A informática e as Tecnologias da informação e comunicação (TICs) tem grande impacto na atualização dos profissionais da saúde, exigindo que os mesmos estejam cada vez mais preparados para acompanhar o uso das tecnologias, buscando conhecimentos teóricos relacionados a essa temática, a fim de promover a convergência entre o desenvolvimento humano e tecnológico, bem como propiciar a utilização da tecnologia de forma humanizada. Nesse sentido, realizou-se um estudo exploratório descritivo e documental, com os objetivos de identificar e analisar os planos das disciplinas de informática em enfermagem dos cursos de graduação de enfermagem da cidade de Brasília- DF e das Universidades do Município de São Paulo-SP, e caracterizar o perfil acadêmico dos professores que as ministram. Para a coleta de dados utilizou-se o sistema eletrônico, e-MEC, de acompanhamento dos processos educacionais nacionais, estruturado pelo Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (INEP) para identificar as Instituições de Ensino Superior (IES) que possuíam disciplina de informática em enfermagem na grade curricular dos curso de enfermagem. Fizeram parte do estudo 3 (três) 11% (IES) que possuiam disciplinas relacionadas a informática em enfermagem, que eram ministradas regularmente. Os planos de disciplinas foram analisados à luz de referenciais teóricos sobre educação e informática em enfermagem pesquisados nacional e internacionalmente, e a análise do perfil acadêmico dos professores foi realizada após estes terem respondido um questionário que visava identificar qual a formação acadêmica, especializações cursadas, tempo de formado, tempo de experiência profissional, tempo de experiência na área de ensino, e tempo em que ministra a disciplina pesquisada. Os resultados revelaram que o plano de disciplinas ministrados apresenta objetivos e conteúdos voltado, predominantemente, para aspectos de uso básico do computador sem articular a informática com o processo de trabalho do enfermeiro. As disciplinas, foco deste estudo, apresentam uma carga horária, com média de 40,3 horas. Com relação ao semestre em que a disciplina é ministrada, duas são ministradas no 3º semestre e uma no 1º semestre e apenas 1 disciplina tem caráter obrigatório. Com relação aos professores que ministram as disciplinas de informática em enfermagem, os resultados mostraram que estes não são da área de enfermagem ou saúde, e isso nos remete a realidade de que os profissionais da saúde, precisam buscar essa formação fora do seu campo de atuação e poucos cursos formais sobre essa temática são oferecidos no país. Concluí-se que a Informática em Enfermagem deva estar presente na formação do enfermeiro de modo a oferecer aos graduandos conhecimentos sobre a aplicação do uso da informática na assistência, na administração, no ensino e na pesquisa. Denota-se que urge a necessidade de uma reflexão nacional conjuntas das instituições de ensino e dos órgaos de classe sobre as competências e habilidades de informática em enfermagem, considerando os modelos e as experiências de capacitação dos enfermeiros propostos internacionalmente. Acredita-se, ainda, que o processo ensino aprendizagem de informática em enfermagem deve estar fundamentado em abordagens inovadoras, com a utilização das novas tecnologias da informação e comunicação, bem como embasado em experiências concretas da prática profissional. / Computing and Information and Communications Techonology (ICTs) has a great impact on utilization of health care professionals, requiring that they are increasinglyprepared to accompany the use of technology, seeking theoretical knowledge related to this issue in order to promote convergence between the human and technological development as well as enabling the use of technology in a humane way. Thus, this study is an exploratory study and documentation, with the objectives of identifying and analyzing the plans of the disciplines of nursing informatics for undergraduate nursing of Brasilia-DF and the University of São Paulo-SP And characterize the academic profile of teachers who teach. To collect data we used the electronic system, e-MEC, the national monitoring of educational processes, structured by the National Institute of Educational Studies Teixeira (INEP) to identify the Higher Education Institutions who had discipline of nursing informatics in the curriculum of the nursing program. The study group 3 (three) 11% (IES) who possessed disciplines related to nursing informatics, and which were held regularly. The plans of subjects were analyzed based on theoretical frameworks on education and nursing informatics surveyed nationally and internationally, and analysis of the academic profile of teachers was carried out after they answered a questionnaire that aimed to identify which academic specializations attended, time trained, professional experience, length of experience in teaching, and time in administering the discipline studied. The results revealed that the plan presents objectives and disciplines taught content focused predominantly on aspects of basic computer use without linking the computer with the process of nursing work. Disciplines, the focus of this study, have a heavy workload, with an average of 40.3 hours. With respect to the semester in which the discipline is taught, are taught in two three and a half in the 1st half and only one discipline has character. With respect to teachers who teach the disciplines of nursing informatics, the results showed they are not in the nursing area, and this leads us to the reality that health professionals need to seek such training outside their field of action and few formal courses on this topic are offered throughout the country. We concluded that the nursing informatics should be present in nursing education in order to offer knowledge to undergraduates on the application of information technology in care, administration, teaching and research. Denotes that there is urgent need for a joint reflection of the national educational institutions and the organs of class on the skills and abilities of nursing informatics, considering the models and experiences of training of nurses offered internationally. It is believed also that the learning process of nursing informatics should be based on innovative approaches to the use of new information technologies and communication as well as grounded in practical experience of professional practice.

