Úlceras de pressão: um estudo com pacientes de unidade de terapia intensiva

To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study

Atributos físicos de Latossolos adubados durante cinco anos com biossólido

A utilização do biossólido para fins agrícolas tem sido uma alternativa viável para resíduos de origem domiciliar e industrial. O objetivo deste trabalho foi avaliar o efeito da aplicação de biossólido nos atributos físicos de Latossolo Vermelho distrófico, textura média (LVd), e Latossolo Vermelho eutroférrico argiloso (LVef). Utilizaram-se as doses, acumuladas em 5 anos, de 0,0, 25,0, 47,5 e 50,0 Mg ha-1 de matéria seca de biossólido, incorporadas até 0,1 m com grade. As amostras deformadas foram coletadas no quinto ano, após a colheita do milho, nas camadas de 0,0-0,1, de 0,1-0,2 e de 0,2-0,3 m para determinação da composição granulométrica e matéria orgânica. As amostras indeformadas coletadas com cilindros metálicos de 0,030 m de altura e 0,048 m de diâmetro, também no quinto ano, foram utilizadas para determinação da densidade, porosidade e retenção de água no solo. A macroporosidade foi superior a partir de 47,5 Mg ha-1 e 50,0 Mg ha-1 de biossólido, no LVd e LVef, respectivamente, e a densidade do solo foi inferior na dose de 50,0 Mg ha-1 no LVd de textura média, na camada de 0,0-0,1 m. A aplicação de 50,0 Mg ha-1 de biossólido não alterou a porosidade total, a microporosidade e a retenção de água nos dois solos. O efeito da aplicação do biossólido depende do tipo de solo e da quantidade aplicada.

Seleção para peso pós-desmama em um rebanho Gir. 1. Resposta direta e correlacionada em 21 anos de seleção

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Uso de técnicas de otimização baseadas em derivadas como suporte do planejamento operacional de redes de distribuição de energia elétrica

The usual programs for load flow calculation were in general developped aiming the simulation of electric energy transmission, subtransmission and distribution systems. However, the mathematical methods and algorithms used by the formulations were based, in majority, just on the characteristics of the transmittion systems, which were the main concern focus of engineers and researchers. Though, the physical characteristics of these systems are quite different from the distribution ones. In the transmission systems, the voltage levels are high and the lines are generally very long. These aspects contribute the capacitive and inductive effects that appear in the system to have a considerable influence in the values of the interest quantities, reason why they should be taken into consideration. Still in the transmission systems, the loads have a macro nature, as for example, cities, neiborhoods, or big industries. These loads are, generally, practically balanced, what reduces the necessity of utilization of three-phase methodology for the load flow calculation. Distribution systems, on the other hand, present different characteristics: the voltage levels are small in comparison to the transmission ones. This almost annul the capacitive effects of the lines. The loads are, in this case, transformers, in whose secondaries are connected small consumers, in a sort of times, mono-phase ones, so that the probability of finding an unbalanced circuit is high. This way, the utilization of three-phase methodologies assumes an important dimension. Besides, equipments like voltage regulators, that use simultaneously the concepts of phase and line voltage in their functioning, need a three-phase methodology, in order to allow the simulation of their real behavior. For the exposed reasons, initially was developped, in the scope of this work, a method for three-phase load flow calculation in order to simulate the steady-state behaviour of distribution systems. Aiming to achieve this goal, the Power Summation Algorithm was used, as a base for developping the three phase method. This algorithm was already widely tested and approved by researchers and engineers in the simulation of radial electric energy distribution systems, mainly for single-phase representation. By our formulation, lines are modeled in three-phase circuits, considering the magnetic coupling between the phases; but the earth effect is considered through the Carson reduction. Its important to point out that, in spite of the loads being normally connected to the transformers secondaries, was considered the hypothesis of existence of star or delta loads connected to the primary circuit. To perform the simulation of voltage regulators, a new model was utilized, allowing the simulation of various types of configurations, according to their real functioning. Finally, was considered the possibility of representation of switches with current measuring in various points of the feeder. The loads are adjusted during the iteractive process, in order to match the current in each switch, converging to the measured value specified by the input data. In a second stage of the work, sensibility parameters were derived taking as base the described load flow, with the objective of suporting further optimization processes. This parameters are found by calculating of the partial derivatives of a variable in respect to another, in general, voltages, losses and reactive powers. After describing the calculation of the sensibility parameters, the Gradient Method was presented, using these parameters to optimize an objective function, that will be defined for each type of study. The first one refers to the reduction of technical losses in a medium voltage feeder, through the installation of capacitor banks; the second one refers to the problem of correction of voltage profile, through the instalation of capacitor banks or voltage regulators. In case of the losses reduction will be considered, as objective function, the sum of the losses in all the parts of the system. To the correction of the voltage profile, the objective function will be the sum of the square voltage deviations in each node, in respect to the rated voltage. In the end of the work, results of application of the described methods in some feeders are presented, aiming to give insight about their performance and acuity

Produtividade e acúmulo de potássio na soja em função da antecipação da adubação potássica no sistema plantio direto

A aplicação antecipada de fertilizante potássico no cultivo de espécies de cobertura no sistema plantio direto (SPD) pode ser vantajosa para a lavoura comercial. O objetivo deste trabalho foi avaliar a produtividade de grãos e a acumulação de K na soja em função da aplicação antecipada de fertilizante potássico na instalação do milheto em relação com o K aplicado na semeadura da soja subseqüente no SPD. O experimento foi realizado na FCA-Unesp em Botucatu-SP, nas safras 2000/2001, 2001/2002 e 2002/2003. Utilizou-se um Latossolo Vermelho distroférrico de textura média, que estava sendo cultivado com soja e aveia-preta no SPD, por dois anos antes da instalação do experimento. O milheto (Pennisetum glaucum) foi semeado em setembro sobre a palhada de aveia-preta (Avena strigosa), e a soja (Glycine max) na primeira quinzena de dezembro, nos três anos agrícolas. Utilizou-se o delineamento experimental em blocos ao acaso no esquema fatorial 4 x 4, com quatro repetições, com 0, 30, 60 e 90 kg ha-1 de K2O no milheto, combinados com 0, 30, 60 e 90 kg ha-1 de K2O na soja. Coletaram-se plantas de soja aos 25, 50, 75 e 100 dias após a emergência, e os grãos no final do ciclo, para a determinação do acúmulo de K e da produtividade. A antecipação de 60 a 90 kg ha-1 de K2O na semeadura do milheto não comprometeu o acúmulo de K na lavoura de soja. As máximas produtividades de soja foram alcançadas no primeiro e segundo ano com doses de 85 a 90 kg ha-1 de K2O, que poderiam ser antecipadas totalmente na semeadura da gramínea de cobertura. A aplicação antecipada de KCl na semeadura do milheto minimizou a exportação de K pela colheita de grãos de soja.

Plantas de cobertura e calagem na implantação do sistema plantio direto

O objetivo deste trabalho foi avaliar o efeito de plantas de cobertura e da calagem sobre a produtividade da soja e as características químicas do perfil do solo, após implantação do plantio direto. O experimento foi realizado em campo por dois anos, em Latossolo Vermelho‑Amarelo. A área era explorada como pastagem há cinco anos. Avaliaram-se três sistemas de cultivo: soja/pousio/soja, soja/Pennisetum glaucum/soja e soja/Urochloa ruziziensis/soja, com aplicação de calcário à dosagem de 0, 0,5, 1,0 e 2,0 vezes a quantidade necessária para elevar a saturação de bases (V) a 50%, na camada de 0-20 cm. O calcário foi incorporado ao solo, a 20 cm de profundidade, previamente à implantação dos sistemas de cultivo. Aos 490 dias após a calagem, foram coletadas amostras de solo das profundidades de 0-­10, 10-­20, 20-­40 e 40­-60 cm. Avaliaram-se o estado nutricional das plantas, as alterações das características químicas do solo e a produtividade da soja. As plantas de cobertura associadas à calagem promovem melhorias nos parâmetros de acidez do solo - sobretudo quando a dose aplicada é igual ou mais elevada do que a recomendada para V 50% -, e aumentam o teor foliar de P e a produtividade da soja, independentemente da calagem. Quanto maior a dose de calcário, maior é o avanço da frente alcalina no solo e a produtividade de grãos.

Teores de macronutrientes em pecíolos e folhas de figueira (Ficus carica L.) em função da adubação potássica

Objetivou-se com este experimento avaliar o estado nutricional de figueira (Ficus carica L., cv. Roxo de Valinhos) conduzida durante o estágio de formação (dois anos agrícolas), submetida a níveis crescentes de potássio. O experimento foi conduzido em área do Pomar da Fazenda Experimental Lageado, da Faculdade de Ciências Agronômicas, Campus de Botucatu. O delineamento experimental utilizado foi em blocos casualizados com quatro repetições e seis tratamentos, dispostos em esquema de parcelas subdivididas no tempo. Os tratamentos constituíram-se de seis níveis de adubação potássica (0, 30, 60, 90, 120 e 150 g. planta-1 de K2O) aplicados em cobertura. Foram realizadas avaliações do estado nutricional das plantas mediante amostragens de folhas e pecíolos cinco meses após a poda de inverno. Os teores nutricionais obtidos no segundo ano agrícola revelaram a manifestação de interação competitiva entre potássio e magnésio nas dosagens acima de 50 g. planta-1 de K2O. Os teores de nitrogênio e enxofre não foram afetados pelas doses crescentes de potássio e os de fósforo tiveram aumentos lineares.

