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Thinking out of the box: revisiting health surveillance based on medical records
- Vanderson S. Sampaio, Rafael Lopes, Mina Cintho Ozahata, Helder I. Nakaya, Erick Sousa, José D. Araújo, Marcelo A.S. Bragatte, Anderson F. Brito, Regina Maura Zettoni Grespan, Maria Ligia Damato Capuani, Helves Humberto Domingues, Alessandra Cristina Guedes Pellini, Sheila de Oliveira Garcia Mateos, Mônica Tilli Reis Pessoa Conde, Fabio Eudes Leal, Ester Sabino, Mariangela Simão, Jorge Kalil
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue 1 / 2023
- Published online by Cambridge University Press:
- 24 October 2023, e185
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- Article
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- You have access Access
- Open access
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Despite the considerable advances in the last years, the health information systems for health surveillance still need to overcome some critical issues so that epidemic detection can be performed in real time. For instance, despite the efforts of the Brazilian Ministry of Health (MoH) to make COVID-19 data available during the pandemic, delays due to data entry and data availability posed an additional threat to disease monitoring. Here, we propose a complementary approach by using electronic medical records (EMRs) data collected in real time to generate a system to enable insights from the local health surveillance system personnel. As a proof of concept, we assessed data from São Caetano do Sul City (SCS), São Paulo, Brazil. We used the “fever” term as a sentinel event. Regular expression techniques were applied to detect febrile diseases. Other specific terms such as “malaria,” “dengue,” “Zika,” or any infectious disease were included in the dictionary and mapped to “fever.” Additionally, after “tokenizing,” we assessed the frequencies of most mentioned terms when fever was also mentioned in the patient complaint. The findings allowed us to detect the overlapping outbreaks of both COVID-19 Omicron BA.1 subvariant and Influenza A virus, which were confirmed by our team by analyzing data from private laboratories and another COVID-19 public monitoring system. Timely information generated from EMRs will be a very important tool to the decision-making process as well as research in epidemiology. Quality and security on the data produced is of paramount importance to allow the use by health surveillance systems.
5 - Sexuality ‘in apps’? Older men who have sex with men and their use of dating apps in Brazil
- Edited by Paul Willis, University of Bristol, Ilkka Pietilä, Helsingin yliopisto, Marjaana Seppänen, Helsingin yliopisto
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- Book:
- Ageing, Men and Social Relations
- Published by:
- Bristol University Press
- Published online:
- 18 January 2024
- Print publication:
- 30 March 2023, pp 69-87
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Summary
Introduction
Erasure of older people’s expressions of sexuality by society is one of many stigmas experienced by aged individuals. However, with slow steps the myth of asexual old age is giving way to discussions about older people’s sexuality, and how the scenario of an active sexual life in older age unfolds and can be influenced by the use of medical technologies (to maintain sexual vigour) or social technologies (to find new partners) (Lochlainn and Kenny, 2013).
Even if the very concepts of sexuality and ageing have undergone changes in the last 20 years (Orimo and Kamiya, 2008), this revolution took place at a ‘global’ scale so much more guided by the Global North, being irregular in other geopolitical and social contexts. In Latin America, in a generalised manner, it still resists discussions about sexuality in formal contexts and some important social structures, such as families, schools, religious centres and healthcare settings (Abdo, 2020). The training of health professionals still faces internal conflicts between the adaptation of local cultures and values and import of international scientific evidence, so that, for many professionals, these social changes do not reflect in their clinical practice, thus reinforcing health services as spaces that maintain social control especially regarding sexuality (Jakubec and Bearskin, 2020). Thus, the study and understanding of older people’s sexuality, in the Latin American, dynamic and technological setting, is still underexplored and is a challenge for local and international researchers, mainly when it comes to non-heterosexual sexualities.
In Latin America, especially in Brazil, homosexual relationships, often marked by significant complacent hedonism associated with the overvaluation of physical attributes capable of provoking attraction and desire (Simões, 2011), are continually modulated by the convergence of sociopolitical advances. This allows them a freer and safer expression of their affectivity, but also by technological advances, which provide them with a greater layer of protection against violence and social judgements and which, currently, affect everyone’s relationship dynamics, regardless of their sexual orientation. A number of studies conducted with Brazilian older adults point out that these advances affect older people in a very particular way, as they allow them (many for the first time) to experience their sexuality in a free way, although issues related to vulnerability to diseases, abandonment and loneliness are still present and significant in this population (Santos and Araújo, 2020; Pereira, 2022).