Perfil de mortalidade de idosos no Rio Grande do Norte: estudo comparativo entre duas faixas etárias e fatores relacionados

Measures of mortality represent one of the most important indicators of health conditions. For comprising the larger rate of deaths, the study of mortality in the elderly population is regarded as essential to understand the health situation. In this sense, the present study aims to analyze the mortality profile of the population from 60 to 69 (young elders) and older than 80 years old (oldest old) in the Rio Grande do Norte state (Brazil) in the period 2001 to 2011, and to identify the association with contextual factors and variables about the quality of the Mortality Information System (SIM). For this purpose, Mortality Proportional (MP) was calculated for the state and Specific Mortality Rate by Age (CMId) , according to chapters of ICD- 10, to the municipalities of Rio Grande do Norte , through data from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IGBE). In order to identify groups of municipalities with similar mortality profiles, Nonhierarchical Clustering K-means method was applied and the Factor Analysis by the Principal Components Analysis was resort to reduce contextual variables. The spatial distribution of these groups and the factors were visualized using the Spatial Analysis Areas technique. During the period investigated, 21,813 younger elders deaths were recorded , with a predominance of deaths from circulatory diseases (32.75%) and neoplasms (22.9 %) . Among the oldest old, 50,637 deaths were observed, which 35.26% occurred because of cardiovascular diseases and 17.27% of ill-defined causes. Clustering Analysis produced three clusters to the two age groups and Factor Analysis reduced the contextual variables into three factors, also the sum of the factor scores was considered. Among the younger elders, the groups are called misinformation profile, development profile and development paradox, which showed a statistically significant association with education and poverty and extreme poverty factors, factorial sum and the variable related to underreporting of deaths. Misinformation profile remained in the oldest old group, accompanied by the epidemiological transition profile and the epidemiological paradox, that were statistically associated with the development and health factor, as well as with the variables that indicate the SIM quality: proportion of blank fields about the schooling and underreporting. It proposed that the mortality profiles of the younger elders and oldest old differ on the importance of the basic causes and that are influenced by different contextual aspects , observing that 60 to 69 years group is more affected by such aspects. Health inequalities can be reduced by measures aimed to improve levels of education and poverty, especially in younger elders, and by optimizing the use of health services, which is more associated to the oldest old health situation. Furthermore, it is important to improve the quality of information for the two age groups

Prevalência de incontinência urinária e fatores associados em idosos institucionalizados

Urinary incontinence (UI) is a geriatric syndrome that is especially prevalent in institutionalized individuals, and that causes economic and social impacts derived from treatment costs and overload of caregiver. UI also entails physical consequences to the health of the elderly, such as urinary tract infections or pressure ulcers, among other health problems. However, the existing national research on this condition is still scarce and comprises serious methodological biases. Therefore, the objective of this study is to determine the prevalence of urinary incontinence and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted between October and December, 2013 and carried out in 10 nursing homes in the city of Natal (Northeast Brazil). UI was verified through the program Minimum Data Set version 3.0, which was also used to assess fecal incontinence, urinary devices and UI control programs. Data collection included sociodemographic information, UI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity and Pfeiffer test for cognitive status). Bivariate analysis was performed using the Chi-Square Test (or Fisher‟s Exact Test) and the Linear Chi-Square Test, calculating the prevalence ratio with 95% confidence interval. Variables with p value under 0.20 were included in the multivariate analysis, which was performed using the Stepwise Forward logistic regression. The inclusion of variables in the final model depended on the likelihood ratio test, absence of multicollinearity and on the Hosmer-Lemeshow test. A statistical significance level of 0.05 was considered. Six (1.8%) hospitalized elderly, one individual in palliative care (0.3%) and one (0.3%) individual under the age of 60 were excluded from the study. The final sample consisted of 321 elderly, mostly females, with a mean age of 81.5 years. The prevalence of UI was 59.43% and the final model revealed statistically a significant association between UI and white race, physical inactivity, stroke, mobility constraints and cognitive decline. The most frequent UI type was functional UI due to physical or cognitive disability, and incontinence control measures were applied only to a minority of residents (approximately 8%). It is concluded that UI is a health issue that affects more than half of the institutionalized elderly, and is associated with white race, physical inactivity, stroke and other geriatric syndromes such as immobility and cognitive disability. Most of these associated factors are modifiable and therefore the findings of this study highlight the importance of UI prevention and treatment in nursing homes, which include general measures, such as physical and psychosocial activities, and specific measures, such as prompted voiding

Prevalência e fatores associados ao risco e a desnutrição em idosos institucionalizados

One of the most important problems in the elderly is a nutritional deficiency. Several physiological changes and the use of multiple drugs interfere with appetite, food intake and absorption of nutrients, which can lead to the risk and malnutrition in the elderly, especially among institutionalized. The present study aimed to evaluate the prevalence of malnutrition and risk for malnutrition and its associated factors in institutionalized elderly. The same can be characterized by the type individual, observational and cross-sectional. Obtaining the sample was through the records of individuals of long-stay institutions for the elderly in the city of Natal, RN. The elderly were evaluated through the Mini Nutritional Assessment (MNA) and triceps skinfold (TSF) and each senior or caregiver answered a questionnaire about information like type and dietary restrictions, accessibility to food, use of alcohol and tobacco, practice physical activity and appetite. Variables such as age, gender, education, marital status, time that the elderly living in the institution, the reason for the institutionalization and comorbidities were taken from the records of each senior. The frequency of food consumption of various food groups was assessed from the questionnaire frequency of feeding study Health, Wellbeing and Aging (HWA). Data were presented as means and standard deviations, absolute and relative frequencies. To analyze the frequency of consumption, there was a factor analysis with extraction of factors from the principal components analysis with varimax rotation. A bivariate analysis was performed using the chi-square and the magnitude of the effect observed by prevalence ratio (95% CI). The Poisson regression assessed the net effect of independent variables on the two outcomes, considering a significance level of 5%. We studied twelve Homes for the Aged totaling 381 seniors eligible for the study. The prevalence of risk of malnutrition was 46.1% (45.9 to 46.2) and malnutrition was 31.4% (31.2 to 31.5). The risk of malnutrition was significantly associated with the presence of urinary incontinence (RP = 1.444, 1.113 to 1.874) was associated with malnutrition and lack of appetite (RP = 1.757, 1.246 to 2.476), the fact that the individuals do not have access to food outside the institution (RP = 0.565, 0.337 to 0.946), low water consumption (RP = 1.646, 1.101 to 2.459) and dementia (PR = 1.537, 1.072 to 2.204). The high prevalence of malnutrition and risk of malnutrition in the study suggests that we should pay attention to information related to eating habits and the presence of comorbidities, as these can influence the nutritional status of this population

Iniciação sexual e fatores associados: um estudo com adolescentes escolares

A iniciação sexual é um marco significativo na vida do indivíduo, ocorrendo geralmente na adolescência. Importantes transformações biopsicossociais ocorrem nesta fase, denotando vulnerabilidades à vida do adolescente, dentre elas, as decorrentes da iniciação sexual, sendo o risco de infecção pelo HIV/aids a mais grave. A infecção pelo HIV/aids constitui atualmente um importante problema de Saúde Pública, estando os jovens no centro da epidemia mundial. No Brasil, dados do último boletim epidemiológico, lançado em 2013, apontam para a tendência de aumento de sua prevalência na população jovem. Desta forma, o presente estudo teve por objetivo investigar a associação entre iniciação sexual e o perfil sociodemográfico, o indicador de conhecimento das formas de transmissão do HIV/aids e fatores biopsicossociais autoestima e habilidades sociais, em adolescentes de 16 a 19 anos, de ambos os sexos, estudantes do nível médio técnico integrado, do Instituto Federal de Educação, Ciências e Tecnologia do Rio Grande do Norte, Campus Natal. Trata-se de um estudo transversal, cuja amostra foi constituída aleatoriamente por 200 alunos que responderam de forma anônima a quatro instrumentos: perfil sociodemográfico, questionário da Pesquisa de Conhecimentos, Atitudes e Práticas na População Brasileira (PCAP), Escala de Autoestima de Rosenberg e o Inventário de Habilidades Sociais para Adolescentes de Del-Prette (IHSA). A análise estatística dos dados foi realizada através do teste qui-quadrado de Pearson e do exato de Fisher (α <5%). A média de idade para a primeira relação sexual foi de 15,96 anos, com o início mais cedo para o sexo masculino. Verificou-se associações estatisticamente significativas entre iniciação sexual e as seguintes variáveis: idade, sexo, situação conjugal, religião, renda familiar, autoestima e o repertório de habilidades sociais. Observou-se ainda que apenas 11% dos adolescentes possuíam conhecimento correto acerca das formas de transmissão do HIV/aids. Conclui-se que os esforços para a prevenção das DST/aids precisam ser direcionados a campanhas e programas mais eficazes, que considerem não somente o caráter informativo, mas também os fatores psicossociais já que estes mostraram-se associados ao início da vida sexual

Prevalência e fatores associados à testagem para HIV em homens que fazem sexo com homens

A infecção por HIV/Aids (vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida) constitui um importante problema mundial de Saúde Pública. Dados do último boletim apresentado pela UNAIDS (Organização das Nações Unidas para Aids) em 2013, apontam que mais de 35 milhões de pessoas vivem com HIV em todo mundo. No Brasil, a epidemia é concentrada, com prevalência de infecção menor que 1% na população de 15 a 49 anos, porém chegando a 10,5% entre homens que fazem sexo com homens (HSH). O diagnóstico precoce do HIV se associa a uma redução da morbidade, mortalidade e também da transmissão desta infecção. O presente estudo tem o objetivo de avaliar a prevalência e fatores associados à testagem prévia para HIV na população de HSH dos municípios de Natal/RN e Parnamirim/RN. Os participantes respondiam a um questionário contendo perguntas referentes a dados sociodemográficos, padrões de relacionamento sexual, conhecimentos sobre HIV/Aids, uso de preservativo, consumo de álcool, drogas e busca de testagem para HIV e sífilis. Em seguida, os que desejassem poderiam realizar teste rápido para HIV e sífilis. No total, foram pesquisados 101 sujeitos, destes, 70 foram recrutados com a utilização da técnica Respondent Driving Sample, e 31 com uma amostra de conveniência. O teste de HIV havia sido realizado por 63,3% dos homens pelo menos uma vez na vida. A testagem prévia para HIV foi associada à idade (27 anos ou mais), realização prévia do teste para sífilis, conhecimento sobre locais onde o teste de HIV é feito gratuitamente e resultado positivo para sífilis no momento da pesquisa. A prevalência de testagem para HIV na amostra foi baixa, semelhante ao verificado em outros estudos com a população HSH. Ações que priorizem a divulgação de locais onde o anti-HIV pode ser realizado gratuitamente e direcionadas para o público jovem parecem ser as mais adequadas para a ampliação da testagem entre os HSH na nossa realidade

O estágio não-obrigatório na formação profissional dos(as) assistentes sociais: trabalho precarizado ou processo didático-pedagógico?