Avaliação da disponibilidade hídrica e da demanda hídrica no trecho do Rio Piranhas-Açu entre os açudes Coremas-mãe D´água e Armando Ribeiro Gonçalves

Piranhas-Açu basin is a Federal watershed with a drainage area of 43.681,5 km2, sited at Brazilian northeast semi arid, with 60% of your area in Paraiba State and 40% in Rio Grande do Norte State. The main river, Piranhas-Açu, has strategic importance for development of these states, because it s an essential source for many socio-economics activities developed along watercourse. The river s reach between Coremas-Mãe D`água Dam and Armando Ribeiro Gonçalves Dam has many irrigation projects, and supply many riverside cities. All this activities practiced in this river s reach consumes high water volumes. Due the importance of this stream and the necessity of an adequate management, this work aims for an impartial and detailed evaluation of real water supply conditions in this river s reach, by the application of hydrological modeling, including the arrangement of main dams in tributaries, and storage reservoir water balance. The rainfall-discharge model s applied in each sub-basins it was selected the model MODHISA- Hydrological Model of Semi Arid, that is a concentrated model with easy application. The simulation produced 50 years of inflows into the reservoirs, for which, were constructed the guaranties curves; and produced 50 years of synthetic discharge data in relevant points on the river and on its affluents; so it was constructed the permanence curves. Confronting the available discharge with the current and futures volumes of raw water captured in this river s reach, it was verified that de demands have high guaranties. This work concluded that the MODHISA Model is suitable to reproduce the hydrologic characteristics of Piranhas-Açu sub-basins, and showing good results

Questões objetivas sobre funções das provas de matemática do vestibular da UFRN dos anos de (2001 a 2008): um diagnóstico sobre os erros que os candidatos cometem

La dificultad que los alumnos encuentran en el aprendizaje de matemática viene siendo objeto de investigación por estudiosos en educación matemática, tanto en Brasil como en el exterior. El objetivo de este estudio consiste em investigar las dificuldades en el aprendizado sobre funciones matemáticas y la influencia de las concepciones alternativas a partir de los errores que los candidatos acerca de las cuestiones sobre funciones en la prueba objetiva de matemática del acceso a la universidad de los años de 2001 a 2008. Teniendo como cuestiones de estudio para alcanzar el objetivo propuesto: identificar la relevancia del tema funciones que son contemplados en las pruebas de acceso a la Universidad; asi como cuáles han sido los tipos de funciones más privilegiados y menos privilegiados; analizar si la contextualización de la pregunta y la presencia de elementos no textuales han influenciado en el aumento de tal dificultad; analizar si la representación semiótica agrega mayor exigencia a la pregunta; analizar respecto a la exigencia matemática de la pregunta; analizar lo que se refiere al desempeño de los candidatos para verificar cuál pregunta tuvo mejor desempeño y cuál el peor e identificar los errores más frecuentemente cometidos por los candidatos en esas pruebas. Las reflexiones de los estudiosos como: Radatz (1980), Cury (1994), Socas (1997), Borasi (1997), Franchi e Rincón (2004), Pochulu (2004) presentan las dificultades en el aprendizaje matemático, que aparecen a partir de los errores cometidos por los alumnos, quando estos errores reciben la influencia de las concepciones alternativas. El estudio que se presenta en esta disertación configura un análisis de los errores que los candidatos han cometido en las preguntas objetivas sobre el tema funciones de las pruebas de acceso a la Universidad de los años de 2001 a 2008, a partir de los relatorios de la Comissão Permanente do Vestibular COMPERVE/UFRN. Con la intención de alcanzar los objetivos propuestos para este estudio, fueran sido construidas categorías de análisis. Los resultados encontrados han sido: El tema funciones es el más frecuente entre los demás con (28,1%); el tipo de función priorizada durante esos años ha sido la función logarítmica con (24%); la contextualización de las preguntas exige una mayor comprensión por parte del candidato de lo que las situaciones directas; la caracterización semiótica posee elementos que estructuran esas preguntas que el educando debe saber asociar al texto; la exigencia matemática posibilitó analizar que el procedimiento medio ha sido el más requisitado; el desempeño de los candidatos ha sido en la mayoría bajo (50%); y los principales errores que ellos han cometido han sido de realizar traducciones incorrectas de las expresiones que aparecen en las situaciones-problema; utilizar todos los datos que aparezcan en el problema sin tomar en cuenta si el cálculo realizado responde a la pregunta solicitada; no interpretar coherentemente las informaciones del gráfico; decodificar incorrectamente los valores representados por literales en una recta numérica. Los resultados señalizan la necesidad de una revisión didáctico-metodológicas de la enseñanza de funciones a raíz de las cuales las dificultades en el aprendizaje se han presentado

