Submitted by Nivaldo Melo (nivaldo.melo@ufvjm.edu.br) on 2015-11-24T15:49:30Z No. of bitstreams: 2 haroldo_neves_paiva.pdf: 1039434 bytes, checksum: 68f194144150cff188a3f0339ce8049d (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-12-01T16:26:06Z (GMT) No. of bitstreams: 2 haroldo_neves_paiva.pdf: 1039434 bytes, checksum: 68f194144150cff188a3f0339ce8049d (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) / Made available in DSpace on 2015-12-01T16:26:06Z (GMT). No. of bitstreams: 2 haroldo_neves_paiva.pdf: 1039434 bytes, checksum: 68f194144150cff188a3f0339ce8049d (MD5) license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Previous issue date: 2015 / O objetivo deste estudo foi investigar a preval?ncia do traumatismo dent?rio e associa??o com fatores cl?nicos: overjet e prote??o labial; demogr?ficos: sexo e condi??o socioecon?mica e fatores comportamentais: capital social e consumo de bebida alco?lica em binge em adolescentes. Estudo transversal foi realizado em um censo de 633 escolares de 12 anos de idade matriculados em escolas p?blicas e privadas da zona urbana da cidade de Diamantina, Minas Gerais. Dados foram coletados por meio de exame cl?nico e pela utiliza??o de question?rios autoaplic?veis. Foi adotada a renda familiar, escolaridade materna para avalia??o da condi??o socioecon?mica; o QCS-AE (Question?rio de Capital Social para Adolescentes Escolares) para medir o capital social e o AUDIT-C (Teste para Identifica??o de Problemas Relacionados ao Uso do ?lcool) para mensurar o consumo em binge de bebida alco?lica. Previamente foi realizado o treinamento e a calibra??o para o diagn?stico do traumatismo dent?rio adotando-se a classifica??o de Andreasen et al. As vari?veis cl?nicas overjet e tipo de prote??o labial foram avaliadas atrav?s de exame. Para obten??o dos resultados foram realizadas an?lise de frequ?ncia e teste de associa??o. As associa??es foram testadas pelo teste qui-quadrado, teste exato de Fisher (p < 0,05) e regress?o log?stica m?ltipla. A preval?ncia de traumatismo dent?rio foi 29,9% e do consumo em binge de bebida alco?lica 22,6%. O traumatismo dent?rio foi mais prevalente entre os adolescentes do sexo masculino (p = 0,010) com overjet acima de 5mm (p < 0,001)e prote??o labial inadequada (p < 0,001). Na an?lise univariada o capital social total (p = 0,039) e a confian?a (p = 0,014) estiveram associados ao traumatismo dent?rio. Os resultados da regress?o log?stica revelaram que o overjet acentuado, a prote??o labial inadequada e o consumo em binge de bebida alco?lica se mantiveram associados ao traumatismo dent?rio [RR = 3,80 (95% IC: 2,13-6,46) p < 0,0001], [RR = 5,58 (95% IC: 3,65-8,53) p < 0,0001] e [RR = 1,928 (95% IC: 1,213-3,063) p = 0,005]. A ado??o de um instrumento especialmente desenvolvido e validado para adolescentes escolares possibilitou a identifica??o dos dom?nios do capital social. A preval?ncia de traumatismo dent?rio aos 12 anos foi elevada e n?o houve associa??o estat?stica com o capital social. Adolescentes do sexo masculino, com overjet acentuado, prote??o labial inadequada e que consumiram bebidas alco?licas em binge tiveram quase duas / Disserta??o (Mestrado) ? Programa de P?s-Gradua??o em Odontologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2015. / ABSTRACT The aim of the present study was to analyze the prevalence of traumatic dental injuries in 12-year-old schoolchildren as well as associations with clinical factors: overjet and lip coverage; demographics: sex and socioeconomic status and behavioral factors: social capital and binge in drinking. A cross-sectional study was carried out involving 633 enrolled in public and private schools in urban areas of city Diamantina, Minas Gerais. Data were collected through a clinical examination and self-administered questionnaires. Socioeconomic data were collected using a questionnaire addressing household income and mother?s schooling, as well as the SCQ-AS (Social Capital Questionnaire for Adolescents Students) to measure social capital and the AUDIT-C (Alcohol Use Disorders Identification Test ? Consumption) to measure the binge in drinking. The classification proposed by Andreasen et al. was used for the determination of traumatic dental injuries. The clinical variables (overjet, lip protection) were determined through a clinical exam performed by an examiner who had undergone a training and calibration exercise. To obtain the results tests of frequency analysis and association were performed. Associations were tested using the chi-square, Fisher exact test (p < 0.05) and multiple logistic regression. The prevalence of dental trauma was 29.9% and the binge in drinking 22.6%. Dental trauma was more prevalent among males (p = 0,010), and those with accentuated overjet (p < 0.001) and with inadequate lip protection (p < 0.001). In univariate analysis, the total social capital (p = 0.039) and confidence (p = 0.014) were associated with dental trauma. The results of multiple logistic regression showed that the accentuated overjet, inadequate lip coverage and binge in drinking remained associated with traumatic dental injuries [RR = 3.80 (95% IC: 2.23-6,46) p < 0.0001], [RR = 5.58 (95% IC: 3.65-8.53) p < 0.0001] e [RR = 1.928 (95% IC: 1.213-3.063) p = 0.005]. The adoption of an instrument specifically developed and validated for schoolchildren 12-year-old allowed to identify several areas of the capital. The prevalence of traumatic dental injury (TDI) was high among the 12-year-old students analyzed. No significant associations were found between traumatic dental injury and socioeconomic status or social capital. Male students with accentuated overjet, inadequate lip coverage and binge in drinking had almost twice as more likely to be affected by traumatic dental trauma.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-22T19:21:56Z No. of bitstreams: 1 AnaKarlaBezerraLopes_DISSERT.pdf: 697846 bytes, checksum: c09eb278844fc45b4693c128d507f33e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-03-07T00:00:36Z (GMT) No. of bitstreams: 1 AnaKarlaBezerraLopes_DISSERT.pdf: 697846 bytes, checksum: c09eb278844fc45b4693c128d507f33e (MD5) / Made available in DSpace on 2017-03-07T00:00:36Z (GMT). No. of bitstreams: 1 AnaKarlaBezerraLopes_DISSERT.pdf: 697846 bytes, checksum: c09eb278844fc45b4693c128d507f33e (MD5) Previous issue date: 2016-09-27 / A S?filis Cong?nita (SC) ? caracterizada como a infec??o do concepto, predominantemente por via transplacent?ria, a partir da gestante infectada n?o tratada ou inadequadamente tratada. No Brasil, os munic?pios com mais de 100.000 habitantes concentram quase 80% do total de casos notificados da doen?a. Dessa forma, o objetivo do estudo ? conhecer a distribui??o da s?filis cong?nita nos munic?pios brasileiros com mais de 100.000 habitantes e avaliar sua correla??o com indicadores socioecon?micos e de servi?os de sa?de, no per?odo entre 2007 e 2013. Trata-se de um estudo ecol?gico e que utilizou como unidade de an?lise os 283 munic?pios brasileiros com mais de 100.000 habitantes. A popula??o do estudo foi constitu?da por todos os casos de S?filis Cong?nita notificados no Sistema de Informa??o de Agravos de Notifica??o (SINAN) nesses munic?pios. Foi realizada a an?lise descritiva dos casos notificados, an?lise bivariada usando o coeficiente de correla??o de Pearson para avaliar o grau de relacionamento da preval?ncia da SC com cada um dos 14 indicadores selecionados para o estudo e an?lise de cluster para agrupar os munic?pios similares e foi realizado o teste t-Student para amostras independentes. No per?odo de 2007 a 2013 foram notificados 38.533 casos da doen?a. A maior parte foi constitu?da por crian?as notificadas antes dos 7 dias de vida, pretas, igualmente distribu?das entre os sexos, de m?es que realizaram o pr?-natal e foram diagnosticadas nesse per?odo ou no momento do parto. As regi?es Norte e Nordeste destacaram-se por serem as ?nicas com m?dia do coeficiente de detec??o acima da nacional (2,54/1.000NV), no per?odo analisado. Dentre as vari?veis relacionadas ? qualidade e cobertura dos servi?os de sa?de, a ?nica significativa foi a vari?vel percentual de nascidos vivos com 7 ou mais consultas de pr?-natal (r = -0,264). O IDHM (r = - 0,151), ?ndice de GINI (r = 0,166), percentual de vulner?veis a pobreza (r = 0,218), percentual de mulheres pretas (r = 0,255), taxa de desemprego (r = 0,286), percentual de mulheres de 10 a 17 anos com filhos (r = 0,256), taxa de s?filis em gestantes (r = 0,480) apresentaram correla??o significativa. Na an?lise de cluster foram gerados dois grupos (Grupo 1 e Grupo 2). Em m?dia, o coeficiente de detec??o da s?filis cong?nita no Grupo 1 foi de 1,45 (DP = 0,06) casos por mil nascidos vivos. O Grupo 2, por sua vez, teve uma m?dia de 5,11 (DP = 0,17) casos por mil nascidos vivos. A diferen?a entre elas foi significativa t(275) = -20,21, p < 0,001. Diante dos resultados encontrados reafirma-se a import?ncia do pr?-natal no enfrentamento da s?filis cong?nita e a influ?ncia dos fatores socioecon?micos nas taxas apresentadas por essa doen?a. / The Congenital Syphilis is characterized as infection of the conceptus, predominantly by transplacental transmission, from infected pregnant untreated or inadequately treated. In Brazil, the cities with more than 100,000 habitants, considered large cities, concentrated almost 80% of all reported cases of the disease. Thus, the objective of the study is to understand the distribution of congenital syphilis in cities with more than 100,000 habitants and assess its correlation with socioeconomic indicators and health services between 2007 and 2013. This is an ecological study and used as the unit of analysis the 283 Brazilian cities with more than 100,000 people. The study population consisted of all cases of congenital syphilis reported in the Notifiable Diseases Information System (SINAN) in these cities. Descriptive analysis of reported cases was performed, the bivariate analysis using Pearson's correlation coefficient to assess the degree of relationship of the prevalence of congenital syphilis with each of the 14 indicators selected for the study and cluster analysis was performed to group the municipalities according to their similarities and was performed Student's t-test to evaluate the difference between the groups. In the period from 2007 to 2013 were reported 38,533 cases of the disease in Brazil. Most of the cases consisted of children reported before 7 days of life, black, equally distributed between the sexes, mothers who underwent prenatal and were diagnosed in that period or at delivery. The northern and northeastern regions stood out for being the only ones with average prevalence above the national (2.54 / 1.000NV) in the period analyzed. Among the variables related to the quality and coverage of health services, the significant one was the percentage of live births variable with 7 or more prenatal consultations (r = -0.264). The IDHM (r = - 0.151), GINI index (r = 0.166), vulnerable percentage of poverty (r = 0.218), percentage of black women (r = 0.255), unemployment rate (r = 0.286), percentage of women 10 to 17 years with children (r = 0.256), Syphilis rate Gestational (r = 0.480) were significantly correlated. In the cluster analysis, two groups were generated (Group 1 and Group 2). On average, the detection rate of congenital syphilis in Group 1 was 1.45 (SD = 0.06) cases per thousand live births. Group 2, in turn, had an average of 5.11 (SD = 0.17) cases per thousand live births. The difference between them was significant t (275) = -20.21, p <0.001. Considering the results reaffirmed the importance of prenatal care in the face of congenital syphilis and the influence of socioeconomic factors in the rates presented by this disease.