Coexisten, en el universo académico, prácticas curriculares obligatorias y no obligatorias que pueden ser remuneradas o no. Delante de la constatación de lagunas en la concepción, gestión y operacionalización de las prácticas no obligatorias remuneradas, escogimos este tema como objeto de nuestra investigación, tratando de analizarlo en el contexto de los cambios sociohistóricos contemporaneos y su influencia en la cualidad de la formación profesional del estudiante de la carrera de Servicio Social. Este estudio tiene como ¨locu¨ de investigación la Facultad de Servicio Social del Estado de Rio Grande del Norte (FASSO/UERN). Este estudio se caracteriza por la adopción de una perspectiva de análisis cualitativa, con la expectativa de develarlo mucho más allá de lo que se muestra en su aparecncia. Para esto, realizamos revisión de literatura, análisis de documentos, observación asistemática y entrevistas con estudiantes y profesionales de las entidades que ofrecen prácticas a los estudiantes. Además se incluyó, en los procedimientos metodológicos, la aplicación de encuestas y conversaciones informales. Constatamos la existencia de lagunas en el desarrolllo de las prácticas no obligatorias remuneradas, ocasionadas por la ausencia de supervisión y por la inclusión de pasantes en sectores y/o actividades desvinculadas de su futura profesión. La investigación nos permitió desvelar situaciones en las que la oferta de plazas ocurre en detrimento de la contratación de empleados, lo que configura un distanciamento de este componente curricular del área de formación profesional, desvirtuando su carácter educacional. Cientes de la coexistencia contradictoria entre situaciones ventajosas y problemáticas en las prácticas no obligatorias remuneradas para el proceso de formación profesional de los asistentes sociales, concluimos que esta modalidad de práctica cuando vinculada a la intervención de la facultad y bajo la supervisión de asistentes sociales, independiente de sus implicaciones en los intereses del mercado, potencializa el desarrollo de competencias y habilidades intrínsecas al proceso de formación profesional; pero si distanciada del área de formación y/o sin el debido acompañamiento didáctico-pedagógico establece poca o ninguna relación con la formación de los asistentes sociales. Pero, incluso distanciadas del ejercicio y de la formación académica en el área de servicio social y/o (llenas de aspectos frágiles) llenas de fallas en el proceso de enseñanza y aprendisaje, estas experiencias ejercen profunda influencia en la formación de los asistentes sociales, pudiendo fragilizar el compromiso con el proyecto ético-político, diseminar el aspecto subalterno de la profesión y hacer confuso y conflictivo el proceso de construcción de la identidad profesional. En este sentido, las inversiones de capital para reducir los gastos con mano de obra, las dificultades vividas por las universidades públicas brasileñas para garantizar la cualidad de la enseñanza delante de la insuficiencia de recursos humanos y materiales y la desvalorización de los componentes no obligatorios del proceso de formación profesional de los asistentes sociales, son factores que obstaculizan el reconocimiento y la materialización del potencial didáctico-pedagógico de las prácticas

O cotidiano do(a) Assistente Social frente as demandas apresentadas pela paciente portadora do câncer de mama em tratamento no Hospital Doutor Luiz Antônio em Natal/RN

This work deals with an analysis related to the social worker s practice in the oncology area. It aims to identify demands, work conditions as well as current challenges related to this profession. It considers the specificities of breast cancer and relates it to political decisions in the health sector considering the concept of contemporary capitalism. The study analyzes professional action and the demands presented by breast cancer patients who are currently in treatment in Hospital Dr. Luiz Antônio em Natal-Rio Grande do Norte-Brazil. The methodological procedures considered of documental analysis, semi-structured interviews (with two social workers that work with fifteen breast cancer patients) as well as participant observation; which was done counting with my own professional practice in the oncology area. Thus, the research also discusses the breast cancer issue in the life of the users considering their social-economical, cultural and political determinants. Factors such as age in which the diagnosis was known, the relation user/social workers, number of children, rights of the oncology patient, place where he/she lives, education, civil status, (re)insertion of the professional in the work field, perception of self-esteem and bio-psycho-social representation of breast cancer in the lives of these women, all of which were dealt with in this research

As condições de trabalho na área de saúde e o processo de adoecimento da (o) assistente social

