Introduction: There is an increased acceptance and demand for online and mobile health (mHealth) interventions to support physical and mental health problems. However, the uptake and engagement of these interventions is relatively low and the evidence base for these interventions requires continual updating in line with technological advances. A systematic review was conducted, focusing on anxiety and depression, to explore the existing evidence base of both physical health and mental health mobile applications. The first research paper explores the acceptability of mHealth interventions for both mental health and physical health problems. The final research paper explores use and strategies when searching for mental health information online. Additionally, perceived quality, sentiment and barriers to online health information was explored. Methods: Studies were identified by searching for articles published between January 2008 and January 2016. Databases included: PsycINFO, MEDLINE, CINAHL PLUS and the Cochrane Central Register of Controlled Trials for 2016. In the research articles, 218 people completed an online survey in January 2016 exploring, online health seeking for mental health and physical health problems, and acceptability of mHealth interventions. Sentiment of online health resources was explored by extracting 432 individual tweets from Twitter. Results: The systematic review revealed twenty-seven studies for inclusion; 10 with a physical health focus and 17 with a mental health focus. Targeted depression applications have the superior evidence base; however, no firm conclusions can be made regarding interventions that targeted physical health, or those measuring anxiety. The first research paper found that face-to-face therapy would more likely meet expectations for treatment of both physical and mental health problems compared to mHealth interventions. Computerised interventions were more likely to meet expectations than mobile applications. Expectations of treatment were higher for the treatment of mental health problems than physical health problems. The second research paper found that a large proportion of the public use the internet to search for information on mental health, with half citing it as their primary source for mental health information. The online survey found that the quality of mental health information available on the internet was rated favourably, compared to mobile applications. Overall, the sentiment towards specific online mental health resources was generally positive. Conclusions: Research into online and mHealth interventions has developed considerably in recent years in line with advances in technology. These interventions have the potential to be an effective treatment of common mental health problems. The systematic review highlighted that depression applications are more established and effective than applications targeting anxiety. The first research paper suggests that mHealth interventions fall short of public expectations for treatment of health problems. The final research paper reflects that the perceived quality of online mental health information is rated favourably. However, many barriers still limit uptake. Future research could focus on continually developing and evaluating evidence based online and mHealth interventions and the outcome of this study suggests that incorporating them more widely into existing care systems, alongside face to face interventions could increase the public’s confidence in these interventions.

An increasing proportion of people in the United Kingdom are living longer with long-term conditions. The National Health Service is facing the challenge of increased pressure on its service provision. A number of key health policy initiatives encourage individuals to make informed choices and purport to give them rights and control over their own health and healthcare. Within this context, people are actively encouraged to self-care, manage diseases, and make decisions and choices about healthcare in an informed way. To facilitate this, it is important to gain an understanding of the health information seeking behaviours of older people. Health information is available from various sources but little is known about the health information seeking behaviours of older people and what affects this. By exploring this, it helps to reveal how health information is sought regarding on-going health conditions and provides greater depth in understanding the health information seeking process. The study explores older people's experiences and views on their health information seeking behaviours and endeavours to gain a better understanding of these experiences and views. The study draws on constructivist grounded theory with two phases to data collection: Nine participants completed un-structured diaries over two months with follow up semi-structured interviews, a further twenty participants participated in semi-structured interviews. Major categories were inductively drawn from participant's responses. Strategies of health information seeking behaviours are not necessarily fixed, but subject to change over time. The analysis suggested three main categories that explained the health information seeking behaviours of older people. Three interrelated conceptual categories were identified: (1) Regulating self (2) Self managing and (3) Self-mobilisation. These categories formed the basis of the emergent substantive theory called 'navigating later life'. There were different patterns of behaviours between participants which captured variations in information seeking; these informed the development of a typology of health information seekers. Ageing in the 21st century is a complex process; with older people inhabiting a world of more choice, multiple sources of knowledge, changed healthcare roles and increased self-care undertaken within the home. The study provides important insights for healthcare professionals and raises implications for strategies aimed at improving older people's access to appropriate health information. The navigation model provides a potentially valuable tool for policy makers when considering the support older people require to self-care.

Ce travail de recherche s'inscrit en sciences de l'information et de la communication et s'intéresse à l'émotion dans la recherche d'information à travers l'exemple des forums de santé. Le succès de ces dispositifs résulte d'une motivation informationnelle et émotionnelle des participants qui peuvent accéder à des témoignages, des informations ponctuelles ou encore des informations médicales filtrées par le vécu du malade (ou du proche de malade) qui s'exprime. Les messages sont donc souvent empreints d'émotion. La problématique s'attache aux évolutions de l'activité d'information et notamment au rôle que peuvent jouer les marqueurs d'émotion dans la structuration des informations mais également lors de leur évaluation. Une première analyse vise à mettre en évidence l'organisation des messages et des indices d'émotion grâce à une analyse de corpus (de fils de discussion provenant de différents forums de santé). Une seconde enquête s'attache à l'analyse de données recueillies pendant une phase d'entretiens et d'expérimentations sur l'utilisation des forums de santé et sur la manière dont les participants évaluent les informations. Les résultats montrent que les informations médicales sont très présentes et majoritairement entremêlées d'indices d'émotion de peur. Toutefois, la joie est l'émotion la plus présente dans l'ensemble du corpus. Enfin, si les marqueurs d'émotion sont des critères d'évaluation, il apparaît que les informations médicales sont également des indices d'évaluation et non les informations évaluées. / This thesis has been carried out in the field of information and communication sciences and focuses on emotion in information retrieval in health fora. The success of these systems results from an informational and emotional motivation from the participants who can access testimonials, punctual information or medical information filtered through the experience of the patients who are writing. The messages often have emotional content. This thesis focuses on developments in information activities and especially on the role that emotional has in the structuring and evaluation of information. The aim of the first analysis is to highlight the organization of messages and their emotional content through a corpus analysis (from different threads of different French-language health fora). A second study focuses on the analysis of data collected during some interviews regarding the use of health fora and the way in which participants evaluate information. The results show that medical information is very present and mostly interspersed with emotion of fear. However, the joy is the emotion mostly present in all the collected corpus. Finally, if the evaluation criteria markers are emotion, it appears that medical information are also evaluation criteria and not the information evaluated.

Made available in DSpace on 2016-06-02T19:48:16Z (GMT). No. of bitstreams: 1 3355.pdf: 2544166 bytes, checksum: 3997021b81781769b20b68ba6a04ee9f (MD5) Previous issue date: 2010-10-22 / The area of the Regional Department of Health (DRS) III has been demonstrating that it possesses good indicators of life quality, besides a number of establishments of health that you/they overcome the average of the state. However, studies demonstrate that the reality of control of TB is far away from the established rates for the organs of health. The death for TB should be a rare event, some authorities of health have been recommending the establishment of a surveillance that qualifies the information through the verification of the death, using methods that identify diagnosis mistakes, what really appears not just for the characteristics of the lethality as a quality indicator and of the treatment opportunity, but it goes much beyond, with the observation of deaths non included previously. It was aimed at to characterize the epidemic profile of the cases of TB that you/they developed for death registered in DRS III of the state of São Paulo, in the period from 2006 to 2008. It was treated of a quantitative and descriptive exploratory study, in which the information of the database were used TBWeb and YES. In the YES, it was used CID regarding the definition of TB, that you/they are the classifications of A15.0 to A19.9. After the individual collection of each bank, the information were confronted for the possible identification of cases subnotificados or sub detected. The characterization of the profile epidemic of the cases of TBWeb identified that, of the 640 cases notified in the period, 22 developed for death, being these 82% of the masculine sex; the predominant age group was of 30-59 years, but with occurrences also among the ends of age, only that in smaller frequency; education from 4 to 7 years of studies; defined occupation as others e not specified