Abstract: CRoss Industry Standard Process for Data Mining (CRISP-DM) is a data mining project development methodology that establishes tasks and levels of abstraction, hierarchically structured to facilitate its implementation through a set of actions that help in making decisions. Essence is a theory that helps identify best practices and essential, common, and universal elements to all endeavor in the software development cycle. In the literature, there are different models of representation of the CRISP-DM methodology, such as verbal model, conceptual model, process understanding model, and ontology. However, it considered that these representation models lack the incorporation of some elements, such as, activities, work products, and roles of the CRISP-DM methodology. In this paper we propose a representation based on Essence of the CRISP-DM methodology, incorporating the essential elements that we believe are missing from existing representations. With the representation in Essence that is proposed, the aim is to improve the understanding of best practices and the essential, common, and universal elements of the CRISP-DM methodology for future implementations in data mining projects. In addition, it seeks to validate that Essence can be used in different of data mining projects.

Abstract This work analyzed the pharmacotherapeutic problems identified by the clinical pharmacist in an intensive care unit (ICU) and the acceptance of pharmaceutical interventions in solving these problems. This is a descriptive cross-sectional retrospective study, carried out in the adult ICU of a public hospital. All patients hospitalized during the study period had their pharmacotherapy monitored and those whose stay at the ICU lasted less than 24 hours were excluded. The pharmacotherapeutic problems were classified according to type, cause, acceptability/implementation, mode of intervention, outcome and related pharmacotherapeutic group. 302 patients were followed up and 350 pharmacotherapeutic problems were identified. Most of them were classified as unnecessary drug-treatment (n=186; 53.1%). The most frequent causes were excessive drug administration (n=181; 97.3%), and antimicrobials was the main group of drugs associated to that type of problem. 350 pharmaceutical interventions were performed, highlighting “prescriber informed only” (n=178; 50.9%), with an average acceptability of 90.7%, with those carried out on site being more effective (93.4%). The number of pharmacotherapeutic problems that were totally solved was 282 (80.6%). Clinical pharmacy activities in the ICU identified, prevented and corrected pharmacotherapeutic problems, contributing to the optimization of pharmacotherapy in aspects related to the need, efficacy and safety of treatments.

ABSTRACT We report the first pediatric case of a Jaguajir agamemnon scorpion sting. This case occurred in the state of Paraná and is the first record of this species in southern Brazil. The patient was admitted within 15 min, with pain, local edema, erythema, whole-body pruritus, and tongue paresthesia within the first two hours, which disappeared thereafter. The patient’s condition was considered mild, with a positive outcome, and she recovered completely.

Resumen Objetivo: determinar los desenlaces renales de los pacientes con requerimiento de diálisis por lesión renal aguda, que ingresaron a la unidad de cuidado intensivo del Hospital Departamental Universitario Santa Sofía de Caldas desde el año 2006 a 2018 y determinar los factores asociados a estos desenlaces. Métodos: estudio retrospectivo de cohortes llevado a cabo en el Hospital Departamental Universitario Santa Sofía de Caldas en 122 pacientes mayores de 18 años, que requirieron diálisis por lesión renal aguda en la unidad de cuidado intensivo entre los años 2006 y 2018. Se evaluó el desenlace compuesto del MAKE (Major Adverse Kidney Events) conformado por recuperación parcial de la función renal, dependencia de la diálisis y muerte con seguimiento a los 90 días y un año. Resultados: existe asociación entre diabetes, puntaje APACHE II, acidosis metabólica, anuria y tiempo de inicio de la diálisis con el MAKE a 90 días y al año. En la regresión logística aquellos pacientes que desarrollaron MAKE a los 90 días tenían mayor probabilidad de haber presentado anuria (OR=6.71; IC95%: 1497-30 076), acidosis (OR=4349; IC95%: 1616-11.7) e inicio tardío de la terapia (OR=3013; IC95%: 1241-7316). En el MAKE a un año hubo resultados similares, adicionando modalidad de terapia continua (OR=2841; IC95%: 1193-6763). Conclusiones: diabetes, APACHE II alto, anuria, acidosis metabólica y terapia dialítica tardía son más frecuentes en pacientes que desarrollan MAKE. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2229).

Abstract Objective: to establish the renal outcomes of patients needing dialysis due to acute kidney injury who were admitted to the intensive care unit at Hospital Departamental Universitario Santa Sofía de Caldas from 2006 to 2018, and determine the factors associated with these outcomes. Methods: a retrospective cohort study carried out at Hospital Departamental Universitario Santa Sofía de Caldas on 122 patients over the age of 18 who required dialysis in the intensive care unit due to acute kidney injury, from 2006 to 2018. The major adverse kidney events (MAKE) composite outcome was evaluated, composed of partial recovery of kidney function, dialysis dependence and death, with 90-day and one-year follow up. Results: there is a relationship between diabetes, the APACHE II score, metabolic acidosis, anuria and the dialysis start time and MAKE at 90 days and one year. In the logistic regression, patients who developed MAKE at 90 days had a greater probability of having had anuria (OR=6.71; 95%CI: 1,497-30,076), acidosis (OR=4,349; 95%CI: 1,616-11.7) and a late treatment start (OR=3,013; 95%CI: 1,241-7,316). The one-year MAKE showed similar results, with the addition of the continu ous therapy modality (OR=2,841; 95%CI: 1,193-6,763). Conclusions: diabetes, a high APACHE II, anuria, metabolic acidosis and late dialysis treat ment are more frequent in patients who develop MAKE. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2229).

Resumen Objetivo: Generar recomendaciones basadas en la evidencia, para la prevención primaria y secundaria, el tratamiento de las lesiones preneoplásicas y el diagnóstico temprano del cáncer gástrico en población adulta, con el propósito de reducir la carga de la enfermedad. Materiales y métodos: El grupo desarrollador estuvo integrado por profesionales de la salud y tomadores de decisiones. Se construyeron preguntas clínicas contestables y se realizó la graduación de los desenlaces. Se elaboró la búsqueda de la información en MEDLINE; EMBASE y CENTRAL, siendo actualizada el 18 de octubre de 2018. La pesquisa también abarcó otras fuentes de información como la Revista Colombiana de Gastroenterología y la lectura en "bola de nieve" de las referencias incluidas. Se contactó a expertos en la materia con el objetivo de identificar estudios relevantes no publicados. Para la construcción de las recomendaciones, se realizó un consenso acorde con los lineamientos propuestos por la metodología GRADE, sopesando los beneficios, los efectos adversos derivados de la intervención, las preferencias de los pacientes y el potencial impacto de las intervenciones sobre los costos. Resultados: Se presenta la versión corta de la "Guía de práctica clínica para la prevención primaria, secundaria y diagnóstico temprano de cáncer gástrico", junto con su evidencia de soporte y respectivas recomendaciones. Conclusiones: Como recomendación central para la implementación, se recomienda erradicar la infección por H. pylori en los pacientes con o sin factores de riesgo, como estrategia de prevención de las condiciones precursoras de cáncer gástrico. La Guía deberá actualizarse en tres años.

Abstract Objetive: Generate recommendations for primary and secondary prevention, treatment of gastric preneoplastic lesions, and early diagnosis of gastric cancer in the adult population, to increase the detection of gastric cancer in early stages. Material and methods: The developer group was made up of health professionals, decision-makers, and a representative of the patients. Answerable clinical questions were constructed and outcomes were graded. The search for information in MEDLINE was carried out; EMBASE and CENTRAL, being updated on October 18, 2018. The search also covered other sources of information such as the Colombian Journal of Gastroenterology and the "snowball" reading of the references included. Experts in the field were contacted to identify studies. For the construction of the recommendations, a consensus was made according to the guidelines proposed by the GRADE methodology, weighing the benefits, the adverse effects derived from the intervention, the preferences of the patients, and the potential impact of the interventions on costs. Results: The short version of the "Clinical practice guidelines for the primary, secondary, and early diagnosis of gastric cancer" is presented together with its supporting evidence and respective recommendations. Conclusions: As a central recommendation for implementation, it is recommended to eradicate H. pylori infection in patients with or without risk factors in whom it is detected to prevent gastric cancer precursor conditions. The Guide will need to be updated in three years.

RESUMO: A determinação do nitrogênio nas plantas por técnicas que permitem um diagnóstico rápido, baseado nas características de crescimento das plantas, pode ser uma ferramenta útil para o manejo nutricional das plantas de café. Assim, o objetivo deste estudo foi avaliar as características de crescimento e rendimento do café conilon irrigado em resposta à diferentes níveis de nitrogênio, resultando na determinação dos níveis mínimos de N necessárias para atingir o rendimento máximo, aqui chamadas de níveis críticos. O experimento foi realizado em Colatina, Espírito Santo, Brasil, em plantações de café conilon, variedade clonal Emcapa 8111, genótipo 02. Foram aplicados seis níveis de nitrogênio (0, 110, 220, 440, 880 e 1320 kg N ha-1) e a resposta em características de crescimento e rendimento foi periodicamente avaliada. Houve um efeito positivo do aumento dos níveis de N sobre o rendimento, na medida em que os níveis de N que forneceram 95% do rendimento máximo (137,4 sacos ha-1 e 108,5 sacos ha-1) nas estações de crescimento 2012/2013 e 2013/2014, respectivamente, foram de 420,7 e 543,1 kg de N ha-1. Houve também um efeito positivo dos níveis de N sobre as características de crescimento e conteúdo de nitrogênio, indicando seu uso como ferramentas para um diagnóstico nutricional rápido, com o objetivo de otimizar o manejo de nitrogênio no café Conilon.

ABSTRACT: The determination of nitrogen in plants by techniques that allow a fast diagnosis, based on plant growth characteristics, can be a useful tool for the nutritional management of coffee plants. Thus, this study evaluated growth and yield characteristics of irrigated conilon coffee in response to different nitrogen levels, resulting in the determination of the minimum N levels required to achieve the maximum yield, here called critical levels. The experiment was carried out in Colatina, Espirito Santo, Brazil, on plantations of conilon coffee, clonal variety Emcapa 8111, genotype 02. Six nitrogen levels were applied (0, 110, 220, 440, 880 and 1320 kg N ha-1) and the response in growth and yield characteristics periodically evaluated. There was a positive effect of the increasing N levels on yield, in that the N levels that provided 95% of the maximum yield (137.4 bags ha-1 and 108.5 bags ha-1) in the 2012/2013 and 2013/2014 growing seasons, respectively, were 420.7 and 543.1 kg N ha-1. There was also a positive effect of N levels on the growth characteristics and nitrogen contents, indicating their use as tools for a rapid nutritional diagnosis, with a view to optimizing the nitrogen management in Conilon coffee.

ABSTRACT Anatomical, physiological, and biochemical analyses have been performed to predict graft compatibility. We analyzed if the concentrations of auxins, jasmonic acid, gibberellins, 1-aminocyclopropane-1-carboxylic acid, zeatin (cytokinin), salicylic acid, and abscisic acid could be used as predictors of compatibility between the rootstocks FOX1 and FOX4 (resistant to Fusarium wilt) and the scion of cherry tomatoes Sweet Heaven (SH). Self-grafted (SH/SH) and ungrafted SH plants (SH) were used as controls. Hormonal analyses were performed on leaves, at 20 and 70 days after grafting (DAG), and roots, at 20 DAG. No expressive concentrations of auxins, gibberellins, or jasmonic acid were detected. The concentrations of 1-aminocyclopropane-1-carboxylic acid, the immediate precursor of ethylene, and zeatin were altered at 20 DAG, but they stabilized at 70 DAG. Salicylic acid levels were reduced in the leaves of grafted plants at 70 DAG. The concentration of abscisic acid (ABA) in the leaves of SH grafted onto FOX1 was higher than in ungrafted and self-grafted plants at 70 DAG, suggesting some degree of incompatibility between these genotypes. The concentration of ABA in the combination FOX4/SH was similar to that in the self-grafted plants. Abscisic acid might be used as a reference phytohormone to predict graft compatibility among tomato genotypes.

Resumen Introducción. La Diabetes Mellitus es una enfermedad compleja que impacta la salud pública debido a su alta prevalencia, el costo que implica y complicaciones asociadas como lo es la alteración cognitiva. Metodología. Se realizó una revisión de tema consultando literatura nacional e internacional en bases de datos de ciencias sociales y ciencias de la salud entre los años 1990-2019 que exponen la posible asociación entre la diabetes mellitus y deterioro cognitivo, así como las posibles rutas que lo conllevan. Resultados. La literatura consultada plantea una relación entre la diabetes mellitus y complicaciones del sistema nervioso central, lesiones neurológicas, deficiencias en la capacidad de atención, pérdida de la memoria, deterioro cognitivo, un considerable incremento en el riesgo de desarrollar demencia y demencia tipo Alzheimer, sin embargo, no se evidencia un consenso en el grado de afectación que pueda tener sobre los procesos cognitivos. Conclusiones. La naturaleza progresiva tanto de la diabetes mellitus, así como el riesgo vascular asociado, sugieren la necesidad de realizar prevención del deterioro cognitivo en pacientes diagnosticados con diabetes mellitus, a partir de una evaluación integral que incluya pruebas neuropsicológicas dentro de los exámenes de rutina.

Abstract Introduction: Diabetes mellitus is a complex and chronic disease that has an impact on public health due to its high prevalence, the implicit economic cost and associated complications like cognitive alterations. Methodology: A review of the topic was carried out across national and international literature in databases of social sciences and health sciences between the years 1990-2019 that expose the possible association between diabetes mellitus and cognitive impairment, as well as the possible routes that lead to cognitive alterations. Results: The consulted literature exposed a link between diabetes mellitus and complications of the central nervous system, neurological lesions, attention capacity deficiencies, memory loss, cognitive impairment, and a considerable increase in the risk of developing dementia and Alzheimer's type dementia. Conclusions: The progressive nature of both diabetes mellitus, and associated vascular risk, suggest the need for prevention of cognitive impairment based on a comprehensive evaluation that includes neuropsychological tests within routine examinations in patients diagnosed with diabetes mellitus.

RESUMO Objetivo: Analisar as distâncias entre as inserções femorais do tendão poplíteo (TP) e o ligamento colateral lateral (LCL) através de dissecções de espécimes cadavéricos em uma população miscigenada. Métodos: Cadáveres frescos foram dissecados. Foram registrados dados antropométricos e foi avaliada a distância da origem do TP e do LCL na região femoral com auxílio de paquímetro digital. Foi também avaliado o diâmetro do footprint femoral do TP e do LCL. Resultados: Foram dissecados 11 joelhos não pareados, 8 homens e 3 mulheres com uma idade média de 71,5 ± 15,2 anos, pesando em média 57,2 ± 15,6 kgs e com altura de 170,5 ± 8,2 cm. A distância do centro do footprint femoral do LCL e do TP foi de 10,0 ± 2,4 mm. As distâncias das bordas mais próximas entre si e das mais distantes entre si foram de 3,1 ± 1,1 mm e 16,3 ± 2,4 mm, respectivamente. Conclusão: A distância entre o ponto central do TP e do LCL em nossa população mais miscigenada demonstrou um valor absoluto menor do que é, frequentemente, relatado na literatura. Uma reconstrução ligamentar do CPL com túneis separados para o LCL e o TP pode não ser tecnicamente possível para indivíduos de qualquer população. Nível de Evidência III, Estudos diagnósticos.

ABSTRACT Objective: To analyse the distances between the femoral insertions of the popliteus tendon (PT) and the lateral collateral ligament (LCL) through dissections of cadaveric specimens in a mixed population. Methods: Fresh cadavers were dissected, and the anthropometric data of all specimens were recorded. The distances from the origin of the PT to the LCL in the femoral region and the diameter of each structure were measured using a digital calliper. Results: In total, 11 unpaired knees were dissected, eight men and three women, with an average age of 71.5 ± 15.2 years, weight of 57.2 ± 15.6 kg, and a mean height of 170.5 ± 8.2 cm. The distance from the center of the femoral footprint of the LCL to the PT was 10.0 ± 2.4 mm. The distances between the edges closest to each other and those more distant from each other were 3.1 ± 1.1 mm and 16.3 ± 2.4 mm, respectively. Conclusion: The distance between the midpoints of the PT and the LCL in our mixed population is smaller than the distances often reported in the literature. PLC reconstruction with separate tunnels for the LCL and PT may not be technically possible for individuals of any population. Level of Evidence III, Diagnostic studies.

Resumen Introducción. La infección del tracto urinario (ITU) es la complicación médica más frecuente durante el embarazo y se asocia con desenlaces materno-perinatales negativos. Objetivos. Determinar la prevalencia de ITU en gestantes en condiciones de vulnerabilidad social de Bucaramanga, Colombia, y realizar una caracterización de los casos de ITU. Además, identificar los factores asociados al desarrollo de esta complicación y el perfil de resistencia antibiótica de los microorganismos causantes de la infección. Materiales y métodos. Se llevó a cabo un análisis secundario de los datos obtenidos en un estudio principal que incluyó 838 gestantes atendidas en la red pública de atención de Bucaramanga. La prevalencia de ITU se estimó considerando el número de gestantes con reporte de urocultivo (n=648). Se realizó un análisis descriptivo de las características de la muestra y un análisis bivariado para evaluar las diferencias en el diagnóstico de ITU. Finalmente, se estimaron los factores asociados a ITU mediante un modelo de regresión log binomial. Resultados. La prevalencia de ITU durante el embarazo fue del 14.51% (n = 94). Se observó que por cada año de aumento en la edad materna hubo una reducción del 6% en la prevalencia de ITU (RP: 0.94, IC95%: 0.90-0.98, p=0.005); además, se encontró una asociación entre tener antecedentes de ITU y desarrollar esta complicación durante la gestación (RP: 3.6, IC95%: 1.81-7.08, p<0.001). Los patógenos aislados más frecuentes fueron Escherichia Coli (75.53%) y Klebsiella spp (17.02%). Conclusión. Cerca del 15% de las participantes tuvieron ITU, por lo que se requiere implementar estrategias de educación en salud dirigidas a las gestantes socialmente vulnerables, principalmente a las más jóvenes y aquellas con antecedentes de ITU, con el fin de reducir su ocurrencia y sus posibles consecuencias para la salud materno-fetal. Igualmente, los datos reportados aquí pueden ayudar al desarrollo de políticas públicas que busquen mejorar la prevención y atención de dicha complicación en esta población.

Abstract Introduction: Urinary tract infection (UTI) is the most common medical complication during pregnancy and is associated with adverse maternal and perinatal outcomes. Objectives: To determine the prevalence of UTI in socially vulnerable pregnant women in Bucaramanga, Colombia, and to characterize these cases. Also, to identify the factors associated with the development of this complication and the antibiotic resistance profile of the microorganisms causing the infection. Materials and methods: Secondary analysis of the data obtained in a main study conducted on 838 pregnant women treated by the public healthcare network of Bucaramanga. The prevalence of UTI was estimated considering the number of pregnant women with a urine culture report (n=648). A descriptive analysis of the sample characteristics and a bivariate analysis were performed to evaluate the differences in the diagnosis of UTI. Finally, factors associated with UTI were estimated using a binomial logistic regression model. Results: The prevalence of UTI during pregnancy was 14.51% (n=94). For each year that maternal age increased, a 6% reduction in the prevalence of UTI (PR: 0.94 95% CI: 0.90-0.98, p<0.001) was observed. Moreover, an association was found between having a history of UTI and developing this complication during pregnancy (PR: 3.6 95% CI: 1.81-7.08, p= 0.005). The most common pathogens isolated were E. Coli (75.53%) and Klebsiella spp (17.02%). Conclusion: About 15% of the participants had UTI, so it is necessary to implement health education strategies aimed at socially vulnerable pregnant women, mainly the youngest and those with a history of UTI, to reduce its occurrence and possible consequences for maternal-fetal health. Furthermore, the data reported herein may help develop public policies to improve prevention and care of UTI in this population.

SUMMARY OBJECTIVE: This study aimed to analyze the compliance with the assistance protocol and factors associated with the judicialization of coagulation factors in severe hemophilia patients. METHODS: A retrospective, cross-sectional study was conducted from June 2015 to May 2016 in adults with severe hemophilia in the Federal District, Brazil using data from their medical records and the Hemovida Web Coagulopathies System. RESULTS: One-hundred and three patients from Federal District, the capital of Brazil, were included in the study. The mean age of the patients was 34.6±10.1. Ninety-three received prophylactic treatment (90.3%) and 53 received recombinant coagulation factors (51.7%). Judicialization occurred in 21 cases (20.4%), 13 of whom disagreed with the assistance protocol (12.6%). In the univariate analysis, an association was observed between reduced judicialization and treatment (4.8 vs. 47.6%; p<0.001) in the hemophilia treatment center and an increase that was associated with use of the recombinant coagulation factor in disagreement with the protocol (38.1 vs. 6.1%; p<0.001). In the multivariate analysis, the odds ratio for judicialization was 0.081 (95% confidence interval [CI] 0.010–0.055) for treatment at the hemophilia treatment center and 5.067 (95%CI 1.392–18.446) for the use of recombinant coagulation factor not in compliance with the protocol. More inhibitor development in judicialized patients (33.3 vs. 4.9%; p<0.001) was found. CONCLUSIONS: The effectiveness of judicialization should be questioned, especially regarding coagulation factor prescriptions that are not in compliance with the protocol. The expense resulting from judicialization has not shown any benefit, and an even greater development of inhibitors during treatment in judicialized patients was found.

RESUMO Objetivo: construir as definições conceituais e operacionais das características definidoras e conceituais dos fatores relacionados do Diagnóstico de Enfermagem (DE) Hipotermia (00006) da NANDA-I, versão 2015-2017, em pacientes adultos no perioperatório. Método: revisão integrativa da literatura nas bases de dados: Medical Literature Analysis and Retrieval System Online (MEDLINE via Pubmed), Cochrane Library, The Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Literatura Latino-Americana em Ciências da Saúde (LILACS). Resultados: 2.041 artigos foram encontrados, 95 selecionadas para leitura na íntegra e 24 utilizadas na construção de tais definições. Foi explorada a literatura cinzenta para garantir robustez à elucidação dos tópicos não encontrados nos artigos. Conclusão: tais definições auxiliarão os enfermeiros da prática cirúrgica na coleta de informações, na determinação acurada do referido DE, no ensino e em pesquisas futuras relacionadas a esse tema, bem como nas próximas etapas de validação de tal DE à população referida.

ABSTRACT Objective: to construct the conceptual and operational definitions of the defining and conceptual characteristics of the related factors of the nursing diagnosis (ND) hypothermia (00006) of NANDA-I, 2015-2017, in adult patients in the perioperative period. Method: an integrative literature review in the Medical Literature Analysis and Retrieval System Online, Cochrane Library, The Cumulative Index to Nursing and Allied Health Literature and in Latin & American Literature in Health Sciences databases. Results: 2,041 articles were found, 95 selected for reading in full and 24 used to construct such definitions. Gay literature was also explored to ensure robustness to the elucidation of topics not found in articles. Conclusion: such definitions will assist nurses in surgical practice in information collection, in accurate determination of the referred ND, in teaching and in future research related to this theme, as well as in the next validation stages of such ND to the referred population.

RESUMEN Objetivo: construir las definiciones conceptuales y operativas de las características definitorias y conceptuales de los factores relacionados del Diagnóstico de Enfermería (DE) Hipotermia (00006) de NANDA-I, versión 2015-2017, en pacientes adultos en el período perioperatorio. Método: revisión integradora de la literatura en las bases de datos: MEDLINE vía Pubmed, Cochrane Library, CINAHL y LILACS. Resultados: se encontraron 2.041 artículos, 95 seleccionados para lectura íntegra y 24 utilizados en la construcción de dichas definiciones. Se exploró la literatura gris para garantizar la solidez de la elucidación de temas que no se encuentran en los artículos. Conclusión: dichas definiciones ayudarán al enfermero en la práctica quirúrgica en la recolección de información, en la determinación precisa de dicho DE, en la docencia y en futuras investigaciones relacionadas con este tema, así como en las próximas etapas de validación de dicho DE a la población referida.