The requirements in the world of work in the contemporary impact on quality of life, health workers in their relations with users and other professionals of the healthcare team. Given this reality, this study discusses the working conditions in health and disease process of (a) having social goals as analyze the implications of working conditions in the disease (the) social workers in state hospitals Metropolitan Region Christmas (NMR); identify the main diseases affecting social workers in hospitals in the SESAP NMR and reveal the relationship between the disease processes of social and working conditions in hospitals in the state NMR. The research was guiding questions to reveal how to configure the work, conditions of work and of the disease process (the) social worker. To grasp the socioeconomic profile of (the) social workers, the characterization of the work, duties and responsibilities in the sociooccupational, factors that interfere with the disease process of (the) social workers of RMN, and actions and investments Policy on Occupational Health RN correlating to illness today is that we set for the unveiling of the movement of the object of study through the methodological approach with documentary research aimed at literature review; extensive direct observation correlated to real life observation and application of 66 (sixty-six) questionnaires. The data from the closed questions were treated using the Statistical Package for the Social Sciences (SPSS). The open questions were transcribed and then analyzed the light of theoretical work on the subject. The research reveals that social workers are subject to conditions and labor relations precarious illness causing health problems because some of these professionals, among them are: stress, allergies and skin conditions or, Read / WMSD among other diseases. Thus, we understand the need for debates about the relationship work (the) social worker and worker health before the contradictions of capital also present in public health services

Turismo e meio ambiente: uma análise do ecoturismo e sua contribuição sócio-ambiental no distrito matutuine: caso da reserva especial de Maputo Moçambique

Mozambique holds a potential for tourism development, especially for nature tourism, due to the existence of conservation areas around the country. The Maputo Special Reserve (MES) is considered as one of the most important conservation area and has benefited from investment in order to incruse the development of tourism in the region. Currently the number of visitors to MES has grown substantially with the intention to develop recreational activities related to ecotourism. Now the challenge lies in the way of optimizing opportunities for tourism development in order to achieve economic benefitis reduction the lead to poverty, without degrading the environment. Ecotourism face the demands and environmental discussions has been assumed as an alternative to the tourist market focused on protected areas, as it is believed that this segment is able to reconcile tourism development and simultaneously improve the conservation of the natural environment and still ensure the recovery of local communities and promoting their welfare. This study aims to analyze, from the perception of the local community, social and environmental contribution of ecotourism in Maputo Special Reserve, Mozambique. The research sought to investigate the relationship between ecotourism development in the region and generate benefits for the socio-environmental communities for residents. To achieve the objective, was chosen a critical analysis about the generation of socio-environmental benefits versus ecotourism in which we opted for a qualitative and quantitative approach seeking to establish the degree of agreement and disagreement about the benefits generated by ecotourism through interviews with community members

Fatores que influenciam o apoio dos residentes á megaeventos: uma análise sobre o projeto FIFA WORLD CUP 2014 em Natal/RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Fatores que influenciam na efetivação de ações para o desenvolvimento do turismo municipal: uma análise da regionalização do turismo no Rio Grande do Norte no ano de 2012

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Fatores capazes de influenciar o apoio dos residentes ao desenvolvimento do turismo religioso em Santa Cruz - RN

This study is about the primary stakeholder management - the resident community, given its participation and support for the development of tourism in touristic destinations. It has as a general aim to analyze the factors that are capable to influence the residents‟ support to the development of religious tourism in Santa Cruz, RN, and the existing interrelationships between factors. In order to achieve this objective, it was necessary to use exploratory and descriptive research, followed by a quantitative approach through questionnaires with 422 residents of Santa Cruz -RN. The study was based on the variables relationship model proposed by Nunkoo and Ramkissoon (2012), it was also used the technique of Structural Equation Modeling - SEM, aiming to explain the relationships between the constructs studied. The results found on the survey suggest that the more residents realize the benefits generated by tourism, as well as trust in government actors in charge of tourism development, the more there will be a propensity to support the development of religious tourism. This result is similar to the one found in the study of Nunkoo and Ramkissoon (2012). We conclude that the structural model that best represents the reality of Santa Cruz -RN is composed of the factors: benefits, costs, and confidence in governmental actors, which are able to influence the support of Santa Cruz‟s residents for the development of religious tourism. It is also noteworthy that it was found a highly significant connection between the factors benefits perceived from tourism and confidence in governmental actors and between both of them, the political support for tourism