in the system; it forms lung clinic in 95% of the cases; in discovery type, 45% happened in the service of Emergency, and the comorbidade alcoholism appeared in 45% of the cases. In the YES, they were identified 34 death declarations that contained as basic cause one of CID with definition of TB and similar occurrence was observed: the masculine sex presents larger acometimento (73,5%), with age group between 30 and 59 years and 91% of the deaths for TB happened in the hospitalar. In the confrontment of the data, he/she identified only 22 cases in common, and 11 were notified in TBWeb, but they were not in the YES and 12 were in the YES, but they consisted in TBWeb. This way, the total of deaths for TB of the area was of 45 cases. The analysis of the systems of information YES and TBWeb identified inconsistency of data pointing flaws in the completion of the same ones. The information disponibilizeds indicate the need of better qualification of the same ones, what can feel through the involved professionals' larger training, as well as for the establishment of periodic confrontments of data in search of possible mistakes. Although they are clear the limitations of the research, imposed partially by the quality of the data, the study made possible to know the profile of the population more reached by the disease and your possible tendencies. It is done necessary also to detach that these information cannot be considered in real time, because although the systems are on-line, it is observed that there is still delay in the flow of the information. / A região do Departamento Regional de Saúde (DRS) III tem demonstrado bons indicadores de qualidade de vida, além de um número de estabelecimentos de saúde que superam a média do estado. No entanto, estudos demonstram que a realidade de controle da tuberculose (TB) está longe das taxas estabelecidas pelos órgãos de saúde. E o óbito por TB que deveria ser um evento raro, vem sendo alvo de algumas autoridades de saúde que recomendam o estabelecimento de uma vigilância que qualifique a informação através da verificação desta ocorrência, baseando-se em métodos que identifiquem erros de diagnóstico, que aponte características da letalidade como um indicador de qualidade e da oportunidade de tratamento, além de possibilitar através da observação, identificar óbitos não inclusos anteriormente. Objetivou-se caracterizar o perfil epidemiológico dos casos de TB que evoluíram para óbito registrado no DRS III do estado de São Paulo, no período de 2006 a 2008. Tratou-se de um estudo exploratório quantitativo e descritivo, no qual foram utilizadas as informações do banco de dados TBWeb e SIM. No SIM, utilizou-se a CID referente à definição de TB, que são as classificações de A15.0 até A19.9. Após a coleta individual de cada banco, as informações foram confrontadas para a possível identificação de casos subnotificados. A caracterização do perfil epidemológico dos casos do TBWeb identificou que, dos 640 casos notificados no período, 22 evoluíram para óbito, sendo estes 82% do sexo masculino; a faixa etária predominante foi de 30-59 anos, mas com ocorrências também entre os extremos de idade, só que em menor frequência; escolaridade de 4 a 7 anos de estudos; ocupação definida como outras e não especificadas no sistema; forma clínica pulmonar em 95% dos casos; em tipo de descoberta, 45% ocorreram no serviço de Urgência/Emergência, e a comorbidade alcoolismo apareceu em 45% dos casos. No SIM, foram identificadas 34 declarações de óbito que continham como causa básica um das CID com definição de TB e observou-se ocorrência semelhante ao do TBWeb: o sexo masculino apresenta maior acometimento (73,5%), com faixa etária entre 30 e 59 anos e 91% dos óbitos por TB ocorreram no hospitalar. No confrontamento dos dados, identificou-se apenas 22 casos em comum, sendo que 11 estavam notificados no TBWeb, mas não estavam no SIM e 12 estavam no SIM, mas constavam no TBWeb. Desta forma, o total de óbitos por TB da região foi de 45 casos. A análise dos sistemas de informação SIM e TBWeb possibilitou identificar inconsistência de dados apontando falhas no preenchimento dos mesmos. As informações disponibilizadas indicam a necessidade de melhor qualificação das mesmas, o que pode se dar por meio de maior capacitação dos profissionais envolvidos, bem como pelo estabelecimento de confrontamentos periódicos de dados em busca de possíveis erros. Embora fiquem claras as limitações da pesquisa, impostas parcialmente pela qualidade dos dados, o estudo possibilitou conhecer o perfil da população mais atingida pela doença e suas possíveis tendências. Faz-se necessário também destacar que estas informações não podem ser consideradas em tempo real, pois embora os sistemas sejam on-line, observa-se que há ainda atraso no fluxo da informação.

