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1.
Environ Monit Assess ; 192(8): 552, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32737629

RESUMO

The high-altitude regions of Himalaya are among the best indicators of climate change yet noticeable for the lack of climate monitoring stations. However, they support ethnic communities whose livelihood activities are climate driven. Consequently, these communities are keen observers of the same and documenting their perception on changing climate is now an important area of global research. Therefore, the present study was conducted with the prime objective of documenting the climate change perception of Bhangalis-a resident community of western Himalaya, and analyzing variation in their perceptions in relation to age and gender. For this, respondent surveys (household, n = 430; individual interviews, n = 240) were carried out and the collected data were subjected to statistical analyses. The study also validated the perception of Bhangalis using the available weather data (1974-2017) through the Mann-Kendall test. The results reveal that Bhangalis perceived 11 indicators of changing climate, of which decrease in snowfall was the most prominent (reported by ~ 97% of the respondents). The perceptions varied between the two genders with males having significantly higher proportion of responses for all the 11 indicators. Similarly, differences in perception among the age groups were also observed, elderly people reported higher proportion of climate change indicators as compared to respondents of lower age. Notably, patterns of temperature and rainfall perceptions by the Bhangalis agreed with the trends of meteorological data. This highlights the importance of the study in documenting knowledge of ethnic communities especially from areas that lack monitoring stations. It argues for involving them in climate change programs.


Assuntos
Mudança Climática , Meteorologia , Idoso , Documentação , Monitoramento Ambiental , Feminino , Humanos , Masculino , Temperatura
2.
J Nurs Adm ; 50(9): 462-467, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32826515

RESUMO

OBJECTIVE: The aim of this study was to quantify the impact of electronic health record (EHR) workstation single sign-on (SSO) for nurses. BACKGROUND: SSO was implemented in 19 hospitals for expedited EHR access. METHODS: Login durations before and after SSO implementation were compared, and the financial value of nursing time liberated from keyboard was estimated. Stratified analyses show time liberated and financial value by staffing level and system size. RESULTS: First-of-shift login was reduced by 5.3 seconds (15.3%) and reconnect duration was reduced by 20.4 seconds (69.9%). SSO liberated 27,962.4 hours of nursing time from keyboard login per year across 19 facilities, and 1,471.7 hours/year/facility, valued at $52,112/facility and $990,128 for 19 hospitals. Time value ranges from $201,835 per year for a 5-hospital system with 300 nurses per facility to $672,790 per year for a 10-facility system with 500 nurses per hospital. CONCLUSIONS: Nurses gained substantial time liberated from EHR keyboard by SSO for patient care, having significant financial value for the organization.


Assuntos
Documentação/tendências , Registros Eletrônicos de Saúde , Hospitais/estatística & dados numéricos , Invenções/economia , Registros Eletrônicos de Saúde/economia , Registros Eletrônicos de Saúde/organização & administração , Humanos , Assistência ao Paciente , Fatores de Tempo
3.
Radiol Clin North Am ; 58(5): 925-933, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32792124

RESUMO

Given the incidence of small renal masses, from benign cysts to malignancy, most radiologists encounter these lesions multiple times during their career. Radiologists have an opportunity to provide critical data that will further refine the understanding of the impact of these masses on patient outcomes. This article summarizes and describes recent updates and understanding of the critical observations and descriptors of renal masses. The templates and glossary of terms presented in this review article facilitate the radiology reporting of such data elements, giving radiologists the opportunity to improve diagnostic accuracy and influence management of small renal masses.