Fatores que afetam o apoio de residentes ao desenvolvimento do turismo em sítios arqueológicos: um estudo no Seridó Potiguar

The tourist activity , which appropriates spaces and natural , cultural , social and economic scenarios in a given locality , requires a model of integrated development necessarily reconciling the support of residents. In this perspective , this study aims to analyze the factors influencing the support of residents in tourism development in archaeological sites , specifically in the two counties of Parelhas and Carnaúba dos Dantas , in Rio Grande do Norte, in the region of Seridó Potiguar as well as the interrelationship existing between these factors . To achieve the proposed objective of the research , a descriptive -exploratory and quantitative study based on the study of Nunkoo and Hamkisson (2012 ) , using the technique of Structural Equation Modeling - SEM to explain the relationships of the constructs used in this research. Data collection was performed during the periodof May 2013 to July 2013. Among other studies, results indicate that , for the profile of the interviewees used , the higher the confidence of the community residing in the government agencies responsible for, the largest tourism will support the resident to the tourism development and that this supply relationship institutions and government agencies an opportunity to enhance their development strategies and social thinking of the resident agent of tourism . It was also found that the analysis model proposed has a better structural relationship when used interviewees who have knowledge about the activities in the archaeological sites , then suggesting the need for further research on the effect of the level of knowledge of the interviewee on the object and support of residents to tourism development

Impactos Geoquímicos e Sócio-Ambientais no Estuário do Rio Potengi Região Metropolitana da Grande Natal/RN

The present work studied the problems faced riverine populations of the estuary Potengi, detaching its perception with regard to the environment, as well as in the evaluation of the institucional arrangement that acts in the place. Questionnaires were used in five riverine communities and conducted interviews with agents of public agencies and colonies of fishermen. There is little understanding of the needing to preserve and weakness in the application of the regulation mechanisms

Caracterização sócio-ambiental do bairro de Felipe Camarão- Natal/ RN

The rapid growth of the Brazilian cities in the latest years has brought a series of problems regarding housing policies and, therefore, the provision of dwellings for the low-income class people. Following the pattern of other capital cities, Natal has repeated the pattern of urbanization practiced in the country, which concentrates the low-income class inhabitants in specific zones of the city known as peripheries or even in a dwelling place for less-favored classes such as Felipe Camarão, which is one of ten boroughs belonging to the western administrative zone, a region which has historically received less attention from the public administrators towards infrastructure investments. Based on those aspects, the general objective of this work is to investigate which main social-environmental alterations have resulted from the processes of urbanization and field occupation in that area. The specific objectives are concerned with verifying 1) the process of urbanization and the process of dividing urban soil from the 1960s; 2) the current configuration of the public spaces in the borough; 3) the process of the deprivation of the original landscape characteristics of Environmental Protection Zones; 4) the dynamics of land occupation which are predominant in dune areas; 5) the dynamics of land occupation which are predominant in mangrove areas; 6) and the destruction of green covering on the land with its consequent alteration of the local floristic pattern. The methodology consisted of in-loco visits; the application of questionnaires as community research; a survey of bibliography published by the organisms and institutions in charge of carrying out the city hall s environmental and housing policies; and descriptive statistics of the collected data. Concerning the pattern of occupation which is predominant in the borough, the treatment of space dispensed by the local dwellers has culminated in the emergence and consolidation of environmental alterations which are clearly different from common occurrence in both the building area represented by housing complexes and in the green areas represented by dunes and mangroves. The data show that there was the predominance of the irregular land occupation process over the official housing policy during the population settlement which contributed with a series of frequent and foreseeable problems in the dynamics of urbanization of poverty such as invasions and appropriations of land parcels, the beginning of irregular arrangement of streets, the formation of villages and slums, which are full of self-constructed housing units, and the occupation and degradation of susceptibly fragile environmental areas such as the dune slopes and the mangroves