BACKGROUND: Over recent decades, the nationwide prevalence of chronic disease among children and adolescents has been on the rise. Conditions such as obesity pose a significant risk to the physical and mental health of individuals in youth as well as in adulthood, as these health risks track into later years and increase in severity. Low-income and racial/ethnic minorities are disproportionately affected by chronic conditions. In particular, African American (AA) youth are reported to have a higher prevalence of fair/poor health than their Caucasian peers. Compounding the effects of this racial disparity in health is the disparity AA youth face in SES, as many live in poverty. The individual and environmental influences associated with factors of race and SES contribute to negative health behaviors leading to poor health status among AA youth living in disadvantaged communities. Health disparities have been shown to manifest in the earliest years of life, therefore the monitoring of at-risk populations of children and adolescents is essential to identifying, addressing, and reducing poor health outcomes throughout the course of life. OBJECTIVE: To determine the health status of AA children and adolescents living in a low-income community using multiple health measures, examine the relationships between these health measures in AA youth, as well as to identify barriers to participation in a family-oriented health promotion program. METHODS: A total of 111 AA boys and girls attending a community fine arts program located in a low-income suburb of Chicago participated in the study. Data from anthropometric measurements, the 20-m Shuttle Run Test, and curl-ups were collected and analyzed to assess the health measures of Body Mass Index (BMI) and BMI Percentile, Cardiorespiratory Fitness (CRF), and Muscular Fitness (MF), respectively. Data pertaining to barriers encountered in attending a health promotion program were collected from 13 families who were active members of the community fine arts program and had participated in health promotion program. The cross-sectional survey consisted of questions pertaining to the different components of the intervention program as well as to family demographic information. RESULTS: The prevalence of overweight and obesity in the entire study population was 34.2%, with 31.6% of boys and 34.8% of girls being classified as overweight/obese. 16.2% of youth categorized specifically as obese, with 26.3% of boys and 15.2% of girls being obese. 43.9% of study participants aged 10-18 years needed improvement in CRF, all of whom were girls. All but one boy reached the healthy fitness zone for curl-ups. Significant positive correlations were found between BMI and age as well as curl-ups and age, and significant negative correlation was found between CRF and age as well as BMI and CRF for AA youth. Of reported barriers, scheduling conflicts and time constraints were consistently most listed by survey respondents. CONCLUSION: Within the at-risk population of AA youth studied, despite high levels of MF, a large proportion presented with problematic health as indicated by the high levels of poor CRF and weight status observed, suggesting a need for intervention in order to address these health issues. An intervention program targeting youth within this and similar communities should take into consideration attenuating excessive program-associated expenses as well as offering more scheduling options and information on efficient food preparation and exercise.

The thesis titled "Health and social situation of people living in the excluded locality "Stalingrad", arose because nowadays they are socially excluded localities increasingly viewfinder researchers, scholars and not least the media. Residents of socially excluded localities get from their neighbors in most cases verbal abuse and an overall disinterest. Locations also receive various nicknames, such as "house of horror" or "gypsy ghetto". The theoretical part of the thesis describes and explains the basic concepts and phenomena that are the subject of the thesis. Such concepts and phenomena are eg. social exclusion and its effects on the lives of individuals affected, or causes of socially excluded localities and what people are at risk of social exclusion. Furthermore, the theoretical part describes the health situation of people living in socially excluded locality in general. There are presented the basic concepts that bind to a medical situation such as quality of life and determinants that affect health and condition. In the last part of the theoretical background is given governs employment and economic situation of the socially excluded locality, focusing on unemployment, work accidents and the impact of unemployment on health. The main aim of this thesis was to describe what health and social situation of people living in the excluded locality "Stalingrad" and the sub-objective was to determine what relationships are