Assuntos
Documentação/métodos , Neoplasias Renais/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Terminologia como Assunto , Tomografia Computadorizada por Raios X/métodos , Humanos , Rim/diagnóstico por imagem
4.
Waste Manag Res ; 38(9): 923-941, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32635832

RESUMO

Waste from the construction sector poses huge challenges for sustainable waste management. This is not only due to the vast amount of waste produced in construction and demolition activities, but also due to pollutants potentially contained in these products. Subject to these conditions, waste management must ensure recovery of as many resources as possible, while making sure to keep material loops clean. This demanding task requires more knowledge about the existing building stock and an adaptation of current demolition processes. Innovative technologies, such as Building Information Modelling, or modern frameworks, such as Geographic Information Systems, offer a high potential to synoptically provide stock material information for future demolition activities for individual objects to be deconstructed as well as for whole cities as a basis for managing the anthropogenic stock and potential urban mining. Suitable methods of data collection allow for acquiring the desired input for the generation of building stock models enriched with demolition-related information. With the latter, selective deconstruction strategies as well as appropriate waste stream routing agendas can be planned and executed, thereby securing safety at work during the demolition process itself and a waste stream routing according to the waste hierarchy. This review article gives an overview of currently deployed building material assessment tools (data capture and visualisation), both a prerequisite for improved information on materials and geometry (and thereby mass/volume). In addition, this article describes workflows employable for the purpose of urban mining in end-of-life buildings, of which one holistic approach will be described in depth.


Assuntos
Indústria da Construção , Gerenciamento de Resíduos , Cidades , Materiais de Construção , Documentação , Sistemas de Informação Geográfica , Resíduos Industriais , Reciclagem
6.
Stud Health Technol Inform ; 272: 151-154, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604623

RESUMO

Decision models (DM), especially Markov Models, play an essential role in the economic evaluation of new medical interventions. The process of DM generation requires expert knowledge of the medical domain and is a time-consuming task. Therefore, the authors propose a new model generation software PrositNG that is connectable to database systems of real-world routine care data. The structure of the model is derived from the entries in a database system by the help of Machine Learning algorithms. The software was implemented with the programming language Java. Two data sources were successfully utilized to demonstrate the value of PrositNG. However, a good understanding of the local documentation routine and software is paramount to use real-world data for model generation.


Assuntos
Aprendizado de Máquina , Software , Bases de Dados Factuais , Documentação
7.
Stud Health Technol Inform ; 272: 233-236, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604644

RESUMO

A large amount of patient data is produced and documented in patient care. Health care professionals expect that this routinely collected patient data can also be used for secondary purposes such as measuring the quality of care or to gain new knowledge. Routine data needs to be documented in a standardized form, based on clinical terminologies, to allow this secondary use of data. In Austria, hospitals are currently moving from paper-based documentation to computer-based documentation, but parts of the documentation are still done in paper-based form or without using clinical terminologies, especially in nursing. This study aims to analyze the availability of standardized electronic patient data in nursing in Austria. We conducted an online survey of 32 senior nursing managers at 32 Austrian hospitals. The study showed that 79% of hospitals use electronic health records for nursing documentation, but only 29% of the nursing care plans are documented in a standardized way using standardized nursing classification systems such as NANDA-I.


Assuntos
Terminologia Padronizada em Enfermagem , Áustria , Documentação , Registros Eletrônicos de Saúde , Humanos , Registros de Enfermagem , Inquéritos e Questionários
8.
Stud Health Technol Inform ; 272: 261-264, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604651

RESUMO

The dissemination of Clinical Decision Support Systems (CDSS) in the medical field is slow due to various reasons such as lacking comprehensibility, low user acceptance, specific problem settings and unique application environments. This paper presents an illustration of the complexity of the CDS development process. Guided by procedural software development models already known from the field of software engineering, we developed a CDS-specific software lifecycle and a CDS development complexity illustration. We based the results on literature research of publicated field reports about successfully developed CDSS. We identified important CDS peculiarities related to the development and documentation process of CDSS and later merged them with generic software engineering models. We then created a CDS complexity illustration that can be used to structure future research in the CDS field as well as any standardisation processes.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Documentação , Software
9.
BMC Bioinformatics ; 21(1): 290, 2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32640981

