Life in the eighteenth-century Tidewater was set against the grim specter of death. Children were especially vulnerable, perishing with disheartening frequency throughout the century. Yet despite the high rates of child mortality, Tidewater culture underwent a revolution in regard to the eighteenth-century family. Children became the emotional focus of the family, becoming cherished for their youthful capering and playful nature. However, child death was no less common. The way in which parents coped with the death of a child changed throughout the century, reflecting the emotionalized understanding of children and childhood. The rituals surrounding the death of a child—from preparations for burial, the funeral, and lasting commemorations—evolved over the course of the eighteenth century, reflecting the new place of the child within the eighteenth-century family and the emotional trauma felt by the family after the death of a child. / Master of Arts

Infant mortality in the Czech Republic and Europe: trends and patterns Abstract This Master's thesis addresses the development of infant mortality in the Czech Republic between the years 1950 and 2016 using more detailed indicators of infant mortality. To evaluate the impact of infant mortality rate, on the lengthening life expectancy at birth in the Czech Republic and selected European countries, a decomposition of life tables is included. Selected European countries are then compared with the use of cluster analysis, based on infant mortality indicators and life expectancy at birth by sex. Finally, an analysis is made on the basis of infant life tables which are calculated by sex, birth weight and legitimacy for the Czech Republic. Keywords: infant mortality, Czech Republic, European countries, tables of infant mortality, sex, child-legitimacy, birth weight, decomposition, cluster analysis

Infant mortality (IM) incidence in health facility systems during or after infant delivery is substantially high in Nigeria. In this quantitative, cross-sectional study, the effects of skill birth attendants (SBAs), prenatal care, and providers of prenatal care on IM in health facility delivery centers were examined. The Mosley and Chen theoretical framework informed this study and was used to explain the relationship between SBAs, prenatal care, and providers of prenatal care and IM. One hundred and sixty infant deaths were examined among mothers who used an SBA versus those who did not, mothers who had prenatal care versus those without, and mothers who received prenatal care from a health facility versus traditional providers. The 2014 verbal and social autopsy secondary data set was analyzed using binary logistic regression technique. There was no significant difference in risk of IM between mothers who had SBA during infant delivery in health facility compared to those without SBA during delivery. Mothers who received prenatal care had a significant higher risk of infant death in a health facility compared to those that did not receive prenatal care. Mothers who received prenatal care from traditional providers did not have a statistically significant risk of IM compared to mothers who received prenatal care from a health facility. The findings could have positive social change implications by encouraging multilevel public health stakeholders to support and promote the use of health surveillance in understanding the barriers and challenges of health facility delivery practices, prenatal care, and use of SBA as it relates to IM to facilitate policy change in maternal and infant care practices in Nigeria.

The aim of the diploma thesis is to analyse which determinants have an impact on infant mortality in West and East Africa for a year 2012 based on correlation and regression analysis. Representative countries Ghana, Nigeria and Senegal for West Africa and Kenya, Tanzania and Uganda for East Africa, were chosen. From the gained results and information, recommendation for possible better future development of infant mortality is concluded as the outcome of the diploma thesis aim. On base of data analysis, one variable, which influences a development of infant mortality, was not identified, but it can be assumed that a complex of variables affects the infant mortality. In this line with final findings, current strategy of development aid is focused primarily on local activities more than just on financial help.

This study attempted to determine variables significant in predicting use of and changes in use of prenatal care; infant mortality; and the relationship between prenatal care and infant birth weight. The data were collected from birth and death certificates at the Public Health Department in Dallas, Texas. Data were tested using analysis of variance, Scheffe' test, and Chi-square. A mother's age, race, income level, marital status, and parity were found to be significant factors in use of prenatal care, and use of care was found to have begun earlier in recent years. Likewise, birth weight was found to be related to the trimester prenatal care began. Conclusions concerning infant mortality could not be drawn due to insufficient data.

INTRODUÇÃO: As mortes no primeiro dia de vida correspondem a 25-45% daquelas em período neonatal, associadas principalmente à assistência prestada às gestantes e aos recém-nascidos durante os períodos pré-parto, intraparto e pós-parto. Estudos epidemiológicos sobre a mortalidade no primeiro dia de vida são necessários para identificar a evitabilidade desses óbitos e, assim, produzir evidências para a tomada de decisões e melhorar os indicadores da mortalidade neonatal precoce no Brasil. OBJETIVO: Calcular as taxas de mortalidade no primeiro dia de vida entre 2010-2015 em oito estados brasileiros com melhor qualidade de informação, avaliar fatores associados e classificar os óbitos segundo causa básica e evitabilidade. MÉTODOS: Estudo descritivo com dados secundários do Sistema de Informações sobre Mortalidade (SIM) e do Sistema de Informações sobre NV (SINASC) disponibilizados pelo Ministério da Saúde através do Departamento de Informática do Sistema Único de Saúde (SUS). Os dados correspondem aos óbitos infantis ocorridos nos anos de 2010 a 2015 de sete estados brasileiros (Espírito Santo, Rio de Janeiro, São Paulo, Paraná, Santa Catarina, Rio Grande do Sul, Mato Grosso do Sul) e do Distrito Federal. Foram calculadas as taxas de mortalidade no primeiro dia de vida (número de óbitos ocorridos no primeiro dia de vida, por mil NV, no local e ano considerado) e a proporção dos óbitos no primeiro dia de vida em relação às mortes de menores de um ano de idade no período entre 2010 e 2015, para os estados selecionados. As análises de tendência temporal foram realizadas por meio de regressão linear, após verificação de não correlação entre os erros-padrão ao longo do tempo, através do teste de Breusch Godfrey. Na análise de regressão linear simples as taxas de mortalidade foram consideradas como variáveis dependentes e os anos do período como variável independente. As taxas de mortalidade no primeiro dia de vida foram comparadas em termos relativos (risco relativo, RR) e absolutos (risco atribuível, RA, diferença absoluta entre taxas) conforme características do NV, do parto e da mãe no período estudado. Os testes estatísticos foram baseados no teste de qui-quadrado. As causas básicas de óbito no primeiro dia de vida foram descritas conforme a Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde 10ª edição (CID-10). Para análise da evitabilidade dos óbitos foi utilizada a \"Lista brasileira de causas de mortes evitáveis por intervenções do Sistema Único de Saúde em menores de cinco anos\". RESULTADOS: 21,6% dos óbitos infantis ocorreu no primeiro dia de vida. A taxa de mortalidade reduziu-se de 2,7 a 2,3 óbitos/1000nascidos vivos (NV). Maiores taxas foram observadas em NV com baixo peso, pré-termos e filhos de mães sem escolaridade. As principais causas dos óbitos foram síndrome da angústia respiratória (8,9%) e imaturidade extrema (5,2%). 66% das causas de óbito foram consideradas evitáveis por adequada atenção à mulher na gestação e ao recém-nascido. CONCLUSÃO: Uma atenção adequada à gestante, ao parto e ao recém-nascido poderiam evitar mortes no primeiro dia de vida / INTRODUCTION: Deaths on the first day of life correspond to 25-45% of the neonatal period, mainly associated with the care given to pregnant women and newborns during the prepartum, intrapartum and postpartum periods. Epidemiological studies on mortality on the first day of life are necessary to identify the avoidance of these deaths and, thus, produce evidence for decision-making and improve the indicators of early neonatal mortality in Brazil. OBJECTIVE: To estimate the rates mortality in the first day of life between 2010 and 2015 in eight Brazilian states with a better quality of information; evaluate associated factors and classify the deaths as to their basic cause and avoidability. METHODS: A descriptive study with secondary data from the Information System on Mortality (ISM) and Information System on Live Births (ISLB) provided by the Ministry of Health through the Department of Informatics of National Health System. The data correspond to the infant deaths occurred between 2010 and 2015 in seven Brazilian states (Espírito Santo, Rio de Janeiro, São Paulo, Paraná, Santa Catarina, Rio Grande do Sul, Mato Grosso do Sul) and the Federal District. The mortality rate on the first day of life (number of deaths occurring on the first day of life, per thousand live births, at the place and year considered) and the proportion of deaths on the first day of life relative to deaths of children under one year in the period between 2010 and 2015, were calculated for the states above. Time trend analyses were performed using linear regression, after verification of non-correlation between the standard errors over time, using the Breusch Godfrey test. In simple linear regression analysis, mortality rates were considered as dependent variables and the years of the period were considered as independent variables. The mortality rates on the first day of life were compared in relative terms (relative risk, RR) and absolute (attributable risk, AR, the absolute difference between rates) according to the characteristics of the live births, birth and the mother during the studied period. Statistical tests were based on the chi-square test. The basic causes of death on the first day of life were described according to the International Statistical Classification of Diseases and Related Health Problems 10th edition (ICD-10). To analyze the evitability of death was used the \"Brazilian list of causes of deaths preventable by the interventions of the National Health System in children under five years\" RESULTS: 21.6% of infant deaths occurred on the first day of life. The mortality rate decreased from 2.7 to 2.3 deaths/1,000 living births. Higher death rates occurred on living birth with low weight, preterm birth and children of mothers with no schooling. The main causes of death were respiratory distress syndrome (8.9%), severe immaturity (5.2%); 66% of those were considered avoidable. CONCLUSION: Adequate attention to pregnant women, parturition, and newborn could avoid deaths on the first day of life

O objetivo deste estudo foi relacionar a gravidade da ventriculomegalia cerebral fetal isolada com o desenvolvimento neurológico pós-natal. Um total de 36 fetos com diagnóstico ultra-sonográfico de ventriculomegalia cerebral isolada foram acompanhados e avaliados quanto ao seu desenvolvimento neurológico entre 0 e 26 meses. Foi definido como ventriculomegalia leve a medida do átrio entre 10 a 15 mm e grave, maior que 15 mm Nos casos de ventriculomegalia grave (n = 19) tivemos 6 óbitos e 3 alterações neurológicas graves. No grupo de ventriculomegalia leve (n = 16) observou-se 3 alterações neurológicas leves / The objective of this study was to correlate the severity of the isolated fetal cerebral ventriculomegaly with the postnatal neurological development. Thirty-six fetuses with ultrasonographic cerebral ventriculomelagy diagnostic were attended and neurological development at the 0 to 26 life months. The definition of according to the ventricular atrium measurements: mild 10 to 15 mm and severe over 15 mm ventriculolomegaly. There cases severe ventriculomegaly (n = 19) the postnatal mortality.6 and 3 neurological development severe. The group with mild ventriculomegaly (n = 16) the neurological development evaluation 3 was light alterations

No Brasil e internacionalmente, a mortalidade infantil é conhecido problema de saúde pública. Embora suas taxas estejam diminuindo, a maior parte desses óbitos ocorre por causas evitáveis, sendo sua redução uma questão de justiça social. Este estudo trata do risco de morte infantil evitável nos últimos seis anos e foi realizado em uma coorte retrospectiva de recém nascidos de mães residentes no município gaúcho de Novo Hamburgo de 2008 a 2013, por meio da vinculação dos bancos de dados do Sistema de Informações sobre Nascidos Vivos (SINASC), Sistema de Informações sobre Mortalidade (SIM) e dos dados das investigações de óbitos infantis dos residentes naquele município. O município onde se deu o estudo obteve uma taxa de mortalidade infantil de 14,0 por mil nascidos vivos para o período, sendo em sua totalidade, investigados; desta taxa de óbitos, 10,4 ocorreram por causas evitáveis. Houve predomínio de ocorrência no período neonatal precoce. Conforme a classificação de evitabilidade SUS, os óbitos seriam reduzíveis principalmente por ações adequadas de promoção à saúde vinculadas a ações adequadas de atenção à saúde, por adequada atenção à mulher na gestação e por ações adequadas de diagnóstico e tratamento. Este estudo identificou grupos expostos a maior risco de morte infantil evitável, onde os seguintes fatores mostraram associação com a mortalidade infantil evitável: Condições socioeconômicas e reprodutivas maternas, nas variáveis raça/cor, escolaridade, situação conjugal, situação reprodutiva e ausência de trabalho remunerado; Pré-natal e nascimento, onde o número de consultas e o local de nascimento e finalmente, a Saúde da criança ao nascimento, onde a idade gestacional, peso ao nascimento, vitalidade do recém-nascido, malformação congênita e gemelaridade, foram preponderantes; todos com χ2; p ≤ 0,01, denotando associação estatística significativa com o óbito infantil. Conferir visibilidade aos determinantes da mortalidade infantil é essencial à tomada de decisões e o conhecimento produzido será potencialmente útil para informar políticas e programas voltados à redução da mortalidade e à promoção da saúde populacional, especialmente a infantil. / Infant mortality is a known public health problem in Brazil and worldwide. Although its rates are decreasing, most of these deaths could be avoided, and its reduction is a matter of social justice. This study talks about the risk of avoidable infant mortality in the last six years in a retrospective cohort of infants from mother who lived in the city of Novo Hamburgo, Rio Grande do Sul, Brazil, from 2008 to 2013. Government data regarding births and infant mortality were analyzed. The city where the study was conducted presented an infant mortality rate of 14.0 every 1000 infants born alive for the period, and mostly occurring in the early neonatal period. They were all investigated, and 10.4 every 1000 infants born alive were avoidable. According to SUS's classification of avoidability, these rates could be lowered mainly with appropriate actions to promote health, linked to appropriate actions of health care by providing specialized care to women during pregnancy and adequate measures for the diagnosis and treatments. This study identified high-risk groups. The main factors associated with infant mortality were: Socio-economical and reproductive conditions of the mother, race/color of the skin, schooling, marital status, absence of paid work; Prenatal and birth, with the number of queries and the birthplace, and, finally, the Health of the child at the moment of birth, where gestational age, birth weight, vitality of the newborn, congenital malformation and twin pregnancy were the most important, all at χ2; p ≤ 0,004, a meaningful statistical association. It is important that the circumstances that determine infant mortality be made visible. This is essential so that the necessary measures will be taken to control it. The knowledge produced here will be potentially useful in programs aimed at improving the quality of health care and decreasing infant mortality rates.

O objetivo deste estudo foi relacionar a gravidade da ventriculomegalia cerebral fetal isolada com o desenvolvimento neurológico pós-natal. Um total de 36 fetos com diagnóstico ultra-sonográfico de ventriculomegalia cerebral isolada foram acompanhados e avaliados quanto ao seu desenvolvimento neurológico entre 0 e 26 meses. Foi definido como ventriculomegalia leve a medida do átrio entre 10 a 15 mm e grave, maior que 15 mm Nos casos de ventriculomegalia grave (n = 19) tivemos 6 óbitos e 3 alterações neurológicas graves. No grupo de ventriculomegalia leve (n = 16) observou-se 3 alterações neurológicas leves / The objective of this study was to correlate the severity of the isolated fetal cerebral ventriculomegaly with the postnatal neurological development. Thirty-six fetuses with ultrasonographic cerebral ventriculomelagy diagnostic were attended and neurological development at the 0 to 26 life months. The definition of according to the ventricular atrium measurements: mild 10 to 15 mm and severe over 15 mm ventriculolomegaly. There cases severe ventriculomegaly (n = 19) the postnatal mortality.6 and 3 neurological development severe. The group with mild ventriculomegaly (n = 16) the neurological development evaluation 3 was light alterations

As ações em saúde contribuem para a melhoria das condições de vida e de saúde da criança, com reflexo na redução da mortalidade infantil. O objetivo do presente estudo foi identificar as ações em saúde para redução da mortalidade infantil apontadas pelos profissionais de saúde que atendem gestantes, recém-nascidos e crianças menores de um ano na atenção básica de um município do interior paulista. Trata-se de um estudo transversal, com abordagem quantitativa, inserido no campo da avaliação em saúde, com aproximação ao componente processo. Foram realizadas entrevistas com os profissionais de saúde, através de dois roteiros semiestruturados, autoaplicados, baseados em frases afirmativas, adaptadas de dois documentos técnicos do Ministério da Saúde. Participaram 54 profissionais da saúde, médicos (ginecologistas e pediatras), enfermeiros e Agentes Comunitários de Saúde (ACS), de três unidades básicas de saúde selecionadas para o estudo. A maioria de médicos e enfermeiros afirmou que somente às vezes as gestantes têm início precoce ao pré-natal, e grande parte respondeu que são realizadas seis ou mais consultas; porém, o mesmo número de profissionais confirmou que somente às vezes isso ocorre. ACS, médicos e enfermeiros mostraram que existe busca ativa às gestantes faltosas ao pré-natal, e os ACS afirmaram que realizam visitas domiciliares com esse intuito. De acordo com 44,4% dos médicos e enfermeiros, as puérperas têm consulta até 42 dias após o parto. Grande parte de todos profissionais de saúde participantes do estudo, afirmou desenvolver ações de incentivo ao aleitamento materno no pré-natal, no puerpério e nos 30 dias, seis e 12 meses de vida da criança; 59,3% responderam que as crianças atendidas na unidade de saúde estão com o esquema de vacinação em dia. A maioria dos médicos e enfermeiros confirmou que a criança recebe ao menos uma consulta na sua primeira semana de vida, mas que às vezes é realizado visita domiciliar por parte desses profissionais; somente quando houver necessidade. Os profissionais, médicos, enfermeiros e ACS, reconhecem que existe a educação permanente na unidade de saúde que trabalham; porém, 51,9% afirmam que às vezes há participação da equipe. Foram identificadas várias ações que correspondem ao que é preconizado pelas políticas públicas de atenção à mulher e à criança. Entretanto ainda existem fragilidades que apontam a necessidade de ampliar a visão dos profissionais de saúde para maior planejamento dessas ações, adequando às necessidades da população materno-infantil atendida nas unidades de saúde com vistas à redução de óbitos infantis / Healthcare action plans improve children\'s life conditions and health, thereby reducing child mortality. This study aimed to identify healthcare actions that decreased child mortality on the basis of reports by healthcare professionals assisting expectant mothers, newborns, and children aged less than one year in basic healthcare units in a city in the state of São Paulo, Brazil. This transversal study adopted a quantitative health assessment approach with process approximation. Healthcare professionals were interviewed by means of two semi-structured, self-applied questionnaires based on affirmative statements; the instrument was adapted from two technical documents of the Brazilian Health Ministry. Fifty-four healthcare professionals including physicians (gynecologists and pediatricians), nurses, and Health Community Agents (HCA) working at three basic health units were selected for this study. Most of the physicians and nurses stated that only sometimes do expectant mothers receive pre-natal care at an early stage. The majority of physicians and nurses stated that pre-natal care includes six or more visits, but they rarely occur. HCA, physicians, and nurses showed that they actively search for expectant mothers that skip pre-natal consultations, and HCA affirmed that they conduct home visits aiming to contact these patients. According to 44.4% of the physicians and nurses, mothers have a visit scheduled for up to 42 days after childbirth. Most of the participants confirmed that they develop actions to encourage breastfeeding during the pre- natal and puerperium periods as well as at 30 days, six months, and twelve months after childbirth. Of all the participants, 59.3% stated that the children assisted at the health units follow the recommended vaccination schedule. Most physicians and nurses confirmed that children are seen at the basic healthcare unit within one week after birth, and that these professionals visit the child at home when necessary. All the participants--physicians, nurses, and HCA--confirmed that ongoing professional education takes place at the basic healthcare unit where they work; however, 51.9% stated that the health team sometimes participates in the activities. It was possible to identify several actions that followed the public policy recommendations for woman and child healthcare. Nevertheless, it is important to make healthcare professionals aware of the need to implement more action plans that meet the requirements of mothers and children assisted at healthcare units, aiming to diminish child mortality