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1.
BJOG ; 127(3): 335-342, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31654606

RESUMO

OBJECTIVE: Asian dust is a natural phenomenon in which dust particles are transported from desert areas in China and Mongolia to East Asia. Short-term exposure to Asian dust has been associated with cardiovascular disease through mechanisms such as systemic inflammation. Because inflammation is a potential trigger of placental abruption, exposure may also lead to abruption. We examined whether exposure to Asian dust was associated with abruption. DESIGN: A bi-directional, time-stratified case-crossover design. SETTING AND POPULATION: From the Japan Perinatal Registry Network database, we identified 3014 patients who delivered singleton births in hospitals in nine Japanese prefectures from 2009 to 2014 with a diagnosis of placental abruption. METHODS: Asian dust levels were measured at Light Detection and Ranging monitoring stations, and these measurements were used to define the Asian dust days. As there was no information on the onset day of abruption, we assumed this day was the day before delivery (lag1). MAIN OUTCOME MEASURES: Placental abruption. RESULTS: During the study period, the Asian dust days ranged from 15 to 71 days, depending on the prefecture. The adjusted odds ratio of placental abruption associated with exposure to Asian dust was 1.4 (95% confidence interval = 1.0, 2.0) for cumulative lags of 1-2 days. Even after adjustment for co-pollutant exposures, this association did not change substantially. CONCLUSIONS: In this Japanese multi-area study, exposure to Asian dust was associated with an increased risk of placental abruption. TWEETABLE ABSTRACT: Exposure to environmental factors such as Asian dust may be a trigger of placental abruption.


Assuntos
Descolamento Prematuro da Placenta , Poeira , Monitoramento Ambiental , Exposição por Inalação/efeitos adversos , Descolamento Prematuro da Placenta/diagnóstico , Descolamento Prematuro da Placenta/epidemiologia , Adulto , Estudos Cross-Over , Monitoramento Ambiental/métodos , Monitoramento Ambiental/estatística & dados numéricos , Feminino , Humanos , Sistemas de Informação/estatística & dados numéricos , Japão/epidemiologia , Gravidez , Medição de Risco , Fatores de Risco
2.
Int J Med Inform ; 134: 104042, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31855847

RESUMO

PURPOSE: To investigate whether the installation of electronic patient journey boards in an inpatient adult rehabilitation centre in Victoria, Australia, is associated with shorter lengths of stay for admitted adult rehabilitation patients. METHODS: A retrospective before-after analysis of 3 259 adult inpatient rehabilitation episodes from 2013 to 2018 was performed, analysing case-mix adjusted lengths of stay. RESULTS: A reduction in case-mix adjusted length of stay of 4.1 days per episode (95 % confidence interval: 2.0-6.4 days) was found. The corresponding reduction in hospital costs was estimated to be $3 738 per episode (95 % confidence interval $2 398-$4 983). CONCLUSIONS: Installation of electronic patient journey boards was associated with shorter lengths of stay in an inpatient adult rehabilitation centre. Additional research is needed to 1) provide further evidence of the causal effect of the boards on length of stay, and 2) investigate the mechanisms by which they reduce lengths of stay (e.g., increased currency of information, changes to procedures, remote viewing) in rehabilitation settings.


Assuntos
Apresentação de Dados/estatística & dados numéricos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Implementação de Plano de Saúde , Hospitalização/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Centros de Reabilitação/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Sistemas de Informação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Vitória
3.
Rev Bras Epidemiol ; 22Suppl 3(Suppl 3): e190010.supl.3, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800849

RESUMO

INTRODUCTION: Brazil presented a high proportion of ill-defined causes of death (IDCD) in 2000, compromising accurate cause-of-death analysis. OBJECTIVE: To analyze specific underlying causes for deaths originally assigned as IDCD in the Mortality Information System (SIM - Sistema de Informação sobre Mortalidade), after investigation activities implemented in country between 2006 and 2017. METHOD: For all IDCD identified in the SIM, municipal health professionals collected information about the final disease obtained from hospital records, autopsies, forms of family health teams, and home investigation. Specific causes among reclassified IDCD after investigation were evaluated according to age groups and four calendar periods. RESULTS: Proportions of IDCD reassigned to other causes after review increased over time, reaching 30.1% in 2017. From a total of 257,367 IDCD reclassified in 2006-2017, neonatal-related conditions, injury, ischemic heart disease and stroke were the leading causes detected in the age groups 0-9 years, 10-29 years, 30-69 years, 70 years and over, respectively. DISCUSSION: The similarity and plausibility of cause-specific proportions derived from the reclassification of IDCD by age group over time indicate the accuracy of the investigation data. CONCLUSION: High proportions of IDCD reassigned to more informative causes after review indicate the success of this approach to correct misclassification in the SIM, an initiative that should be maintained. Training physicians on death certification along with better quality of medical care and access to health services would lead to further improvement.


Assuntos
Causas de Morte , Coleta de Dados/métodos , Sistemas de Informação/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Autopsia/estatística & dados numéricos , Brasil/epidemiologia , Criança , Pré-Escolar , Atestado de Óbito , Feminino , Humanos , Lactente , Entrevistas como Assunto/estatística & dados numéricos , Masculino , Registros Médicos/estatística & dados numéricos , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
4.
Cien Saude Colet ; 24(5): 1831-1844, 2019 May 30.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31166516

RESUMO

The investigation of deaths from ill-defined causes (DIDC) has been a strategy of health services to reduce the proportion of these events. This study aimed to estimate the adherence of municipalities to the use of recommended forms in the investigation of DIDC and the impact of these investigations on the reduction of these deaths in the Mortality Information System. The use of the Investigation of Death from Ill-defined Cause (IOCMD) and Verbal Autopsy (VA)forms and the proportion of reclassified underlying cause of death following investigations were analyzed in a probabilistic sample of 27 municipalities of Bahia state, and its capital Salvador, in 2010. Of the 27 municipalities, approximately 50% used the recommended forms to investigate DIDCs. Of the 1,092DIDCs in the sample, 53.1% were investigated: in 40.5% of the cases, only the IOCMD form was used; in 15.3%, only the VA form was used; and both forms were used in 14.3% of the cases. The investigation of DIDCs reduced the percentages of these deaths from 16.5% to 9.9% and proved to be more effective when performed using the recommended forms.


Assuntos
Autopsia , Causas de Morte , Coleta de Dados/métodos , Sistemas de Informação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Brasil , Criança , Pré-Escolar , Estudos Transversais , Formulários como Assunto , Humanos , Lactente , Pessoa de Meia-Idade , Adulto Jovem
5.
Cien Saude Colet ; 24(5): 1945-1958, 2019 May 30.
Artigo em Português | MEDLINE | ID: mdl-31166527

RESUMO

This study assesses the quality of the SIM and SINASC information systems in coverage, incompleteness and consistency aspects, as well as the contribution of the linkage for data retrieval. It includes all live births and infant deaths in Rio Grande do Sul from 2000 to 2014. The records were paired by deterministic linkage through the DNV number and, in its absence, by probabilistic linkage. SINASC's coverage rose from 72.2% in 2000 to 98.9%, namely a 37% increase in the number of matched records. All variables in SINASC presented excellent incompleteness throughout the period, except for the number of dead children and maternal occupation. SIM presented poor or very poor incompleteness for most of the variables until 2003. Although it improved, in 2014, six variables still presented regular or poor incompleteness. The linkage procedure greatly reduced the incompleteness for most variables. There was a great variability in terms of consistency: while for gender this percentage was over 97% throughout the period, for another five variables it was still less than 75% in 2014. SINASC presented high coverage level and excellent incompleteness. Problems related to consistency persist. This study shows the linkage technic efficiency to retrieve missing information.


Assuntos
Declaração de Nascimento , Atestado de Óbito , Sistemas de Informação/estatística & dados numéricos , Nascimento Vivo , Brasil , Feminino , Humanos , Lactente , Mortalidade Infantil/tendências , Recém-Nascido , Sistemas de Informação/normas , Masculino , Registro Médico Coordenado , Gravidez
6.
Epidemiol Serv Saude ; 28(1): e2018079, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30970071

RESUMO

OBJECTIVE: to analyze the mortality coefficient trend for road traffic accidents involving pedestrians in Brazil, by sex, age range and macro-region, between 1996 and 2015. METHODS: this was an ecological time series study using data from the Ministry of Health's Mortality Information System (SIM); Prais-Winstein generalized linear regression was used to calculate annual percentage change. RESULTS: pedestrian deaths corresponded to 26.5% of deaths due to road traffic accidents; mortality among pedestrians decreased 63.2% in the country as a whole, with the standardized coefficient varying between 8.9 to 3.3 per 100,000 inhabitants, although the decrease in the country's North and the Northeast regions was slower than the national average; being run over was significantly higher among men and the elderly. CONCLUSION: although mortality among pedestrians is decreasing in all regions of the country, current figures still account for a large part of road traffic mortality.