Resumen Para las organizaciones es importante conocer el comportamiento de los procesos a través de la gestión del riesgo y la evaluación de los indicadores clave de desempeño (Key Performance Indicators, KPI). Un propósito del ciclo de mejoramiento continuo "planear - hacer - verificar - actuar" (PHVA) es determinar el estado de los indicadores y realizar reingeniería de procesos para lograr el cumplimiento ideal. La gestión del riesgo previene la desviación de los indicadores frente a las metas propuestas. Para determinar las variables relevantes de un proceso es necesario establecer mecanismos de monitoreo y control como forma eficiente de obtención de conocimiento basado en el uso de técnicas como las de minería de datos (MD). Estos conceptos se han articulado aquí en un modelo desarrollado para lograr el estado ideal de los KPI en una organización, y se evidencian a través de un caso de estudio aplicado en un proceso misional de una institución de educación superior, por medio del cual se describe el éxito de la teoría y el análisis planteados. Este modelo establece unos componentes a partir de la articulación de características de MD, la gestión de procesos de negocio o Business Process Management (BPM) y el ciclo PHVA con gestión del riesgo, de tal suerte que se hace posible un diseño ajustado a las necesidades particulares que sirve como modelo para investigaciones futuras.

Abstract Recognizing the behavior of processes through risk management and the assessment of value indicators (KPI), which stands for 'Key Performance Indicators', is something of paramount importance for institutions. One of the purposes of the continuous PDCA improvement cycle (Plan - Do - Check - Act) is to determine the state of the indicators and carry out processes reengineering to achieve the ideal goal. Risk management comes from the deviation of the indicators with respect to the proposed goals. In order to determine the relevant variables of a process, monitoring and control mechanisms must be set as an efficient way to obtain the knowledge based on the use of data mining techniques (MD). These concepts articulate in a model that was developed to achieve the ideal condition of the KPIs within an institution, and it is evidenced through a case study applied to a missional process in an institution of higher education. The establishment of data mining, business process management (BPM), PDCA continuous improvement cycle (Plan - Do - Check - Act), and risk management characteristics was used to define the components of the model. The aforementioned allowed to create an effective model, capable of meeting the needs of this research in particular, and able to be used as a model for future research. The proposed model was applied to a specific case, which allowed to describe the success of the theory, as well as the analysis stated.

Resumo Para as organizações é importante conhecer o comportamento dos processos por meio da gestão de risco e da avaliação dos indicadores chave de desempenho (Key Performance Indicators, KPI). Um propósito do ciclo de melhoria contínua "planejar - fazer - verificar - agir" (PHVA) é determinar o estado dos indicadores e realizar reengenharia de processos para conseguir a execução ideal. A gestão de risco previne o desvio dos indicadores diante das metas propostas. Para determinar as variáveis relevantes de um processo é necessário estabelecer mecanismos de monitoramento e de controle como forma eficiente de obtenção de conhecimento baseado no uso de técnicas como as de mineração de dados (MD). Esses conceitos foram articulados aqui num modelo desenvolvido para alcançar o estado ideal dos KPI numa organização, e são evidenciados por meio de um caso de estudo aplicado num processo missional de uma instituição de educação superior, por meio do qual se descreve o sucesso da teoria e das análises propostas. Esse modelo estabelece uns componentes a partir da articulação de características de MD, a gestão de processos de negócio ou Business Process Management (BPM) e o ciclo PHVA com gestão de risco, de tal forma que se torna possível um desenho ajustado às necessidades particulares que serve como modelo para pesquisas futuras.

ABSTRACT Objective: to analyze the content of the defining characteristics of the Disturbed Sleep Pattern Nursing Diagnosis (00198) in patients with Acute Coronary Syndrome. Method: content analysis performed by specialists who achieved a score equal to or greater than five, according to established criteria: clinical experience, teaching and/or research; participation in research groups; doctorate degree; master's degree; specialization and/or residency in cardiology and/or sleep and/or nursing classifications. Eight defining characteristics were evaluated for their relationship to population, relevance, clarity and accuracy. Descriptive statistics were performed to characterize the sample, binomial statistical test to establish if there is agreement between the experts and chi-square and Fisher's exact to establish associations between the evaluated items and the experts' variables. Results: 54 experts participated in the study. The defining characteristics validated by the experts were the following: dissatisfaction with sleep, feeling unrested, sleep deprivation, alteration in sleep pattern, unintentional awakening, difficulty initiating sleep and daytime sleepiness. There was a statistically significant association between evaluated items and the variables time of training, time of operation and punctuation. Conclusion: seven of the eight defining characteristics were considered valid after the application of binomial test. This study will contribute to the refinement of the Disturbed Sleep Pattern Nursing Diagnosis (000198) and may enable the improvement of the quality of care of patients hospitalized with Acute Coronary Syndrome regarding changes in sleep pattern. The content analysis stage will support the next stage of the validation process of the present diagnosis, the clinical validation.

