Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-01-22T11:05:18Z No. of bitstreams: 1 AndresadaCunhaSuaresDissertacaoParcial2017.pdf: 145410 bytes, checksum: 5bf4fccd3f065ddfa1b74986b17838b7 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-01-22T11:06:04Z (GMT) No. of bitstreams: 1 AndresadaCunhaSuaresDissertacaoParcial2017.pdf: 145410 bytes, checksum: 5bf4fccd3f065ddfa1b74986b17838b7 (MD5) / Made available in DSpace on 2018-01-22T11:06:04Z (GMT). No. of bitstreams: 1 AndresadaCunhaSuaresDissertacaoParcial2017.pdf: 145410 bytes, checksum: 5bf4fccd3f065ddfa1b74986b17838b7 (MD5) Previous issue date: 2017-08-07 / UCB / Respiratory diseases, including influenza virus infection and its complications are major causes of mortality particularly in the elderly. Influenza vaccination has emerged as a national strategy to reduce the impact on mortality from respiratory diseases in the elderly and has been managed since 1999. This study aimed to evaluate the impact of influenza vaccination on the mortality trend from respiratory diseases in the Brazilian elderly population (??? 60 years), in the period from 2008 to 2014. Deaths from respiratory diseases associated with influenza were analyzed according to gender and age and compared to vaccination coverage against influenza in the study population. This observational, longitudinal mixed-type ecological study combined different time periods and territories in different age groups. Secondary data from the Mortality Information System of the Ministry of Health (SIM / MS), National Immunization Program Information System (NIP-SI) and estimates from the Brazilian Institute of Geography and Statistics (IBGE) were used. Mortality rates for selected causes were related with the age of the study population. Moreover, higher mortality rates were observed among men and among residents in the South and Southeast regions of Brazil. Mortality coefficients did not show a significant increase in the year 2009 when the first pandemic of the 21st century occurred due to Pandemic Influenza (H1N1). Mortality rates from respiratory diseases and influenza vaccination coverage were not correlated. The present study assessed the impact of influenza vaccination on mortality rates of elderly people nationwide through a historical data series. However the seasonality of influenza virus must be considered in order to determine preventive actions and guide local public health policies. / As doen??as respirat??rias, entre elas a infec????o pelo v??rus influenza e suas complica????es, constituem importante causa de mortalidade particularmente entre os idosos. A vacina????o contra esta doen??a surgiu como estrat??gia nacional de impacto na redu????o da morbimortalidade de idosos por doen??as do aparelho respirat??rio e vem sendo administrada desde 1999. O objetivo do presente estudo foi avaliar o impacto da vacina????o contra influenza no comportamento da mortalidade por doen??as respirat??rias na popula????o idosa brasileira (??? 60 anos), no per??odo de 2008 a 2014. Foi realizada an??lise da ocorr??ncia de ??bitos por doen??as respirat??rias associadas ?? influenza, segundo sexo e faixa et??ria estratificada, comparando com a cobertura vacinal contra a gripe na popula????o em estudo. Trata-se de estudo observacional, do tipo ecol??gico longitudinal misto, combinando diferentes per??odos de tempo e agregado territorial em diferentes faixas et??rias definidas, utilizando-se dados secund??rios do Sistema de Informa????es em Mortalidade do Minist??rio da Sa??de (SIM/MS), Sistema de Informa????es do Programa Nacional de Imuniza????o (SI-PNI) e estimativas do Instituto Brasileiro de Geografia e Estat??stica (IBGE). Observaram-se tend??ncias crescentes nas taxas de mortalidade com o aumento da idade da popula????o em estudo. Al??m disso, valores mais elevados desses indicadores foram observados em homens e nos residentes nas regi??es Sul e Sudeste. Os coeficientes de mortalidade n??o mostraram eleva????o significativa no ano de 2009, no qual ocorreu a primeira pandemia do s??culo XXI pela Influenza Pand??mica (H1N1). Ao comparar a taxa de mortalidade por doen??as respirat??rias e a cobertura vacinal contra influenza n??o foi observado o resultado desejado de redu????o de ??bitos com o aumento da cobertura. O presente estudo demonstrou uma avalia????o macro da cobertura vacinal contra influenza no perfil de mortalidade de idosos ao mostrar o panorama nacional atrav??s de uma s??rie hist??rica. Entretanto, ?? preciso considerar a sazonalidade do v??rus influenza com vistas a determinar a????es preventivas e subsidiar pol??ticas de sa??de loco regionais voltadas para a especificidade de cada regi??o.