residents of the excluded localities "Stalingrad" with their neighbors who live near the site. Have been established two research questions were: VO1: What is the history of people living in the excluded locality "Stalingrad" in the health and social context? VO2: There is a relationship between social and health situation of people living in the Czech excluded locality "Stalingrad"? In the research part of the work is characterized by the research group, which consisted of two informants from socially excluded locality "Stalingrad" and three neighbors who live near that site. For data acquisition, qualitative and strategy to be exact, narrative interviews. Before beginning the interview informants were familiar to the interview and its course, and were satisfied that the talks are completely anonymous and will be used only for the purposes of this thesis. It was determined topic of conversation for people living in excluded locality "Stalingrad" I set the question "Tell me about your life in "Stalingrad" from the time you've moved up until now.". For people living close to the site was established topic question "Tell me about your relationship with the neighbors of "Stalingrad". Interviews were transcribed verbatim and then analyzed using open coding and axial coding. In the discussion of the information obtained is compared with the available literature and research. The results are that the health situation of these people of "Stalingrad" is hampered mainly because of the physically demanding work (work in the forest, in a construction company, car service). Health situation of the signed occupational injuries suffered by the informant and his friend. These injuries are undoubtedly permanently signed on the quality of life of these people. A potential threat to the health status of the moisture that gets into the homes destroyed because of the structure of the garage. The social situation is such that informant have due to high spending three jobs that have yet demanding working hours. Social situation affects the fact that residents of "Stalingrad" must commute to work, and that it must invest a larger sum of money to refurbishment of dwellings. In the past, there were some conflicts and problems with the adoption of the residents of "Stalingrad" in the village community. In the conclusion of thesis is mentioned possible use of this work. The work may be assisted by social workers or Roma coordinators in solving health and social situation of people living in the surveyed area.

It was previously proposed that expression of secondary sexual characteristics may provide cues to individual's immunocompetence. Body odour could partly serve as one of such characteristics, which provides crucial information about potentional partner even in humans. The main aim of the diploma thesis was to test a relationship between body odour quality and reactivity of immune system. In empirical part of the study we collected body odour samples from 21 men aged between 18-40 years before and two weeks after the vaccination against hepatitis A and B (Twinrix) and meningococcus (Menveo). The participant's blood samples were obtained three times to determine levels of IgG and IgM antibodies (markers of reactivity of immune system), testosterone, cortisol and CRP levels. In the second part of the study, a panel of 88 female raters aged 18-40 assessed body odour samples for their attractiveness, intensity and healthiness. In contrast to our expectations, we found no significant association between levels of antibodies induced by vaccination and perceived body odour attractiveness and health. Simultaneously, there were no significant changes in body odour ratings, neither in levels of testosterone and cortisol ratings, before and after the vaccination. However, we found a negative association...

Made available in DSpace on 2015-07-22T20:50:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-09-29 / Este trabalho busca correlacionar os indicadores de saúde Mortalidade Geral, Mortalidade Infantil, Materna e por Causas Externas com os indicadores macroeconômicos Inflação, Desemprego e Renda no Brasil durante o período de 1980-2009, contribuindo para a reflexão se as instabilidades ou recessões econômicas interferem na saúde dos indivíduos. A fundamentação teórica tem como base a literatura sobre condições macroeconômicas e saúde. Verificamos que existem diversos trabalhos relacionando a mortalidade com renda e desemprego, porém poucos que agregam a variável inflação, sendo que, dentre eles, nenhum especifica uma série histórica do Brasil. O método aplicado foi empírico-analítico de séries históricas dos Indicadores propostos, sendo que para os resultados das correlações utilizou-se a técnica de regressão linear simples, através do software STATA. Os resultados favoreceram a hipótese de Philips, ou seja, quanto existe queda da inflação, o desemprego aumenta e consequentemente a renda diminui; o que em tese temos piores condições de vida e saúde, consequentemente maiores taxas de mortalidade. Nas correlações entre mortalidade infantil, materna e externa, encontramos esse resultado; nas recessões econômicas as taxas de mortalidade aumentam. Acreditamos ser necessário certo grau de cautela na interpretação dos resultados, a fim de evitar a aceitação de associações definitivas sem considerar outras variáveis não analisadas nessa tese que podem sofrer variações por outros fatores. As análises de regressão efetuadas no presente trabalho sugerem que existe uma relação entre os indicadores de saúde e econômicos estudados, onde baixa inflação ocasiona aumento do desemprego e baixa renda, levando a pior condição de saúde e a elevadas taxas de mortalidade. / This work aims to correlate the health indicators General Mortality, Infant Mortality, Maternal and External Causes macroeconomic indicators with Inflation, Unemployment and Income in Brazil during the period 1980-2009, contributing to the debate if the instabilities or interfere in economic downturns health of individuals. The theoretical literature is based on macroeconomic conditions and health. We find that there are several studies relating mortality with income and unemployment, but few that add the variable inflation, and among them, none specifies a series of Brazil. The method was applied empirical-analytic time series of proposed indicators, and for the results of the correlations we used the technique of linear regression through the softwar STATA. The results favored the hypothesis of Philips, that is all that is fall in inflation, unemployment increases and income decreases accordingly, which supposedly have worse living conditions and health, hence higher rates of mortality. The correlations between child mortality, maternal and foreign, we find this result, economic downturns in mortality rates increase. We believe it is necessary degree of caution in interpreting the results in order to avoid outright acceptance of associations without considering other variables not analyzed in this thesis which may vary for other factors not considered. Regression analysis performed in this study suggest that a relationship exists between health indicators and economic studies, where low inflation leads to higher unemployment and low incomes, leading to poor health and high mortality rates. / TEDE / BV UNIFESP: Teses e dissertações

Este trabalho teve como objetivo desenvolver um modelo para mensuração do desempenho na gestão hospitalar por meio de indicadores chaves, desdobrados em boas práticas, elencados nas perspectivas do Balanced Scorecard visando delinear o enfoque estratégico organizacional. Após a delimitação das boas práticas, projetou-se a valoração da performance ideal esperada e diagnosticou-se a realizada, oportunizando a elaboração de um índice de desenvolvimento que foi submetido ao método de apoio a decisão multicritério ELECTRE II, resultando na ordenação para detecção e priorização das alternativas fragilizadas. Por meio de pesquisa bibliográfica, possibilitou-se evidenciar que uma quantidade relevante de trabalhos converge ao indicar como eficiente a utilização do BSC aliado aos métodos de apoio a decisão multicritério, sendo verificados 43 indicadores chaves de desempenho comumente utilizados. Destes, 15 foram escolhidos e desdobrados em 57 boas práticas, tidas por sub-indicadores, para aplicação do método de mensuração do desempenho hospitalar. Os resultados do método proposto demonstraram-se satisfatórios pelo fato de direcionarem os pontos críticos que necessitam serem melhores desenvolvidos na organização, além de apoiarem os processos de tomadas de decisão e estarem de acordo com a missão, visão e valores da organização estudada. / This study aimed to develop a model for performance measurement in hospital management through key indicators, unfold into good practices listed in the Balanced Scorecard perspectives aiming to outline the organizational strategic focus. After the definition of best practices, designed to valuation of ideal performance expected and diagnosed to held, providing opportunities for the development of a development index which was subjected to the method of supporting multi-criteria decision ELECTRE II, resulting in order to detect and prioritization of vulnerable alternatives. Through literature, if allowed to evidence that a significant amount of work converges to indicate how effective the use of BSC ally methods of supporting multi-criteria decision being checked 43 key performance indicators commonly used. Of these, 15 were chosen and deployed in 57 good practices taken by sub-indicators for the application of hospital performance measurement method. The results of the proposed method proved to be satisfactory because steering plenty of critical points that need to be better developed in the organization, and support decision-making processes and be in accordance with the mission, vision and values of the organization studied.

