Care Information Systems Research Articles

Association Between Mortality and Time Spent Out of Bed in Older-Adult Nursing Home Residents.

For older adults, spending time out of bed is important for preventing functional decline, but its relationship to mortality is not clear. In this study, we aimed to investigate the association between mortality and time spent out of bed in Japanese older-adult nursing home residents. We conducted a cohort study using data from the Long-term Care Information System for Evidence database. We used data collected between April 2022 and March 2024 from older-adult nursing home residents who required assistance with the activities of daily living. We compared outcome data between residents who spent 6 or more hours per day out of bed (group L) and those who spent less than 6 hours per day out of bed (group S). The outcome was all-cause mortality. Data were analyzed using Kaplan-Meier curves and Cox regression models. Data from 185 older-adult nursing home residents (median age: 89years; 141 women) were analyzed. Group L included 144 residents (77.8% of all participants). Of the 185 participants, 40 died during the observation period. Mortality in group L was significantly lower than in group S (16.7% vs 39.0%, P= .002). Kaplan-Meier curve analysis after the log-rank test revealed a significantly higher mortality in group S than group L. Univariate and multivariate Cox regression analyses with robust (Huber-White) standard errors identified the factor of time spent out of bed (≥6h) as a significant and independent risk factor for mortality. More time spent out of bed is associated with lower mortality in older-adult nursing home residents who require assistance with the activities of daily living.

Value-based health care for Aboriginal peoples with chronic conditions in the Northern Territory: a cohort study.

ObjectiveThis study aimed to investigate associations between patient activation, healthcare use and clinical outcomes for Aboriginal peoples living with a chronic condition in remote Northern Territory (NT) communities.MethodsA retrospective cohort study was undertaken between 2 April 2020 and 1 April 2022 to measure activation and its associations with chronic conditions secondary prevention treatment targets and healthcare usage: hospitalisations, potentially preventable hospitalisations and patient travel. All Aboriginal peoples enrolled at NT Government health services, who had one or more preventable chronic conditions and were prescribed one or more oral chronic condition medications identified in the Primary Care Information System, were included in the study. Patient activation was defined as a 90-day medicine possession ratio ≥80%. An activated patient has the belief, knowledge, skills and behaviours to manage their chronic conditions.ResultsA total of 5356 patients met the inclusion criteria; 9% of these patients were activated. Activated patients were older and sicker but were significantly more likely to achieve treatment targets for glycosylated haemoglobin, blood pressure and total and low-density lipoprotein cholesterol. Activated patients used more primary healthcare and outpatient resources and had a non-significant trend for less acute care use.ConclusionsThe remote NT Government primary healthcare system is providing low-value chronic conditions care for patients. As identified by Aboriginal peoples, strengthening culturally appropriate self-management support could lead to more patients becoming activated, better health outcomes and decreased acute care demand.

Promoting the Resilience of Health Care Information Systems—The Day Hospitals Stood Still

This Viewpoint describes health care disruption owing to a global computer system outage and advocates for preventive methods to avoid future IT events disrupting the health care sector.

Web-Based Nursing Care Documentation for Students to Support Online Learning

Nursing care is the most critical element in nursing services, which aims to improve the patient’s health status. Ineffective and inefficient care documentation can impact the quality of nursing services. However, the increasingly advanced development of technology provides freedom for the health world to improve the quality of patient-centered services. Educational institutions have also used information technology in learning process activities. As prospective health professionals, students must be equipped with competencies to support their performance. In this study, a web-based nursing care information system was developed to assist students in documenting care activities. The website application was designed to increase student competency in nursing documentation activities to provide high-quality nursing services even though learning is online. The waterfall model approach was used in application design. The design stage started with analyzing application requirements, followed by system design and coding. Next, using a Likert-scale questionnaire, a usability test was performed on 15 beta users to assess the functionality of the application. The results showed that the nursing care website application was easy to use and that students felt satisfied. It is hoped that the website application can be made more attractive by including a decisional support system to make it easier for students to enforce nursing diagnoses on patients.

Continuous Blood Pressure Indices During the First 72 Hours and Functional Outcome in Patients with Spontaneous Intracerebral Hemorrhage.

