Regina Kazue Tanno de Souza

Characteristics of mortality in traffic accidents in an area of southern Brazil

OBJECTIVE The mortality by traffic accidents is discussed by means of the characterization of residents who died as a result of accidents in 1992. MATERIAL AND METHOD The study population was made up of all the victims of accidents which occurred in 1992 and who died in the same year. RESULTS AND CONCLUSIONS The majority of victims were males between the ages of 20 and 49 years who were pedestrians (29%), motorcycle riders (34%) or cyclists (18%). The accidents occurred mostly in the early afternoon and evening at crossroads of the busiest avenues. It may be concluded that even in the interior towns the consequences of traffic accidents constitute one of the principal hazards to the populations health and reveal a distinct pattern that calls for measures specific prevention.

Condições de vida e mortalidade infantil no Estado do Paraná, Brasil, 1997/2001

This objective of this paper was to verify the relations between the living and infrastructure conditions of municipalities in the State of Paraná, Brazil, and infant mortality rate and its components. An ecological study was carried out having the 399 municipalities of the State being classified into five clusters of living conditions. Infant, neonatal and postneonatal rates were calculated for the period 1997/2001. The mean infant, neonatal and postneonatal mortality rates in the State were, respectively, 19.3, 12.0 and 7.3 per 1,000 live births. Postneonatal mortality rates ranged from 8.7 (cluster of worst living conditions) to 6.3 per 1,000 live births (in the cluster classified as having the best living conditions). Regarding the neonatal component, clusters classified as holding the best and the worst living conditions presented the lowest values: 11.8 and 11.4 per 1,000 live births, respectively. We conclude that the postneonatal component still adequately discriminate living conditions in the State of Paraná. However, there is a need of complementary studies that aim to clarify the causes of similar neonatal mortality rates observed in the richest and in the poorest cluster of municipalities.

Probabilidade de morrer no primeiro ano de vida em área urbana da região sul, Brasil

A birth-cohort of 4,876 children born alive in hospital were selected and followed through up to the age of one year with a view to estimating the risk of dying in the first year of life. All of them were born in 1989, in one of the seven hospitals of an urban area of Southern Brazil and the only requirement for belonging to the cohort was that of residence on the area. The selected variables were: sex, birthweight, age at moment of death, underlying cause of death, and maternal age. The estimated probability of dying in the first year was of 19.9 per 1,000 (77.3% of the deaths occurred during the neonatal period). Perinatal causes and congenital malformations contributed to 80% of the deaths, and infectious diseases were the underlying cause of death in only 1.1% of the losses. The risk of dying in the first year of life due to afections arising during the perinatal period was higher among vaginally delivered babies (20.3 per 1,000) than it was for those born by cesarean section (9 per 1,000). A higher probability of death was present among infants born to adolescent mothers, and those with low birthweight (less than 2,500g). The results brought out the need for improving the quality of prenatal and infant care. They also suggested the hypothesis of a possible association between higher infant mortality and lower socio-economic level.Coorte constituida por 4.876 criancas nascidas vivas, em hospitais do Municipio de Maringa-PR (Brasil), em 1989, foi acompanhada com a finalidade de estimar a probabilidade de morrer no primeiro ano de vida. As variaveis de estudo foram sexo, peso ao nascer, idade da mae, subgrupos etarios e causa basica de morte. A probabilidade de morte no primeiro ano de vida foi estimada em 19,9 por mil, sendo que 77,3% dos obitos ocorreram no periodo neonatal. As causas perinatais, juntamente com as anomalias congenitas, responderam por mais de 80% dos obitos, e as doencas infecciosas e parasitarias, por apenas 1,1%. A probabilidade de morrer no primeiro ano de vida devido as afeccoes originadas no periodo perinatal foi superior nas criancas nascidas de parto normal (20,3 por mil) em relacao a das nascidas por cesarea (9 por mil). O risco de morrer foi maior nos filhos de mulheres adolescentes, nas criancas nascidas com peso inferior a 2.500g. Os resultados chamam a atencao para a necessidade de melhorar a qualidade da assistencia pre-natal, ao parto e ao recem-nascido e sugerem possivel associacao entre maior mortalidade e pior nivel socioeconomico.Coorte constituida por 4.876 criancas nascidas vivas, em hospitais do Municipio de Maringa-PR (Brasil), em 1989, foi acompanhada com a finalidade de estimar a probabilidade de morrer no primeiro ano de vida. As variaveis de estudo foram sexo, peso ao nascer, idade da mae, subgrupos etarios e causa basica de morte. A probabilidade de morte no primeiro ano de vida foi estimada em 19,9 por mil, sendo que 77,3% dos obitos ocorreram no periodo neonatal. As causas perinatais, juntamente com as anomalias congenitas, responderam por mais de 80% dos obitos, e as doencas infecciosas e parasitarias, por apenas 1,1%. A probabilidade de morrer no primeiro ano de vida devido as afeccoes originadas no periodo perinatal foi superior nas criancas nascidas de parto normal (20,3 por mil) em relacao a das nascidas por cesarea (9 por mil). O risco de morrer foi maior nos filhos de mulheres adolescentes, nas criancas nascidas com peso inferior a 2.500g. Os resultados chamam a atencao para a necessidade de melhorar a qualidade da assistencia pre-natal, ao parto e ao recem-nascido e sugerem possivel associacao entre maior mortalidade e pior nivel socioeconomico.

