Nathália Lima Pedrosa

Comunicação entre mãe HIV+ e filho à luz da tacêsica em ambiente natural e experimental

Resumen La kinésica es la forma de expresión de comunicación noverbal relacionada al toque, desvelándose como importante modo de expresión en el relacionamiento de madres con bebés. La finalidad fue comparar comunicación kinésica entre madre VIH+ y su hijo, en ambiente natural y experimental, durante los cuidados maternos del baño y de la higiene. Filmaciones de los cuidados fueron efectuadas en los dos ambientes, seguidas por análisis descriptivo por expertos en comunicación. A pesar de las similitudes en la utilización de la kinésica en los dos ambientes, en los aspectos de localización, intensidad y frecuencia del toque, la comunicación mediada por el toque mostró ser ejecutada de forma incipiente, sobretodo en el ambiente natural. Se estimula orientar y motivar las madres para ampliar e incrementar los toques durante los cuidados con los hijos para estimular precozmente la expansión del vínculo con su hijo y proveer el desarrollo cognitivo y relacional del bebé. Palabras-clave: VIH-1. Niño. Comunicación. Enfermería. Enfermeira. Doutora em Doenças Tropicais. Professora do Depar tamento de Enfermagem da Universidade Federal do Ceará (UFC). Pesquisadora do CNPq. For taleza-CE. Brasil. E-mail: marligalvao@gmail.com; 2 Enfermeira. Mestranda em Enfermagem do Programa de Pós-Graduação em Enfermagem da UFC. Bolsista CAPES Demanda Social. For taleza – CE. Brasil. E-mail: ivanacristinalima@gmail.com;Acadêmica do Curso de Enfermagem da UFC. Bolsista do CNPq-PIBIC-UFC. For taleza-CE. Brasil. E-mail: laladefatima@gmail.com; Acadêmica do Curso de Enfermagem da UFC. Bolsista CNPq-PIBIC-UFC. For talezaCE. Brasil. E-mail: nati.ufc@gmail.com PESQUISA RESEARCH INVESTIGACIÓN Kinesics is the way non-verbal communication is expressed, related to touch. It reveals to be an important expression mode in the relationship between mothers and infants. The goal was to compare kinesics communication between an HIV+ mother and her child, in a natural and an experimental environment, during maternal care for bathing and diaper change. Care was filmed in both environments and descriptively analyzed by communication experts. Despite similarities between the use of kinesics in the natural and experimental environment, regarding touch location, intensity and frequency, touch-mediated communication showed to be executed incipiently, mainly in the natural environment. Thus, mothers should be guided and motivated to expand and increase touch while taking care of their children, with a view to early stimulating the expansion of bonding with their children and enhancing the infants’ cognitive and relational development.A tacesica e a forma de expressao da comunicacao nao verbal relacionada ao toque ou tato, desvelando-se como importante modo de expressao no relacionamento das maes com os bebes. Objetivou-se comparar a comunicacao tacesica entre mae HIV positivo e seu filho, em ambiente natural e experimental, durante os cuidados maternos do banho e da troca. Filmagens dos cuidados foram realizadas nos dois ambientes e analisadas de forma descritiva por peritos em comunicacao. Apesar das similaridades da utilizacao da tacesica em ambiente natural e experimental, nos aspectos relativos a localizacao, intensidade e frequencia do toque, a comunicacao mediada pelo toque demonstrou ser executada de modo incipiente, sobretudo no ambiente natural. Assim incentiva-se orientar e motivar as maes para ampliar e incrementar os toques durante os cuidados com os filhos com vistas a estimular precocemente a ampliacao do vinculo com seu filho e proporcionar o desenvolvimento cognitivo e relacional do bebe.

The historic data series on AIDS in the state of Ceará, Brazil

This study describes the historic records on AIDS in the Brazilian state of Ceará, with analysis by gender, age group and race. It is a descriptive, retrospective, ecological study, analyzing 7,896 notifications of cases of AIDS, of people aged 13 and above, resident in the Ceará, over the period 2001 through 2011. Percentage occurrences and other data were calculated based on the variables gender, age group and race. Average and comparison tests were made, considering p < 0.05 and the trend line. There is a progressive increase in the number of cases. The majority of cases are in men. The ratio between the sexes falls from 2003 through 2007, but the number of women is still lower overall in the period. Higher rates of occurrence were found between the ages of 30 and 39, and of those with black-white mixed-race skin color (80%). Based on the variables studied in the series that was analyzed, the results indicate a need for differentiated strategies in prevention and control of the disease in the state.

