212 research outputs found

    Investigating the Difference in Mortality Estimates between the Social Security Administration Trustees' Report and the Human Mortality Database

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    This study’s goal was to determine whether differences in data or differences in methods explain the divergence between the mortality estimates at ages 65 and older of the Social Security Administration (SSA) and the Human Mortality Database (HMD). These differences, increasing since 1968, are an issue of significant value considering the importance of SSA estimates and projections to determine the long term solvency of the Social Security Trust Funds, as well as of other government programs such as Medicare and Medicaid. The two organizations use different data and different methods to construct their estimates. In particular, the HMD relies on national statistics from the vital registration system and the Census Bureau, while the SSA uses Medicare program enrollment data. Applying the SSA methods to the HMD data showed that differences in the data, rather than in the methods, explain the entire gap in life expectancy at age 65, with the HMD indicator 0.4 years higher for 2014 than the SSA. The study also determined that the gap resulted mostly from lower mortality rates at ages 65 to 84 years (rather than at 85 and older) up to about 2005 to 2006, but that the growing divergence since then is nearly entirely due to increasingly lower mortality at ages above 85. The pattern was found to be similar for men and for women, though the gap is slightly larger for the latter. Additional investigations, with more detailed data, will be necessary to assess whether data reliability or issues of representativeness explain the difference.The U.S. Social Security Administration, RRC08098401-10, R-UM18-01https://deepblue.lib.umich.edu/bitstream/2027.42/148663/1/wp394.pdfDescription of wp394.pdf : Working pape

    A morte no contexto da enfermagem obstétrica: uma perspectiva do cuidar

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    The authors intend to unveil facets of the meaning of mother‚Äôs care who has lost her baby at the end of pregnancy, in the nursery labor view. For that, they used a Qualitative Research Methodology. The phenomenological methodology of inquiry allowed them to reach the subject of the study. The data were collected from obstetric office employees that answers reveals important points linked to this mother‚Äôs care.Os autores se prop√Ķem desvelar facetas do significado do cuidado √† m√£e que vivencia a perda do filho ao final da gesta√ß√£o, aos olhos dos funcion√°rios do Servi√ßo de Enfermagem que cuidam dessa m√£e. Para tanto, recorreram a uma Metodologia de Pesquisa Qualitativa - a investiga√ß√£o fenomenol√≥gica - que lhes permita o acesso a esse objeto de estudo, √† sua ess√™ncia. Foram coletados depoimentos de funcion√°rios de uma Cl√≠nica Obst√©trica, mediante uma quest√£o orientadora. A an√°lise dos depoimentos desvela facetas relevantes ligadas ao cuidado dessa m√£e

    Analisadores de pr√°ticas de apoio em humaniza√ß√£o e educa√ß√£o permanente em sa√ļde