A qualidade de vida do trabalhador, assim como sua saúde têm sofrido grandes impactos ocasionados pela evolução da indústria, da tecnologia e dos processos de produção. O profissional especialista em Odontologia do Trabalho tem por compromisso a identificação e prevenção de doenças relativas ao trabalho, com manifestações bucais, além da implementação de ações de promoção e preservação da saúde dos trabalhadores. A reunião dos dados relativos à saúde dos indivíduos, dados estes baseados em seus prontuários e colhidos quando da realização dos exames odontológicos para fins trabalhistas, podem dimensionar as condições, ou seja, o nível de saúde de determinada população. Com o aumento progressivo de dados, tão intenso no mundo todo,e frente às deficiências apresentadas no fluxo das informações relativas à saúde do trabalhador por meio de documentos físicos, nos propusemos a desenvolver um software direcionado ao registro e gerenciamento de dados, específico para Odontologia do Trabalho, que abrangesse, agregasse e vinculasse, de maneira concomitante, as informações referentes às empresas contratantes, aos funcionários e às condições de saúde bucal dos mesmos. Para tanto tivemos o apoio financeiro da OT BRASIL - excelência em saúde ocupacional bucal. Os sistemas foram produzidos para interface Web, podendo ser acessado através de qualquer computador conectado à Internet. Utilizou-se o moderno conceito AJAX proporcionando mais dinâmica, criatividade, suavidade e produtividade para as aplicações. O software recebeu o nome de OT BRASIL e é constituído por módulos integrados, devidamente personalizados, proporcionando melhor adaptação à empresa. O acesso é seguro e controlado por login, senha e níveis de usuário. Concluiu-se que o software OT BRASIL proporciona um ganho inestimável à Odontologia do Trabalho, no que diz respeito ao registro e gestão de informações, relativas à saúde dos trabalhadores; viabiliza a elaboração de um prontuário digital para Odontologia do Trabalho; possibilita obtenção de registros longitudinais dos exames trabalhistas realizados e oportuniza o planejamento e implementação de ações de promoção, prevenção e preservação da saúde bucal dos trabalhadores. / The quality of life of the employee, as well as their health has suffered major impacts caused by the development of industry, technology and production processes. The Occupational Dentistry specialist is committed to identifying and preventing work related diseases with oral manifestations, in addition to implementing actions to promote and preserve the health of workers. The gathering of data on the individuals health such data is based on their dental records and harvested when performing dental examinations for labor purposes, can determine the scale of health conditions, that is, the level of health of a given population. Due to the progressive increase of data, so intense worldwide, and attributable to the deficiencies in the flow of information relating to workers health through paper documents; we set out to develop a software directed to the registration and management of data, specific to Occupational Dentistry, encompassing, aggregating and linking in a concomitant manner, the information related to the contractors, employees and their oral health conditions. Thereunto, we had the financial support of OT BRAZIL- excellence in occupational oral health. The system was produced for Web interface and with access through any Internet-connected computer. The modern AJAX concept was used providing a more dynamic, creative, smooth and productive application. The software named OTBRAZIL and it is composed of integrated modules, duly customized, providing better adaptation for the company. The access is secure, controlled by username and password, and user levels. It was concluded that the OTBRAZIL software provides an invaluable gain to Occupational Dentistry, with regard to the registration and management of information concerning the workers health; enables the development of a digital medical record for Occupational Dentistry; permits the obtaining of longitudinal records of work exams and favors the planning and the implementation of actions to promote, prevent and preserve the employees oral health.

A qualidade de vida do trabalhador, assim como sua saúde têm sofrido grandes impactos ocasionados pela evolução da indústria, da tecnologia e dos processos de produção. O profissional especialista em Odontologia do Trabalho tem por compromisso a identificação e prevenção de doenças relativas ao trabalho, com manifestações bucais, além da implementação de ações de promoção e preservação da saúde dos trabalhadores. A reunião dos dados relativos à saúde dos indivíduos, dados estes baseados em seus prontuários e colhidos quando da realização dos exames odontológicos para fins trabalhistas, podem dimensionar as condições, ou seja, o nível de saúde de determinada população. Com o aumento progressivo de dados, tão intenso no mundo todo,e frente às deficiências apresentadas no fluxo das informações relativas à saúde do trabalhador por meio de documentos físicos, nos propusemos a desenvolver um software direcionado ao registro e gerenciamento de dados, específico para Odontologia do Trabalho, que abrangesse, agregasse e vinculasse, de maneira concomitante, as informações referentes às empresas contratantes, aos funcionários e às condições de saúde bucal dos mesmos. Para tanto tivemos o apoio financeiro da OT BRASIL - excelência em saúde ocupacional bucal. Os sistemas foram produzidos para interface Web, podendo ser acessado através de qualquer computador conectado à Internet. Utilizou-se o moderno conceito AJAX proporcionando mais dinâmica, criatividade, suavidade e produtividade para as aplicações. O software recebeu o nome de OT BRASIL e é constituído por módulos integrados, devidamente personalizados, proporcionando melhor adaptação à empresa. O acesso é seguro e controlado por login, senha e níveis de usuário. Concluiu-se que o software OT BRASIL proporciona um ganho inestimável à Odontologia do Trabalho, no que diz respeito ao registro e gestão de informações, relativas à saúde dos trabalhadores; viabiliza a elaboração de um prontuário digital para Odontologia do Trabalho; possibilita obtenção de registros longitudinais dos exames trabalhistas realizados e oportuniza o planejamento e implementação de ações de promoção, prevenção e preservação da saúde bucal dos trabalhadores. / The quality of life of the employee, as well as their health has suffered major impacts caused by the development of industry, technology and production processes. The Occupational Dentistry specialist is committed to identifying and preventing work related diseases with oral manifestations, in addition to implementing actions to promote and preserve the health of workers. The gathering of data on the individuals health such data is based on their dental records and harvested when performing dental examinations for labor purposes, can determine the scale of health conditions, that is, the level of health of a given population. Due to the progressive increase of data, so intense worldwide, and attributable to the deficiencies in the flow of information relating to workers health through paper documents; we set out to develop a software directed to the registration and management of data, specific to Occupational Dentistry, encompassing, aggregating and linking in a concomitant manner, the information related to the contractors, employees and their oral health conditions. Thereunto, we had the financial support of OT BRAZIL- excellence in occupational oral health. The system was produced for Web interface and with access through any Internet-connected computer. The modern AJAX concept was used providing a more dynamic, creative, smooth and productive application. The software named OTBRAZIL and it is composed of integrated modules, duly customized, providing better adaptation for the company. The access is secure, controlled by username and password, and user levels. It was concluded that the OTBRAZIL software provides an invaluable gain to Occupational Dentistry, with regard to the registration and management of information concerning the workers health; enables the development of a digital medical record for Occupational Dentistry; permits the obtaining of longitudinal records of work exams and favors the planning and the implementation of actions to promote, prevent and preserve the employees oral health.