Spatial analysis of infection by the human immunodeficiency virus among pregnant women

; ;OBJETIVOS: ; ; analizar la distribucion espacial de los casos notificados de gestantes infectadas por el virus de la inmunodeficiencia humana e identificar las areas urbanas de mayor vulnerabilidad social para la ocurrencia de la infeccion entre gestantes. ; ; ; ;METODO: ; ; estudio ecologico, desarrollado mediante tecnicas de analisis espacial de datos de area. Se utilizaron datos secundarios del Sistema de Informacion de Notificacion de Enfermedades, del municipio de Recife, Pernambuco. Los datos sobre natalidad fueron obtenidos del Sistema de Informacion sobre Nacidos Vivos y los datos socioeconomicos del Censo Demografico 2010. ; ; ; ;RESULTADOS: ; ; se verifico la presencia de autocorrelacion espacial, siendo el Indice Global de Moran significativo para la distribucion. Se identificaron clusters, considerados areas de alto riesgo, localizados en barrios agrupados, con tasas de infeccion en gestantes igualmente altas entre si. Se distinguio un barrio, situado en el noroeste del municipio, considerado en fase de transicion epidemiologica. ; ; ; ;CONCLUSION: ; ; las precarias condiciones de vida evidenciadas por los indicadores analfabetismo, la ausencia de prenatal y la pobreza, se mostraron relevantes para el riesgo de la transmision vertical del HIV, convergiendo para el agrupamiento de casos entre regiones desfavorecidas. ; ;OBJECTIVES: to analyze the spatial distribution of reported cases of pregnant women infected by the human immunodeficiency virus and to identify the urban areas with greater social vulnerability to the infection among pregnant women. METHOD: ecological study, developed by means of spatial analysis techniques of area data. Secondary data were used from the Brazilian National Disease Notification System for the city of Recife, Pernambuco. Birth data were obtained from the Brazilian Information System on Live Births and socioeconomic data from the 2010 Demographic Census. RESULTS: the presence of spatial self-correlation was verified. Morans Index was significant for the distribution. Clusters were identified, considered as high-risk areas, located in grouped neighborhoods, with equally high infection rates among pregnant women. A neighborhood located in the Northwest of the city was distinguished, considered in an epidemiological transition phase. CONCLUSION: precarious living conditions, as evidenced by the indicators illiteracy, absence of prenatal care and poverty, were relevant for the risk of vertical HIV transmission, converging to the grouping of cases among disadvantaged regions.

Análise espacial da infecção pelo vírus da imunodeficiência humana entre gestantes

; ;OBJETIVOS: ; ; analizar la distribucion espacial de los casos notificados de gestantes infectadas por el virus de la inmunodeficiencia humana e identificar las areas urbanas de mayor vulnerabilidad social para la ocurrencia de la infeccion entre gestantes. ; ; ; ;METODO: ; ; estudio ecologico, desarrollado mediante tecnicas de analisis espacial de datos de area. Se utilizaron datos secundarios del Sistema de Informacion de Notificacion de Enfermedades, del municipio de Recife, Pernambuco. Los datos sobre natalidad fueron obtenidos del Sistema de Informacion sobre Nacidos Vivos y los datos socioeconomicos del Censo Demografico 2010. ; ; ; ;RESULTADOS: ; ; se verifico la presencia de autocorrelacion espacial, siendo el Indice Global de Moran significativo para la distribucion. Se identificaron clusters, considerados areas de alto riesgo, localizados en barrios agrupados, con tasas de infeccion en gestantes igualmente altas entre si. Se distinguio un barrio, situado en el noroeste del municipio, considerado en fase de transicion epidemiologica. ; ; ; ;CONCLUSION: ; ; las precarias condiciones de vida evidenciadas por los indicadores analfabetismo, la ausencia de prenatal y la pobreza, se mostraron relevantes para el riesgo de la transmision vertical del HIV, convergiendo para el agrupamiento de casos entre regiones desfavorecidas. ; ;OBJECTIVES: to analyze the spatial distribution of reported cases of pregnant women infected by the human immunodeficiency virus and to identify the urban areas with greater social vulnerability to the infection among pregnant women. METHOD: ecological study, developed by means of spatial analysis techniques of area data. Secondary data were used from the Brazilian National Disease Notification System for the city of Recife, Pernambuco. Birth data were obtained from the Brazilian Information System on Live Births and socioeconomic data from the 2010 Demographic Census. RESULTS: the presence of spatial self-correlation was verified. Morans Index was significant for the distribution. Clusters were identified, considered as high-risk areas, located in grouped neighborhoods, with equally high infection rates among pregnant women. A neighborhood located in the Northwest of the city was distinguished, considered in an epidemiological transition phase. CONCLUSION: precarious living conditions, as evidenced by the indicators illiteracy, absence of prenatal care and poverty, were relevant for the risk of vertical HIV transmission, converging to the grouping of cases among disadvantaged regions.

Análisis espacial de la infección por el virus de la inmunodeficiencia humana entre gestantes

; ;OBJETIVOS: ; ; analizar la distribucion espacial de los casos notificados de gestantes infectadas por el virus de la inmunodeficiencia humana e identificar las areas urbanas de mayor vulnerabilidad social para la ocurrencia de la infeccion entre gestantes. ; ; ; ;METODO: ; ; estudio ecologico, desarrollado mediante tecnicas de analisis espacial de datos de area. Se utilizaron datos secundarios del Sistema de Informacion de Notificacion de Enfermedades, del municipio de Recife, Pernambuco. Los datos sobre natalidad fueron obtenidos del Sistema de Informacion sobre Nacidos Vivos y los datos socioeconomicos del Censo Demografico 2010. ; ; ; ;RESULTADOS: ; ; se verifico la presencia de autocorrelacion espacial, siendo el Indice Global de Moran significativo para la distribucion. Se identificaron clusters, considerados areas de alto riesgo, localizados en barrios agrupados, con tasas de infeccion en gestantes igualmente altas entre si. Se distinguio un barrio, situado en el noroeste del municipio, considerado en fase de transicion epidemiologica. ; ; ; ;CONCLUSION: ; ; las precarias condiciones de vida evidenciadas por los indicadores analfabetismo, la ausencia de prenatal y la pobreza, se mostraron relevantes para el riesgo de la transmision vertical del HIV, convergiendo para el agrupamiento de casos entre regiones desfavorecidas. ; ;OBJECTIVES: to analyze the spatial distribution of reported cases of pregnant women infected by the human immunodeficiency virus and to identify the urban areas with greater social vulnerability to the infection among pregnant women. METHOD: ecological study, developed by means of spatial analysis techniques of area data. Secondary data were used from the Brazilian National Disease Notification System for the city of Recife, Pernambuco. Birth data were obtained from the Brazilian Information System on Live Births and socioeconomic data from the 2010 Demographic Census. RESULTS: the presence of spatial self-correlation was verified. Morans Index was significant for the distribution. Clusters were identified, considered as high-risk areas, located in grouped neighborhoods, with equally high infection rates among pregnant women. A neighborhood located in the Northwest of the city was distinguished, considered in an epidemiological transition phase. CONCLUSION: precarious living conditions, as evidenced by the indicators illiteracy, absence of prenatal care and poverty, were relevant for the risk of vertical HIV transmission, converging to the grouping of cases among disadvantaged regions.

Specialized care for people with AIDS in the state of Ceara, Brazil

OBJECTIVE To analyze if the distribution of specialized care services for HIV/AIDS is associated with AIDS rates. METHODS Ecological study, for which the distribution of 10 specialized care services in the Ceara state, Northeastern Brazil, was obtained, and the mean rates of the disease were estimated per mesoregion. We evaluated 7,896 individuals who had been diagnosed with AIDS, were aged 13 years or older, lived in Ceara, and had been informed of their condition between 2001 and 2011. Maps were constructed to verify the relationship between the distribution of AIDS cases and institutionalized support networks in the 2001-2006 and 2007-2011 periods. BoxMap and LisaMap were used for data analysis. The Voronoi diagram was applied for the distribution of the studied services. RESULTS Specialized care services concentrated in AIDS clusters in the metropolitan area. The Noroeste Cearense and west of the Sertoes Cearenses had high AIDS rates, but a low number of specialized care services over time. Two of these services were implemented where clusters of the disease exist in the second period. The application of the Voronoi diagram showed that the specialized care services located outside the metropolitan area covered a large territory. We identified one polygon that had no services. CONCLUSIONS The scenario of AIDS cases spread away from major urban areas demands the creation of social support services in areas other than the capital and the metropolitan area of the state; this can reduce access barriers to these institutions. It is necessary to create specialized care services for HIV/AIDS in the Noroeste Cearense and north of Jaguaribe.

