Mortalidade fetal e infantil na cidade de Surubim, Pernambuco

Enquadramento: Com a redução global da mortalidade infantil no Brasil, o componente perinatal passou a exercer maior influência neste indicador, sendo necessário, portanto, um maior enfoque nas análises dessa componente. Objectivo: Levantar o perfil da mortalidade infantil e fetal e a evitabilidade destes óbitos, no município de Surubim, Pernambuco, no período de Junho de 2011 a Dezembro de 2014. Métodos: Estudo retrospectivo com enfoque descritivo, cuja a amostra foi de 56 óbitos investigados com base em 53 Fichas de Investigação da Secretaria de Saúde de Surubim. Este número corresponde a 66,66% dos casos entre 2011 e 2014 em fetos e menores de um ano, residentes de Surubim, Pernambuco. Utilizados como fontes de dados, os Bancos do Sistema de Informações sobre Mortalidade (SIM) e o Sistema de Informações sobre Nascidos Vivos (SINASC) do Ministério da Saúde (DATASUS), ambos com boa cobertura e qualidade satisfatória das informações, e Fichas usadas pelo Grupo Técnico de Investigação do Óbito do Município. Resultados: Em 2011, 23 óbitos (11 fetais e 12 infantis), 07 investigados, 1 fetal e 6 infantis; em 2012, 26 óbitos (12 fetais e 14 infantis), 23 investigados, 9 fetais e 14 infantis; em 2013, 17 óbitos (11 fetais e 6 infantis), 14 investigados, 9 fetais e 5 infantis; e em 2014, 19 óbitos (7 fetais e 12 infantis), 12 investigados, 4 fetais e 8 infantis. A Taxa de Mortalidade Infantil e Fetal para o período foi de 13,8/1000nv e 12,6/1000nv(2011), 15/1000nv e 13/1000nv(2012), 7/1000nv e 12,7/1000nv(2013),13/1000nv e 8/1000nv(2014)nv. 60,61% dos óbitos fetais e 91,3% dos óbitos infantis foram por causas evitáveis. Inconclusivos 06, não evitáveis 02 fetais e 07 Infantis. Conclusão:Consideram-se necessárias mudanças no processo de trabalho da equipe de saúde, capacitação da equipe multidisciplinar na perspectiva de trabalho colaborativo de maior equidade e efetividade clínica de forma a dotar a assistência à mulher fértil, à mulher grávida, à puérpera,ao feto e ao recém-nascido,com vistas à redução da mortalidade infantil e neonatal precoce por causas evitáveis. Palavras-chave: mortalidade infantil, mortalidade neonatal precoce, evitabilidade.

Peer interaction in mixed age groups: a study in the computer area of an early childhood education center in Portugal

The study was developed as a teacher-research project during initial teacher education – Masters Degree of Early Childhood and Primary Education, in Portugal. It analysed the interactions between children of 3 to 6 years old, during the use of the computer as a free choice activity, confronting situations between peers of the same age and situations between peers of different ages. The focus of the analysis was the collaborative interactions. This was a qualitative study. Children could choose the computer, amongst other interest areas, and work for around an hour in pairs. In the computer, children used mainly educational games. During four weeks, the interactions between the pairs were audio recorded. Field notes and informal interviews to the children were also used to collect data. Eleven children were involved in the study with ages ranging from 3 to 6 years old. Baseline data on children’s basic computer proficiency was collected using the Individualized Computer Proficiency Checklist (ICPC) by Hyun. The recorded interactions were analysed using the types of talk offered by Scrimshaw and Perkins and Wegerif and Scrimshaw: cumulative talk, exploratory talk, disputational talk, and tutorial talk. This framework was already used in a study in an early childhood education context in Portugal by Amante. The results reveal differences in computer use and characterize the observed interactions. Seven different pairs of children's interactions were analysed. More than a third of the interactions were cumulative talk, followed by exploratory talk, tutorial talk and disputational talk. Comparing same and mixed age pairs, we observed that cumulative talk is the more present interaction, but in same age pairs this is followed by exploratory talk whereas in the mixed age pairs it is tutorial talk that has the second largest percentage. The pairs formed by the children were very asymmetrical in terms of age and computer proficiency. This lead to the more tutorial interactions, where one children showed the other or directed him/her on how to play. The results show that collaboration is present during the use of a computer area in early childhood education. The free choice of the children means the adults can only suggest pairing suited to specific interactions between the children. Another way to support children in more exploratory talk interactions could be by discussing the way the older children can help the younger ones beyond directing or correcting their work.