RESUMO
Introdução: A mortalidade por câncer do colo do útero é considerada evitável. Altas taxas e tendência ascendente são observadas no Nordeste do Brasil. Objetivo: Avaliar a distribuição espacial da mortalidade por câncer do colo do útero nos municípios do Nordeste do Brasil no período 2015-2019 e sua correlação com indicadores sociodemográficos. Método: Os dados de mortalidade foram obtidos junto ao Sistema de Informação sobre Mortalidade do DATASUS. Calcularam-se as taxas de mortalidade por 100 mil mulheres, suavizadas por meio do estimador bayesiano empírico. Avaliou-se a correlação espacial das taxas de mortalidade por meio do índice de Moran global e local. E testou-se a correlação das taxas de mortalidade com os indicadores sociodemográficos por meio da análise bivariada. O mapeamento e as análises foram realizados nos softwares GeoDa e R, e considerados estatisticamente significativos valores de p<0,05. Resultados: As taxas variaram de 1,0 a 27,2 óbitos por 100 mil mulheres, com as maiores taxas concentradas nos municípios do Maranhão, Piauí, Ceará, Alagoas e Sergipe. Clusters com alta mortalidade foram observados nos municípios do Maranhão e do Piauí (próximo ao Maranhão), no litoral de Pernambuco, Alagoas, Sergipe e Bahia. Verificou-se associação entre os indicadores socioeconômicos e a mortalidade por câncer do colo do útero. Localidades com os piores indicadores mostram maiores taxas de mortalidade por essa neoplasia. Conclusão: Observaram-se altas taxas de mortalidade nos municípios com piores indicadores sociodemográficos, indicando as limitações do sistema de saúde para reduzir essas taxas nas cidades com menor desenvolvimento socioeconômico.
Introduction: Cervical cancer mortality is considered preventable. High rates and an upward temporal trend and observed in Brazil's Northeast. Objective: To evaluate the spatial distribution of cervical cancer mortality of municipalities in Brazil's Northeast in the period 2015-2019 and its correlation with sociodemographic indicators. Method: Mortality data were obtained from DATASUS Mortality Information System. Mortality rates per 100,000 women were calculated and smoothed using the empirical Bayesian estimator. The spatial correlation of mortality rates was evaluated using the global and local Moran index. Moreover, the correlation between mortality rates and sociodemographic indicators was tested using bivariate analysis. Mapping and analyzes were performed using GeoDa and R software, values of p<0.05 were considered statistically significant. Results: Rates ranged from 1.0 to 27.2 deaths per 100,000 women, with the highest rates concentrated in the municipalities of Maranhão, Piauí, Ceará, Alagoas, and Sergipe. Clusters with high mortality were observed in the municipalities of Maranhão and Piauí (close to Maranhão) on the coast of Pernambuco, Alagoas, Sergipe, and Bahia. An association between socioeconomic indicators and mortality by cervical cancer was found. Municipalities with the worst indicators show higher mortality rates by this neoplasm. Conclusion: High mortality rates were observed in municipalities with the worst sociodemographic indicators, indicating the health system's limitations in reducing these rates in cities with low socioeconomic development.
Introducción: La mortalidad por cáncer de útero se considera prevenible. Se observan tasas elevadas y una tendencia al alza en el Nordeste de Brasil. Objetivo: Evaluar la distribución espacial de la mortalidad por cáncer de cuello uterino en municipios del Nordeste de Brasil en el período 2015-2019 y su correlación con indicadores sociodemográficos. Método: Los datos de mortalidad se obtuvieron del Sistema de Información de Mortalidad DATASUS. Se calcularon las tasas de mortalidad por 100 000 mujeres, suavizadas mediante el estimador empírico bayesiano. La correlación espacial de las tasas de mortalidad se evaluó mediante el índice de Moran global y local. Y se probó la correlación entre las tasas de mortalidad y los indicadores sociodemográficos mediante análisis bivariado. El mapeo y los análisis se realizaron utilizando los softwares GeoDa y R, y valores de p<0,05 se consideraron estadísticamente significativos. Resultados: Las tasas oscilaron entre 1,0 y 27,2 muertes por 100 000 mujeres, con las mayores tasas concentradas en los municipios de Maranhão, Piauí, Ceará, Alagoas y Sergipe. Se observaron conglomerados con alta mortalidad en los municipios de Maranhão y Piauí (cerca de Maranhão), en el litoral de Pernambuco, Alagoas, Sergipe y Bahia. Hubo una asociación entre los indicadores socioeconómicos y la mortalidad por cáncer de cuello uterino. Las localidades con peores indicadores presentan mayores tasas de mortalidad por esta neoplasia Conclusión: Se observaron altas tasas de mortalidad en los municipios con peores indicadores sociodemográficos, lo que indica las limitaciones del sistema de salud para reducir estas tasas en los municipios con menor desarrollo socioeconómico.
Assuntos
Fatores Socioeconômicos , Neoplasias do Colo do Útero , Indicadores Básicos de Saúde , Mortalidade , Análise EspacialRESUMO
About half of the world's population remains without access to internet in an era of digital transformation. In this study, we aimed to investigate the impact of implementing the use of logic and mathematics through digital literacy on a population of elementary school students in a town in Northeast Brazil. In a non-randomized experimental longitudinal intervention study, 5th-grade students were followed during one semester. They underwent observational testing during class with the use of scales to evaluate their activities in a digital environment, and they were evaluated with respect to their ability to use digital devices. A logic/math assessment was applied prior to and at the end of the course for intervention group and compared to a control group. Questionnaires were used to assess the educators', legal guardians' and students' perceptions on digital habits and their respective sociodemographic features. The intervention consisted of a 16-h long course developed consisting of 8 2-h long classes which focused on digital technology, digital culture, and computational thinking. The students had a strong interest in the classes. Although some students did not have prior contact with computers, their development was outstanding. Digital literacy competencies and technology-use behavior increased throughout the semester independent of family income and use of digital devices at home. Students progressively improved their interaction with the computer (e.g. touchpad and typing skills) and their confidence in the digital environment. Students' scores on the logic/math assessment showed significant improvement. This was not observed in the control group, demonstrating the importance of this type of intervention even with one provided by a 16-h course. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10639-021-10711-z.
