaliação nacional, uma vez que o instrumento construído se baseou nas avaliações do SAEB. O conjunto dos três artigos nos mostrou que, embora as pesquisas neste campo sejam recentes, é possível pensar em avaliações em larga escala realizadas no computador. Isto porque, além dos desempenhos em PPT e CBT serem diferentes, as estratégias de resolução das questões se modificam de acordo com o meio de realização. Além disso, o uso da tecnologia pode ser uma maneira mais eficaz de retornar às escolas seus resultados, de modo que modificações possam ser feitas dentro de um mesmo ano letivo. Por fim, trazendo o computador para esta nova finalidade, é possível explorar diferentes habilidades dos alunos, motivar o uso desta ferramenta no ambiente escolar e agilizar o processo de avaliação nacional.

Philosophiae Doctor - PhD / The need for clean, non-toxic drinking water supplies, free of pollutants and metal contamination is vital in impoverished areas and the developing world alike. With this in mind, the development of accurate, inexpensive, portable and simple devices for remote sensing applications is therefore pivotal for early detection and the prevention of illnesses. Over the last two decades, adsorptive stripping voltammetry (AdSV) has emerged as a superior detection method over common analytical techniques due to its low-cost instrumentation, unskilled labour and ability to detect a wide range of analytes. / 2020-08-31

Les S-nitrosothiols (RSNOs) sont considérés comme des stocks circulant de monoxyde d'azote (NO) et qui ont de nombreux rôles in vivo. Une variation de la proportion des taux de RSNOs a été démontrée dans de nombreuses maladies. Il est donc important de pouvoir identifier et quantifier chaque RSNO dans les fluides biologiques pour la réalisation de diagnostics médicaux. Il devient alors intéressant de développer des outils analytiques pour la détermination des RSNOs, en utilisant de faibles volumes d'échantillons biologiques. Ce travail de thèse a ainsi été orienté vers le développement d'outils analytiques miniaturisés pour l'analyse des RSNOs dans les fluides biologiques, en se focalisant sur la conception de micro-dispositifs (laboratoires sur puce), intégrant toutes les étapes de l'analyse, à savoir l'injection, la séparation, la décomposition et la détection sur un seul et même dispositif pour l'identification et la quantification des RSNOs. Pour cela, chaque étape a dû être optimisée. Ainsi, une meilleure compréhension de la réactivité des RSNOs, en terme de voies de décomposition et de cinétique, a été étudiée en développant deux méthodologies basées sur l'électrophorèse capillaire (CE) couplée soit à la spectrométrie de masse (MS) soit à une détection par mesure de conductivité sans contact à couplage capacitif (C4D). Par la suite, les conditions de décomposition et la détection sensible du NO libéré ont été réalisées en utilisant des microcapteurs électrochimiques à NO. Sur la base des résultats obtenus, deux stratégies originales ont été développées pour la détection de la totalité des RSNOs présents dans le plasma (i) via la décomposition des RSNOs en utilisant des nanoparticules d’or couplées à des microcapteurs NO et (ii) via la conception d’un dispositif miniaturisé de diagnostic sur papier. Finalement, grâce à l’optimisation des étapes de décomposition, de séparation et de détection, une étude préliminaire a été menée pour concevoir une micropuce d’électrophorèse intégrant la décomposition des RSNOs et une détection électrochimique afin de quantifier indépendamment différents RSNOs. / S- nitrosothiols (RSNOs) are considered as biological circulating stock of nitric oxide (NO) that have many roles in vivo. The variation of RSNOs proportion has been recognized in many diseases, so that the identification and quantitation of each RSNO in biological fluids is of prime importance. There is thus interest for the development of analytical tools for their determination, using low biological sample volumes. This PhD work was thus orientated towards the development of miniaturized analytical tools for the analysis of RSNOs in biological fluids, with a focus on microdevices (lab-on-a-chip), by integrating the injection, separation, decomposition and detection steps for the simultaneous identification and quantitation of various RSNOs. To this aim, a better understanding of RSNO reactivity, in terms of decomposition, was necessary and was assessed by developing two methodologies based on capillary electrophoresis (CE) coupled to different detection techniques: mass spectrometry (MS) and capacitively coupled contactless conductivity detection (C4D). Then, the conditions for RSNOs decomposition and further sensitive detection of released NO by miniaturized electrochemical NO-sensors were determined. Finally, two original strategies were developed for the detection of the total amount of RSNOs in plasma (i) decomposition using gold nanoparticles and (ii) conception of miniaturized paper-based point of care device. Thanks to the optimization of decomposition, separation and detection steps, preliminary work was conducted to develop a microchip electrophoresis coupled to RSNOs decomposition to quantify separately the different RSNOs.

