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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
341

SELinux policy management framework for HIS

Marin, Luis Franco January 2008 (has links)
Health Information Systems (HIS) make extensive use of Information and Communication Technologies (ICT). The use of ICT aids in improving the quality and efficiency of healthcare services by making healthcare information available at the point of care (Goldstein, Groen, Ponkshe, and Wine, 2007). The increasing availability of healthcare data presents security and privacy issues which have not yet been fully addressed (Liu, Caelli, May, and Croll, 2008a). Healthcare organisations have to comply with the security and privacy requirements stated in laws, regulations and ethical standards, while managing healthcare information. Protecting the security and privacy of healthcare information is a very complex task (Liu, May, Caelli and Croll, 2008b). In order to simplify the complexity of providing security and privacy in HIS, appropriate information security services and mechanisms have to be implemented. Solutions at the application layer have already been implemented in HIS such as those existing in healthcare web services (Weaver et al., 2003). In addition, Discretionary Access Control (DAC) is the most commonly implemented access control model to restrict access to resources at the OS layer (Liu, Caelli, May, Croll and Henricksen, 2007a). Nevertheless, the combination of application security mechanisms and DAC at the OS layer has been stated to be insufficient in satisfying security requirements in computer systems (Loscocco et al., 1998). This thesis investigates the feasibility of implementing Security Enhanced Linux (SELinux) to enforce a Role-Based Access Control (RBAC) policy to help protect resources at the Operating System (OS) layer. SELinux provides Mandatory Access Control (MAC) mechanisms at the OS layer. These mechanisms can contain the damage from compromised applications and restrict access to resources according to the security policy implemented. The main contribution of this research is to provide a modern framework to implement and manage SELinux in HIS. The proposed framework introduces SELinux Profiles to restrict access permissions over the system resources to authorised users. The feasibility of using SELinux profiles in HIS was demonstrated through the creation of a prototype, which was submitted to various attack scenarios. The prototype was also subjected to testing during emergency scenarios, where changes to the security policies had to be made on the spot. Attack scenarios were based on vulnerabilities common at the application layer. SELinux demonstrated that it could effectively contain attacks at the application layer and provide adequate flexibility during emergency situations. However, even with the use of current tools, the development of SELinux policies can be very complex. Further research has to be made in order to simplify the management of SELinux policies and access permissions. In addition, SELinux related technologies, such as the Policy Management Server by Tresys Technologies, need to be researched in order to provide solutions at different layers of protection.
342

A project to improve the information seeking skills and increase the use of evidence-based research in public health practice.

VonVille, Helena. Lloyd, Linda E. Symanski, Elaine January 2008 (has links)
Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-05, page: 2673. Adviser: Linda Lloyd. Includes bibliographical references.
343

Análise de sobrevida e perfil epidemiológico de casos de AIDS em Porto Alegre/RS : limitações e potencialidades da vigilância epidemiológica

