Design Thinking para bibliotecas: um toolkit para design centrado no usuário / Design Thinking for libraries: a toolkit for user-centered design

O livro "Design Thinking para Bibliotecas" foi idealizado pela IDEO, com patrocínio da Fundação Bill & Melinda Gates. A FEBAB obteve autorização para traduzi-lo com participação voluntário da professora Adriana Souza e a revisão de Paula Macedo. É uma experiência para quem pretende conhecer uma nova filosofia em que o surgimento de problemas sejam potencialmente transformados por uma equipe em oportunidades para ação por meio de processos de inspiração, ideação e iteração.

Redes de coautoría de investigación en salud pública en Santander / Co-authorship research networks in public health in Santander

Introducción. Aunque hay mucha investigación relacionada con la salud pública, aún persisten grandes desigualdades en este campo. Es necesario conocer cómo se genera el conocimiento y cómo se divulga al público para acercar la investigación a los tomadores de decisiones. Objetivo. Caracterizar las redes de investigación en salud pública en Santander, Colombia. Materiales y métodos. Se analizaron las redes sociales con base en la coautoría de publicaciones científicas de investigadores residentes en Santander durante el 2012. Se identificó a los investigadores mediante el llamado muestreo de "bola de nieve". Las publicaciones se buscaron en bases de datos nacionales e internacionales. Se calcularon la densidad y la distancia geodésica promedio de la red, así como el tamaño, las parejas, el agente conector ( broker ) y la ´homofilia´ (afinidad) de las redes egocéntricas. Resultados. Se detectaron 531 investigadores, la mayoría en epidemiología (77,59 %) y en más de un área temática. La densidad de la red fue de 0,0058 y, la distancia geodésica promedio, de 4,418. Varios indicadores sugirieron que las redes egocéntricas más cohesionadas fueron las de quienes investigan en más de un área del conocimiento o en epidemiología. La ´homofilia´ fue menor en sistemas de salud, bioestadística y ciencias sociales y del comportamiento, así como en instituciones hospitalarias privadas y en la universidad pública. Conclusiones. La estructura de la red sugiere una fase de crecimiento de la investigación y un predominio de la aproximación epidemiológica. Es necesario fortalecer las demás áreas de salud pública para mejorar la respuesta ante las necesidades de salud del departamento.

Introduction: Although a good deal of research in public health has been performed, large inequalities still exist in health. It is necessary to know how knowledge is generated and disseminated to the public in order for research to reach decision-makers. Objective: To characterize public health research networks in Santander, Colombia. Materials and methods: Analysis of social networks based on co-authorship of scientific publications by researchers living in Santander in 2012. Researchers were identified using a "snowball" technique. The publications search was conducted using national and international databases. The density and average geodesic distance of networks were calculated, as was the size, pairs, brokers and homophily of egocentric networks. Results: There were 531 researchers. Most worked in epidemiology (77.59%), and in more than one thematic field. The network density was 0.0058 and the average geodesic distance was 4.418. Several indicators suggested that the most cohesive egocentric networks were those in which researches investigated more than in one knowledge area or in epidemiology. Homophily was lower for health systems, biostatistics and social and behavioral sciences, as well as private hospitals and the public university. Conclusions: The network structure suggests a growth phase in research and a predominance of epidemi-ology. Other public health areas need strengthening so as to better address the health needs of the state.

The world´s microbiology laboratories can be a global microbial sensor network / Los laboratorios de microbiología del mundo pueden convertirse en una red de detección microbiana