Justification de l’étude. Les déficits immunitaires primitifs (DIP) sont caractérisés par une grande hétérogénéité clinique, biologique, génétique et thérapeutique. Très peu de connaissances sont disponibles quant au devenir à long terme des patients en termes d’état de santé et de qualité de vie. Objectif : L'objectif principal de l’étude est de mettre en place un dispositif capable d’étudier les déterminants du devenir à long terme d’une cohorte de patients présentant un diagnostic de DIP diagnostiqué au cours de leur enfance. Résultats. Au 1er juin 2016, 1014 patients ont été inclus dans la cohorte sur les 1800 interrogés. La cohorte adulte montre que l’état de santé est marqué par la prévalence très élevée d’évènements de santé sévère ou très sévères (touchant 87% des adultes), avec un taux de cancer de 7.6%. Comparé aux normes françaises, tous les domaines de qualité de vie sont significativement altérés. Seuls les patients greffés présentent une qualité de vie meilleure par rapport aux patients non greffés. Nous montrons que la QoL est inversement proportionnelle à la survenue de complications sévères. L’étude pédiatrique fait le même constat, démontrant que c’est très tôt pendant l’enfance que surviennent les complications sévères dont l’impact sur leur qualité de vie est majeur. Conclusion : les patients atteints de DIP présentent un état de santé marqué par une fréquence très élevée d’évènements de santé de haut grade, et ceci très précocement dans l’enfance. La lourdeur de leur état de santé est le déterminant principal de la mauvaise qualité de vie des patients, justifiant d’une prise en charge spécialisée et multidisciplinaires dès le diagnostic posé. / Importance: Most children with primary immunodeficiencies (PID) now reach adulthood. Assessment of their long-term health status represents a major challenge. We aimed to gain insight into how PID affects patient health status and quality of life (QoL). Design: The French Reference Center for PIDs (CEREDIH) initiated a prospective multicenter cohort which enrolled participants who met all inclusion criteria: (1) patient with PID included in the CEREDIH registry, (2) clinical diagnosis before 18 years, (3) alive and living in France. Among 1810 patients eligible for inclusion (on 1/17/2016), 1047 were children, and 763 were adults. A severity score was assigned to each health condition: grade 1 (mild) to grade 4 (life-threatening/disabling). We report the health status of children by focusing on two endpoints: grade 4 conditions and grade 3 or 4 conditions. Results: In the adult study, only 12% of adults with PID had never experienced severe or life-threatening conditions, and 7.6% of patients had been diagnosed with cancer. Furthermore, adults reported significantly lower scores for all domains of QoL, and QoL was strongly associated with poor health conditions. In the pediatric study, the response rate was 62.5%. Of the 656 children participants, 83% experienced at least one grade 3 or 4 condition. Children with PID scored significantly lower for most QoL domains. QoL was strongly associated with heavy burden of health conditions. Conclusions: Taken together, these studies demonstrate that the deleterious health effects bore by patients with PID become heavy since childhood, emphasizing the need to establish multidisciplinary healthcare teams, from childhood.

Orientador: Maria da Luz Rosario de Sousa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-05T16:23:03Z (GMT). No. of bitstreams: 1 Batista_SuzyPessanhaRangel_M.pdf: 371104 bytes, checksum: 3b67095dc2f1e7d66440ff57330dd2be (MD5) Previous issue date: 2005 / Resumo: Os objetivos deste trabalho foram: 1) analisar o sistema de informação na saúde bucal em Campos dos Goytacazes (RJ) em 2004; 2) comparar a relação do IDH (Índice de Desenvolvimento Humano) com a saúde bucal nos municípios do norte fluminense do Estado do Rio de Janeiro em 2004; 3) verificar a prevalência e severidade da cárie dentária, em pré-escolares e escolares da rede pública, nas idades de 06 e 12 anos, em Campos dos Goytacazes (RJ), no ano de 2002. Para se atingir o objetivo 1 foram coletados dados através de leitura de documentos oficiais e algumas dissertações; resgate do histórico do Sistema de Informação na Saúde, através de entrevista semi-estruturada e finalmente comparação dos indicadores de avaliação do sistema de informação em saúde bucal deste município, disponibilizados pelo Sistema de Informação SIA/SUS, em