Beck, Caroline January 2014 (has links)
O acesso universal aos serviços de saúde e terapia antirretroviral foram importantes no aumento da sobrevida de pessoas vivendo com HIV/AIDS (PVHA). A incidência de comorbidades crônicas, porém, aumentou proporcionalmente. Considerando a epidemia de AIDS no RS, especialmente em Porto Alegre, é preciso investigar a sobrevida de PVHA no contexto local, especialmente entre coinfectados HIV/Tuberculose. Dados foram obtidos pelo relacionamento dos bancos SIM e SINAN 2007-2012. Foi utilizado o modelo de regressão de COX para obter o hazard ratio, o método de Kaplan-Meier para estimativas de sobrevida O banco compreendeu 1800 casos notificados em 2007. Correspondem a 60% homens, brancos em sua maioria (67%), com mediana de idade igual a 37 anos (AIQ=14), a maioria dos casos possui baixa escolaridade. Cerca de 70% adquiriu a doença via transmissão sexual. Comparados aos casos notificados por critério óbito, os óbitos totais tem maior proporção de indivíduos de raça/cor preta (46,1% e 32,5%, respectivamente) e maior freqüência de indivíduos do sexo masculino (40,0% e 27,8%, respectivamente). A proporção de dados incompletos também é maior para a escolaridade (72,1% e 68,7%, respect.), contagem de CD4+ (76% e 68%, respect.). Na análise bivariada a transmissão sanguínea, raça/cor negra e baixa escolaridade foram fatores associados a maior risco de óbito. Sexo feminino e idade acima de 30 anos foram fatores associados a menor risco de óbito por AIDS Raça/cor negra, transmissão do HIV pro via sanguínea, presença de infecção por TB e baixa escolaridade são fatores associados à mortalidade aumentada no modelo multivariado. A sobrevida média foi de 1.495 dias (IC 95% 1449 – 1550). O percentual de dados incompletos sugerem que o relacionamento dimensiona a subnotificação mas não qualifica o processo de vigilância. O Critério Óbito representa a perda de oportunidades de intervenção em eventos preveníveis e pode servir como indicador negativo da vigilância. / Universal Access to health services and antiretroviral therapy were crucial in improving the survival or people living with HIV/AIDS (PLHA). The incidence of cronic comorbidities, however, have proportionally rised. Considering the AIDS epidemics in the state of Rio Grande do Sul, specifically in the city of Porto Alegre, it is important to determine the survival of PLHA in a local context, specially between individuals coinfected with TB. Data were obtained by the linkage of SIM and SINAN databases from 2007-2012. A COX regression model was used for the hazard ratios, and the Kaplan-Meier method in order to determine survival estimates. The resulting database had 1800 cases notified in 2007. Sixty percent were male, mostly of white race (67%), median age of 37 years old (IQR=14), mosto f them had low schooling. Around 70% acquired the vírus through sexual transmission. Compared to the total of cases, those notified by the death criteria have proportionally more individuals of the black race (46,1% and 32,5%, respectively) and more males (40% and 27,8%, respectively). The proportion of incomplete data is also higher for scholarity (72,1% and 68,7% respectively) and CD4+ T lymphocite cell count (76% e 68%, respectively). Blood transmission, black race and low scholarity were associated with a higher risk of death in the bivariate analysis. Female gender and age over 30 years were factors associated with a low risk of AIDS-related death. In the multivariate model black race, blood transmission of the vírus e low scholarity were factors associated with higher mortality. Mean survival was of 1495 days (95% CI 1449 – 1550). The proportion of incomplete data suggests that the linkage scales the underreporting but doesn’t qualify the surveillance process. Death criterion represents missed opportunities of interventions in preventable events, and might serve as negative indicator of the surveillance.
344

Automated Injection of Curated Knowledge Into Real-Time Clinical Systems: CDS Architecture for the 21st Century

January 2018 (has links)
abstract: Clinical Decision Support (CDS) is primarily associated with alerts, reminders, order entry, rule-based invocation, diagnostic aids, and on-demand information retrieval. While valuable, these foci have been in production use for decades, and do not provide a broader, interoperable means of plugging structured clinical knowledge into live electronic health record (EHR) ecosystems for purposes of orchestrating the user experiences of patients and clinicians. To date, the gap between knowledge representation and user-facing EHR integration has been considered an “implementation concern” requiring unscalable manual human efforts and governance coordination. Drafting a questionnaire engineered to meet the specifications of the HL7 CDS Knowledge Artifact specification, for example, carries no reasonable expectation that it may be imported and deployed into a live system without significant burdens. Dramatic reduction of the time and effort gap in the research and application cycle could be revolutionary. Doing so, however, requires both a floor-to-ceiling precoordination of functional boundaries in the knowledge management lifecycle, as well as formalization of the human processes by which this occurs. This research introduces ARTAKA: Architecture for Real-Time Application of Knowledge Artifacts, as a concrete floor-to-ceiling technological blueprint for both provider heath IT (HIT) and vendor organizations to incrementally introduce value into existing systems dynamically. This is made possible by service-ization of curated knowledge artifacts, then injected into a highly scalable backend infrastructure by automated orchestration through public marketplaces. Supplementary examples of client app integration are also provided. Compilation of knowledge into platform-specific form has been left flexible, in so far as implementations comply with ARTAKA’s Context Event Service (CES) communication and Health Services Platform (HSP) Marketplace service packaging standards. Towards the goal of interoperable human processes, ARTAKA’s treatment of knowledge artifacts as a specialized form of software allows knowledge engineers to operate as a type of software engineering practice. Thus, nearly a century of software development processes, tools, policies, and lessons offer immediate benefit: in some cases, with remarkable parity. Analyses of experimentation is provided with guidelines in how choice aspects of software development life cycles (SDLCs) apply to knowledge artifact development in an ARTAKA environment. Portions of this culminating document have been further initiated with Standards Developing Organizations (SDOs) intended to ultimately produce normative standards, as have active relationships with other bodies. / Dissertation/Thesis / Doctoral Dissertation Biomedical Informatics 2018
345