The microbes that infect us spread in global and local epidemics, and the resistance genes that block their treatment spread within and between them. All we can know about where they are to track and contain them comes from the only places that can see them, the world´s microbiology laboratories, but most report each patient´s microbe only to that patient´s caregiver. Sensors, ranging from instruments to birdwatchers, are now being linked in electronic networks to monitor and interpret algorithmically in real-time ocean currents, atmospheric carbon, supply-chain inventory, bird migration, etc. To so link the world´s microbiology laboratories as exquisite sensors in a truly lifesaving real-time network their data must be accessed and fully subtyped. Microbiology laboratories put individual reports into inaccessible paper or mutually incompatible electronic reporting systems, but those from more than 2,200 laboratories in more than 108 countries worldwide are now accessed and translated into compatible WHONET files. These increasingly web-based files could initiate a global microbial sensor network. Unused microbiology laboratory byproduct data, now from drug susceptibility and biochemical testing but increasingly from new technologies (genotyping, MALDI-TOF, etc.), can be reused to subtype microbes of each genus/species into sub-groupings that are discriminated and traced with greater sensitivity. Ongoing statistical delineation of subtypes from global sensor network data will improve detection of movement into any patient of a microbe or resistance gene from another patient, medical center or country. Growing data on clinical manifestations and global distributions of subtypes can automate comments for patient´s reports, select microbes to genotype and alert responders.

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Strategic alliances: an analysis of Catalan hospitals / Alianzas estratégicas: un análisis de los hospitales catalanes

OBJECTIVE: To analyze the strategic alliances that Catalan hospitals form with other health care entities and other types of institutions to foster technological and organizational innovation. METHODS: Qualitative case studies were conducted at a sample of 16 public hospitals in Catalonia, Spain. The sample was limited to three (Level 1-3) of Catalonia's four levels of hospitals (classified according to the complexity of the diagnoses and treatments they provide), but Level 4 hospitals were considered as part of the network in the analysis of the alliances. At each hospital, interviews were conducted with the manager, the medical director, and the service director, using a questionnaire that gathered information on strategic alliances with a focus on telemedicine. Qualitative data processing was applied to identify patterns of alliances between hospitals and other institutions. RESULTS: Catalan hospitals interact with other health care agents through three main types of associations: alliances with other hospitals (the most frequent type); alliances with primary care centers (reported mostly by Level 2 hospitals); and alliances with other institutions (e.g., local government, medical companies, and universities). Human resource-sharing (staff mobility) and training were reported most frequently as reasons for creating the alliances. CONCLUSIONS: Strategic alliances are formed between hospitals and other health care agents to help improve performance, competitiveness, and services provided to users. These results may help health care system managers promote strategic alliances as a means of optimizing system efficiency without reducing user satisfaction-a key challenge within the context of the current economic situation.

OBJETIVO: Analizar las alianzas estratégicas que los hospitales catalanes forjan con otras entidades de atención de la salud y otros tipos de instituciones para fomentar la innovación tecnológica y de las organizaciones. MÉTODOS: Se condujeron estudios cualitativos de casos en una muestra de 16 hospitales públicos de Cataluña, España. La muestra se limitó a tres (Niveles 1 a 3) de los cuatro niveles de los hospitales catalanes (clasificados según la complejidad de los diagnósticos y los tratamientos que proporcionan), pero los hospitales de Nivel 4 se consideraron parte de la red en el análisis de las alianzas. En cada hospital se efectuaron entrevistas con el gerente, el director médico y el director de servicio, mediante un cuestionario que recopilaba información sobre las alianzas estratégicas con hincapié en la telemedicina. Se aplicó el procesamiento cualitativo de datos para identificar los modelos de alianzas entre los hospitales y otras instituciones. RESULTADOS: Los hospitales catalanes interactúan con otros agentes de atención de la salud a través de tres tipos principales de asociaciones: alianzas con otros hospitales (el tipo más frecuente); alianzas con centros de atención primaria (según lo informado principalmente por los hospitales de Nivel 2); y alianzas con otras instituciones (por ejemplo, el gobierno local, las empresas médicas y las universidades). El intercambio de recursos humanos (movilidad del personal) y la capacitación fueron mencionados como los motivos más frecuentes para crear las alianzas. CONCLUSIONES: Se forman alianzas estratégicas entre los hospitales y otros agentes de atención de la salud con el objeto de mejorar el desempeño, la competitividad y los servicios prestados a los usuarios. Estos resultados pueden ayudar a los gerentes de los sistemas de atención de la salud a promover alianzas estratégicas como medio para optimizar la eficiencia del sistema sin reducir la satisfacción de los usuarios -un reto clave en el contexto de la situación económica actual.