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    Las Pol√≠ticas Nacionales de Humanizaci√≥n y Educaci√≥n Permanente en Salud han mostrado avances y retrocesos en su proceso hist√≥rico. Algunos conceptos del marco te√≥rico del an√°lisis institucional pueden contribuir a estos temas, como el concepto de analizador. El objetivo de este art√≠culo fue discutir los analizadores identificados en una investigaci√≥n-intervenci√≥n, con profesionales que act√ļan como apoyadores de la humanizaci√≥n y/o articuladores de la educaci√≥n permanente en salud en municipios de S√£o Paulo. El marco te√≥rico-metodol√≥gico fue el del an√°lisis institucional, l√≠nea sociocl√≠nica, destac√°ndose el trabajo de los analizadores. Participaron 30 personas en los grupos de intervenci√≥n. Se destacan tres analizadores: (1) el analizador hist√≥rico Covid-19; (2) el analizador de tiempo; (3) el analizador de silencio. Estos analizadores iluminan tensiones como: el lugar perif√©rico de la atenci√≥n primaria, el malestar ante el ‚Äúno saber‚ÄĚ y/o el letargo ante el no hacer impuesto y la paradoja de crear e interrumpir tanto las acciones asistenciales como de apoyo a los equipos.The National Policies of Humanization and Permanent Health Education (PHE) have shown advances and setbacks in their historical process. Some concepts from the theoretical framework of institutional analysis can contribute in these themes, such as the concept of analyzer. This article discusses the analyzers identified in an intervention research with professionals who work as supporters of humanization and/or articulators of PHE in municipalities of the state of S√£o Paulo. The theoretical-methodological framework is the institutional analysis, socio-clinical line, focusing on the work of the analyzers.As Pol√≠ticas Nacionais de Humaniza√ß√£o e Educa√ß√£o Permanente em Sa√ļde t√™m mostrado em seu processo hist√≥rico avan√ßos e retrocessos. Alguns conceitos do referencial te√≥rico da an√°lise institucional podem contribuir nesses temas, como o conceito de analisador. O objetivo do presente estudo foi discutir os analisadores identificados em uma pesquisa-interven√ß√£o, com profissionais que exercem a fun√ß√£o de apoiadores de humaniza√ß√£o e/ou de articuladores de educa√ß√£o permanente em sa√ļde em munic√≠pios paulistas. O quadro te√≥rico-metodol√≥gico √© a an√°lise institucional, linha s√≥cio-cl√≠nica, sendo destacado, o trabalho dos analisadores. Participaram 30 pessoas dos grupos de interven√ß√£o. Destacamos tr√™s analisadores: (1) o analisador hist√≥rico Covid-19; (2) o analisador tempo; (3) o analisador sil√™ncio. Esses analisadores iluminaram tens√Ķes como: o lugar perif√©rico da aten√ß√£o b√°sica, o desconforto frente ao ‚Äún√£o saber‚ÄĚ e/ou a letargia ante o n√£o-fazer imposto e o paradoxo de criar e interromper tanto a√ß√Ķes de cuidado, como de suporte √†s equipes

    Frailty at death: An examination of multiple causes of death in four low mortality countries in 2017

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    Background: The increasing prevalence of frailty in ageing populations represents a major social and public health challenge which warrants a better understanding of the contribution of frailty to the morbid process. Objective: To examine frailty-related mortality as reported on death certificates in France, Italy, Spain, and the United States in 2017. Methods: We identify frailty at death for the population aged 50 years and over in France, Italy, Spain, and the United States. We estimate the proportions of deaths by sex, age group, and country using specific frailty-related ICD-codes on the death certificate, (1) as the underlying cause of death (UC), (2) elsewhere in Part I (sequence of diseases or conditions or events leading directly to death), and (3) anywhere in Part II (conditions that do not belong in Part I but whose presence contributed to death). Results: The age-standardized proportion of deaths with frailty at ages 50 and over is highest in Italy (25.0҆) followed by France (24.1҆) and Spain (17.3҆), and lowest in the United States (14.0҆). Cross-country differences are smaller when frailty-related codes are either the underlying cause of the death or reported in Part II. Frailty-related mortality increases with age and is higher among females than males. Dementia is the most frequently reported frailty-related code. Conclusions: Notable cross-country differences were found in the prevalence and type of frailty-related symptoms at death, even after adjusting for differential age distributions. Contribution: Strong similarities between countries were found that warrant monitoring frailty at death in low-mortality countries to complement information on frailty prevalence in the living population

    Gerenciamento comunit√°rio de recursos h√≠dricos, uma quest√£o de sa√ļde: a √°gua que temos e a √°gua que queremos: percep√ß√£o dos usu√°rios de sociedades de √°gua em um munic√≠pio rural da sub-bacia hidrogr√°fica do Forqueta, RSCommunity management of water.....

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    Os Comit√™s de Bacia Hidrogr√°fica (CBH) foram criados para democratizar e descentralizar a gest√£o das √°guas, compatibilizando os usos necess√°rios para suprir as demandas de cada setor e garantindo a qualidade do recurso para as futuras gera√ß√Ķes. Em √°reas rurais da sub-bacia do rio Forqueta, assim como em outras regi√Ķes rurais do estado do Rio Grande do Sul, o abastecimento de √°gua para a popula√ß√£o √© realizado por associa√ß√Ķes de moradores, chamadas por eles de sociedades de √°gua. Este estudo objetivou discutir as percep√ß√Ķes dos presidentes das sociedades de √°gua sobre a gest√£o dos recursos h√≠dricos, principalmente sobre aspectos quali-quantitativos locais. As informa√ß√Ķes foram coletadas a partir de entrevistas individuais e de rodas de conversa, realizadas com os presidentes das sociedades de √°gua do munic√≠pio de Marques de Souza/RS e do acompanhamento das reuni√Ķes do Comit√™ Taquari-Antas. A pesquisa classifica-se como explorat√≥ria, observacional, qualitativa. Como potencialidades, os entrevistados apontam que as sociedades de √°gua facilitaram o acesso √† √°gua, mas h√° uma desvaloriza√ß√£o do recurso, retratada pelo desperd√≠cio e pela polui√ß√£o, podendo impactar a sa√ļde das comunidades. Para enfrentar esses fatores, foi sugerido o tratamento de esgoto, a preserva√ß√£o da mata ciliar, a limita√ß√£o do uso da √°gua e campanhas de educa√ß√£o quanto ao seu uso e preserva√ß√£o. Destaca-se que a popula√ß√£o n√£o est√° ciente dos dados qualitativos dos recursos h√≠dricos da bacia hidrogr√°fica, nem mesmo da poss√≠vel contamina√ß√£o de seus po√ßos por agrot√≥xicos, aponta o que a necessidade de estrat√©gias de educa√ß√£o ambiental. A falta de comunica√ß√£o entre os etrevistados e o Comit√™ de Bacia ao qual pertencem √© outro elemento que necessita ser trabalhado.Abstract The hydrographic Basin Monitoring Committees were created to democratize and decentralize water management, harmonizing the uses needed to meet the demands of each sector and ensuring the quality of the resource for future generations. In rural areas of the sub-basin of the Forqueta River as well as in other rural regions of the state of Rio Grande do Sul, the water supply for the population is carried out by local residents‚Äô associations who call themselves ‚Äúwater societies‚ÄĚ. This study aimed to discuss the perceptions of the presidents of the ‚Äúwater societies‚ÄĚ on the management of water resources, mainly on local qualitative and quantitative aspects. Data were collected from individual interviews and conversation circles, carried out with the presidents of the ‚Äúwater societies‚ÄĚ in the municipality of Marques de Souza/Rio Grande do Sul and from the follow-up meetings with the Taquari-Antas Committee. The research is classified as exploratory, observational and qualitative. The results show that the respondents point out that the ‚Äúwater societies‚ÄĚ facilitated access to water, however there is a depreciation of the resource, evidenced by the waste and pollution, which can impact on the health of the communities. Thus, it was suggested sewage treatment, the preservation of riparian vegetation, water use restrictions and educational campaigns, focusing on the use and preservation of water. It is noteworthy that the population is not aware about the qualitative data of the water resources of the basin, but they also ignore about the possible contamination of their wells by pesticides, indicating the need for environmental education strategies. The lack of communication between the ‚Äúwater societies‚ÄĚ and the Basin Monitoring Committee to which they belong is another element that needs to be worked

    A an√°lise de implica√ß√£o profissional como um dispositivo de educa√ß√£o permanente em sa√ļde

