Análise do perfil epidemiológico dos exames citopatológico do colo do útero em Altamira no período de 2014 a 2020: dados a partir do SISCAN / Analysis of the epidemiological profile of cervical cytopathological exams in Altamira in the period from 2014 to 2020: data from SISCAN / Análisis del perfil epidemiológico de los exámenes citopatológicos de cérvix en Altamira en el periodo de 2014 a 2020: datos del SISCAN

OBJETIVO: Este trabalho aborda sobre características referente aos exames citopatológicos do colo do útero em Altamira, coletado no Sistema de Informação do Câncer, dentro do período de 2014 a 2020. Observou-se também a qualidade da interpretação dos principais resultados encontrados, sobre a técnica de coleta e qualidade de exames. O objetivo é analisar o perfil epidemiológico dos exames citopatológicos do colo do útero do município. MÉTODO: A metodologia realizada foi estudo quantitativo, de corte transversal, epidemiológico, descritiva e analítico. RESULTADOS: Verificou- se um crescimento anual na taxa de cobertura do exame do preventivo no período de 2014 a 2019, que está ligado à implementação do Plano de Desenvolvimento Regional Sustentável do Xingu, e que esse crescimento mostra uma diferença estatística significativa entre a taxa de cobertura de Altamira, Pará, Brasil. Observou-se presença de falhas no preenchimento da ficha de notificação é referente ao campo da escolaridade das pacientes que não apresentam registro. Quanto a faixa etária mais frequente que realizam o exame do preventivo está entre 25 a 34 anos e as lesões intraepiteliais do colo uterino mais frequentes são: a de baixo grau que corresponde à população jovem (<34 anos) e de alto grau entre 25 a 44 anos.

OBJECTIVE: This paper deals with characteristics related to cytopathological examinations of the cervix in Altamira, collected in the Cancer Information System, within the period from 2014 to 2020. It was also observed the quality of interpretation of the main results found, on the technique collection and quality of exams. The objective is to analyze the epidemiological profile of cytopathological tests of the cervix in the city. METHOD: The methodology used was a quantitative, cross- sectional, epidemiological study, descriptive and analytical approach. RESULTS: As a result, there was an annual growth in the coverage rate of the preventive exam in the period from 2014 to 2019, which is linked to the implementation of the Xingu Sustainable Regional Development Plan, and that this growth shows a significant statistical difference between the coverage rate of Altamira, Pará, Brazil. It was observed the presence of failures in completing the notification form referring to the field of education of patients who do not have a record. As for the most frequent age group that undergoes the preventive examination, it is between 25 and 34 years old and the most frequent intraepithelial lesions of the uterine cervix are: low-grade, which corresponds to the young population (<34 years) and high-grade, between 25 and 34 years old. 44 years.

OBJETIVO: En este trabajo se abordan las características relacionadas con los exámenes citopatológicos de cérvix en Altamira, recogidos en el Sistema de Información del Cáncer, en el periodo comprendido entre 2014 y 2020. También se observó la calidad de interpretación de los principales resultados encontrados, sobre la técnica de recolección y calidad de los exámenes. El objetivo es analizar el perfil epidemiológico de los exámenes citopatológicos de cuello uterino en la ciudad. MÉTODO: La metodología utilizada fue un estudio cuantitativo, transversal, epidemiológico, de abordaje descriptivo y analítico. RESULTADOS: Como resultado, se observó un crecimiento anual de la tasa de cobertura del examen preventivo en el período de 2014 a 2019, que está vinculado a la implementación del Plan de Desarrollo Regional Sostenible Xingu, y que este crecimiento muestra una diferencia estadística significativa entre la tasa de cobertura de Altamira, Pará, Brasil. Se observó la presencia de fallas en el llenado del formulario de notificación referente al campo de la educación de los pacientes que no tienen un registro. En cuanto al grupo de edad más frecuente que se somete al examen preventivo, es entre 25 y 34 años y las lesiones intraepiteliales del cuello uterino más frecuentes son: de bajo grado, que corresponde a la población joven (<34 años) y de alto grado, entre 25 y 44 años.