Assuntos
Acidentes de Trânsito/mortalidade , Pedestres/estatística & dados numéricos , Ferimentos e Lesões/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Sistemas de Informação/estatística & dados numéricos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fatores de Tempo , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etiologia , Adulto Jovem
7.
Cad Saude Publica ; 35(3): e00098918, 2019 04 08.
Artigo em Português | MEDLINE | ID: mdl-30970098

RESUMO

The prevalence of preterm births has shown a growing trend in many countries, including developed ones. Studies in Brazil have shown that the Information System on Live Births (SINASC, in Portuguese), until 2010, underestimated the prevalence of preterm births, when compared with studies based on primary data. Starting in 2011, gestational age at birth has been calculated in SINASC according to the last menstrual period (LMP), when available. This study sought to evaluate the accuracy of the gestational age assessment using LMP, compared with two other estimates, and correlate it with birth weight. This is a population study with data from SINASC available from Brazilian Health Informatics Department between 2011 and 2015. Definitions of preterm birth, low birth weight and birth asphyxia were taken from the literature. Adequacy of birth weigh to gestational age was calculated based on Fenton and Intergrowth-21 curves. We compared weight means according to the presence or lack of preterm birth. gestational age assessment was based on LMP in 58.5% and 41.5% used another method. We found that the preterm proportion was 12% in the LMP group and 8.4% in the other method group, while low birth weight was 6.5% and 8.4%, respectively. Mean weight of preterm infants was higher in the LMP group. Use of LMP as a gestational age estimator overestimated the proportion of weight equal to or higher than 2,500g among preterm infants, which does not seem compatible with the expected distribution for this group. LMP favored "correction" of prematurity for the parameters that are comparable to those of primary data studies, though the distortions we found between gestational age and birth weigh may indicate that there are still problems with this estimator.


Assuntos
Idade Gestacional , Sistemas de Informação/estatística & dados numéricos , Nascimento Vivo/epidemiologia , Nascimento Prematuro/epidemiologia , Declaração de Nascimento , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Triagem Neonatal/métodos , Gravidez , Nascimento Prematuro/diagnóstico por imagem , Prevalência , Reprodutibilidade dos Testes , Ultrassonografia Pré-Natal
8.
Epidemiol Serv Saude ; 28(1): e2018093, 2019 03 21.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30916240

RESUMO

OBJECTIVE: to analyze the completeness and reliability of data on perinatal deaths held on Brazil's Mortality Information System (SIM) in 2011-2012. METHODS: this was a study evaluating the quality of completeness of data on perinatal deaths reported on SIM compared to data from the 'Birth in Brazil' survey for the same period; to evaluate reliability, we used the Kappa coefficient, the intraclass correlation coefficient (ICC) and the Bland-Altman plot method. RESULTS: completeness was greater than 80%, and agreement was 0.61 for 10 of the 12 evaluated fields; aggregated gestation length (Kappa coefficient=0.542) and continuous gestation length (ICC=0.448) for early neonatal deaths and fetal deaths, respectively, had regular agreement; graphical evaluation of gestation length showed that the fetal death metric was underestimated and that early neonatal deaths were overestimated by between 25 and 35 weeks of gestation. CONCLUSION: the information analyzed available on SIM for perinatal deaths is complete and reliable for the period analyzed.


Assuntos
Morte Fetal , Sistemas de Informação/estatística & dados numéricos , Morte Perinatal , Mortalidade Perinatal , Brasil/epidemiologia , Confiabilidade dos Dados , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Sistemas de Informação/normas , Gravidez , Reprodutibilidade dos Testes , Inquéritos e Questionários
9.
Epidemiol Serv Saude ; 28(1): e2018384, 2019 03 21.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30916242

RESUMO

OBJECTIVE: to evaluate the implantation of the Mortality Information System (SIM) in Pernambuco, Brazil. METHODS: this was an evaluation study; primary data (questionnaires) and secondary data (SIM) were used for the municipalities to estimate the degree of implantation (DI), comparing structure and process indicators with outcome indicators; data were consolidated by region and state. RESULTS: SIM was partially implanted in the state (70.6%) and its regions (66.3% to 74.8%); 'management' (75.1%), 'issuing and filling in' (79.1%), and 'processing' (71.7%) were partially implanted; 'collection' (80.7%) was implanted; while 'distribution and control' (49.7%) and 'analysis and dissemination' (58.0%) had incipient implantation; more than 90% coverage was found for deaths with defined underlying causes, as well as for municipalities with monthly data transfer, and death certificates typed and sent on a timely basis; consistency was found between DI and outcome indicators, which improved as DI increased. CONCLUSION: SIM was found to be only partially implanted owing to inadequacies in distribution, control, analysis and dissemination, thus influencing unfavorably the effects observed.


Assuntos
Atestado de Óbito , Sistemas de Informação/estatística & dados numéricos , Mortalidade , Brasil , Cidades , Humanos , Inquéritos e Questionários , Fatores de Tempo
10.
Epidemiol Serv Saude ; 28(1): e2018187, 2019 01 24.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30698223

RESUMO

OBJECTIVE: to evaluate the implantation of the Notifiable Diseases Information System (SINAN) in Pernambuco, Brasil, 2014. METHODS: This was an evaluation study based on primary data (interviews) and secondary data (SINAN documents/data) provided by the State Health Department and its Regional Divisions in order to estimate the degree of SINAN implantation, comparing structure and process indicators with results achieved. RESULTS: SINAN was found to be partially implemented at central level (77.2%); and at regional level (61.2%), ranging from 54.7 to 71.6%; the following components had been implemented: reporting/investigation (90.0%) and processing (84.1%); analysis/divulgation had been partially implemented (61.6%); while monitoring (53.4%) and management (56.8%) were incipient; there was a lack of planning and published information bulletins; 46.9% of municipalities closed compulsory reporting on time; 68.7% sent batches regularly, 3.0% of tuberculosis cases were duplicated. CONCLUSION: SINAN was found to be partially implemented in Pernambuco due to shortcomings in monitoring and management, with negative influences on system results; its strengths related to reporting, investigation and data processing.


Assuntos
Notificação de Doenças/estatística & dados numéricos , Monitoramento Epidemiológico , Sistemas de Informação/estatística & dados numéricos , Tuberculose/epidemiologia , Brasil/epidemiologia , Coleta de Dados , Humanos , Fatores de Tempo
11.
Epidemiol Serv Saude ; 27(4): e2018058, 2018 11 29.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30517353

RESUMO

OBJECTIVE: to describe improvement of the quality of data on the underlying cause of death from external causes, after performing Health, Public Security and Press sector database linkage in the State of Rio de Janeiro, Brazil, 2014. METHODS: deterministic data linkage on deaths from external causes of undetermined intent and deaths from undetermined natural causes held on the Mortality Information System (SIM), Forensic Institute, Civil Police, Urgent Mobile Care Service (SAMU) and press databases. RESULTS: of the 13,916 deaths from external causes, deaths from causes of undetermined intent were reduced from 5,836 (41.9%) to 958 (6.9%); while 222 (10.7%) of the 2,069 deaths from undetermined natural causes were reclassified to external causes; there was an increase in mortality due to traffic accidents (93.0%), assault (71.6%), legal intervention (744.7%), intentional self-harm (112%) and other accidents (29.9%). CONCLUSION: there was an improvement in the quality of the information by type of underlying cause of death from external causes, using a strategy that can be reproduced by other services.