L'objectif premier de ce projet est la mise au point de procédés de fabrication microélectroniques/microtechnologiques compatibles avec l'utilisation d'un support papier. Pour cela, des techniques comme l'évaporation thermique sous vide, la photolithographie, l'électrodéposition et l'anodisation d'aluminium ont été développées et adaptées à ce support. Des bancs de caractérisations structurels, électriques et flexibles ont été aussi mis en œuvre pour étudier la fiabilité des couches déposées sur un tel substrat. En application, un capteur d'humidité à base d'oxyde d'aluminium flexible a été fabriqué et les tests en humidité ont montré d'excellents résultats permettant de valider le travail effectué. / The primary objective of this project is the implementation of microelectronics/microtechnology processes compatible with the use of paper-based substrate. For this purpose, techniques such as thermal vacuum evaporation, photolithography, electroplating and anodizing aluminum have been developed and adapted to this substrate. Structural, electrical and flexible characterizations benches have also been implemented to study the reliability of the layers deposited on such substrate. A moisture sensor based on flexible aluminum oxide was made and humidity tests have shown excellent results which validate the work.

This paper deals with medical data extraction from electronic patient record (EPR) system. Most of the medical data are stored in patient record systems, and data that are much valuable for medical research. If a researcher wants to extract medical information today, it has to be done manually because the data are stored in unstructured textual format in a system created by hospital staff. There is no way of extracting data in structure way. This paper is going to introduce an information extraction application for EPR system that allows the researcher to set up a study with inclusion and parameters for extraction for retrospective surveys in a webuser-interface environment. Inclusion is what the researcher would like to study (a defined category or criteria) and parameters specify the characteristics of inclusion the criteria. Result of this application provides an extracted clinical data that is used for retrospective surveys, downloadable to an MS-Excel file.

<p>In the year of 2020, an international pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has afflicted tens of millions of people’s life also disrupting global economics. Diagnostic testing is an important part of ensuring public health until a vaccine that has been shown to be safe and effective is made available to the general public. Most tests for detecting COVID-19 utilize quantitative polymerase chain reaction (qPCR) assays, which is a specific and relatively simple quantitative assay that could provide adequate sensitivity for diagnosing early infection. Although powerful, these lab-based molecular assays have a significant lag time, usually several days before receiving results. To satisfy the needs of different purposes (diagnostics, screening, and surveillance), a unified approach is impractical. This thesis presents an alternative testing method supporting the current procedure of point of care (POC) testing and in community testing. This paper-based test overcomes the limitations of current testing methods by utilizing reverse-transcription loop-mediated isothermal amplification (RT-LAMP) and receiving the result on-site by a color change in the presence of the virus within 60 minutes. The test utilizes untreated freshly collected saliva, a less invasive specimen, as the sample and possesses a limit of detection (LoD) of 200 copies of virus per microliter of whole saliva with an analytical sensitivity of 97% and analytical specificity of 100%. The test requires minimal operator training and could be fabricated on a large-scale using roll-to-roll methods. Since the test is based on nucleic acids, the testing platform itself lends to further applications <a>including food safety monitoring, animal diagnostic, etc. simply by changing the specific primers</a>. </p>