Evolución del parto por cesárea en la provincia del Neuquén, 2000-2020 / Caesarean section rate evolution in Neuquén province, 2000 to 2020

RESUMEN INTRODUCCIÓN: El nacimiento por cesárea se encuentra en aumento en todo el mundo, con diferencias significativas entre regiones. El objetivo fue determinar la situación del porcentaje de cesárea en mujeres con parto en la provincia del Neuquén en 2000-2020, buscando diferencias entre subsectores, zonas sanitarias, localidades e instituciones de salud . MÉTODOS: Se analizaron las estadísticas del Sistema Informático Perinatal referentes a vía de parto, recién nacidos y mujeres con partos entre 2000 y 2020. Se realizó un análisis estratificado del porcentaje de cesáreas, describiendo medidas de tendencia central, de dispersión y velocidad promedio de incremento anual . RESULTADOS: Las características sociodemográficas de madres gestantes se han modificado, con un descenso del embarazo adolescente y un aumento de madres de más de 35 años. Se observó un mayor porcentaje de bajo peso al nacer en el subsector privado y una importante disminución de la tasa bruta de natalidad, con mayor descenso en el interior provincial. Se encontró un aumento sostenido, así como diferencias crecientes y muy significativas entre subsectores (y dentro de estos entre las distintas instituciones) . DISCUSIÓN: Existen diferencias muy significativas en los resultados si se comparan los diferentes subsectores e instituciones respecto al nacimiento por cesárea. Estos resultados son un aporte para la construcción de políticas acordes a la realidad epidemiológica de la provincia y de cada institución de salud.

ABSTRACT INTRODUCTION: Cesarean delivery is increasing all over the world, with significant differences between regions. The aim was to determine the cesarean section rate in women giving birth between 2000 and 2020 in Neuquén province, seeking for differences between sub-sectors, health zones, cities and health institutions . METHODS: Statistics from the Perinatal Information System were analyzed regarding type of delivery, newborns and women delivering between 2000 and 2020. A stratified analysis of the cesarean section rate was conducted, describing central tendency and dispersion measures, and the average annual rate of increase . RESULTS: Maternal sociodemographic characteristics have changed, with adolescent pregnancy decrease and a higher number of mothers older than 35 years of age. The percentage of low birth weight was higher in the private sub-sector, with a significant decrease of gross birth rate, mainly inside the province. There was a steady increase as well as growing and very significant differences between sub-sectors (and within them between the different institutions) . DISCUSSION: The results show very significant differences when comparing sub-sectors and institutions regarding cesarean birth, and contribute to building policies tailored to the epidemiological situation of the province and each health institution.

Mapping a high-level overview of information flows in the Dutch declaration chain for medical specialist health care.

This study is based on Philippe van der Voorn's master's dissertation at the Utrecht University, Department of Science, Information and Computing Sciences. The problem identified was a lack of an integrated information chain and clear governance structure for information flow in the Netherlands' health care sector. The method of Design Science was followed to construct an overview model of the chain, and towards a business process model that is intuitive for both technical and business users. An initial declaration chain was identified in the literature and presented, to be confirmed and elaborated on via eight interviews at seven different organisations in the medical specialist health care sector. Based on these interviews, the draft overview was adjusted and a Business Process Model and Notation model created that indicates the shared understanding of the data elements and activities between the organisations. The contribution of the overview of the declaration chain, in particular, can help medical specialist staff obtain an understanding of the administrative side of their work, and with a clear information infrastructure lead to better working processes and information quality. F.J.

Zero-knowledge identity authentication for internet of vehicles: Improvement and application.

The popularity of Internet of Vehicles (IoV) has made people's driving environment more comfortable and convenient. However, with the integration of external networks and the vehicle networks, the vulnerabilities of the Controller Area Network (CAN) are exposed, allowing attackers to remotely invade vehicle networks through external devices. Based on the remote attack model for vulnerabilities of the in-vehicle CAN, we designed an efficient and safe identity authentication scheme based on Feige-Fiat-Shamir (FFS) zero-knowledge identification scheme with extremely high soundness. We used the method of zero-one reversal and two-to-one verification to solve the problem that FFS cannot effectively resist guessing attacks. Then, we carried out a theoretical analysis of the scheme's security and evaluated it on the software and hardware platform. Finally, regarding time overhead, under the same parameters, compared with the existing scheme, the scheme can complete the authentication within 6.1ms without having to go through multiple rounds of interaction, which reduces the additional authentication delay and enables all private keys to participate in one round of authentication, thereby eliminating the possibility that a private key may not be involved in the original protocol. Regarding security and soundness, as long as private keys are not cracked, the scheme can resist guessing attacks, which is more secure than the existing scheme.

Evaluation of digital vaccine card in nursing practice in vaccination room.

OBJECTIVE: develop and evaluate a vaccine application for mobile devices, with update integrated with the National Immunization Program Information System, for care in vaccination rooms. METHOD: methodological research based on the Pressman System Development Life Cycle theory developed in three stages: integrative literature review, computational development, and application evaluation. The product was evaluated as to satisfaction, using a validated questionnaire, and as to usability by the System Usability Scale. RESULTS: the application functionalities were based on the survey of technological Innovations on immunization, published in the scientific literature. It displays user vaccines directly from the National Immunization Program Information System, notifies about upcoming vaccines, and enables the inclusion of vaccine cards of dependents. The evaluation resulted in users' mean score of 90.5 ± 11.1 and health professionals' mean score of 84.2 ± 19.4. CONCLUSION: the application is a technological tool with potential to improve the work process in vaccination rooms and to reach the goals of vaccine coverage. It synchronizes data with the National Immunization Program Information System, thus enabling the maintenance of people's vaccination history.

[Evaluation of data from the Brazilian Information System on Live Births (SINASC)]. / Avaliação das informações do Sistema de Informações sobre Nascidos Vivos (SINASC), Brasil.

This study is a quantitative and qualitative assessment of data from the Brazilian Information System on Live Births (SINASC) in Brazil. Coverage of the data by municipality was estimated as the ratio between reported and estimated live births. Data quality in the SINASC was assessed via probabilistic linkage with the database from the Birth in Brazil study, 2011-2012, and kappa coefficients of agreement were calculated. In 2013, data coverage was high and homogeneous in all states of Brazil. However, the analysis according to municipalities (counties) showed greater spatial heterogeneity. As for completeness of information in SINASC, kappa coefficients were statistically different from zero for all the tested variables (p < 0.001), and marginal distributions of all the variables were similar in the two databases. Gestational age was the variable with the worst agreement, with a kappa value of 0.461. The indicator that describes the inconsistencies, measured by the sum of the square of the differences between the reported and expected prematurity rates by birthweight bracket, showed the highest value in the North of Brazil and the lowest in the South, pointing to geographic inequalities in measurement of gestational age.

Neste trabalho, avaliam-se quantitativa e qualitativamente as informações do Sistema de Informações sobre Nascidos Vivos (SINASC). A cobertura das informações por município foi estimada pela razão entre nascidos vivos informados e estimados. Para avaliação da qualidade das informações do SINASC, relacionou-se o sistema à base de dados do estudo Nascer no Brasil, 2011-2012, e foram estimados coeficientes kappa de concordância. Em 2013, a cobertura das informações foi alta e homogênea em todas as Unidades da Federação. Entretanto, a análise por município brasileiro apresentou maior heterogeneidade espacial. Quanto à qualidade de preenchimento das informações do SINASC, os coeficientes kappa de concordância foram estatisticamente diferentes de zero para todas as variáveis testadas (p < 0,001), e as distribuições marginais para todas as variáveis consideradas foram semelhantes nas duas bases de dados. A idade gestacional foi a variável que mostrou pior concordância, com valor de kappa de 0,461. O indicador que descreve as inconsistências, medido pela soma do quadrado das diferenças entre os percentuais de prematuridade informados e esperados por faixa de peso ao nascer, teve o valor mais alto na Região Norte e o menor na Região Sul, apontando para desigualdades geográficas na mensuração da idade gestacional.

En este trabajo, se evalúa cuantitativa y cualitativamente la información del Sistema de Información sobre Nacidos Vivos (SINASC) de Brasil. La cobertura de la información por municipio se estimó por la razón entre nacidos vivos informados y estimados. Para la evaluación de la calidad de la información del SINASC, se efectuó la relación del sistema con la base de datos del estudio Nacer no Brasil, 2011-2012 y se estimaron los coeficientes kappa de concordancia. En 2013, la cobertura de la información fue alta y homogénea en todas las unidades de la Federación. No obstante, el análisis por municipio brasileño presentó mayor heterogeneidad espacial. En cuanto a la calidad de cumplimentación de la información del SINASC, los coeficientes kappa de concordancia fueron estadísticamente diferentes de cero para todas las variables probadas (p < 0,001) y las distribuciones marginales para todas las variables consideradas fueron semejantes en las dos bases de datos. La edad gestacional fue la variable que mostró peor concordancia, con valor de kappa de 0,461. El indicador que describe las inconsistencias, medido por la suma del cuadrado de las diferencias entre los porcentajes de prematuridad informados y esperados por franja de peso al nacer, tuvo el valor más alto en la región Norte y el menor en la Sur, apuntando desigualdades geográficas en la medición de la edad gestacional.

[Microdatasus: a package for downloading and preprocessing microdata from Brazilian Health Informatics Department (DATASUS)]. / Microdatasus: pacote para download e pré-processamento de microdados do Departamento de Informática do SUS (DATASUS).

This study aimed to develop an algorithm for downloading and preprocessing microdata furnished by the Brazilian Health Informatics Department (DATASUS) for various health information systems, using the R statistical programming language. The package allows downloading and preprocessing data from various health information systems, with the inclusion of labeling categorical fields in the files. The download function was capable of directly accessing and reducing the workload for the selection of microdata files and variables in DATASUS, while the preprocessing function enabled automatic coding of various categorical fields. The package thus enables a continuous workflow in the same program, in which the algorithm allows downloading and preprocessing and other packages in R allow analyzing data from the health information systems in the Brazilian Unified National Health System (SUS).

O objetivo do estudo foi desenvolver um algoritmo capaz de realizar o download e o pré-processamento de microdados fornecidos pelo Departamento de Informática do SUS (DATASUS) para diversos sistemas de informações em saúde para a linguagem de programação estatística R. O pacote desenvolvido permite o download e o pré-processamento de dados de diversos sistemas de informação em saúde, com a inclusão da rotulagem dos campos categóricos nos arquivos. A função de download foi capaz de acessar diretamente e reduzir o volume de trabalho para a seleção de arquivos e variáveis de microdados junto ao DATASUS. Já a função de pré-processamento foi capaz de efetuar a codificação automática de diversos campos categóricos. Dessa forma, a utilização desse pacote possibilita um fluxo de trabalho contínuo no mesmo programa, no qual esse algoritmo permite o download e o pré-processamento, e outros pacotes do R permitem a análise de dados dos sistemas de informação em saúde do Sistema Único de Saúde (SUS).

El objetivo del estudio fue desarrollar un algoritmo capaz de realizar la descarga y pre-procesamiento de microdatos, proporcionados por el Departamento de Informática del SUS (DATASUS), para diversos sistemas de información en salud, así como para el lenguaje de programación estadístico R. El paquete desarrollado permite la descarga y preprocesamiento de datos de diversos sistemas de información en salud, con la inclusión del rótulo de los campos categóricos en los archivos. La función de descarga se mostró capaz de acceder directamente y reducir el volumen de trabajo para la selección de archivos y variables de microdatos a través del DATASUS, mientras que la función de pre-procesamiento fue capaz de efectuar la codificación automática de diversos campos categóricos. De esta forma, la utilización de este paquete posibilita un flujo de trabajo continuo en el mismo programa, donde este algoritmo permite la descarga y preprocesamiento y otros paquetes del R permiten el análisis de datos de los sistemas de información en salud del Sistema Único de Salud (SUS).

Anonymity preserving and round effective three-party authentication key exchange protocol based on chaotic maps.

Three-party authentication key exchange (3PAKE) is a protocol that allows two users to set up a common session key with the help of a trusted remote server, which is effective for secret communication between clients in a large-scale network environment. Since chaotic maps have superior characteristics, researchers have recently presented some of the studies that apply it to authentication key exchange and cryptography. Providing user anonymity in the authentication key exchange is one of the important security requirements to protect users' personal secrets. We analyse Lu et al.'s scheme which attempts to provide user anonymity and we prove that his scheme has errors in the key exchange phase and password change phase. We propose a round-effective three-party authentication key exchange (3PAKE) protocol that provides user anonymity and we analyse its security properties based on BAN logic and AVISPA tool.

Use of Big Data and Information and Communications Technology in Disasters: An Integrative Review.

ABSTRACTNovel approaches to improving disaster response have begun to include the use of big data and information and communication technology (ICT). However, there remains a dearth of literature on the use of these technologies in disasters. We have conducted an integrative literature review on the role of ICT and big data in disasters. Included in the review were 113 studies that met our predetermined inclusion criteria. Most studies used qualitative methods (39.8%, n=45) over mixed methods (31%, n=35) or quantitative methods (29.2%, n=33). Nearly 80% (n=88) covered only the response phase of disasters and only 15% (n=17) of the studies addressed disasters in low- and middle-income countries. The 4 most frequently mentioned tools were geographic information systems, social media, patient information, and disaster modeling. We suggest testing ICT and big data tools more widely, especially outside of high-income countries, as well as in nonresponse phases of disasters (eg, disaster recovery), to increase an understanding of the utility of ICT and big data in disasters. Future studies should also include descriptions of the intended users of the tools, as well as implementation challenges, to assist other disaster response professionals in adapting or creating similar tools. (Disaster Med Public Health Preparedness. 2019;13:353-367).

