Supporting Clinical Care: SOFA on FHIR.

To illustrate to health professionals how interoperability may improve patient care we (1) built a prototype to automate the sequential organ failure assessment (SOFA) risk score and (2) designed its display on a medical dashboard. In Accordance with prioritized system requirements from stakeholder interviews, the prototype microservice uses FHIR as the first focus of this work. As the second focus, PretoFaces were used to facilitate user interface design feedback. Our interoperable prototype met all requirements of the highest priority. As a microservice in a SOA, it collects and extracts needed data from a FHIR server and computes the SOFA score and its subscores. Additionally, most requirements of second and third highest priority were met. In parallel, PretoFaces of interfaces were inspired by the requirements. We showed that an automatically computed SOFA score can be speedily developed using FHIR.

Scientific sexism: the gender bias in the scientific production of the Universidade de São Paulo.

OBJECTIVE: To investigate gender inequity in the scientific production of the University of Sao Paulo. METHODS: Members of the University of Sao Paulo faculty are the study population. The Web of Science repository was the source of the publication metrics. We selected the measures: total publications and citations, average of citations per year and item, H-index, and history of citations between 1950 and 2019. We used the name of the faculty member as a proxy to the gender identity. We use descriptive statistics to characterize the metrics. We evaluated the scissors effect by selecting faculty members with a high H-index. The historical series of citations was projected until 2100. We carry out analyses for the general population and working time subgroups: less than 10 years, 10 to 20 years, and 20 years or more. RESULTS: Of the 8,325 faculty members, we included 3,067 (36.8%). Among those included, 1,893 (61.7%) were male and 1,174 (38.28%) female. The male gender presented higher values in the publication metrics (average of articles: M = 67.0 versus F = 49.7; average of citations/year: M = 53.9 versus F = 35.9), and H-index (M = 14.5 versus F = 12.4). Among the 100 individuals with the highest H-index (≥ 37), 83% are male. The male curve grows faster in the historical series of citations, opening a difference between the groups whose separation is confirmed by the projection. DISCUSSION: Scientific production at the Universidade de São Paulo is subject to a gender bias. Two-thirds of the faculty are male, and hiring over the past few decades perpetuates this pattern. The large majority of high impact faculty members are male. CONCLUSION: Our analysis suggests that the Universidade de São Paulo will not overcome gender inequality in scientific production without substantive affirmative action. Development does not happen by chance but through choices that are affirmative, decisive, and long-term oriented.

A web-based information system for a regional public mental healthcare service network in Brazil.

BACKGROUND: Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network. CASE PRESENTATION: After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients' status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding. CONCLUSION: We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized public health system. Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation.

Scientific sexism: the gender bias in the scientific production of the Universidade de São Paulo / Sexismo científico: o viés de gênero na produção científica da Universidade de São Paulo

ABSTRACT OBJECTIVE To investigate gender inequity in the scientific production of the University of Sao Paulo. METHODS Members of the University of Sao Paulo faculty are the study population. The Web of Science repository was the source of the publication metrics. We selected the measures: total publications and citations, average of citations per year and item, H-index, and history of citations between 1950 and 2019. We used the name of the faculty member as a proxy to the gender identity. We use descriptive statistics to characterize the metrics. We evaluated the scissors effect by selecting faculty members with a high H-index. The historical series of citations was projected until 2100. We carry out analyses for the general population and working time subgroups: less than 10 years, 10 to 20 years, and 20 years or more. RESULTS Of the 8,325 faculty members, we included 3,067 (36.8%). Among those included, 1,893 (61.7%) were male and 1,174 (38.28%) female. The male gender presented higher values in the publication metrics (average of articles: M = 67.0 versus F = 49.7; average of citations/year: M = 53.9 versus F = 35.9), and H-index (M = 14.5 versus F = 12.4). Among the 100 individuals with the highest H-index (≥ 37), 83% are male. The male curve grows faster in the historical series of citations, opening a difference between the groups whose separation is confirmed by the projection. DISCUSSION Scientific production at the Universidade de São Paulo is subject to a gender bias. Two-thirds of the faculty are male, and hiring over the past few decades perpetuates this pattern. The large majority of high impact faculty members are male. CONCLUSION Our analysis suggests that the Universidade de São Paulo will not overcome gender inequality in scientific production without substantive affirmative action. Development does not happen by chance but through choices that are affirmative, decisive, and long-term oriented.

RESUMO OBJETIVO Investigar desigualdades de gênero na produção científica de docentes da Universidade de São Paulo. MÉTODOS A população consiste em professores(as) da Universidade de São Paulo. O repositório Web of Science foi a fonte das métricas de publicação. Selecionamos as medidas: total de publicações e citações, média de citações por ano e por item, índice H e histórico de citações entre 1950 e 2019. Usamos o nome do(a) docente como um proxy para a identidade de gênero. Usamos estatísticas descritivas para caracterizar as métricas. Avaliamos o efeito tesoura selecionando os(as) professores(as) com índice H alto. A série histórica de citações foi projetada até 2100. Realizamos análises para a população geral e subgrupos de tempo de trabalho: menos de 10 anos, de 10 a 20 anos e 20 anos ou mais. RESULTADOS Dos 8.325 docentes, incluímos 3.067 (36,8%). Dentre os incluídos, 1.893 (61,7%) eram professores e 1.174 (38,28%) professoras. O gênero masculino apresentou valores mais altos nas métricas de publicação (média de artigos: M = 67,0 versus F = 49,7; média de citações/ano: M = 53,9 versus F = 35,9) e índice H (M = 14,5 versus F = 12,4). Entre os 100 indivíduos com maior índice H (≥ 37), 83% são do gênero masculino. Na série histórica de citações, a curva masculina cresce mais rápido, abrindo uma diferença entre os grupos com afastamento confirmado pela projeção. DISCUSSÃO A produção científica na Universidade de São Paulo está sujeita a um viés de gênero. Dois terços do corpo docente são do gênero masculino, e as contratações das últimas décadas perpetuam esse padrão. A grande maioria dos membros com alto impacto no corpo docente é do sexo masculino. CONCLUSÃO Nossas análises sugerem que a Universidade de São Paulo não superará a desigualdade de gênero na produção científica sem uma ação afirmativa substancial. O desenvolvimento não acontece por acaso, mas por meio de escolhas afirmativas, decisivas e de longo prazo.

Aprendizado eletrônico na formação multiprofissional em saúde: avaliação inicial / E-learning in multi-professional health training: an initial evaluation

O objetivo deste relato é apresentar, dentro da proposta do Programa Nacional de Reorientação da Formação Profissional em Saúde (Pró-Saúde), uma parte do projeto da Faculdade de Medicina de Ribeirão Preto (USP). Trata-se da estratégia de inserção das Tecnologias de Informação e Comunicação (TIC) no ensino de graduação extramuros da FMRP, que visa definir e implantar recursos tecnológicos de Aprendizado Eletrônico para apoiar atividades discentes e docentes, gestão da informação, educação continuada e segunda opinião formativa. A trajetória metodológica delineou tanto o processo de atendimento de parte das ações do eixo Cenário de Prática em Atenção Básica de saúde relativa ao processo de ampliação da rede de malha ótica, essencial para suporte às atividades de desenvolvimento do uso das TIC, quanto a abordagem qualitativa de um estudo exploratório sobre a utilização do Teleduc no primeiro ano do eixo de Atenção à Saúde da Comunidade (ASC) do curso de Medicina. Nesta investigação foram realizados dois grupos focais com aplicação de questionário estruturado a discentes e docentes.

As part of the proposal of the National Program for Reorientation of Professional Training in Health (Pró-Saúde), this report discusses the project at the Ribeirão Preto School of Medicine, University of São Paulo (FMRP/USP). The focus is a strategy for the inclusion of information and communication technologies in extramural undergraduate training at FMRP, aimed at defining and deploying e-learning technological resources to support student and faculty activities, information management, continuing education, and formative second opinion. The methodological approach designed both the process of covering part of the actions from the Setting for Practice in Primary Healthcare pertaining to expansion of the fiber optic network, essential for supporting and developing ICT use, and the qualitative approach of an exploratory study on the use of e-learning in the first year of the Community Healthcare course in the undergraduate medical program. The study used two focus groups and a structured questionnaire for students and faculty.