Trends in morbid obesity and in bariatric surgeries covered by the Brazilian public health system

Background Obesity is an increasingly serious public health problem on a global level. Morbid obesity, defined as a body mass index greater than 40 kg/m2, is associated with increased mortality and a high burden of obesity-related morbidities. Methods To study the prevalence of morbid obesity in Brazil, three national anthropometric surveys were reanalyzed. Data about bariatric surgeries were obtained from the Ministry of Health Hospital Information System, which is available online. Results A 255% rise in the prevalence of morbid obesity was observed, starting at 0.18% in 1975-1976 and growing to 0.33% in 1989 and 0.64% in 2002-2003. There was a higher rate in the South in the first two surveys, but the prevalence in the Southeast rose steadily, reaching 0.77% in 2002-2003 and overtaking the South. Since 1999, the Brazilian Unified Health System has covered surgical treatment for morbid obesity. From 2000 to 2006, there was a sixfold increase in the number of surgeries, which topped the 2,500 mark in 2006. The geographic distribution of these surgeries is heavily concentrated in the Southeast, the most developed region of Brazil, where there is also the highest prevalence of morbid obesity. This was followed by the Southern region. Conclusions The figures for the rise in morbid obesity in Brazil are startling, especially the increase among men. This is a situation that calls for further study, alongside measures to encourage the adoption of healthy lifestyles. Preventive measures aimed at slowing down or reversing the obesity epidemic are urgently required

Support Tool to the Validation Process of Functional Requirements

The activity of validating identified requirements for an information system helps to improve the quality of a requirements specification document and, consequently, the success of a project. Although various different support tools to requirements engineering exist in the market, there is still a lack of automated support for validation activity. In this context, the purpose of this paper is to make up for that deficiency, with the use of an automated tool, to provide the resources for the execution of an adequate validation activity. The contribution of this study is to enable an agile and effective follow-up of the scope established for the requirements, so as to lead the development to a solution which would satisfy the real necessities of the users, as well as to supply project managers with relevant information about the maturity of the analysts involved in requirements specification.

Criminal Liability of Organizations, Corporations, Legal Persons, and Similar Entities on Law of Portuguese Cybercrime: A Brief Discussion on the Issue of Crimes of “False Information,” the “Damage on Other Programs or Computer Data,” the “Computer-Software Sabotage,” the “Illegitimate Access,” the “Unlawful Interception,” and “Illegitimate Reproduction of the Protected Program”

Abstract: in Portugal, and in much of the legal systems of Europe, «legal persons» are likely to be criminally responsibilities also for cybercrimes. Like for example the following crimes: «false information»; «damage on other programs or computer data»; «computer-software sabotage»; «illegitimate access»; «unlawful interception» and «illegitimate reproduction of protected program». However, in Portugal, have many exceptions. Exceptions to the «question of criminal liability» of «legal persons». Some «legal persons» can not be blamed for cybercrime. The legislature did not leave! These «legal persons» are v.g. the following («public entities»): legal persons under public law, which include the public business entities; entities utilities, regardless of ownership; or other legal persons exercising public powers. In other words, and again as an example, a Portuguese public university or a private concessionaire of a public service in Portugal, can not commit (in Portugal) any one of cybercrime pointed. Fair? Unfair. All laws should provide that all legal persons can commit cybercrimes. PS: resumo do artigo em inglês.

Gestão em farmácia - Implementação de um sistema de distribuição de medicamentos Pyxis®: um estudo de caso de dois hospitais centrais

Mestrado em Intervenção Sócio-Organizacional na Saúde - Área de especialização: Políticas de Administração e Gestão em Saúde

Performance evaluation of hospitals that provide care in the public health system, Brazil

OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System.METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction.RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed.CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

Extensible metadata repository for information systems

Thesis submitted to Faculdade de Ciências e Tecnologia of the Universidade Nova de Lisboa, in partial fulfillment of the requirements for the degree of Master in Computer Science

National Immunization Program: Computerized System as a tool for new challenges

The scope and coverage of the Brazilian Immunization Program can be compared with those in developed countries because it provides a large number of vaccines and has a considerable coverage. The increasing complexity of the program brings challenges regarding its development, high coverage levels, access equality, and safety. The Immunization Information System, with nominal data, is an innovative tool that can more accurately monitor these indicators and allows the evaluation of the impact of new vaccination strategies. The main difficulties for such a system are in its implementation process, training of professionals, mastering its use, its constant maintenance needs and ensuring the information contained remain confidential. Therefore, encouraging the development of this tool should be part of public health policies and should also be involved in the three spheres of government as well as the public and private vaccination services.