Management of intracerebral hemorrhage (ICH) is challenged by limited therapeutic options and a complex relationship between blood pressure (BP) dynamics, especially BP variability (BPV) and ICH outcome. In an exploratory analysis of prospectively collected data on consecutive patients with nontraumatic ICH between 2015 and 2020, continuous BP accessed via an arterial line extracted from the Intellispace Critical Care and Anesthesia information system (Philips Healthcare) was analyzed over the first 72 h post admission. Arterial lines were used as part of standard clinical practice in the intensive care, ensuring high fidelity and real-time data essential for acute care settings. BPV was assessed through successive variation (SV), standard deviation (SD), and coefficient of variation using all available BP measurements. Multivariate regression models were applied to evaluate the association between BPV indices and functional outcome at 3 months. Among 261 patients (mean age 69.6 ± 15.2 years, 47.9% female, median National Institutes of Health Stroke Scale [NIHSS] score 6 [interquartile range 2-12]) analyzed, lower systolic BP upon admission (< 140 mm Hg) and lower systolic BPV were significantly associated with favorable outcome, whereas higher diastolic BPV correlated with improved outcomes. In the multivariate analysis, diastolic BPV (SD, SV) within the first 72 h post admission emerged as an independent predictor of good functional outcome (modified Rankin Scale score < 3; odds ratio 1.123, 95% confidence interval CI 1.008-1.184, p = 0.035), whereas systolic BPV (SD) showed a negative association. Patients with better outcomes also exhibited distinct clinical characteristics, including younger age, lower median NIHSS scores, and less prevalence of anticoagulation therapy upon admission. This study shows the prognostic value of BPV in the acute phase of ICH. Lower systolic BPV (SD) and higher diastolic BPV (SD, SV) were associated with better functional outcomes, challenging traditional BP management strategies. These findings might help to tailor a personalized BP management in ICH.

Implementation of the Observational Medical Outcomes Partnership Model in Electronic Medical Record Systems: Evaluation Study Using Factor Analysis and Decision-Making Trial and Evaluation Laboratory-Best-Worst Methods.

Electronic medical record (EMR) systems are essential in health care for collecting and storing patient medical data. They provide critical information to doctors and caregivers, facilitating improved decision-making and patient care. Despite their significance, optimizing EMR systems is crucial for enhancing health care quality. Implementing the Observational Medical Outcomes Partnership (OMOP) shared data model represents a promising approach to improve EMR performance and overall health care outcomes. This study aims to evaluate the effects of implementing the OMOP shared data model in EMR systems and to assess its impact on enhancing health care quality. In this study, 3 distinct methodologies are used to explore various aspects of health care information systems. First, factor analysis is utilized to investigate the correlations between EMR systems and attitudes toward OMOP. Second, the best-worst method (BWM) is applied to determine the weights of criteria and subcriteria. Lastly, the decision-making trial and evaluation laboratory technique is used to illustrate the interactions and interdependencies among the identified criteria. In this research, we evaluated the AliHealth EMR system by surveying 98 users and practitioners to assess its effectiveness and user satisfaction. The study reveals that among all components, "EMR resolution" holds the highest importance with a weight of 0.31007783, highlighting its significant role in the evaluation. Conversely, "EMR ease of use" has the lowest weight of 0.1860467, indicating that stakeholders prioritize the resolution aspect over ease of use in their assessment of EMR systems. The findings highlight that stakeholders prioritize certain aspects of EMR systems, with "EMR resolution" being the most valued component.

Physical Function Trajectory among High-Functioning Long-Term Care Facility Residents: Utilizing Japanese National Data.

Physical function trajectory (PFT) is associated with mortality and hospitalization risks. We aimed to identify and compare the PFTs of newly admitted high-functioning older adults during their first six months at long-term care (LTC) facilities. In this multicenter retrospective cohort study, we included newly admitted high-functioning older adults (Barthel index > 60) from 47 Japanese LTC facilities. The primary outcome was physical function changes after admission. Data were collected from the Long-Term Care Information System for Evidence (LIFE), which monitored LTC facility residents' function between 1 January 2021 and 31 January 2022. A group-based trajectory model and binomial logistic regression analyses were applied to identify and compare residents' PFTs. Among the 718 residents included, the average age was 85.69 years and 64.5% were female. PFTs were classified as maintenance (66.0%), improvement (9.5%), slight decline (16.6%), and large decline (7.9%). The improvement group had significantly fewer residents who expressed a lack of interest in daily activities (odds ratio (OR) 0.45; 95% confidence interval (CI) 0.21-0.97) compared to the maintenance group. The large decline group had significantly more residents with a low BMI at admission (OR 2.42; 95% CI 1.29-4.55) and residents who did not use dentures (OR 0.49; 95% CI 0.26-0.95), compared to the maintenance group. Considering future PFTs may aid the development of care plans and the provision of appropriate interventions. Moreover, utilizing existing data has the potential to maintain residents' physical independence and enhance the quality of care without burdening residents themselves or staff.

Heart Rate Variability and Functional Outcomes of Patients with Spontaneous Intracerebral Hemorrhage.

The relationship between heart rate variability (HRV) changes potentially indicating autonomic dysregulation following spontaneous intracerebral hemorrhage (ICH) and functional outcome has not yet been fully elucidated. This study investigated the effects of HRV during the initial 96 h after admission on 90-day functional outcome in ICH patients. We included patients with spontaneous ICH in a prospective cohort single-center study. Continuous HR data were retrieved from the Intellispace Critical Care and Anesthesia information system (Philips Healthcare) and analyzed within the following time intervals: 0-2, 0-8, 0-12, 0-24, 0-48, 0-72, and 8-16, 16-24, 24-48, 48-72, 72-96 h after admission. HRV was determined from all available HR values by calculating the successive variability (SV), standard deviation (SD), and coefficient of variation (CV). Low HRV was set as SD ≤ 11.4 ms, and high HRV as SD > 11.4 ms. The clinical severity of ICH was assessed using the National Institutes of Health Stroke Scale (NIHSS) and functional outcome using the modified Rankin Scale (mRS). Good functional outcome was defined as mRS 0-2. The cohort included 261 ICH patients (mean age ± SD 69.6 ± 16.5 years, 48.7% female, median NIHSS 6 (2, 12), median ICH score 1 (0, 2), of whom 106 (40.6%) had good functional outcome. All patients had the lowest HRV at admission, which increased during the first two days. Comparing ICH patients with low HRV (n = 141) and high HRV (n = 118), those with good outcome showed significantly lower HRV during the first three days (0-72 h: HRV SD good outcome 10.6 ± 3.5 ms vs. poor outcome 12.0 ± 4.0 ms; p = 0.004). Logistic regression revealed that advanced age, high premorbid mRS, and high NIHSS at admission were significant predictors of poor functional outcome, while reduced SD of HRV showed a non-significant trend towards good functional outcome (0-72 h: OR 0.898; CI 0.800-1.008; p = 0.067). Our results indicate autonomic dysfunction with sympathetic hyperactivity after spontaneous ICH, as reflected by the evidence of the lower HRV in the first days. Initially increased sympathetic tone appears to have a protective effect, as suggested by the comparatively lower HRV in patients with good functional outcome at the first days.

Enhancing the Security of Information Systems Using Iot Technology

A medical patient information system is one of the systems that are currently in widespread use, and one of these is the psychiatric patient information system, which is used in clinics that treat patients who suffer from mental illnesses. It entails keeping track of the patients who visit these clinics for treatment and ensuring that they receive the necessary medications at the appropriate dosages. Patient information such as text, images, or others must be retained in this sort of system, and the reports that the system generates regularly for pharmaceuticals that are dispensed in various clinics separate this type of system from others. This study presents an innovative security strategy for accessing a managed care information system, emphasizing the use of IoT technology to enhance password security and protect sensitive patient information. Utilizing the Internet of Things (IoT) technology has enhanced the efficiency of creating secure passwords. The results of the tests showed that the goal of protecting patient information from people who didn't want to see it was very secure. This was shown in the literature.

A study on requirement optimization of intelligent health care information system for rural elderly based on improved FKM-TOPSIS method

Against the backdrop of China’s young and middle-aged population moving to the cities to work, older adults in rural areas of China are facing even more severe old-age and healthcare dilemmas. Under such circumstances, how to improve the functions of age-appropriate smart wearable products to meet the needs of older adults in rural areas for old age and health care has become a focal issue in Chinese society. In this paper, we change the traditional Fuzzy Kano Model (FKM) research method, quantify the research results, and use the superiority and inferiority coefficient formula to scientifically classify user needs after conducting research on different functions of smart wearable devices and obtaining different user needs: M denotes must-be demand; O denotes performance demand; A denotes attractive demand; and I denote indifferent demand. A theoretical multidimensional analysis of the generated data was performed to determine the requirements priority of the rural elderly. Then, using the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach, compute the relative closeness of user satisfaction, i.e., the priority of functional needs. Finally, testing the product prototypes of “PC-based and mobile-based” information systems of smart wearable devices and identifying the most critical demand concentrated on emergency assistance for rural older adults. Such as 120 Call, Call Emergency Contacts, Positioning System, Blood Pressure Testing, Heartbeat Pulse Monitoring, etc. These functions can effectively reduce the health risks of older adults in critical emergencies, confirm the scientific character of user demand prioritization, establish the viability of the study, and provide new ideas for intelligent product-related research to continue.

Continuous arterial blood pressure indices and early hematoma expansion in patients with spontaneous intracerebral hemorrhage

ObjectiveBlood pressure variability (BPV) and its potential association with early hematoma expansion (HE) in intracerebral hemorrhage (ICH) remains to be fully elucidated. Our study explores the potential link between BPV within the first 24 h after admission and HE in ICH. MethodsIn a prospective cohort single-center study, we analyzed consecutive patients with spontaneous ICH. Continuous BP data via an arterial line extracted from the Intellispace Critical Care and Anesthesia information system (Philips Healthcare) were analyzed over 0–2, 0–8, 0–12, and 0–24 h intervals post-admission. BPV was assessed through successive variability (SV), standard deviation (SD), and coefficient of variation (CV) using all available BP measurements. Early HE was defined as an absolute [≥ 6 ml] or relative [≥ 33 %] increase in ICH volume on 24-hours follow-up brain imaging. Secondary endpoints were the influence of BP on admission and other potential risk factors for HE. ResultsAmong 305 ICH-patients (mean age ± SD 70.1 ± 14.9 years, 47.9 % female, median NIHSS 6 (3, 13), median ICH score 1 (1, 2)), 41 (13.4 %) experienced HE. HE-patients had higher NIHSS (p = 0.015), ICH-score (p = 0.005), ICH volume (p < 0.001) and higher pre-anticoagulation treatment (p = 0.004) on admission. There was no difference in BPV comparing ICH-patients with HE to those without. However, patients with HE had significantly lower diastolic BP (76.6 ± 14.8 vs. 86.3 ± 19.7 mmHg, p = 0.005) and MAP (103.2 ± 22.4 vs. 112.2 ± 22.6, p = 0.027) on admission. This pattern of lower diastolic BP persisted across the first 24 h. Logistic regression revealed larger ICH volume and pre-existing anticoagulation as significant predictors of HE, with higher initial diastolic BP reducing HE risk. Hemorrhages ≥ 30 cm3 showed significantly lower initial diastolic BP, MAP, and BPV across all time frames compared to ICH < 30 cm3. ConclusionsBPV within the first 24 h was not associated with HE. Lower diastolic BP on admission, anticoagulation use, and larger ICH volume are potential predictors for HE. However, larger hemorrhage size (>30 cm3) experienced lower absolute BP and BPV indices and worse clinical outcomes. These findings suggest a nuanced relationship between BP dynamics and ICH severity, underscoring the need for individualized BP management in acute ICH care. Further research is necessary to explore these relationships and optimize treatment strategies.

Protection of Personal Data in Telemedicine

The protection of personal data in telemedicine in the context of current legislation and regulatory acts of the European Union is considered. Social relations in the field of use of personal data in telemedicine are studied, in particular, legal regulation of the use of personal data processed in health care information systems. In the information society, the right to health care and medical care is closely related to the right to access information. The right to access to information is a guarantee of the exercise of the right to health care and medical care, defines its content and contributes to equal access of every person to medical care. It is indicated that ensuring the balance of private and public interests in telemedicine requires differentiation of the conditions for processing personal health data. As an additional condition for the processing of personal data for specific purposes, it is proposed to provide for the consent of the subject of personal data to data processing with the right to refuse processing. Such purposes may include, in particular, the processing of electronic health records in the unified state health information system, the processing of depersonalized personal health data for research purposes. This approach contributes to the protection of public interests in health care and takes into account the autonomy of the will of the subject of personal data, his interests in the field of personal information security, corresponds to approaches to legal regulation in the European Union.