Relação entre índices fisiológicos aeróbios e desempenho em provas de curta e média duração em ciclistas de elite

Poucos são os estudos que possibilitam verificar quais as respostas fisiológicas são associadas ao desempenho em uma amostra de ciclistas de elite nacional. Portanto, o objetivo do presente estudo foi determinar e relacionar diferentes índices fisiológicos aeróbios com o desempenho em testes contra relógio de 4 e 20km em ciclistas de alto nível. A amostra foi composta por 14 ciclistas profissionais de elite nacional do sexo masculino (28,5 ± 4,7 anos, 73,47 ± 8,29 kg, 176 ± 6,76 cm), que realizaram um teste progressivo em laboratório para a determinação do consumo máximo de oxigênio (VO2max: 62,23 ± 8,28 ml·kg·min-1), intensidade relativa ao VO2max (iVO2max: 500,83 ± 58,65 w), economia de movimento (EM: 0,1166 ± 0,0362 ml·kg·min·w-1) e 1º e 2º limiares ventilatórios (LV1: 348,21 ± 43,26 w; LV2: 417,86 ± 60,79 w, respectivamente). Também foram submetidos a duas provas de 4 e 20km contra relógio. Para correlação entre os índices fisiológicos e desempenho, foi utilizado o coeficiente de correlação de Pearson (p< 0,05). Não foi encontrada correlação entre os índices fisiológicos (VO2max absoluto e relativo, iVO2max, EM, LV1 e LV2) e o desempenho de 4km (r= 0.38; 0.16; -0.33; 0.20; -0.50; -0.20, respectivamente) e 20km (r= 0.24; 0.01; -0.13; -0.12; -0.48; -0.19, respectivamente) contra relógio em atletas de alto nível. Estes resultados sugerem que tais variáveis não apresentam capacidade de explicar o desempenho em provas de contra relógio nas respectivas distâncias, provavelmente, devido à homogeneidade entre os sujeitos.

Desempenho de pacientes com acidente vascular encefalico em testes de reconhecimento de tividades de vida diaria com frequencia autocontrolada e pre- determinada Luciana Protásio de Melo Natal 2009

The stimulation of motor learning is an important component to a rehabilitation and type of practice used is de basic importance to Physiotherapy. The motor skills are the types more basic of behavior that subjects must acquire throughout its lives and observational learning one of forms for its acquisition. Objective: This study aimed to compare performance of patients post- stroke on test of recognition of activities of day life using self-controlled and externally determined practice. Intervention: Forty subjects had been evaluated, 20 stroke patients (the mean age was 57,9?}6,7 years, schooling 6,7?}3,09 years and time of injury 23,4?}17,2 months) and 20 health subjects (the mean age 55,4?}5,9 years and schooling 8?}3,7 years). All was evaluated about independence functional (FIM) and cognitive state (MMSE), and patients were also evaluated about neurologic state (NIHSS). Later, all realized a recognition of activities of day life test (drink water and speak to telephone) on self-controlled (PAUTO and CAUTO) and externally determined (P20 and C20) frequency. The stroke subjects also were examined for a three-dimensional system of kinematic analysis, when they have drink water. The statistic analysis was realized for chi-square and t Student tests. Results: This was not difference, about number of rightness, between groups of self-controlled and externally determined practice (p=502;0,005), and also not between patients and control groups (p=502;0,005). Patients mean velocity (PAUTO: 141,1mm/sec and P20: 141,6mm/sec) and peak velocity (PAUTO: 652,1mm/sec and P20: 598,6mm/sec) were reduced, as well as the angles reached for elbow (PAUTO: 66,60 and 124,40; P20: 66,30 and 128,50 extension e flexion respectively) regarding literature. Conclusions: The performance on recognition of activities of day life test was similar between on self-controlled and externally determined frequency, showing both technique may be used to stimulate motor learning on chronic patients after stroke

Avaliação da desadaptação das selas de próteses parciais removíveis após 1 a 5 anos de uso

