Health information systems: their use in monitoring patients with hypertension or diabetes: a case study of the system at home remedy used in Rio de Janeiro

Made available in DSpace on 2011-05-04T12:36:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2009Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Os Sistemas de Informação em Saúde são importantes para o conhecimento do perfil epidemiológico da população, subsidiando os tomadores de decisão na elaboração de programas de prevenção de doenças e promoção da saúde. Além disso, favorecem o monitoramento e a avaliação das intervenções realizadas. Para analisar a efetiva utilização desses sistemas no controle da hipertensão arterial e do diabetes mellitus, que são os principais fatores de risco para as doenças cardiovasculares, foi desenvolvido um estudo de caso, de caráter descritivo exploratório, do Sistema Remédio em Casa utilizado no município do Rio de Janeiro. A investigação consistiu em uma pesquisa qualitativa, baseada em análise documental, observação e entrevistas semiestruturadas. Foram entrevistados cinco profissionais ocupantes de cargo de gerência e coordenação, nos três níveis de gestão municipal. Os resultados do estudo indicam que o município não utiliza seu sistema de informação, destinado ao acompanhamento dos pacientes hipertensos e diabéticos, de maneira satisfatória, não permitindo o gerenciamento e a avaliação dos Programas de Hipertensão Arterial e Diabetes de forma efetiva. Além disso, não envia seus dados ao Cadastro Nacional de Portadores de Hipertensão e Diabetes Mellitus, definido pelo Ministério da Saúde. Conclui-se, portanto, que algumas mudanças devem ser realizadas no Sistema de Informação do Rio de Janeiro, de forma que sejam atendidas as demandas específicas do município e, também, aquelas solicitadas pelo nível federal, necessitando de uma maior articulação entre as duas esferas de governo.Health Information Systems are essential to provide adequate knowledge of the population’s epidemiological profile, besides supporting decision-makers in planning disease prevention and health promotion programs. They also facilitate monitoring and evaluation of interventions. To analyze the actual utilization of such systems in the control of arterial hypertension and diabetes mellitus (the principal risk factors for cardiovascular diseases), a descriptive, exploratory case study was performed in the Home Delivery Medication System used in the city of Rio de Janeiro. The research consisted of a qualitative study based on document analysis, observation, and semistructured interviews. Five professionals were interviewed, occupying management and coordination positions at the three levels of municipal administration. The study’s findings indicate that the city fails to satisfactorily use its information system for monitoring hypertensive and diabetic patients, thus not allowing the effective management and evaluation of the Programs on Arterial Hypertension and Diabetes. The city also fails to send its data to the National Registry of Patients with Arterial Hypertension and Diabetes Mellitus, as established by the Ministry of Health. In conclusion, several changes are needed in the Health Information System in Rio de Janeiro in order to meet the city’s specific demands as well as those from the Federal level, a process that requires greater linkage between the two spheres of government

Cavitation intensifying bags improve ultrasonic advanced oxidation with Pd/Al2O3 catalyst

Advanced oxidation processes can potentially eliminate organic contaminants from industrial waste streams as well as persistent pharmaceutical components in drinking water. We explore for the first time the utilization of Cavitation Intensifying Bags (CIB) in combination with Pd/Al2O3 catalyst as possible advanced oxidation technology for wastewater streams, oxidizing terephthalic acid (TA) to 2-hydroxyterephthalic acid (HTA). The detailed characterization of this novel reaction system reveals that, during sonication, the presence of surface pits of the CIB improves the reproducibility and thus the control of the sonication process, when compared to oxidation in non-pitted bags. Detailed reaction kinetics shows that in the CIB reactor the reaction order to TA is zero, which is attributed to the large excess of TA in the system. The rate of HTA formation increased ten-fold from ∼0.01 μM*min-1 during sonication in the CIB, to ∼0.10 μM*min-1 for CIB in the presence of the Pd/Al2O3 catalyst. This enhancement was ascribed to a combination of improved mass transport, the creation of thermal gradients, and Pd/Al2O3 catalyst near the cavitating bubbles. Further analysis of the kinetics of HTA formation on Pd/Al2O3 indicated that initially the reaction underwent through an induction period of 20 min, where the HTA concentration was ∼ 0.3 μM. After this, the reaction rate increased reaching HTA concentrations ∼ 6 μM after 40 minutes. This behavior resembled that observed during oxidation of hydrocarbons on metal catalysts, where the slow rate formation of hydroperoxides on the metal surface is followed by rapid product formation upon reaching a critical concentration. Finally, a global analysis using the Intensification Factor (IF) reveals that CIB in combination with the Pd/Al2O3 catalyst is a desirable option for the oxidation of TA when considering increased oxidation rates and costs