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2017-03-16T21:44:40Z No. of bitstreams: 1 DISSERTA??O FERNANDA VERS?O CAPA DURA.pdf: 4333883 bytes, checksum: db37432e4c72154490e1dd23a9328846 (MD5) / Made available in DSpace on 2017-03-16T21:44:40Z (GMT). No. of bitstreams: 1 DISSERTA??O FERNANDA VERS?O CAPA DURA.pdf: 4333883 bytes, checksum: db37432e4c72154490e1dd23a9328846 (MD5) Previous issue date: 2015-12-14 / Funda??o de Amparo ? Pesquisa do Estado da Bahia - FAPEB / Brazil has for forty years with the national immunization program, which provides free vaccinations for the population in all cycles of life. Among the adult population, we highlight the vaccination in you work in the health sector, which have increased risk of getting sick from infectious diseases, within the work, but also outside of it. The aim of this study was to determine the vaccination status of health workers as well as the factors that determine the complete vaccination for adult calendar health ministry. for this, it was built four articles: 1 - vaccination profile of workers in the health sector of Bahia; 2 - Factors associated with vaccination among workers of primary care and medium complexity in Bahia; 3 Immunization status against hepatitis B workers of primary care and medium complexity of Bahia, Brazil; 4 - Vaccination against hepatitis B and Anti-HBs among health workers. It is considered the study of the determination of vaccination among specific groups such as health workers, a chance to build service strategies to maintain its protected population of diseases that have specific immunizations. This study sought to simplify a complex outcome. This was a pioneering study, to investigate the vaccination status and its completeness for all vaccines provided by the health ministry for adults through a methodology that could provide subsidies for triggering preventive actions to SUS workers not only to local reality, but above all national. This study allowed the analysis of information from various realities of working conditions in Bahia related to the vaccination process. Research like this certify that the knowledge produced can be used in public administration. Given the situation of low immunization when investigated the completion of the immunization schedule adults, suggest the workshops with workers linked to the health sector, focused on reducing barriers to access to vaccination strategies to improve the acceptance of immunizations and the perception of the subjects regarding their health. / O Brasil conta h? quarenta anos com o programa nacional de imuniza??o, que garante vacina??o gratuita para a popula??o em todos ciclos da vida. Entre a popula??o adulta, destacamos a vacina??o nos trabalhares do setor sa?de, que possuem risco acrescido de adoecer por doen?as infecciosas, dentro do trabalho, mas tamb?m fora de dele. O objetivo deste estudo foi reconhecer a situa??o vacinal dos trabalhadores da sa?de, bem como os fatores que determinam a vacina??o completa para o calend?rio do adulto do minist?rio da sa?de. para isso, foram constru?dos quatro artigos: 1 - Perfil vacinal dos trabalhadores do setor sa?de da Bahia; 2 - Fatores associados ? vacina??o entre trabalhadores da aten??o prim?ria e m?dia complexidade na Bahia; 3- Situa??o vacinal contra hepatite b em trabalhadores da aten??o prim?ria e m?dia complexidade da Bahia, Brasil; 4 ? Vacina??o contra hepatite B e Anti-HBs entre trabalhadores da sa?de. Considera-se o estudo da determina??o da vacina??o entre grupos espec?ficos, como os trabalhadores da sa?de, uma possibilidade para constru??o de estrat?gias do servi?o para manter sua popula??o protegida de doen?as que possuem imunizantes espec?ficos. Esse trabalho buscou simplificar um desfecho complexo. Tratou-se de um estudo pioneiro, por investigar o estado vacinal e sua completude para todas as vacinas previstas pelo minist?rio da sa?de para adultos atrav?s de uma proposta metodol?gica que pudesse oferecer subs?dios para o desencadeamento de a??es de car?ter preventivo para trabalhadores do SUS n?o apenas para realidade local, mas, sobretudo, nacional. Este estudo possibilitou a an?lise de informa??es de v?rias realidades de condi??es de trabalho na Bahia relacionadas ao processo de vacina??o. Pesquisas como esta certificam que o conhecimento produzido pode ser utilizado na gest?o p?blica. Diante da situa??o de baixa imuniza??o, quando investigada a completude do calend?rio vacinal do adulto, sugere-se a realiza??o de oficinas com os trabalhadores vinculados ao setor sa?de, focadas na redu??o das barreiras de acesso ? vacina??o, em estrat?gias para melhorar a aceita??o de imuniza??es e sobre a percep??o dos sujeitos com rela??o ? sua sa?de.