Assuntos
Acidentes/estatística & dados numéricos , Causas de Morte , Confiabilidade dos Dados , Violência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Criança , Bases de Dados Factuais/normas , Bases de Dados Factuais/estatística & dados numéricos , Morte , Feminino , Humanos , Sistemas de Informação/normas , Sistemas de Informação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
12.
Epidemiol Serv Saude ; 27(3): e2017471, 2018 10 22.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30365702

RESUMO

OBJECTIVE: to evaluate the time trend of proportional mortality due to ill-defined causes, in Tocantins and Palmas, Brazil, 1998-2014. METHODS: this was a time trend study using data from the Mortality Information System (SIM) and the Death Verification Service (SVO); we evaluated the time trend of this type of this mortality using Joinpoint Regression. RESULTS: between 1998 and 2014, proportional mortality from ill-defined causes fell 88.5% in Tocantins and 88.1% in Palmas; the trend test indicated statistically significant inflection points in 1998-2004 (-4.14; p=0.001) for Tocantins and in 1998-2000 (-7.92; p<0.005) for Palmas; a certain degree of stability was observed with effect from 2004. CONCLUSION: there was a significant decline in proportional mortality due to ill-defined causes in Tocantins; however, it is still necessary to intensify actions aimed at improving the quality of information on mortality in some municipalities.


Assuntos
Causas de Morte/tendências , Sistemas de Informação/estatística & dados numéricos , Mortalidade/tendências , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
13.
Rev Bras Epidemiol ; 21: e180019, 2018 Oct 11.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30328938

RESUMO

INTRODUCTION: Tuberculosis (TB) is one of the world's major public health problems. Epidemiological surveillance has proved to be an important tool to assist in the control and prevention of communicable diseases such as TB and AIDS. This study aimed to estimate the rate and factors associated with the underreporting of TB among cases of coinfection with human immunodeficiency virus (HIV)/AIDS in the state of Pernambuco, based on data from the TB and Aids Notifiable Diseases Information System (Sinan TB and Sinan AIDS). METHODS: A cross-sectional study was carried out based on the records of the TB and AIDS Notification System to identify cases of TB underreporting in the study period. In order to identify underreporting, a probabilistic linkage was undertaken using RecLink III software. RESULTS: The rate of TB underreporting was 29%, and the factors associated were: presenting a clinical form of TB as cavitary or unspecified pulmonary TB or having both kinds of TB at the same time; being treated outside the municipality of Recife; and being treated at health services not specialized for HIV/AIDS. DISCUSSION: The proportion of underreporting found in our study was lower than that observed in other Brazilian studies that took into account underreporting from mortality data. CONCLUSION: The variables associated with underreporting of TB were mostly related to the healthcare system rather than to individual characteristics, which points to the need for training of health professionals in order to notify the information systems correctly.


Assuntos
Síndrome de Imunodeficiência Adquirida/epidemiologia , Coinfecção/epidemiologia , Sistemas de Informação/estatística & dados numéricos , Vigilância da População/métodos , Tuberculose/epidemiologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Notificação de Doenças , Monitoramento Epidemiológico , Feminino , Humanos , Masculino , Registro Médico Coordenado
14.
Epidemiol Serv Saude ; 27(3): e2017139, 2018 09 21.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30281711

RESUMO

OBJECTIVE: to analyze age-period-cohort (APC) effects on mortality from chronic obstructive pulmonary disease (COPD) in the municipalities of Porto Alegre, RS, and Rio de Janeiro, RJ, Brazil, between 1980 and 2014. METHODS: this was a time series study using corrected Mortality Information System (SIM) data; APC effects were estimated by Poisson regression, in relation to the 1935 cohort. RESULTS: relative risk (RR) of death due to COPD for males decreased in the most recent birth cohort (1970-1974) in Porto Alegre (RR=0.39; 95%CI 0.32;0.48) and Rio de Janeiro (RR=0.42; 95%CI 0.38;0.48); while among women an increase in risk of death due to COPD was observed in Rio de Janeiro in more recent cohorts (RR=1.41; 95%CI 1.20;1.67). CONCLUSION: risk of death due to COPD decreased among men, while risk among women in Rio de Janeiro increased.


Assuntos
Sistemas de Informação/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/mortalidade , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Cidades , Efeito de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fatores de Risco , Fatores Sexuais , Fatores de Tempo
15.
Comput Methods Programs Biomed ; 164: 101-109, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30195418