In the United States, the health care sector is 20 years behind in the use of information technology to improve the process of health care delivery as compared to other sectors. Patients have to deliver their data over and over again to every health professional they see. Most health care facilities act as data repositories with limited capabilities of data analysis or data exchange. A remaining challenge is, how do we encourage the use of IT in the health care sector that will improve care coordination, save lives, make patients more involved in decision-making, and save money for the American people? According to Healthy People 2020, several challenges such as making health IT more usable, helping users to adapt to the new uses of health IT, and monitoring the impact of health IT on health care quality, safety, and efficiency, will require multidisciplinary models, new data systems, and abundant research. In this dissertation, I developed and used systems engineering methods to understand the role of new health IT in improving the coordination, safety, and efficiency of health care delivery. It is well known that care coordination issues may result in preventable hospital readmissions. In this dissertation, I identified the status of the care coordination and hospital readmission issues in the United States, and the potential areas where systems engineering would make significant contributions (see Appendix B). This literature review introduced me to a second study (see Appendix C), in which I identified specific patient cohorts, within chronically ill patients, that are at a higher risk of being readmitted within 30 days. Important to note is that the largest volume of preventable hospital readmissions occurs among chronically ill patients. This study was a retrospective data analysis of a representative patient cohort from Tampa, Florida, based on multivariate logistic regression and Cox proportional hazards models. After finishing these two studies, I directed my research efforts to understand and generate evidence on the role of new health IT (i.e., health information exchange, HIE) in improving care coordination, and thereby reducing the chances of a patient to be unnecessarily readmitted to the hospital. HIE is the electronic exchange of patient data among different stakeholders in the health care industry. The exchange of patient data is achieved, for example, by connecting electronic medical records systems between unaffiliated health care providers. It is expected that HIE will allow physicians, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically, and thereby improving the speed, quality, safety and cost of patient care. The federal government, through the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, is actively stimulating health care providers to engage in HIE, so that they can freely exchange patient information. Although these networks of information exchange are the promise of a less fragmented and more efficient health care system, there are only a few functional and financially sustainable HIEs across the United States. Current evidence suggests four barriers for HIE: •Usability and interface issues of HIE systems •Privacy and security concerns of patient data •Lack of sustainable business models for HIE organizations •Loss of strategic advantage of "owning" patient information by joining HIE to freely share data To contribute in reducing usability and interface issues of HIE systems, I performed a user needs assessment for the internal medicine department of Tampa General Hospital in Tampa, Florida. I used qualitative research tools (see Appendix D) and machine learning techniques (see Appendix E) to answer the following fundamental questions: How do clinicians integrate patient information allocated in outside health care facilities? What are the types of information needed the most for efficient and effective medical decision-making? Additionally, I built a strategic gaming model (see Appendix F) to analyze the strategic role of "owning" patient information that health care providers lose by joining an HIE. Using bilevel mathematical programs, I mimic the hospital decision of joining HIE and the patient decision of switching from one hospital to another one. The fundamental questions I tried to answer were: What is the role of competition in the decision of whether or not hospitals will engage in HIE? Our mathematical framework can also be used by policy makers to answer the following question: What are the optimal levels of monetary incentives that will spur HIE engagement in a specific region? Answering these fundamental questions will support both the development of user-friendly HIE systems and the creation of more effective health IT policy to promote and generate HIE engagement. Through the development of these five studies, I demonstrated how systems engineering tools can be used by policy makers and health care providers to make health IT more useful, and to monitor and support the impact of health IT on health care quality, safety, and efficiency.

Introdução: Dados da Organização Mundial da Saúde apontam a intoxicação como um importante problema de saúde pública em todo o mundo, especialmente em países subdesenvolvidos ou em desenvolvimento. Objetivos: estimar a taxa de mortalidade e descrever os óbitos por intoxicação exógena (IE) no município de São Paulo (MSP) no ano de 2014. Métodos: Utilizaram-se as informações dos registros dos óbitos (causa básica) no Sistema de Informação sobre Mortalidade (SIM) e no Sistema de Informação de Agravos de Notificação (SINAN). Para o relacionamento probabilístico foram selecionadas as variáveis: nome, data de nascimento e sexo. Foram utilizados os softwares OpenRecLink para o linkage, Stata® para análise de dados e o TabWin para a distribuição espacial dos óbitos por IE. Os óbitos foram descritos em relação às características do local de ocorrência, circunstância da exposição, grupo do agente tóxico e classificação final. Foi utilizado o método de captura-recaptura para estimar o número de óbitos, após o relacionamento dos bancos de dados. Resultados: Os dados do SIM apontaram para uma taxa de mortalidade por IE de 5,2/100.000 habitantes no MSP, em 2014. O distrito administrativo de São Miguel apresentou a maior taxa de mortalidade 12,2/100.000 habitantes. A maior parte dos óbitos (n=412) foi atestada por médico do IML. O sexo masculino foi o que apresentou maior frequência (71 por cento ). A faixa etária de maior mortalidade foi a de 20 a 39 anos. Foi possível identificar uma grande diferença entre o número de óbitos por intoxicação registrado no SIM (n=596) e o estimado (n=1.514,5) pelo método de captura-recaptura. A taxa de mortalidade estimada pelo método de capturarecaptura foi de 13,2/100.000 habitantes. Dessa forma identificou-se um sub-registro de óbito de 60,6 por cento . Conclusões: Os resultados mostram que a mortalidade por IE é subestimada quando comparada a calculada a partir da captura-recaptura de dados. O relacionamento das bases de dados é importante para estimar a magnitude da ocorrência dos óbitos por IE. Há a necessidade de formulação de políticas públicas voltadas à prática da vigilância das intoxicações, qualificação dos profissionais da assistência à saúde para o diagnóstico das IE e capacitação aos responsáveis pelo registro dos casos / Background: Data from the World Health Organization indicates poisoning as a major public health problem worldwide, especially in underdeveloped or developing countries. Objective: to estimate the mortality rate and to describe deaths from exogenous poisoning (EP) in São Paulo city in the year 2014. Methods: Data from the death records (basic cause) were collected in the Mortality Information System (MIS) and in the Notifiable Diseases Information System (NDIS). For the probabilistic relationship the following variables were selected: name, date of birth and gender. OpenRecLink software was used for linkage, Stata® for data analysis and TabWin for spatial distribution of deaths by EP. Deaths were described in relation to the characteristics of the place of occurrence, exposure circumstance, toxic agent group and final classification. The capture-recapture method was used to estimate the number of deaths, after the linkage of the databases. Results: The MIS data pointed to a mortality rate by EP of 5,2/100.000 inhabitants in São Paulo city in 2014. São Miguel administrative district presented the highest mortality rate 12,2/100.000 inhabitants. Most part of the deaths (n=412) were attested by IML doctor. The male gender was the one with the highest frequency (71 per cent ). The age group with the highest incidence was 20 to 39 years. It was possible to identify a large difference between the number of intoxication deaths recorded in the MIS (n=596) and the estimated (n=1.514,5) by the capture-recapture method. The mortality rate estimated by the capture-recapture method was 13,2/100.000 inhabitants. In this way, a 60,6 per cent underreporting of death was identified. Conclusions: The obtained results show that the mortality by EP is underestimated when compared to the calculated from the capture-recapture data. The linkage of databases is important to estimate the magnitude of the occurrence of death by EP. There is a need for formulation of public policies aimed at the practice of poisoning surveillance, qualification of health care professionals for the EP diagnosis and training of those responsible for case registration

Trata-se de um estudo que teve como proposta utilizar os dados do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS) como medida complementar para a identificação de mortes maternas não informadas. Foram investigados os Estados de São Paulo, Paraná, Pará, Ceará e Mato Grosso, nos anos de 1999 e 2000. Foram utilizados dados secundários dos CD-ROMs Movimento de Autorização de Internação Hospitalar do Sistema Único de Saúde (SUS), em seus arquivos reduzidos, por meio de formulários das AIHs que constituem o banco de dados informatizado e processado nacionalmente pelo SIH-SUS. Os resultados desta investigação possibilitaram identificar 651 mortes, sendo que 596 foram informadas pelo SIH-SUS como mortes maternas e 55 foram mortes maternas mascaradas ou presumíveis, obtidos a partir de procedimentos obstétricos e diagnósticos secundários pertencentes ao Capítulo XV da CID 10 - Gravidez, parto e puerpério, registrados no SIH-SUS. O presente estudo revelou que tal sistema de informação pode ser utilizado como medida complementar para a identificação de mortes maternas não informadas. / This study aimed at using data from the Hospital Information System of the Unified Health System (SIH-SUS) as a complementary measure for the identification of unreported maternal deaths. The states of São Paulo, Paraná, Pará, Ceará and Mato Grosso were investigated for years 1999 and 2000. Secondary data from CD-ROMs for Reports of Hospitalization Authorizations (AIH) of the Unified Health System (SUS) in reduced files were used through AIH forms comprising the database of computerized data which is nationally processed by SIH-SUS. The results of this investigation enabled the identification of 651 deaths, of which 596 were reported by SIH-SUS as maternal deaths and 55 were disguised or presumable maternal deaths obtained from obstetric procedures and secondary diagnoses according to Chapter XV of the International Classification of Diseases 10 - Pregnancy, delivery and puerperium recorded by SIH-SUS. This study showed that this information system can be used as a complementary measure for the identification of unreported maternal deaths.

A história da luta contra a hanseníase no Estado de São Paulo foi ímpar, assim como todo o movimento sanitário, incomum na história da saúde mundial, pela maneira como se desenvolveu e a rapidez com que foi implementado. Utilizar intensivamente a informação na gestão da saúde é o que confere o diferencial na qualificação do processo decisório. Esta constatação impõe a necessidade de implementação de estratégias políticas e técnicas que superem os limites ainda existentes na gestão da informação em saúde no Brasil. Esta pesquisa objetivou descrever a trajetória da informação sobre a hanseníase, a partir do começo do século XIX, em São Paulo, e sua conexão com a implantação e o desenvolvimento do conceito e das práticas de vigilância e controle desse agravo. O estudo foi de natureza exploratória. Foram utilizadas análises bibliográficas, documental, e também o banco de dados de notificação de hanseníase do Centro de Vigilância Epidemiológica “Prof. Alexandre Vranjac” da Secretaria de Estado da Saúde de São Paulo para a construção da linha temporal sobre a informação na hanseníase em âmbito mundial, nacional e estadual. Os ganhos em quantidade de armazenamento e velocidade de análise, possibilitados pelo uso de bancos de dados informatizados, enfatizam os problemas da coleta e inserção das informações nos sistemas. Todos os elos da cadeia de informações, da coleta à sua utilização, são responsáveis pela adequação, integridade, precisão, acurácia e confiabilidade de todo o processo. O volume de dados em saúde, em São Paulo, principalmente na hanseníase, é enorme, todavia, a imprecisão deles em determinados períodos inviabiliza sua utilização para análises consistentes e fidedignas. Os problemas da não-informação são pontuais, ou seja, há alguns municípios que sistematicamente são os responsáveis. O investimento de recursos deve ser dirigido ao treinamento dos responsáveis pela coleta e inclusão das informações no sistema, e também à criação de mecanismos para incentivar o comprometimento e aumentar a percepção da importância dessas funções. / The history of the fight against Hansen’s disease in the State of São Paulo was unique, as well as the whole sanitary movement, unusual in the world health history, due to the manner in which this fight was conducted and the quickness in which it was implemented. Intensive use of information in health management is what lends uniqueness to the decision making process. This statement brings forth the need to implement political strategies and techniques capable to overcome the limits that still stand in the management of health information in Brazil. This research was designed to describe the route of information regarding Hansen’s disease, up from the start of the XIX Century, in São Paulo and its connection with the implanting and the development of surveillance and control practices associated to this hazard. The study had exploratory venue, employing bibliographical and documental analysis as well as the databank of reports of Hansen’s disease of the Epidemiological Surveillance Center “Prof. Alexandre Vranjac”, of the State Secretary of Health of São Paulo, in order to trace a time line of the information on Hansen’s disease comprising worldwide, nationwide and statewide levels. The profits in the amount of storage and quickness of analysis ensued by the use of cybernetic databanks stress the problems registered at data collection and also at the input of information in the system. All the links in the information chain, from collection to usage, are responsible for adequation, integrity, precision, accuracy and reliability of the whole process. Health data volume, in São Paulo, especially regarding Hansen’s disease, is enormous, however their imprecision, during some periods render these data useless for consistent and reliable analysis. Problems of no information are punctual, meaning some cities are systematically responsible for not registering their data. Resource investment must be directed to training programs of officers responsible for the collection and input of the information in the system, and must also be directed to the creation of mechanisms designed to increase commitment and further the perception of the importance of these tasks.