La Organización Panamericana de la Salud y la salud internacional: una historia de formación, conceptualización y desarrollo colectivo / The Pan American Health Organization and international health: a history of training, conceptualization, and collective development

El entorno global, cada vez más complejo y en constante cambio, requiere líderes con competencias especiales para responder eficazmente a este escenario. En este contexto, la Organización Panamericana de la Salud (OPS) va más allá de los modelos tradicionales de formación en materia de liderazgo tanto en cuanto al diseño como al modelo conceptual de la salud internacional. Como organización de salud intergubernamental y centenaria, la OPS ofrece a los participantes una posición ventajosa única desde la cual pueden conceptualizar, compartir experiencias y desarrollar proyectos pertinentes para la salud internacional. Con más de dos decenios de experiencia (1985-2006) en la preparación de profesionales a través del Programa de Formación en Salud Internacional que lo antecedió, el Programa de Líderes en Salud Internacional "Edmundo Granda Ugalde" (PLSI) utiliza un diseño innovador, actividades de aprendizaje virtuales y prácticas, y un enfoque basado en problemas para analizar los principales conceptos, teorías, actores, fuerzas y procesos en el campo de la salud internacional. En colaboración con las representaciones de la OPS/OMS e instituciones nacionales, los participantes desarrollan proyectos nacionales basados en los temas de salud prioritarios, muchos de los cuales se integran en la cooperación técnica de la Organización y/o son ejecutados por los ministerios pertinentes y otras entidades en sus respectivos países o subregiones. Desde su inicio en el 2008, en el PLSI han participado 185 personas en representación de 31 países, lo que se suma a las 187 personas capacitadas mediante el programa antecesor. Estas iniciativas han contribuido al desarrollo de profesionales de la salud dedicados a la salud internacional en la Región de las Américas, y ha hecho aportes importantes hacia la comprensión conceptual de la salud internacional mediante la promoción del debate sobre este tema.

A constantly changing and increasingly complex global environment requires leaders with special competencies to respond effectively to this scenario. Within this context, the Pan American Health Organization (PAHO) goes beyond traditional leadership training models both in terms of its design as well as its conceptual approach to international health. As an intergovernmental, centenary organization in health, PAHO allows participants a unique vantage point from which to conceptualize, share experiences and develop projects relevant to international health. Derived from over two decades of experience (1985-2006) training professionals through its predessor Training Program in International Health, the Leaders in International Health Program "Edmundo Granda Ugalde" (LIHP) utilizes an innovative design, virtual and practical learning activities, and a problem-based approach to analyze the main concepts, theories, actors, forces, and processes relevant to international health. In collaboration with PAHO/WHO Representative Offices and national institutions, participants develop country projects based on priority health issues, many of which are integrated into the Organization's technical cooperation and/or implemented by relevant ministries and other entities in their respective countries/subregions. A total of 185 participants representing 31 countries have participated in the LIHP since its inception in 2008, building upon the 187 trained through its predecessor. These initiatives have contributed to the development of health professionals in the Region of the Americas devoted to international health, as well as provided important input towards a conceptual understanding of international health by fostering debate on this issue.

Sistema de salud de Ecuador / The health system of Ecuador

En este trabajo se describen las condiciones de salud en Ecuador y, con mayor detalle, las características del sistema ecuatoriano de salud, incluyendo su estructura y cobertura, sus fuentes de financiamiento, los recursos físicos, materiales y humanos de los que dispone, las tareas de rectoría que desarrolla el Ministerio de Salud Pública, la generación de información en salud, las tareas de investigación, y la participación de los ciudadanos en la operación y evaluación del sistema. También se discuten las innovaciones más recientes que se han implantado en el sistema ecuatoriano de salud dentro de las que destaca la incorporación de un capítulo específico sobre salud a la nueva Constitución que reconoce a la protección de la salud como un derecho humano y la construcción de la Red Pública Integral de Salud.

This paper describes the health conditions in Ecuador and, in more detail, the characteristics of the Ecuadorian health system, including its structure and coverage, its financial sources, the physical, material and human resources available, and the stewardship activities developed by the Ministry of Public Health. It also describes the structure and content of its health information system, and the participation of citizens in the operation and evaluation of the health system. The paper ends with a discussion of the most recent policy innovations implemented in the Ecuadorian system, including the incorporation of a chapter on health into the new Constitution which recognizes the protection of health as a human right, and the construction of the Comprehensive Public Health Network.

Sistemas de información en salud en la región mesoamericana / Health information systems in the Mesoamerican region

OBJETIVO: Evaluar y analizar los sistemas de información en salud (sis) en la región mesoamericana. MATERIAL Y MÉTODOS: Se utilizó el marco conceptual y las herramientas de la Red de la Métrica en Salud (RMS) que evalúa seis componentes de los SIS: recursos, indicadores, fuentes de datos, administración de la información, productos y uso. RESULTADOS: La percepción sobre el desarrollo de los sis de la región mesoamericana se considera presente pero no adecuada (57%), con la mejor percepción para México (75%) y la menor para El Salvador (41%). El componente del SIS menos desarrollado, es decir, el no adecuado, fue el de administración de la información (37%). Por el contrario, el componente con mejor calificación fue el de indicadores (poco más de 69%, adecuado). En ninguno de los casos los componentes lograron ser muy adecuados. CONCLUSIÓN: El nivel de desarrollo de los sis es heterogéneo entre los países. Es necesario generar mecanismos de cooperación para el intercambio de experiencias exitosas que fomenten una colaboración horizontal y permitan mejorar los sis actuales para dar sustento a la toma de decisiones y a la evaluación de intervenciones en salud, como los de la iniciativa mesoamericana de la salud.

OBJECTIVE: To evaluate and analyze health information systems (his) in the Mesoamerican Region. MATERIAL AND METHODS: The conceptual framework and tools of the Health Metrics Network (nhm) was used. It measures six components of the his assessment: resources, indicators, data sources, information management, products and use. RESULTS: In this study we found that the average score of the HIS in the Mesoamerican region was 57%, being the maximum value for Mexico (75%) and the minimum for El Salvador (41%). The item that had lowest scores was that referring to the Management and Administration, where the average assessment was 37%, placing it as present but not adequate. The component with the highest score was Information Products with more than 69%, adequate. In any case, no items were very adequate. CONCLUSION: The performance of his is heterogeneous between countries. It is necessary to strengthen and standardize the criteria of the his in the region, so that these are integrated and used in the decision making process based on real information.

Diseño e implementación del sistema de información para la relación docencia-servicio del programa de enfermería en la Universidad Libre de Pereira / Design and implementation of information system for teaching-service relationship of the nursing program at the Universidad Libre of Pereira

Objetivo: Presentar la metodología empleada en el diseño del sistema de información para la relación docencia-servicio, según el acuerdo 003 de 2003 y describir los resultados de su implementación en el primer semestre de 2008. Metodología: Se construyeron indicadores a partir de los criterios de evaluación para cada una de los factores y características del acuerdo. Se definieron los subsistemas de gestión y operación y la información generada de las unidades básicas: convenio, acta de reunión de la relación docencia-servicio, evaluación y costos y suministros. Resultados: El 100 de los convenios se realizó con instituciones que tenían certificación y habilitación y se elaboraron siguiendo los criterios del modelo docencia-servicio. Se realizaron comités al inicio del semestre, en el 100 de los convenios realizados. El 37,5, de los usuarios atendidos por los estudiantes fueron adultos jóvenes, el 18,0 niños menores de 10 años y adultos mayores, el 10,4. Los diagnósticos enfermeros más frecuentes fueron: el riesgo de infección, el dolor agudo y el deterioro de la movilidad física. El 36,6 de los procedimientos de enfermería fueron administrativos el 39,8, clínicos y el 23,6 de tipo ambulatorio y comunitario. Conclusiones: El diseño del sistema de información para la relación docencia-servicio ha sido útil para realizar su seguimiento desde el orden gerencial y operativo y en el proceso de toma de decisiones referente al proceso educativo de los estudiantes de enfermería durante sus prácticas formativas.

Objective: To present the methodology used in designing the information system for teaching-service relationship, according to the agreement 003 of 2003 and describing the results of its implementation in the first semester of 2008. Methodology: Indicators were constructed upon the evaluation criteria for each of the factors and features of the agreement. Management and operational subsystems were defined and the information generated from the basic units: agreement, minutes of meeting of the Teaching-service relationship, evaluation, costs and supplies. Results: 100 of the agreements were made with institutions with certification and accreditation and developed using the criteria of teaching-service model. Committees were made at the beginning of the semester, in the 100 of the agreements. 37.5 of users assisted by the students were young adults, 18.0 children under age 10 and 10.4 senior adults. The most frequent nursing diagnoses were: the risk of infection, acute pain and impaired physical mobility. The 36.6 of the nursing procedures were administrative, 39.8 clinical and 23.6 of outpatient and community patients. Conclusions: The design of follow up system for teaching-service relationship has been useful for tracking of the managerial and operational command and the decision making process, relating to the education of nursing students during their internship.

Current clinical research environment: focus on psychiatry

The introduction of international guidelines on Good Clinical Practices (GCP) in 1996, immediately followed by the publication of Resolution CNS 196/96 in Brazil, created a great opportunity for Brazilian research centers to participate in international trials. Such studies must be strictly monitored in order to assure compliance with the regulations, as well as with the standards of patient safety. Clear agreement among the investigator, the sponsor and the institution carrying out the study must be previously defined in order to avoid any conflicts of interest during or after the study. Operational aspects, such as the time needed to gain regulatory approval of the study design, strategies for patient recruitment/retention and appropriate logistics, are also important. In 2005, the Brazilian National Clinical Research Network was established, bringing together a number of research centers in teaching hospitals. The objective was to subsidize public clinical research with state-of-the-art practices and appropriate technical/scientific training programs. The development of research protocols that prioritize public health care needs in Brazil is other fundamental goal of this network. This article addresses general aspects of clinical research, as well as some specific issues in psychiatry. Improving the health and quality of life of the global population is certainly the major objective of all of the work done in this area.

A introdução de diretrizes internacionais de Boas Práticas Clínicas, em 1996, imediatamente seguida pela publicação da Resolução do Conselho Nacional de Saúde 196/96, abriu uma grande oportunidade para a participação de centros de pesquisa brasileiros em estudos internacionais. Tais estudos devem ser estritamente monitorados, a fim de assegurar a adesão às legislações, assim como garantir a segurança dos pacientes envolvidos. A fim de evitar possíveis conflitos de interesse durante e após o estudo, todos os aspectos relacionados devem ser claramente definidos previamente entre o pesquisador, o patrocinador e a instituição. Aspectos operacionais, tais como tempo para aprovação regulatória do estudo, métodos de recrutamento e retenção de pacientes e a logística em geral, também são importantes. Em 2005, a Rede Nacional de Pesquisa Clínica foi criada no Brasil, somando a experiência de vários centros de pesquisa ligados a hospitais de ensino. Seu objetivo é reforçar a atividade de pesquisa clínica no país, com práticas atualizadas e adequado treinamento técnico-científico. O desenvolvimento de protocolos de pesquisa que foquem as prioridades de saúde do país é outro objetivo fundamental da Rede. Aspectos gerais da pesquisa clínica e algumas particularidades em Psiquiatria são discutidos no artigo. O objetivo final de todo o trabalho nesta área de pesquisa é, sem dúvida, a busca de melhores condições de saúde e qualidade de vida da população.