Informação em saúde para o planejamento em vigilância sanitária na gestão municipal.

Amaral, Sueli Andrade January 2008 (has links)
p. 1-61 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-24T17:40:27Z No. of bitstreams: 1 3333.pdf: 629201 bytes, checksum: 1045c2e81a35871697bfeed84c16ad43 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:01:50Z (GMT) No. of bitstreams: 1 3333.pdf: 629201 bytes, checksum: 1045c2e81a35871697bfeed84c16ad43 (MD5) / Made available in DSpace on 2013-05-04T17:01:50Z (GMT). No. of bitstreams: 1 3333.pdf: 629201 bytes, checksum: 1045c2e81a35871697bfeed84c16ad43 (MD5) Previous issue date: 2008 / Os Sistemas de Informação em Saúde (SIS) contribuem para identificar problemas individuais e coletivos do quadro sanitário de uma população, propiciando elementos para análise da situação e subsidiando as ações. Por isto são considerados instrumentos de gestão e devem ser utilizados nas práticas de planejamento e execução das ações de vigilância sanitária (VISA) relativas à promoção, proteção e reabilitação da saúde e em sua avaliação. O estudo tem por objetivo descrever a situação da aplicação da informação em saúde no planejamento das ações de vigilância sanitária na gestão municipal. Mais especificamente identificar o grau de conhecimento dos profissionais sobre os SIS e descrever de que maneira os dados são utilizados pelos profissionais no planejamento. Trata-se de um estudo de caso, transversal e observacional, de caráter exploratório e descritivo, que apresenta abordagens quantitativas caracterizadas pela identificação dos dados existentes nos SIS e abordagens qualitativas que incluiram entrevistas com profissionais do setor e a apreciação da rede e da organização dos serviços por meio de análise documental. A análise e a interpretação dos dados são de natureza qualitativa. Os resultados apontam que os profissionais consideram o planejamento das ações de vigilância sanitária deficiente uma vez que não ocorre de maneira periódica, sistemática e uniforme com a utilização do enfoque estratégico situacional. Os entrevistados souberam definir SIS, mas demonstraram pouco conhecimento real dos vários sistemas existentes. Esses disponibilizam dados que dizem respeito à situação de saúde, entretanto a sua utilização não acontece para planejar as ações específicas de VISA, e uma das principais causas apontadas é a falta de conhecimento no manuseio destes sistemas pela equipe. / Vitória da conquista
346

Análise de sobrevida e perfil epidemiológico de casos de AIDS em Porto Alegre/RS : limitações e potencialidades da vigilância epidemiológica

