THE POTENTIAL OF TELECOMMUNICATIONS IN CANCER CLINICAL TRIALS: AN OVERVIEW

This review article explores the potential bene?ts and challenges of using telecommunications technology, including telemedicine and mobile health apps, in cancer clinical trials. The author conducted a search of four electronic databases for studies published in English between 2010 and 2021 that evaluated the use of telecommunications technology in adult cancer patients and reported patient outcomes. The studies were grouped based on the type of telecommunications technology used, and the outcomes were synthesized to provide an overview of the potential impact of telecommunications technology on cancer clinical trials. Telecommunications technologies were found to improve patient access and recruitment, data collection, management, and analysis, and enable real-time monitoring of patients' health and adherence to treatment. Telecommunications technologies can also reduce trial costs by minimizing the need for in- person visits and other expenses. However, the implementation of telecommunications technologies in clinical trials is not without challenges, including technical issues, patient acceptance and adherence, regulatory and legal approvals, and variability in healthcare systems. The author suggests that addressing these challenges could lead to improved patient outcomes and better overall health outcomes for cancer patients

Emerging roles of telemedicine in dementia treatment and care / Papéis emergentes da telemedicina no tratamento e cuidado da demência

ABSTRACT. Dementia is a neurological disorder that affects memory, thinking, orientation, and other important functions of the brain; telemedicine is a part of the healthcare delivery system involving diagnosis and consultation over telecommunications devices such as mobile phones and computers. In this review, we assessed the impact, accessibility, and possible improvements in telemedicine in dementia treatment. Regarding the use of telemedicine in the treatment, we evaluated its impact on the management of the disease (i.e., diagnosis and follow-up). We also evaluated studies on the current improvements and accessibility of telemedicine in dementia treatment. The review findings showed that it is effective in diagnosing patients, monitoring their progress during treatment, and providing caregiver support. However, studies have revealed a lack of accessibility and improvement in telemedicine among the elderly, particularly in West African countries. Finally, lasting solutions were provided to address the problems in the review permanently.

RESUMO. A demência é um distúrbio neurológico que afeta a memória, o pensamento, a orientação e outras funções importantes do cérebro, enquanto a telemedicina faz parte do sistema de prestação de cuidados de saúde que envolve diagnóstico e consulta por meio de dispositivos de telecomunicações, como telefones celulares e computadores. Nesta revisão, avaliamos o impacto, a acessibilidade e as possíveis melhorias da telemedicina no tratamento da demência. Ao avaliar o impacto da telemedicina no tratamento da demência, avaliamos também seu impacto no manejo da demência (ou seja, diagnóstico e acompanhamento do tratamento da demência). Também avaliamos estudos sobre as melhorias atuais a acessibilidade da telemedicina no tratamento da demência. Os resultados da revisão mostraram que a telemedicina é eficaz para diagnosticar pacientes, monitorar seu progresso durante o tratamento e fornecer suporte ao cuidador. No entanto, estudos revelaram falta de acessibilidade e melhoria da telemedicina entre os idosos, principalmente nos países da África Ocidental. Finalmente, para resolver o problema, foram fornecidas soluções duradouras para resolver permanentemente os problemas na revisão.

Efectos de una intervención con llamadas telefónicas educativas para mejorar la adherencia y el control metabólico en personas con diabetes mellitus tipo 2 mal controlada: Un ensayo clínico aleatorizado / Effects of an Intervention with educational phone calls to improve adherence and metabolic control in people with type 2 diabetes mellitus: A randomized clinical trial

Introducción: Las tecnologías de información y comunicación pueden ayudarnos a mejorar el control metabólico y la adherencia de las personas con diabetes mellitus tipo 2 (DM2). Objetivo: Evaluar los efectos de una intervención con llamadas telefónicas en pacientes ambulatorios con DM2 mal controlada de un hospital en Perú. Material y Métodos: Ensayo clínico aleatorizado. Incluimos adultos con DM2 con mal control glicémico (HbA1c > 7%), quienes fueron aleatorizados al grupo control (cuidado usual) o al grupo intervención (cuidado usual más una intervención con llamadas telefónicas cada dos semanas por tres meses). El desenlace principal fue la reducción ≥ 1% de hemoglobina glicosilada a los tres meses. Resultados: Se reclutó 94 participantes (47 en cada grupo). La edad promedio fue 59,8 años (DE: 10,2), 69,2 % fueron mujeres. A los tres meses, solo 14/47 participantes del grupo control y 13/47 participantes del grupo intervención tuvieron medición de HbA1c. Entre estos, el porcentaje de los que lograron una disminución ≥ 1% de HbA1c fue de 35,7% (5/14) en el grupo control y 53,8% (7/13) en el grupo intervención (RR: 0,72, IC 95%: 0,35-1,47). No se encontró diferencias en la adherencia al tratamiento entre ambos grupos. Conclusiones: No se encontró diferencias estadísticamente significativas para los desenlaces de interés. Posiblemente esto se deba al bajo porcentaje de participantes a los que se logró completar el seguimiento.

Introduction: Information and communication technologies can help us improve metabolic control and adherence in people with type 2 diabetes mellitus (DM2). Objective: To evaluate the effects of an intervention with telephone calls in outpatients with poorly controlled DM2 in a hospital in Peru. Material and Methods: Randomized clinical trial. We included adults with DM2 with poor glycemic control, who were randomized to the control group (usual care) or to the intervention group (usual care plus a telephone intervention every two weeks for three months). The primary outcome was a ≥ 1% reduction in glycosylated hemoglobin at three months. Results: 94 participants were recruited (47 in each group). Mean age was 59.8 years (SD: 10.2), 69.2 % were women. At three months, only 14/47 participants in the control group and 13/47 participants in the intervention group had HbA1c measurement. Among these, the percentage of those who achieved a ≥ 1% decrease in HbA1c was 35,7% (5/14) in the control group and 53,8% (7/13) in the intervention group (RR: 0,72, 95% CI: 0,35-1,47). No differences were found in adherence to treatment between groups. Conclusions: No statistically significant differences were found for the outcomes of interest. This is possibly due to the low percentage of participants who were able to complete follow-up. Innovative solutions are needed to improve the control of people with DM2.

Efectos de una intervención con llamadas telefónicas educativas para mejorar la adherencia y el control metabólico en personas con diabetes mellitus tipo 2 mal controlada: un ensayo clínico aleatorizado / Effects of an Intervention with educational phone calls to improve adherence and metabolic control in people with type 2 diabetes mellitus: a randomized clinical trial

RESUMEN Introducción: Las tecnologías de información y comunicación pueden ayudarnos a mejorar el control metabólico y la adherencia de las personas con diabetes mellitus tipo 2 (DM2). Objetivo: Evaluar los efectos de una intervención con llamadas telefónicas en pacientes ambulatorios con DM2 mal controlada de un hospital en Perú. Métodos: Ensayo clínico aleatorizado. Incluimos adultos con DM2 con mal control glicémico (HbA1c > 7%), quienes fueron aleatorizados al grupo control (cuidado usual) o al grupo intervención (cuidado usual más una intervención con llamadas telefónicas cada dos semanas por tres meses). El desenlace principal fue la reducción ≥ 1% de hemoglobina glicosilada a los tres meses. Resultados: Se reclutó 94 participantes (47 en cada grupo). La edad promedio fue 59,8 años (DE: 10,2), 69,2 % fueron mujeres. A los tres meses, solo 14/47 participantes del grupo control y 13/47 participantes del grupo intervención tuvieron medición de HbA1c. Entre estos, el porcentaje de los que lograron una disminución ≥ 1% de HbA1c fue de 35,7% (5/14) en el grupo control y 53,8% (7/13) en el grupo intervención (RR: 0,72, IC 95%: 0,35-1,47). No se encontró diferencias en la adherencia al tratamiento entre ambos grupos. Conclusiones: No se encontró diferencias estadísticamente significativas para los desenlaces de interés. Posiblemente esto se deba al bajo porcentaje de participantes a los que se logró completar el seguimiento.

ABSTRACT Introduction: Information and communication technologies can help us improve metabolic control and adherence in people with type 2 diabetes mellitus (DM2). Objective: To evaluate the effects of an intervention with telephone calls in outpatients with poorly controlled DM2 in a hospital in Peru. Methods: Randomized clinical trial. We included adults with DM2 with poor glycemic control, who were randomized to the control group (usual care) or to the intervention group (usual care plus a telephone intervention every two weeks for three months). The primary outcome was a ≥ 1% reduction in glycosylated hemoglobin at three months. Results: 94 participants were recruited (47 in each group). Mean age was 59.8 years (SD: 10.2), 69.2 % were women. At three months, only 14/47 participants in the control group and 13/47 participants in the intervention group had HbA1c measurement. Among these, the percentage of those who achieved a ≥ 1% decrease in HbA1c was 35,7% (5/14) in the control group and 53,8% (7/13) in the intervention group (RR: 0,72, 95% CI: 0,35-1,47). No differences were found in adherence to treatment between groups. Conclusions: No statistically significant differences were found for the outcomes of interest. This is possibly due to the low percentage of participants who were able to complete follow-up. Innovative solutions are needed to improve the control of people with DM2.

Representações discursivas da mídia sobre a privatização das telecomunicações / Representaciones discursivas de los medios de comunicación acerca de la privatización de las telecomunicaciones / Discursive media representations on telecommunications privatization

Resumo O artigo analisa a representação discursiva da mídia escrita hegemônica sobre a privatização das telecomunicações no Brasil. Desde a redemocratização política no país, a privatização de empresas estatais permanece na pauta de governos de diferentes posições ideológicas. Assumindo a grande imprensa como uma das principais influenciadoras da opinião pública, analisamos um corpus de 869 artigos de jornais de grande circulação e o comparamos a 344 artigos de mídias pró e antiprivatização. A análise, quantitativa e qualitativa, mostrou como a imprensa restringe o campo lexical das privatizações às empresas e aos negócios, sugerindo o discurso de que as telecomunicações são como qualquer outro negócio e tornando desnecessária sua discussão com a sociedade. A análise das principais colocações também mostrou como a privatização vem sendo representada como um marco histórico. A pesquisa contribui de duas maneiras para a administração pública e para os estudos organizacionais: traz uma materialidade para a discussão acerca das representações da privatização e apresenta uma metodologia de análise discursiva com base em grandes coleções de documentos.

Resumen El artículo analiza la representación discursiva de los medios escritos hegemónicos sobre la privatización de las telecomunicaciones en Brasil. Desde la redemocratización política del país, la privatización de las empresas estatales ha permanecido en la agenda de los gobiernos de diferentes posiciones ideológicas. Asumiendo que la prensa convencional es uno de los principales influenciadores de la opinión pública, analizamos un corpus de 869 artículos de periódicos de amplia circulación y lo comparamos con 344 artículos de medios pro y antiprivatización. El análisis, cuantitativo y cualitativo, mostró cómo la prensa restringe el campo léxico de la privatización a empresas y negocios, sugiriendo el discurso de que las telecomunicaciones son como cualquier otro negocio y haciendo innecesaria su discusión con la sociedad. El análisis de las principales colocaciones también mostró cómo la privatización ha sido representada como un hito histórico. La investigación contribuye de dos maneras a la administración pública y a los estudios organizacionales: aporta materialidad a la discusión sobre las representaciones de la privatización y presenta una metodología de análisis discursivo basada en grandes colecciones de documentos.

Abstract This paper analyzes the discursive representation of the hegemonic written media on the privatization of telecommunications in Brazil. Since the country's political re-democratization, the privatization of state-owned companies has remained on the agenda of governments from different ideological positions. Assuming the mainstream media as one of the leading influencers of public opinion, we analyzed a corpus of 869 articles from widely circulated newspapers and compared it to 344 articles in pro and anti-privatization media. The quantitative and qualitative analysis showed how the press restricts the lexical field of privatization to companies and businesses, suggesting the discourse that telecommunications is like any other business, which renders its discussion with society unnecessary. The analysis of the main collocations also showed how privatization has been represented as a historic landmark. The research contributes in two ways to public administration and organizational studies: it brings materiality to the discussion about the representations of privatization and presents a methodology of discursive analysis based on extensive collection of documents.

COVID-19 pandemic accelerated virtual transformation in dental education: a multicenter review of remote teaching and teledentistry / Transformação virtual acelerada pela pandemia de COVID-19 na educação odontológica: uma revisão multicêntrica do ensino à distância e da teleodontologia

ABSTRACT Although prior to the pandemic there was some resistance to the virtualization of dental education, the COVID-19 pandemic is providing us a unique opportunity to overcome several barriers that previously blocked the adoption of remote teaching and teledentistry. Thanks to the extended availability of telecommunications, digital technologies, and platforms, remote education and teledentistry appear to be the preferred choice to maintain dental education and patient care active under this pandemic, without contamination risks. In this paper, we review valid remote education strategies and possible alternatives useful in virtual transformation in dental education. Furthermore, the role of teledentistry and its advantages and challenges are also revised. Under the current pandemic context, as dental educators, we are called to be creative and flexible. Every dental school should adapt and use remote education as much as possible until clinical attention can be readopted. The evidence presented in this review supports our position that under this pandemic, remote education and telemedicine/teledentistry may be "the virtual convenient solution", to adapt and improve the hitherto classic way of teaching dentistry through tele-education.

RESUMO Embora antes da pandemia houvesse alguma resistência à virtualização da educação odontológica, a pandemia COVID-19 está nos fornecendo uma oportunidade única de superar várias barreiras que anteriormente bloqueavam a adoção do ensino à distância e teledontologia. Graças à ampla disponibilidade de telecomunicações, tecnologias digitais e plataformas, a educação à distância e a teledontologia parecem ser a escolha preferida para manter a educação odontológica e o atendimento ativo aos pacientes durante a pandemia, sem riscos de contaminação. Neste artigo, revisamos estratégias válidas de educação a distância e possíveis alternativas úteis na transformação virtual na educação odontológica. Além disso, o papel do teleodontologia e suas vantagens, assim como também os desafios. No atual contexto pandêmico, como educadores odontológicos, somos chamados a ser criativos e flexíveis. Cada escola de odontologia deve se adaptar e usar a educação à distância, tanto quanto possível, até que a atenção clínica possa ser readotada. As evidências apresentadas nesta revisão corroboram nossa posição de que, sob esta pandemia, a educação a distância e a telemedicina / teleodontologia podem ser "a solução virtual conveniente", para adaptar e aprimorar a forma até então clássica de ensino de odontologia, agora por meio da teleducação.

Recomendaciones para la comunicación de malas noticias por teléfono durante la pandemia por SARS-CoV-2 / Recommendations for communicating bad news by phone during the SARS-CoV-2 pandemic / Recomendações para a comunicação de más notícias por telefone durante a pandemia do SARS-CoV-2

RESUMEN La pandemia actual por SARS-CoV-2 presenta desafíos específicos para los profesionales de salud en el campo de la atención sanitaria. En este contexto de emergencia, la comunicación de malas noticias toma especial relevancia por el modo particular en que debe llevarse a cabo: la necesidad de mantener distanciamiento sanitario y las restricciones de movilidad impuestas a la población general hacen que esta tarea deba ser realizada, muchas veces, de manera remota, en su mayoría mediante llamados telefónicos. Esto enfrenta a los profesionales a una serie de obstáculos particulares: a) la mayoría de ellos poseen escasa o nula formación sobre esta clase de habilidades comunicativas, b) la comunicación efectiva de malas noticias depende, en gran parte, del lenguaje corporal utilizado, ausente en este tipo de intercambios, y c) dado que este tipo de diálogo remoto no es recomendable -con excepción de circunstancias particulares como la actual- existe escasa literatura disponible para guiar a quienes deben cumplir esta tarea. Este manuscrito ofrece recomendaciones sobre pautas básicas para la comunicación remota de malas noticias por teléfono, en situaciones en las cuales no se pueda llevar a cabo esta tarea de forma presencial. Se presenta una propuesta estructurada en torno de cuatro "momentos" para orientar la transmisión de malas noticias a distancia, con el fin de mejorar los cuidados a pacientes, familiares y cuidadores durante este intercambio y también reducir el impacto negativo que este intercambio tiene sobre los profesionales de la salud.(AU)

ABSTRACT The current SARS-CoV-2 pandemic presents specific challenges for health professionals in the healthcare setting. In this emergency context, the communication of bad news is especially relevant because of the particular way it must be done: the need to maintain social distance or mobility restrictions imposed on the general population means that this task must often be carried out remotely, mostly by telephone calls. This confronts professionals with a number of particular obstacles: a) most of them have little or no training in this kind of communication skills, b) effective communication of bad news largely depends on body language, which is absent in this type of exchange, and c) since this type of remote dialogue is not recommended — except in particular circumstances such as the current ones — there is little literature available to guide the professionals who must carry out this task. This manuscript offers recommendations for remote communication of bad news by telephone, applicable to situations in which this task cannot be carried out in person. A proposal structured around four "moments" is presented to guide the remote transmission of bad news in order to improve the care of patients, families and caregivers during this exchange and to reduce the negative impact from it on health professionals.(AU)

RESUMO A actual pandemia do SARS-CoV-2 apresenta desafios específicos para os profissionais de saúde na área da saúde. Neste contexto de emergência, a comunicação de más notícias é particularmente relevante devido à forma específica como deve ser feita: a necessidade de manter a distância social ou as restrições de mobilidade impostas à população em geral implica que esta tarefa seja frequentemente realizada à distância, sobretudo através de chamadas telefónicas. Isto confronta os profissionais com uma série de obstáculos particulares: a) a maioria deles tem pouca ou nenhuma formação neste tipo de competências de comunicação, b) a comunicação eficaz de más notícias depende, em grande medida, da linguagem corporal utilizada, que está ausente neste tipo de intercâmbio, e c) como este tipo de diálogo à distância não é recomendado - excepto em circunstâncias particulares como a actual - há pouca literatura disponível para orientar aqueles que devem realizar esta tarefa. Este manuscrito oferece recomendações sobre a comunicação à distância de más notícias por telefone para situações em que esta tarefa não pode ser realizada pessoalmente. É apresentada uma proposta estruturada em torno de quatro "momentos" para orientar a transmissão de más notícias à distância, a fim de melhorar os cuidados prestados aos doentes, às famílias e aos prestadores de cuidados durante este intercâmbio e também para reduzir o impacto negativo que este intercâmbio tem sobre os profissionais de saúde.(AU)

Precarização do trabalho no teleatendimento e a saúde dos trabalhadores: uma contribuição crítica ao trabalho do fonoaudiólogo / Telemarketing's work precarization and worker's health: a critical contribution to the work of the speech, language and hearing professional / La precarización del trabajo en telemarketing y la salud de los trabajadores: una contribucion crítica al trabajo del fonoaudiólogo

Este artigo tem como objetivo discutir o trabalho do fonoaudiólogo no âmbito dos serviços de teleatendimento. Para tal, são abordadas as principais formas de organização do trabalho na sociedade capitalista, seguidas de alguns elementos referentes ao debate da Precarização do Trabalho e seus impactos na saúde, buscando-se dar enfoque na situação das empresas de teleatendimento. Posteriormente, são apresentadas e discutidas as principais ações desempenhadas pelos fonoaudiólogos neste setor, que, em geral, tendem a reproduzir o modelo taylorizado da Medicina do Trabalho. Por fim, defende-se que o fonoaudiólogo redirecione o foco de seu trabalho e conduza suas ações voltadas aos trabalhadores de teleatendimento na perspectiva da Vigilância em Saúde do Trabalhador, principalmente no âmbito dos serviços que compõem a Rede de Atenção Integral à Saúde do Trabalhador, e não nos serviços tradicionais que tendem a legitimar o processo de precarização do trabalho, buscando fortalecer o papel do Sistema Único de Saúde no cuidado integral aos trabalhadores e na superação desta lógica de organização e gestão do trabalho.

This article aims to discuss the work of the professional of speech, language and hearing sciences in the context of telemarketing. The central focus is the debate about the precariousness of work in this field and its implications on worker's health. Initially we discuss the main ways of the organization of work in capitalism, followed by some elements concerning the precarious work and its relation to health, focusing the telemarketing companies' situation. It is also presented and discussed the main actions performed by speech, language and hearing professionals in this sector, which, in general, tend to reproduce the Occupational Medicine based on Taylor's model. Finally, it is argued that these professionals can change their work and their actions according to a Comprehensive Care Network of Occupational Health, from the perspective of Worker's Health Surveillance, and not to the traditional services which tend to legitimize the precarious work. Thus, we seek to strengthen the role of Brazil's National Health System in the worker's comprehensive care and overcoming this way of organization and management of work.