relação àqueles sugeridos por Narvai (1996). Para se atingir o objetivo 2 os dados do IDH (Índice de Desenvolvimento Humano) foram coletados no site do PNUD (Programa das Nações Unidas para o Desenvolvimento) e os dados de saúde bucal foram coletados no site do DATASUS (Departamento de Informação e Informática do Sistema Único de Saúde) no ano de 2004. Para atingir-se o terceiro objetivo realizou-se um levantamento epidemiológico e a amostra aleatória e sistemática, sendo realizados exames bucais de 528 escolares. Estes exames foram realizados segundo os critérios da Organização Mundial da Saúde (WHO, 1997), utilizando-se os índices ceod e CPOD para cárie dentária. Dos indicadores do modelo de atenção obteve-se 14,2% de procedimentos preventivos individuais, 23,4% de procedimentos coletivos, 3,9% de serviços especializados, atingindo uma média de 8 minutos por atendimento e com acesso à assistência de 31,2% à população, caracterizando uma ênfase restauradora e não mutiladora. No segundo capítulo a maioria dos municípios do Norte Fluminense do Estado do Rio de Janeiro apresentou seu IDH médio (entre 0,500 e 0,799) seguindo o parâmetro nacional e que o município com o mais baixo IDH apresentou o maior percentual de exodontias por ações individuais e a menor cobertura de consulta odontológica e o município com o mais alto IDH apresentou o maior percentual de procedimentos coletivos. No terceiro capítulo aos 06 anos de idade, o ceod foi de 3,2, sendo que 28,0% eram livres de cárie e aos 12 anos de idade o CPOD foi de 3,1, sendo 23,1% livres de cárie / Abstract: The objectives of this work were: 1) to analyze the information system in the oral helth of Campos dos Goytacazes (RJ) in 2004; 2) to compare the relation of IDH (Human Development Index) with the oral health in the cities of the north ¿fluminense¿ in the state of Rio de Janeiro in 2004; 3) to verify the prevalence and severity of tooth decay, in schools and preschool of the public net, in the ages of six and twelve years old, in Campos dos Goytacazes (RJ), in the year of 2002. In order to reach the objective 1, the data were collected through the reading of official documents and some dissertations; the retrieval of the history of the Health Information System, through a semi-structured interview and finally, a comparison of the evaluation indicators of the information system in the oral health of this city, available through the Information System SIA/SUS, in relation to that suggested by Narvai (1996). To achieve the objective 2, the data of the the IDH (Index of Human Development) were collected in the site of the PNUD (United Nation Program for Development) and the data of oral health were collected in the site of the DATASUS (Information and Informatique Department of the Single Health System) in the year of 2004. To reach the third objective, it was done an epidemiological study and a systematic and random sample, and 528 oral examinations were made in schools. These examinations were realized according to the World Health Organization (WHO, 1997) criteria, using the dmft and DMFT criteria for tooth decay. From the indicators of the model, it was obtained 14,2% of individual preventive procedures, 23,4% of collective procedures, 3,9% of specialized services, reaching a mean of 8 minutes for each appointment and the access to the assistance was 31,2%, characterizing an emphasis to the restoration and no-mutilating. In the second chapter, the majority of the cities of the north ¿fluminense¿ of the state of Rio de Janeiro showed its mean IDH (between 0,500 and 0,799) following the national parameter and the city with the lowest IDH showed the greatest percentage of exodontics by individuals actions and the smallest coverage of dental visit and the city with the highest IDH showed the greatest percentage of collective procedures. In the third chapter at six years old, the dmft was 3,2; with 28% decay free and at twelve years old the DMFT was 3,1; with 23,1% decay free / Mestrado / Saude Coletiva / Mestre em Odontologia

