Mortalidade infantil e condições socioeconômicas nas microrregiões do Nordeste Brasileiro

The study aims to answer the following question: what are the different profiles of infant mortality, according to demographic, socioeconomic, infrastructure and health care, for the micro-regions at the Northeast of Brazil? Thus, the main objective is to analyze the profiles or typologies associated mortality levels sociodemographic conditions of the micro-regions, in the year 2010. To this end, the databases of birth and death certificates of SIM and SINASC (DATASUS/MS), were taken from the 2010 population Census microdata and from SIDRA/IBGE. As a methodology, a weighted multiple linear regression model was used in the analysis in order to find the most significant variables in the explanation child mortality for the year 2010. Also a cluster analysis was performed, seeking evidence, initially, of homogeneous groups of micro-regions, from of the significant variables. The logit of the infant mortality rate was used as dependent variable, while variables such as demographic, socioeconomic, infrastructure and health care in the micro-regions were taken as the independent variables of the model. The Bayesian estimation technique was applied to the database of births and deaths, due to the inconvenient fact of underreporting and random fluctuations of small quantities in small areas. The techniques of Spatial Statistics were used to determine the spatial behavior of the distribution of rates from thematic maps. In conclusion, we used the method GoM (Grade of Membership), to find typologies of mortality, associated with the selected variables by micro-regions, in order to respond the main question of the study. The results points out to the formation of three profiles: Profile 1, high infant mortality and unfavorable social conditions; Profile 2, low infant mortality, with a median social conditions of life; and Profile 3, median and high infant mortality social conditions. With this classification, it was found that, out of 188 micro-regions, 20 (10%) fits the extreme profile 1, 59 (31.4%) was characterized in the extreme profile 2, 34 (18.1%) was characterized in the extreme profile 3 and only 9 (4.8%) was classified as amorphous profile. The other micro-regions framed up in the profiles mixed. Such profiles suggest the need for different interventions in terms of public policies aimed to reducing child mortality in the region

Conhecimento do enfermeiro sobre as ações de vigilância epidemiológica no Hospital Universitário Onofre Lopes, Natal, RN

This is an exploratory descriptive study with quantitative approach, aiming to verify the nurses' knowledge concerning the epidemiological surveillance activities at the Onofre Lopes hospital (HUOL), in Natal, Rio Grande do Norte. The study was performed with 63 nurses from the hospital and the data were collected through a questionnaire. All data were analyzed using descriptive statistics. The results were discussed and organized into four sections: nurses' knowledge on hospital epidemiological surveillance; procedures of the professional nurse through compulsory notification diseases; difficulties found by nurses to register the compulsory notification diseases and suggestions of strategies to joint epidemiological surveillance service with the care practices of nurses. The results showed that 55.55% of nurses know the main action of epidemiological surveillance, compulsory notification of diseases, and that 42.86% reported to the Hospital Epidemiology Center , while 57.14% did not allocate the information for this service. Most nurses found it difficult to perform notification for not knowing its flow; for the surveillance service does not operate 24 hours and for vagueness on diagnostic of disorders. Suggestions of strategies to improve the quality of epidemiological information are focused on training of nurses in hospital epidemiological surveillance; working in partnership with the surveillance center; diffusion of information on surveillance and conducting a daily active search. It comes to conclusion that most nurses don't notify the Surveillance Center about Compulsory Notification Diseases and it wasn't observed the incorporation of integrality values between the hospital surveillance and all nurses, since this principle guides the actions of health services based on dialogue, listening, ethical commitment, sharing of knowledge among professionals of various services and respect towards other professionals. Therefore, the integrality gap in the actions of the nurses studied, as well as in the surveillance service does not mobilize the potential of such services to changes in the sense of achievement of practices aimed at a special attention model that combines preventive and corrective actions, proposed and desired by SUS. Through the difficulties presented, it becomes important to recommend educational processes with strategy to transform the conducts, besides proposing actions under the principle of integrality provide responses agile and effective, as the purpose of VE hospital emergency care by the current epidemic

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