Assessment of informatization for the dispensing of medications at a university hospital

INTRODUCTION: Informatics and automation are important tools for the reduction of work, errors and costs in a hospital pharmacy. OBJECTIVES: To describe the structuring and function of an informatized system for the dispensing of medications and to assess its effect on nursing and pharmacy services during the period from 1997 to 2003. MATERIALS and METHODS: In this descriptive and retrospective study, we performed an analysis of documents addressing the structuring and implementation of the informatized medication dispensing system. In addition, we analyzed the perceptions of nurses, pharmacists and pharmacy assistants who participated in the structuring phase of the system when interviewed about the effect of informatization on administrative aspects (e.g., requisition of medications, presentation of the dispensed medication and system operationalization). RESULTS: The major advantages provided by the new system were 1) the elimination of manual transcripts for prescribed medications, 2) increased speed, 3) better identification of the doses prescribed by physicians, 4) medication labels containing all necessary identification and 5) practicality and safety of optical bar code-based verification of the requested and dispensed medications. CONCLUSIONS: The great majority of the interviewees considered the informatized medication supply system to be of good quality. Analysis of the data provided information that could contribute to the expansion and refinement of the system, provide support for studies regarding the utilization of medications and offer new perspectives for work and productivity.

Autopsy: quality assurance in the ICU

Objective: To examine the correlation between the clinical diagnosis and autopsy findings in adult patients who died in an intensive care unit (ICU). To determine the rate of agreement of the basic and terminal causes of death and the types of errors in order to improve quality control of future care,Design, Retrospective study.Setting: Adult ICU in a university hospital.Patients: 30 adult patients who died in the ICU. with the exclusion of medicolegal cases.Methods and main results: Anatomo-clinical meetings were held to analyze the pre- and postmortem correlations in 30 consecutive autopsies at the ICU of the University Hospital, School of Medicine of Botucatu/ UNESP, from January 1994 to January 1997. The rate of correct clinical diagnoses of the basic cause was 66.7 %; in 23.3 % of cases, if the correct diagnosis was made, management would have been different, as would have been the evolution of the patient's course (Class I error): in 10 % of the cases the error would not have led to a change in management (Class II error). The rate of correct clinical diagnoses of terminal cause was 80 %.Conclusions: the rate of recognition of the basic cause was 66.7 %, which is consistent with the literature, but the Class I error rate was higher than that reported in the literature.

A new short and simple health-related quality of life measurement for paediatric rheumatic diseases: initial validation in juvenile idiopathic arthritis

Objective. To develop and validate a new short and simple measure of health-related quality of life (HRQL) in children with juvenile idiopathic arthritis (JIA).Methods. The Paediatric Rheumatology Quality of Life Scale (PRQL) is a 10-item questionnaire that explores HRQL in two domains: physical health (PhH) and psychosocial health (PsH). Validation of the parent proxy report and child self-report versions of the instrument was accomplished by evaluating 472 JIA patients and similar to 800 healthy children. Validation analyses included assessment of feasibility, face and content validity; construct and discriminative ability; internal structure and consistency; test-retest reliability; responsiveness to clinical change; and minimal clinically important difference.Results. The PRQL was found to be feasible and to possess both face and content validity. The PRQL score correlated in the predicted range with most of the other JIA outcome measures, thereby demonstrating good construct validity, and discriminated well between different levels of disease severity. Assessment of internal structure (factor analysis) revealed that the PhH and PsH subscales identify two unambiguously separated domains. The internal consistency (Cronbach's alpha) was 0.86. The intraclass correlation coefficient for test-retest reliability was 0.91. The PRQL revealed fair responsiveness, with a standardized response mean of 0.67 in improved patients. Overall, the PRQL appeared to be more able to capture physical HRQL than psychosocial HRQL.Conclusion. The PRQL was found to possess good measurement properties and is, therefore, a valid instrument for the assessment of HRQL in children with JIA. This tool is primarily proposed for use in standard clinical care.

Development, Optimization and Validation of Gas Chromatographic Fingerprinting of Brazilian Commercial Diesel Fuel for Quality Control

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Evaluation of the performance of pharmacists in terms of providing health assistance at a university hospital

OBJETIVE: This study aimed to assess the practices of pharmacists in Hospital Care. Method - we interviewed 20 pharmacists from the Pharmacy Division by applying a structured instrument, in September 2005. This instrument addressed aspects related to the main activities at the Hospital Pharmacy, which were assessed according to indicators organized into five areas: sector management, hospital pharmacotechniques, committee activities, information and pharmacotherapeutic follow-up, as well as teaching and research activities.RESULTS: the Pharmacy Division considered all structural aspects under analysis as essential for the good development and application of its services. We found that some essential services, such as the Medication Information Service and Pharmacotherapeutic Follow-up, were absent. Pharmacist professionals were dissatisfied about human resource and physical structure dimensioning, and they presented as not very active in terms of Pharmaceutical Care.CONCLUSION: Results indicate that care is still centered on the drug, with few clinical activities. We suggest reformulations in service management, particularly in the management of pharmacists.

Remote Sensing Detection of atmospheric pollutants using Lidar, Sodar and correlation with air quality data in an industrial area

Optical remote sensing techniques have obvious advantages for monitoring gas and aerosol emissions, since they enable the operation over large distances, far from hostile environments, and fast processing of the measured signal. In this study two remote sensing devices, namely a Lidar (Light Detection and Ranging) for monitoring the vertical profile of backscattered light intensity, and a Sodar (Acoustic Radar, Sound Detection and Ranging) for monitoring the vertical profile of the wind vector were operated during specific periods. The acquired data were processed and compared with data of air quality obtained from ground level monitoring stations, in order to verify the possibility of using the remote sensing techniques to monitor industrial emissions. The campaigns were carried out in the area of the Environmental Research Center (Cepema) of the University of São Paulo, in the city of Cubatão, Brazil, a large industrial site, where numerous different industries are located, including an oil refinery, a steel plant, as well as fertilizer, cement and chemical/petrochemical plants. The local environmental problems caused by the industrial activities are aggravated by the climate and topography of the site, unfavorable to pollutant dispersion. Results of a campaign are presented for a 24- hour period, showing data of a Lidar, an air quality monitoring station and a Sodar. © 2011 SPIE.

Perceived quality of life and physical activity in Brazilian older adults

The purpose of this study was to investigate the association between self-perceived quality of life and physical activity in Brazilian older adults. We investigated 199 individuals (117 men and 82 women) aged between 60 to 70 years old, employees of a public university. Physical activity was estimated by the short version of the International Physical Activity Questionnaire (IPAQ). Self-perceived quality of life was assessed using the World Health Organization Quality of Life (WHOQOL-Bref) questionnaire composed of four domains: physical, psychological, social relationship and environment. There was no difference in self-perceived quality of life between men and women. In contrast, quality of life was associated with physical activity even after adjustment for gender, schooling and income. The physical domain presented the strongest association with physical inactivity (Odds Ratio = 2.70, 95% CI 1.87-3.52). Only the environment domain evaluated by WHOQOL-Bref was not associated to physical inactivity. Among the older, improved self-perceived quality of life is positively associated to physical activity. © FTCD/FIP-MOC.

Oral health-related quality of life and satisfaction before and after treatment with complete dentures in a Dental School in Brazil

Purpose: The aim of this study was to evaluate the impact of treatment with new complete dentures on oral health-related quality of life and satisfaction of edentulous patients attending the Prosthodontic Department in a Dental School in Brazil. Methods: A total of 70 edentulous subjects (37-86 years) treated by undergradute students at the Araçatuba Dental School, University of State of São Paulo, were accessed. A specific questionnaire for edentulous patients (EDENT) based on the Oral Health Impact Profile (OHIP-EDENT) was applied to collect information on patient oral health-related quality of life. Questions related to the personal satisfaction of the edentulous patients with their complete dentures were also included. The patients were accessed before the treatment, and 3 months after receiving the new dentures. Results: After rehabilitation with new complete dentures, all domains of OHIP-EDENT showed significant improvements. There was also a significant improvement in patient satisfaction after placement of new complete dentures. Furthermore, it was possible to observe association between upper denture satisfaction and age. Conclusion: Conventional complete dentures may have a positive impact on oral health-related quality of life and satisfaction of edentulous patients. © 2012 Japan Prosthodontic Society.

Sleep quality and its associations with leisure-time exercise and excess weight among civil servants

O objetivo do estudo foi analisar a associação entre qualidade do sono, prática de exercícios físicos no lazer e obesidade entre servidores públicos de uma universidade. A amostra foi composta por 92 adultos de ambos os sexos. Qualidade do sono e atividade física foram coletadas por meio de questionário. O excesso de peso/obesidade foi diagnosticado pelo índice de massa corporal, o qual foi calculado com valores de peso e estatura relatados pelos avaliados. A prevalência de pessoas com sono alterado foi de 53,84%. Houve associação entre obesidade (OR= 7,22 [ORIC95%: 1,65-31,5]) e pior qualidade do sono, bem como, prática de atividade física e melhor qualidade do sono (OR= 0,19 [ORIC95%: 0,04-0,95]), independente de outros fatores de confusão. Concluiu-se que há alta ocorrência de distúrbios do sono, a qual foi associada de maneira independente com a prática de exercícios físicos e a obesidade.

Fruit quality in the peach and nectarine with application of hydrogenated cyanamide and mineral oil

This work evaluated the quality of the fruit in peach and nectarine cultivars with and without the application of hydrogenated cyanamide and mineral oil, for two production cycles (2009 and 2010). The experiment was carried out at the School of Agricultural Science of the São Paulo State University (UNESP), at Botucatu in the Brazilian state of São Paulo, located at latitude 22º51'55 S and longitude 48º26'22 E, at an altitude of 810 m. The predominant climate type is warm temperate (mesothermal) with rains in the summer and dry in the winter. The following were evaluated: soluble solids, titratable acidity, pH, ratio, firmness, vitamin C and pulp yield. The use of hydrogenated cyanamide and mineral oil had no effect on the quality attributes of the fruit, except for pH, where those fruits under application of the products showed higher values. The cultivars all had a pulp yield greater than 90%, with 'Tourmaline' showing the highest yield (96 %). The levels of vitamin C varied according to the cultivars, where 'Marli' (16.9 mg 100 g-1) and 'Dourado-2' (16.5 mg 100 g-1), stood out for having the highest levels.

The Digital Divide in the University: The Appropriation of ICT in Higher Education Students from Bogota, Colombia

The growth and integration of ICTs in the global economy have created conditions that profoundly affect our society, dividing communities between those who effectively appropriate these resources and those who do not, what is called the digital divide. This exploratory study seeks to propose and validate ways of assessing this phenomenon in higher education, from the construction of a model and a comprehensive methodology that value contextual conditions, in addition to measuring access factors and motivation for use, that have been employed in previous research. To obtain indications about the behavior of this phenomenon, we developed research with students from three universities in Bogota, administering 566 surveys in four phases that would test the variables proposed in the model. The results show that the variables of the model link causally, with the strongest relations between education, attitude towards ICTs and ICT application. Although students have good access to ICTs and high levels of education, no strong relationship was found in regards to perceived impact on production. This may be explained by a superficial appropriation of ICT, due to a context that is alien to its conditions of origin (industrialism, innovation), poor quality of education and economies not centered around R&D.