An Intelligent Distributed System for Environmental Management

Environmental management is a complex task. The amount and heterogeneity of the data needed for an environmental decision making tool is overwhelming without adequate database systems and innovative methodologies. As far as data management, data interaction and data processing is concerned we here propose the use of a Geographical Information System (GIS) whilst for the decision making we suggest a Multi-Agent System (MAS) architecture. With the adoption of a GIS we hope to provide a complementary coexistence between heterogeneous data sets, a correct data structure, a good storage capacity and a friendly user’s interface. By choosing a distributed architecture such as a Multi-Agent System, where each agent is a semi-autonomous Expert System with the necessary skills to cooperate with the others in order to solve a given task, we hope to ensure a dynamic problem decomposition and to achieve a better performance compared with standard monolithical architectures. Finally, and in view of the partial, imprecise, and ever changing character of information available for decision making, Belief Revision capabilities are added to the system. Our aim is to present and discuss an intelligent environmental management system capable of suggesting the more appropriate land-use actions based on the existing spatial and non-spatial constraints.

Intelligent Distributed Environmental Decision Support System

This article discusses the development of an Intelligent Distributed Environmental Decision Support System, built upon the association of a Multi-agent Belief Revision System with a Geographical Information System (GIS). The inherent multidisciplinary features of the involved expertises in the field of environmental management, the need to define clear policies that allow the synthesis of divergent perspectives, its systematic application, and the reduction of the costs and time that result from this integration, are the main reasons that motivate the proposal of this project. This paper is organised in two parts: in the first part we present and discuss the developed Distributed Belief Revision Test-bed — DiBeRT; in the second part we analyse its application to the environmental decision support domain, with special emphasis on the interface with a GIS.

Automated illustration of multimedia stories

Submitted in part fulfillment of the requirements for the degree of Master in Computer Science

FireSpotter a VGI-Based Forest Fire Reporting System

Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies.

Desenho e desenvolvimento de um Sistema de Informação em Oracle ADF

Um Sistema de Informação consiste num sistema capaz de armazenar, organizar e estruturar dados para ajudar a responder às necessidades das empresas, passando também pela capacidade de resposta às questões diárias das empresas. Assim, um Sistema de Informação pode ser definido como o software que ajuda a organizar e analisar dados, tendo como objetivo fornecer informação útil na altura certa para que possa ser utilizada para a tomada de decisões ou para uma gestão mais eficiente dos diversos fluxos que uma empresa pode conter. Neste sentido, o projeto apresentado centra-se no desenho e construção de um Sistema de Informação capaz de gerir o negócio de uma empresa do setor alimentar, mais propriamente do setor da transformação de carnes. Foi desenvolvido em Oracle ADF, de forma a aproveitar as vantagens inerentes à tecnologia e ao desenvolvimento web. Sendo uma tecnologia relativamente nova no mercado e dominada por poucos, a sua utilização neste momento pode tornar-se uma grande vantagem. Para o desenvolvimento da aplicação foi realizado o levantamento e análise de requisitos, foi criada a base de dados capaz de suportar o funcionamento do software e desenvolvido um sistema de login, capaz de gerir as sessões de cada utilizador. Foi implementado um processo de introdução e edição de informação, nomeadamente o registo de entradas, transformações e saídas. Contemplou-se também uma secção com dados mestre da empresa com a possibilidade de inserção, atualização e/ou remoção. Além disso, foram incorporadas validações em todos os processos que são usados pelos utilizadores, de modo a evitar a existência de dados incoerentes ou duplicados. Relativamente à lógica de negócio, foi embutida na aplicação de forma a permitir consultar a informação de forma clara, rápida e em diversos lugares, reduzindo tempo e tarefas ao colaborador/utilizador, visto que os processos foram automatizados. Com a implementação deste Sistema de Informação, a empresa pode usufruir de um sistema integrado capaz de gerir e controlar todo o seu processo produtivo, reduzindo custos e desperdícios, aumentando a produtividade e eficiência.

Designing and implementing a performance measurement system in Auto Ribeiro, Lda.

In any business it is very important to measure the performance and it helps to select key information to make better decisions on time. This research focuses on the design and implementation of a performance measurement system in a Portuguese medium size firm operating in the specialized health care transformation vehicles industry. From the evidence that outputs from Auto Ribeiro’s current information system is misaligned with the company’s objectives and strategy, this research tries to solve this business problem through the development of a Balanced Scorecard analysis, although there are some issues, which deserve further development.