Orientador: Maria Ines Monteiro / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-08T15:24:21Z (GMT). No. of bitstreams: 1 Vedovato_TatianaGiovanelli_M.pdf: 23337257 bytes, checksum: e75fa12c7ad84b24943b71cee30e8412 (MD5) Previous issue date: 2007 / Resumo: O objetivo dessa pesquisa foi caracterizar o perfil sociodemográfico, estilo de vida e condições de saúde e trabalho relacionados com a capacidade para o trabalho dos professores do ensino fundamental e médio. Trata-se de um estudo transversal com amostra intencional realizado em nove escolas estaduais em duas cidades do interior do estado de São Paulo. Utilizaram-se: o questionário com dados sociodemográficos, estilo de vida, trabalho e riscos ocupacionais; o instrumento para avaliar o índice de Capacidade para o Trabalho (ICT) e o Questionário sobre Estresse Ocupacional. A amostra foi composta por 258 professores, sendo 81,8% mulheres, com média de idade de 41,4 anos (DP 9,2) e 43,4% eram sedentários. A média do ICT desses professores foi de 38,6 pontos (DP 5,8). Os riscos no trabalho mais destacados foram repetitividade de movimentos, uso constante da voz e trabalho estressante. Houve associação estatística significativa entre baixa capacidade para o trabalho e as variáveis sexo/feminino (p=0,0321); idade (diminuição do escore do ICT com a elevação da idade) (p=0,0155); saúde comparada com a de outras pessoas como pior ou igual (p<0001); dor nos últimos seis meses e/ou na última semana (p<0001); uso de medicamentos (p<0001) e os que não praticavam atividade física (p=0,0237). Esses dados sugerem a necessidade de ações que visem a promoção à saúde dos professores e a prevenção do desgaste mental e físico visando melhorias nas condições de trabalho das escolas / Abstract: The aim of this study was to feature the social-demographic profile, life style, health and work status related to the work ability of teachers from primary and secondary school levels. One is about a cross-sectional study that had intentional choice of nine state schools with balance of interviews in two towns in Sao Paulo state. They had been used: the questionnaire with social-demographic data, life style, work and occupational risks; instruments to evaluate the Work Ability Index (WAI) and the Occupational Stress Questionnaire (OSQ). The sample was composed by 258 school teachers, being 81.8% females, with an average age of 41,4 years (SD 9,2) and 43.4% were sedentary. WAI mean score from these teachers was 38,6 (SD 5,8). The most relevant work risks were: repetitive movement, constant use of voice and stressful work. There has been a significant statistical association among the worst WAI and women variables (p=0,0321), age (reduction props up of the WAI with the rise of the age) (p=0,0155) also it diminishes the WAI, compared health status to other people as being worse or equal (p<.0001); pain in the last six months and/or last week (p<.0001), medicine use (p<0001) and did not practice physical exercises (p=0,0237). These data suggest the need of actions that lead to healthcare policies for teachers and prevention of physical and mental stress and the improvements of schools work conditions / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

Objetivo: Discutir criticamente, descrever e analisar os dados de óbitos infantis disponibilizados pelos serviços públicos da província de Cabinda-Angola. Método: Foram estudados nascimentos vivos em hospitais da província de Cabinda, e óbitos de menores de um ano de idade, nos anos 2007 e 2008. Como fonte de dados foram utilizados os registrados nos livros de registro dos hospitais municipais, d o hospital provincial e do escritório provincial da OMS de Cabinda. Os dados são contextualizados pela experiência do autor como habitante da região. Resultados: Os resultados deste trabalho mostram que em 2008 morreram mais crianças no primeiro dia de vida (109) que nos 11 meses restantes (97). Contudo, evidencia-se que 200 óbitos (54,64 por cento ) ocorreram em menores de 28 dias de idade em 2007 enquanto que para o mesmo período em 2008 morreram 178 crianças, Quanto às causas básicas de mortes infantis, a malária é destacada como principal causa. Isoladamente a malária responde aproximadamente por uma morte a cada três crianças falecidas. Dentre as doenças evitáveis por vacinação, o tétano responde por cerca de 5 por cento das mortes. Entre as doenças controláveis por saneamento básico, as diarréias ocupam posição de destaque 9,83 por cento em 2007 e 3,27 por cento em 2008. A redução de 65 para 40 óbitos por pneumonia entre as crianças inscreve-a como segunda ou terceira causa mais importante de óbito entre as crianças cabindenses, partilhando espaço com a asfixia neonatal (17,75 por cento em 2007 e 26,90 por cento em 2008). Apesar das dificuldades e limitantes da qualidade das informações encontradas durante a coleta de dados, buscou-se valorizar as existentes e que foram analisa das neste trabalho. Conclusões: Os resultados obtidos indicam que em Cabinda, melhorias na qualidade de assistência pré-natal, ao parto e ao recém-nascido de risco, poderiam reduzir ainda que parcialmente a Mortalidade Infantil. Fatores como condições inadequadas de abastecimento de água, falta de saneamento básico, dentre outros, revelaram ter papel importante como condicionantes da elevada Mortalidade Infantil observada em Cabinda. Apesar de ser atraente priorizar investimentos dos recursos em ações curativas, este trabalho reforça a perspectiva revisitar as políticas locais de Saúde e priorizar as atividades preventivas nos municípios da grande Cabinda. Assim, sugere-se a implantação de uma rede primária de assistência à saúde e um investimento permanente na melhoria da qualidade das informações de Saúde / Objective: To critically discuss, describe and analyze the infant deaths data available for public services in the province of Cabinda-Angola. Method: A total of live births in hospitals in the province of Cabinda, and deaths of children under one year of age, in years 2007 and 2008. The data source were used those recorded on the records of municipal hospitals, the provincial hospital and the provincial office of WHO in Cabinda. The data are contextualized by the author\'s experience as an inhabitant of the region. Results: The results of this study suggested that in 2008 more children died in the first days of life (109) than in the remaining 11 months (97). However, it is clear that 200 deaths (54.64 per cent ) occurred in children younger than 28 day- old in 2007 while for the same period in 2008 died 178 children. As the root causes of child deaths, malaria is highlighted as the main cause. Malaria alone accounts for approximately one death every three children who die. Among the vaccinepreventable diseases, tetanus accounts for about 5 per cent of deaths. Among the diseases controlled by sanitation, diarrhea, occupy a prominent position in 2007, 9.83 per cent and 3.27 per cent in 2008. The reduction from 65 to 40 deaths from pneumonia among children falls as the second or third most important cause of death among children Cabinda, sharing space with neonatal asphyxia (17.75 per cent in 2007 and 26.90 per cent in 2008). Despite the difficulties, limiting the quality of information found during the data collection, we sought to enhance existing ones, which were analyzed in this work. Conclusions: The results indicate that in Cabinda, improvements in quality of prenatal care, childbirth and the newborn at risk, even partially could reduce infant mortality. Factors such as inadequate water supply, poor sanitation, among others, were found to have important role as determinants of high infant mortality observed in Cabinda. Despite being attractive investments prioritize resources on curative actions, this work reinforces the perspective of revisit policies and prioritize local health preventive activities in the great area of Cabinda. Thus, we suggest the establishment of a network of primary health care and an ongoing investment to improve the quality of information on Health

O envelhecimento populacional vem ocorrendo de forma extremamente rápida nos países em desenvolvimento, implicando em maior prevalência de doenças crônico-degenerativas. Dentre estas, destaca-se o diabetes mellitus, síndrome caracterizada por estado crônico de hiperglicemia e distúrbios no metabolismo de carboidratos, lipídios e proteínas, associada à deficiência absoluta ou relativa de insulina e/ou à sua ação no organismo. A prevalência de diabetes vem aumentando em proporções epidêmicas, principalmente entre os idosos, e suas complicações são altamente incapacitantes e onerosas para o Sistema de Saúde. Assim, os objetivos do presente estudo foram: traçar o perfil das condições de vida e saúde da população idosa (60 anos e mais), residente no município de São Paulo, portadora de diabetes mellitus e verificar a associação da doença à ocorrência de óbito nesta população em um período de seis anos. Para isso foram utilizados dados do Estudo SABE– Saúde, Bem-Estar e Envelhecimento, inquérito multicêntrico desenvolvido em países da América Latina e Caribe. Este estudo caracteriza-se, no primeiro momento, como uma pesquisa exploratória, descritiva, retrospectiva e com abordagem quantitativa, e no segundo momento, como um estudo longitudinal. A prevalência de diabetes mellitus encontrada foi de 17,9%, comparável à de países desenvolvidos; esta prevalência decrescia com a idade, levando à suposição de que estes idosos estariam tendo uma mortalidade precoce. Mulheres apresentaram maior prevalência em todas as faixas etárias. Quanto às condições sócio-demográficas, verificou-se que os diabéticos, sobretudo as mulheres, possuíam baixa escolaridade e referiram renda insuficiente para suas despesas; uma parcela importante destes idosos ainda trabalhava, justificando a necessidade de aumentar sua fonte de renda. A maioria dos homens vivia em casais ou em arranjos bigeracionais, enquanto as mulheres viviam em arranjos bi e trigeracionais, refletindo maior dependência destas com relação à ajuda de filhos e/ou netos. Verificou-se com grande freqüência inadequação do tratamento da doença nestes idosos, com 16% em monoterapia com dieta e 17,4% sem tratamento algum; apesar disto, a maioria acreditava ter bom controle da doença. Encontrou-se entre os diabéticos maiores prevalências de obesidade, sedentarismo, hipertensão, doenças cardíacas, artrite, acidente vascular cerebral, amputações de membros inferiores, quedas, incontinência urinária e intestinal, dificuldade nas atividades de vida diária, declínio cognitivo e depressão. A procura por atendimento médico e internações hospitalares também foram mais freqüentes entre os portadores da doença, que também apresentaram internações mais prolongadas, refletindo o impacto da doença no Sistema de Saúde. Por fim, verificou-se através de regressão logística a grande influência do diabetes mellitus no desfecho óbito, multiplicando este risco em 2,55 vezes quando associado a outras enfermidades. Estes resultados reforçam a necessidade do estabelecimento de políticas públicas voltadas para a detecção precoce da doença e prevenção de suas complicações, principalmente nas faixas etárias mais elevadas / Population ageing has been occurring extremely fast in developing countries, leading to high rates of chronic diseases. Diabetes mellitus, a syndrome characterized by chronic hyperglycemia and disturbances of carbohydrate, fat and protein metabolism associated with absolute or relative deficiencies of insulin and/or in its action, is one of the most important of these conditions. Prevalence of diabetes is increasing in epidemic proportions, especially among older people, and the burden of its complications constitutes a serious health problem. The purposes of this study were: to describe social and health conditions of elderly diabetic subjects living in the city of São Paulo and to investigate the association between diabetes and mortality in a period of six years. This study is part of the project entitled SABE – Health, Ageing and Well-Being, a multicenter survey conducted in Latin America and The Caribbean. Prevalence of diabetes in people aged &#8805; 60 years was 17,9%, as high as in most developed countries; this prevalence decreased with age, leading to the supposition that these elders are dying sooner than non diabetic subjects. Women had higher prevalences in every age group. It was found that diabetic elders, especially women, were low-income and had poor educational level; most of those subjects were still working at the time of the survey. Men tended to live with their wives or with sons/daughters, while women tended to live with sons/daughters and/or grandchildren, reflecting higher need of care. It was verified that treatment of diabetes was far from ideal in this population, 16% were under monotherapy with diet and 17,4% were not receiving any treatment; despite that, most of the patients believed having good control of diabetes. Prevalences of obesity, physical inactivity, hypertension, cardiac diseases, arthritis, stroke, lower limb amputations, falls, urinary and fecal incontinences, functional and cognitive impairment and depression were higher in diabetic than in non diabetic elders. Frequencies of physician visits and hospitalizations were also higher among elderly diabetic patients, and hospitalizations tended to be longer in this population, reflecting its burden on health system. The impact of diabetes on mortality was verified through logistic regression model. It was found that diabetes associated with at least one comorbid condition increased mortality risk (odds ratio) in 2,55 (p=0,000). These findings show that public health policies are necessary to get earlier diagnosis and prevent the complications of diabetes, especially among elderly people