THE IMPORTANCE OF CONGENITAL MALFORMATIONS AT BIRTH

Introduction: Countries that have overcome high infant mortality rates show, nowadays, concentration of deaths in the neonatal period and, within it, mainly in the first week of life (early neonatal deaths). Regarding causes of death, as some diseases have started to be controlled, a significant proportional increase in the participation of congenital malformations has been verified. Objective: To describe the prevalence of congenital malformations (CM) at birth in conceptuses (stillbirths and live births) of women hospitalized in institutions located in the city of São Paulo, Brazil. Methods: Descriptive, cross-sectional study carried out at 4 hospitals in the city of São Paulo during 3 months in the 2 and semester of 2011. Data were collected by means of interviews with the women and examinations of hospital records. The CM were studied according to variables of epidemiological and socio-demographic interest. The deaths were analyzed according to underlying and associated causes. Results: The results showed the occurrence of 9.1% of CM registered among stillbirths and 4.3% among live births. Among the latter – 238 newborns – 284 CM were registered, totaling 1.2 CM per live birth with CM registered. Among the 238 newborns that had a CM register, there were 10 deaths by CM (4.2%). This value differs from the one verified among the live births without CM register that died (19 out of 5,341 or 0.4%). Aiming to identify possible  occurrences of death after hospital discharge, a linkage was performed between the official mortality database of the city of São Paulo and the study’s database. The occurrence of 18 deaths was found in this way, 4 of which were caused by CM. Thus, the total of deaths in the 1 st year of life was 47, and 14 of them had CM as the underlying cause, which leads to a proportional infant mortality by CM equal to 29.8% and an infant mortality coefficient by CM of 2.5%o live births. The data show a high undercount of CM in the registers of the official information systems (regarding SINASC, the prevalence of CM in the study was three times the prevalence for the city of São Paulo and 5.4 times the prevalence for Brazil). Conclusion: It is necessary to implement measures to improve the register of CM in the information systems, such as: raising doctors’ awareness concerning the importance of diagnosing CM and registering it in the newborn’s hospital records, creating a specific space to register the CM in the newborn’s hospital records, and qualifying and monitoring the personnel in charge of filling in the Certificate of Live Birth and transcribing it to the information systems

Avaliação do sistema de informação sobre nascidos vivos e o uso de seus dados em epidemiologia e estatísticas de saúde

O Ministério da Saúde, considerando a existência de falhas do ponto de vista quantitativo (cobertura) no registro de nascidos vivos, no Brasil, e a impossibilidade de conhecer a distribuição dos nascidos vivos segundo algumas variáveis importantes sob a óptica clínico/epidemiológica (peso ao nascer, Índice de Apgar, duração da gestação, tipo de parto, paridade, idade e instrução da mãe), implantou em 1990, no Brasil, o Sistema de Informações sobre Nascidos Vivos - SINASC- tendo como documento-base a Declaração de Nascido Vivo - DN - com a finalidade de suprir essas lacunas. Com o objetivo de avaliar a cobertura e a fidedignidade das informações geradas pelo SINASC, foi analisada a distribuição dos nascidos vivos hospitalares segundo características epidcmiológicas relativas ao produto de concepção, à gravidez, ao parto e à mãe. A população de estudo compreendeu 15.142 nascidos vivos hospitalares ocorridos em cinco municípios do Estado de São Paulo, Brasil, no período de janeiro a julho de 1992. Os resultados permitiram reconhecer excelente cobertura do SINASC (emissão de DN acima de 99,5%) e ótima fidedignidade do preenchimento das DNs, para a maioria das variáveis, quando comparadas aos documentos hospitalares. Para algumas características foi observada maior fragilidade (Índice de Apgar, duração da gestação, instrução da mãe, número total de filhos tidos e nome do pai). São apresentadas sugestões para o aperfeiçoamento do SINASC e recomendados treinamentos/reciclagens do pessoal envolvido no preenchimento das DNs. O estudo confirma o fato de os dados permitirem análise válida para o conhecimento de aspectos ligados à saúde materno-infantil. Do ponto de vista epidemiológico, o estudo permitiu detectar proporções elevadas de parto operatório (48,4%), mães adolescentes (17,5%) e o valor estimado para o baixo peso ao nascer foi de 8,5%.The Brazilian Ministry of Health implemented, in 1990, a System of Information of Live Births (SINASC) which introduced a Birth Certificate with a view to obtaining the total number of these events and their distribution according to epidemiological, demographic and clinical characteristics. It was decided to evaluate the System according to its coverage and the quality of information obtained, two years after its initial implementation. The population of this study consists of 15,142 hospital live births which occurred in five cities of the State of São Paulo, Brazil, in 1992. Birth Certificates and the corresponding maternal and child hospital records were examined visually with a view to checking data recorded on the Birth Certificate. It was seen that the system achieved a high degree of completeness (99.5%) and obtained a very accurate report for most of the items, though rather poor reporting for Apgar Score, length of gestation, mother's schooling, parity and father's name. This study allows suggestions to be made for the reformulation of some items and regarding the necessity for retraining the hospital personnel involved in the filling in of the certificates. Overall this study confirms that the Birth Certificate data are adequate for a valid analysis of aspects of maternal and child health research. The data showed high percentages of adolescent mothers (17.5%) and deliveries by cesarian section (48.4%). The percentage of low birth weight was 8.5%

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Anais do V Encontro Brasileiro de Educomunicação: Educação midiática e políticas públicas

A presente coletânea, que chega ao público através de um suporte digital, tem como objetivo disponibilizar os papers, bem como os relatos de experiências educomunicativas apresentados durante o V ENCONTRO BRASILEIRO DE EDUCOMUNICAÇÃO, que teve como tema central: “Educação Midiática e Políticas Públicas”. O evento foi realizado em São Paulo, entre 19 e 21 de setembro de 2013, a partir de uma parceria entre o NCE/USP - Núcleo de Comunicação e Educação da USP, a Licenciatura em Educomunicação da ECA/USP, a ABPEducom – Associação Brasileira de Pesquisadores e Profissionais da Educomunicação e a FAPCOM – Faculdade Paulus de Tecnologia e Comunicação, que ofereceu seu campus, na Vila Mariana, para os atos do evento. Os presentes anais disponibilizam o texto de abertura, de autoria do coordenador geral do evento, denominado “Educação midiática e políticas públicas: vertentes históricas da emergência da Educomunicação na América Latina”. Na sequência, apresentam 61 papers sobre aspectos específicos da temática geral, resultantes de pesquisas na área, seguidos de 27 relatos de práticas educomunicativas, em nível nacional

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost