Pub Date : 2020-08-06DOI: 10.1590/scielopreprints.993
Leandro Pereira Garcia, J. Traebert, A. Boing, Grazielli Faria Zimmer Santos, L. Pedebôs, E. d’Orsi, P. Prado, M. Veras, Giuliano Boava, A. F. Boing
OBJECTIVE To analyze the association between the transmission potential of SARS-CoV-2 and the decisions made by the municipal government of Florianópolis (Brazil) regarding social distancing. METHODS We analyzed new cases of COVID-19 identified in Florianópolis residents between February 1 and July 14, 2020, using a nowcasting approach. Decrees related to COVID-19 published in the Official Gazette of the Municipality between February 1 and July 14, 2020 were also analyzed. Based on the actions proposed in the decrees, whether they loosened social distancing measures, or increased or maintained existing restrictions, was analyzed, thus creating a Social Distancing Index. Time-dependent reproduction numbers (Rt) for a period of 14 days prior to each decree were calculated. A matrix was constructed associating the classification of each decree and the Rt values, analyzing the consonance or dissonance between the potential dissemination of SARS-CoV-2 and the actions of the decrees. RESULTS A total of 5,374 cases of COVID-19 and 26 decrees were analyzed. Nine decrees increased social distancing measures, nine maintained them, and eight loosened them. Of the 26 actions, 9 were consonant and 17 dissonant with the tendency indicated by the Rt. Dissonance was observed in all of the decrees that maintained the distance measures or loosened them. The fastest expansion in the number of new cases and the greatest amount of dissonant decrees was found in the last two months analyzed. CONCLUSION There was an important divergence between municipal measures of social distancing with epidemiological indicators at the time of each political decision.
{"title":"The potential spread of Covid-19 and government decision-making: a retrospective analysis in Florianópolis, Brazil.","authors":"Leandro Pereira Garcia, J. Traebert, A. Boing, Grazielli Faria Zimmer Santos, L. Pedebôs, E. d’Orsi, P. Prado, M. Veras, Giuliano Boava, A. F. Boing","doi":"10.1590/scielopreprints.993","DOIUrl":"https://doi.org/10.1590/scielopreprints.993","url":null,"abstract":"OBJECTIVE\u0000To analyze the association between the transmission potential of SARS-CoV-2 and the decisions made by the municipal government of Florianópolis (Brazil) regarding social distancing.\u0000\u0000\u0000METHODS\u0000We analyzed new cases of COVID-19 identified in Florianópolis residents between February 1 and July 14, 2020, using a nowcasting approach. Decrees related to COVID-19 published in the Official Gazette of the Municipality between February 1 and July 14, 2020 were also analyzed. Based on the actions proposed in the decrees, whether they loosened social distancing measures, or increased or maintained existing restrictions, was analyzed, thus creating a Social Distancing Index. Time-dependent reproduction numbers (Rt) for a period of 14 days prior to each decree were calculated. A matrix was constructed associating the classification of each decree and the Rt values, analyzing the consonance or dissonance between the potential dissemination of SARS-CoV-2 and the actions of the decrees.\u0000\u0000\u0000RESULTS\u0000A total of 5,374 cases of COVID-19 and 26 decrees were analyzed. Nine decrees increased social distancing measures, nine maintained them, and eight loosened them. Of the 26 actions, 9 were consonant and 17 dissonant with the tendency indicated by the Rt. Dissonance was observed in all of the decrees that maintained the distance measures or loosened them. The fastest expansion in the number of new cases and the greatest amount of dissonant decrees was found in the last two months analyzed.\u0000\u0000\u0000CONCLUSION\u0000There was an important divergence between municipal measures of social distancing with epidemiological indicators at the time of each political decision.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67337419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.1590/1980-549720190008.supl.3
C. M. Minto, A. M. Cascão, Sheylla Lima, F. G. Kuyumjian, Luciana Godoy, M. F. M. Souza
INTRODUCTION Deaths classified as Garbage Cause (GC) are considered to be of little use in triggering public health prevention actions. OBJECTIVE Evaluate the impact of hospital research on recovering the true root cause of death. METHODOLOGY Descriptive study on the investigation of deaths with root causes classified as garbage code in ten selected hospitals with the highest number of this cause of death in the states of Rio de Janeiro (RJ) and São Paulo (SP), Brazil, in 2017. The investigation considered the patient's medical record, which contains the information collected by hospital surveillance professionals in a standardized form. RESULTS 2,579 deaths with a GC and 2,116 with GC priorities. The highest proportion occurred in the 70-year-old or older group with differences in the predominant causes as a function of the life cycle. The GC reclassification was 41.9% and 93.6% of deaths investigated in RJ and SP, respectively. Deaths which had altered causes and remained as garbage code were analyzed for change in severity level, which take into account the potential impact of GC in the mortality profile. Thus, 70.7% and 73.6% of GC deaths with very high and with high level, respectively, were reclassified to lower levels. Among the garbage codes that went to well-defined causes, the ICD-10 External Causes chapter was the one that rendered the highest number of deaths. CONCLUSION The investigation allowed to qualify causes of death and demonstrated the need for professional training on the definition of the root cause of death.
{"title":"Evaluation study of the improvement of the quality of death information in hospitals of the states of Rio de Janeiro and São Paulo, Brazil, 2017.","authors":"C. M. Minto, A. M. Cascão, Sheylla Lima, F. G. Kuyumjian, Luciana Godoy, M. F. M. Souza","doi":"10.1590/1980-549720190008.supl.3","DOIUrl":"https://doi.org/10.1590/1980-549720190008.supl.3","url":null,"abstract":"INTRODUCTION\u0000Deaths classified as Garbage Cause (GC) are considered to be of little use in triggering public health prevention actions.\u0000\u0000\u0000OBJECTIVE\u0000Evaluate the impact of hospital research on recovering the true root cause of death.\u0000\u0000\u0000METHODOLOGY\u0000Descriptive study on the investigation of deaths with root causes classified as garbage code in ten selected hospitals with the highest number of this cause of death in the states of Rio de Janeiro (RJ) and São Paulo (SP), Brazil, in 2017. The investigation considered the patient's medical record, which contains the information collected by hospital surveillance professionals in a standardized form.\u0000\u0000\u0000RESULTS\u00002,579 deaths with a GC and 2,116 with GC priorities. The highest proportion occurred in the 70-year-old or older group with differences in the predominant causes as a function of the life cycle. The GC reclassification was 41.9% and 93.6% of deaths investigated in RJ and SP, respectively. Deaths which had altered causes and remained as garbage code were analyzed for change in severity level, which take into account the potential impact of GC in the mortality profile. Thus, 70.7% and 73.6% of GC deaths with very high and with high level, respectively, were reclassified to lower levels. Among the garbage codes that went to well-defined causes, the ICD-10 External Causes chapter was the one that rendered the highest number of deaths.\u0000\u0000\u0000CONCLUSION\u0000The investigation allowed to qualify causes of death and demonstrated the need for professional training on the definition of the root cause of death.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.1590/1980-549720190007.supl.3
C. Oliveira, Denise Leão Ciríaco, C. Silva, Herbert Charles Silva Barros, C. C. Cunha, E. França
OBJECTIVE to evaluate the impact of investigation of deaths classified as garbage codes (GC) on the quality of the causes-of-death information in municipalities in the Northeast region of Brazil in 2017. METHOD an investigation was conducted on the deaths classified as GC in 18 municipalities in the Northeast region as follows: identification of deaths with priority GC; review of medical records from health services and forensic institutes; and evaluation of the reclassification of causes of death according to the International Classification of Diseases (ICD-10) and groupings of the Global Burden of Disease 2015 (GBD 2015). RESULTS among 18,681 deaths classified as priority GC, 7,352 (39%) were investigated and, of these, 5,160 (70%) had reclassified causes, of which 4,087 (79%) were changed to specified causes. Ill-defined causes (n = 4,392) were the most frequent among GC and those with a higher proportion of cause change (80%), and 57% were changed to specified causes. The reduction of GC contributed to the detection of a wide variety of specific causes according to groups of level 3 of the GBD 2015, being the interpersonal violence the cause that obtained the highest percentage change (11.8%). CONCLUSION The investigation of deaths with priority GC proved to be an important strategy to specify causes of death, and it may influence the formulation, execution and evaluation of health policies.