RESUMO

BACKGROUND: Well-characterized biomaterials of high quality have great potential for acceleration and quality improvement in translational biomedical research. To improve accessibility of local sample collections, efforts have been made to create central biomaterial banks and catalogues. Available technical solutions for creating professional local sample catalogues and connecting them to central systems are cost intensive and/or technically complex to implement. Therefore, the Translational Thematic Unit HIV of the German Center for Infection Research (DZIF) developed a Laboratory Information and Management System (LIMS) called HIV Engaged Research Technology (HEnRY) for implementation into the Translational Platform HIV (TP-HIV) at the DZIF and other research networks. RESULTS: HEnRY is developed at the University Hospital of Cologne. It is an advanced LIMS to manage processing and storage of samples and aliquots of different sample types. Features include: monitoring of stored samples and associated information data selection via query tools or Structured Query Language (SQL) preparation of summary documents, including scannable search lists centralized management of the practical laboratory part of multicentre studies (e.g. import of drawing schemes and sample processing steps), preparation of aliquot shipments, including associated documents to be added to shipments unique and secure identification of aliquots through use of customizable Quick Response (QR) code labels directly from HEnRY support of aliquot data transmission to central registries. In summary, HEnRY offers all features necessary for a LIMS software. In addition, the structure of HEnRY provides sufficient flexibility to allow the implementation in other research areas. CONCLUSION: HEnRY is a free biobanking tool published under the MIT license. While it was developed to support HIV research in Germany, the feature set and language options, allow much broader applications and make this a powerful free research tool.


Assuntos
Bancos de Espécimes Biológicos , Software , Materiais Biocompatíveis , Sistemas Computacionais , Gerenciamento de Dados , Documentação , Humanos , Laboratórios , Estudos Multicêntricos como Assunto
10.
S Afr Med J ; 110(2): 140-144, 2020 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-32657686

RESUMO

BACKGROUND: Anaesthesia-related mortality is an important, potentially avoidable cause of perioperative mortality. A procedure-related death notification (PRDN) instrument is completed by relevant medical practitioners after a procedure-related death and is used to audit practice and identify areas of care that require improvement. It is also used in medicolegal investigations when establishing cause of death, and in the case of litigation. The current South African (SA) PRDN instrument, designated the GW7/24 form, contains both surgical and anaesthetic sections and is considered to be outdated, inadequate and in need of revision. OBJECTIVES: To develop and validate a revised anaesthetic section of the SA PRDN instrument that can be used for procedure-related deaths in future and be used to update the GW7/24 form for epidemiological, forensic or academic use. METHODS: Lynn's two-stage model was utilised. After an extensive literature review, a provisional PRDN instrument was developed. This provisional instrument was debated and reviewed at a peer group discussion in which 6 local experts took part. These experts were anaesthetic and forensic pathology specialists who specifically have expert knowledge on procedure-related deaths. A revised PRDN instrument was developed, which was then rated by 8 national experts using a Likert scale. The content validity index (CVI) for each item and for the instrument as a whole was then established. Items with a CVI <0.88 were removed to formulate the final PRDN instrument. RESULTS: The provisional PRDN instrument consisted of 14 domains and 66 items. The revised PRDN instrument consisted of 13 domains and 65 items, of which 3 items with a CVI <0.88 were removed. The final PRDN instrument, after minor revisions based on suggestions from the 8 national experts, consisted of 18 domains and 79 items. Every item on the form was declared relevant and important by the national experts, with the final instrument scoring an overall CVI of 1. CONCLUSIONS: A comprehensive, updated and validated anaesthetic section of the SA PRDN instrument was developed. This could be used as a government and anaesthesiology society-endorsed template when updating the current GW7/24 form.