Data from social media platforms are being actively mined for trends and patterns of interests. Problems such as sentiment analysis and prediction of election outcomes have become tremendously popular due to the unprecedented availability of social interactivity data of different types. In this thesis we address two problems that have been relatively unexplored. The first problem relates to mining beliefs, in particular health beliefs, and their surveillance using social media. The second problem relates to investigation of factors associated with engagement of U.S. Federal Health Agencies via Twitter and Facebook. In addressing the first problem we propose a novel computational framework for belief surveillance. This framework can be used for 1) surveillance of any given belief in the form of a probe, and 2) automatically harvesting health-related probes. We present our estimates of support, opposition and doubt for these probes some of which represent true information, in the sense that they are supported by scientific evidence, others represent false information and the remaining represent debatable propositions. We show for example that the levels of support in false and debatable probes are surprisingly high. We also study the scientific novelty of these probes and find that some of the harvested probes with sparse scientific evidence may indicate novel hypothesis. We also show the suitability of off-the-shelf classifiers for belief surveillance. We find these classifiers are quite generalizable and can be used for classifying newly harvested probes. Finally, we show the ability of harvesting and tracking probes over time. Although our work is focused in health care, the approach is broadly applicable to other domains as well. For the second problem, our specific goals are to study factors associated with the amount and duration of engagement of organizations. We use negative binomial hurdle regression models and Cox proportional hazards survival models for these. For Twitter, the hurdle analysis shows that presence of user-mention is positively associated with the amount of engagement while negative sentiment has inverse association. Content of tweets is also equally important for engagement. The survival analyses indicate that engagement duration is positively associated with follower count. For Facebook, both hurdle and survival analyses show that number of page likes and positive sentiment are correlated with higher and prolonged engagement while few content types are negatively correlated with engagement. We also find patterns of engagement that are consistent across Twitter and Facebook.

Long waitlists and growing numbers of unattached patients are indicative of a Canadian healthcare system which is unable to address the demands of a growing and aging population. Health information technology is one solution offering respite, but brings its own issues. Health information technology includes primary care physician office systems, telehealth and jurisdictional EHRs integrated through interoperability standards to share data across care providers. This dissertation explores effects that health information technology has on primary care. Literature reviews provided context of health information systems adoption. Surveys and semi-structured interviews gathered information from health system actors. Workflow analysis illustrated how technology could change physician office workflow. Exam room observations illustrated how technology affects proxemics and haptics in the patient encounter. This research derived change management models which quantified substantial change management costs related to adoption of physician office systems. We found that physicians have concerns over how health information technology will affect efficiency, financial, quality, liability, safety and other factors. Physicians in smaller suburban physician offices take little time to select a system for their needs. Urban, academic and hospital physicians spend more time networking with colleagues and devote funds to project management and training. Our studies showed that stronger professional networks, more complete training, a managed approach to implementation and in-house technical support are more influential in facilitating adoption than remuneration models. Telemedicine can improve quality of care, the referral process for family physicians and access to services for patients. Teledermatology was shown to make significant improvements in access to services for patients, but referring physicians are concerned about their liability if they follow the recommendations of a dermatologist who has not seen their patient face-to-face. Certification organizations mitigate liability, procurement and financial risk to qualifying family physicians by pre-qualifying vendor solutions, coaching physicians through procurement and reimbursing family physicians for purchasing an approved system. We found that centralization plays a key role in adoption of health information systems at the jurisdictional and primary care level. Online scheduling can reduce human resource requirements used in scheduling, if the system is well implemented, well documented and easy to use. / Engineering Management

A Stroke can affect different parts of the human body depending on the area of brain effected; our research focuses on upper limb motor dysfunction for stroke patients. In current practice, ordinal scale systems are used for conducting physical assessment of upper limb impairment. The reliability of these assessments is questionable, since their coarse ratings cannot reliably distinguish between the different levels of performance. This thesis describes the design, implementation and evaluation of a novel system to facilitate stroke diagnosis which relies on data collected with an innovative KINARM robotic tool. This robotic tool allows for an objective quantification of motor function and performance assessment for stroke patients. The main methodology for the research is Case Based Reasoning (CBR) - an effective paradigm of artificial intelligence that relies on the principle that a new problem is solved by observing similar, previously encountered problems and adapting their known solutions. A CBR system was designed and implemented for a repository of stroke subjects who had an explicit diagnosis and prognosis. For a new stroke patient, whose diagnosis was yet to be confirmed and who had an indefinite prognosis, the CBR model was effectively used to retrieve analogous cases of previous stroke patients. These similar cases provide useful information to the clinicians, facilitating them in reaching a potential solution for stroke diagnosis and also a means to validate other imaging tests and clinical assessments to confirm the diagnosis and prognosis. / Thesis (Master, Computing) -- Queen's University, 2008-09-27 11:14:04.85

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In order to support people's everyday health and wellness goals, health practitioners and organizations are embracing a more holistic approach to medicine---supporting patients both as individuals and members of their families and communities, and meeting people where they are: at home, work, and school. This 'everyday' approach to health has been enabled by new technologies, both dedicated-devices and services designed specifically for health sensing and feedback -- and multipurpose --such as smartphones and broadband-connected computers. Our physical relationship with computing has also become more intimate, and personal health devices can now track and report an unprecedented amount of information about our bodies, following their users around to an extent no doctor, coach or dietitian ever could. But we still have much to learn about how pervasive health devices can actually help promote the adoption of new health practices in daily life. Once they're `in the wild,' such devices interact with their users, but also the physical, social and political worlds in which those users live. These external factors---such as the walkablity of a person's neighborhood or the social acceptability of exercise and fitness activities---play a significant role in people's ability to change their health behaviors and sustain that change. Specifically, social theories of behavior change suggest that peer support may be critical in changing health attitudes and behaviors. These theories---Social Support Theory, Social Cognitive Theory and Social Comparison Theory among them---offer both larger frameworks for understanding the social influences of health behavior change and specific mechanisms by which that behavior change could be supported through interpersonal interaction. However, we are only beginning to understand the role that pervasive health technologies can play in supporting and mediating social interaction to motivate people's exploration and adoption of healthy behaviors. In this dissertation I seek to better understand how social computing technologies can help people help each other live healthier lives. I ground my research in a participant-led investigation of a specific population and condition: adolescents and obesity prevention. I want to understand how social behavior change theories from psychology and sociology apply to pervasive social health technology. Which mechanisms work and why? How does introducing a pervasive social health system into a community affect individuals' behaviors and attitudes towards their health? Finally, I want to contribute back to those theories, testing their effectiveness in novel technologically mediated situations. Adolescent obesity is a particularly salient domain in which to study these issues. In the last 30 years, adolescent obesity rates in the US alone have tripled, and although they have leveled off in recent years they remain elevated compared to historical norms. Habits formed during adolescence can have lifelong effects, and health promotion research shows that even the simple act of walking more each day has lasting benefits. Everyday health and fitness research in HCI has generally focused on social comparison and "gamified" competition. This is especially true in studies focused on adolescents and teens. However, both theory from social psychology and evidence from the health promotion community suggest that these direct egocentric models of behavior change may be limited in scope: they may only work for certain kinds of people, and their effects may be short-lived once the competitive framework is removed. I see an opportunity for a different approach: social tools for everyday adolescent health. These systems, embedded in existing school and community practices, can leverage scalable, non-competitive social interaction to catalyze positive perceptions of physical activity and social support for fitness, while remaining grounded in the local environment. Over the last several years I have completed a series of field engagements with middle school students in the Atlanta area. I have focused on students in a majority-minority low-income community in the Atlanta metropolitan area facing above-average adult obesity levels, and I have involved the students as informants throughout the design process. In this dissertation, I report findings based on a series of participatory design-based formative explorations; the iterative design of a pedometer-based pervasive health system to test these theories in practice; and the deployment of this system---StepStream---in three configurations: a prototype deployment, a `self-tracking' deployment, and a `social' deployment. In this dissertation, I test the following thesis: A school-based social fitness approach to everyday adolescent health can positively influence offline health behaviors in real-world settings. Furthermore, a noncompetitive social fitness system can perform comparably in attitude and behavior change to more competitive or direct-comparison systems, especially for those most in need of behavior change}. I make the following contributions: (1) The identification of tensions and priorities for the design of everyday health systems for adolescents; (2) A design overview of StepStream, a social tool for everyday adolescent health; (3) A description of StepStream's deployment from a socio-technical perspective, describing the intervention as a school-based pervasive computing system; (4) An empirical study of a noncompetitive awareness system for physical activity; (5) A comparison of this system in two configurations in two different middle schools; (6) An analysis of observational learning and collective efficacy in a pervasive health system.