Ideally, every person in the world should have access to a safe and clean water supply; if not all sources of water are clean and safe, at the very least, an effective method to detect water contamination should be readily available. An effective detection method should not only be sensitive, rapid, robust, and affordable, but, ideally, it should also be equipment-free and easy to transport and deliver to the end-users. The main goal of this project is to develop a variety of bits and pieces of bioassay systems, with a particular focus on paper-based bioactive devices in order to provide portable and ready-to-use biosensors which can be useable by anyone anywhere around the world without requiring formal training. According to the World Health Organization (WHO), 76,000 people each year die in India alone because of pesticide poisoning. Long term exposure to organophosphate pesticides is known to have adverse effects on neurological function and can lead to Alzheimer's Disease, Attention Deficit Hyperactivity Disorder (ADHD), and reduced Intelligence Quotient (IQ). The likelihood of long term exposure to pesticides is heightened in developing countries, so a reliable and inexpensive pesticide sensor is a much-needed device in the developing world. To address this need, this project reports on the development of a fully-automated bioactive paper-based sensor for the detection of organophosphate pesticides. In the proposed biosensor, two innovations were implemented to achieve a full-automated format for the pesticide sensor: (I) First is a PUMP ON A PAPER (Jahanshahi-Anbuhi et al., LOC, 2012) that increases the flow rate of fluids within paper-based microfluidic analytical devices and sequentially brings two separate liquid streams to the enzyme test zone on the paper sensor, and (II) the second innovation is a PIPETTE ON A PAPER (Jahanshahi-Anbuhi et al., LOC, 2014) that involved the creation of a pullulan (a natural non-ionic polysaccharide) temporary bridge-system to transfer a known amount of solution to the sensing zone that, gives the enzyme zone a chance to dry and accept the substrate solution from the slow channel after a fixed period of time. This proposed format results in a simplified assay that detects the presence of pesticides automatically without any further manipulation from the user. However, the shelf life of this assay kit is challenging due to instability of both enzyme (AChE) and substrate (IDA) at room temperature. AChE loses its enzymatic activity when stored at room temperature and IDA becomes oxidized quickly. This problem is not unique to these two bio reagents, however; almost all bioassays which use bio-reagents (such as enzymes and small-molecular substrates) are unstable to varying degrees and require special shipping and storage. The instability of these molecules can arise from either thermal denaturation or chemical modification, such as oxidation or hydrolysis. Because of these issues, they often have to be shipped on dry ice with special packaging, which is costly. The cost of maintaining a cold chain for distributing bio-reagents accounts for up to 80% of the cost. Aside from the cost, these reagents also have to be stored in bulk in refrigerators or freezers to minimize the loss of activity, but they must be thawed and aliquoted for their intended tests. Repeated freezing and thawing can result in a significant loss of activity, which often leads to less reliable test results. These issues make running such assays in resource-limited settings a significant challenge. There is, therefore, an urgent need for an assay system with stable reagents that is easy to use, simple to read, inexpensive, and that includes a method for the long-term stabilization of enzymes and other unstable reagents in pre-measured quantities. To overcome to all these issues, pullulan is utilized for the development of pill-based-biosensors. Pullulan dissolves quickly in aqueous solutions and shows very high oxygen barrier properties in its film form. Considering the unique properties of pullulan, it is hypothesized that pullulan may be suitable for producing assay pills with encapsulated enzymes or other unstable molecules and may provide a simplified platform for carrying out bioassays in resource-limited settings. The application of these pill-based-biosensors is shown via the entrapment of AChE and IDA for the creation of an assay kit that can detect organophosphate pesticides (Jahanshahi-Anbuhi et al., Angew. Chem., 2014). Moreover, this thesis reports on the stabilization of highly unstable firefly luciferase for the detection of microorganisms and, more particularly, ATP. Through the use of pullulan, this thesis demonstrates that both the enzyme and the substrate can be protected, immobilized, and stabilized at room temperature, instead of the existing storage methods, which require temperatures <-20˚C. This innovation allows for a more convenient method of shipping the bioassay kits around the world without any extra care. Furthermore, pullulan-based films are utilized for the development of a method for controlled multidirectional flow within paper-based biosensors. This method provides the possibility of trapping labile and volatile reagents and stabilizing them by forming thin films with pullulan. The trapped reagents within pullulan films can be strategically stacked and assembled on a paper strip in different directions. Furthermore, should the need arise, these reagents can be released and delivered sequentially or simultaneously in both vertical and lateral directions through the paper. The application of this method is shown for: (I) creation of "ready-to-use" assay kit for the detection of Escherichia coli (E. Coli). This assay kit has the step of cell lysing and proceeds automatically to the step in which enzymes react. The second application (II) shows the trapping of Simon’s reagents, which is widely used for methamphetamine detection. Overall, these unique fabrication techniques can be widely used for the preparation of highly stable, ready-to-use, and user-friendly biosensors. We are currently working on the detection of other contaminants such as heavy metals, and we are starting on vaccine stabilization and delivery, which would have a tremendous impact for society. / Dissertation / Doctor of Engineering (DEng)

<p>In 2021, an estimated 1.5 million people were diagnosed with HIV globally, increasing the total to 38.4 million people. Approximately 16% of this population were unaware of their infected status and required HIV testing, which is a critical first step in HIV prevention, treatment, and care. Hence, there is a need to develop a rapid, user-friendly, and cost-effective point-of-care test for HIV detection. The time between HIV infection and a detectable host HIV antibody concentration can extend up to 90 days. By incorporating more sensitive testing for the HIV p24 antigen on the virus, the diagnosis lag can be reduced to 17 days. This window could be further shortened by using horseradish peroxidase (HRP) enzyme as a signal enhancement technique. The work herein focuses on developing an enzymatically signal-enhanced lateral flow assay test for the p24 antigen to detect HIV during the acute phase of infection. Conjugation chemistry for the sandwich assay was characterized using DLS and UV-Vis. Dot blots were then used to assess and enhance the functionality of the individual components via a visual color gradient formed by the protein coupled with antibody-conjugated gold nanoparticles. A quantitative analysis was performed using ImageJ software through signal pixel intensity analysis. A limit of detection (LoD) of 6 ng/mL was obtained for the detection of the p24 antigen. This LoD was improved to 0.2 ng/mL by incorporating HRP signal enhancement with the diaminobenzidine substrate. This 30x signal improvement could drive down the LoD even further to improve the sensitivity of the commercial p24 antigen tests. Different fabrication and scalability studies were performed to produce a cost- efficient, fully functional prototype of a paper-based lateral flow device incorporating the signal- enhanced p24 assay. This study serves as a solid foundation to research focused on creating more efficient point-of-care tests that can be used in resource-limited settings to provide early detection of HIV for the 6 million individuals who are currently unaware of their HIV status. </p>

<p>Fully portable, rapid, and user-friendly sensors can successfully lead to the continuous monitoring of toxins present in the ecosystem as well as the detection of biomarkers to prevent diseases. Towards this goal, we explore electrochemical and colorimetric methods to develop platforms for the on-site detection of pesticides, heavy metals, and inflammation biomarkers. </p> <p>This thesis presents work with the primary aim of developing non-biological and biological-based platforms. Chapter 2 describes a fully roll-to-roll electrochemical sensor with high sensing and manufacturing reproducibility for detecting nitroaromatic organophosphorus pesticides (NOPPs). This sensor is based on a flexible, screen-printed silver electrode modified with a graphene nanoplatelets coating and a zirconia coating. This chapter outlines the evaluation of the electrocatalytic activity of zirconia towards the reduction of NOPPs, using methyl parathion as a pesticide sample. Furthermore, it describes the fundamentals of electrochemistry focused on voltammetry techniques used for surface characterization and quantification. The topics reviewed serve as the first step to further manufacturing sensors through large-scale methods (e.g., roll-to-roll). Chapter 3 describes the development of a dual-modality sensing system for the detection of mercury in river waters with high accuracy and precision. The objective of this project was to incorporate colorimetric platforms into the electrochemical methods to create a dual detection design and avert false positives and negatives. Here, novel bio-functional aptamers were incorporated in a sensor containing a paper test that detects mercury by a color change and an electrochemical test that measures charge transfer resistance changes upon aptamer-target interaction. For this platform, the colorimetric test demonstrates the utilization of two systems that consist of silver and gold citrate-capped nanoparticles bio-functionalized with highly specific aptamers. The mechanism of detection of these two systems is through Ps-AgNPs and Ps-AuNPs aggregation as a result of ssDNA-Hg2+ interaction. Using Ps-AuNPs microparticles, Chapter 4 describes a fully colorimetric and smartphone-based biosensor for detecting cardiac troponin T, a biomarker for diagnosing acute myocardial infarction. Here, a comparison in detection performance between Whatman grade 1 and high-flow filter paper is reviewed. Finally, Chapter 5 evaluates the colorimetric detection performance of Ps-AuNPs microparticles towards imidacloprid and carbendazim, two of the pesticides most found in imported produce in the United States. The chapter compares gold-based microparticles in which different aptamers were immobilized, and image acquisition approaches.</p> <p>All sensors reported in this thesis are especially suitable for environmental contaminants monitoring or point-of-care diagnosis applications. The materials selection, use or synthesis, and platforms’ performance optimization, development, and feasibility for scale-up manufacturing are expected to advance on-site biosensing technologies and their commercialization.</p>