Assuntos
Anestesia/mortalidade , Causas de Morte , Morte , Documentação/métodos , Documentação/normas , Humanos , Reprodutibilidade dos Testes , África do Sul
11.
S Afr Med J ; 110(5): 396-399, 2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32657724

RESUMO

BACKGROUND: Some patients need referral within the health system to achieve optimal care, and referral letters are an important part of this process. Healthcare practitioners often complain that referral letters lack information, are inaccurate, or direct patients to the wrong place. Poor communication affects patient experience and outcomes, has budgetary and service planning implications, and impacts on staff relationships and morale. OBJECTIVES: To investigate the quality and appropriateness of referral letters received by the medical outpatient department of a regional hospital in Eastern Cape Province, South Africa. METHODS: Letters were collected by departmental staff as patients arrived at the clinic. Each letter was independently analysed by two healthcare workers for content and appropriateness, using defined criteria. RESULTS: Of 100 letters collected between March and May 2017, 85 were suitable for analysis. Patient and clinician identifiers were present in >85%, but key clinical information was missing in 87%, and 48% did not state a reason for referral. It was possible to make triage decisions based on the letter in only 35% of cases. Nineteen percent of referrals were classified as inappropriate. CONCLUSIONS: Most letters lacked important clinical information, probably because of a combination of factors: gaps in clinical knowledge of referring clinicians who service a population with a high burden of disease and complex pathology; under-resourced peripheral healthcare clinics; inadequate staff-to-patient ratios; and time constraints. A suggested focus for improvement is education at undergraduate and postgraduate level, which should emphasise preparation for community service, specifically highlighting techniques for preparing good-quality referrals.


Assuntos
Documentação/normas , Encaminhamento e Consulta , Humanos , Auditoria Médica , Ambulatório Hospitalar , Estudos Prospectivos , África do Sul
13.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32719089

RESUMO

Female genital mutilation or cutting (FGM/C) involves medically unnecessary cutting of parts or all of the external female genitalia. It is outlawed in the United States and much of the world but is still known to occur in more than 30 countries. FGM/C most often is performed on children, from infancy to adolescence, and has significant morbidity and mortality. In 2018, an estimated 200 million girls and women alive at that time had undergone FGM/C worldwide. Some estimate that more than 500 000 girls and women in the United States have had or are at risk for having FGM/C. However, pediatric prevalence of FGM/C is only estimated given that most pediatric cases remain undiagnosed both in countries of origin and in the Western world, including in the United States. It is a cultural practice not directly tied to any specific religion, ethnicity, or race and has occurred in the United States. Although it is mostly a pediatric practice, currently there is no standard FGM/C teaching required for health care providers who care for children, including pediatricians, family physicians, child abuse pediatricians, pediatric urologists, and pediatric urogynecologists. This clinical report is the first comprehensive summary of FGM/C in children and includes education regarding a standard-of-care approach for examination of external female genitalia at all health supervision examinations, diagnosis, complications, management, treatment, culturally sensitive discussion and counseling approaches, and legal and ethical considerations.


Assuntos
Circuncisão Feminina , Criança , Maus-Tratos Infantis , Cicatriz/etiologia , Circuncisão Feminina/efeitos adversos , Circuncisão Feminina/classificação , Circuncisão Feminina/legislação & jurisprudência , Circuncisão Feminina/psicologia , Competência Clínica , Confidencialidade , Documentação , Feminino , Doenças Urogenitais Femininas/etiologia , Procedimentos Cirúrgicos em Ginecologia , Humanos , Infecções/etiologia , Infertilidade Feminina/etiologia , Consentimento Livre e Esclarecido , Classificação Internacional de Doenças , Notificação de Abuso , Anamnese , Saúde Mental , Dor/etiologia , Pediatras , Exame Físico , Prevalência , Refugiados/legislação & jurisprudência , Sexualidade
15.
Value Health ; 23(6): 689-696, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32540225