Made available in DSpace on 2014-12-17T14:46:32Z (GMT). No. of bitstreams: 1 CleoniceACA.pdf: 1045754 bytes, checksum: 23e958d7fcf55b4af799c77dde6db262 (MD5) Previous issue date: 2008-02-16 / The present study analyzes the conceptions and the nursing workers' practices about the relationship between vaccination and biosecurity in a public hospital of reference in communicable diseases in Natal/RN. It is treated, therefore, of a exploratory/descriptive study with qualitative and quantitative approach. They were constituted as collaborators of the research twenty-two nursing professionals, being five nurses, three auxiliary and fourteen technicians in nursing. The information were obtained through the interview technique with semi-structured route. In the quantitative approach, the information were analyzed by statistics and presented in form of tables and graphs to characterize the workers and the aspects related to the vaccination situation of the same ones; and in the qualitative approach, we used the method of content analysis. The analysis was accomplished starting from the categories empiric coming from the process of analysis of the field material, measure through inferences and interpretations based on the authors studied in the theoretical referential of the research. Starting from the analysis of the results, we verified that the nursing interviewees' workers establish in a clear way and it aims at, in your speeches, a direct relationship between vaccination and biosecurity besides attributing a meaning of great importance with relationship to the use of the vaccines in your professional lives in what refers to the control and decrease of the risks, above all the biological ones, to the which are exposed in the daily exercise of your functions. However, when analyzing those workers' vaccination situation, we verified that the vaccination covering still meets on this side of the expected for the vaccines of occupational interest, with prominence just for the vaccines against diphtheria and tetanus and to against hepatitis B, that presented coverings considered very good and above the national average. Considering that the institution, although has a service of health occupational active and offer some vaccines of occupational interest, it still presents a work of little mobilization in what refers to the consciousness and the workers' permanent education with relationship to the need and importance of the occupational vaccination, not only for your workers' protection, as well as measure in the infection control and, therefore, as safety for your patients/clients. We understood that that work type didn't still become politics guided by ministries of Health or of the Labor, however, it falls to the institutions that work for the interest of the workers' health to struggle for all and any action and mobilization that have as objective protects the workers of the risks in your work atmosphere / O presente estudo analisa as concep??es e as pr?ticas dos trabalhadores de enfermagem sobre a rela??o entre vacina??o e biosseguran?a em um hospital p?blico de refer?ncia em doen?as infecto contagiosas em Natal/RN. Trata-se, portanto, de um estudo explorat?rio/descritivo com abordagem qualitativa e quantitativa. Constitu?ram-se como colaboradores da pesquisa vinte e dois profissionais de enfermagem, sendo cinco enfermeiras, tr?s auxiliares e quatorze t?cnicos em enfermagem. As informa??es foram obtidas atrav?s da t?cnica de entrevista com roteiro semi-estruturado. Na abordagem quantitativa, as informa??es foram analisadas estatisticamente e apresentadas em forma de tabelas e gr?ficos para caracterizar os trabalhadores e os aspectos relacionados ? situa??o vacinal dos mesmos; e na abordagem qualitativa, utilizamos o m?todo de an?lise de conte?do. A an?lise foi realizada a partir das categorias emp?ricas advindas do processo de an?lise do material de campo, medida atrav?s de infer?ncias e interpreta??es baseadas nos autores estudados no referencial te?rico da pesquisa. A partir da an?lise dos resultados, constatamos que os trabalhadores de enfermagem entrevistados estabelecem de forma clara e objetiva, nas suas falas, uma rela??o direta entre vacina??o e biosseguran?a al?m de atribuir um significado de grande import?ncia quanto ao uso das vacinas em suas vidas profissionais no que se refere ao controle e diminui??o dos riscos, sobretudo os biol?gicos, aos quais se encontram expostos no exerc?cio cotidiano de suas fun??es. No entanto, ao analisar a situa??o vacinal desses trabalhadores, verificamos que a cobertura vacinal ainda se encontra aqu?m