Hipertensão arterial e saúde da família: atenção aos portadores em município de pequeno porte na região Sul do Brasil

OBJECTIVE Based on the analysis of indicators which express the rationale of the actions of the program, we developed a cross-sectional study to assess the performance of a Family Healthcare Team as regards the care provided to individuals with arterial hypertension living in a small municipality. METHODS The study carried out was based on the analysis of the records (Record A) of SIAB (Primary Care Information System) of 418 individuals suffering from arterial hypertension, of 351 records stored in the primary healthcare center, and of 376 interviews with individuals living in the area under the teams care, in the year 2003. The following variables were studied: gender, age, family income, housing conditions, health services used, presence of diabetes mellitus, coverage and concentration of care. RESULTS Women above 60 years of age prevailed. They were 65.7% of the cases. The arterial hypertension prevalence rate was 18%, and was different for both genders: for women it was 22.3%. The coverage was 64.1% for appointments with doctors, 32.4% for appointments with nurses, and 36.4% for home visits. The information on files revealed that 25.8% of hypertensive individuals did not receive care in 2003 and 52.7% did not receive care in the last semester. The concentration of care was below the recommendation. CONCLUSION The information showed that the organization of health care does not reflect the rationale of health surveillance in that services focus mostly on meeting spontaneous demand, which in turn reflects unpreparedness as to the use of information systems for the planning and evaluation of actions.

Mortalidade em migrantes japoneses residentes no Paraná, Brasil

INTRODUCAO: A experiencia da morbimortalidade de migrantes em relacao aos padroes existentes nos locais de sua origem e seu destino mostra-se interessante, em epidemiologia, permitindo distinguir possiveis fatores de risco culturais, sociais e ambientais, por um lado, e aqueles geneticos, por outro. O objetivo do estudo foi analisar o padrao de mortalidade da populacao de nascidos no Japao e residentes no Parana (Brasil), comparando-o ao perfil do Japao e ao do Parana. METODOS: A populacao exposta foi constituida pelos imigrantes japoneses - isseis - residentes no Parana, com 50 e mais anos, identificada por ocasiao do X Recenseamento Geral do Brasil, em 1o de setembro de 1991. Os obitos, ocorridos entre 1o de marco de 1990 e 28 de fevereiro de 1993, foram apurados do Sistema de Informacao de Mortalidade do Ministerio da Saude. Foram calculadas taxas de mortalidade padronizadas por idade, ajustadas pela populacao-padrao mundial de 50 e mais anos, em cada sexo, para cada grupo de estudo. Foram estimados a razao de mortalidade padronizada e o respectivo intervalo de 95% de confianca para causas selecionadas, relacionando isseis/residentes no Japao e isseis/residentes no Parana. RESULTADOS: A mortalidade das mulheres isseis ocupou posicao intermediaria quando comparada a do Japao e a do Parana; os homens apresentaram valor bastante proximo ao do Japao. Isseis do sexo masculino, quando comparados com os homens do Japao, apresentaram taxa significantemente mais baixa para câncer de estomago, porem, mais alta para diabetes e doencas isquemicas do coracao. Em mulheres isseis somente a taxa de mortalidade por câncer de pulmao apresentou-se significantemente inferior a taxa feminina do Japao; as demais taxas foram estatisticamente maiores. Quando os dados foram comparados com os do Parana, os isseis apresentaram taxas mais baixas para doencas isquemicas do coracao e doencas cerebrovasculares, porem, similares quanto ao câncer de estomago e de pulmao. Diferentemente dos homens, entre as isseis houve taxas mais baixas para câncer de pulmao e doencas isquemicas do coracao. Para diabetes mellitus e doencas cerebrovasculares nao foram constatadas diferencas estatisticamente significantes. CONCLUSAO: Evidenciou-se afastamento do padrao de mortalidade de isseis quando comparado ao de seu pais de origem (Japao) e uma aproximacao ao perfil do local de destino. Tais constatacoes sugerem influencia de fatores socioculturais, principalmente, das praticas dieteticas, na mortalidade por alguns agravos.