RESUMO

OBJECTIVES: Value and health technology assessment (V/HTA) is often used in clinical, access, and reimbursement decisions. V/HTA data-source selection may not be transparent, which is a necessary element for stakeholder understanding and trust and for fostering accountability among decision makers. Peer review is considered one mechanism for judging data trustworthiness. Our objective was (1) to use publicly available documentation of V/HTA methods to identify requirements for inclusion of peer-reviewed evidence sources, (2) to compare and contrast US and non-US approaches, and (3) to assess evidence sources used in published V/HTA reports. METHODS: Publicly available methods documentation from 11 V/HTA organizations in North America and Europe were manually searched and abstracted for descriptions of requirements and recommendations regarding search strategy and evidence-source selection. The bibliographies of a subset of V/HTA reports published in 2018 were manually abstracted for evidence-source types used in each. RESULTS: Heterogeneity in evidence-source retrieval and selection was observed across all V/HTA organizations, with more pronounced differences between US and non-US organizations. Not all documentation of organizations' methods address the evidence-source selection processes (7 of 11), and few explicitly reference peer-reviewed sources (3 of 11). Documentation of the evidence-source selection strategy was inconsistent across reports (6 of 13), and the level of detail provided varied across organizations. Some information on evidence-source selection was often included in confidential documentation and was not publicly available. CONCLUSIONS: Disparities exist among V/HTA organizations in requirements and guidance regarding evidence-source selection. Standardization of evidence-source selection strategies and documentation could help improve V/HTA transparency and has implications for decision making based on report findings.


Assuntos
Documentação/normas , Revisão por Pares , Avaliação da Tecnologia Biomédica/métodos , Europa (Continente) , Humanos , América do Norte
16.
Am J Otolaryngol ; 41(5): 102611, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32580066

RESUMO

Within otolaryngology, scribes have been utilized as a means of increasing clinic efficiency and easing workload on physicians. During the COVID-19 pandemic, a majority of otolaryngology clinic appointments at academic institutions have been moved to telemedicine in order to limit interpersonal contacts. At the height of the pandemic, our institution has protocolized scribe participation from in-person to remote. Scribes have virtually participated in telemedicine appointments in an effort to facilitate documentation and enhance the patient-physician relationship. Beyond the pandemic, as patients start being evaluated in-person, the risk of contamination and spread through aerosol generating procedures has limited the number of ancillary support staff that can be present in the examination rooms. As such, virtual scribing from a separate location within the clinic has been deemed warranted. This paper documents the protocols on virtual scribing for both telemedicine and a hybrid approach for in-clinic appointments where high-risk procedures are being performed.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Documentação , Otolaringologia , Pneumonia Viral/epidemiologia , Telemedicina/organização & administração , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
17.
Stud Health Technol Inform ; 271: 232-239, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32578568

RESUMO

BACKGROUND: Processing of free text written medical texts involves many difficulties arising from typographical errors, synonyms, and abbreviations occurring in the texts. METHODS: In this study, the applicability of the most common string similarity measures were analyzed and compared for the keyword-based medical text search. RESULTS: The usefulness of the similarity measures was studied in a set of medical documents containing more than 20,000 echocardiography reports. Experimental results showed that the Jaro-Winkler dissimilarity measure is the most capable measure to explore the content of the medical texts.


Assuntos
Benchmarking , Documentação
18.
Stud Health Technol Inform ; 271: 240-247, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32578569

RESUMO

BACKGROUND: Health information technologies as electronic health records (EHR) have the potential to improve the quality and efficiency of health care. Implementing national EHR in nursing homes in Tyrol is a required task within the next years. OBJECTIVES: To explore and analyze the current situation of information exchange in nursing homes in Tyrol as well as expected potentials and challenges of an ELGA implementation from a nursing management perspective. METHODS: Semi-structured interviews with nine nursing managers of nursing homes in Tyrol were conducted and analyzed using qualitative content analysis. RESULTS: The explorative interviews offered a glance at the actual information exchange with other institutions and at the perception of nursing managers regarding potentials (e.g. decreasing organizational effort) and challenges (e.g. incompleteness of available patient information) of the nationally mandated implementation of ELGA in the nursing homes in Tyrol. CONCLUSION: The interviews with the nine nursing managers of nursing homes in Tyrol revealed some hopes (e.g. the reduction of double documentation) that ELGA will probably not be able to fulfill.


Assuntos
Registros Eletrônicos de Saúde , Informática Médica , Assistência à Saúde , Documentação , Casas de Saúde
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