The non-adaptation of the removable partial prosthesis (RPP) base to fibromucosal tissue is caused by resorption of residual ridges (RRR). The onset of bone resorption, which occurs after tooth extraction and continues throughout life, is accelerated by local or systemic factors. Aim: Assess the degree of non-adaptation of removable partial prosthesis saddles and the factors that influence it. Methodology: A sectional study was conducted with 81 patients using RPP who had their prostheses installed between 2003 and 2007 (1 to 5 years of use) at the Faculty of Dentistry of the Universidade Federal do Rio Grande do Norte (UFRN). After anamnese and clinical examination, a cast was made with polyether-based material, using the base of the prosthesis to make the impression. The base of the saddle was loaded with the casting material and positioned in the mouth, applying pressure on the supports. After polymerization, the material was removed from the saddle and measurements were taken at 3 different points using a pachymeter. Results: The non-adaptation of the saddle increased significantly with years of use (p = 0.005). The tooth-tissue supported prostheses obtained higher mean non-adaptation values than those of tooth supported prostheses (p < 0.001). Flaccid mucosa showed the worst non-adaptation results, which were statistically different from resilient mucosa (p < 0.001). The greater the extension of the saddle, the greater the non-adaptation (p < 0.001). The natural tooth antagonistic arch yielded better results than did RPP and total prosthesis (p < 0.001). Saddle non-adaptation at the free end was less near the pillar tooth and greater in the more posterior region (p < 0.001). When adaptation of the supports to the niches was poor, greater saddle non-adaptation occurred than when it was good or fair (p < 0.001). Saddles located in the posterior region of the arch had greater non-adaptation than those in the anterior region (p = 0.023). Conclusion: The mean non-adaptation of the saddle to the residual ridges was 0.27 mm. It can be concluded that, even with the use of RPP, bone height reduction was slight within the 1-5-year period of use. The following are factors that influence adaptation of the RPP saddle base: years of use, age, force transmission path to the alveolar bone, location of the toothless area, antagonistic arch, type of mucosa, adaptation of supports to the niche and extension of the saddle

Valor prognóstico de células TCD8+ E natural killer em carcinoma epidermóide oral e orofaringeano tratado com radioterapia e quimioterapia

The most common malignant neoplasm of the oral cavity and oropharynx are squamous cell carcinoma. Injuries to the same stage and subjected to the same treatment protocol have sometimes different evolutionary courses. The scope of this study was to investigate, through a retrospective cohort, associations between the number of CD8 + T cells and natural killer, identified immunohistochemically in the inflammatory infiltrate in a series of cases of oral squamous cell carcinoma and orofaringeano, and the level of tumor response to radiotherapy and chemotherapy, overall survival and relapse-free survival of patients. We identified 54 patients with unresectable disease were treated exclusively with radiotherapy and chemotherapy. The median follow-up was 22 months. The sample was characterized by the predominance of male subjects, median age 60 years, all were smokers. The most frequent site was the tongue and 81.5% were in stage IV. Patients with disease in the oral cavity had a worse response to treatment (p = 0.006), worse relapse-free survival (p = 0.007), worse overall survival (p = 0.007). The advanced T stage was shown a negative prognostic factor (p= 0.006) for the clinical treatment response made. Immunohistochemistry was performed to select CD8 + cells (anti-CD8) and NK cells (anti-CD57). Lymphocytes positive and negative markings were counted using the program ImageJ ®. Two groups were created for each marking evaluated: Group I patients with more than 50% cells positive, Group II: less than 50% of labeled cells. For CD8 + cells detected in 38 (70.3%) of Group I were CD8 + and 16 (29.7%) Group II CD8 +. For NK cells, 26 (48.15%) Group I NK and 28 (51.85%) Group II NK. Regarding the clinical response to treatment, we observed that 39% of patients achieved a complete response and 25.9% remained without recurrence at the end of follow-up. These results were better in Group I CD8 + (p = 0.2). Identified that 72.2% of patients progressed to death, this finding had no association with the immunohistochemical data. There was no statistically significant differences between the number of CD8 + and NK cells and the ability of tumor response to radiotherapy and chemotherapy, or with overall survival and relapse-free survival of patients. However, especially in relation to a learned response, we found that this group of patients with advanced disease have a low count of CD8 + T cells active. Believing in the role that the immune response plays in the local fight against neoplastic cells, however, our results do not support the use of quantitative analysis of CD8 + T cells and NK cells as a prognostic factors for oral squamous cell carcinoma and oropharynx

Soil management and nitrogen fertilization for sprinkler-irrigated upland rice cultivars

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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