AIDS em crianças: a influência dos diferenciais socioeconômicos no Município de Fortaleza, Ceará, Brasil

Objetivou-se analisar a relacao entre casos de AIDS em criancas e caracteristicas socioeconomicas de bairros de Fortaleza, Ceara, Brasil. Estudo ecologico descritivo, cujos dados socioeconomicos foram obtidos do Censo Demografico de 2010 e os de AIDS em criancas referentes ao periodo de 2001 a 2011 no Sistema de Notificacao de Agravos. Realizou-se analise de correlacao de Pearson e utilizou-se o indice de Moran para verificar a autocorrelacao espacial. Adotou-se o modelo multinomial para identificar clusters. Verificou-se 57,8% das criancas do sexo masculino. Em 18,8% das criancas o diagnostico ocorreu apos os dois anos de idade. Observou-se correlacao espacial positiva dos casos de AIDS em criancas em relacao a renda (I = 0,6; p = 0,001) e a proporcao de pobres (I = 0,5; p = 0,001). Os bairros com essa caracterizacao estao localizados principalmente ao noroeste e sudoeste da cidade. A correlacao espacial dos casos de AIDS em criancas com os indicadores socioeconomicos evidencia a necessidade de intervencoes voltadas a saude e melhoria das condicoes de vida.This study aimed to analyze the relationship between pediatric AIDS cases and neighborhood socioeconomic characteristics in Fortaleza, Ceará State, Brazil. This was an ecological and descriptive study with socioeconomic data from the 2010 Population Census and AIDS data in children for 2001-2011 from the Information System on Notifiable Diseases. Pearsons correlation was performed and the Moran index was used to verify spatial autocorrelation. A multinomial model was used to identify clusters. Of the total sample, 57.8% were male. In 18.8% of the children, the diagnosis was made after two years of age. There was a positive spatial correlation between AIDS cases in children and income (I = 0.6; p = 0.001) and the proportion of poor (I = 0.5; p = 0.001). Neighborhoods with these characteristics are mainly located in the Northwest and Southwest areas of the city. Spatial correlation between pediatric AIDS cases and socioeconomic indicators highlights the need for interventions aimed at improving health and living conditions.

SIDA en niños: la influencia de las diferencias socioeconómicas en la ciudad de Fortaleza, Ceará, Brasil

Objetivou-se analisar a relacao entre casos de AIDS em criancas e caracteristicas socioeconomicas de bairros de Fortaleza, Ceara, Brasil. Estudo ecologico descritivo, cujos dados socioeconomicos foram obtidos do Censo Demografico de 2010 e os de AIDS em criancas referentes ao periodo de 2001 a 2011 no Sistema de Notificacao de Agravos. Realizou-se analise de correlacao de Pearson e utilizou-se o indice de Moran para verificar a autocorrelacao espacial. Adotou-se o modelo multinomial para identificar clusters. Verificou-se 57,8% das criancas do sexo masculino. Em 18,8% das criancas o diagnostico ocorreu apos os dois anos de idade. Observou-se correlacao espacial positiva dos casos de AIDS em criancas em relacao a renda (I = 0,6; p = 0,001) e a proporcao de pobres (I = 0,5; p = 0,001). Os bairros com essa caracterizacao estao localizados principalmente ao noroeste e sudoeste da cidade. A correlacao espacial dos casos de AIDS em criancas com os indicadores socioeconomicos evidencia a necessidade de intervencoes voltadas a saude e melhoria das condicoes de vida.This study aimed to analyze the relationship between pediatric AIDS cases and neighborhood socioeconomic characteristics in Fortaleza, Ceará State, Brazil. This was an ecological and descriptive study with socioeconomic data from the 2010 Population Census and AIDS data in children for 2001-2011 from the Information System on Notifiable Diseases. Pearsons correlation was performed and the Moran index was used to verify spatial autocorrelation. A multinomial model was used to identify clusters. Of the total sample, 57.8% were male. In 18.8% of the children, the diagnosis was made after two years of age. There was a positive spatial correlation between AIDS cases in children and income (I = 0.6; p = 0.001) and the proportion of poor (I = 0.5; p = 0.001). Neighborhoods with these characteristics are mainly located in the Northwest and Southwest areas of the city. Spatial correlation between pediatric AIDS cases and socioeconomic indicators highlights the need for interventions aimed at improving health and living conditions.

[AIDS in children: the influence of socioeconomic differences in Fortaleza Ceara State Brazil]

Objetivou-se analisar a relacao entre casos de AIDS em criancas e caracteristicas socioeconomicas de bairros de Fortaleza, Ceara, Brasil. Estudo ecologico descritivo, cujos dados socioeconomicos foram obtidos do Censo Demografico de 2010 e os de AIDS em criancas referentes ao periodo de 2001 a 2011 no Sistema de Notificacao de Agravos. Realizou-se analise de correlacao de Pearson e utilizou-se o indice de Moran para verificar a autocorrelacao espacial. Adotou-se o modelo multinomial para identificar clusters. Verificou-se 57,8% das criancas do sexo masculino. Em 18,8% das criancas o diagnostico ocorreu apos os dois anos de idade. Observou-se correlacao espacial positiva dos casos de AIDS em criancas em relacao a renda (I = 0,6; p = 0,001) e a proporcao de pobres (I = 0,5; p = 0,001). Os bairros com essa caracterizacao estao localizados principalmente ao noroeste e sudoeste da cidade. A correlacao espacial dos casos de AIDS em criancas com os indicadores socioeconomicos evidencia a necessidade de intervencoes voltadas a saude e melhoria das condicoes de vida.This study aimed to analyze the relationship between pediatric AIDS cases and neighborhood socioeconomic characteristics in Fortaleza, Ceará State, Brazil. This was an ecological and descriptive study with socioeconomic data from the 2010 Population Census and AIDS data in children for 2001-2011 from the Information System on Notifiable Diseases. Pearsons correlation was performed and the Moran index was used to verify spatial autocorrelation. A multinomial model was used to identify clusters. Of the total sample, 57.8% were male. In 18.8% of the children, the diagnosis was made after two years of age. There was a positive spatial correlation between AIDS cases in children and income (I = 0.6; p = 0.001) and the proportion of poor (I = 0.5; p = 0.001). Neighborhoods with these characteristics are mainly located in the Northwest and Southwest areas of the city. Spatial correlation between pediatric AIDS cases and socioeconomic indicators highlights the need for interventions aimed at improving health and living conditions.

Domestic accidents and nursing diagnoses of children exposed to HIV at birth

Objective: The objective was to identify risk factors for domestic accidents in children exposed to HIV at birth and to indicate associated nursing diagnoses. Methods: A descriptive and exploratory qualitative study, conducted in the home environment of 12 families, consisting of mother and child exposed to HIV at birth, between January and February 2011. It used photography as a technological resource to target those at risk of accidents and a semistructured form to characterize the families. We analyzed the data according to risk situations recommended by safety standards for the prevention of domestic accidents. Results: The injuries identified with the greatest risk of occurrence were: falls and fractures, poisoning, electric shock and suffocation/choking/gagging. The risks identified were the basis for the classification of nursing diagnoses. Conclusion: The home environment should be the focus of continuous assessment, so as to enhance interventions to reduce vulnerability to health problems in children.Objetivou-se identificar fatores de riscos para acidentes domesticos em criancas nascidas expostas ao HIV e indicar os diagnosticos de enfermagem associados. Metodos: Estudo exploratorio-descritivo, qualitativo, realizado no ambiente domiciliar de 12 familias compostas por mae HIV+ e crianca nascida exposta ao virus, entre janeiro e fevereiro de 2011. Usaram-se a fotografia como recurso tecnologico para apontar as situacoes de risco de acidentes e o formulario semiestruturado para caracterizacao das familias. Analisaram-se os dados em conformidade as situacoes de risco preconizadas por normas de seguranca para prevencao de acidentes domesticos. Resultados: Os acidentes identificados de maior risco para ocorrencia foram: quedas e traumas; intoxicacoes; choque eletrico e asfixias/sufocacoes/engasgos. Os riscos identificados serviram de base para a classificacao dos diagnosticos de enfermagem. Conclusao: O ambiente domiciliar deve ser foco de avaliacao continua, de modo que propicie intervencoes para reducao de vulnerabilidade de agravos a saude infantil.