Avaliação das informações do Sistema de Informações sobre Nascidos Vivos (SINASC), Brasil / Evaluation of data from the Brazilian Information System on Live Births (SINASC) / Evaluación de la información del Sistema de Información sobre Nacidos Vivos (SINASC), Brasil

Resumo: Neste trabalho, avaliam-se quantitativa e qualitativamente as informações do Sistema de Informações sobre Nascidos Vivos (SINASC). A cobertura das informações por município foi estimada pela razão entre nascidos vivos informados e estimados. Para avaliação da qualidade das informações do SINASC, relacionou-se o sistema à base de dados do estudo Nascer no Brasil, 2011-2012, e foram estimados coeficientes kappa de concordância. Em 2013, a cobertura das informações foi alta e homogênea em todas as Unidades da Federação. Entretanto, a análise por município brasileiro apresentou maior heterogeneidade espacial. Quanto à qualidade de preenchimento das informações do SINASC, os coeficientes kappa de concordância foram estatisticamente diferentes de zero para todas as variáveis testadas (p < 0,001), e as distribuições marginais para todas as variáveis consideradas foram semelhantes nas duas bases de dados. A idade gestacional foi a variável que mostrou pior concordância, com valor de kappa de 0,461. O indicador que descreve as inconsistências, medido pela soma do quadrado das diferenças entre os percentuais de prematuridade informados e esperados por faixa de peso ao nascer, teve o valor mais alto na Região Norte e o menor na Região Sul, apontando para desigualdades geográficas na mensuração da idade gestacional.

Abstract: This study is a quantitative and qualitative assessment of data from the Brazilian Information System on Live Births (SINASC) in Brazil. Coverage of the data by municipality was estimated as the ratio between reported and estimated live births. Data quality in the SINASC was assessed via probabilistic linkage with the database from the Birth in Brazil study, 2011-2012, and kappa coefficients of agreement were calculated. In 2013, data coverage was high and homogeneous in all states of Brazil. However, the analysis according to municipalities (counties) showed greater spatial heterogeneity. As for completeness of information in SINASC, kappa coefficients were statistically different from zero for all the tested variables (p < 0.001), and marginal distributions of all the variables were similar in the two databases. Gestational age was the variable with the worst agreement, with a kappa value of 0.461. The indicator that describes the inconsistencies, measured by the sum of the square of the differences between the reported and expected prematurity rates by birthweight bracket, showed the highest value in the North of Brazil and the lowest in the South, pointing to geographic inequalities in measurement of gestational age.

Resumen: En este trabajo, se evalúa cuantitativa y cualitativamente la información del Sistema de Información sobre Nacidos Vivos (SINASC) de Brasil. La cobertura de la información por municipio se estimó por la razón entre nacidos vivos informados y estimados. Para la evaluación de la calidad de la información del SINASC, se efectuó la relación del sistema con la base de datos del estudio Nacer no Brasil, 2011-2012 y se estimaron los coeficientes kappa de concordancia. En 2013, la cobertura de la información fue alta y homogénea en todas las unidades de la Federación. No obstante, el análisis por municipio brasileño presentó mayor heterogeneidad espacial. En cuanto a la calidad de cumplimentación de la información del SINASC, los coeficientes kappa de concordancia fueron estadísticamente diferentes de cero para todas las variables probadas (p < 0,001) y las distribuciones marginales para todas las variables consideradas fueron semejantes en las dos bases de datos. La edad gestacional fue la variable que mostró peor concordancia, con valor de kappa de 0,461. El indicador que describe las inconsistencias, medido por la suma del cuadrado de las diferencias entre los porcentajes de prematuridad informados y esperados por franja de peso al nacer, tuvo el valor más alto en la región Norte y el menor en la Sur, apuntando desigualdades geográficas en la medición de la edad gestacional.

Microdatasus: pacote para download e pré-processamento de microdados do Departamento de Informática do SUS (DATASUS) / Microdatasus: a package for downloading and preprocessing microdata from Brazilian Health Informatics Department (DATASUS) / Microdatasus: paquete para descarga y pre-procesamiento de microdatos del Departamento de Informática del SUS (DATASUS)

O objetivo do estudo foi desenvolver um algoritmo capaz de realizar o download e o pré-processamento de microdados fornecidos pelo Departamento de Informática do SUS (DATASUS) para diversos sistemas de informações em saúde para a linguagem de programação estatística R. O pacote desenvolvido permite o download e o pré-processamento de dados de diversos sistemas de informação em saúde, com a inclusão da rotulagem dos campos categóricos nos arquivos. A função de download foi capaz de acessar diretamente e reduzir o volume de trabalho para a seleção de arquivos e variáveis de microdados junto ao DATASUS. Já a função de pré-processamento foi capaz de efetuar a codificação automática de diversos campos categóricos. Dessa forma, a utilização desse pacote possibilita um fluxo de trabalho contínuo no mesmo programa, no qual esse algoritmo permite o download e o pré-processamento, e outros pacotes do R permitem a análise de dados dos sistemas de informação em saúde do Sistema Único de Saúde (SUS).