RESUMEN Objetivo: analizar el contenido de las características definidoras del Diagnóstico de Enfermería de Patrón de Sueño Perjudicado (00198) en pacientes con Síndrome Coronario Agudo. Método: análisis de contenido realizado por especialistas que obtuvieron una puntaje mayor o igual a cinco, de acuerdo con los criterios establecidos: experiencia clínica, en docencia y/o en investigación; participación en grupos de investigación; doctorado; maestría; especialización y/o residencia en cardiología y/o en clasificaciones de enfermería. Se evaluaron ocho características definidoras en cuanto a su relación con la población, relevancia, claridad y precisión. Se realizó un análisis estadístico descriptivo para caracterizar la muestra, una prueba estadística de binomios para establecer si había concordancia entre los especialistas y las pruebas de chi-cuadrado y exacto de Fisher para establecer asociaciones entre los puntos evaluados y las variables de los especialistas. Resultados: del estudio participaron 54 especialistas. Las características definidoras que evaluaron los especialistas fueron las siguientes: insatisfacción con el sueño, no sentirse descansado, privación del sueño, alteración en el patrón de sueño, despertar no intencional, dificultad para iniciar el sueño y somnolencia diurna. Se registró una asociación estadística significativa entre los puntos evaluados y las siguientes variables: tiempo de formación, tiempo de ejercicio en la profesión y puntuación. Conclusión: siete de las ocho Características definidoras se consideraron válidas después de aplicar la prueba de binomios. El presente estudio contribuirá a perfeccionar el Diagnóstico de Enfermería de Patrón de Sueño Perjudicado (000198) y podrá hacer posible que se mejore la calidad de la atención de pacientes internados con Síndrome Coronario Agudo en lo referente a alteraciones en el patrón de sueño. La etapa del análisis de contenido servirá de ayuda para la próxima etapa del proceso de validación del presente diagnóstico: la validación clínica.

RESUMO Objetivo: analisar o conteúdo das características definidoras do Diagnóstico de Enfermagem Padrão de Sono Prejudicado (00198) em pacientes com Síndrome Coronariana Aguda. Método: análise de conteúdo realizada por especialistas que atingiram pontuação igual ou maior a cinco, de acordo com critérios estabelecidos: experiência clínica, no ensino e/ou pesquisa; participação em grupos de pesquisa; doutorado; mestrado; especialização e/ou residência em cardiologia e/ou sono e/ou classificações de enfermagem. Oito características definidoras foram avaliadas quanto a sua relação com a população, relevância, clareza e precisão. Realizou-se estatística descritiva para caracterização da amostra, teste estatístico binomial para estabelecer se há concordância entre os especialistas e qui-quadrado e exato de Fisher para estabelecer associações entre os itens avaliados e variáveis dos especialistas. Resultados: 54 especialistas participaram do estudo. As características definidoras validadas pelos especialistas foram: insatisfação com o sono, não se sentir descansado, privação do sono, alteração do padrão de sono, despertar não intencional, dificuldade para iniciar o sono e sonolência diurna. Houve associação estatística significativa entre itens avaliados e as variáveis tempo de formação, tempo de atuação e pontuação. Conclusão: sete das oito características definidoras foram consideradas válidas após aplicação de teste binomial. O presente estudo contribuirá para o refinamento do Diagnóstico de Enfermagem Padrão de Sono Prejudicado (000198) e poderá possibilitar a melhoria da qualidade do atendimento de pacientes internados com Síndrome Coronariana Aguda no que tange a alterações do padrão de sono. A etapa de análise de conteúdo subsidiará a próxima etapa do processo de validação do presente diagnóstico, a validação clínica.