E-voting in Brazil - the risks to democracy

Literature has shown that countries with strong democratic traditions, such as the United States and Canada, are not yet using electronic voting systems intensively, due to the concern for and emphasis on security. It has revealed that there is no such thing as an error-free computer system, let alone an electronic voting system, and that existing technology does not offer the conditions necessary for a reliable, accurate and secure electronic voting system. In this context, then, what are the risks of e-voting to democracy? In what ways, if at all, can more fragile, less mature democracies be buttressed with e-voting systems? As a key component of e-democracy, it seems that e-voting technologies are to become more secure and increasingly reliable in the near future and will indeed be adopted in many countries. In what ways, if at all, will the introduction of such systems increase voter confidence in the political system, promote citizen engagement in political life, and nurture the evolution of democracy? If both e-voting and edemocracy are emerging based on popular demand - that is, as a demand-driven alternative to current processes, then there is no doubt that they are likely to enhance and improve the efficiency of traditional democracy. However, if e-voting technology is being introduced based on a supply-driven fashion - the technology exists therefore it should and must be implemented - then the implications for democracy should be considered. Brazil's introduction of e-voting offers a cautionary tale of supply-driven technological implication. The purpose of this paper is to demonstrate how the introduction of e-voting in Brazil is highly risky to democracy due to the lack of emphasis on security and the lack of a sociallyinformed and socially driven approach to technological innovation. The Brazilian example illustrates the democratic implications of a market-driven approach. The lack of a technology strategy designed to promote and extend democratic principles is not surprising given the closed door, market-based negotiations that led to the adoption of e-voting in Brazil. The promise, and indeed, the imperative of a democratic, voter-centered approach as an alternative for the development of an electronic voting system, is explored in the paper

OntONeo: The Obstetric and Neonatal Ontology

This paper presents the Obstetric and Neonatal Ontology (OntONeo). This ontology has been created to provide a consensus representation of salient electronic health record (EHR) data and to serve interoperability of the associated data and information systems. More generally, it will serve interoperability of clinical and translational data, for example deriving from genomics disciplines and from clinical trials. Interoperability of EHR data is important to ensuring continuity of care during the prenatal and postnatal periods for both mother and child. As a strategy to advance such interoperability we use an approach based on ontological realism and on the ontology development principles of the Open Biomedical Ontologies Foundry, including reuse of reference ontologies wherever possible. We describe the structure and coverage domain of OntONeo and the process of creating and maintaining the ontology

The Software and Information Services Sector in Argentina: Pros and Cons of an Inward-Orientated Development Strategy

software information services, developing countries, Argentina

Medical Informatics

Information technology has been revolutionizing the everyday life of the common man, while medical science has been making rapid strides in understanding disease mechanisms, developing diagnostic techniques and effecting successful treatment regimen, even for those cases which would have been classified as a poor prognosis a decade earlier. The confluence of information technology and biomedicine has brought into its ambit additional dimensions of computerized databases for patient conditions, revolutionizing the way health care and patient information is recorded, processed, interpreted and utilized for improving the quality of life. This book consists of seven chapters dealing with the three primary issues of medical information acquisition from a patient's and health care professional's perspective, translational approaches from a researcher's point of view, and finally the application potential as required by the clinicians/physician. The book covers modern issues in Information Technology, Bioinformatics Methods and Clinical Applications. The chapters describe the basic process of acquisition of information in a health system, recent technological developments in biomedicine and the realistic evaluation of medical informatics

A systematic review of the nature of dispensing errors in hospital pharmacies

Background: Dispensing errors are common in hospital pharmacies. Investigating dispensing errors is important for identifying the factors involved and developing strategies to reduce their occurrence. Objectives: To review published studies exploring the incidence and types of dispensing errors in hospital pharmacies and factors contributing to these errors. Methods: Electronic databases including PubMed, Scopus, Ovid, and Web of Science were searched for articles published between January 2000 and January 2015. Inclusion criteria were: studies published in English, and studies investigating type, incidence and factors contributing to dispensing errors in hospital pharmacies. One researcher searched for all relevant published articles, screened all titles and abstracts, and obtained complete articles. A second researcher assessed the titles, abstracts, and complete articles to verify the reliability of the selected articles. Key findings: Fifteen studies met the inclusion criteria all of which were conducted in just four countries. Reviewing incident reports and direct observation were the main methods used to investigate dispensing errors. Dispensing error rates varied between countries (0.015%–33.5%) depending on the dispensing system, research method, and classification of dispensing error types. The most frequent dispensing errors reported were dispensing the wrong medicine, dispensing the wrong drug strength, and dispensing the wrong dosage form. The most common factors associated with dispensing errors were: high workload, low staffing, mix-up of look-alike/sound-alike drugs, lack of knowledge/experience, distractions/interruptions, and communication problems within the dispensary team. Conclusion: Studies relating to dispensing errors in hospital pharmacies are few in number and have been conducted in just four countries. The majority of these studies focused on the investigation of dispensing error types with no mention of contributing factors or strategies for reducing dispensing errors. Others studies are thus needed to investigate dispensing errors in hospital pharmacies, and a combined approach is recommended to investigate contributing factors associated with dispensing errors and explore strategies for reducing these errors.Peer reviewe

Linking Theoretical Perspectives to Analyze Health Information and Communication Technologies in Brazil

Over the course of the past thirty years, Brazil has developed health information systems (HIS). However, to date these HIS are fragmented and ongoing endeavors to integrate them have failed. Thus, this research-in-progress links two theoretical streams, namely: (a) HIS in developing countries; and (b) Information and Information Technology in Health, in order to establish a framework to assess health information and communication technologies (ICT) in Brazil. The proposed framework sees health ICT as a public policy aiming at developing technical artifacts – information systems, standards, processes and rules – to assist society in health issues. Besides, this framework sets up analytical dimensions for assessing this public policy, namely democratization, effectiveness, sustainability, and synergy. The proposed framework also enables the analysis of the trajectory of this public policy via the actors involved with it – politicians, bureaucrats, executives, and civil society –, who interact with each other within spaces influenced by rules and material elements such as information systems and previous standards

Examining the quality of record linkage process using nationwide Brazilian administrative databases to build a large birth cohort.

BACKGROUND: Research using linked routine population-based data collected for non-research purposes has increased in recent years because they are a rich and detailed source of information. The objective of this study is to present an approach to prepare and link data from administrative sources in a middle-income country, to estimate its quality and to identify potential sources of bias by comparing linked and non-linked individuals. METHODS: We linked two administrative datasets with data covering the period 2001 to 2015, using maternal attributes (name, age, date of birth, and municipally of residence) from Brazil: live birth information system and the 100 Million Brazilian Cohort (created using administrative records from over 114 million individuals whose families applied for social assistance via the Unified Register for Social Programmes) implementing an in house developed linkage tool CIDACS-RL. We then estimated the proportion of highly probably link and examined the characteristics of missed-matches to identify any potential source of bias. RESULTS: A total of 27,699,891 live births were submited to linkage with maternal information recorded in the baseline of the 100 Million Brazilian Cohort dataset of those, 16,447,414 (59.4%) children were found registered in the 100 Million Brazilian Cohort dataset. The proportion of highly probably link ranged from 39.3% in 2001 to 82.1% in 2014. A substantial improvement in the linkage after the introduction of maternal date of birth attribute, in 2011, was observed. Our analyses indicated a slightly higher proportion of missing data among missed matches and a higher proportion of people living in an urban area and self-declared as Caucasian among linked pairs when compared with non-linked sets. DISCUSSION: We demonstrated that CIDACS-RL is capable of performing high quality linkage even with a limited number of common attributes, using indexation as a blocking strategy in larg e routine databases from a middle-income country. However, residual records occurred more among people under worse living conditions. The results presented in this study reinforce the need of evaluating linkage quality and when necessary to take linkage error into account for the analyses of any generated dataset