Validação de design de armazém automatizado com uso de simulação discreta

Dissertação de mestrado em Engenharia de Sistemas

Producción de información para las políticas públicas: observatorio de salud mental y derechos humanos en la provincia de córdoba. Documented information and indicators for the pubic policies in mental health: human rights obseratory in córdoba

El problema que enfrenta la institucionalidad estatal argentina es que existe un serio déficit de información no solamente en el momento de evaluar un resultado, sino ya al momento de diseñar la política. Las estadísticas oficiales de hechos vitales, salud y educación son difundidas en el mejor de los casos con un año de atraso. La información de indicadores de salud por su nivel de desagregación no permite conocer las realidades locales. Es posible constatar la falta de información sobre las medidas tomadas para asegurar el cumplimiento de las obligaciones del Estado en lo relativo a políticas y programas de salud mental. Del mismo modo que los organismos internacionales determinan los deficits de los sistemas de atención a la salud mental a través de las brechas de tratamiento y aun cuando no se dispone de estimaciones precisas se habla de brechas de información, que expresarían la distancia entre la información necesaria y la efectivamente disponible (OPS, 2009). Desde el mes de diciembre de 2007 se conforma la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos, con el objeto de instalar en agenda la necesidad de contar con una legislación que brinde el marco normativo para la transformación del sector. En los meses de octubre y noviembre de 2010 se aprobaron sendas leyes de salud mental en la Provincia de Córdoba y a nivel nacional. Ambas proponen la transformación progresiva en los sistemas de atención a los problemas de salud mental de la población. Desde la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos se afirma que la legislación es un marco necesario pero no suficiente, en tanto se constata que las princiales violaciones a los derechos humanos se producen en situaciones concretas. El presente proyecto nace de la necesidad de contar con un sistema de información que permita conocer la transformación de los servicios de salud mental en la provincia de Córdoba a partir de la sanción de la ley 9848 de Salud Mental en el mes de octubre de 2010. Una vez logrado este objetivo legislativo, se pretende monitorear la gestión con la formulación de los siguientes interrogantes: ¿a través de qué indicadores medir, evaluar y monitorear si la producción de los servicios de salud mental se lleva adelante desde la perspectiva del enfoque de derechos sancionada en el marco normativo vigente?; ¿cuáles son los indicadores que desde dicha perspectiva los organismos estatales de producción de servicios deben elaborar para el compromiso de acción y la rendición de cuentas frente a la ciudadanía? ¿cuáles son los indicadores que la ciudadanía debe reclamar a los fines de monitorear el cumplimiento de dichos compromisos? La puesta en marcha del Observatorio de Salud Mental y Derechos Humanos permitirá analizar las políticas y programas de salud mental desde la perspectiva de los derechos humanos y avanzar en el monitoreo de la producción de los servicios de salud mental. Objetivo General: analizar y hacer visible el cumplimiento de los objetivos sancionados en la ley 9848 de Salud Mental a través de la observación, el monitoreo y la incidencia en las políticas de salud mental de la provincia de Córdoba. Metodología: la construcción de indicadores de derechos humanos para la salud mental. El Observatorio de Salud Mental y Derechos Humanos pretende dar cuenta de las transformaciones que van a ocurrir a partir de la sanción de la ley 9848. Los resultados esperados están ligados a la producción y difusión de información sistematizada sobre las transformaciones en salud mental, a la vigilancia y el análisis del efecto/impacto de las políticas e incidir en las decisiones. El Observatorio pretende reconocer e integrar la información disponible y proponer indicadores que den cuenta de la situación inicial al momento de la implementación de los marcos normativos y permitir el monitoreo de las transformaciones emergentes. This project stems from the need for an information system designed to show the transformation of mental health services in the province of Cordoba after the enactment of the Mental Health Act 9848 in October 2010. Once achieved this legislative objective is to monitor the management with the formulation of the following questions: through which indicators to measure, evaluate and monitor whether the production of mental health services are carried forward from the perspective of rights-based approach enacted in two laws?, What are the indicators from that perspective the production agencies should develop services for the commitment to action and accountability to the public? What are the indicators that the public should demand that the purpose of monitoring compliance with these commitments? The launch of the Centre for Mental Health and Human Rights will review the policies and mental health programs from the perspective of human rights and progress in monitoring the production of mental health services. General Objective: to analyze and highlight the achievement of the objectives sanctioned by the Mental Health Act 9848 through the observation, monitoring and impact on mental health policy in the province of Cordoba. Methodology: building human rights indicators for mental health Mental Observatory Health and Human Rights aims to account for the changes that will occur after the enactment of Law 9848. The expected results are linked to production and dissemination of systematic information about changes in mental health, surveillance and analysis of the effect / impact and influence policy decisions. The Centre aims to recognize and integrate the available information and propose indicators that account for the initial situation at the time of implementation of regulatory frameworks and allow monitoring of change emerging.