do esperado para as vacinas de interesse ocupacional, com destaque apenas para as vacinas contra difteria e t?tano e a contra hepatite B, que apresentaram coberturas consideradas muito boas e acima da m?dia nacional. Considerando que a institui??o, embora tenha um servi?o de sa?de ocupacional atuante e ofere?a algumas vacinas de interesse ocupacional, ainda apresenta um trabalho de pouca mobiliza??o no que se refere ? sensibiliza??o e educa??o permanente dos trabalhadores quanto ? necessidade e import?ncia da vacina??o ocupacional, n?o s? para a prote??o dos seus trabalhadores, como tamb?m como medida no controle de infec??o e, portanto, como seguran?a para os seus pacientes/clientes. Entendemos que esse tipo de trabalho ainda n?o se transformou em pol?tica orientada pelos Minist?rios da Sa?de ou do Trabalho, por?m, cabe ?s institui??es que trabalham pelo interesse da sa?de dos trabalhadores lutar por toda e qualquer a??o e mobiliza??o que tenham como objetivo proteger os trabalhadores dos riscos no seu ambiente de trabalho

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-10-02T23:54:53Z No. of bitstreams: 1 FranciscoIranylsonGomesDeBrito_DISSERT.pdf: 2162249 bytes, checksum: 705807d11afddba0f2b504f6e0886a8d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-10-09T21:40:02Z (GMT) No. of bitstreams: 1 FranciscoIranylsonGomesDeBrito_DISSERT.pdf: 2162249 bytes, checksum: 705807d11afddba0f2b504f6e0886a8d (MD5) / Made available in DSpace on 2017-10-09T21:40:02Z (GMT). No. of bitstreams: 1 FranciscoIranylsonGomesDeBrito_DISSERT.pdf: 2162249 bytes, checksum: 705807d11afddba0f2b504f6e0886a8d (MD5) Previous issue date: 2016-11-28 / O presente trabalho prop?e um novo modelo de an?lise da efici?ncia do sistema de sa?de p?blica do Brasil a partir da avalia??o dos gastos na vacina??o dos munic?pios. Considerando que a sa?de funciona de forma interligada entre seus agentes, a efici?ncia de uma forma geral pode ser afetada por problemas de base como a vacina??o na qual contribui para o controle das doen?as transmiss?veis e de morte. Verifica-se, assim, que a imuniza??o pode influenciar na efici?ncia do sistema de sa?de em sua totalidade. ? importante destacar que o m?todo de pesquisa utilizado foi predominantemente descritivo com aplica??o da An?lise Envolt?ria de Dados com modelagem din?mica (Dynamic Data Envelopment Analysis - DDEA) para determinar a efici?ncia das unidades tomadoras de decis?o (DMU) entre os anos de 2013 a 2015. A amostra coletada contempla as regi?es metropolitanas nas quais s?o compostas por 631 munic?pios e Bras?lia visto que a mesma n?o ? considerada munic?pio. Deve-se ressaltar que foram exclu?dos 2 munic?pios da an?lise por n?o apresentarem informa??es suficientes. De acordo com o Minist?rio da Sa?de, as vari?veis que comp?em a modelagem matem?tica s?o classificadas como indicadores de desempenho, e est?o organizadas no modelo conceitual de pesquisa da seguinte forma: inputs (gasto per capta com sa?de e percentual aplicado com gasto profil?tico e terap?utico); carry ? over (percentual de cobertura de vacina??o) e outputs (percentual aplicado com assist?ncia hospitalar, ambulatorial e com medicamentos). Admitindo a grande extens?o territorial do Brasil e suas diferen?as demogr?ficas e socioecon?micas entre as regi?es, a an?lise de dados est? sistematizada em 4 est?gios. No primeiro est?gio, os dados foram rodados e agrupados com todas DMU?s. No segundo, por regi?es. No terceiro por Estados e o ?ltimo por portes dos munic?pios. De acordo com as an?lises realizadas, os resultados apontaram n?veis de efici?ncias distintas em cada est?gio entre as an?lises globais e por per?odos entre os munic?pios. Ainda nas an?lises realizadas por porte de munic?pios o qual ? considerado o maior est?gio de n?vel de homogeneidade da amostra, ? apontado que quanto maior o munic?pio, maior ser? a sua efici?ncia. Este resultado demonstra a import?ncia dos investimentos na sa?de, pois quanto maior o munic?pio, maior ser? sua arrecada??o pr?pria e sua receita corrente l?quida. Dessa forma, haver? um aumento da aplica??o de recursos na sa?de devido a obrigatoriedade legal e, tamb?m, um aumento nos repasses do governo estadual e federal, pois as verbas s?o distribu?das de acordo com o n?mero de habitantes por munic?pio. Contudo, ? importante ressaltar que cabe aos gestores analisar e se espelhar nos relat?rios gerenciais e financeiros dos munic?pios com n?vel de efici?ncia maior para que possam melhorar seu desempenho. / The present work proposes a new model for the analysis of the efficiency of the Brazilian public health system based on the