Beck, Caroline January 2014 (has links)
O acesso universal aos serviços de saúde e terapia antirretroviral foram importantes no aumento da sobrevida de pessoas vivendo com HIV/AIDS (PVHA). A incidência de comorbidades crônicas, porém, aumentou proporcionalmente. Considerando a epidemia de AIDS no RS, especialmente em Porto Alegre, é preciso investigar a sobrevida de PVHA no contexto local, especialmente entre coinfectados HIV/Tuberculose. Dados foram obtidos pelo relacionamento dos bancos SIM e SINAN 2007-2012. Foi utilizado o modelo de regressão de COX para obter o hazard ratio, o método de Kaplan-Meier para estimativas de sobrevida O banco compreendeu 1800 casos notificados em 2007. Correspondem a 60% homens, brancos em sua maioria (67%), com mediana de idade igual a 37 anos (AIQ=14), a maioria dos casos possui baixa escolaridade. Cerca de 70% adquiriu a doença via transmissão sexual. Comparados aos casos notificados por critério óbito, os óbitos totais tem maior proporção de indivíduos de raça/cor preta (46,1% e 32,5%, respectivamente) e maior freqüência de indivíduos do sexo masculino (40,0% e 27,8%, respectivamente). A proporção de dados incompletos também é maior para a escolaridade (72,1% e 68,7%, respect.), contagem de CD4+ (76% e 68%, respect.). Na análise bivariada a transmissão sanguínea, raça/cor negra e baixa escolaridade foram fatores associados a maior risco de óbito. Sexo feminino e idade acima de 30 anos foram fatores associados a menor risco de óbito por AIDS Raça/cor negra, transmissão do HIV pro via sanguínea, presença de infecção por TB e baixa escolaridade são fatores associados à mortalidade aumentada no modelo multivariado. A sobrevida média foi de 1.495 dias (IC 95% 1449 – 1550). O percentual de dados incompletos sugerem que o relacionamento dimensiona a subnotificação mas não qualifica o processo de vigilância. O Critério Óbito representa a perda de oportunidades de intervenção em eventos preveníveis e pode servir como indicador negativo da vigilância. / Universal Access to health services and antiretroviral therapy were crucial in improving the survival or people living with HIV/AIDS (PLHA). The incidence of cronic comorbidities, however, have proportionally rised. Considering the AIDS epidemics in the state of Rio Grande do Sul, specifically in the city of Porto Alegre, it is important to determine the survival of PLHA in a local context, specially between individuals coinfected with TB. Data were obtained by the linkage of SIM and SINAN databases from 2007-2012. A COX regression model was used for the hazard ratios, and the Kaplan-Meier method in order to determine survival estimates. The resulting database had 1800 cases notified in 2007. Sixty percent were male, mostly of white race (67%), median age of 37 years old (IQR=14), mosto f them had low schooling. Around 70% acquired the vírus through sexual transmission. Compared to the total of cases, those notified by the death criteria have proportionally more individuals of the black race (46,1% and 32,5%, respectively) and more males (40% and 27,8%, respectively). The proportion of incomplete data is also higher for scholarity (72,1% and 68,7% respectively) and CD4+ T lymphocite cell count (76% e 68%, respectively). Blood transmission, black race and low scholarity were associated with a higher risk of death in the bivariate analysis. Female gender and age over 30 years were factors associated with a low risk of AIDS-related death. In the multivariate model black race, blood transmission of the vírus e low scholarity were factors associated with higher mortality. Mean survival was of 1495 days (95% CI 1449 – 1550). The proportion of incomplete data suggests that the linkage scales the underreporting but doesn’t qualify the surveillance process. Death criterion represents missed opportunities of interventions in preventable events, and might serve as negative indicator of the surveillance.
347

