Base de dados : MEDLINE
Pesquisa : N02.278.220 [Categoria DeCS]
Referências encontradas : 4131 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 414 ir para página                         

  1 / 4131 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28742925
[Au] Autor:Thurman W; Harrison TC; Blozis SA; Dionne-Vahalik M; Mead S
[Ti] Título:A Capabilities Approach to Environmental Impact on Nursing Home Resident Quality of Life.
[So] Source:Res Gerontol Nurs;10(4):162-170, 2017 07 01.
[Is] ISSN:1938-2464
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Nursing homes are the major provider of intermediate and long-term care outside of the hospital setting to individuals whose capacity for self-care is limited due to physical or cognitive impairments. Yet, despite their need for assistance, residents of nursing homes want to control their lives, set their routines, and do enjoyable things. The extent to which residents can maintain autonomy and dignity is important. The current study suggests an environmental gerontological framework, rooted in a capabilities approach, that can be used to consider environmental impact on quality of life in nursing homes. Using a cross-sectional survey of nursing home residents in Texas, environmental factors that might predict residents' quality of life as well as possible interactions of environmental factors and residents' characteristics that might predict well-being were examined. Environmental orientation and perception of social activities were important predictors of residents' quality of life, but geographic location and facility size were not important predictors. [Res Gerontol Nurs. 2017; 10(4):162-170.].
[Mh] Termos MeSH primário: Atividades Cotidianas/psicologia
Pessoas com Deficiência/estatística & dados numéricos
Casas de Saúde/organização & administração
Autonomia Pessoal
Qualidade de Vida/psicologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
Ambiente de Instituições de Saúde
Instituição de Longa Permanência para Idosos
Seres Humanos
Masculino
Texas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180217
[Lr] Data última revisão:
180217
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.3928/19404921-20170621-03


  2 / 4131 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:25816386
[Au] Autor:Margolies R; Gurnaney H; Egeth M; Fink N; Soosaar J; Shames A; Rehman M
[Ad] Endereço:Core Human Factors, Inc., Bala Cynwyd, PA, USA rebecca@corehf.com.
[Ti] Título:Positioning patient status monitors in a family waiting room.
[So] Source:HERD;8(2):103-9, 2015.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine where to place patient status displays for family members in the operating room family waiting room at The Children's Hospital of Philadelphia. METHODS: We calculated the percentage of seats from which wall monitors placed in hypothetical positions would be usable. We validated the usability of the new monitors by observing nonemployees' use of monitors in the waiting room 1 week before and 1 week after implementation. RESULTS: Compared to the legacy monitor, the new monitors were observed to be used from more locations within the waiting room and more people were observed to use the new monitors soon after entering the waiting room. CONCLUSIONS: Seemingly trivial decisions like where in a waiting room to place monitors can be informed by careful data collection and the consequences can observably impact communication between hospital staff and family members waiting for loved ones in surgery.
[Mh] Termos MeSH primário: Criança Hospitalizada
Terminais de Computador/normas
Família/psicologia
Monitorização Fisiológica/métodos
Sistemas de Informação em Salas Cirúrgicas/organização & administração
Relações Profissional-Família
[Mh] Termos MeSH secundário: Criança
Comunicação
Coleta de Dados
Ambiente de Instituições de Saúde
Hospitais Pediátricos
Seres Humanos
Monitorização Fisiológica/normas
Sistemas de Informação em Salas Cirúrgicas/normas
Philadelphia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/1937586714566407


  3 / 4131 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:25816190
[Au] Autor:Campagnol G; Shepley MM
[Ti] Título:Positive distraction and the rehabilitation hospitals of joão filgueiras lima.
[So] Source:HERD;8(1):199-227, 2014.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This article discusses the use of positive distraction, an evidence-based design approach, in rehabilitation hospitals in Brazil through the work of João Filgueiras Lima ("Lelé"). BACKGROUND: In many parts of the world architects may not formally incorporate theories of positive distraction and evidence-based design, but there are multiple international examples of health facility architects and designers that use nature, daylighting, art, and social interaction to enhance the healing experience. The work of the Brazilian architect João Filgueiras Lima is a particularly salient example. Lima has been a dominant figure in 20th and 21st century Brazilian architecture and the architect of several rehabilitation facilities. METHODS: First positive distraction is defined as it relates to nature and art, and in the context of rehabilitation hospitals. Second, rehabilitation facilities are defined. The discussion then focuses on awareness of evidence-based design in Latin America. Next, Brazilian healthcare architecture is discussed along with the history of the Brazilian Sarah rehabilitation hospitals designed by Lelé and Lelé's role in the history of Brazilian architecture. Last we look at Lelé's use of positive distraction. RESULTS: Despite Lelé's recognition in Brazil, his work has not gained much international exposure. Lelé played a critical role in the design of the Sarah facilities and served on the board of directors for the Technological Center of the Sarah Network (CTRS) in Brazil from 1992 to 2009. Based on our review of his work it was clear that Lelé used positive distraction as a tool for creating healing environments. CONCLUSIONS: In spite of the lack of formal integration of evidence-based design in healthcare architecture in Latin America, many of its basic tenets have been incorporated in Brazilian rehabilitation hospitals. Lelé's projects are a clear example of this phenomenon and demonstrate an alignment between research and practitioner objectives. The presence of nature, art, and natural light in his rehabilitation hospitals serves as a model for evidence-based design in facilities throughout the world and presents an opportunity to measure the benefits of positive distraction on rehabilitation patient outcomes.
[Mh] Termos MeSH primário: Projeto Arquitetônico Baseado em Evidências/métodos
Ambiente de Instituições de Saúde/organização & administração
Arquitetura Hospitalar/métodos
Centros de Reabilitação/organização & administração
[Mh] Termos MeSH secundário: Brasil
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/193758671400800113


