AIDS-related mortality in Pará Province, Brazilian Amazon region: Spatial and temporal analysis.

Despite considerable therapeutic advances in the care of people living with human immunodeficiency virus (HIV) and with the acquired immunodeficiency syndrome (AIDS) and an overall reduction of 47% in the AIDS mortality rate in the last decade, the AIDS-mortality rates remains high. The social determinants of health (SDH) have a direct influence on the dynamics of this phenomenon. However, changes in SDH caused by the implemented policies against HIV have been poorly investigated. Moreover, the Brazilian rainforest has had the highest and continuously increasing AIDS mortality rate in Brazil since the 1980s. In this study, AIDS mortality in a province of the Brazilian rainforest was examined by using temporal and spatial analyses. METHODS: In this ecological study, data from 2007 to 2018 were extracted from the Mortality Information System provided by the State Department of Public Health of Pará. For the temporal analysis, the integrated autoregressive model of moving average (ARIMA) and locally weighted polynomial regression (STLF) were used to forecast AIDS mortality from 2019 to 2022. For the spatial analysis, spatial autocorrelation and geographically weighted regression (GWR) analyses were employed. RESULTS: The samples consisted of 6,498 notifications for AIDS-related deaths. From 2007 to 2013, the AIDS mortality rates showed an upward trend, followed by a stabilization until 2018 and an upward forecasted trend from 2019 to 2022. High mortality rates and high-high clusters were found in economic pole municipalities. Furthermore, AIDS mortality risk was directly associated with per capita income and demographic density, except in the southwestern region of Pará, which exhibited an inverse association with population density. CONCLUSION: Although the policies against HIV may have contributed to the stabilization of AIDS mortality rates from 2013 in Pará, the upward forecasted trend until 2022 raises an alert and concern to health authorities to provide reinforcement of the policies. The geographic variability of AIDS mortality promoted by SDH provides subsidies to health authorities to implement SDH-focused strategies for AIDS mortality reduction.

The Temporal and Spatial Epidemiology Employed in the Elimination of the HIV Epidemic in the Largest Capital of the Brazilian Rainforest.

BACKGROUND: The main goal of this study was to analyze the human immunodeficiency virus (HIV) epidemic temporally and spatially in Belém from 2007 to 2018. METHODS: The incidence rates were analyzed according to time using autoregressive integrated moving-average models, as well as spatially using spatial autocorrelation, Kernel density, scan statistics, and regression techniques. RESULTS: During the study period, 6007 notifications of new cases of HIV/AIDS were reported. The time series analysis revealed a stabilized trend of incidence from 2007 to October 2016, followed by irregular fluctuations until the end of December 2018. Seasonal behavior was observed from 2019 to 2022. The high-high incidence clusters were found in the central and transition areas. An expansion of the number of new reported cases was observed in the central area. Three spatial risk zones were observed. The higher relative risk zone was concentrated in the transition area. The spatial regression showed that the incidence rates were positively correlated with the Family Health Strategy (FHS) coverage. CONCLUSIONS: To eliminate HIV in Belém, it will be necessary to decentralize testing and ART and expand the coverage of FHS to ensure universal access to healthcare for citizens.

Integrative review on the incidence of HIV infection and its socio-spatial determinants.

OBJECTIVES: to identify the socio-spatial determinants associated with the incidence of infection by the human immunodeficiency virus (HIV) described in national and international literature. METHODS: integrative literature review that included original articles indexed in the LILACS, PUBMED, CINAHL, and Scopus databases, from 2015 to 2019. The synthesis of the articles was done in a descriptive manner in two categories according to the type of approach. RESULTS: 13 articles were selected, with a predominance of ecological studies. Regions with deficient access to health services, high population density, higher rates of poverty, intense migratory flow, border areas, as well as precarious socioeconomic conditions, and risk behaviors are associated with higher rates of infection. FINAL CONSIDERATIONS: the influence of regional inequalities on the incidence of HIV infection is revealed, confirming the relevance of spatial analysis techniques for mapping the distribution of diseases and identifying risk areas.

Integrative review on the incidence of HIV infection and its socio-spatial determinants / Revisión integrativa sobre incidencia de infección por VIH y sus determinantes socioespaciales / Revisão integrativa sobre incidência de infecção pelo HIV e seus determinantes socioespaciais

ABSTRACT Objectives: to identify the socio-spatial determinants associated with the incidence of infection by the human immunodeficiency virus (HIV) described in national and international literature. Methods: integrative literature review that included original articles indexed in the LILACS, PUBMED, CINAHL, and Scopus databases, from 2015 to 2019. The synthesis of the articles was done in a descriptive manner in two categories according to the type of approach. Results: 13 articles were selected, with a predominance of ecological studies. Regions with deficient access to health services, high population density, higher rates of poverty, intense migratory flow, border areas, as well as precarious socioeconomic conditions, and risk behaviors are associated with higher rates of infection. Final Considerations: the influence of regional inequalities on the incidence of HIV infection is revealed, confirming the relevance of spatial analysis techniques for mapping the distribution of diseases and identifying risk areas.

RESUMEN Objetivos: identificar los determinantes socioespaciales relacionados a la incidencia de infección por virus de la inmunodeficiencia humana (VIH) descritos en la literatura nacional e internacional. Métodos: revisión integrativa de la literatura que incluyó artículos originales indexados en las bases de datos LILACS, PUBMED, CINAHL y Scopus, de 2015 a 2019. Síntesis de artículos hecha de manera descriptiva en dos categorías segundo el tipo de abordaje. Resultados: seleccionados 13 artículos, con predominio de estudios ecológicos. Regiones con acceso deficiente a los servicios de salud, alta densidad poblacional, mayores índices de pobreza, intenso flujo migratorio, áreas fronterizas, bien como precarias condiciones socioeconómicas y comportamientos de riesgo están relacionados a las mayores tasas de infección. Consideraciones Finales: se revela influencia de las desigualdades regionales sobre la incidencia de infección por VIH, ratificando la relevancia de técnicas de análisis espacial para el mapeo de la distribución de enfermedades e identificación de áreas de riesgo.

RESUMO Objetivos: identificar os determinantes socioespaciais associados à incidência de infecção pelo vírus da imunodeficiência humana (HIV) descritos na literatura nacional e internacional. Métodos: revisão integrativa da literatura que incluiu artigos originais indexados nas bases de dados LILACS, PUBMED, CINAHL e Scopus, no recorte temporal de 2015 a 2019. A síntese dos artigos foi feita de forma descritiva em duas categorias segundo o tipo de abordagem. Resultados: foram selecionados 13 artigos, com predomínio de estudos ecológicos. Regiões com acesso deficiente aos serviços de saúde, alta densidade populacional, maiores índices de pobreza, intenso fluxo migratório, áreas fronteiriças, bem como precárias condições socioeconômicas e comportamentos de risco estão associados às maiores taxas de infecção. Considerações Finais: revela-se a influência das desigualdades regionais sobre a incidência de infecção pelo HIV, ratificando a relevância das técnicas de análise espacial para o mapeamento da distribuição de doenças e identificação de áreas de risco.

A elaboração de evoluções de enfermagem e possíveis dificuldades: percepção do enfermeiro / The nursing evolutions' elaboration and possible difficulties: the nurse's perception / La elaboración de evoluciones de enfermería y posibles dificultades: percepción del enfermero

Estudo descritivo e qualitativo, com o objetivo de analisar a percepção dos enfermeiros de um hospital público do município de Belém, acerca de possíveis dificuldades, para elaboração de evoluções escritas. O estudo foi realizado no mês de setembro de 2016, nas clínicas cirúrgica e no 2° Departamento de Câncer, de um hospital-escola, referência em oncologia, localizado no município de Belém/PA. Os participantes do estudo foram oito enfermeiras, entrevistadas a partir de um roteiro semiestruturado. A análise dos dados se deu através da análise de conteúdo, emergindo três categorias temáticas. As dificuldades concentram-se, principalmente, na declaração da falta de tempo, potencialmente decorrente da realização de outras atividades além das de cuidado, e agravada pelo reduzido número de profissionais, o que pode refletir na perda de informações sobre os resultados dos cuidados prestados e da avaliação de sua qualidade, e priorização de atividades administrativas. Conclui-se que, de acordo com os participantes do estudo, a falta de tempo é o principal fator dificultador para a realização da evolução de enfermagem em todos os aspectos que deve contemplar.(AU)

Descritive and qualitative research, with the objetive to analyse the nurses perception of a public hospital in the city of Belém about the possible difficulties to elaborate written evolutions. The study was performed in September 2016, in the surgical clinics and in the 2nd Cancer Department, of a school hospital, reference in oncology, located in Belém/PA. The research's participants were eight nurses, interviewed from a semi-structured script. Data analysis was made through content analysis, originating three tematic categories. The difficulties concentrate, mainly, in alegation of lack of time, which is potentially due to activities other than care, and aggravated by the reduced number of professionals, which may reflect the loss of information about the care outcomes and the evaluation of its quality, and prioritization of administrative activities. It is concluded that, according to the participants of the study, the lack of time is the main obstacle to the achievement of the nursing record in all aspects that should contemplate.(AU)