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    Objetivo: analizar la implicaci√≥n profesional con los colaboradores de humanizaci√≥n y los articuladores de educaci√≥n permanente en salud como un dispositivo de Educaci√≥n Permanente en Salud. M√©todo: investigaci√≥n-intervenci√≥n, de abordaje cualitativo, fundamentado en el referencial te√≥rico del An√°lisis Institucional. Participaron de la investigaci√≥n 35 colaboradores de humanizaci√≥n y/o articuladores de educaci√≥n permanente. Fueron realizadas encuestas semiestructuradas, encuentros mensuales, encuentros de restituci√≥n y el diario de investigaci√≥n como instrumentos para la producci√≥n de los datos. El an√°lisis del material fue hecho seg√ļn los principios del referencial del estudio y los resultados fueron presentados seg√ļn las dimensiones ideol√≥gica, organizacional y libidinal de la implicaci√≥n profesional. Resultados: fueron identificadas: la contradicci√≥n en pensarse en un perfil profesional para el desarrollo del apoyo y de la articulaci√≥n; los sentimientos de des√°nimo, pesimismo y optimismo en el desarrollo de esas funciones; los atravesamientos que la profesi√≥n de enfermer√≠a ejerce en el hacer apoyo y articulaci√≥n; el tiempo de ejercicio profesional; y la ausencia/presencia del deseo en el desarrollo de las mismas. Conclusion: el an√°lisis de implicaci√≥n profesional consisti√≥ en un potente dispositivo generador de procesos formativos. Ella posibilit√≥ el aprendizaje y la reflexi√≥n de la pr√°ctica por medio del an√°lisis de las acciones que fueron ejecutadas por los profesionales, generando transformaciones de la concepci√≥n del trabajo en salud.Objective: analyze professional implication with the support of humanization and articulators of permanent education in health as a tool of Permanent Education in Health. Method: this is an interventional study of qualitative approach, based on the theoretical reference of Institutional Analysis. Thirty-five humanization supporters and/or permanent education articulators participated in this study. Semi-structured interviews, monthly meetings, restitution meetings and a daily logbook were used as tools for data production. The material was analyzed according to the principles of the study reference and the results were presented according to the ideological, organizational and libidinal dimensions of professional implication. Results: this study identified a contradiction when finding a professional profile for the development of support and articulation; feelings of discouragement, pessimism and optimism in the development of these roles; influences of the nursing profession on the development of support and articulation; length of professional service; and the absence/presence of desire in such development. Conclusion: the analysis of professional implication consisted of a powerful tool generating training processes. It allowed learning and reflection of the practice through analysis of the actions performed by the professionals, generating changes in the conception of work in health.Objetivo: analisar a implica√ß√£o profissional com os apoiadores de humaniza√ß√£o e os articuladores de educa√ß√£o permanente em sa√ļde como um dispositivo de Educa√ß√£o Permanente em Sa√ļde. M√©todo: pesquisa-interven√ß√£o, de abordagem qualitativa, fundamentada no referencial te√≥rico da An√°lise Institucional. Participaram da pesquisa 35 apoiadores de humaniza√ß√£o e/ou articuladores de educa√ß√£o permanente. Foram utilizadas entrevistas semiestruturadas, encontros mensais, encontros de restitui√ß√£o e o di√°rio de pesquisa como instrumentos para a produ√ß√£o dos dados. A an√°lise do material foi feita segundo os princ√≠pios do referencial do estudo e os resultados foram apresentados conforme as dimens√Ķes ideol√≥gica, organizacional e libidinal da implica√ß√£o profissional. Resultados: foram identificadas: a contradi√ß√£o em se pensar em um perfil profissional para o desenvolvimento do apoio e da articula√ß√£o; os sentimentos de des√Ęnimo, pessimismo e otimismo no desenvolvimento dessas fun√ß√Ķes; os atravessamentos que a profiss√£o de enfermagem exerce no fazer apoio e articula√ß√£o; o tempo de exerc√≠cio profissional; e a aus√™ncia/presen√ßa do desejo no desenvolvimento das mesmas. Conclus√£o: a an√°lise de implica√ß√£o profissional consistiu em um potente dispositivo gerador de processos formativos. Ela possibilitou o aprendizado e a reflex√£o da pr√°tica por meio da an√°lise das a√ß√Ķes executadas pelos profissionais, gerando transforma√ß√Ķes da concep√ß√£o do trabalho em sa√ļde

    The short-term mortality fluctuation data series, monitoring mortality shocks across time and space.

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    The COVID-19 pandemic has revealed substantial coverage and quality gaps in existing international and national statistical monitoring systems. It is striking that obtaining timely, accurate, and comparable across countries data in order to adequately respond to unexpected epidemiological threats is very challenging. The most robust and reliable approach to quantify the mortality burden due to short-term risk factors is based on estimating weekly excess deaths. This approach is more reliable than monitoring deaths with COVID-19 diagnosis or calculating incidence or fatality rates affected by numerous problems such as testing coverage and comparability of diagnostic approaches. In response to the emerging data challenges, a new data resource on weekly mortality has been established. The Short-term Mortality Fluctuations (STMF, available at www.mortality.org ) data series is the first international database providing open-access harmonized, uniform, and fully documented data on weekly all-cause mortality. The STMF online vizualisation tool provides an opportunity to perform a quick assessment of the excess weekly mortality in one or several countries by means of an interactive graphical interface

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