Os sistemas de informação em saúde permitem melhorias no processo de gestão e assistência ao paciente. A fundação HEMOBA é responsável pela assistência médica e transfusional de grande parcela da população baiana, pelo SUS, em seu ambulatório transfusional e de atendimento à pacientes com doenças hematológicas benignas. A doença falciforme (DF) é uma das doenças hereditárias mais prevalentes no mundo, sendo a Bahia o estado brasileiro onde é encontrada sua maior prevalência. A transfusão sanguínea é uma das bases para o seu tratamento. Não existe sistema informatizado no atendimento desses pacientes nem banco de dados sobre essa população na instituição. OBJETIVO: Desenvolver um Software para seguimento transfusional em hemoterapia, com ênfase no acompanhamento de pacientes falciformes, possibilitando descrever e analisar aspectos transfusionais dessa população e dos doadores. MATERIAIS E MÉTODOS: Foi desenvolvido um Software, denominado BDTrans, utilizando a metodologia de Ciclo de Vida de Desenvolvimento de Sistemas, que possibilitou um estudo analítico, transversal, com abordagem qualitativa e quantitativa, dos dados extraídos do sistema. Foram acompanhadas crianças falciformes, de 0 a 18 anos, em regime transfusional, atendidas no ambulatório da Fundação HEMOBA. RESULTADOS: Foram incluídos 108 pacientes, destes 58% apresentavam DTC alterado e 38% apresentavam passado de AVC. As crianças residentes em Salvador correspondiam a 34%. A maioria das transfusões foi iniciada na faixa etária entre 2-8 anos (61%) e 9-12 anos (24,7%). 28% dos pacientes iniciou o regime transfusional em 2011, seguido dos anos de 2012 com 16%. A prevalência de aloimunização eritrocitária foi de 26%, sendo os principais aloanticorpos contra antígenos do sistema Rh e Kell. CONCLUSÃO: A utilização do Software possibilitou tornar os dados mais acessíveis para análise clínica e epidemiológica, auxiliando na gestão e assistência à saúde. O sistema poderá ser utilizado como base para o desenvolvimento de um programa de fidelização de doadores fenotipados em um futuro próximo. / Softwares built for data collection from Health Centers are important tools for patient care and for public health decisions. The HEMOBA foundation is responsible for health assistance of a great proportion of the population from the State of Bahia, including medical care and transfusional assistance to patients with benign hematological disorders. Sickle cell disease is one of the most prevalent hereditary disorders in the world, and the State of Bahia has the highest prevalence of the S mutation in Brazil. Blood transfusion is one of the treatment modalities for sickle cell patients, and there is no software for data collection of the clinical and transfusional program. OBJECTIVE: to develop a software to help follow up the transfusional program of the HEMOBA foundation, including the sickle cell patients, collecting transfusional data and blood donor information. MATERIALS AND METHODS: we developed a software called \"BDTrans\", using the methodology of the \"Cicle of Life System Development\", that allowed an analytical, transversal study with both qualitative and quantitative approach of the data extracted from the program. Sickle cell children from 0 to 18 years who were on transfusion at The HEMOBA foundation were the subject of our study. RESULTS: 108 sickle cell patients were included, 58% had brain vasculopathy and 38% had a history of stroke. 34% of the children lived in Salvador. The age range of the children when the transfusion program started was between 2-8 years (61%) and 9-12 years (24.7%). 28% of the patients started the transfusional program in 2011, and 16% started in 2012. The prevalence of red cell alloimmunization was 26%, most of the antibodies were against Rh and Kell blood groups. CONCLUSION: The utilization of the BDTrans Software promoted the collection of clinical and transfusional data from sickle cell patients, possibilitating the evaluation of their transfusional program, and providing important information to the public health system. The software can also be used to develop a fidelization program of phenotyped blood donors in the near future.

The study looked at the viability of using mobile phones by an academic health library to provide health information to rural women. It is understood that Mobile phones have become household items thereby providing an opportunity for organisation to use them for information delivery. Access to information by individuals is essential in reducing people’s levels of uncertainty especially in matters that relate to growth and survival such as health. The central research question upon which this study was based was, “How can an academic library adopt the use of mobile phones as an information delivery device to enhance access to health information for rural women?” with sub-questions focusing on information needs and sources of health information for women and the adaptation of mobile services within the library. It further looked at appropriate partnership needed in developing mobile services for health information delivery. Reviewed literature revealed that mobile phones are already being used by several organisations in making available information. In particular academic libraries have embraced the mobile revolution by creating mobile services for their users. A qualitative approach was adopted for this study and interviews were used for all the three categories of respondents, who are rural women from Buyengo sub-county, health workers from Kakaire health centre iv and librarians from Albert Cook Medical Library. Findings from the study have shown that in the information era where one’s survival is highly dependent upon information, rural women do not have access to credible sources of health information despite the fact that they have high demand for health information because of the soaring disease burden in rural areas. The study without doubt has led to the establishment that the use of mobile phones to fill this gap is a cost effective and life saving venture which if well set up and implemented will add to the global programmes initiated with the aim of reducing child mortality, maternal deaths and combating HIV/AIDS, malaria and other diseases. / Mini Dissertation (MIT)--University of Pretoria, 2015. / Information Science / MIT / Unrestricted