This study aimed to develop an algorithm for downloading and preprocessing microdata furnished by the Brazilian Health Informatics Department (DATASUS) for various health information systems, using the R statistical programming language. The package allows downloading and preprocessing data from various health information systems, with the inclusion of labeling categorical fields in the files. The download function was capable of directly accessing and reducing the workload for the selection of microdata files and variables in DATASUS, while the preprocessing function enabled automatic coding of various categorical fields. The package thus enables a continuous workflow in the same program, in which the algorithm allows downloading and preprocessing and other packages in R allow analyzing data from the health information systems in the Brazilian Unified National Health System (SUS).

El objetivo del estudio fue desarrollar un algoritmo capaz de realizar la descarga y pre-procesamiento de microdatos, proporcionados por el Departamento de Informática del SUS (DATASUS), para diversos sistemas de información en salud, así como para el lenguaje de programación estadístico R. El paquete desarrollado permite la descarga y preprocesamiento de datos de diversos sistemas de información en salud, con la inclusión del rótulo de los campos categóricos en los archivos. La función de descarga se mostró capaz de acceder directamente y reducir el volumen de trabajo para la selección de archivos y variables de microdatos a través del DATASUS, mientras que la función de pre-procesamiento fue capaz de efectuar la codificación automática de diversos campos categóricos. De esta forma, la utilización de este paquete posibilita un flujo de trabajo continuo en el mismo programa, donde este algoritmo permite la descarga y preprocesamiento y otros paquetes del R permiten el análisis de datos de los sistemas de información en salud del Sistema Único de Salud (SUS).

ICASME: An Improved Cloud-Based Authentication Scheme for Medical Environment.

Unlike the traditional medical system, telecare medicine information system (TMIS) ensures that patients can get health-care services via the Internet at home. Authenticated key agreement protocol is very important for protecting the security in TMIS. Recently scholars have proposed a lot of authenticated key agreement protocols. In 2016, Chiou et al. demonstrated that Chen et al.'s authentication scheme fails to provide user's anonymity and message authentication and then proposed an enhanced scheme (Chiou et al., J. Med. Syst. 40(4):1-15, 2006) to overcome these drawbacks. In this paper, we demonstrate that Chiou et al.'s scheme is defenseless against key compromise impersonation (KCI) attack and also fails to provide forward security. Moreover, we propose a novel authentication scheme namely ICASME to overcome the mentioned weaknesses in this paper. Security analyses show that ICASME achieves the forward security and KCI attack resistance. In addition, it is proved that the time taken to implement the ICASME is not intolerable compared to the original protocol.

[Proposal for an epidemiological observatory in the Brazilian Unified National Health System]. / Proposta de um observatório epidemiológico do Sistema Único de Saúde.

Following the creation of the Brazilian Unified National Health System (SUS), the Brazilian Health Informatics Department (DATASUS) was established in 1991, aimed at organizing information systems and databases in health. Online data access and viewing is free and open, using tables and graphs of aggregate data and access to raw data. However, the current form of data access does not fully meet the demands by health system administrators and other users for a flexible, user-friendly tool that allows dealing with various relevant health issues in the knowledge search and decision-making. We propose an ancillary system capable of generating monthly summary reports that are easy to access and understand, with an emphasis on viewing information through graphs and maps.

Proposta de um observatório epidemiológico do Sistema Único de Saúde / Proposal for an epidemiological observatory in the Brazilian Unified National Health System / Propuesta de un observatorio epidemiológico del Sistema Único de Salud brasileño

Após a criação do Sistema Único de Saúde (SUS), o Departamento de Informática do SUS (DATASUS) foi estabelecido em 1991, objetivando a organização de sistemas de informação e bases de dados em saúde. O acesso e visualização dos dados são realizados de forma gratuita e aberta pela Internet, por meio de tabelas e gráficos de dados agregados ou acesso a dados brutos. A presente forma de acesso aos dados não atende completamente a demanda dos gestores e outros usuários por uma ferramenta flexível e de fácil uso, que permita lidar com diferentes aspectos da saúde que sejam relevantes na busca de conhecimento e no processo de decisão. Nós propomos um sistema auxiliar capaz de gerar relatórios mensais sintéticos de maneira automatizada, que sejam facilmente acessados e também de fácil compreensão, com ênfase na visualização de informações valendo-se de gráficos e mapas.