Electronic Bedside Documentation and Nurse-Patient Communication: A Dissertation

Gaudet, Cynthia 25 April 2014 (has links)
Nurses are often the first members of the health care team with whom patients interact. The initial impression of the nurses’ receptiveness to the patients’ needs influences the patients’ views of their overall care. Researchers have suggested that understanding communication between individuals can provide the human link, or social element, to the successful implementation and use of electronic health records, including documentation (Lanham, Leykum, & McDaniel, 2012). Zadvinskis, Chipps, and Yen (2014) identified that the helpful features of bedside documentation systems were offset by the mismatch between the system and nurse’s workflow. The purpose of this micro-ethnography study was to explore the culture of nurse-patient interaction associated with electronic documentation at the bedside. Data were collected through passive participant observation, audio-taping of the nurse-patient interactions, and informal and semi-structured interviews with the nurses. A total of twenty-six observations were conducted on three nursing units at an urban healthcare facility in New England. These three units were occupied by similar patient populations and all patients required cardiac monitoring. Three themes consistently emerged from qualitative data analysis: the nurses paused during verbal communication, the nurses played a game of tag between the patient and the computer, and the nurses performed automatic or machine-like actions. The participants described these themes in the informal and semi-structured interviews. The nurses’ actions were observed during passive participant observation, and the audio-taped interactions supported these themes. Understanding the adaptation of caregiving necessitated by bedside electronic documentation will have a positive impact on developing systems that interface seamlessly with the nurses’ workflow and encourage patients’ active participation in their care.
348

Avaliação do grau de conformidade às normas e recomendações em gestão da segurança da informação digital em hospitais / Assessment of the level of conformity of hospitals to electronic information security standards and recommendations

Gottberg, Heitor Neves [UNIFESP] 28 July 2010 (has links) (PDF)
Made available in DSpace on 2015-07-22T20:49:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-07-28 / CONTEXTO: A confidencialidade, integridade e disponibilidade das informações de pacientes são demandas intrínsecas aos serviços hospitalares e, atualmente, a informatização vem crescendo no dia a dia operacional destas instituições. OBJETIVO: O objetivo desta pesquisa é realizar uma avaliação exploratória sobre o grau de conformidade de um grupo de hospitais aos requisitos de gestão da segurança da informação digital a partir de normas e recomendações da literatura quando do uso dos sistemas de registro eletrônico de saúde (S-RES). MÉTODOS: A partir do estudo de normas internacionais e da resolução 1821/07 do CFM, desenvolvemos um ―padrão ouro‖ da gestão da segurança da informação e dos Sistemas de Registro Eletrônico em Saúde, elaborando um questionário disponibilizado via Internet onde cada hospital pode conseguir um grau estimado de conformidade com este padrão e identificar quais áreas estão mais (ou menos) próximas do nível desejável. RESULTADOS: A partir das respostas obtidas com um grupo de hospitais, obtivemos um grau de conformidade médio em processos de gestão de segurança da informação de 37% (em uma escala de 0% a 100%) e de 38% na conformidade dos S-RES. CONCLUSÃO: Concluímos demonstrando que o tema da segurança da informação é incipiente nas preocupações e investimentos hospitalares e que, apesar de existir material específico, os gestores ainda não implementaram as soluções que atendam às características específicas do setor de saúde. / CONTEXT: Confidentiality, integrity and availability of patient information are intrinsic to hospital services and nowadays computerization is growing in day to day operations of these institutions. OBJECTIVE: This work intends to assess the level of conformity to the standards and literature recommendations in Information Security of an exploratory group of hospitals using Electronic Health Records Systems (EHR-S). METHODS: From the study of international standards and of resolution 1821/07 of the Federal Council of Medicine (CFM), we have developed a ―gold standard‖ of information security management and electronic health record systems, elaborated a questionnaire and released it via the Internet where each hospital can achieve an ―estimated‖ degree of compliance with this standard and identify which areas are more (or less) compliant to this desirable level. RESULTS: From the replies obtained with a group of hospitals, we have seen an average a degree of compliance of 37% in information security management processes (on a scale from 0% to 100%) and 38% in compliance of EHR-S. CONCLUSION: We finalize showing that the issue of information security management (ISM) is incipient on concerns and investments of hospitals, and that even though specific knowledge and material is available, managers have not yet implemented solutions that meet the specific characteristics and information security demands of the healthcare industry. / TEDE / BV UNIFESP: Teses e dissertações
349