Factors Associated with Road Accidents among Brazilian Motorcycle Couriers

The objective of the study was to identify factors associated with reports of road accidents, among motorcycle couriers in two medium-sized municipalities in southern Brazil. A self-administered questionnaire was answered by motorcycle couriers that had worked for at least 12 months in this profession. The outcomes analyzed were reports on accidents and serious accidents over the 12 months prior to the survey. Bivariate and multivariate analyses by means of logistic regression were carried out to investigate factors that were independently associated with the outcomes. Seven hundred and fifty motorcycle couriers, of mean age 29.5 years (standard deviation = 8.1 ), were included in the study. Young age (18 to 24 years compared to ≥25 years, odds ratio [OR] = 1.77) speeding (OR = 1.48), and use of cell phones while driving (OR = 1.43) were factors independently associated with reports of accidents. For serious accidents, there was an association with alternation of work shifts (OR = 1.91) and speeding (OR = 1.67). The characteristics associated with accidents—personal (young age), behavioral (use of cell phones while driving and speeding), and professional (speeding and alternation of work shifts)—reveal the need to adopt wide-ranging strategies to reduce these accidents, including better work conditions for these motorcyclists.

Sub-registro de nascimentos vivos hospitalares em área urbana da região sul do Brasil, em 1989

With a view to evaluating the real situation of the vital statistics as regards their completeness in the city of Maringa, Parana State, Brazil, 4,876 hospital live births which occurred during 1989 were studied. The rate of under-registration was estimated as 9.1%, varying according to maternal age, parity and financial condition. The results lead to the hypothesis of an association between under registration and lower socioeconomical levels. The study also describes all the necessary steps to establish the link between the two sets of events, live birth and legal registration.Com o objetivo de avaliar a real situacao do Registro Civil, no Municipio de Maringa, PR, Brasil, foram estudados 4.876 nascimentos vivos ocorridos nos seus hospitais, em 1989, filhos de mulheres nele residentes. Sao apresentadas as etapas que permitiram identificar, dentre a populacao de estudo, os nascimentos registrados (mesclagem de dois arquivos). A estimativa maxima da taxa de sub-registro, no primeiro ano de vida, foi igual a 9,1%, variando segundo idade da mae (quanto mais jovem, maior a taxa), situacao previdenciaria (indigentes com a maior estimativa) e paridade (primiparas, menor valor), permitindo aventar a hipotese de associacao entre sub-registro e piores niveis socioeconomicos.The sample consisted of 4876 live births that occurred in the hospitals in the city of Maringa PR Brazil January 1 - December 31 1989. Prior consultation of the registries in 6 hospitals maternity ward records and medical records provided the information. The municipal civil registry books provided data on births. About 9.1% of those 4876 births were not recorded in the books of Maringa. The rate of under-registration diminished with increasing age of the mother. The highest rate occurred in the 13-14 year old maternal age group (21.4%) followed by the 15-19 year old group (11.5%) while for mothers aged 30-39 years the rate was 5.7%. The under-registration of births to adolescent mothers was statistically significant (alpha=0.05). The possible explanation could be related to the marital situation and socioeconomic status of adolescents. Only 6.5% of first born children did not get registered in the civil registry compared to 28.1% of those born fifth to fourteenth in birth order. Accordingly a significant association was detected with parity (alpha=0.05). 7.6% of children born by cesarean section were not registered and this rate increased to 12.7% for those born by normal delivery. This indicates the possible influence of economic factors in the type of delivery. Another important factor was delayed reporting: up to 15 days by law for the father and 60 days for other declarants. In Maringa 86.8% of registrations were done by the father and 11.5% by the mother as the declarant. The inclusion of declaration of births in Maringa contributes to the correction of distortions. It will be possible by monitoring to detect children at a high risk for mortality and to take decisive action to prevent death within the first year of life.

Características de carcaça de cabritos criados em dois sistemas de terminação

Was evaluated carcass characteristics of feedlot goats Saanen, Saanen and 7/8 Boer - 1/8 Saanen semi-confined, as well as the influence of the genetic groups and finishing systems on the commercial performance, compactness index, not constituents, area ribeye, shear force, fat, moisture and ether extract content. Were used 31 bulls, with approximately 128 days of age and 22.9±2.4kg live weight (LW). Of these, 22 were Saanen, and nine animals were crossbred 7/8 Boer - 1/8 Saanen. The Saanen animals were divided into two groups of 11 animals each, one group and another kept in a feedlot in semiconfinement, while crossbreds were kept in semiconfinement. Was compared the finishing systems in Saanen, and genetic groups in semi-confined system. The confined animals received 3.5% of LW in complete pelleted ration, the semiconfinados had access to pasture and supplementation of 1.5% of LW in pelleted concentrate ration. At 47 days of terminating the animals were slaughtered and the carcass characteristics determined using a sample loin dissected. Differences were observed between finishing systems for commercial carcass yield, carcass compactness index, not constituents carcass, loin eye area, shear force, fat, moisture and ether extract. Between genetic groups, differences were observed for ribeye area, fat thickness and mineral matter. The finishing system exerted influence on carcass traits evaluated. The Saanen can be used for the production of meat when subjected to confinement.