RESUMO

BACKGROUND AND OBJECTIVES: Telecare Medicine Information System (TMIS) enables physicians to efficiently and conveniently make certain diagnoses and medical treatment for patients over the insecure public Internet. To ensure patients securely access to medicinal services, many authentication schemes have been proposed. Although numerous cryptographic authentication schemes for TMIS have been proposed with the aim to ensure data security, user privacy and authentication, various forms of attacks make these schemes impractical. METHODS: To design a truly secure and practical authentication scheme for TMIS, a new biometrics-based authentication key exchange protocol for multi-server TMIS without sharing the system private key with distributed servers is presented in this work. RESULTS: Our proposed protocol has perfect security features including mutual authentication, user anonymity, perfect forward secrecy and resisting various well-known attacks, and these security feathers are confirmed by the BAN logic and heuristic cryptanalysis, respectively. CONCLUSIONS: A secure biometrics-based authentication key exchange protocol for multi-server TMIS is presented in this work, which has perfect security properties including perfect forward secrecy, supporting user anonymity, etc., and can withstand various attacks such as impersonation attack, off-line password guessing attack, etc.. Considering security is the most important factor for an authentication scheme, so our scheme is more suitable for multi-server TMIS.


Assuntos
Identificação Biométrica/métodos , Segurança Computacional/normas , Troca de Informação em Saúde/normas , Telemedicina/normas , Identificação Biométrica/normas , Identificação Biométrica/estatística & dados numéricos , Segurança Computacional/estatística & dados numéricos , Confidencialidade , Lógica Fuzzy , Troca de Informação em Saúde/estatística & dados numéricos , Humanos , Sistemas de Informação/normas , Sistemas de Informação/estatística & dados numéricos , Telemedicina/estatística & dados numéricos
16.
Hu Li Za Zhi ; 65(4): 109-116, 2018 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-30066329

RESUMO

BACKGROUND & PROBLEMS: The unit promoted the use of a disease management information system, but lacked consensus regarding its use. The problems that were identified included: the business-oriented design of the information system, lack of education and training, dual-track operations, and awkward operation interface. Use of the information system among nurses in the unit had thus decreased over time. PURPOSE: To increase the prevalence of use of the disease management information system. RESOLUTIONS: The diffusion of innovation theory was applied to strengthen the innovative characteristics of the disease management information system. The improvement measures adopted included: incorporation of recommendations, revision of the information system, provision of testing, arranging education and training sessions for the nurses, implementation of a regular audit system, and the revision of standard operating procedures. RESULTS: The prevalence of use of the disease management information system increased from 33.3% pretest to 100% posttest. CONCLUSIONS: This project applied the diffusion of innovation theory to strengthen the innovative characteristics of the disease management information system, guide the nurses to adapt and change, and improve their use of and satisfaction with the disease management information system.


Assuntos
Difusão de Inovações , Gerenciamento Clínico , Sistemas de Informação/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/psicologia , Humanos
17.
BMC Med Res Methodol ; 18(1): 76, 2018 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-29980173

RESUMO

BACKGROUND: Records pertaining to individuals whose identity cannot be verified with legal documentation may contain errors, or be incorrect by intention of the individual. Probabilistic data linkage, especially in vulnerable populations where the incidence of such records may be higher, must be considerate of the usage of these records. METHODS: A data linkage was conducted between Queensland Youth Justice records and the Australian National Death Index. Links were assessed to determine how often they were made using the unverified (alias) records that would not have been made in their absence (i.e. links that were not also made using solely verified records). Anomalies in the linked records were investigated in order to make evaluations of the sensitivity and specificity of the linkage, compared to the links made using only verified records. RESULTS: From links made using verified records only, 1309 deaths were identified (2.6% of individuals). Using alias records in addition, the number of links increased by 16%. Links made using alias records only were more common in females, and those born after 1985. Different records belonging to the same individual in the justice dataset did not link to different death records, however there were instances of the same death record linking to multiple cohort individuals. CONCLUSIONS: The inclusion of aliases in data linkage in youths involved in the justice system increased mortality ascertainment without any discernible increase in false positive matches. We therefore conclude that alias records should be included in data linkage procedures in order to avoid biased attenuation of ascertainment in vulnerable populations, leading to the concealment of health inequality.


Assuntos
Sistemas de Informação/estatística & dados numéricos , Registros/estatística & dados numéricos , Justiça Social/normas , Populações Vulneráveis/estatística & dados numéricos , Adolescente , Austrália , Declaração de Nascimento , Estudos de Coortes , Atestado de Óbito , Feminino , Humanos , Armazenamento e Recuperação da Informação/métodos , Armazenamento e Recuperação da Informação/estatística & dados numéricos , Masculino , Reprodutibilidade dos Testes
18.
Yearb Med Inform ; 27(1): 243-251, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29681029

RESUMO

OBJECTIVES: The paper presents a review of the history of medical informatics in Romania, starting from the pioneering works, relating the present, and foreseeing the future. METHODS: Major milestones of the development of this field have not been simply enumerated, but described within the specific socio-political frame, grasping the entire context over the last four decades in Romania. Two main perspectives have been traced: education and training in medical informatics and implementations in healthcare. RESULTS: Four distinctive historical periods are identified and the major events of each period are described in a critical manner. The history of the Romanian Society of Medical Informatics is presented in a separate chapter. The last section is dedicated to the present state of the field in Romania. CONCLUSION: The history of Romanian Medical Informatics spans many years and is rich in content. The Romanian Society of Medical Informatics is mainly the result of the efforts undertaken by an enthusiastic and sound professional community, trying to continue the tradition, to achieve new goals, and to work as an active member of the international biomedical/health informatics community.


Assuntos
Informática Médica/história , História do Século XX , História do Século XXI , Sistemas de Informação/história , Sistemas de Informação/estatística & dados numéricos , Tecnologia da Informação/história , Informática Médica/educação , Informática Médica/legislação & jurisprudência , Romênia
19.
Genome Res ; 28(5): 759-765, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29650552

RESUMO

Scientific research plays a key role in the advancement of human knowledge and pursuit of solutions to important societal challenges. Typically, research occurs within specific institutions where data are generated and subsequently analyzed. Although collaborative science bringing together multiple institutions is now common, in such collaborations the analytical processing of the data is often performed by individual researchers within the team, with only limited internal oversight and critical analysis of the workflow prior to publication. Here, we show how hackathons can be a means of enhancing collaborative science by enabling peer review before results of analyses are published by cross-validating the design of studies or underlying data sets and by driving reproducibility of scientific analyses. Traditionally, in data analysis processes, data generators and bioinformaticians are divided and do not collaborate on analyzing the data. Hackathons are a good strategy to build bridges over the traditional divide and are potentially a great agile extension to the more structured collaborations between multiple investigators and institutions.


Assuntos
Pesquisa Biomédica/métodos , Sistemas de Informação/estatística & dados numéricos , Comunicação Interdisciplinar , Transferência de Tecnologia , Pesquisa Biomédica/organização & administração , Comportamento Cooperativo , Humanos , Sistemas de Informação/organização & administração , Malária Falciparum/parasitologia , Malária Falciparum/prevenção & controle , Plasmodium falciparum/fisiologia , África do Sul
20.
Cad Saude Publica ; 34(2): e00039217, 2018 02 19.
Artigo em Português | MEDLINE | ID: mdl-29489943

RESUMO

The article assessed the quality of completion of the maternal school variable in Brazilian state capitals and its regional distribution, based on the Brazilian Information System on Live Births (SINASC) with processed data from live birth certificates. A descriptive study was conducted in the time series from 1996 to 2013, with a total de 12,062,064 births, of which 11,442,494 (94.86%) had valid information on the maternal schooling variable. The results were calculated as the number of incomplete results in the variable per 1,000 live births, and the trend was assessed with the Joinpoint software, version 4.3.1. According to regional analysis, the South of Brazil showed a downward trend in incompleteness of maternal schooling throughout the study in all the state capitals of that region. Most of the country's other state capitals also showed improvement in the variable's completeness. However, there were different trends in some state capitals, even with greater incompleteness at the end of the period when compared to the beginning. SINASC proved to be a valuable source of data on mothers and their newborns, besides information on conditions in labor, delivery, and birth in the country. Maternal schooling, considered an important factor for obstetric and neonatal outcomes, is particularly useful for elaborating and evaluating policies and measures in maternal and child health. Thus, to achieve maximum completeness in data on this variable requires joint effort by health professionals and administrators, thereby guaranteeing the data's trustworthiness.


Assuntos
Declaração de Nascimento , Bases de Dados Factuais/normas , Sistemas de Informação/estatística & dados numéricos , Nascimento Vivo , Registro Médico Coordenado/normas , Brasil , Cidades , Bases de Dados Factuais/estatística & dados numéricos , Escolaridade , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Recém-Nascido , Características de Residência , População Urbana
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