evaluation of the vaccination expenditures of the municipalities. Considering that health functions interconnectedly among its agents, overall efficiency can be affected by underlying problems such as vaccination in which it contributes to the control of communicable diseases and death. Thus, immunization can influence the efficiency of the health system as a whole. It is important to highlight that the research method used was predominantly descriptive with the application of Dynamic Data Envelopment Analysis (DDEA) to determine the efficiency of the decision making units (DMU) between the years of 2013 and 2015. The collected sample contemplates the metropolitan regions in which they are composed by 631 municipalities and Bras?lia since it is not considered a municipality. It should be noted that 2 municipalities were excluded from the analysis because they did not present sufficient information. According to the Ministry of Health, the variables that make up the mathematical modeling are classified as performance indicators, and are organized in the conceptual research model as follows: inputs (expenditure per capita with health and percentage applied with prophylactic and therapeutic expenditure) ; carry - over (percentage of vaccination coverage) and outputs (percentage applied with hospital, outpatient, and medication assistance). Assuming the great territorial extension of Brazil and its demographic and socioeconomic differences between regions, the data analysis is systematized in 4 stages. In the first stage, the data were rotated and grouped with all DMU's. In the second, by regions. In the third by states and the last by ports of the municipalities. According to the analyzes, the results indicated different levels of efficiencies at each stage between the global analyzes and by periods between the municipalities. Still in the analyzes carried out by municipalities, which is considered the highest stage of homogeneity level of the sample, it is pointed out that the larger the municipality, the greater its efficiency. This result demonstrates the importance of investments in health, since the larger the municipality, the higher will be its own collection and its current net revenue. In this way, there will be an increase in the application of resources in health due to legal obligation and also an increase in the transfers of the state and federal government, since the funds are distributed according to the number of inhabitants per municipality. However, it is important to emphasize that it is up to managers to analyze and mirror the management and financial reports of municipalities with a higher level of efficiency so that they can improve their performance.

Submitted by Celso Magalhaes (celsomagalhaes@ufrrj.br) on 2017-05-19T12:03:19Z No. of bitstreams: 1 2016 - Pablo Amauri Carvalho de Ara?jo e Souza.pdf: 3429164 bytes, checksum: c1da6eb8bb41fc96de0b7e5ca2a9570f (MD5) / Made available in DSpace on 2017-05-19T12:03:19Z (GMT). No. of bitstreams: 1 2016 - Pablo Amauri Carvalho de Ara?jo e Souza.pdf: 3429164 bytes, checksum: c1da6eb8bb41fc96de0b7e5ca2a9570f (MD5) Previous issue date: 2016-06-13 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / This work highlights the importance of well administrated vaccination as prophylactic activity, making it a key element of mathematical modeling about the spreading of an infection by Influenza H1N1 virus in a human population. The model counts with Optimal Control theory to achieve a vaccination strategy that balance infection?s prevention and your own cost in a hypothetical population exposed to a virus. The numerical solutions of ordinary differential equations systems generated by model is given via Finite Difference Method, that reveals the populational dynamics during the time while the vaccine is distributed, in various different situations of virus exposition and vaccination cost. / Este trabalho ressalta a import?ncia da vacina??o bem administrada como atividade profil?tica, tornando-a elemento chave da modelagem matem?tica do espalhamento da infec??o pelo v?rus Influenza H1N1 em uma popula??o humana. O modelo conta com a teoria de Controle ?timo para alcan?ar uma estrat?gia de vacina??o, que equilibre a preven??o da infec??o e seu pr?prio custo em uma popula??o hipot?tica exposta ao v?rus. As solu??es num?ricas dos sistemas de equa??es diferenciais ordin?rias gerados pelo modelo ficam a cargo do M?todo das Diferen?as Finitas, revelando a din?mica populacional no per?odo de tempo em que a vacina ? distribu?da, em distintas situa??es de exposi??o ao v?rus e custo da vacina??o.