Made available in DSpace on 2015-07-15T13:31:41Z (GMT). No. of bitstreams: 1 DISSERTA_MARLA.pdf: 612061 bytes, checksum: 166910dfea7fd46850738ceab0614740 (MD5) Previous issue date: 2008-01-10 / During pregnancy occur in the woman organism, physiological changes as a result of high levels of sex hormones necessary to maintenance of pregnancy. Local changes also occurred during this period, including in the mouth. The objective of this study was to evaluate the relationship between lesions in the oral mucosa of pregnant who the municipality of Feira de Santana - BA and the biological and social aspects as well as the prevalence of such lesions in the sample studied. It was done a descriptive study was done where it was applied a form and an oral clinical examination was done in the sample of 204 pregnant. After the procedure of collecting data, it was done a descriptive analysis of the interest variables, and finally stratified analysis and logistic regression. The results showed that pregnant who participated in the survey had an age group that ranged from 14 to 39 years, the majority was dun, had a family income between 1 and 3 minimum wages, and reported to be housewife. 38.2% of them had some kind of lesion in mouth, and the injury that was more detected was gingivitis with 30.4% of the cases. We could conclude that pregnant who were in first 2 quarters have a lower prevalence of oral lesions than those who are in the 3 rd quarter. / Durante a gravidez ocorrem, no organismo da mulher, altera??es fisiol?gicas em conseq??ncia dos n?veis elevados de horm?nios sexuais, necess?rias para a manuten??o da gesta??o. Altera??es locais tamb?m ocorrem neste per?odo, incluindo a boca. O objetivo deste estudo foi avaliar a preval?ncia de les?es bucais em gestantes atendidas nas Unidades do Programa de Sa?de da Fam?lia no munic?pio de Feira de Santana BA e estudar a sua rela??o com os aspectos biossociais na amostra estudada. Foi realizado um estudo descritivo durante o per?odo de mar?o a julho de 2007 onde se aplicou um formul?rio e se realizou exame cl?nico bucal em uma amostra de 204 gestantes. Ap?s o procedimento de coleta de dados, procedeu-se a an?lise estat?stica, onde foi realizada a an?lise descritiva das vari?veis de interesse, a estratificada e por fim, regress?o log?stica. Os resultados mostraram que as gestantes que participaram da pesquisa tinham uma faixa et?ria que variava de 14 a 39 anos, a maioria era parda (65,7%), tinha uma renda familiar entre 1 e 3 sal?rios m?nimos, e relatou ser dona-de-casa. Quanto ? presen?a de les?o, 38,2% delas apresentaram algum tipo de les?o em boca, sendo que a gengivite foi a les?o mais encontrada, com 30,4% dos casos. P?de-se concluir que mulheres que se encontram no 1? e 2? trimestres gestacionais t?m uma menor preval?ncia de les?o bucal do que aquelas que se encontram no 3? trimestre gestacional.

Made available in DSpace on 2014-12-17T15:43:54Z (GMT). No. of bitstreams: 1 TamiresCO_DISSERT.pdf: 2102694 bytes, checksum: 012c621a76fb7620be2aeb0ae8487c91 (MD5) Previous issue date: 2014-02-24 / 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 / As medidas de mortalidade representam um dos mais importantes indicadores das condi??es de sa?de. Por concentrar a maior carga de mortes, o estudo da mortalidade da parcela idosa da popula??o se configura como essencial para a compreens?o da situa??o de sa?de. Nesse sentido, o presente trabalho se prop?e a analisar o perfil de mortalidade da popula??o de 60 a 69 anos (idosos mais jovens) e de 80 anos ou mais de idade (idosos longevos) no estado do Rio Grande do Norte no per?odo de 2001 a 2011, bem como identificar os fatores contextuais e de qualidade do Sistema de Informa??es sobre Mortalidade (SIM) relacionados. Para tanto, foram calculados a Mortalidade Proporcional (MP) para o estado e o Coeficiente de Mortalidade Espec?fico por Idade (CMId), segundo cap?tulo CID-10, para os munic?pios do Rio Grande do Norte, a partir dos dados do Sistema de Informa??es sobre Mortalidade (SIM) e do Instituto Brasileiro de Geografia e Estat?stica (IGBE). A fim de identificar os grupos de munic?pios com perfis de mortalidade similares para CMIds, foi realizada a An?lise de Conglomerados n?o Hier?rquicos do tipo K-means e, para a redu??o das vari?veis independentes contextuais, recorreu-se ? Analise Fatorial pelo m?todo de An?lise de Componentes Principais. As distribui??es espaciais de tais grupos e fatores produzidos foram visualizadas atrav?s da t?cnica An?lise Espacial de ?reas. No per?odo investigado, foram registrados 21.813 ?bitos de idosos mais jovens, com predom?nio das mortes por doen?as do aparelho circulat?rio (32,75%) e neoplasmas (22.9%). Entre os idosos longevos, foram registrados 50.637 ?bitos, sendo 35,26% por doen?as do aparelho circulat?rio e 17,27% por causas mal definidas. A An?lise de Conglomerados formou tr?s grupos para as duas faixas et?rias de interesse e a An?lise Fatorial reduziu as vari?veis independentes contextuais em tr?s fatores, sendo considerada tamb?m a soma dos escores fatoriais. Entre os idosos mais jovens, formaram-se os grupos perfil do desconhecimento, perfil do desenvolvimento e paradoxo do desenvolvimento, que obtiveram associa??o estatisticamente significativa com os fatores educa??o e pobreza, extrema pobreza, soma fatorial, e com a vari?vel relacionada ? subnotifica??o dos ?bitos. O grupo perfil do desconhecimento permaneceu na faixa et?ria longeva, acompanhado do perfil de transi??o epidemiol?gica e do paradoxo epidemiol?gico,que foram estatisticamente associado ao fator desenvolvimento e sa?de e ?s vari?veis que indicam a qualidade SIM: propor??o de campos em branco sobre a escolaridade e de sub-registro. Depreende-se que os perfis de mortalidade de idosos mais jovens e longevos apresentam diferen?as quanto ? import?ncia das causas b?sicas e que s?o influenciados por distintos aspectos contextuais, sendo os idosos de 60 a 69 anos mais afetados por tais aspectos. Medidas direcionadas ? melhoria dos n?veis de educa??o e pobreza dos munic?pios podem contribuir para a redu??o das desigualdades em sa?de relacionadas aos idosos mais jovens, principalmente, bem como a otimiza??o da utiliza??o dos servi?os de sa?de, que se relaciona mais expressivamente ao quadro de sa?de dos idosos longevos, especialmente no que diz respeito ? qualidade das informa??es para os dois grupos de idade

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-08-22T22:37:22Z No. of bitstreams: 1 MarquionyMarquesDosSantos_DISSERT.pdf: 515406 bytes, checksum: 721e10a5f51bb581301f352d6f424312 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-22T22:56:01Z (GMT) No. of bitstreams: 1 MarquionyMarquesDosSantos_DISSERT.pdf: 515406 bytes, checksum: 721e10a5f51bb581301f352d6f424312 (MD5) / Made available in DSpace on 2016-08-22T22:56:01Z (GMT). No. of bitstreams: 1 MarquionyMarquesDosSantos_DISSERT.pdf: 515406 bytes, checksum: 721e10a5f51bb581301f352d6f424312 (MD5) Previous issue date: 2015-02-27 / O perfil epidemiol?gico dos indiv?duos que desenvolvem aids no Brasil mudou no decorrer do tempo. Dentre estas modifica??es, um dado preocupante ? o aumento da incid?ncia de aids em idosos em todo pa?s. Mas, no entanto, ainda n?o est? claro se o aumento dos casos de aids ? suficiente para produzir uma mudan?a nas medidas de tend?ncia nos ?ltimos anos nos estados brasileiros, e se esse aumento possui um efeito a partir dos indicadores socioecon?mico-demogr?ficos. Neste sentido, o objetivo do presente estudo ? analisar as taxas de incid?ncia de aids em idosos no Brasil e o seu efeito nas desigualdades socioecon?mico-demogr?ficas, no per?odo de 2000 a 2012. Trata-se de um estudo ecol?gico de s?ries temporais para conhecer o comportamento da s?rie hist?rica das taxas de incid?ncia de aids em idosos no per?odo de 2000 a 2012. As taxas foram calculadas utilizando os dados secund?rios do Sistema de Informa??o de Agravos de Notifica??o e do Instituto Brasileiro de Geografia e Estat?stica. Os dados foram submetidos a tratamento estat?stico para conhecer as tend?ncias das taxas de incid?ncia, atrav?s do modelo de regress?o polinomial e do modelo de regress?o log-linear joinpoint, como tamb?m, a an?lise de regress?o linear simples para conhecer a rela??o das tend?ncias com as vari?veis socioecon?mico-demogr?ficas. Foram utilizados os programas SPSS 20.0? e Joinpoint 4.1.1. Todos os testes foram realizados considerando uma signific?ncia estat?stica de 5%. Ap?s a an?lise, no Brasil foram notificados 62.052 casos novos de aids em idosos no per?odo de 2000 a 2012. Neste per?odo, foi encontrado um crescimento significativo para o sexo masculino, tanto na faixa et?ria de 50 a 59 anos (APPC: 3,46%; p<0,001), como acima de 59 anos de (AAPC: 4,38%; p<0,001). Para o sexo feminino, o crescimento foi significativo e possui os maiores incrementos da s?rie hist?rica, quando comparado ao sexo masculino, nas duas faixas et?rias, (AAPC: 4,62%; p<0,001 e AAPC: 6,53%; p<0,001) respectivamente. Os maiores incrementos s?o observados em mulheres e nos estados das Regi?es Norte e Nordeste. Nos estados da Regi?o Sudeste observa-se estabiliza??o das taxas em toda s?rie hist?rica. As tend?ncias da raz?o entre os sexos tiveram uma redu??o significativa, como tamb?m, uma aproxima??o nas duas faixas et?rias do estudo, chegando a uma propor??o de 1,7 homens para cada mulher na faixa et?ria mais jovem. As tend?ncias estiveram relacionadas com as taxas de analfabetismo, com o aumento da desigualdade social e com o menor desenvolvimento humano nos estados brasileiros. Conclui-se que no Brasil a incid?ncia de aids em idosos segue uma tend?ncia de aumento em indiv?duos maiores de 50 anos. Destacam-se os maiores ?ndices do estudo em mulheres e nos estados das Regi?es Norte e Nordeste. Nesse sentido, o pa?s precisa aprimorar as pol?ticas voltadas aos idosos com DST/aids, capacitando profissionais de sa?de e desenvolvendo medidas eficazes para a preven??o e diagn?stico precoce das pessoas contaminadas, principalmente em locais com recursos limitados e com alta desigualdade social. Em longo prazo, cabe desenvolver novos estudos para compreender se as medidas tomadas foram eficazes para reduzir as tend?ncias apontadas neste estudo. / The characteristics profile of individuals who develop AIDS in Brazil has changed over time. Among these modifications, a worrying finding is the increased incidence of AIDS in the elderly across the country. But, however, is not yet clear whether the increase in AIDS cases is sufficient to produce a change in the trend of measures in recent years in the Brazilian states, and this increase has an effect from the socioeconomic and demographic indicators. In this sense, the objective of this study is to analyze the AIDS incidence rates among the elderly in Brazil and its effect on socioeconomic and demographic inequalities in the period 2000 to 2012. This is an ecological time-series study to meet behavior of the time series of the incidence rates of AIDS in the elderly from 2000 to 2012. the rates were calculated using the secondary data from Diseases Information System Notification and the Brazilian Institute of Geography and Statistics. Data were analyzed statistically to know the trends in incidence rates, by polynomial regression model and joinpoint log-linear regression model, but also the simple linear regression analysis to find the relationship of trends with variables socioeconomic and demographic. SPSS 20.0? and Joinpoint 4.1.1 programs were used. All tests were carried out considering a significance of 5%. After the analysis, in Brazil were reported 62,052 new cases of AIDS in the elderly from 2000 to 2012. During this period, a significant increase was found for males, both aged 50-59 years (APPC: 3.46 %, p <0.001), such as above 59 years (AAPC: 4.38%; p <0.001). For females, the increase was significant and has the largest increments in the time series, when compared to males in both age groups (AAPC: 4.62%, p <0.001 and AAPC: 6.53%; p <0.001) respectively. The largest increases are observed in women and in the states of North and Northeast. In the Southeast Region is observed stabilization of rates throughout the series. The reason of trends between the sexes had a significant reduction, but also an approach in both age groups of the study, reaching a ratio of 1.7 males for every female in the youngest age group. The trends were related to illiteracy rates, with increasing social inequality and the lowest human development in the Brazilian states. We conclude that in Brazil the incidence of AIDS in the elderly follows an increasing trend in individuals over 50 years. Noteworthy are the highest rates of study in women and in the states of North and Northeast. In this sense, the country needs to enhance policies towards older people with STD / AIDS, training health professionals and developing effective measures for the prevention and early diagnosis of infected people, especially in places with limited resources and high social inequality. In the long term, it is developing new studies to understand whether the measures taken were effective in reducing the trends identified in this study.

Made available in DSpace on 2014-12-17T15:43:48Z (GMT). No. of bitstreams: 1 MatheusSM_DISSERT.pdf: 826650 bytes, checksum: 41c585f7d1d37e8e9af7b5caa4e9f50f (MD5) Previous issue date: 2012-12-21 / Investments in health have controversial influence on results of the health of populations, besides being subject rarely explored in literature. Moreover, from the 1970s, the social determinants of health have been consolidated in the disease process as multifactorial factors (social, economic, cultural, etc.) that directly or indirectly influence the occurrence of health problems of populations, as well as mortality rates. This study aimed to evaluate the influence of these investments and the social determinants of health on infant mortality and its neonatal and post-neonatal mortality. This is an ecological study, in which the sample was composed of Brazilians cities with over 80,000 inhabitants, avoiding fluctuations in mortality rates for common small populations, and ensure greater coverage of information systems on mortality and births Brazilians and, therefore, increase data consistency. To isolate the effect of investments in health, we used multiple linear regression. The socioeconomic indicators (p <0.001, p = 0.004, p <0.001), the inequality index (p <0.001, p = 0.001, p = 0.006) and coverage of prenatal visits (p <0.001, p <0.001; p = 0.005) were associated with infant mortality rate total, neonatal and post-neonatal, and the Gross Domestic Product per capita only influenced the overall infant mortality rate and neonatal (p=0.022; 0.045). Investments in health, in this model, lost statistical significance, showing no correlation with mortality rates among children under one year. We conclude that the social determinants of health has an influence on the variation in mortality rates of Brazilian cities, however the same was not observed for indicators of health investment / Os investimentos em sa?de possuem controversa influ?ncia nos resultados em sa?de das popula??es, al?m de serem temas pouco recorrentes na literatura. Por outro lado, a partir da d?cada de 1970, os determinantes sociais em sa?de se consolidaram no processo sa?dedoen?a como fatores multifacet?rios (sociais, econ?micos, culturais entre outros) que influenciam direta ou indiretamente a ocorr?ncia de agravos ? sa?de das popula??es, bem como as taxas de mortalidade. Esse estudo buscou avaliar a influ?ncia desses investimentos e dos determinantes sociais em sa?de sobre a taxa de mortalidade infantil e seus componentes neonatal e p?s-neonatal. Trata-se de um estudo ecol?gico, no qual a amostra foi composta por munic?pios brasileiros com mais de 80 mil habitantes, evitando-se, assim, flutua??es nas taxas de mortalidade comum para pequenas popula??es, al?m de garantir maior cobertura dos sistemas de informa??o sobre mortalidade e sobre nascidos vivos brasileiros e, com isso, aumentar a consist?ncia dos dados. Para isolar o efeito dos investimentos em sa?de, utilizouse a regress?o linear m?ltipla. Os indicadores socioecon?micos (p<0,001; p=0,004; p<0,001), o ?ndice de desigualdade (p<0,001; p=0,001; p=0,006) e a cobertura de consultas pr?-natal (p<0,001; p<0,001; p=0,005) apresentaram rela??o com a taxa de mortalidade infantil total, neonatal e p?s-neonatal, sendo que o Produto Interno Bruto per capita influenciou apenas a taxa de mortalidade infantil total e neonatal (p=0,022; 0,045). Os investimentos em sa?de, nesse modelo, perderam signific?ncia estat?stica, n?o apresentando correla??o com os ?ndices de mortalidade entre as crian?as menores de um ano. Conclui-se que os determinantes sociais de sa?de tem influ?ncia na varia??o das taxas de mortalidade dos munic?pios brasileiros, no entanto o mesmo n?o foi observado para os indicadores de investimento em sa?de

Made available in DSpace on 2014-12-17T15:43:53Z (GMT). No. of bitstreams: 1 GerlieneMSA_DISSERT.pdf: 1373192 bytes, checksum: ae98ef68760a45b957ffea40dff5d730 (MD5) Previous issue date: 2013-02-22 / Many surveys are conducted comparing oral health conditions with individual variables, such as socioeconomic and demographic factors. However, in the same way that individuals differ among themselves, the groups also have their own characteristics and the effects of this differentiation must be researched. Brazil, despite being one of the major economic powers of the world and shows an improvement in the average value of its health indicators, is also one of the most unequal and remains among the countries with the greatest health inequities. The purpose of this study was to investigate the importance of social determinants on the contextual level oral health among Brazilian adolescents, population not much researched by the literature. The research was made using an ecological approach in order to identify possible inequalities between cities and capitals. Using data from SBBrasil 2010 it was evaluated less common outcomes (loss of first molar, dental care index and T-Health) which provide information on the degree of morbidity of caries and health level of dental tissues, in addition to analyze the related services. The association of these oral health indicators with socioeconomic factors such as income, employment, education and inequality, collected from Census 2010, was analyzed by simple and multiple linear regressions. The study included the 27 state capitals and four clusters representing the municipalities of the country. It was possible to see better access to services in locations with better income distribution. However, the strong association of contextual factors related to poverty, low levels of education and poor housing and jobs with poorer levels of oral health in adolescents seems to overshadow the effects of income inequalities on dental caries in the country. In some locations, particularly within the North and Northeast, whichever one keeps dentistry mutilating, whose effects are already noticeable in its adolescent population. Access to restorative services in Brazil remains limited and unequal. The results of this study highlight the inequities in oral health in the country and show the need of the inclusion of new perspectives on the traditional approach of Preventive Dentistry and education models in Dentistry. Tackling health inequalities in oral health in the country requires the cooperation of various actors involved in the process and the inclusion of oral health in the context of overall health. The social determinants approach, as well as evaluating the distribution of oral diseases in the country and its inclusion in the context of overall health, should guide the implementation of programs and oral health practices in order to contribute to the reduction of inequalities / Muitas pesquisas s?o realizadas confrontando condi??es de sa?de bucal com vari?veis individuais, como fatores socioecon?micos e demogr?ficos. No entanto, da mesma forma que os indiv?duos divergem entre si, os grupos tamb?m possuem caracter?sticas pr?prias e os efeitos dessa diferencia??o precisam ser pesquisados. O Brasil, apesar de ser uma das maiores pot?ncias econ?micas do mundo e vir apresentando uma melhoria no valor m?dio de seus indicadores de sa?de, ? tamb?m um dos mais desiguais e permanece entre os pa?ses com maiores iniquidades em sa?de. A proposta deste estudo foi pesquisar a import?ncia dos determinantes sociais a n?vel contextual na sa?de bucal de adolescentes brasileiros, popula??o pouco pesquisada na literatura. A pesquisa foi feita atrav?s de uma abordagem ecol?gica, no intuito de identificar poss?veis desigualdades entre munic?pios e capitais. Utilizando dados do SBBrasil 2010, foram avaliados desfechos menos comuns (perda do 1? molar, ?ndice de cuidados odontol?gicos e T-Health) que fornecem informa??es sobre o grau de morbidade da c?rie e o n?vel de sa?de dos tecidos dent?rios, al?m de abordar aspectos relacionados aos servi?os. A associa??o destes indicadores de sa?de bucal com fatores socioecon?micos como renda, emprego, educa??o e desigualdade, coletados do CENSO 2010, foi analisada por meio de regress?o linear simples e m?ltipla. Os dom?nios do estudo inclu?ram as 27 capitais brasileiras e 4 clusters representativos dos munic?pios do interior do pa?s. Foi poss?vel constatar um melhor acesso aos servi?os em localidades com melhor distribui??o de renda. No entanto, a forte associa??o de fatores contextuais relativos ? pobreza, baixos n?veis de educa??o e m?s condi??es de moradia e emprego com piores n?veis de sa?de bucal em adolescentes parece ofuscar os efeitos das desigualdades de renda sobre os agravos bucais no pa?s. Em algumas localidades, em especial no interior das regi?es Norte e Nordeste, continua prevalecendo uma odontologia mutiladora, cujos efeitos s?o percept?veis j? em sua popula??o adolescente. O acesso aos servi?os restauradores no Brasil ainda permanece limitado e desigual. Os resultados deste estudo evidenciam as iniquidades em sa?de bucal no pa?s e mostram a necessidade da inclus?o de novas perspectivas na abordagem tradicional da Odontologia Preventiva e nos modelos de educa??o em Odontologia. O combate a essas iniquidades requer a coopera??o dos v?rios autores envolvidos no processo e a inclus?o da sa?de bucal no contexto da sa?de geral. A abordagem dos determinantes sociais, bem como a avalia??o da distribui??o das doen?as bucais no territ?rio brasileiro e sua inclus?o no contexto da sa?de em geral, devem nortear a implementa??o de programas e a??es em sa?de bucal, de forma a contribuir para a redu??o das desigualdades

Made available in DSpace on 2014-12-17T14:13:33Z (GMT). No. of bitstreams: 1 Luciana Araujo dos Reis_TESE.pdf: 848815 bytes, checksum: 04f63f3692dd763098a691a380845864 (MD5) Previous issue date: 2010-03-31 / (Objective) Assess the functional capacity and determine the difference between the means of functional capacity (basic and instrumental activities of daily living) and the age groups of elderly residents in an outlying area in the hinterland of Bahia/Northeast of Brazil. (Methods) Analytical study with cross-sectional design and a sample of 150 elderly individuals enrolled in four Health Units in the municipality of Jequi?, Bahia, Brazil. The instrument consisted of sociodemographic and health data, the Barthel Index and the Lawton scale. (Results) In all, 78.00% of the elderly were classified as dependent in the basic activities and 65.33% in the instrumental activities of daily living. Using the Kruskal- Wallis test, we found a statistically significant difference between the means of instrumental activities and the age groups (p= 0.011). (Conclusion) An elevated number of elderly were classified as dependent in terms of functional capacity and increased age is related to greater impairment in the execution of instrumental activities of daily living / Objetivo: O prop?sito dessa investiga??o foi analisar a rela??o entre ambiente familiar e capacidade funcional de idosos residentes em domic?lio. M?todos: Trata-se de uma pesquisa do tipo anal?tica com delineamento transversal e abordagem quantitativa, tendo uma amostra representativa de 235 idosos, com m?dia de idade de 73,52 (?9,41) anos, cadastrados em quatro Unidades de Sa?de do bairro do Jequiezinho, no munic?pio de Jequi?, Bahia. A coleta de dados foi realizada com a aplica??o de quatro instrumentos: Caracteriza??o sociodemogr?ficos e de sa?de; ?ndice de Barthel (Atividades b?sicas de vida di?ria) e Escala de Lawton (Atividades instrumentais de vida di?ria) utilizados para avaliar a capacidade funcional e o Invent?rio de Percep??o do Suporte Familiar. Para an?lise estat?stica foram utilizados procedimentos da estat?stica descritiva (freq??ncia, m?dia, desvio padr?o e mediana) e o c?lculo da respectiva raz?o de chances mediante regress?o log?stica bin?ria, para an?lise de fatores hierarquicamente agrupados; p<0,05. Resultados: Encontrou-se uma maior distribui??o de 69,80% dos idosos classificados como dependentes nas atividades b?sicas de vida di?ria, sendo mais freq?entes os idosos com depend?ncia do tipo leve 41,70% (n=98). E nas atividades instrumentais de vida di?ria 61,30% (n=144) dos idosos foram denominados dependentes, verificando se uma maior distribui??o de depend?ncia do tipo parcial, 31,90% (n=75). Quanto ? percep??o do suporte familiar, no dom?nio Afetividade-Consist?ncia, a maioria dos idosos apresentou pontua??o alta 71,10% (n=167), no dom?nio Adapta??o-familiar, houve uma maior freq??ncia de idosos com pontua??o baixa 44,70% (n=105) e no dom?nio Autonomia houve uma maior distribui??o de idosos com pontua??o alta 48,90% (n=115). Na pontua??o total do Invent?rio de Percep??o do Suporte Familiar, houve uma maior xv freq??ncia de idosos com pontua??o alta 40,90% (n=96) pontos. Verificou-se diferen?a estat?stica significativa entre comprometimento da capacidade funcional em rela??o ?s atividades b?sicas de vida di?ria e as vari?veis, estado civil vi?vo (p=0,004) e casado (p=0,020), presen?a de problemas de sa?de (p= 0,010) e seq?elas (p<0,001), pontua??o alta do dom?nio Afetividade-Consist?ncia (p=0,030) e pontua??o M?dio-Alta do dom?nio Adapta??o-Familiar (p=0,010). Enquanto que em rela??o ao comprometimento da capacidade funcional referente ?s atividades instrumentais de vida di?ria n?o foi encontrada diferen?a estat?stica significativa com as vari?veis do estudo e com os dom?nios do Invent?rio de Percep??o do Suporte Familiar. Conclus?es: Diante dos resultados encontrados verificou-se que a maioria dos idosos estudados apresentou prec?rias condi??es socioecon?micas e de sa?de, comprometimento de pelo menos dois dom?nios do Invent?rio de percep??o do suporte familiar e elevado grau de limita??o funcional. Constatou-se ainda que o ambiente familiar estar relacionado com as limita??es funcionais de idosos residentes em domic?lio.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-10T16:52:35Z No. of bitstreams: 1 DivianeAlvesDaSilva_TESE.pdf: 1589141 bytes, checksum: 6f4b5d84ef15ebd80e623a387a7d41af (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-02-10T22:14:05Z (GMT) No. of bitstreams: 1 DivianeAlvesDaSilva_TESE.pdf: 1589141 bytes, checksum: 6f4b5d84ef15ebd80e623a387a7d41af (MD5) / Made available in DSpace on 2017-02-10T22:14:05Z (GMT). No. of bitstreams: 1 DivianeAlvesDaSilva_TESE.pdf: 1589141 bytes, checksum: 6f4b5d84ef15ebd80e623a387a7d41af (MD5) Previous issue date: 2016-06-28 / A transi??o da estrutura et?ria no Brasil ocorre de forma r?pida e em ambiente socioecon?mico desfavor?vel. O Nordeste brasileiro, historicamente, destacado pela presen?a de profundas desigualdades sociais apresenta-se como a terceira regi?o mais envelhecida do pa?s e tal fato ganha import?ncia, considerando sua extensa dimens?o territorial, bem como o contexto s?cio-ambiental desfavor?vel. O objetivo deste estudo foi analisar a rela??o entre o contexto e o envelhecimento populacional na regi?o Nordeste do Brasil. Trata-se de um estudo ecol?gico, cujo cen?rio corresponde ? regi?o Nordeste, composta por 9 estados e 1.794 munic?pios. Foram coletados dados demogr?ficos e de indicadores socioecon?micos, nas bases eletr?nicas do Instituto Brasileiro de Geografia e Estat?stica ? IBGE, do Instituto de Pesquisa Econ?mica e Aplicada ? IPEA, do Atlas de Desenvolvimento Humano do Programa das Na??es Unidas para o Desenvolvimento ? PNUD e do Departamento de Inform?tica do SUS ? DATASUS. O desfecho do estudo consistiu nos n?veis de envelhecimento populacional, definidos a partir de an?lise de conglomerados que agrupou os munic?pios, considerando cinco indicadores demogr?ficos de envelhecimento (percentual de idosos, ?ndice de envelhecimento, sobreenvelhecimento, depend?ncia senil e ?ndice de substitui??o da popula??o em idade ativa). Foi utilizada a an?lise de componentes principais para obten??o de fatores socioecon?micos e demogr?ficos, que representaram as vari?veis independentes do estudo. Outras vari?veis de import?ncia te?rica para o desfecho tamb?m foram selecionadas. Realizou-se o georreferenciamento dos dados da vari?vel dependente, utilizando TabWin 3.6b, para identifica??o visual do perfil de envelhecimento da regi?o, segundo os n?veis de envelhecimento. Nas an?lises de associa??o utilizou-se o teste ANOVA, para os fatores e demais vari?veis quantitativas, e o teste do Qui-quadrado, para as vari?veis categ?ricas. Em ambos os testes considerou-se um n?vel de signific?ncia de 5%. Utilizou-se a an?lise de regress?o log?stica ordinal para verificar as associa??es finais com o desfecho. Observou-se que o envelhecimento populacional no Nordeste apresenta um padr?o de distribui??o espacial heterog?neo, com concentra??o de maiores n?veis na regi?o do semi?rido, atingindo o sert?o e centro-sul do Cear?, partes das regi?es oeste, central e agreste do Rio Grande do Norte, e quase a totalidade do estado da Para?ba, ? exce??o da regi?o litor?nea. Os altos n?veis de envelhecimento associaram-se a bons n?veis de educa??o, depend?ncia de renda governamental, ao saldo migrat?rio da popula??o geral, ? raz?o urbano-rural e a alguns estados da regi?o, tomando como refer?ncia para compara??o, o estado da Para?ba. Considera-se importante o estudo situacional do envelhecimento no Nordeste brasileiro que, embora desigual, destaca-se pela presen?a de grandes contingentes de idosos. O entendimento de tal distribui??o, por sua vez, pode levar ? identifica??o de fatores determinantes locais e/ou gerais do envelhecimento das popula??es, a serem abordados nas pol?ticas p?blicas pr?-envelhecimento. / The changing age distribution in Brazil occurs quickly and in an unfavorable environment socio-economically. The Brazilian Northeast, historically, highlighted by the presence of deep social inequality appears as the third most aged region of the country and this fact becomes important, considering its extensive territorial dimension as well as an unfavorable socio-environmental context. The aim of this study was to analyze the relationship between the context and the aging population in the Northeast of Brazil. This is an ecological study, whose scenario corresponds to the Northeast region, consisting of nine states and 1,794 municipalities. We collected demographic data and several socioeconomic indicators in the electronic databases of the Brazilian Institute of Geography and Statistics (IBGE), Applied Economic Research Institute (IPEA), the Human Development Atlas of the United Nations Development Programme (PNUD) and the SUS Department of Informatics (DATASUS). The outcome of the study was the levels of population aging, defined from cluster analysis that grouped municipalities, considering five demographic aging indicators (percentage of elderly, aging index, ?over-aging?, senile dependence and population replacement in active age index). The principal component analysis was used to obtain socioeconomic-demographics factors, which represented the independent variables of the study. Other variables with theoretical importance for the outcome were also selected. It was held georeferencing of the outcome variable data using TabWin 3.6b, for visual identification of Northeast aging profile, according to the levels of aging. In association analyzes used the ANOVA test for the factors and others quantitative variables and the chi-square test for categorical variables. In both tests it was considered a 5% significance level. We used the ordinal logistic regression analysis to verify the actual associations with the outcome. It was observed that aging in the Northeast shows a pattern of heterogeneous distribution, with concentration higher levels in the region belonging to the semi-arid region, covering the interior and south-central of the Cear? state, parts of the western, central and harsh regions of Rio Grande do Norte state, and almost all of the area of Paraiba state, except the coastal region. The high levels of aging were associated with good levels of education, dependence on government income, the net migration of the general population, the reason urban/rural and some states of the region, taking as reference for comparison, the state of Paraiba. It is important the aging situational study in Northeast Brazil, a region that, although unequally, has a large contingent of elderly. The understanding of such distribution, in turn, can lead to the identification of local and/or general determinants of the population aging, to be addressed in the pro-aging policies.