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

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

Análise da evolução costeira do litoral setentrional do estado do rio grande do norte, região sob influência da indústria petrolífera

The northern coast of Rio Grande do Norte State is characterized by strong changes in coastal morphology, caused by various geological and climatic factors. In this region are installed the main socio-economic activities of the State, highlighting the oil industry, which exerts much of its activities in the coastal area studied. Erosion is a constant problem in this region because it affects the entire local populace to the destruction of houses and trade, rendering tourism, affecting the livelihood activities and industrial activities. The greatest risk is related to environmental damage that can be caused by the oil spill in this region. To understand what determines the changes in coastal morphology this Doctoral Thesis is proposed to identify the factors at local, regional and even global corroborate coastal dynamics to this coast in question. For this study, used several different products and tools for interpreting the conditions of the erosive effect that dominates the whole northern coast of the State, in an attempt to quantify and describe the causes and effects that affect the entire coastal zone monitored. The development of activities is built into the projects Rede 05 PETROMAR (CTPETRO-FINEP/PETROBRAS/CNPq), PETRORISCO, HIDROSEMA, PETROMAR e Rede 05/04 POTMAR (FNDCT/CTPETROFINEP/ CNPq), in the activities of multidisciplinary and inter-features in issues involving environmental monitoring and oil activity

Fatores de sucesso ou insucesso do turismo ambientalmente sustentável : percepção das autoridades públicas no pólo costa das dunas do Rio Grande do Norte

This study aims to compare the thermal performance of tiles made from recycled material (waste packaging cardboard with aluminized film) with the tiles of fiber and bitumen, fiber cement and red ceramic with the aim of verifying the suitability of tile to be used in hot and humid climate of low latitude. The samples were selected according to the availability from Natal RN market, as they are sold to the consumers. The methodology was based on studies that used experimental apparatus composed of thermal chambers heated by banks of incandescent bulbs, to analyze the thermal performance of materials. The tiles in the study were submitted to analysis of thermal performance, thermophysical properties and absorptance, using chambers of thermal performance, measuring the thermophysical properties and portable spectrometer, respectively. Comparative analysis of thermal performance between two samples of the recycled material with dimple sizes and different amounts of aluminum were made, in order to verify, if these characteristics had some interference on the thermal performance of them; the results showed no significant performance differences between the samples. The data obtained in chambers of thermal performance and confirmed by statistical analysis, showed, that the tile of recycled material have similar thermal performance to the tile of fiber cement. In addition to these tests was carried out the automatic monitoring of a building covered with tiles of recycled material, to verify its thermal performance in a real situation. The results showed that recycled shingles must be used with technical criteria similar to those used for fiber cement tiles, with regard to the heat gain into the building. Within these criteria should be taken into account local characteristics, especially in regions with hot and humid climate, and its use must be associated, according to the literature, to elements of thermal insulation and use of passive techniques such as vented attics, ceilings and right foot higher

Fatores de riscos cardiovasculares em adolescentes da cidade do Natal-RN

Estudos têm demonstrado elevada prevalência de fatores de risco cardiovascular em adolescentes a redor do mundo, entretanto, é possível que esses fatores de risco se comportem de modo diferente em diferentes localidades. Objetivos: Examinar a prevalência do sobrepeso/obesidade e sua associação com outros fatores de risco cardiovasculares, em adolescentes, da cidade do Natal-Brasil. Métodos: Estudo observacional de delineamento transversal, realizado em 626 adolescentes (10 a 19 anos) de ambos os sexos. Foram estudadas as variáveis: peso, idade, gênero, cor, escolaridade, renda familiar, hábitos de vida, história familiar, peso, estatura, índice de massa corporal, relação cintura/quadril, pressão arterial, perfil lipídico, Glicose e Insulina de jejum e pós Dextrosol. Resultados: Foram avaliados 273 (43,6%) adolescentes do sexo masculino e 353 (56,4%) feminino. 26,4% dos adolescentes apresentaram sobrepeso/obesidade. A presença de obesidade familiar foi relatada por mais de 30 % da nossa amostra. Na análise de regressão logística múltipla; Idade, renda familiar, percentil de pressão sistólica, história familiar de hipertensão e obesidade, triglicerídeos, HDL colesterol, e HOMA RI mostraram-se associados com sobrepeso/obesidade. A relação cintura quadril apresentou-se mais elevada nas mulheres, e encontramos 10,9 % dos adolescentes com percentil de pressão sistólica (PAS) 95, e 7,4 % com percentil de pressão diastólica (PAD) 95. As dosagens de triglicerídeos, colesterol HDL e HOMA-RI alterados foram mais prevalentes nos que apresentavam IMC aumentado. As alterações do xi colesterol total, triglicerídios, glicemia pós dextrosol e HOMA teste, tiveram maior prevalência no gênero feminino. Na regressão logística binária, foram observadas associações do sobrepeso / obesidade com idade; OR 0,85, IC de 95% (0,78-0,92); p<0,001, pressão arterial sistólica; OR 2,65, IC de 95% (1,18- 5,94); p< 0,020, renda familiar; OR 2,34, IC de 95% (1,53-3,58); p< 0,001, história familiar de hipertensão arterial; OR 1,76, IC de 95% (1,15-2,71); p< 0,009, história familiar de obesidade; OR 1,50, IC de 95% (1,09-2,27); p< 0,04, aumento dos trigliceridios; OR 2,74, IC de 95% (1,69-4,43); p< 0,001, redução do colesterol; HDL OR 0,58, IC de 95% (0,38-0,87); p< 0,009 e o aumento do HOMA OR 3,16, IC de 95% (1,64 - 6,02); p<0,001. Conclusão: A prevalência de fatores de risco cardiovascular em Natal – Brasil se constitui em grave problema de saúde pública, atingindo níveis que se igualam ou até superam os de outras cidades tanto no Brasil, como em outros países

Alterações dos parâmetros climáticos no município de Apodi-RN, antes e após a construção da barragem Santa Cruz do Apodi, e formação do lago

Este trabalho teve como objetivo principal analisar as mudanças ocorridas no clima local onde o município de Apodi/RN está inserido, em virtude da construção da Barragem Santa Cruz do Apodi. Foram utilizadas para o tratamento dos dados climáticos precipitação pluviométrica, umidade relativa do ar e temperatura técnicas estatísticas como Desvio Padrão, Teste T, Coeficiente de Variação e Média aritmética, além do modelo matemático. Para o balanço hídrico foi aplicado o método de Thornthwait (1948), considerando dois períodos em análise: o anterior e posterior a construção da Barragem Santa Cruz do Apodi, respectivamente 1995 e 2005. os resultados obtidos permitiram inferir que a hipótese inicial levantada se confirma, ou seja, a construção da Barragem Santa Cruz do Apodi, está influenciando diretamente numa alteração no que concerne à condição atmosférica local, especialmente no parâmetro umidade relativa do ar. Quanto ao balanço hídrico, observou-se a predominância do déficit hídrico especialmente entre os meses de junho a janeiro, período de estiagem; um excedente ocorrente entre os meses de maio e junho, conseqüente do período chuvoso; e uma reposição hídrica antecedendo e sucedendo este período, chuvoso, ou seja, compreendendo os meses de fevereiro a junho. Todas as considerações e análises poderão contribuir para o planejamento de abastecimento d´água, a irrigação, auxílio na previsão de enchentes e estiagens, bem como o manejo do uso da água subterrânea

Distribuição socioespacial dos fatores dinâmicos da população na Região Metropolitana de Natal

The Metropolitan Region of Natal, like other metropolitan regions in Brazil, was marked by intense and rapid urbanization of the country occurred only in the second half of the twentieth century, coinciding with the process of consolidation of the industry in the country, resulting in serious urban social problems, such as the increase in slums, lack of infrastructure and this increase in violence in urban centers. When enters the reality of the metropolitan region, assessing the impacts of restructuring productive in the context of globalization, analyzing how the socio-economic factors influencing the dynamic of the population, whose configuration was shown to be contradictory according to social class busy. Accordingly, we studied the demographic configuration of the Metropolitan Region of Natal, analyzing their spatial distribution and their socio-demographic differences in light of building a type socio-space, which cuts the metropolitan space in homogeneous areas