O SUS, o DATASUS e a informação em saúde: uma proposta de gestão participativa / The SUS, DATASUS and health information: a proposal for participatory management

Ferraz, Lygia Helena Valle da Costa January 2009 (has links)
Made available in DSpace on 2011-05-04T12:36:27Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / O DATASUS é um órgão pertencente à Secretaria Executiva do Ministério da Saúde cujo funcionamento relaciona-se diretamente à ação produtora, receptora, ordenadora e disseminadora de informações. Identifica-se que a questão da informação tem forte relação com o processo democrático. Neste sentido, o objetivo deste trabalho é refletir sobre a conformação de um processo de gestão participativa (práticas e saberes) que possibilite a interlocução de órgãos do governo, instituições de ensino e pesquisa, associações científicas e outras instâncias representativas da sociedade, no âmbito do DATASUS, visando enfrentar os desafios de desenvolvimento, pesquisa e incorporação de Tecnologia de Informação em saúde. Pretende-se, assim, propiciar melhores condições de gestão, disseminação de informações para as ações de saúde, em consonância com a Política Nacional de Saúde. O presente trabalho inicia-se com uma breve apresentação do contexto histórico que envolveu a criação do DATASUS e dos Sistemas de Informação em Saúde SIS. Apresenta, ainda, conceitos e reflexões acerca da informação sob diferentes enfoques: as potencialidades das bases de dados na produção da informação, a relação entre o Estado e a informação, sob a ótica da área da Tecnologia da Informação (TI), identifica estágios de maturidade desta área nas organizações. Em seguida, desenvolve-se uma análise do DATASUS e sua relação com o SUS sob dois aspectos: O primeiro tendo como referência o contexto jurídico e o segundo buscando identificar o grau de visibilidade e permeabilidade do DATASUS em sua inserção no universo do SUS a partir da análise das reuniões da Comissão Intergestores Tripartite12 que ocorreram no período de 2006 até julho de 2009. Finalmente são apresentados conceitos relativos à participação popular buscando uma aproximação da possível composição da instância de gestão participativa proposta. / DATASUS, the Information Department of Brazil’s Unified National Health System, belongs to the Executive Secretariat of the Ministry of Health. The Department’s work pertains directly to producing, receiving, organizing, and disseminating information. According to widespread agreement, information is closely related to the democratic process. In this sense, the current study’s objective is to reflect on the establishment of a participatory management process (including practices and knowledge) that fosters dialogue between government agencies, teaching and research institutions, scientific associations, and other representative organizations of society within the sphere of DATASUS, aimed at tackling the challenges of developing, researching, and incorporating information technology in health. The goal is thus to promote better conditions for managing and disseminating information for health-related activities, in keeping with Brazil’s National Health Policy. The study begins with a brief overview of the historical context involving the creation of DATASUS and the Health Information Systems. The study also presents concepts and reflections on information from different approaches: the potentialities of databases for producing information and the relationship between the state and information from the perspective of information technology (IT), identifying the related stages of maturity in organizations. Next, the author develops an analysis of DATASUS and its relationship to the Unified National Health System (SUS) on two key issues. The first relates to the legal context, and the second seeks to identify the degree of visibility and permeability of DATASUS as part of the National Health System, based on an analysis of the meetings of the Tripartite Intergovernmental Commission12 held from 2006 to July 2009. The study concludes by presenting concepts on popular participation, seeking an approach to the possible make-up of the proposed participatory management authority.
350

O círculo vicioso da Leptospirose: ampliando o conceito de negligência em saúde no Brasil

Rodrigues, Cláudio Manuel January 2016 (has links)
Submitted by Claudio Rodrigues (cmrodrigues@fiocruz.br) on 2016-06-28T19:14:00Z No. of bitstreams: 1 CLAUDIO RODRIGUES_DISSERTAÇAO CORRIGIDA .pdf: 2265812 bytes, checksum: 68f7d8387b81a68dfe4e2de14e1cb850 (MD5) / Approved for entry into archive by Vanessa Suane (vanessa.suane@icict.fiocruz.br) on 2016-06-30T13:57:52Z (GMT) No. of bitstreams: 1 CLAUDIO RODRIGUES_DISSERTAÇAO CORRIGIDA .pdf: 2265812 bytes, checksum: 68f7d8387b81a68dfe4e2de14e1cb850 (MD5) / Made available in DSpace on 2016-06-30T13:57:52Z (GMT). No. of bitstreams: 1 CLAUDIO RODRIGUES_DISSERTAÇAO CORRIGIDA .pdf: 2265812 bytes, checksum: 68f7d8387b81a68dfe4e2de14e1cb850 (MD5) Previous issue date: 2016 / Made available in DSpace on 2016-07-13T19:26:55Z (GMT). No. of bitstreams: 3 CLAUDIO RODRIGUES_DISSERTAÇAO CORRIGIDA .pdf.txt: 244228 bytes, checksum: d272b68943e8fa361482f6a470d564f7 (MD5) license.txt: 2991 bytes, checksum: 5a560609d32a3863062d77ff32785d58 (MD5) CLAUDIO RODRIGUES_DISSERTAÇAO CORRIGIDA .pdf: 2265812 bytes, checksum: 68f7d8387b81a68dfe4e2de14e1cb850 (MD5) Previous issue date: 2016 / Fiocruz. Centro de Desenvolvimento Tecnológico em Saúde / A leptospirose é a zoonose de maior incidência mundial, apesar de não haver uma confiável estimativa de sua carga global. Calcula-se que anualmente ocorram mais de um milhão de casos no mundo, o que possivelmente leve a 58.900 óbitos em todo planeta. No Brasil, o Ministério da Saúde vem empregando esforços para qualificar o diagnóstico e o tratamento da doença, mas que não necessariamente repercute na elevação do número de notificações de suspeitos. Sendo assim, foi proposta a Matriz do Círculo Vicioso da Negligência da Leptospirose no Brasil avaliando diversos aspectos inerentes a falta de um diagnóstico mais precoce e preciso para evitar a subnotificação de casos e a falta de uma real incidência e de carga global da doença, o que impactaria diretamente no planejamento da gestão em saúde, corroborada por pesquisa de opinião com especialistas defendendo a visão da negligência para com a informação em saúde no Brasil. A coleta de dados foi realizada por um questionário eletrônico, do tipo opinião, e disponibilizada através de e-mail a profissionais e pesquisadores selecionados previamente através de parâmetros curriculares na Plataforma Lattes. Como uma síntese do resultado podemos afirmar que, no geral, tanto os pesquisadores quanto os profissionais em saúde humana e animal foram coesos quanto à adesão às premissas enunciadas. Das 22 questões apenas três foram fortemente refutadas, o que confere certo grau de adesão às premissas apresentadas, agregando valor simbólico à matriz proposta. / Leptospirosis is the worldwide most incident zoonosis in the world, although there is no estimate global load that can be trustable. The annual appraisal cases suggested more than a million cases in a globally analysis, what may lead to a death rate near 58.900 people. Therefore, to leptospirosis ongoing circle matrix was proposed in Brazil to evaluate inherent features of the disease, as the lack of a real incidence rate, by means of underreporting and the absence of a precise global charge disease information. These two factors has an impact that could inevitably lead to a lack of awareness to implement forthright health planning emplacement in the future, by Brazilian government, coupled to the fact that the country public health specialist standpoints agreed with the lack of this reliability about Brazilian health data. The process of data gathering was performed by statement opinion electronic quiz, sent by email to previously selected researchers trough curriculum background criteria at Plataforma Lattes. As a synthesis of the results, we could assure allege that as well as researchers and professionals, even at human or animal health agreed with the prior placed assumptions. Only three of 22 questions at the quiz were contested, which besides conferring some adhesion to the previously presented assumptions, also adds emblematic value to the proposed matrix.

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