  4 / 4131 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:25816189
[Au] Autor:Shepley MM; Song Y
[Ti] Título:Design research and the globalization of healthcare environments.
[So] Source:HERD;8(1):158-98, 2014.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Global healthcare practice has expanded in the past 20 years. At the same time the incorporation of research into the design process has gained prominence as a best practice among architects. The authors of this study investigated the status of design research in a variety of international settings. We intended to answer the question, "how pervasive is healthcare design research outside of the United States?" METHOD: The authors reviewed the international literature on the design of healthcare facilities. More than 500 international studies and conference proceedings were incorporated in this literature review. A team of five research assistants searched multiple databases comparing approximately 16 keywords to geographic location. Some of those keywords included: evidence-based design, salutogenic design, design research, and healthcare environment. Additional articles were gathered by contacting prominent researchers and asking for their personal assessment of local health design research studies. RESULTS: While there are design researchers in most parts of the world, the majority of studies focus on the needs of populations in developed countries and generate guidelines that have significant cost and cultural implications that prohibit their implementation in developing countries. Additionally, the body of literature discussing the role of culture in healthcare environments is extremely limited. CONCLUSION: Design researchers must address the cultural implications of their studies. Additionally, we need to expand our research objectives to address healthcare design in countries that have not been previous considered.
[Mh] Termos MeSH primário: Competência Cultural
Arquitetura de Instituições de Saúde/métodos
Ambiente de Instituições de Saúde/organização & administração
Internacionalidade
[Mh] Termos MeSH secundário: Projeto Arquitetônico Baseado em Evidências
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Medicina Tradicional
Determinação de Necessidades de Cuidados de Saúde
Pesquisa
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/193758671400800112


  5 / 4131 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:25816188
[Au] Autor:Marquardt G; Bueter K; Motzek T
[Ti] Título:Impact of the design of the built environment on people with dementia: an evidence-based review.
[So] Source:HERD;8(1):127-57, 2014.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: In this review the impact of the design of the built environment on people with dementia in long-term care settings is systematically analyzed and summarized. Architects and designers will be provided with credible evidence on which they can confidently base their design decisions. Researchers will be able to determine which environmental aspects have been well investigated and where there are gaps in the current state of the research. BACKGROUND: A great number of studies have established a relationship between the design of the physical environment of long-term care settings and outcomes of people with dementia. However, the methods employed are heterogeneous and the results are often conflicting. Consequently, the process of integrating the best evidence available into architectural designs may be hindered. METHODS: A systematic literature search was conducted reviewing studies that meet certain inclusion criteria. Using an evidence-based approach, the methodical quality of the studies was rated. RESULTS: One hundred sixty-nine studies were found. They were thematically summarized into four main categories: basic design decisions, environmental attributes, ambience, and environmental information. The effectiveness of the interventions on the behavior, cognition, function, well being, social abilities, orientation, and care outcomes on people with dementia was illustrated by matrices. CONCLUSIONS: Results of this review indicate that, with the exception of cognition, specific design interventions are beneficial to the outcomes of people with dementia. Overall, the field of environmental design for people with dementia is well researched in many aspects and only few gaps in knowledge were identified.
[Mh] Termos MeSH primário: Demência/psicologia
Arquitetura de Instituições de Saúde
Ambiente de Instituições de Saúde/organização & administração
Instituição de Longa Permanência para Idosos/organização & administração
Casas de Saúde/organização & administração
[Mh] Termos MeSH secundário: Atividades Cotidianas
Seres Humanos
Relações Interpessoais
Segurança do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/193758671400800111