Estimation of prevalence of chronic Chagas disease in Brazilian municipalitiesEstimación de la prevalencia de la enfermedad de Chagas crónica en los municipios brasileños

The objective of this study is to estimate the prevalence of chronic Chagas disease (CCD) in Brazil: in the general population, in women, and in women of childbearing age. A meta-analysis of the literature was conducted to extract data on the prevalence of CCD in municipalities in Brazil in the 2010-2022 period: in the general population, in women, and in women of childbearing age. Municipal-level CCD indicators available in health information systems were selected. Statistical modeling of the data extracted from the meta-analysis (based on data obtained from information systems) was applied to linear, generalized linear, and additive models. The five most appropriate models were selected from a total of 549 models tested to obtain a consensus model (adjusted R2 = 54%). The most important predictor was self-reported CCD in the primary health care information system. Zero prevalence was estimated in 1 792 (32%) of Brazil's 5 570 municipalities; in the remaining 3 778 municipalities, average prevalence of the disease was estimated at 3.25% (± 2.9%). The number of carriers of CCD was estimated for the Brazilian population (~3.7 million), for women (~2.1 million) and for women of childbearing age (~590 000). The disease reproduction rate was calculated at 1.0336. All estimates refer to the 2015-2016 period. The estimated prevalence of CCD, especially among women of childbearing age, highlights the challenge of vertical transmission in Brazilian municipalities. Mathematical projections suggest that these estimates should be included in the national program for the elimination of vertical transmission of Chagas disease.

Nonspecific Effects of the Bacillus Calmette-Guérin Vaccine in Portuguese Children Under 5 Years of Age: Protocol for a Population-Based Historical Birth Cohort Study.

The Bacillus Calmette-Guérin vaccine (BCG) against tuberculosis (TB) shows beneficial nonspecific effects, which are likely related to innate immune training. Until 2016, a single BCG dose was administered to all newborns in Portugal. In July 2016, a clinical guideline established that only children under 6 years belonging to high-risk groups should receive BCG. This might have prevented nonvaccinated children from developing trained immunological responses as effectively as BCG-vaccinated children. This study aims to investigate if there is variation in TB-related and all-cause mortality, and severe, moderate, or mild morbidity in children under 5 years of age, and whether such variation might be explained by the BCG vaccination policy change in 2016. This population-based historical birth cohort study includes children under 5 years of age born in Portugal between July 1, 2010, and June 30, 2021. Newborns with low birth weight, premature status, or known or suspected HIV infection are excluded. The follow-up period is until the completion of 5 years of age or the end of follow-up (June 30, 2021). The study will use secondary data from the National Health Service user registry, death certificate database, vaccination registry, communicable diseases surveillance system, TB surveillance system, diagnosis-related group information system for hospital admissions and emergency department visits, and primary health care information system. The data will be linked. Primary outcomes include person-time incidence rates of death (all causes and TB), TB diagnosis, and all causes and some specific causes of severe, moderate, or mild morbidity, and the incidence rate ratio of nonvaccinated to BCG-vaccinated children. We will compare the probability of surviving the first and fifth years of life or of not having severe, moderate, or mild morbidity during the follow-up period according to exposure (BCG vaccinated or nonvaccinated, number of doses, and time from birth until the first dose), using the log-rank test for assessing differences in survival rates between exposed and nonexposed children and hazard ratios for quantifying the differences. Moreover, we will perform a proportional hazards regression analysis. Ethics approval has been obtained. In March 2022, database owners were contacted to present the project and discuss the request for data. A unique identifier will be used. In July 2023, a process of redefinition of the variables per database was initiated. Data were received in October and November 2023. In November 2023, further work was conducted. By April 2024, we expect to start analyzing the full data set. The results will contribute to the accumulating body of knowledge and might have relevance to guide global BCG vaccination policy. Data linkage can contribute to a swifter mechanism to use available health data to conduct population-based studies and inform policy decision-making. ClinicalTrials.gov NCT05471167; https://clinicaltrials.gov/study/NCT05471167. DERR1-10.2196/55332.

Benzodiazepines for pediatric epilepsies and their risks in a cohort within the French health care data.

The management of antiseizure treatment in patients with epilepsy relies on the benefit-risk ratio. Data on antiseizure medication (ASM) use in children are limited. We described antiseizure medication use in children with epilepsy (CwE) in France, with a focus on the chronic use of benzodiazepines and related implications. We conducted a 5-year cohort study from January 2012, using data from the French national health care data system (Système National des Données de Santé). We included CwE identified through International Classification of Diseases, 10th Revision codes and medications from January 2012 to December 2015 and followed them until December 2016. We described ASMs and assessed whether the risk of initiating a polytherapy after a bitherapy depends on whether benzodiazepine was included in the bitherapy. We identified 62 885 CwE. Valproate was the most reimbursed ASM (40%), followed by lamotrigine (17.6%), levetiracetam (9.3%), clobazam (6.1%), and carbamazepine (5.8%). Prescriptions were initiated at the hospital in 74.5% of CwE. We observed a decrease in the number of CwE with at least one benzodiazepine reimbursement from 15.3% in 2013 to 10.1% in 2016 (p < .0001). The prevalence of CwE with levetiracetam reimbursements increased, whereas that of CwE with valproate decreased. A switch from a bitherapy to a polytherapy was more likely when the bitherapy included a benzodiazepine (subdistribution hazard ratio [sHR] = 1.20 [1.03-1.39]). The prevalence of CwE with at least one benzodiazepine reimbursement decreased during the study period. Benzodiazepines were associated with an increased use of subsequent ASM polytherapy.

Enhancing quality of life and medication adherence for people living with HIV: the impact of an information system

BackgroundThe widespread availability of antiretroviral therapy has led to improvements in life expectancy and thus an increase in the number of people living with HIV/AIDS (PLWHA) worldwide. However, a similar increase in the number of newly-diagnosed patients in Cyprus suggests the need for solutions designed to improve monitoring, planning, and patient communication. In this study, we aimed to determine whether the use of an information system to manage PLWHA might contribute to improved quality of life and critical adherence to prescribed drug regimens and ongoing medical care.MethodsA randomized controlled trial study was conducted in Cyprus based on information that we collected using the highly valid and reliable Greek translation of the World Health Organization (WHO) Quality of Life (QOL) HIV-BREF questionnaire to assess sociodemographic variables and patient compliance. We distributed 200 questionnaires before implementing a Health Medical Care (HMC) information system at our clinic. Six months after implementing this system, 68 of the completed questionnaires were selected, including two groups of 34 participants who had been assigned at random to the intervention or the control group. Participants included PLWHA aged ≥ 18 years who had been receiving antiretroviral therapy for more than 12 months between July 15, 2020, and July 15, 2022.ResultsThe changes in baseline to six-month scores reported for the intervention group were significantly higher than in the control group in all six subscales assessed with the WHOQOL-HIV-BREF questionnaire, as well as in the assessment of compliance. Furthermore, compliance with treatment was associated with higher scores in the questionnaire subscales, including physical health, psychological health, degree of autonomy, social relationships, life circumstances, and spirituality/religious/personal beliefs. We also identified specific demographic factors and behaviors that were associated with better compliance with scheduled medical care and the prescribed drug regimen. Specifically, men exhibited better compliance than women and younger PLWHA exhibited better compliance than the elderly as did individuals who reported a higher level of educational attainment. Additionally, individuals who did not use addictive substances, consumed less alcohol, and were managed using the monitoring information system all exhibited better compliance compared to those in the control group.ConclusionThe results of this study suggest that management of PLWHA via the use of an information system can contribute to improved QOL and drug compliance.

Impact of Motivation for Eating Habits, Appetite and Food Satisfaction, and Food Consciousness on Food Intake and Weight Loss in Older Nursing Home Patients.

This study analyzed data from the Long-term care Information system For Evidence (LIFE) database to examine the effects of motivation to eat, appetite and food satisfaction, and food consciousness on food intake and weight loss. Of the 748 nursing home residents enrolled in the LIFE database, 336 met the eligibility criteria for this cross-sectional study. Motivation to eat, appetite and food satisfaction, and food consciousness were rated on five-point Likert scales (e.g., good, fair, normal, not so good, and not good). We applied Spearman rank correlation coefficient and multiple regression analyses to analyze the relationships between these three items, daily energy and protein intake, and body weight loss over 6 months. The mean participant age was 87.4±8.1 years and 259 (77%) were female. The required levels of care included-level 1, 1 (0%); level 2, 4 (1%); level 3, 107 (32%); level 4, 135 (40%); and level 5, 89 (27%). The mean daily energy intake was 28.2±7.8 kcal/kg. The mean daily protein intake was 1.1±0.3 g/kg. The mean weight loss over six months was 1.2±0.7 kg. We observed strong positive correlations among motivation to eat, appetite and food satisfaction, and food consciousness (r&gt;0.8). These three items were significantly associated with higher daily energy intake but not with daily protein intake. Only appetite and food satisfaction were significantly associated with lower weight loss over six months. The observed associations of appetite and food satisfaction suggest that these factors may be more important to assess than motivation to eat or food consciousness among older adult residents of long-term care facilities.

Evaluation of the impact of the implementation of the new primary health care information system on records of patient care and home visits in Brazil

The replacement of the Primary Care Information System (SIAB, 1998-2015), as of January 2016, by the new Health Information System for Primary Care (SISAB) determined new forms of collecting, processing, and using information, with a possible impact on the records of activities carried out in primary health care in Brazil. This study aimed to evaluate the implementation impact of the new information system on records of physicians' and nurses' patient care and home visits of community health workers (CHW) in Brazil from 2007 to 2019. To this end, a Bayesian structural time-series model approach was used, based on a diffuse state-space regression. From 2016 to 2019, 463.47 million physician care, 210.61 million nursing care, and 1.28 billion CHW visits were recorded. Following the trend recorded before the implementation, 598.86 million, 430.46 million, and 1.5 billion physician and nursing appointments and CHW visits would be expected, respectively. In relative terms, there was a decrease of 25% in physician care, 51% in nursing care, and 15% in CHW visits when compared to the value expected by the Bayesian method. The negative impact on the records of patient care and home visits identified in this study, whether due to difficulties in adapting to the new system or a reduction in improper records, must be investigated so that the challenge of improving the primary care information system can be understood and overcome in a planned way.

Access to oral health services in the Xukuru do Ororubá Indigenous Territory (2017-2018): analysis of performance indicators.

This ecological study conducted with secondary data extracted from the Indigenous Health Care Information System (SIASI) analyzed the access to oral health services provided to Xukuru do Ororubá Indigenous peoples from 2017 to 2018. The units of analysis were the Indigenous villages. The services delivered by the oral health teams working in the context were analyzed, verifying access and performance indicators and their parameters. The socioeconomic and demographic conditions, the provision of services, and the spatial components of the territory were characterized. The correlation coefficients between indicators were estimated. The results showed a growing coverage of first dental appointments, the mean number of procedures per capita, the percentage of tooth extractions, the coverage of supervised tooth brushing, and a decrease in the rate of completed treatments. There were better access opportunities for the Xukuru do Ororubá Indigenous people in the period analyzed. However, there is a persistent need to strengthen the continuity of services to complete treatments. The study points to the need for indicators suitable for the context of Indigenous health and the potential of the SIASI for oral health surveillance.

Modeling marketing communication in a farm plant care information system

The article substantiates the need to use the marketing communication channel in specialised software for agriculture. The purpose of such a channel is to provide information to farmers about the availability of planting material, technical means that ensure the processes of the production cycle, services of specialized contractors, etc. in the market. The content of such a channel in the software should be personalized, i.e., based on the user profile and his activity in the software product. The aim of the research is to create an information model that demonstrates the transformation of software product processes when implementing a marketing communication channel. To realize the goal, all the key objects involved in the mentioned processes are established, all the links between them are established. The obtained results became the basis for using the method of information modeling in order to create a model of the process of interaction between users of the system, its main modules and the module responsible for generating content for marketing communication. The developed model shows the information flows arising between the subjects of interaction during the realization of the functional capabilities of the information system.