Objective: Access to, and reliance upon, high quality data is an enabling cornerstone of modern health delivery systems. Sadly, health systems are often awash with poor quality data which contributes both to adverse outcomes and can compromise the search for new knowledge. Traditional approaches to purging poor data from health information systems often require manual, laborious and time-consuming procedures at the collection, sanitizing and processing stages of the information life cycle with results that often remain sub-optimal. A promising solution may lie with semantic technologies - a family of computational standards and algorithms capable of expressing and deriving the meaning of data elements. Semantic approaches purport to offer the ability to represent clinical knowledge in ways that can support complex searching and reasoning tasks. It is argued that this ability offers exciting promise as a novel approach to assessing and improving data quality. This study examines the effectiveness of semantic web technologies as a mechanism by which high quality data can be collected and assessed in health settings. To make this assessment, key study objectives include determining the ability to construct of valid semantic data model that sufficiently expresses the complexity present in the data as well as the development of a comprehensive set of validation rules that can be applied semantically to test the effectiveness of the proposed semantic framework. Methods: The Semantic Framework for Data Quality Assessment (SemDQ) was designed. A core component of the framework is an ontology representing data elements and their relationships in a given domain. In this study, the ontology was developed using openEHR standards with extensions to capture data elements used in for patient care and research purposes in a large organ transplant program. Data quality dimensions were defined and corresponding criteria for assessing data quality were developed for each dimension. These criteria were then applied using semantic technology to an anonymized research dataset containing medical data on transplant patients. Results were validated by clinical researchers. Another test was performed on a simulated dataset with the same attributes as the research dataset to confirm the computational accuracy and effectiveness of the framework. Results: A prototype of SemDQ was successfully implemented, consisting of an ontological model integrating the openEHR reference model, a vocabulary of transplant variables and a set of data quality dimensions. Thirteen criteria in three data quality dimensions were transformed into computational constructs using semantic web standards. Reasoning and logic inconsistency checking were first performed on the simulated dataset, which contains carefully constructed test cases to ensure the correctness and completeness of logical computation. The same quality checking algorithms were applied to an established research database. Data quality defects were successfully identified in the dataset which was manually cleansed and validated periodically. Among the 103,505 data entries, application of two criteria did not return any error, while eleven of the criteria detected erroneous or missing data, with the error rates ranging from 0.05% to 79.9%. Multiple review sessions were held with clinical researchers to verify the results. The SemDQ framework was refined to reflect the intricate clinical knowledge. Data corrections were implemented in the source dataset as well as in the clinical system used in the transplant program resulting in improved quality of data for both clinical and research purposes. Implications: This study demonstrates the feasibility and benefits of using semantic technologies in data quality assessment processes. SemDQ is based on semantic web standards which allows easy reuse of rules and leverages generic reasoning engines for computation purposes. This mechanism avoids the shortcomings that come with proprietary rule engines which often make ruleset and knowledge developed for one dataset difficult to reuse in different datasets, even in a similar clinical domain. SemDQ can implement rules that have shown to have a greater capacity of detect complex cross-reference logic inconsistencies. In addition, the framework allows easy extension of knowledge base to cooperate more data types and validation criteria. It has the potential to be incorporated into current workflow in clinical care setting to reduce data errors during the process of data capture.