Estudio descriptivo y cualitativo, con el objetivo de analizar la percepción de los enfermeros de un hospital público del municipio de Belém, acerca de posibles dificultades, para la elaboración de evoluciones escritas. El estudio fue realizado en el mes de septiembre de 2016, en las clínicas quirúrgicas y en el 2° Departamento de Cáncer, de un hospital-escuela, referencia en oncología, localizado en el municipio de Belém / PA. Los participantes del estúdio fueron ocho enfermeras, entrevistadas a partir de un itinerario semiestructurado. El análisis de los datos se dio a través del análisis de contenido, emergiendo tres categorías temáticas. Las dificultades se concentran principalmente en la declaración de la falta de tiempo, potencialmente derivada de la realización de otras actividades además de las de cuidado, y agravada por el reducido número de profesionales, lo que puede reflejar en la pérdida de informaciones sobre los resultados de los cuidados prestados y de la evaluación de su calidad, y priorización de actividades administrativas. Se concluye que, de acuerdo con los participantes del estudio, la falta de tiempo es el principal factor dificultador para la realización de la evolución de enfermería en todos los aspectos que debe contemplar.(AU)

Registros de enfermagem: uma revisão integrativa da literatura / Nursing records: a review of literature

Revisão integrativa da literatura, com o objetivo descrever a produção científica sobre as principais informações encontrados nos registros de enfermagem, através da seguinte questão de pesquisa: Qual a produção científica acerca dos registros de enfermagem difundida por periódicos brasileiros, no período de 2005 a 2015. Dez artigos foram selecionados e analisados segundo a Análise de Conteúdo, proposta por Laurence Bardin, originando três categorias de estudo: aspectos técnicos, aspectos éticos e legais, e conteúdo. Foram constatadas falhas na escrita dos registros de enfermagem, seja em aspectos técnicos, éticos e legais, como também no conteúdo destes. Evidenciou-se que, embora os profissionais de enfermagem conheçam a importância dos registros de enfermagem, na prática, nem sempre vem sendo realizado. Concluiu-se sobre a necessidade de um intenso investimento em educação permanente, atendimento de protocolos legais existentes para sua elaboração, além de produção de estudos sobre o tema a fim de esclarecer o que tem deixado de ser registrado sobre os cuidados prestados e chamar atenção para o que deve ser considerado essencialmente nessas evoluções.

An integrative review of the literature, with the objective of to describe the scientific production that brings the main evidences of nursing records through the following research question: What is the scientific production about the nursing records published by Brazilian periodicals, from 2005 to 2015. Ten articles were selected and analyzed according to the content analysis, proposed by Laurence Bardin, giving rise to three categories of study: technical aspects, ethical and legal aspects, and content. Failure to write nursing records was observed: technical, ethical and legal aspects, as well as in their content. It was evidenced that, although nursing professionals know the importance of nursing records, in practice, it is not always being performed. There is a need for an intense investment in continued education, attending to existing legal protocols for its elaboration, as well as producing studies on the subject in order to clarify what has ceased to be registered about the care provided and draw attention to what should be considered essentially in these evolutions.

Revisión integradora de la literatura, con el objetivo de describir la producción científica que trae las principales evidencias de los registros de enfermería, a través de la siguiente cuestión de investigación: Cuál es la producción científica acerca de la generalizada por las revistas brasileñas de enfermería registros, en el periodo 2005-2015. Se seleccionaron diez artículos y se analizaron mediante análisis de contenido propuesto por Laurence Bardin, lo que resulta en tres categorías de estudio: aspectos técnicos, éticos y legales, y el contenido. No se han encontrado fallos en la escritura de los registros de enfermería, ya sea en técnica, ética y legal, así como el contenido de las mismas. Era evidente que, si bien saben los profesionales de enfermería no siempre se está realizando la importancia de los registros de enfermería en la práctica. Hay una necesidad de inversión intensiva en la educación continua, servicio de protocolos legales para su desarrollo, así como la producción de los estudios existentes sobre el tema con el fin de aclarar lo que ha dejado de estar registrado en la atención recibida y llamar la atención sobre lo que debería ser consideran esencialmente estos desarrollos