Following the creation of the Brazilian Unified National Health System (SUS), the Brazilian Health Informatics Department (DATASUS) was established in 1991, aimed at organizing information systems and databases in health. Online data access and viewing is free and open, using tables and graphs of aggregate data and access to raw data. However, the current form of data access does not fully meet the demands by health system administrators and other users for a flexible, user-friendly tool that allows dealing with various relevant health issues in the knowledge search and decision-making. We propose an ancillary system capable of generating monthly summary reports that are easy to access and understand, with an emphasis on viewing information through graphs and maps.

Tras la creación del Sistema Único de Salud (SUS) en Brasil, se estableció en 1991 el Departamento de Informática del SUS (DATASUS), con el objetivo de organizar sistemas de información y bases de datos en salud. El acceso y visualización de los datos se realizan de forma gratuita y abierta, vía Internet, mediante tablas y gráficos de datos agregados o de acceso a datos brutos. La presente forma de acceso a los datos no atiende completamente la demanda de los gestores y otros usuarios de una herramienta flexible y de fácil uso, que permita enfrentarse a diferentes aspectos de la salud que sean relevantes en la búsqueda de conocimiento y en el proceso de decisión. Nosotros proponemos un sistema auxiliar capaz de generar informes mensuales sintéticos, de manera automatizada, que sean de fácil acceso y también de fácil comprensión, con énfasis en la visualización de información, valiéndose de gráficos y mapas.

A Robust and Anonymous Two Factor Authentication and Key Agreement Protocol for Telecare Medicine Information Systems.

Nowadays people can get many services including health-care services from distributed information systems remotely via public network. By considering that these systems are built on public network, they are vulnerable to many malicious attacks. Hence it is necessary to introduce an effective mechanism to protect both users and severs. Recently many two-factor authentication schemes have been proposed to achieve this goal. In 2016, Li et al. demonstrated that Lee et al.'s scheme was not satisfactory to be deployed in practice because of its security weaknesses and then proposed a security enhanced scheme to overcome these drawbacks. In this paper, we analyze Li et al.'s scheme is still not satisfactory to be applied in telecare medicine information systems (TMIS) because it fails to withstand off-line dictionary attack and known session-specific temporary information attack. Moreover, their scheme cannot provide card revocation services for lost smart card. In order to solve these security problems, we propose an improved scheme. Then we analyze our scheme by using BAN-logic model and compare the improved scheme with related schemes to prove that our scheme is advantageous to be applied in practice.

Design of a Secure Authentication and Key Agreement Scheme Preserving User Privacy Usable in Telecare Medicine Information Systems.

Authentication and key agreement schemes play a very important role in enhancing the level of security of telecare medicine information systems (TMISs). Recently, Amin and Biswas demonstrated that the authentication scheme proposed by Giri et al. is vulnerable to off-line password guessing attacks and privileged insider attacks and also does not provide user anonymity. They also proposed an improved authentication scheme, claiming that it resists various security attacks. However, this paper demonstrates that Amin and Biswas's scheme is defenseless against off-line password guessing attacks and replay attacks and also does not provide perfect forward secrecy. This paper also shows that Giri et al.'s scheme not only suffers from the weaknesses pointed out by Amin and Biswas, but it also is vulnerable to replay attacks and does not provide perfect forward secrecy. Moreover, this paper proposes a novel authentication and key agreement scheme to overcome the mentioned weaknesses. Security and performance analyses show that the proposed scheme not only overcomes the mentioned security weaknesses, but also is more efficient than the previous schemes.

Designing Mobile Applications for Emergency Response: Citizens Acting as Human Sensors.

