Twitter, a popular social media outlet, has evolved into a vast source of linguistic data, rich with opinion, sentiment, and discussion. We mined data from several public Twitter endpoints to identify content relevant to healthcare providers and public health regulatory professionals. We began by compiling content related to electronic nicotine delivery systems (or e-cigarettes) as these had become popular alternatives to tobacco products. There was an apparent need to remove high frequency tweeting entities, called bots, that would spam messages, advertisements, and fabricate testimonials. Algorithms were constructed using natural language processing and machine learning to sift human responses from automated accounts with high degrees of accuracy. We found the average hyperlink per tweet, the average character dissimilarity between each individual's content, as well as the rate of introduction of unique words were valuable attributes in identifying automated accounts. We performed a 10-fold Cross Validation and measured performance of each set of tweet features, at various bin sizes, the best of which performed with 97% accuracy. These methods were used to isolate automated content related to the advertising of electronic cigarettes. A rich taxonomy of automated entities, including robots, cyborgs, and spammers, each with different measurable linguistic features were categorized. Electronic cigarette related posts were classified as automated or organic and content was investigated with a hedonometric sentiment analysis. The overwhelming majority (≈ 80%) were automated, many of which were commercial in nature. Others used false testimonials that were sent directly to individuals as a personalized form of targeted marketing. Many tweets advertised nicotine vaporizer fluid (or e-liquid) in various “kid-friendly” flavors including 'Fudge Brownie', 'Hot Chocolate', 'Circus Cotton Candy' along with every imaginable flavor of fruit, which were long ago banned for traditional tobacco products. Others offered free trials, as well as incentives to retweet and spread the post among their own network. Free prize giveaways were also hosted whose raffle tickets were issued for sharing their tweet. Due to the large youth presence on the public social media platform, this was evidence that the marketing of electronic cigarettes needed considerable regulation. Twitter has since officially banned all electronic cigarette advertising on their platform. Social media has the capacity to afford the healthcare industry with valuable feedback from patients who reveal and express their medical decision-making process, as well as self-reported quality of life indicators both during and post treatment. We have studied several active cancer patient populations, discussing their experiences with the disease as well as survivor-ship. We experimented with a Convolutional Neural Network (CNN) as well as logistic regression to classify tweets as patient related. This led to a sample of 845 breast cancer survivor accounts to study, over 16 months. We found positive sentiments regarding patient treatment, raising support, and spreading awareness. A large portion of negative sentiments were shared regarding political legislation that could result in loss of coverage of their healthcare. We refer to these online public testimonies as “Invisible Patient Reported Outcomes” (iPROs), because they carry relevant indicators, yet are difficult to capture by conventional means of self-reporting. Our methods can be readily applied interdisciplinary to obtain insights into a particular group of public opinions. Capturing iPROs and public sentiments from online communication can help inform healthcare professionals and regulators, leading to more connected and personalized treatment regimens. Social listening can provide valuable insights into public health surveillance strategies.