Este artículo tiene como objetivo discutir el trabajo del fonoaudiólogo en el telemarketing. Inicialmente se ocupa de las principales formas de organización del trabajo en la sociedad capitalista, seguidas de algunos elementos acerca del debate sobre la precarización del trabajo y sus impactos en la salud, centrandose en la situación de las empresas de telemarketing. Posteriormente, se presentan y discuten las principales acciones llevadas a cabo por los fonoaudiólogos en este sector, que, en general, tienden a reproducir el modelo taylorizado de Medicina del Trabajo. Por último, se sostiene que el fonoaudiólogo cambie el foco de su trabajo y conduzca sus acciones direccionadas a los trabajadores dentro de la perspectiva de la Vigilancia en la Salud del Trabajador, principalmente en los servicios que componen la Red de Atención Integral a la Salud del Trabajador, y no en los servicios tradicionales que tienden a legitimar el proceso de precarización del trabajo, tratando así de fortalecer el papel del Sistema Único de Salud en la atención integral a los trabajadores y en la superación de esta lógica de organización y gestión del trabajo.

Relação entre as condições de trabalho e de voz autorreferidas por teleoperadores de uma central de emergência / Relationship between working and voice conditions self-reported by telemarketers of an emergency call center

RESUMO Objetivo investigar se existe associação entre os sintomas vocais, a queixa vocal e as condições de trabalho e da voz autorreferidas por teleoperadores. Método participaram 72 teleoperadores, de ambos os gêneros, atuantes em uma central de atendimento em emergência. Eles responderam ao questionário que levantou dados pessoais, queixa vocal, sintomas vocais e condições de trabalho. A análise dos dados foi realizada por meio do Teste Quiquadrado, Teste exato de Fisher e do Teste Mann-Whitney. Resultados houve associação entre o grupo de teleoperadores com queixa de distúrbio da voz para os aspectos de condição de trabalho como empresa ruidosa, e para os aspectos de condição de voz: mudança na voz e faltas ao trabalho. Observaram-se diferenças entre a média de sintomas vocais auditivos para: eco na sala, mudança na voz e faltas ao trabalho, assim como se observou entre a média de sintomas vocais sensoriais dos participantes em relação às variáveis: ritmo de trabalho estressante, empresa ruidosa, barulho vindo de outras salas, eco na sala, uso do rádio, mudança na voz e faltas ao trabalho. Conclusão existe associação entre a presença de queixa vocal, o número de sintomas vocais auditivos e sensoriais e as condições de trabalho autorreferidas pelos teleoperadores pesquisados.

ABSTRACT Purpose To investigate whether there is association between vocal symptoms, voice complaint, and working and voice conditions self-reported by telemarketers. Methods Study participants were 72 telemarketing operators, both genders, who work in an emergency call center. They responded to a questionnaire on personal data, voice complaints, vocal symptoms, and working conditions. Data analysis was performed using the Chi-square, Mann-Whitney, and Fisher’s Exact tests. Results Correlation was found between the telemarketers in the study group and voice disorder complaint for aspects of working condition, such as noisy working environment, and aspects of voice condition, such as change in the voice and workplace absence. Differences were observed between the mean of auditory vocal symptoms of participants for echo in the work room, change in voice, and workplace absence, as well as between the mean of their sensory vocal symptoms in relation to the variables stressful work rate, noisy working environment, noise from other rooms, echo in the work room, radio use, change in voice, and workplace absence. Conclusion Correlation was found between the presence of vocal complaints, number of auditory and sensory vocal symptoms, and working conditions self-reported by the telemarketers surveyed.

Qualidade de vida profissional de atendentes de central de telecomunicações / Calidad de la vida profesional de operadores de una central de telecomunicaciones / Quality of working life of call-center workers

RESUMO Objetivo: verificar perfil e qualidade de vida profissional (QVP) de atendentes de uma central de telecomunicações. Método: pesquisa de natureza quantitativa, realizada em uma central de telecomunicações da cidade de São José do Rio Preto - SP, utilizando-se o questionário QVP-35. Resultados: Sobre o perfil: 80,2% mulheres; 66,3% solteiros, escolaridade até ensino médio e 6 horas diárias de trabalho; idade média de 28 anos; 92,9% único emprego e tempo médio de trabalho na empresa de 3 anos. Aspectos positivos da QVP: motivação intrínseca, capacitação para o trabalho, recursos disponíveis e apoio social. Aspectos negativos da QVP: carga de trabalho e apoio organizacional. Conclusão: os dados obtidos apontam necessidade de melhor organização do processo de trabalho dos teleatendentes na empresa e subsidiam outras pesquisas neste contexto.

RESUMEN Objetivo: comprobar el perfil y la calidad de vida profesional (CVP) de operadores de una central de telecomunicaciones. Método: investigación científica de naturaleza cuantitativa, realizada en una central de telecomunicaciones dela ciudad de São José do Rio Preto (estado de São Paulo), valiéndose del cuestionario CVP-35. Resultados: el 80,2% eran mujeres; el 66,3%, solteros; la escolaridad era de nivel secundario; la edad promedio era de 28 años; para el 92,9% era el único empleo y el tiempo medio de trabajo en la empresa, de 3 años con 6 horas diarias de trabajo. Los aspectos positivos de la CVP fueron: motivación intrínseca, capacitación para el trabajo, recursos disponibles y apoyo social. Los aspectos negativos fueron la carga de trabajo y el apoyo organizacional. Conclusión: los datos obtenidos señalan la necesidad de mejorar la organización del proceso de trabajo de los operadores telefónicos en la empresa y subsidiar otras investigaciones en este mismo contexto.

ABSTRACT Objective: to analyze the profile and quality of working life (QWL) of call-center workers. Method: quantitative research, conducted in one call-center of the city of São José do Rio Preto - SP, using the QVP-35 questionnaire. Results: profile was composed by: 80.2% women; 66.3% were single, with high school diploma and 6 hours of daily working hours; mean age of 28 years; 92.9% had only one job with mean working experience of 3 years. Positive aspects of QWL: intrinsic motivation, working ability, available resources and social support. Negative aspects of QWL: workload and organizational support. Conclusion: the data obtained indicate the need for better organization of call-center working processes in the company and suggests other researches in this context.

Public Safety Communication and Networking Technologies for Disaster Response and Medical Assistance / 한양의대학술지

Future major disasters require the development of socially transparent and rational-decision-making procedures. Recent reports indicate that the frequency of human disasters are decreasing while natural disasters and social disasters are becoming more frequent. The creation of a disaster communication network, which is essential in protecting the life and property as well as providing a sense of societal security. Standards for a modern disaster communication network must be developed at the national level, with national state support for a 3rd generation partnership project such as a Public Safety-LTE that allows the construction of an effective national disaster network plan. Compliance and certification standards to ensure interoperability of communications and other equipment are necessary for the creation of a modern national disaster network that allows more efficient management of disaster situations. It can be expected that our efforts and example can help other countries to build a standard protocol for managing the national disasters.

Recent Directions in Telemedicine: Review of Trends in Research and Practice / 대한의료정보학회지

OBJECTIVES: Healthcare is now routinely delivered by telecommunications-based services in all developed countries and an increasing number of developing countries. Telemedicine is used in many clinical specialities and across numerous healthcare settings, which range from mobile patient-centric applications to complex interactions amongst clinicians in tertiary referral hospital settings. This paper discusses some recent areas of significant development and progress in the field with the purpose of identifying strong trends in both research and practice activities. METHODS: To establish the breadth of new ideas and directions in the field, a review of literature was made by searching PubMed for recent publications including terms (telemedicine OR telehealth) AND (challenge OR direction OR innovation OR new OR novel OR trend), for all searchable categories. 3,433 publications were identified that have appeared since January 1, 2005 (2,172 of these since January 1, 2010), based on a search conducted on June 1, 2015. RESULTS: The current interest areas in these papers span both synchronous telemedicine, including intensive care, emergency medicine, and mental health, and asynchronous telemedicine, including wound and burns care, dermatology and ophthalmology. CONCLUSIONS: It is concluded that two major drivers of contemporary tele medicine development are a high volume demand for a particular clinical service, and/or a high criticality of need for clinical exper tise to deliver the service. These areas offer promise for further study and enhancement of applicable telemedicine methods and have the potential for large-scale deployments internationally, which would contribute significantly to the advancement of healthcare.

Current Status and Progress of Telemedicine in Korea and Other Countries / 대한의료정보학회지

OBJECTIVES: The purpose of this study was to review the current telemedicine of the Korea and the telemedicine of the other countries. METHODS: This study reviewed several documents on telemedicine and summarized the documents on the initiation of the telemedicine of the Korea, the recent regulations of the government, the analytical research results, and the telemedicine of foreign countries. RESULTS: One of recent demonstration trials of telemedicine began in July 2015 in the Korea. The plan was to conduct an emergency telemedical treatment trial among the cooperative medical service centers until the end of February 2016. No telemedical services were provided at the level of local primary care clinics, and there was 1.2% provision at the hospital level. The Europe Union and the United States had more active telemedical services in comparison to the Korea. CONCLUSIONS: The introduction and usage of telemedicine in the Korea was behind those of other countries. It is necessary to develop a proactive support policy for telemedicine through a government implemented trial.

Current Clinical Status of Telehealth in Korea: Categories, Scientific Basis, and Obstacles / 대한의료정보학회지

OBJECTIVES: Through telehealth, medical services have expanded beyond spatial boundaries and are now available in living spaces outside of hospitals. It can also contribute to patient medical knowledge improvement because patients can access their hospital records and data from home. However, concepts of telehealth are rather vague in Korea. METHODS: We refer to several clinical reports to determine the current clinical status of and obstacles to telehealth in Korea. RESULTS: Patients' health conditions are now reported regularly to doctors remotely, and patients can receive varied assistance. Self-improvement based on minute details that are beyond medical staff's reach is another possible benefit that may be realized with the help of a variety of medical equipment (sensors). The feasibility, clinical effect, and cost-benefit of telehealth have been verified by scientific evidence. CONCLUSIONS: Patients will be able to improve their treatment adherence by receiving help from various professionals, such as doctors, nurses, nutritionists, and sports therapists. This means that the actual treatment time per patient will increase as well. Ultimately, this will increase the quality of patients' self-administration of care to impede disease progression and prevent complications.

Proposal on the Establishment of Telemedicine Guidelines for Korea / 대한의료정보학회지

OBJECTIVES: An official guideline must be prepared for legalizing the doctor-patient telemedicine system based on the evaluations of the ongoing telemedicine demonstration project performed by the Korean government. In this study, critical items of the Korean telemedicine guideline are suggested based on the guidelines of developed countries. METHODS: To investigate the telemedicine guidelines of developed countries, a keyword of 'telemedicine guidelines' was used for Google search to find out US, Australian, and Japanese guidelines. The common items included in two or more of the followings were screened: US Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interactions, the Australian New South Wales (NSW) Agency for Clinical Innovation Guidelines for the use of Telehealth for Clinical and Non Clinical Settings in NSW, and the Japanese Guidelines for the practice of home telemedicine. RESULTS: A total of 22 common items of the following four domains, which could be used for the Korean guideline were screened: the common features in overall considerations (6 items), the common features in clinical considerations (6 items), the common features in technical considerations (5 items), and the common features in privacy considerations (5 items). These 22 items were suggested as the critical items of the Korean telemedicine guideline. CONCLUSIONS: The screened 22 items of the telemedicine guideline must be further organized for details. Additional studies and professional opinions on the telemedicine cases and on the guidelines of developed countries are required to establish the Korean guideline in the near future.

La Red de Telesalud de las Américas y su papel en la atención primaria de la salud / The Telehealth Network of the Americas and its role in primary health care

La necesidad de garantizar un acceso equitativo a la salud, con independencia de las limitaciones geográficas, económicas y tecnológicas, motivó a los estados miembros de la Organización de Estados Americanos a impulsar la creación de una Red de Telesalud de las Américas (Red TSA) dependiente de la Comisión Interamericana de Telecomunicaciones. La Red TSA es un desarrollo centrado en el uso de las nuevas tecnologías de la información y la comunicación aplicadas a la salud, asentado en valores de respeto, equidad y solidaridad y amparado en la filosofía de la atención primaria de la salud e integrado por instituciones gubernamentales y no gubernamentales, foros de universidades, federaciones hospitalarias y empresas de telecomunicaciones, y ha iniciado su difusión en diferentes ámbitos continentales y mundiales relacionados con la telemedicina. Entre sus primeros logros, ha puesto en marcha una novedosa herramienta de aplicación en situaciones de catástrofes y escasa accesibilidad geográfica (estación de telemedicina móvil), consistente en un maletín portátil compuesto por un ordenador, diferentes dispositivos digitales (otoscopio, oftalmoscopio, microscopio y dermatoscopio), cámara digital de alta resolución, negatoscopio y antena de conexión satelital. Este maletín permite dar apoyo especializado a los médicos rurales y locales de atención primaria de la salud alejados de los grandes centros urbanos.

The need to guarantee equitable access to health regardless of geographic, economic, or technological barriers motivated the Member States of the Organization of American States to create the Telehealth Network of the Americas, coordinated by the Inter-American Telecommunication Committee. The Network focuses on the use of new information and communications technology applied to health, based on the values of respect, equity, and solidarity and mandated by the philosophy of primary health. Its members include government agencies, nongovernmental organizations, university forums, hospital federations, and telecommunications companies, and it has already extended its reach to other continents and to different fields in which telemedicine is being used. Among its first achievements, it has implemented an innovative tool to be used in cases of disaster or limited geographic access. This mobile telemedicine station is housed in a portable case that includes a computer, various digital devices (otoscope, ophthalmoscope, microscope, dermatoscope), a high-resolution digital camera, an X-ray film viewer, and a satellite antenna. With this tool, it is possible to provide specialized support for rural physicians and primary health care workers located far from large urban centers.

Technology Acceptance and Adoption of Innovative Smartphone Uses among Hospital Employees / 대한의료정보학회지

OBJECTIVES: The number of healthcare institutions adopting smartphones continues to increase, implying that their utilization is undoubtedly gaining attention. Understanding the needs of smartphone users will provide a greater opportunity for successful information technology acceptance by expanding the scope of its utilization. This study focuses on how smartphones are accepted and utilized in hospitals and analyzes the factors influencing users' attitude, social influence, and intention of use. METHODS: For the study model, the researcher has mainly adopted the Theory of Reasoned Action and further modified and used the models of Technology Acceptance and Information Systems Success. To test the model empirically, a survey was conducted with 122 professionals on information development teams in Korean tertiary hospitals. RESULTS: The common smartphone usage modes were Internet searching, e-mail, scheduling, and social networking in consecutive order. Phone calls consisted of 51.4% of work-related purposes, while other functions, such as text message, Web browser, and scheduling, were mostly used for personal purposes. Costs, contents quality, innovation, ease of use, and support were shown to have statistically significant effects on user attitude, and social influence, portability, security, content quality, and innovation were significant. User attitude and social influence were both statistically significant with respect to intention of use, with user attitude greater than social influence. CONCLUSIONS: The participating staff were analyzed as having strong personal faith and principles, independent from their external environment. Timely information exchanges among medical staff will facilitate appropriate communication and improved health services to patients in need.

Initial experience at a university teaching hospital from using telemedicine to promote education through video conferencing / Experiência inicial de um hospital universitário utilizando a telemedicina na promoção de educação através de vídeo-conferências

CONTEXT AND OBJECTIVE: Telehealth and telemedicine services are advancing rapidly, with an increasing spectrum of information and communication technologies that can be applied broadly to the population's health, and to medical education. The aim here was to report our institution's experience from 100 videoconferencing meetings between five different countries in the Americas over a one-year period. DESIGN AND SETTING: Retrospective study at Universidade Estadual de Campinas. METHODS: Through a Microsoft Excel database, all conferences in all specialties held at our institution from September 2009 to August 2010 were analyzed retrospectively. RESULTS: A total of 647 students, physicians and professors participated in telemedicine meetings. A monthly mean of 8.3 (± 4.3) teleconferences were held over the analysis period. Excluding holidays and the month of inaugurating the telemedicine theatre, our teleconference rate reached a mean of 10.3 (± 2.7), or two teleconferences a week, on average. Trauma surgery and meetings on patient safety were by far the most common subjects discussed in our teleconference meetings, accounting for 22 percent and 21 percent of the total calls. CONCLUSION: Our experience with telemedicine meetings has increased students' interest; helped our institution to follow and discuss protocols that are already accepted worldwide; and stimulated professors to promote telemedicine-related research in their own specialties and keep up-to-date. These high-technology meetings have shortened distances in our vast country, and to other reference centers abroad. This virtual proximity has enabled discussion of international training with students and residents, to increase their overall knowledge and improve their education within this institution.

CONTEXTO E OBJETIVO: Serviços de telessaúde e telemedicina estão avançando rapidamente, com um espectro cada vez maior de tecnologias da informação e comunicação que podem ser aplicadas de forma ampla para a saúde da população, bem como para a educação médica. O objetivo deste artigo é relatar a experiência da nossa instituição com 100 reuniões por videoconferência entre cinco diferentes países das Américas no período de um ano. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo na Universidade Estadual de Campinas. MÉTODOS: Através de um banco de dados do Microsoft Excel, foram analisadas retrospectivamente todas as conferências realizadas em nossa instituição, de setembro de 2009 a agosto de 2010, em todas as especialidades. RESULTADOS: Um total de 647 alunos, médicos e professores participaram das reuniões de telemedicina. Em média, 8,3 (± 4,3) teleconferências foram realizadas mensalmente durante o período analisado. Excluindo os feriados e o mês de inauguração do anfiteatro de telemedicina, as nossas taxas de teleconferência atingiram a média de 10,3 (± 2,7), ou duas teleconferências sobre uma média semanal. Cirurgia do Trauma e reuniões sobre segurança dos pacientes foram, de longe, os temas mais comuns discutidos em nossas reuniões de teleconferência, correspondendo por 22 por cento e 21 por cento do total de chamadas. CONCLUSÃO: Nossa experiência com as reuniões de telemedicina aumentou o interesse dos alunos, ajudou a nossa instituição a acompanhar e discutir protocolos que já são aceitos em todo o mundo e estimulou nossos professores a promover pesquisas relacionadas à telemedicina em suas próprias especialidades, mantendo-os atualizados. Essas reuniões com envolvimento de alta tecnologia encurtaram as distâncias dentro de nosso país vasto e com outros centros de referência no exterior. Esta proximidade virtual permitiu discussões com alunos e residentes sobre estágios internacionais a fim de aumentar seu conhecimento global e melhorar a sua educação dentro da própria instituição.

Ubiquitous Health in Korea: Progress, Barriers, and Prospects / 대한의료정보학회지

OBJECTIVES: Korea has one of the most advanced information technology (IT) infrastructures in the world, and the application of IT in health systems is rapidly progressing from computerization to information systems, ubiquitous systems, and smart systems. This study aims to analyze Korean environments in regards to the development of their u-Health industry and propose directions for u-Healthcare services based on this analysis. METHODS: This paper reviews the background, progress history, and current status of u-Health in Korea, and suggests strategies for the u-Health industry based on an analysis of its barriers and obstacles. RESULTS: When u-Health was introduced to Koreans, their policies and approaches focused mainly on environmental factors, yet these efforts have not progressed further to impact the u-Healthcare service industry itself. To develop the u-Healthcare industry, four points need to be considered: the development and support of the practical service model, institutional support, support of core technology and industry, and the institutionalization of health management service. CONCLUSIONS: Korea is at a strategic point to start building u-Healthcare service delivery models. u-Healthcare is a healthcare service that provides added value through u-Health environments. By identifying critical success factors in u-Healthcare, we can strengthen the u-Health industry and implement policies to coordinate our efforts in the process of value chains to which we belong.

Multimedia Message Service (MMS) Improves Comprehension of Discharge Instruction in the Patients with Lacerations

PURPOSE: This study was carried out to determine whether the use of multimedia message service (MMS) as discharge instructions about post-suture care improves patient's comprehension for those information. METHODS: One hundred nineteen (119) patients with lacerations and their caregivers who visited the Emergency Room at Soonchunhyang University Cheonan Hospital were included in this study. Participants were randomly assigned to receive MMS (n=66) or paper (n=53) discharge instructions after providing informed consent to engage in this study. Within 48 hours of discharge, an investigator called each participant by phone and asked a series of questions designed to test the participant's comprehension of their discharge instructions. In addition, participants were asked to complete questionnaires about confidence, accessibility, compliance, and the usefulness of discharge instructions. RESULTS: There were no differences in age, sex, educational background and subject (patient or caregiver) between the MMS and the paper group. In both groups, the mean and standard deviation in comprehension score was 8.1+/-1.3 and 6.6 +/-1.8, respectively. The difference was statistically significant (p<0.001). 'Yes' group of MMS and paper was 40(60.6%) and 16(30.2%) in accessibility, 39(59.1%) and 19(35.8%) in compliance, 26(39.3%) and 20(37.7%) in usefulness, respectively. CONCLUSION: The use of MMS as discharge instructions for patients with laceration improves patient comprehension.