{"title":"The impact of the investigation on deaths classified as garbage codes on the quality of the cause-of-death information in the Northeast region, Brazil.","authors":"C. Oliveira, Denise Leão Ciríaco, C. Silva, Herbert Charles Silva Barros, C. C. Cunha, E. França","doi":"10.1590/1980-549720190007.supl.3","DOIUrl":"https://doi.org/10.1590/1980-549720190007.supl.3","url":null,"abstract":"OBJECTIVE\u0000to evaluate the impact of investigation of deaths classified as garbage codes (GC) on the quality of the causes-of-death information in municipalities in the Northeast region of Brazil in 2017.\u0000\u0000\u0000METHOD\u0000an investigation was conducted on the deaths classified as GC in 18 municipalities in the Northeast region as follows: identification of deaths with priority GC; review of medical records from health services and forensic institutes; and evaluation of the reclassification of causes of death according to the International Classification of Diseases (ICD-10) and groupings of the Global Burden of Disease 2015 (GBD 2015).\u0000\u0000\u0000RESULTS\u0000among 18,681 deaths classified as priority GC, 7,352 (39%) were investigated and, of these, 5,160 (70%) had reclassified causes, of which 4,087 (79%) were changed to specified causes. Ill-defined causes (n = 4,392) were the most frequent among GC and those with a higher proportion of cause change (80%), and 57% were changed to specified causes. The reduction of GC contributed to the detection of a wide variety of specific causes according to groups of level 3 of the GBD 2015, being the interpersonal violence the cause that obtained the highest percentage change (11.8%).\u0000\u0000\u0000CONCLUSION\u0000The investigation of deaths with priority GC proved to be an important strategy to specify causes of death, and it may influence the formulation, execution and evaluation of health policies.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.1590/1980-549720190005.supl.3
M. F. Marinho, E. França, R. Teixeira, L. Ishitani, C. C. Cunha, M. R. Santos, Ashley Frederes, J. Cortez-Escalante, D. Abreu
INTRODUCTION Knowing the number of deaths and their causes is relevant information for public health managers. However, the cause of death is often classified with codes that are not useful for mortality analysis, called garbage codes (GC). OBJECTIVE To describe and evaluate the impact of investigation of the underlying cause of poorly classified deaths on death certificates in 2017. METHODS Based on a standardized protocol, GC deaths from 60 municipalities were investigated, mainly in hospital records and autopsy services. Managers at the state level of the Mortality Information System also developed procedures to improve the classification of causes of death, with the consequent adherence of other municipalities (n = 4022). This made it possible to compare the results of GC research between these two groups of municipalities. RESULTS In the country, among the 108,826 GC investigated in 2017, 48% were reclassified to specific causes. In the 60 focus municipalities, 58% of the 35,366 investigated deaths from GC were reclassified. After the intervention, the proportion of deaths classified as GC decreased by 11% in the country and 17% in the municipalities. DISCUSSION The research in hospital records enabled almost half of the deaths from GC investigated to be reclassified. This is the first study to investigate GC in hospital records of more than 100,000 deaths. The 60 cities targeted by the intervention had better results than the other cities. CONCLUSION The intervention proved to be an appropriate initiative to improve the quality of information on cause of death and should be encouraged.
{"title":"Data for health: impact on improving the quality of cause-of-death information in Brazil.","authors":"M. F. Marinho, E. França, R. Teixeira, L. Ishitani, C. C. Cunha, M. R. Santos, Ashley Frederes, J. Cortez-Escalante, D. Abreu","doi":"10.1590/1980-549720190005.supl.3","DOIUrl":"https://doi.org/10.1590/1980-549720190005.supl.3","url":null,"abstract":"INTRODUCTION\u0000Knowing the number of deaths and their causes is relevant information for public health managers. However, the cause of death is often classified with codes that are not useful for mortality analysis, called garbage codes (GC).\u0000\u0000\u0000OBJECTIVE\u0000To describe and evaluate the impact of investigation of the underlying cause of poorly classified deaths on death certificates in 2017.\u0000\u0000\u0000METHODS\u0000Based on a standardized protocol, GC deaths from 60 municipalities were investigated, mainly in hospital records and autopsy services. Managers at the state level of the Mortality Information System also developed procedures to improve the classification of causes of death, with the consequent adherence of other municipalities (n = 4022). This made it possible to compare the results of GC research between these two groups of municipalities.\u0000\u0000\u0000RESULTS\u0000In the country, among the 108,826 GC investigated in 2017, 48% were reclassified to specific causes. In the 60 focus municipalities, 58% of the 35,366 investigated deaths from GC were reclassified. After the intervention, the proportion of deaths classified as GC decreased by 11% in the country and 17% in the municipalities.\u0000\u0000\u0000DISCUSSION\u0000The research in hospital records enabled almost half of the deaths from GC investigated to be reclassified. This is the first study to investigate GC in hospital records of more than 100,000 deaths. The 60 cities targeted by the intervention had better results than the other cities.\u0000\u0000\u0000CONCLUSION\u0000The intervention proved to be an appropriate initiative to improve the quality of information on cause of death and should be encouraged.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.1590/1980-549720190013.supl.3
Samira Nascimento Mamed, A. M. Ramos, V. Araújo, Wagner Santos de Jesus, L. Ishitani, E. França
INTRODUCTION Unspecified stroke (UnST) is of great importance in mortality statistics, as it is the fourth leading cause of death in Brazil. The objective of this study was to identify the profile of reclassified causes of death after investigation of deaths caused by UnST in Brazil. METHODS All deaths registered as UnST in 2017 in the Mortality Information System (SIM) were considered as garbage codes. The specific causes, detected after investigation in 60 selected cities, were analyzed by age and sex. RESULTS Of the total deaths due to UnST identified in these 60 cities (n = 11,289), 25.8% were investigated. Of these, 56.3% were reclassified to ischemic stroke, 12.7% to hemorrhagic stroke, and 23.3% to other specific causes, such as diabetes and chronic kidney disease, in both sexes. DISCUSSION The higher proportion of deaths due to ischemic stroke in comparison to hemorrhagic stroke was expected. However, the detection of other specific causes outside the stroke group indicates possible quality problems in the filling of death certificate (DC). CONCLUSION The investigations allowed the identification of subgroups of deaths due to stroke. In addition to the research, however, it is important to conduct physician training in the adequate filling in of the DC, in order to improve estimates of specific stroke mortality, and to enable appropriate targeting of health actions and services.
{"title":"Profile of deaths from unspecified stroke after investigation of garbage codes in 60 cities in Brazil, 2017.","authors":"Samira Nascimento Mamed, A. M. Ramos, V. Araújo, Wagner Santos de Jesus, L. Ishitani, E. França","doi":"10.1590/1980-549720190013.supl.3","DOIUrl":"https://doi.org/10.1590/1980-549720190013.supl.3","url":null,"abstract":"INTRODUCTION\u0000Unspecified stroke (UnST) is of great importance in mortality statistics, as it is the fourth leading cause of death in Brazil. The objective of this study was to identify the profile of reclassified causes of death after investigation of deaths caused by UnST in Brazil.\u0000\u0000\u0000METHODS\u0000All deaths registered as UnST in 2017 in the Mortality Information System (SIM) were considered as garbage codes. The specific causes, detected after investigation in 60 selected cities, were analyzed by age and sex.\u0000\u0000\u0000RESULTS\u0000Of the total deaths due to UnST identified in these 60 cities (n = 11,289), 25.8% were investigated. Of these, 56.3% were reclassified to ischemic stroke, 12.7% to hemorrhagic stroke, and 23.3% to other specific causes, such as diabetes and chronic kidney disease, in both sexes.\u0000\u0000\u0000DISCUSSION\u0000The higher proportion of deaths due to ischemic stroke in comparison to hemorrhagic stroke was expected. However, the detection of other specific causes outside the stroke group indicates possible quality problems in the filling of death certificate (DC).\u0000\u0000\u0000CONCLUSION\u0000The investigations allowed the identification of subgroups of deaths due to stroke. In addition to the research, however, it is important to conduct physician training in the adequate filling in of the DC, in order to improve estimates of specific stroke mortality, and to enable appropriate targeting of health actions and services.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.1590/1980-549720190012.supl.3
M. R. Santos, C. C. Cunha, L. Ishitani, E. França
INTRODUCTION Sepsis represents the occurrence of systemic inflammatory response syndrome triggered by the initial infection of an organ or system. When sepsis is certified as the cause of death, the first diagnosis is lost, leading to inaccurate information as to its origin. OBJECTIVE To analyze the underlying causes of death from sepsis after investigation in 60 Brazilian municipalities in 2017. METHODOLOGY All deaths recorded in the Mortality Information System (SIM) as sepsis in 2017 were selected, and the proportions of reclassified deaths were calculated based on the results of research conducted in hospitals and other health services. RESULTS Of the 6,486 deaths from sepsis that occurred in the 60 municipalities, 1,584 (24.4%) were investigated, and of these, 1,308 (82.6%) were reclassified with other underlying causes. Individuals aged from 70 to 89 years old showed the highest concentration in the records, with 49.3% of cases. More than 60% of the deaths from sepsis reclassified after the investigation had chronic non-communicable diseases as underlying causes (65.6%), with diabetes being the most common specific cause in this group. Communicable diseases (9.6%) and external causes (5.6%) such as falls were also detected as underlying causes. CONCLUSION The investigation of deaths from sepsis made it possible to identify the true causes of death and the proportions of reclassification. This information will improve the quality of mortality data and support the planning of public health actions in Brazil.
{"title":"Deaths from sepsis: underlying causes of death after investigation in 60 Brazilian municipalities in 2017.","authors":"M. R. Santos, C. C. Cunha, L. Ishitani, E. França","doi":"10.1590/1980-549720190012.supl.3","DOIUrl":"https://doi.org/10.1590/1980-549720190012.supl.3","url":null,"abstract":"INTRODUCTION\u0000Sepsis represents the occurrence of systemic inflammatory response syndrome triggered by the initial infection of an organ or system. When sepsis is certified as the cause of death, the first diagnosis is lost, leading to inaccurate information as to its origin.\u0000\u0000\u0000OBJECTIVE\u0000To analyze the underlying causes of death from sepsis after investigation in 60 Brazilian municipalities in 2017.\u0000\u0000\u0000METHODOLOGY\u0000All deaths recorded in the Mortality Information System (SIM) as sepsis in 2017 were selected, and the proportions of reclassified deaths were calculated based on the results of research conducted in hospitals and other health services.\u0000\u0000\u0000RESULTS\u0000Of the 6,486 deaths from sepsis that occurred in the 60 municipalities, 1,584 (24.4%) were investigated, and of these, 1,308 (82.6%) were reclassified with other underlying causes. Individuals aged from 70 to 89 years old showed the highest concentration in the records, with 49.3% of cases. More than 60% of the deaths from sepsis reclassified after the investigation had chronic non-communicable diseases as underlying causes (65.6%), with diabetes being the most common specific cause in this group. Communicable diseases (9.6%) and external causes (5.6%) such as falls were also detected as underlying causes.\u0000\u0000\u0000CONCLUSION\u0000The investigation of deaths from sepsis made it possible to identify the true causes of death and the proportions of reclassification. This information will improve the quality of mortality data and support the planning of public health actions in Brazil.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.1590/1980-549720190001.supl.3
E. França
{"title":"Garbage codes assigned as cause-of-death in health statistics.","authors":"E. França","doi":"10.1590/1980-549720190001.supl.3","DOIUrl":"https://doi.org/10.1590/1980-549720190001.supl.3","url":null,"abstract":"","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.1590/1980-549720190011.supl.3
Adauto Martins Soares Filho, C. H. Vasconcelos, A. Nóbrega, I. Pinto, E. Merchán-Hamann, L. Ishitani, E. França
BACKGROUND Unspecified causes of death are among the traditional indicators of quality of information. OBJECTIVE To verify the performance of the 60 cities in the Data for Health Initiative project and to analyze the reclassification of unspecified external causes of death (UEC). METHODS Using the 2017 records from the Mortality Information System, the proportion and percent change in UEC were compared after investigation between project cities and other cities, and the percent of reclassification to specific external causes was calculated. RESULTS The project cities comprised 52% (n = 11,759) of the total UEC in Brazil, of which 64.5% were reclassified after investigation, whereas the other cities reclassified 31% of UEC. Results were similar for men, youth, blacks, metropolitan cities, the Southeast region, and deaths attested by forensic institutes. In the project cities, pedestrian traffic accidents were external causes with greater reclassification. In men, the UEC was reclassified to homicides (23.8%) and accident of terrestrial transportation (ATT) (11.1%), with motorcyclists (4.4%) and pedestrians (4.3%) being the most prominent. In women, these causes were changed to other accident causes (20.8%), ATT (10.6%) and homicides (7.9%). UEC changed to ATT (18.3%) in the age groups of 0-14 years old and to homicides (32.5%) in the age groups of 15-44 years. CONCLUSION The project cities obtained better results after investigation of UEC, enabling analysis of the reclassification to specific causes by sex and age groups.
