Evolution Of The Deaths Registry System In Brazil: Associations With Changes In The Mortality Profile, Under-registration Of Death Counts, And Ill-defined Causes Of Death.

This paper examines the spatial pattern of ill-defined causes of death across Brazilian regions, and its relationship with the evolution of completeness of the deaths registry and changes in the mortality age profile. We make use of the Brazilian Health Informatics Department mortality database and population censuses from 1980 to 2010. We applied demographic methods to evaluate the quality of mortality data for 137 small areas and correct for under-registration of death counts when necessary. The second part of the analysis uses linear regression models to investigate the relationship between, on the one hand, changes in death counts coverage and age profile of mortality, and on the other, changes in the reporting of ill-defined causes of death. The completeness of death counts coverage increases from about 80% in 1980-1991 to over 95% in 2000-2010 at the same time the percentage of ill-defined causes of deaths reduced about 53% in the country. The analysis suggests that the government's efforts to improve data quality are proving successful, and they will allow for a better understanding of the dynamics of health and the mortality transition.301721-3

The Association between Conditional Cash Transfer Programmes and Cohort Fertility: Evidence from Brazil

Brazil’s Bolsa Família Programme (BFP) aims to combat poverty and social inequalities through monetary transfers to families. A much-discussed indirect effect of the programme was its correlation to the fertility of the beneficiary families. In this paper, we use a cohort fertility approach with parity progression ratios that differs from existing literature, which mainly used period fertility measures, to better understand the relationship between fertility and the BFP. This study analyses the relationship between the BFP and the reproduction of Brazilian women. We use data from the 2010 Brazilian micro-censuses, the only census after the start of the BFP in 2004, to reconstruct the childbirth history of women with incomplete reproductive cycles (women aged 25 to 29), and estimate parity progression ratios (PPRs) and cohort fertility rates (CFR). In addition, we estimate propensity score matching (PSM) models comparing fertility outcomes of beneficiaries and non-beneficiaries of the programme. Our results show distinct differences in CFRs and PPRs. On average, BFP beneficiaries had more children than women not covered by the programme. This finding remained consistent even after controlling for educational gradients and other covariates. Our empirical findings show that women opt for a “rational” strategy, where they tend to have children in more rapid succession up until three children. These findings contradict the recent literature that has not found any correlation between BFP and fertility. The results also suggest that cohort analyses may fill certain gaps left by previous studies of period fertility. This paper is one of a few that have analysed the relationship between a conditional income transfer programme and cohort measures in Brazil

Educational pairings and fertility decline in Brazil: An analysis using cohort fertility

Background: Brazil's fertility transition was the result of multiple socioeconomic transformations that started during the second quarter of the 20th century. Education expansion played an important role in this process by promoting changes in social norms and in assortative mating profiles. Objective: The goal is to estimate cohort fertility rates (CFR) of women in union by educational pairing (different combinations of men's and women's educational levels) and whether changes observed in assortative mating profiles were associated to the Brazilian cohort fertility transition. Methods: First, we estimate CFR by educational pairings for women cohorts born between 1925 and 1969. Second, we decompose the difference in CFR between younger and older cohorts into two components, the effects of changes in the composition of educational pairings (structural changes) and the rate effects (other factors). Results: The CFR of couples in Brazil declined from levels higher than 6 children per women for cohorts born in 1925-1929, to less than 3 children for women born in 1965-1969. Changes in the composition of educational pairing corresponded to approximately one-third of these reductions in cohort fertility. Conclusions: These results suggest that changes in the composition of educational pairing related to the rising education levels of men and women corresponded to an important share of the cohort fertility decline of women in unions. Contribution: The evaluation of the Brazilian fertility transition through the lens of cohort fertility and educational pairings may provide new insights and methodological alternatives for assessing fertility transition in countries that rely on censuses as the main data source for fertility estimation

Diferenciais de mortalidade, beneficiários do Instituto Nacional do Seguro Social do Brasil em 2015

Este trabalho tem por objetivo estimar a mortalidade e analisar seus diferenciais por sexo, idade e grupos de beneficiários do Instituto Nacional de Seguro Social (INSS) brasileiro em 2015 e fazer comparações com estimativas oficiais para a população geral, avaliando a distribuição dos óbitos por idade e da sobrevida a partir dos 65 anos. Os resultados reforçam a necessidade de mais estudos sobre diferenciais de mortalidade entre grupos de beneficiários e do contínuo investimento para a melhoria da qualidade dos dados. O envelhecimento populacional, entre outros aspectos, pressiona o sistema de previdência social brasileiro, com preocupação real sobre sua sustentabilidade. As tábuas de vida por subgrupos populacionais são fundamentais como ferramenta para análise do equilíbrio financeiro e atuarial do sistema. Os resultados contribuem para o debate sobre os diferenciais de mortalidade entre grupos de beneficiários do regimente geral de previdência e da seguridade social no Brasil. Os dados de óbitos e população são dos registros administrativos do INSS. Utilizaram-se os modelos Gompertz e Van der Maen e regressão Topals para estimar as taxas de mortalidade acima de 65 anos, segundo os seguintes grupos de beneficiários: aposentados por idade do Regime Geral de Previdência Social (RGPS) – desagregados por clientelas urbana e rural; aposentados por tempo de contribuição; e beneficiários de amparos assistenciais para idosos de baixa renda. Entre os principais resultados, foi possível minimizar o crossover nas taxas de mortalidade das idades avançadas, quando a mortalidade da população menos favorecida se torna menor do que a mortalidade de populações com melhores indicadores sociais. Cotejando os resultados com as estimativas oficiais de mortalidade, observou-se que as esperanças de vida para as idades de 65 e 75 anos para a população-alvo desse estudo são maiores do que na população geral.This paper aims to estimate mortality and analyze its differentials by sex, age, and groups of beneficiaries of the Brazilian National Institute of Social Security (INSS) in 2015 and make comparisons with official estimates for the general population, assessing the distribution of deaths by age and of survival after 65 years old. The results reinforce the need for more studies on mortality differentials between beneficiary groups and for continuous investment to improve the quality of the data. Population aging, among other aspects, puts pressure on the Brazilian social security system, and there is real concern about its sustainability. Life tables by population subgroups are fundamental as a tool for analyzing the financial and actuarial equilibrium of the system. The results contribute to the debate on the mortality differentials between groups of beneficiaries of the general pension and social security system in Brazil. The death and population data derive from the administrative records of the INSS. We used Gompertz and Van de Maen models and Topals regression to estimate the mortality rates above the age of 65, according to the following beneficiary groups: retirees through age of the General Social Security Regime (Regime Geral de Previdência Social – RGPS) – disaggregated by urban and rural clienteles; retirees through period of contribution; and beneficiaries of welfare support for low income seniors. Among the main results, it was possible to minimize the crossover in the mortality rates of older ages, when the mortality of the less advantaged population becomes lower than the mortality of populations with better social indicators. Cross-checking the results with the official mortality estimates, it was observed that life expectancies for the 65 and 75 year old age groups of the target population of this study are higher than in the general population

Atualizações sobre as considerações nutricionais no Diabetes mellitus tipo 2

A dieta é um dos aspectos comportamentais mais importantes do tratamento do diabetes, a terapia nutricional médica é o processo pelo qual um nutricionista adapta uma abordagem de planejamento de refeições para pessoas com diabetes com base em fatores médicos, de estilo de vida e pessoais, e é um componente integral do controle do diabetes e educação para o autogerenciamento do diabetes. O plano de terapia nutricional médica é o processo pelo qual um nutricionista adapta uma abordagem de planejamento de refeições para pessoas com diabetes com base em fatores médicos, de estilo de vida e pessoais.  A maior ênfase deve ser dada aos benefícios de reduzir a ingestão calórica e induzir a perda de peso para pacientes com diabetes tipo 2 e sobrepeso. Uma perda de peso sustentada de até 5 a 10% do peso corporal inicial pode ter um impacto benéfico duradouro na glicose sérica, dislipidemia e hipertensão. A atividade física, dieta e modificação comportamental são componentes importantes de todos os programas para conseguir a perda de peso. Existem opções adicionais para perda de peso, incluindo adição de medicamentos para promover a perda de peso e cirurgia bariátrica.&nbsp

AUTOIMAGEM DA MULHER MASTECTOMIZADA: IMPACTOS E REPERCUSSÕES ADVINDOS DO CÂNCER DE MAMA

Introduction: Self-image is defined as the way an individual perceives and feels about their own body. In addition, it is related to the concepts of ‘image’ and ‘body’, whose interpretation goes beyond language and encompasses a broader dimension by taking into account the uniqueness of each being. Objective: To promote reflection on the proposed theme. Methodology: This is a descriptive bibliographic review with a qualitative approach, analyzing scientific literature that refers us to the research object. The bibliographic research is based on already published material with the aim of analyzing different positions on a given subject. Analysis and discussion of results: The Enimar de Paula1; recommended care for mastectomized women are: avoiding sun exposure; not pressing on the side of the operated limb; being careful not to suffer burns, scratches and cuts; not receiving injections, vaccines or blood extraction on the upper limb homolateral to surgery; avoiding cuticle removal; not carrying weight; exercising upper limbs; among others. Conclusion: The nurse also has the duty to follow up on health education activities, which aim to provide information related to necessary care after mastectomy, which assists women in the recovery process.Introdução: A autoimagem é definida como a maneira pela qual um indivíduo se percebe e se sente em relação ao seu próprio corpo. Além disso, está relacionada aos conceitos de ‘imagem’ e ‘corpo’, cuja interpretação vai além da linguagem e abrange uma dimensão mais ampla ao levar em conta a singularidade de cada ser Objetivo: Promover flexão acerca da temática proposta Metodologia: Trata-se de uma revisão bibliográfica de caráter descritivo e abordagem qualitativa, com análise de literaturas científicas que nos remetam ao objeto de pesquisa. A pesquisa bibliográfica é elaborada com base em material já publicado com o objetivo de analisar posições diversas em relação a determinado assunto Análise e discussão dos resultados: A importância de se adotarem as medidas diárias para a diminuição da probabilidade de complicações pós-operatórias. Dentre os cuidados recomendados às mulheres mastectomizadas, estão: evitar a exposição ao sol; não pressionar o lado do membro operado; ter cuidado para não sofrer queimaduras, arranhões e cortes; não receber injeções, vacinas ou extrair sangue no membro superior homolateral à cirurgia; evitar remover cutícula; não carregar peso; exercitar os membros superiores; entre outros Conclusão: O enfermeiro também tem o dever de acompanhar as atividades educativas em saúde, que objetivam fornecer informações relacionadas aos cuidados necessários após a mastectomia, que auxiliam a mulher no processo de recuperação

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans – anteaters, sloths, and armadillos – have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with 24 domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, ten anteaters, and six sloths. Our dataset includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data-paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the south of the USA, Mexico, and Caribbean countries at the northern portion of the Neotropics, to its austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n=5,941), and Cyclopes sp. has the fewest (n=240). The armadillo species with the most data is Dasypus novemcinctus (n=11,588), and the least recorded for Calyptophractus retusus (n=33). With regards to sloth species, Bradypus variegatus has the most records (n=962), and Bradypus pygmaeus has the fewest (n=12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other datasets of Neotropical Series which will become available very soon (i.e. Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans dataset