  6 / 4131 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:25816184
[Au] Autor:Lu Y; Wang Y
[Ti] Título:Design characteristics of acute care units in china.
[So] Source:HERD;8(1):81-93, 2014.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe the current state of design characteristics of acute care units in China's public hospitals and compare these with characteristics with acute care units in the United States. BACKGROUND: The healthcare construction industry in China is one of the fastest growing sectors in China and, arguably, in the world. Understanding the physical design of acute care units in China is of great importance because it will influence a large population. METHODS: Descriptive study was performed of unit configuration, size, patient visibility, distance to nursing station and supplies, and lighting conditions in 25 units in 19 public hospitals built after 2003. Data and information were collected based on spatial and visibility analysis. RESULTS: The study identified major design characteristics of the recently built (from 2003 onward) acute care units in China, comparing them, where appropriate, with those in U.S. It found there are three dominant types of unit layout: single-corridor (52%), triangular (36%), and double-corridor (12%). The number of private rooms is very low (11%), compared with two- or three-bed rooms. Centralized nursing stations are the only type of nurses' working area. China also has a large unit size in terms of number of patient beds. The average number of patient beds in a unit is 40.6 in China (versus 32.9 in U.S.). The care units in China have longer walking distance from nursing station to patient bedside. The percentage of beds visible from a nursing station is lower in China than in the U.S. The access to natural light and direct sunlight in patient rooms is greater in China compared with those in U.S.-100% of patient rooms in China have natural lighting. A majority of them face south or southeast and thus receiving direct sunlight (91.4%). CONCLUSIONS: Because of the differences in economies and building codes, there are dramatic differences between the spatial characteristics of acute care units in China and the United States.
[Mh] Termos MeSH primário: Ambiente de Instituições de Saúde/estatística & dados numéricos
Arquitetura Hospitalar/estatística & dados numéricos
Hospitais Públicos/estatística & dados numéricos
[Mh] Termos MeSH secundário: China
Número de Leitos em Hospital/estatística & dados numéricos
Seres Humanos
Recursos Humanos de Enfermagem/organização & administração
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/193758671400800107


  7 / 4131 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:25816183
[Au] Autor:Elf M; Wijk H
[Ti] Título:Space planners' perception of an assessment instrument for briefs in the pre-design phase of new healthcare environments.
[So] Source:HERD;8(1):67-80, 2014.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The main purpose of the study was to investigate the usability of a newly developed instrument designed to assess the content and quality briefs (CQB-I) in programs for new healthcare environments. We studied the perception of using the instrument on a group of space planners. BACKGROUND: The study is part of a larger project designed to ensure the quality of the planning of new healthcare environments with a focus on documents (programs or briefs) created in the early phases of the planning process. In this study, we used an instrument that measures the clarity of the mission statement for the project based on user needs and care activities that will take place in the new healthcare environment. The instrument further evaluates whether there are clear patient-related outcome measures specified and whether the information in the documents is person-oriented and evidence-based. METHODS: The study used a mixed-method design where the relevance and usability of the instrument was estimated and a focus group interview was conducted. RESULTS: The study showed that a CQB-I is perceived to be a relevant instrument primarily as a guide for programming, but also for monitoring the produced programs. CONCLUSIONS: Instruments like CQB-I can help to bring research results into planning and contribute to dialogue and collaboration in the early phases of a planning process by orienting planning participants to user needs and facilitating the discussion and articulation of clear performance indicators.
[Mh] Termos MeSH primário: Arquitetura de Instituições de Saúde/métodos
Ambiente de Instituições de Saúde/métodos
Determinação de Necessidades de Cuidados de Saúde/organização & administração
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Comportamento Cooperativo
Grupos Focais
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/193758671400800106


  8 / 4131 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:25816182
[Au] Autor:Persson J; Dalholm EH; Johansson G
[Ti] Título:Informing Hospital Change Processes through Visualization and Simulation: A Case Study at a Children's Emergency Clinic.
[So] Source:HERD;8(1):45-66, 2014.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To demonstrate the use of visualization and simulation tools in order to involve stakeholders and inform the process in hospital change processes, illustrated by an empirical study from a children's emergency clinic. BACKGROUND: Reorganization and redevelopment of a hospital is a complex activity that involves many stakeholders and demands. Visualization and simulation tools have proven useful for involving practitioners and eliciting relevant knowledge. More knowledge is desired about how these tools can be implemented in practice for hospital planning processes. METHODS: A participatory planning process including practitioners and researchers was executed over a 3-year period to evaluate a combination of visualization and simulation tools to involve stakeholders in the planning process and to elicit knowledge about needs and requirements. RESULTS: The initial clinic proposal from the architect was discarded as a result of the empirical study. Much general knowledge about the needs of the organization was extracted by means of the adopted tools. Some of the tools proved to be more accessible than others for the practitioners participating in the study. The combination of tools added value to the process by presenting information in alternative ways and eliciting questions from different angles. CONCLUSIONS: Visualization and simulation tools inform a planning process (or other types of change processes) by providing the means to see beyond present demands and current work structures. Long-term involvement in combination with accessible tools is central for creating a participatory setting where the practitioners' knowledge guides the process.
[Mh] Termos MeSH primário: Simulação por Computador
Serviço Hospitalar de Emergência/organização & administração
Arquitetura Hospitalar/métodos
Hospitais Pediátricos/organização & administração
Determinação de Necessidades de Cuidados de Saúde/organização & administração
[Mh] Termos MeSH secundário: Ambiente de Instituições de Saúde
Pessoal de Saúde
Seres Humanos
Estudos de Casos Organizacionais
Suécia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/193758671400800105


