10 research outputs found

    The nationwide electronic health record: the Australian case

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    Introduction. Given the historical fragmentation of health information systems generated by multiple local, regional, and national initiatives for deployment of information and communication technologies, many countries have sought solutions to allow interoperability of existing systems or the proposition of single systems to collect clinical data on a national scale. Objective. To study the Australian case of implementation of the patient electronic medical record on a national scale, considered a successful initiative in the international scenario and aimed at patient empowerment. Methods. A qualitative descriptive study was carried out based on a documentary survey, including scientific articles and gray literature. Results. A total of 1301 PubMed papers related to the electronic medical record of Australia were retrieved and, after applying inclusion and exclusion criteria, 23 articles related to the current initiative were selected and five documents obtained from official and from non-governmental agencies websites. Four central aspects were observed: context of the health system, implementation process, characteristics and evaluations on the Australian electronic health record. Conclusion. Even though the Australian initiative electronic health record has received international recognition, many barriers still need to be overcome to improve acceptance by population and health professionals involved in its use. Furthermore, a nationwide shared patient-controlled health record deeply alters traditional power relations, usually physician-centered, requiring a comprehensive review of health work processes.Introdu√ß√£o. Dada a hist√≥rica fragmenta√ß√£o dos sistemas de informa√ß√Ķes em sa√ļde gerada por m√ļltiplas iniciativas locais, regionais e nacionais de implanta√ß√£o de tecnologias de informa√ß√£o e comunica√ß√£o, muitos pa√≠ses t√™m buscado solu√ß√Ķes que permitam a interoperabilidade dos sistemas existentes e/ou a proposi√ß√£o de sistemas √ļnicos para a coleta de dados cl√≠nicos em escala nacional. Objetivo. Estudar o caso australiano de implanta√ß√£o do prontu√°rio eletr√īnico do paciente em escala nacional, por ser considerada uma iniciativa bem sucedida no cen√°rio internacional e que visa o empoderamento do paciente. Metodologia. Realizou-se um estudo qualitativo descritivo com base em levantamento documental, incluindo artigos cient√≠ficos e literatura cinzenta. Resultados. Foram recuperados 1301 artigos da PubMed relacionados ao prontu√°rio eletr√īnico da Austr√°lia e, ap√≥s a aplica√ß√£o de crit√©rios de inclus√£o e exclus√£o, 23 artigos relacionados √† iniciativa australiana foram selecionados, bem como cinco documentos em portais governamentais e de organiza√ß√Ķes n√£o-governamentais. Quatro aspectos centrais foram observados: o sistema de sa√ļde australiano, o processo de implanta√ß√£o, as caracter√≠sticas e as avalia√ß√Ķes sobre o prontu√°rio eletr√īnico australiano. Conclus√£o. Embora o sistema nacional de prontu√°rio eletr√īnico da Austr√°lia seja reconhecido internacionalmente como uma iniciativa bem-sucedida, muitas barreiras precisam ser superadas para que haja uma aceita√ß√£o ampla por parte da popula√ß√£o e dos profissionais de sa√ļde envolvidos em sua utiliza√ß√£o. Adicionalmente, um sistema de prontu√°rio eletr√īnico compartilhado a n√≠vel nacional, controlado pelo paciente, altera substancialmente as tradicionais rela√ß√Ķes de poder, geralmente m√©dico-centradas, requerendo uma revis√£o dos processos de trabalho na assist√™ncia em sa√ļde

    Disciplinas sobre informa√ß√£o em sa√ļde ministradas entre 2008-2018 na Universidade de S√£o Paulo

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    In the 2000s, the Department of Social Medicine of the Medical School of Ribeir√£o Preto, University of S√£o Paulo, Brazil, conceived five disciplines related to the field of health information that could be carried out by students of the undergraduate courses in Biomedical Informatics and Undergraduate Information Science. These are: Health Information Sources, Health Documentation, Communication and Dissemination of Health Information, Health Terminologies and Health Information Technologies. The objective of this work was to present these disciplines and their developments in the last 10 years. For the construction of the study, the public data available on the academic platforms of the University were consulted, as well as the anonymous assessments that the students made about the disciplines were accessed. As a result, it was observed that, over 10 years, 763 students benefited from this offer, acquiring new informational and technological skills

    Disseminating health evidence summaries to increase evidence use in health care

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    OBJECTIVE: To verify whether an intervention based on disseminating health evidence summaries by e-mail to health professionals increases access to health evidence databases, and whether health professionals intend to apply the evidence received by e-mail in their clinical practice. METHODS: This quantitative study started with a survey to collect demographic data and patterns of access to health evidence databases. It was followed by a longitudinal intervention, over 48 weeks, that disseminated 143 health evidence summaries to 339 health professionals with higher education degree who work in the Brazilian Unified Health System. In the longitudinal intervention phase, health professionals voluntarily assessed the received health evidence summaries using the information assessment method. Finally, the study concluded with a survey to identify changes in accessing health evidence databases. RESULTS: Of the 339 Brazilian health professionals participating in this research, 90 (26.5%) answered the initial and final surveys. After 48 weeks, there was an increase in the use of health evidence databases; 186 (54.9%) participants submitted 7,942 assessments of health evidence summaries, which were relevant for patient care in 5,409 (68%) assessments. CONCLUSIONS: The dissemination of health evidence summaries by e-mail to health professionals in Brazil increases the reported use of evidence in clinical practice

    Disseminating health evidence summaries to increase evidence use in health care

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    ABSTRACT OBJECTIVE: To verify whether an intervention based on disseminating health evidence summaries by e-mail to health professionals increases access to health evidence databases, and whether health professionals intend to apply the evidence received by e-mail in their clinical practice. METHODS: This quantitative study started with a survey to collect demographic data and patterns of access to health evidence databases. It was followed by a longitudinal intervention, over 48 weeks, that disseminated 143 health evidence summaries to 339 health professionals with higher education degree who work in the Brazilian Unified Health System. In the longitudinal intervention phase, health professionals voluntarily assessed the received health evidence summaries using the information assessment method. Finally, the study concluded with a survey to identify changes in accessing health evidence databases. RESULTS: Of the 339 Brazilian health professionals participating in this research, 90 (26.5%) answered the initial and final surveys. After 48 weeks, there was an increase in the use of health evidence databases; 186 (54.9%) participants submitted 7,942 assessments of health evidence summaries, which were relevant for patient care in 5,409 (68%) assessments. CONCLUSIONS: The dissemination of health evidence summaries by e-mail to health professionals in Brazil increases the reported use of evidence in clinical practice

    Mixed methods research and mixed reviews of literature: concepts, design, and evaluation criteria

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    Mixed methods and mixed literature reviews can provide a window of opportunity for researchers to enter in the process of science internationalization. In this paper, we systematize concepts, design, and evaluation criteria related to research using mixed methods and mixed literature reviews. Initially, we performed a selective literature review, considering the criteria of text relevance in order to have an initial understanding of essential aspects of mixed methods and mixed reviews. Then, we present a case report showing the perception of Brazilian researchers on a teaching and learning experience on mixed methods and mixed reviews. As a result, we understand that knowledge on mixed research methods and mixed literature reviews has the potential to increase the capacity of national and international research; increase the critical mass of reviewers for the work in development agencies and national and international journals; and strengthen international cooperation for the development of research projects.O emprego de m√©todos mistos e revis√Ķes de literatura mistas pode ser uma janela de oportunidades para que os pesquisadores se insiram no processo de internacionaliza√ß√£o da ci√™ncia. Desse modo, o presente trabalho sistematiza conceitos, formas de constru√ß√£o e crit√©rios de avalia√ß√£o relacionados a pesquisas empregando m√©todos mistos e revis√Ķes de literatura mistas. No que se refere √† metodologia, empregou-se uma revis√£o de literatura seletiva, considerando o crit√©rio de relev√Ęncia do texto para que se tenha uma inicializa√ß√£o e compreens√£o dos aspectos essenciais relacionados a m√©todos mistos e revis√Ķes mistas. Em seguida, empregou-se um relato de caso que apresenta a percep√ß√£o de pesquisadores brasileiros sobre uma experi√™ncia de ensino-aprendizagem com a tem√°tica de m√©todos mistos e revis√Ķes mistas. Como resultado, entende-se que o conhecimento sobre m√©todos de pesquisa mistos e revis√Ķes de literatura mistas tem potencial para aumentar a capacidade de investiga√ß√£o nacional e internacional; ampliar a massa cr√≠tica de revisores para a atua√ß√£o em ag√™ncias de fomento e em peri√≥dicos nacionais e internacionais; e, refor√ßar a colabora√ß√£o internacional para desenvolvimento de projetos de pesquisa

    O prontu√°rio eletr√īnico do paciente no s√©culo XXI: contribui√ß√Ķes necess√°rias da ci√™ncia da informa√ß√£o

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    The electronic health record raises informational and technological issues, including some that can be addressed using knowledge from the information science field and from informational professionals. To explore these issues, this article departs from the scope of electronic health record and establishes possible connections within the scope of information science. In these connections, information from literature reviews was combined with knowledge obtained by observation of contexts of health records production and use, by observation and analysis of health records in different formats and from different institutions, and by contact with health professionals, information professionals, computing professionals, managers, and researchers that work directly with health records. Results describe informational and technological issues of electronic health record that are related to the processes of creation, communication, identification, selection, acquisition, organization and retrieval, storage, preservation, analysis and synthesis, and assessment of information. Conclusions show that in the 21st Century, the electronic health record, when considered in its local, regional, national and international dimensions, presents issues that are adequate to the purposeful activity of information professionals, and constitutes research field for the information science, which can contribute to health improvement and, simultaneously, can expand, test, and refine its theories, hypotheses, and methodologies.A constru√ß√£o do prontu√°rio eletr√īnico do paciente demanda metodologias informacionais e tecnol√≥gicas. Tem-se por objetivo levantar aquelas que podem ter resolubilidade por meio dos conhecimentos da ci√™ncia da informa√ß√£o e de seus profissionais. Como metodologia para elaborar o estudo, partiu-se do escopo de prontu√°rio eletr√īnico do paciente estabelecendo-se conex√Ķes poss√≠veis com o escopo da ci√™ncia da informa√ß√£o. Nestas conex√Ķes, combinaram-se os conhecimentos adquiridos por revis√£o da literatura, por observa√ß√£o de contextos de produ√ß√£o e uso do prontu√°rio do paciente, por observa√ß√£o e an√°lise de prontu√°rios em diferentes suportes e em diferentes institui√ß√Ķes, pelo contato direto com profissionais da sa√ļde, da informa√ß√£o e da inform√°tica que trabalham diretamente com o prontu√°rio do paciente, gestores, docentes e pesquisadores que fazem uso de prontu√°rios de pacientes. O resultado descreve demandas informacionais e tecnol√≥gicas do prontu√°rio eletr√īnico do paciente relacionadas aos processos de cria√ß√£o, comunica√ß√£o, identifica√ß√£o, sele√ß√£o, aquisi√ß√£o, organiza√ß√£o e recupera√ß√£o, armazenagem, preserva√ß√£o, an√°lise e s√≠ntese, e avalia√ß√£o da informa√ß√£o. Conclui-se que, no s√©culo XXI, o prontu√°rio eletr√īnico do paciente, se considerado em sua dimens√£o local, regional, nacional e internacional, apresenta demandas prop√≠cias para a atua√ß√£o propositiva do profissional da informa√ß√£o e constitui campo de pesquisa para que a ci√™ncia da informa√ß√£o, de um lado, contribua com a sa√ļde e, de outro, amplie, teste e aperfei√ßoe suas teorias, hip√≥teses e metodologias

    Disseminating health evidence summaries to increase evidence use in health care

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    From medical librarian to informacionist: semantic traces of their profiles and areas of performance

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    This literature review retakes the discussion of the profiles and competences of the information area professional, specifically, in the health field. Therefore, the aim here is to outline the new fields of performance for the informationist and the profiles required in the health context

    Effects of biomass burning on nasal mucociliary clearance and mucus properties after sugarcane harvesting

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    Objective: Biofuel from sugarcane is widely produced in developing countries and is a clean and renewable alternative source of energy. However, sugarcane harvesting is mostly performed after biomass burning. The aim of this study was to evaluate the effects of harvesting after biomass burning on nasal mucociliary clearance and the nasal mucus properties of farm workers. Methods: Twenty seven sugarcane workers (21-45 years old) were evaluated at the end of two successive time-periods: first at the end of a 6-month harvesting period (harvesting), and then at the end of a 3-month period without harvesting (non-harvesting). Nasal mucociliary clearance was evaluated by the saccharine transit test, and mucus properties were analyzed using in vitro mucus contact angle and mucus transportability by sneeze. Arterial blood pressure, heart rate, respiratory rate, pulse oximetry, body temperature, associated illness, and exhaled carbon monoxide were registered. Results: Data are presented as mean values (95% confidence interval). The multivariate model analysis adjusted for age, body-mass index, smoking status and years of working with this agricultural practice showed that harvesting yielded prolonged saccharine transit test in 7.83 min (1.88-13.78), increased mucus contact angle in 8.68 degrees (3.18-14.17) and decreased transportability by sneeze in 32.12 mm (-44.83 to -19.42) compared with the non-harvesting period. No significant differences were detected in any of the clinical parameter at either time-period. Conclusion: Sugarcane harvesting after biomass burning negatively affects the first barrier of the respiratory system in farm workers by impairing nasal mucociliary clearance and inducing abnormal mucus properties. (C) 2011 Elsevier Inc. All rights reserved.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico[CNPq 470393/2008-4]Fundacao de Amparo a Pesquisa do Estado de Sao Paulo[FAPESP 2007/51605-9
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