Orientador: Vera Lucia Pamplona Tonete / Resumo: Introdução: atualmente, embora se constate a redução dos índices de morbimortalidade infantil em todas as regiões do país, ainda há muito que se fazer para promover a saúde de crianças, especialmente daquelas mais vulneráveis. O presente estudo aborda o tema da vigilância à saúde de recém-nascidos de risco, com base em protocolo de organização de serviços. Considera-se que protocolo compõe-se de rotinas de cuidados e ações de gestão de um determinado serviço, equipe ou departamento, elaborado a partir da produção de conhecimentos e práticas dos profissionais envolvidos, com respaldo de evidências científicas. Objetivo: elaborar protocolo de organização de serviços para a redução de óbitos infantis na região de saúde do Vale do Jurumirim, São Paulo, com enfoque na vigilância à saúde de recém-nascidos de risco. Aspectos metodológicos: trata-se de uma pesquisa-intervenção, composta por uma etapa inicial, quando foi realizado estudo transversal e descritivo sobre o perfil epidemiológico regional de recém-nascidos vivos em 2013 e das crianças que foram a óbito nesse mesmo ano, durante o primeiro ano de vida, buscando a correspondência aos critérios de risco ao nascer indicados pelo Ministério da Saúde. Nesta primeira etapa, buscou-se também caracterizar a rede de atenção à saúde materno-infantil disponível na região em foco. Em uma etapa posterior, foi realizada intervenção participativa, que incluiu duas oficinas de oito horas para elaboração do protocolo pretendido, envolvendo 3... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Although it is currently noticed a decline in infant mortality rate in all the regions of the country there is still a lot to do to promote child health care, especially those children who are more vulnerable. The current study deals with the topic of health monitoring of newborn babies at risk based on service organizing protocol. It is considered that protocol consists of routine care and management procedure of a particular service, team or department, by putting together healthcare professionals’ knowledge and experience and supported by scientific evidences. Objective: Putting together service organizing protocol to decline infant mortality in the region of Vale do Jurumirim, São Paulo, focused on health care monitoring of newborn babies at risk. Methodological Aspects: It is about intervention survey consisted of an initial stage when it was done a transversal and descriptive study of the regional epidemic profile of newborn babies born in 2013 and one-year-old children or younger who died that year, aiming at the correspondence between risk criteria at birth according to the Department of Health. In this initial stage, attention to maternal-infant health care was given when it was available in that region. In a later stage, participative intervention was carried out, which included two eight-hour workshops to put together intended protocol, involving 34 managers and healthcare professionals and maternal-infant health care monitoring of that particular reg... (Complete abstract click electronic access below) / Mestre

Submitted by JULIANA PIERAMI DE FREITAS null (jupierami@hotmail.com) on 2016-04-28T23:49:36Z No. of bitstreams: 1 Dissertacao Juliana 2504.pdf: 1553097 bytes, checksum: 7fab2bad78418aed6d927c6d8c388edc (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-05-02T16:57:55Z (GMT) No. of bitstreams: 1 freitas_jp_me_bot.pdf: 1553097 bytes, checksum: 7fab2bad78418aed6d927c6d8c388edc (MD5) / Made available in DSpace on 2016-05-02T16:57:55Z (GMT). No. of bitstreams: 1 freitas_jp_me_bot.pdf: 1553097 bytes, checksum: 7fab2bad78418aed6d927c6d8c388edc (MD5) Previous issue date: 2016-03-02 / Introdução: atualmente, embora se constate a redução dos índices de morbimortalidade infantil em todas as regiões do país, ainda há muito que se fazer para promover a saúde de crianças, especialmente daquelas mais vulneráveis. O presente estudo aborda o tema da vigilância à saúde de recém-nascidos de risco, com base em protocolo de organização de serviços. Considera-se que protocolo compõe-se de rotinas de cuidados e ações de gestão de um determinado serviço, equipe ou departamento, elaborado a partir da produção de conhecimentos e práticas dos profissionais envolvidos, com respaldo de evidências científicas. Objetivo: elaborar protocolo de organização de serviços para a redução de óbitos infantis na região de saúde do Vale do Jurumirim, São Paulo, com enfoque na vigilância à saúde de recém-nascidos de risco. Aspectos metodológicos: trata-se de uma pesquisa-intervenção, composta por uma etapa inicial, quando foi realizado estudo transversal e descritivo sobre o perfil epidemiológico regional de recém-nascidos vivos em 2013 e das crianças que foram a óbito nesse mesmo ano, durante o primeiro ano de vida, buscando a correspondência aos critérios de risco ao nascer indicados pelo Ministério da Saúde. Nesta primeira etapa, buscou-se também caracterizar a rede de atenção à saúde materno-infantil disponível na região em foco. Em uma etapa posterior, foi realizada intervenção participativa, que incluiu duas oficinas de oito horas para elaboração do protocolo pretendido, envolvendo 34 gestores e profissionais da atenção e vigilância à saúde materno-infantil da referida região. Os dados de cunho quantitativo foram colhidos de bancos públicos e documentos oficiais e descritos estatisticamente, enquanto que os de cunho qualitativo foram obtidos a partir do preenchimento do modelo proposto por Werneck, Faria e Campos, anotações em diário de campo e de roteiro com questões que nortearam as discussões durante as oficinas. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista. Resultados: no ano de 2013, na região de saúde do Vale do Jurumirim foram contabilizados 3748 nascidos vivos, sendo que 9,8% desses apresentaram correspondência a pelo menos um dos critérios de risco ao nascer estudados. Neste mesmo ano, ocorreram 47 óbitos infantis, com 80,8% desses no componente neonatal, distribuídos em 12 municípios dos 17 municípios da região. Constatou-se que houve em todos os óbitos infantis correspondência a pelo menos um dos critérios de risco ao nascer estudados. Sobre vigilância e atenção à saúde materno-infantil, verificou-se que existiam fragilidades quanto ao trabalho em rede, bem como não se tinham estabelecidas estratégias para identificação e segmento de crianças expostas a riscos de adoecer e morrer. Com base nesses achados, coletivamente, foi possível estabelecer: os critérios de risco ao nascer para classificar os recém-nascidos vivos da região e a forma de considerá-los; o elenco de atividades a serem desenvolvidas, com seus respectivos responsáveis; os mecanismos de acompanhamento e avaliação; bem como o fluxograma de atividades para detecção e abordagem de recém-nascido de risco. Considerações finais: como produto desta pesquisa-intervenção foi elaborado o protocolo para a vigilância de recém-nascidos de risco na região de saúde do Vale do Jurumirim. Considera-se que o processo para tal produção foi cientificamente respaldado, contando com a participação ampla e ativa dos profissionais envolvidos com a vigilância e atenção à saúde materno-infantil dessa região. Sendo por definição um instrumento a ser revisto periodicamente, recomenda-se a avaliação do protocolo elaborado após um ano de sua implementação. / Introduction: Although it is currently noticed a decline in infant mortality rate in all the regions of the country there is still a lot to do to promote child health care, especially those children who are more vulnerable. The current study deals with the topic of health monitoring of newborn babies at risk based on service organizing protocol. It is considered that protocol consists of routine care and management procedure of a particular service, team or department, by putting together healthcare professionals’ knowledge and experience and supported by scientific evidences. Objective: Putting together service organizing protocol to decline infant mortality in the region of Vale do Jurumirim, São Paulo, focused on health care monitoring of newborn babies at risk. Methodological Aspects: It is about intervention survey consisted of an initial stage when it was done a transversal and descriptive study of the regional epidemic profile of newborn babies born in 2013 and one-year-old children or younger who died that year, aiming at the correspondence between risk criteria at birth according to the Department of Health. In this initial stage, attention to maternal-infant health care was given when it was available in that region. In a later stage, participative intervention was carried out, which included two eight-hour workshops to put together intended protocol, involving 34 managers and healthcare professionals and maternal-infant health care monitoring of that particular region. Information characterized by quantity was collected from public data and statistical official documents whereas information characterized by quality was collected from the filling out of model proposed by Werneck, Faria and Campos, notes in field log and itinerary containing questions asked during the workshop. This study was approved by Ethic Committee in Survey of the Medical University in Botucatu of the Paulista State University. Results: In 2013, 3,748 newborn babies were born in Vale do Jurumirim region, 9.8% showed at least one correspondence of the risk criteria studied. That year, 47 infants died, 80.8% during neonatal in 12 cities of that 17-city region. It was noticed that there was, at birth, at least one correspondence of the risk criteria studied in all the infant deaths. When it comes to maternalinfant health care monitoring, it was checked that there were flaws in networking and strategies to identify children exposed to risks of becoming sick and dying had not been established. Based on these findings, it has been possible to establish collectively: risk criteria at birth to classify newborn babies in the region and the way to consider them; activities to be developed with their respective responsible ones; the mechanics of accompanying and evaluating; as well as the flow chart of activities to detect and approach newborn babies at risk. Final Consideration: As a product of this intervention survey, a protocol to monitor newborn babies at risk in the region of Vale do Jurumirim was put together. It is considered that the procedure to produce such a protocol was scientifically supported, counting on the ample and active participation of healthcare professionals concerned with maternal-infant health care in that region. It is also, by definition, a tool to be revised periodically, evaluation of this protocol is recommended after one year of its implementation.