  9 / 4131 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:25816181
[Au] Autor:Burpee H; McDade E
[Ti] Título:Comparative analysis of hospital energy use: pacific northwest and scandinavia.
[So] Source:HERD;8(1):20-44, 2014.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This study aimed to establish the potential for significant energy reduction in hospitals in the United States by providing evidence of Scandinavian operational precedents with high Interior Environmental Quality (IEQ) and substantially lower energy profiles than comparable U.S. facilities. These facilities set important precedents for design teams seeking operational examples for achieving aggressive energy and interior environmental quality goals. This examination of operational hospitals is intended to offer hospital owners, designers, and building managers a strong case and concrete framework for strategies to achieve exceptionally high performing buildings. BACKGROUND: Energy efficient hospitals have the potential to significantly impact the U.S.'s overall energy profile, and key stakeholders in the hospital industry need specific, operationally grounded precedents in order to successfully implement informed energy reduction strategies. This study is an outgrowth of previous research evaluating high quality, low energy hospitals that serve as examples for new high performance hospital design, construction, and operation. Through extensive interviews, numerous site visits, the development of case studies, and data collection, this team has established thorough qualitative and quantitative analyses of several contemporary hospitals in Scandinavia and the Pacific Northwest. Many Scandinavian hospitals demonstrate a low energy profile, and when analyzed in comparison with U.S. hospitals, such Scandinavian precedents help define the framework required to make significant changes in the U.S. hospital building industry. METHODS: Eight hospitals, four Scandinavian and four Pacific Northwest, were quantitatively compared using the Environmental Protection Agency's Portfolio Manager, allowing researchers to answer specific questions about the impact of energy source and architectural and mechanical strategies on energy efficiency in operational hospitals. RESULTS: Specific architectural, mechanical, and plant systems make these Scandinavian hospitals more energy efficient than their Pacific Northwest counterparts. More importantly, synergistic systems integration allows for their significant reductions in energy consumption. CONCLUSIONS: This quantitative comparison of operational Scandinavian and Pacific Northwest hospitals resulted in compelling evidence of the potential for deep energy savings in the U.S., and allowed researchers to outline specific strategies for achieving such reductions.
[Mh] Termos MeSH primário: Conservação de Recursos Energéticos/estatística & dados numéricos
Fontes de Energia Elétrica/estatística & dados numéricos
Ambiente de Instituições de Saúde/estatística & dados numéricos
Arquitetura Hospitalar/estatística & dados numéricos
[Mh] Termos MeSH secundário: Noroeste dos Estados Unidos
Países Escandinavos e Nórdicos
Estados Unidos
United States Environmental Protection Agency
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/193758671400800104


  10 / 4131 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29194329
[Au] Autor:Kaelin K; Okland K
[Ad] Endereço:Herman Miller, Inc, Zeeland, Michigan.
[Ti] Título:Buildings, Barriers, and Breakthroughs: Bridging Gaps in the Health Care Enterprise.
[So] Source:Nurs Adm Q;42(1):15-25, 2018 Jan/Mar.
[Is] ISSN:1550-5103
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Health care architecture and design are critical resources that are often underestimated and overlooked. As we seek to extract every available resource at our disposal to serve patients and sustain the bottom line, it is vital that we consider the influence the building imposes on the patient and caregiver experiences. Buildings impact both caregiver behaviors and the economic enterprise and are, therefore, the business of health care executives. This understanding is not only an executive obligation, it is an executive opportunity. Furthermore, the built environment can be a source for innovation in an industry whose future depends on nurse leaders to champion ingenuity with simplicity and relevance. Nurse leaders are ideally positioned to bridge health care building design and best practice.
[Mh] Termos MeSH primário: Assistência à Saúde/normas
Projeto Arquitetônico Baseado em Evidências/normas
Papel do Profissional de Enfermagem
[Mh] Termos MeSH secundário: Assistência à Saúde/economia
Projeto Arquitetônico Baseado em Evidências/economia
Ambiente de Instituições de Saúde
Seres Humanos
Liderança
Enfermeiras Administradoras
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171218
[Lr] Data última revisão:
171218
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1097/NAQ.0000000000000269



página 1 de 414 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde