Made available in DSpace on 2014-12-17T15:38:41Z (GMT). No. of bitstreams: 1 VanessaABMG.pdf: 453215 bytes, checksum: 24ae84f6ac14ea21a38c45ddaeeb8fed (MD5) Previous issue date: 2008-06-11 / Violence is a complex and multifarious phenomenon that has convoked the government to think about strategies to face the question. This work is about one of these strategies proposed by brazilian Health Minister: the Individual notification/investigation Card - Domestic Violence, Sexual and/or others Interpersonal Violences . This instrument is a notification protocol which is been implanted in all of the country. This process is in course in Natal/RN. This work is a report of one research realized in five units of basic health care network of Natal/RN concerning this process about the implementation of the violence notification card. The study aims to cartography all the process of card implantation, discussing the used strategies, the drawn course, difficulties and possibilities as well as how the researcher intended to map subjective process involved at health professional acting at violence case and the propose to use the card. Meetings were held at each unit and a daily fieldwork report was used as research instrument. In this investigation it was observed that notifying violence involves a complexity that is not present in other kinds of notification as consequence of the phenomenon characteristic and health workers are invited to act in different perspective that knowledge and instruments of traditional health fieldwork available does not work. It was observed that the notification card, as a possible instrument of intervention, are considered important detectors from process of work at health basic care and health policies. Depending the way the instrument is used, it may incentive different discussions and manners to offer health care or in other way it can reproduce control and vigilance logics. Consequently it is necessary to consider some factors pointed out at this experience, implanting instruments like this, thinking about these limits and possibilities / A viol?ncia ? um fen?meno complexo e multicausal que tem convocado o poder p?blico a desenvolver estrat?gias para o seu enfrentamento. O presente estudo versa sobre uma dessas estrat?gias propostas pelo Minist?rio da Sa?de: a Ficha de Notifica??o/Investiga??o Individual Viol?ncia Dom?stica, Sexual e/ou outras Viol?ncias Interpessoais . Tal instrumento se trata de um protocolo de notifica??o que vem sendo implantado em todo o pa?s. Este processo encontra-se em andamento no munic?pio de Natal/RN. Este trabalho ? o relato de uma pesquisa realizada em cinco unidades da rede b?sica de sa?de do munic?pio acerca do processo de implanta??o da ficha de notifica??o da viol?ncia. Teve como objetivos realizar uma cartografia de todo o processo envolvido na implanta??o da ficha, problematizando as estrat?gias utilizadas, o percurso tra?ado, as dificuldades e possibilidades, bem como pretendeu mapear os processos subjetivos que atravessam a atua??o dos profissionais de sa?de frente ?s demandas da viol?ncia e ? proposta de uso deste instrumento. Metodologicamente, foram realizados encontros com cada um dos servi?os e se fez uso de um di?rio de campo. Nessa investiga??o percebeu-se que notificar a viol?ncia envolve complexidades n?o presentes em outros tipos de notifica??es pelas pr?prias caracter?sticas do fen?meno viol?ncia, pois os profissionais s?o convocados a assumirem posturas para as quais os conhecimentos e instrumentos tradicionais em sa?de n?o respondem satisfatoriamente. Percebeu-se que a ficha de notifica??o, enquanto instrumento poss?vel de interven??o, configura-se como um analisador importante dos processos de trabalho da aten??o b?sica e das pol?ticas da ?rea. Dependendo de como for manejado, esse instrumento pode ter a pot?ncia de suscitar novas discuss?es e modos de ofertar sa?de, mas tamb?m de reproduzir uma l?gica de controle e vigil?ncia. Faz-se necess?rio, ent?o, considerar alguns fatores apontados nessa experi?ncia quando da implanta??o de instrumentos como esse, problematizando seus limites e suas potencialidades

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-08-25T20:40:47Z No. of bitstreams: 1 CleoniceAndreaAlvesCavalcante_TESE.pdf: 8036565 bytes, checksum: efa569bc829aa595c30731ac52f5d5a7 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-26T19:35:54Z (GMT) No. of bitstreams: 1 CleoniceAndreaAlvesCavalcante_TESE.pdf: 8036565 bytes, checksum: efa569bc829aa595c30731ac52f5d5a7 (MD5) / Made available in DSpace on 2016-08-26T19:35:54Z (GMT). No. of bitstreams: 1 CleoniceAndreaAlvesCavalcante_TESE.pdf: 8036565 bytes, checksum: efa569bc829aa595c30731ac52f5d5a7 (MD5) Previous issue date: 2016-01-28 / As doen?as e agravos relacionados ao trabalho configuram-se em importante problema de Sa?de P?blica no Brasil e no mundo. No entanto, a realidade desses agravos ainda se constitui em uma lacuna no que diz respeito ? caracteriza??o e situa??o epidemiol?gica das mesmas, especialmente no Brasil. Diante disso, o presente estudo teve como objetivo analisar a magnitude da morbidade relacionada ao trabalho no Estado do Rio Grande do Norte, no per?odo de 2007 a 2014. Trata-se de um estudo ecol?gico, quantitativo de delineamento transversal, tendo como unidade de an?lise os munic?pios do estado do Rio Grande do Norte. Os dados foram coletados a partir da base estadual do Sistema de Informa??es de Agravos Notific?veis (SINAN) do Centro de Refer?ncia de Sa?de do Trabalhador (CEREST) da Secretaria de Estado da Sa?de P?blica do Rio Grande do Norte. A coleta de dados ocorreu entre mar?o e junho de 2015, ap?s a aprova??o do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte, atrav?s do Parecer N? 014/2014. A popula??o foi representada pelo universo de casos de doen?as e agravos relacionados ao trabalho que foram notificados e encerrados no sistema no per?odo de 2007 a 2014. Os dados foram organizados em banco de dados eletr?nicos do Microsoft Excel vers?o 2010 e exportados para o programa estat?stico SPSS vers?o 20.0, analisados por meio da estat?stica descritiva e anal?tica, apresentados em forma de tabelas e gr?ficos. Para tanto, utilizou-se o Microsoft Excel 2007 e um software estat?stico. Dos 10.161 casos de agravos relacionados ao trabalho notificados, destacaram-se os acidentes biol?gicos (52,84%) e de trabalho grave (37,49%). Quanto ?s doen?as, destacaram-se as osteomusculares (4,82%), transtornos mentais (2,19%) e intoxica??o ex?gena (1,97%). Houve predomin?ncia dos agravos entre homens nos acidentes graves (91,80%), transtornos mentais (70,00%) e intoxica??es ex?genas (52,84%). As mulheres foram mais acometidas por acidente biol?gico (77,50%) e doen?as osteomusculares (64,10%). Entre os agravos predominou a cor parda, m?dia de 35,86 anos de idade, baixa escolaridade e trabalhadores no mercado formal. Dentre os acidentes ocupacionais, destacaram os biol?gicos (n=5.369) que corresponderam a 52,84% com predom?nio de casos entre os profissionais de enfermagem (48,31%). A exposi??o percut?nea foi a mais frequente (73,05%) e as circunst?ncias de ocorr?ncia foi o descarte inadequado de perfurocortantes (45,28%), a agulha o agente mais comum (66,62%) e o material org?nico foi o sangue (72,99%). A maioria dos trabalhadores acidentados era vacinada contra HBV (68,13%), por?m sem informa??o quanto ? avalia??o da resposta vacinal. A evolu??o dos casos predominou a situa??o ignorada com perda de acompanhamento do seguimento cl?nico. Houve ainda aumento na notifica??o de acidentes de trabalho grave com predomin?ncia: sexo masculino, trabalhadores entre25 a 44 anos e do acidente t?pico. A incapacidade tempor?ria ? evolu??o mais comum e a m?o a parte mais atingida; a ind?stria extrativa e da constru??o civil teve o maior n?mero de casos e o empregado registrado. Constatou-se um aumento expressivo na notifica??o dos agravos relacionados ao trabalho no per?odo analisado, sobretudo os acidentes. Em rela??o ?s doen?as, observou-se um aumento nos casos de doen?as osteomusculares, transtornos mentais e intoxica??o ex?gena. No entanto, o sistema de informa??o ainda carece de melhoria tanto na cobertura como na qualidade dos dados no sentido de demonstrar com maior fidedignidade a magnitude dos eventos para subsidiar o planejamento das a??es em Sa?de do Trabalhador no estado. / Diseases and disorders related to work sets up an important public health problem in Brazil and worldwide. However, the reality of these diseases still constitutes a gap with regard to its characterization and epidemiological situation, especially in Brazil. In this context, this study aims to analyze the magnitude of morbidity related to work from the injuries and illnesses reported by Health the Diseases Notifiable of Health of the State Public River Health Department worker Reference Center Information System services Grande do Norte from 2007 to 2014. It is ecological study, quantitative cross-sectional study in which the analysis unit of the municipalities of Rio Grande do Norte. Data were collected from the state base of Diseases Notifiable Information System Centre of the Secretariat of State Workers' Health Reference Public Health of Rio Grande do Norte, between March and June 2015, after the approval of the Committee of Ethics in Research of the Federal University of Rio Grande do Norte, Opinion 014/2014. The population was represented by the universe of cases of diseases and disorders related to work that were reported and shut down the system from 2007 to 2014. Data were analyzed using descriptive and inferential statistics, presented in tables, graphs, charts and figures. For this, we used the Microsoft Excel 2007 and SPSS version 20.0. To check the significance level we opted for the application of the chi-square or Fisher tests. We adopted the significance level of p <0.05. Of the 10,161 cases of diseases related to the reported work, the biological work accidents had the highest percentage (52.84%) followed by serious occupational accidents (37.49%). For diseases, the highlights were musculoskeletal (4.82%), mental disorders (2.19%) and exogenous intoxication (1.97%). Among men, there was a predominance of major accidents (91.80%), mental disorders (70.00%) and exogenous poisoning (52.84%). Women were most affected by biological accidents (77.50%) and musculoskeletal diseases (64.10%). Among workers who have suffered injuries predominated mulatto (%), mean age of 35.86 years, low education (%) and workers in the formal sector (%). Among the accidents, biological (n = 5,369) accounted for 52.84% of cases occurred predominantly among nursing professionals (48.31%). The percutaneous exposure was the most frequent (73.05%) and the occurrence of circumstances was improper disposal of sharps (45.28%), the needle the most common agent (66.62%) and the organic material was blood (72.99%). Most injured workers were vaccinated against hepatitis B (68.13%), but no information as to the assessment of the vaccine response. In the course of the disease predominated ignored the situation with loss of monitoring of clinical follow-up (55.62%). There was also an increase in the notification of serious industrial accidents predominantly male (91.80%) workers aged 25-44 years (54.3%) and typical accidents (76.3%). The temporary disability was the most common outcome (55.53%) and hand the most affected part (33.00%); the mining and construction industry had the highest number of cases (25.1%) in registered employee (34.2%). The findings of this study show a positive result in relation to increased mandatory reporting of injuries and illnesses related to work together to health services that meet victimized workers, towards the occurrence of knowledge of these accidents for decision making in public plans and policies of health. However, the information system still needs improvement in both the coverage and the quality of the data to demonstrate with greater reliability the magnitude of events to support the planning of workers' health into shares in the state.

Sub-?rea de concentra??o: Sa?de e Biol?gicas. / Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:55:10Z No. of bitstreams: 2 walber_antonio_lima.pdf: 4878433 bytes, checksum: c24021a7e230463e47eae78ab1e296f8 (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:55:52Z (GMT) No. of bitstreams: 2 walber_antonio_lima.pdf: 4878433 bytes, checksum: c24021a7e230463e47eae78ab1e296f8 (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:56:47Z (GMT) No. of bitstreams: 2 walber_antonio_lima.pdf: 4878433 bytes, checksum: c24021a7e230463e47eae78ab1e296f8 (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Made available in DSpace on 2015-01-09T16:56:47Z (GMT). No. of bitstreams: 2 walber_antonio_lima.pdf: 4878433 bytes, checksum: c24021a7e230463e47eae78ab1e296f8 (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Previous issue date: 2013 / Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG) / Funda??o Diamantinense de Apoio ao Ensino, Pesquisa e Extens?o (FUNDAEP) / O cruzamento das informa??es advindas do Sistema de Informa??o de Agravos de Notifica??o (SINAN), com as do Servi?o de Aten??o Especializada (SAE) onde funciona o Centro de Testagem e Aconselhamento (CTA) da Acquired Immunodeficiency Syndrome (Aids), juntamente com a constru??o de mapas tem?ticos com auxilio do Sistema de Informa??o Geogr?fica (SIG), s?o ainda um desafio para as gest?es loco-regionais e demandam estudos mais detalhados. Objetivo - Compreender o funcionamento do Centro de Testagem e Aconselhamento (CTA) de Diamantina, com ?nfase na distribui??o espacial dos pacientes acompanhados pelo servi?o no per?odo de 1996 a 2012. Metodologia - Trata-se de um estudo transversal, de car?ter avaliativo, com an?lise descritiva. As microrregi?es de sa?de de Diamantina e de Minas Novas/Turmalina/Capelinha tem como sede Diamantina, no Alto Vale do Jequitinhonha (Minas Gerais), referencia para HIV/Aids. Foram utilizados os registros de HIV/Aids desde 1996 at? 2012. As informa??es do SINAN e dos prontu?rios cl?nicos do SAE/CTA foram tabuladas e analisadas utilizando os programas Microsoft Office?, Excel, al?m do ArcGIS? (Vers?o 9.2) para confec??o dos mapas. Resultados - A popula??o da micro de Diamantina comp?e-se de 166.961 habitantes e da micro Minas Novas/Turmalina/Capelinha comp?e-se de 119.551 habitantes, totalizando juntas 286.512 habitantes. A preval?ncia do HIV/Aids em rela??o ? popula??o total: no CTA 112 casos com a taxa em 39,09% por 100.000 habitantes e no SINAN 148 casos com 51,65% / 100.000 habitantes. Os dados para a preval?ncia da doen?a s?o discordantes para as duas micros. Na vari?vel ra?a/cor (branca/preto/pardo/ignorado), o mais freq?ente foi o ignorado. Discuss?o - O SAE/CTA de forma regionalizada tem que trazer funcionalidade para os moradores da macrorregi?o. Esse tipo de atendimento al?m de desafogar os grandes centros urbanos permite ao servi?o local o acolhimento e o acompanhamento humanizado, o que pode ser revertido em indicadores confi?veis e a ades?o ao tratamento. Quanto ? avalia??o do funcionamento do SAE/CTA, esses centros constituem um conjunto de servi?os heterog?neos e as diretrizes que norteiam a implanta??o dos servi?os n?o est? plenamente em funcionamento, o que pode refletir nos baixos indicadores de resolubilidade e produtividade. Conclus?o - A investiga??o da distribui??o espacial dos pacientes HIV/Aids revelou que as vari?veis faixa et?ria, sexo e munic?pio e microrregi?o de origem s?o consistentes e permitem esta visualiza??o, enquanto as demais, em especial ra?a/cor, escolaridade e categoria de exposi??o ainda necessitam de melhorias no preenchimento das fichas cl?nicas e na completude dos campos do SINAN. Quanto ? concord?ncia entre os dados do SINAN e SAE/CTA, o estudo verificou que esta ocorre parcialmente, uma vez que se est? trabalhando com bases distintas, cada uma com caracter?stica peculiar, no decorrer da trajet?ria de longos anos da doen?a e do servi?o. A qualidade das informa??es precisa ser aprimorada, caso contr?rio corre-se o risco de implementa??o de a??es de controle, sem que o seu impacto sobre a resolu??o do problema possa ser avaliado com base em evid?ncias. A produ??o dos mapas tem?ticos contribuiu na visualiza??o dos indicadores estudados, o que nos leva a recomendar o uso do SIG na sa?de em qualquer regi?o de abrang?ncia e cobertura. Para um servi?o de boa qualidade no SAE/CTA, s?o imprescind?veis ainda investimentos na educa??o permanente para gestores e t?cnicos, como por exemplo, para uso de ferramentas modernas. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / ABSTRACT The crossing of the information from the Information System for Notifiable Diseases (SINAN), with the ones from Specialized Care Service (SAE) where the Counseling and Testing Center (CTA) of the Acquired Immunodeficiency Syndrome (Aids) operates, with the production of thematic maps using the Geographic Information System (GIS), are still a challenge for local and regional administrations and require more detailed studies. Objective ? To understand how works the Testing and Counseling Center (CTA) of Diamantina, with focus in the spatial distribution of patients that were followed by this service during 1996 to 2012 period. Methodology - This is a transversal study, which has an evaluative character, with descriptive analysis. The health micro-regions of Diamantina and of Minas Novas/Turmalina/Capelinha have their seat in Diamantina, located in Alto Vale do Jequitinhonha (Minas Gerais), which is a reference to HIV/Aids. We used HIV/Aids records from 1996 to 2012. The information from SINAN and from SAE/CTA clinical records were tabulated and analyzed using the Microsoft Office?, Excel, and ArcGIS ? (Version 9.2) for maps production. Results - The population of micro Diamantina consists of 166 961 inhabitants and of micro Minas Novas/Turmalina/Capelinha consists of 119 551 inhabitants, totaling together 286 512 inhabitants. The prevalence of HIV/Aids in relation to the total population: in CTA 112 cases with the rate at 39.09% 100,000 habitants and in SINAN 148 cases with 51.65% /100,000. The data for the prevalence of the disease are discordant for the two micro-regions. In the variable race/color (white/black/brown/ignored), the most frequent was the ignored. Discussion - The SAE/CTA, on a regional way, has to bring functionality to the residents of the macro-region. This type of care, in addition to unburden the big urban centers, allows to the local service an humanized reception and monitoring, which can be reversed in reliable indicators and adherence to treatment. As for the evaluation of the functioning of SAE/CTA, these centers are a set of heterogeneous services and the guidelines for implementation of the services are not fully functioning, which may reflect in the low resolution and productivity indicators. Conclusion - The investigation of the spatial distribution of HIV/Aids patients revealed that the variables age, sex and city and micro-region of origin are consistent and allow this view, while the others, especially race/color, education and exposure category still require improvements in filling out of clinical records and in completing SINAN fields. Regarding the agreement between SINAN and SAE/CTA data, the study found that it occurs partly, because different bases are being used, each one with a singular characteristic, during the course of long years of the disease and the service. The quality of information needs to be improved, otherwise control actions can be implemented without their impact on the resolution of the problem can be evaluated based on evidence. The production of thematic maps contributed to the view of the indicators studied, which leads us to recommend the use of GIS in health in any region of scope and coverage. For a good quality service in SAE/CTA, investments in continuing education for managers and technicians are still essential, for example, for the use of modern tools.

Submitted by SBI Biblioteca Digital (sbi.bibliotecadigital@puc-campinas.edu.br) on 2017-03-23T16:32:26Z No. of bitstreams: 1 TIAGO FERRAZ DE ARRUDA E AGUIRRE.pdf: 2934402 bytes, checksum: 0c5e2b67a128e05fdf51ba8be3b36d3d (MD5) / Made available in DSpace on 2017-03-23T16:32:26Z (GMT). No. of bitstreams: 1 TIAGO FERRAZ DE ARRUDA E AGUIRRE.pdf: 2934402 bytes, checksum: 0c5e2b67a128e05fdf51ba8be3b36d3d (MD5) Previous issue date: 2017-02-09 / Pontif?cia Universidade Cat?lica de Campinas ? PUC Campinas / Brazil is a Federative Republic with 5,641 municipalities, and 94% of them (5,336) with less than 100,000 inhabitants, and 72% (4,074) with less than 20,000 inhabitants. Due to the low investment in urban planning and disaster forecast, the public sector response time of cities, state and federation is longer than the expected by the population that need to live with tragedy imminent risk. Financial resources restriction of small cities together with low investment in ICT solutions to improve the quality of the services delivered to the population. However, the financial impact after tragedy is significant. Considering the expenses increase with disasters impacts and the disaster planning financial investment resources restriction context, the use of open standards in network components (sensors, hubs, proxies, database systems), with cloud data processing, allows solution design and implementation to leverage the natural disasters management planning in small cities with effectiveness and cost significantly lower than the currently available solutions. This study deals with the proposition and implementation of a flood risk management system, allowing its integration with sensor networks with to assist risk analysts in identifying and warning floods, enabling notification service through mobile devices of the interested community. This work seeks to minimize mainly the social and financial damage caused by floods. / Brasil ? uma Rep?blica Federativa que possui 5.641 munic?pios sendo 5.336 deles (94%) com popula??o inferior a 100.000 habitantes, e 4.074 com popula??o inferior a 20.000 habitantes (72%). Com pouco investimento em planejamento urbano e na antecipa??o de desastres, o tempo de atendimento do setor p?blico, na esfera municipal, estadual ou federal est? aqu?m do esperado pela popula??o que precisa conviver com o risco iminente de trag?dia. A restri??o de recursos financeiros nos munic?pios pequenos corrobora com o baixo investimento em solu??es de tecnologia de informa??o e comunica??es para melhorar a qualidade dos servi?os prestados ? popula??o. Considerando o crescimento das despesas com impactos de desastres e o contexto de restri??o de recursos financeiros para investimento em planejamento e antecipa??o de desastres, a utiliza??o de padr?es abertos nos elementos da rede (sensores, aglutinadores e replicadores de dados (proxies) e sistemas de banco de dados), em conjunto com processamento de dados em nuvem (cloud computing), possibilita o projeto e implementa??o de solu??o para apoiar o planejamento e gest?o de desastres naturais em pequenos munic?pios com boa assertividade e custo significativamente inferior ?s solu??es atualmente dispon?veis. Este trabalho trata da proposi??o e implementa??o de um sistema de ger?ncia de risco de enchentes, possibilitando sua integra??o com redes de sensores para auxiliar os analistas de riscos na identifica??o e alerta de possibilidade de enchentes, ativando servi?o de notifica??es por meio de dispositivos m?veis da comunidade interessada. Busca-se minimizar, principalmente, os preju?zos sociais e financeiros ocasionados por enchentes.