{"title":"Improvement of the unspecified external causes classification based on the investigation of death in Brazil in 2017.","authors":"Adauto Martins Soares Filho, C. H. Vasconcelos, A. Nóbrega, I. Pinto, E. Merchán-Hamann, L. Ishitani, E. França","doi":"10.1590/1980-549720190011.supl.3","DOIUrl":"https://doi.org/10.1590/1980-549720190011.supl.3","url":null,"abstract":"BACKGROUND\u0000Unspecified causes of death are among the traditional indicators of quality of information.\u0000\u0000\u0000OBJECTIVE\u0000To verify the performance of the 60 cities in the Data for Health Initiative project and to analyze the reclassification of unspecified external causes of death (UEC).\u0000\u0000\u0000METHODS\u0000Using the 2017 records from the Mortality Information System, the proportion and percent change in UEC were compared after investigation between project cities and other cities, and the percent of reclassification to specific external causes was calculated.\u0000\u0000\u0000RESULTS\u0000The project cities comprised 52% (n = 11,759) of the total UEC in Brazil, of which 64.5% were reclassified after investigation, whereas the other cities reclassified 31% of UEC. Results were similar for men, youth, blacks, metropolitan cities, the Southeast region, and deaths attested by forensic institutes. In the project cities, pedestrian traffic accidents were external causes with greater reclassification. In men, the UEC was reclassified to homicides (23.8%) and accident of terrestrial transportation (ATT) (11.1%), with motorcyclists (4.4%) and pedestrians (4.3%) being the most prominent. In women, these causes were changed to other accident causes (20.8%), ATT (10.6%) and homicides (7.9%). UEC changed to ATT (18.3%) in the age groups of 0-14 years old and to homicides (32.5%) in the age groups of 15-44 years.\u0000\u0000\u0000CONCLUSION\u0000The project cities obtained better results after investigation of UEC, enabling analysis of the reclassification to specific causes by sex and age groups.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-28DOI: 10.1590/1980-549720190014.supl.3
Lenice Harumi Ishitani, C. D. Cunha, R. Ladeira, P. Corrêa, Mayara Rocha dos Santos, Maria Albertina Santiago Rego, Dácio de Lyra Rabello Neto, Mauro Taniguchi, Cristiano Lehrer, Lucia Maria Miana Mattos Paixão, Ashley Frederes, M. F. D. Souza, E. França
INTRODUCTION A smartphone application named AtestaDO was developed to support physicians with medical certification of the cause of death. The objective of this study is to evaluate the acceptability of the app. METHODS Physicians were invited to attend meetings on the proper certification of cause of death, and to evaluate the application in a national workshop in Natal (first stage) and in two large hospitals in Belo Horizonte (second and third stages). RESULTS In Natal, 82% of 38 physicians had more than 20 years of experience and in Belo Horizonte, more than 67% of 58 physicians had less than 5 years of experience. The sections "Application interface", "How to certify the causes of death", "Practice with exercises" and "Other information for physicians" were positively evaluated by more than 50% of physicians in Belo Horizonte. In Natal, all sections were positively evaluated by at least 80% of participants. More than 70% of the participants in both Natal and the second stage of Belo Horizonte indicated they would possibly use AtestaDO to guide filling of a death certificate. The probability of using AtestaDO to teach classes on filling death certificates was 83.3% for Natal's physicians but less than 60% in Belo Horizonte. In the three stages, most physicians would recommend using the application to other colleagues. CONCLUSION The evaluation of AtestaDO showed good acceptability. We expect that the use of this tool enables improvements in medical certification of causes of death.
{"title":"Evaluation of a smartphone application to improve medical certification of the cause of death.","authors":"Lenice Harumi Ishitani, C. D. Cunha, R. Ladeira, P. Corrêa, Mayara Rocha dos Santos, Maria Albertina Santiago Rego, Dácio de Lyra Rabello Neto, Mauro Taniguchi, Cristiano Lehrer, Lucia Maria Miana Mattos Paixão, Ashley Frederes, M. F. D. Souza, E. França","doi":"10.1590/1980-549720190014.supl.3","DOIUrl":"https://doi.org/10.1590/1980-549720190014.supl.3","url":null,"abstract":"INTRODUCTION\u0000A smartphone application named AtestaDO was developed to support physicians with medical certification of the cause of death. The objective of this study is to evaluate the acceptability of the app.\u0000\u0000\u0000METHODS\u0000Physicians were invited to attend meetings on the proper certification of cause of death, and to evaluate the application in a national workshop in Natal (first stage) and in two large hospitals in Belo Horizonte (second and third stages).\u0000\u0000\u0000RESULTS\u0000In Natal, 82% of 38 physicians had more than 20 years of experience and in Belo Horizonte, more than 67% of 58 physicians had less than 5 years of experience. The sections \"Application interface\", \"How to certify the causes of death\", \"Practice with exercises\" and \"Other information for physicians\" were positively evaluated by more than 50% of physicians in Belo Horizonte. In Natal, all sections were positively evaluated by at least 80% of participants. More than 70% of the participants in both Natal and the second stage of Belo Horizonte indicated they would possibly use AtestaDO to guide filling of a death certificate. The probability of using AtestaDO to teach classes on filling death certificates was 83.3% for Natal's physicians but less than 60% in Belo Horizonte. In the three stages, most physicians would recommend using the application to other colleagues.\u0000\u0000\u0000CONCLUSION\u0000The evaluation of AtestaDO showed good acceptability. We expect that the use of this tool enables improvements in medical certification of causes of death.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67307486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-25DOI: 10.1590/1980-549720190065
B. Costa, K. Silva, Pablo Magno da Silveira, Juliane Berria, André Ribeiro Machado, É. Petroski
INTRODUCTION This study evaluated the effect of an intervention on the engagement in physical activity (PA) and sedentary behavior (SB) of sixth to ninth grade students during school-time, physical education (PE) classes, and recesses at two public schools in Florianopolis, SC, Brazil. METHOD Schools were divided into control and experimental groups. Participants wore accelerometers during school-time, and PA and SB were estimated for school-time, PE classes and recesses at the baseline and after the intervention. The intervention was composed of four components: changes were made in the PE classes, including giving instruction to teachers; sports equipment was made available for use during recesses; educational sessions on the format of classes were conducted; folders and posters were distributed. Data was analyzed using an Analysis of Covariance for repeated measures comparing baseline data with post intervention data, and for independent samples when comparing control and intervention groups. RESULTS A low proportion of engagement in PA and a large engagement in SB was observed on the baseline. PA decreased in the intervention group during PE classes, while it increased in the control group with regard to school-time, PE classes, and recess. The intervention group accumulated more SB during school-time and PE classes after the intervention, while a decrease in the control group's SB during school-time was observed. CONCLUSION The intervention was not effective in increasing PA or decreasing SB. Environmental and school's organizational factors impact how interventions are conducted, and should be considered beforehand.
{"title":"The effect of an intervention on physical activity of moderate-and-vigorous intensity, and sedentary behavior during adolescents' time at school.","authors":"B. Costa, K. Silva, Pablo Magno da Silveira, Juliane Berria, André Ribeiro Machado, É. Petroski","doi":"10.1590/1980-549720190065","DOIUrl":"https://doi.org/10.1590/1980-549720190065","url":null,"abstract":"INTRODUCTION\u0000This study evaluated the effect of an intervention on the engagement in physical activity (PA) and sedentary behavior (SB) of sixth to ninth grade students during school-time, physical education (PE) classes, and recesses at two public schools in Florianopolis, SC, Brazil.\u0000\u0000\u0000METHOD\u0000Schools were divided into control and experimental groups. Participants wore accelerometers during school-time, and PA and SB were estimated for school-time, PE classes and recesses at the baseline and after the intervention. The intervention was composed of four components: changes were made in the PE classes, including giving instruction to teachers; sports equipment was made available for use during recesses; educational sessions on the format of classes were conducted; folders and posters were distributed. Data was analyzed using an Analysis of Covariance for repeated measures comparing baseline data with post intervention data, and for independent samples when comparing control and intervention groups.\u0000\u0000\u0000RESULTS\u0000A low proportion of engagement in PA and a large engagement in SB was observed on the baseline. PA decreased in the intervention group during PE classes, while it increased in the control group with regard to school-time, PE classes, and recess. The intervention group accumulated more SB during school-time and PE classes after the intervention, while a decrease in the control group's SB during school-time was observed.\u0000\u0000\u0000CONCLUSION\u0000The intervention was not effective in increasing PA or decreasing SB. Environmental and school's organizational factors impact how interventions are conducted, and should be considered beforehand.","PeriodicalId":35426,"journal":{"name":"Revista Brasileira de Epidemiologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67308104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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