O Sistema de informação utilizado pelo Enfermeiro no gerenciamento do processo de cuidar / The management software used by nurses in the care process

Este artigo trata de pesquisa sobre a utilização do Sistema de Informação em Saúde pelo enfermeiro em sua prática de cuidar, demonstrando a importância da utilização desse instrumento em suas ações gerenciais. O método é o exploratório-descritivo, com abordagem qualitativa. Pesquisa realizada em Curitiba, Estado do Paraná, no Distrito Sanitário do Bairro Novo. Das onze unidades de saúde que compõem o Distrito Sanitário, oito têm como autoridade sanitária, profissionais enfermeiros, que são responsáveis pela implantação, pelo acompanhamento e avaliação dos programas no município, portanto, mediadores entre os usuários do sistema de informação em saúde e a instituição. As informações foram obtidas mediante entrevistas semi-estruturadas. A análise baseou-se na técnica de análise de conteúdo, a qual possibilitou a apreensão de três unidades de contexto e sete unidades de significação. O artigo apresenta duas unidades de contexto e uma unidade de significação para cada uma...

Canales Endémicos y Marcadores de Resistencia Bacteriana, en Instituciones de Tercer nivel de Bogota, Colombia / Endemic channels and bacterial resistance markers in third-level hospitals in Bogotá, Colombia

Objetivo: Determinar los perfiles de resistencia bacteriana y los canales endémicos en 14 instituciones de tercer nivel. Métodos: Población. Bogotá-Colombia, 14 hospitales pertenecientes al Grupo para el Control de la Resistencia Bacteriana de Bogotá (GREBO). A partir de la información obtenida de los laboratorios de microbiología de los centros participantes (métodos automatizados y manuales), se creó una base de datos usando los programas BacLink 2.0 y Whonet 5.3, durante los años 2001, 2002 y 2003. Los perfiles de susceptibilidad fueron hallados acordes a las normas de la nCCLS (2003). Se realizó un análisis descriptivo de los diferentes marcadores de resistencia y se determinó el canal endémico de la resistencia para los hospitales, utilizando los puntos entre los percentiles 25 y 75 por ciento, para cada mes durante el periodo de estudio. Resultados: Se analizaron 84664 aislamientos. Los más frecuentes fueron Escherichia coli, Staphylococcus aureus, Staphylococcus coagulasa negativo, Klebsiella pneumoniae y Pseudomonas aeruginosa. La resistencia para los años 2001, 2002 y 2003 fue respectivamente: S. aureus meticilino resistente: 41 por ciento, 48 por ciento, 48 por ciento; Staphylococcus coagulasa negativo resistente a oxacilina: 75 por ciento, 73 por ciento, 72 por ciento; E. faecium vancomicina resistente: 14 por ciento, 9 por ciento, 3 por ciento; K. pneumoniae resistente a cefalosporinas de tercera generación: 37 por ciento, 25 por ciento, 23 por ciento; P. aeruginosa resistente a imipenem: 24 por ciento, 22 por ciento, 17 por ciento; P. aeruginosa resistente a ciprofloxacina: 46 por ciento, 46 por ciento, 35 por ciento, A. baumannii resistente a imipenem: 11 por ciento, 29 por ciento, 39 por ciento. Los canales endémicos evidenciaron la problemática de la resistencia bacteriana, esta se centró en la presencia de S. aureus meticilino resistente y en el marcado incremento de la resistencia de A. baumanni a imipenem. Conclusiones: Se destacan los altos porcentajes de resistencia para todos los marcadores de impacto epidemiológico a nivel hospitalario especialmente en Unidades de Cuidado Intensivo.

Manual de procedimientos LILDBI-Web v1.5a, para descripción bibliográfica e indexación de la información / Manual of procedures LILDBI-Web v1.5a for bibliographical description and indexación of the information

Presenta Manual de procedimientos "LILDBI-Web v1.5a", para descripción bibliográfica e indexación de la información. Este manual orienta al documentalista al ingreso de información en una base de datos con campos definidos en el formato a través de la Metodología LILACS y la Estandarización, de los elementos de datos internacionales, entre el Sistema de Clasificación de la Biblioteca Nacional de Medicina de los Estados Unidos. Además contiene la metodología, procedimientos, técnicas y aprendizajes para ser utilizadas en el desarrollo de la gestión de la informacion y la comunicación en salud y orientada a la calidad de los servicios que se brindan a los usuarios virtuales y presenciales, en cada una de la unidades de Información de la Red Biomédica, coordinada por la Biblioteca Nacional de Salud de Nicaragua.