When an emergency occurs, citizens can be a helpful support for the operation centers involved in the response activities. As witnesses to a crisis, they initially can share updated and detailed information about what is going on. Moreover, thanks to the current technological evolution people are able to quickly and easily gather rich information and transmit it through different communication channels. Indeed, modern mobile devices embed several sensors such as GPS receivers, Wi-Fi, accelerometers or cameras that can transform users into well-equipped human sensors. For these reasons, emergency organizations and small and medium enterprises have demonstrated a growing interest in developing smart applications for reporting any exceptional circumstances. In this paper, we present a practical study about this kind of applications for identifying both limitations and common features. Based on a study of relevant existent contributions in this area and our personal direct experience in developing and evaluating emergency management solutions, our aim is to propose several findings about how to design effective and efficient mobile emergency notification applications. For this purpose we have exploited the basic sensors of modern mobile devices and the users' aptitude for using them. The evaluation consists of a practical and a theoretical part. In the practical part, we have simulated a traffic accident as closely as possible to a real scenario, with a victim lying on the ground near a car in the middle of a street. For the theoretical part, we have interviewed some emergency experts for collecting their opinions about the utility of the proposed solution. Results from this evaluation phase confirm the positive impact that EN application have for both operators' and citizens' perspective. Moreover, we collected several findings useful for future design challenges in the same area, as shown in the final redesign of the proposed application.

Mortalidade por tuberculose no interior de São Paulo ­ Brasil (2006-2008) / Mortality from tuberculosis in the countryside of São Paulo - Brazil (2006-2008)

Estudo epidemiológico, descritivo, com objetivo de caracterizar o perfil epidemiológico dos óbitos por tuberculose no período de 2006 a 2008 do Departamento Regional de Saúde III do Estado de São Paulo ­Brasil. A população foi constituída pelas notificações de casos de tuberculose registradas no Sistema de Controle de Pacientes com Tuberculose e de declarações de óbito com causa básica de tuberculose, registradas no Sistema de Informação sobre Mortalidade, de residentes da região de abrangência do Departamento. Foram notificados no Sistema de Tuberculose 640 casos e no Sistema de Informação sobre Mortalidade 34 óbitos. Confrontando-se os dados foram identificados 22 óbitos coincidentes em ambos os bancos, perfazendo, portanto, um total de 45 óbitos por tuberculose, que ocorreram principalmente em homens, na faixa etária de 30-59 anos e com a forma pulmonar da doença, 45% das notificações ocorreram fora da atenção primária e o intervalo médio entre a notificação e o óbito indicou diagnóstico tardio da doença em 77% dos casos. Conclui-se que a região necessita de uma revisão na inserção de dados em ambos os sistemas de informações, além de estudos que analise as estratégias utilizadas nas ações de controle da doença e da atuação da atenção primária neste contexto.

This is an epidemiological and descriptive study aiming to characterize the epidemiological profile of deathsdue to tuberculosisin the period from 2006 to 2008 of the Regional Health Department III of the State of São Paulo, Brazil. The population was selected through reports of tuberculosis cases recorded in the Tuberculosis Patient Control Registers and death certificates with underlying cause of tuberculosis of the residents of the region covered, registered in the Mortality Information System Department. It was observed 640 reported cases in the Tuberculosis System and 34 deaths in the Information System of Mortality. It was possible to identify 22 deaths when both databases were crossed each other. Thus, there were a total of 45 deaths due to tuberculosis, which occurred mostly in male, with a mean age of 30-59 years and the pulmonary form of the disease. Forty-five percent (45%) of the reported cases occurred outside the primary health care, and the mean interval between notification and death indicated a delayed diagnosisin 77% of the cases. In conclusion, the results showed the importance of data entry reviewing in both information systems, beyond of studies to analyze strategies considered for disease control and also to measure the performance of the primary health care in this context.

Design and Analysis of an Enhanced Patient-Server Mutual Authentication Protocol for Telecare Medical Information System.

In order to access remote medical server, generally the patients utilize smart card to login to the server. It has been observed that most of the user (patient) authentication protocols suffer from smart card stolen attack that means the attacker can mount several common attacks after extracting smart card information. Recently, Lu et al.'s proposes a session key agreement protocol between the patient and remote medical server and claims that the same protocol is secure against relevant security attacks. However, this paper presents several security attacks on Lu et al.'s protocol such as identity trace attack, new smart card issue attack, patient impersonation attack and medical server impersonation attack. In order to fix the mentioned security pitfalls including smart card stolen attack, this paper proposes an efficient remote mutual authentication protocol using smart card. We have then simulated the proposed protocol using widely-accepted AVISPA simulation tool whose results make certain that the same protocol is secure against active and passive attacks including replay and man-in-the-middle attacks. Moreover, the rigorous security analysis proves that the proposed protocol provides strong security protection on the relevant security attacks including smart card stolen attack. We compare the proposed scheme with several related schemes in terms of computation cost and communication cost as well as security functionalities. It has been observed that the proposed scheme is comparatively better than related existing schemes.