Coordinated, network-based research as a strategic component of science in Brazil

Scientific research plays a fundamental role in the health and development of any society, since all technological advances depend ultimately on scientific discovery and the generation of wealth is intricately dependent on technological advance. Due to their importance, science and technology generally occupy important places in the hierarchical structure of developed societies, and they receive considerable public and private investment. Publicly funded science is almost entirely devoted to discovery, and it is administered and structured in a very similar way throughout the world. Particularly in the biological sciences, this structure, which is very much centered on the individual scientist and his own hypothesis-based investigations, may not be the best suited for either discovery in the context of complex biological systems, or for the efficient advancement of fundamental knowledge into practical utility. The adoption of other organizational paradigms, which permit a more coordinated and interactive research structure, may provide important opportunities to accelerate the scientific process and further enhance its relevance and contribution to society. The key alternative is a structure that incorporates larger organizational units to tackle larger and more complex problems. One example of such a unit is the research network. Brazil has utilized such networks to great effect in genome sequencing projects, demonstrating their relevance to the Brazilian research community and opening the possibility of their wider utility in the future

Experiência com um sistema de informações via Internet sobre radioterapia / Experience with an Internet information system about radiotherapy

Foi criado um canal independente de informações acerca do tratamento do câncer com radioterapia: o site "www.iradioterapia.com", que disponibiliza informações na Internet, tendo como base dados científicos e linhas de condutas diversas. Sempre de modo ético, profissionais da saúde, estudantes, pacientes e familiares, entre outros, podem obter informações teóricas a respeito de condutas, opções terapêuticas e atualizações em relação aos tratamentos disponíveis em nível mundial, além de tira-dúvidas on-line. Podem também participar de grupos de debates entre os próprios interessados. Na rede desde agosto/2000, já foram registrados 4000 acessos, com dezenas de dúvidas de pacientes respondidas e fóruns realizados. As principais questões levantadas são a respeito de condutas médicas, cuidados com o paciente e prognóstico da doença. Nota-se ausência de informações dirigidas à pacientes e familiares acerca do tratamento radioterápico. O acesso democrático e livre de informações ligadas à saúde e medicina possibilita a melhoria das técnicas de tratamento, da relação médico-paciente e tranqüilização do paciente durante o tratamento. O sistema de acesso a informações via Internet permitiu melhor participação dos pacientes e seus familiares no seu tratamento, propiciando maior conforto e tranqüilidade. Com informação acessível, pacientes colaboram nas consultas com seus médicos e buscam melhores opções técnicas.

Maternal mortality surveillance and maternal death reviews in countries of the Eastern Mediterranean Region

This paper presents the findings of a 1999 survey of 19 countries of the World Health Organization Eastern Mediterranean Region on maternal mortality surveillance systems and death review activities in the Region. Data were collected by questionnaire completed by ministry of health personnel. The findings show that 13 countries require official reporting of deaths of women of reproductive age. Most of the countries conduct maternal death reviews although only 8 have surveillance systems. Other areas investigated were the sources of information on maternal deaths, types of data collected, how the data are analysed and how such data are used. There is a need to strengthen information systems on maternal mortality in the Region in order to guide decision-makers in the planning and evaluation of maternal health programmes

Pattern of use of medical information made available via an Internet website.

INTRODUCTION: The Internet is probably the fastest growing means of public communication. Those who seek health and medical information are using it increasingly. We decided to study the pattern of use of information made available via an Internet website. METHOD: Retrospective analysis of the entries made on the guest book and direct inquiries made to the webmaster of an established and well known Sri Lankan medical website from 1 February 1997 to 20 November 1998. RESULTS: During this period 23,373 web surfers visited the site. There were 222 guest book entries and 12 direct inquiries to the webmaster. The analysis of these entries and inquiries show that there is a wide gap in use of the information available at this website between web surfers from the developed and the developing countries. CONCLUSION: Governments in developing countries must plan to make computers and information technology as well as telecommunication services affordable and widely available.