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OBJECTIVE:To analyze the infl uence of demographic, socioeconomic, health, and contextual factors of the Brazilian federation units on the functional disability of the elderly. METHODS:Cross-sectional study based on data from the 2003 PNAD (Brazilian National Household Survey), of IBGE (Brazilian Institute of Geography and Statistics) and Ipea (Institute of Applied Economic Research). The sample was composed of 33,515 individuals aged 60 years and older. The dependent variable was functional disability, measured by diffi culty in climbing slopes or stairs. The independent variables were divided into two levels: individual (demographic, socioeconomic and health-related characteristics) and contextual (Gini Index and Gross Domestic Product per capita by Brazilian state in 2000). A multinomial and multilevel logistic regression model was utilized in order to estimate the effect of the independent variables on the functional disability of the elderly. RESULTS:Functional disability was associated with demographic, socioeconomic and health factors. At the individual level, sex, level of schooling, income, occupation, self-perception of health and chronic diseases were the factors that were most strongly related to functional disability. At the contextual level, income inequality proved to exert an important infl uence. CONCLUSIONS: Self-perception of health is the factor that is most strongly related to the functional disability of the elderly in Brazil, followed by chronic diseases. Sex, occupation, level of schooling and income are also highly associated with it. Actions that approach the main factors associated with functional disability can contribute signifi cantly to the well-being and quality of life of the elderly.

6%). Half of the sample had less than 5 years of schooling and the mean monthly individual income was low (US$ 210.00). Condom use was very low either during lifetime (8%) or in the last 6 months (16%

Abstract

Despite their longer life expectancy, the women faced more years with functional disability. The number of years with functional disability and dependence was also higher for the women. Public policies should take into account the differing needs of elderly women and of elderly men as well as other specific characteristics of this older population.

The objectives of this study were to evaluate anti-retroviral (ARV) prescription pickups during twelve months following the first prescription and to identify factors associated with irregular pickups or permanent dropout in two public HIV/AIDS referral centers in Belo Horizonte, Minas Gerais State, Brazil. Participants (n = 323) were antiretroviral naïve and were recruited from May 2001 to May 2002. A total of 98 (30.3%) patients abandoned treatment, and 187 (57.9%) had at least one irregular pickup. Patients with irregular pickups and dropouts were compared to those with regular pickups. Multinomial multivariate analysis showed that living outside Belo Horizonte, CD4+ T-lymphocyte count greater than 200/mm(3), and antiretroviral regimen without protease inhibitors were associated with irregular pickups. In addition to these variables, not being on other medications, and any non-adherence recorded on patient charts were associated with treatment dropout. Pharmacy records are important potential indicators of non-adherence and should be incorporated as such in clinical practice. Strategies should be prioritized to reach out to dropouts or patients with irregular ARV pickups.

IntroduçãoOs sistemas de informação em saúde são ferramentas fundamentais para subsidiar a tomada de decisões e auxiliar a organização dos serviços, por meio do planejamento das ações e do acompanhamento e avaliação dos objetivos propostos. O sistema de saúde brasileiro tem larga experiência com a captura e o uso de informações. No entanto, Morais e Gómez (2007) fazem uma reflexão de que os atuais pressupostos, práticas e saberes de informação e informática em saúde não mais dão conta da complexidade do processo saúde/doença/cuidado, apontando algumas questões: a fragmentação dos indivíduos entre diversas bases de dados em saúde, o que acar-

Estudo de base populacional para determinar perfis de óbitos neonatais precoces ocorridos em Belo Horizonte, Minas Gerais, Brasil, de 2000 a 2003. A definição dos perfis de causas amplia possibilidade de análise sob enfoque de evitabilidade, justificada pela persistência de altas taxas de mortalidade neonatal precoce. Três perfis foram gerados, a partir do enfoque de causas múltiplas, sob a perspectiva dos conjuntos nebulosos ("fuzzy sets"), utilizando-se técnica Grade of Membership. Relacionaram-se esses perfis ao peso de nascimento e a natureza jurídica do hospital de ocorrência do óbito. Nos hospitais da rede privada ocorreram "óbitos dificilmente preveníveis, com menção de malformação congênita" (perfil 2). Aos hospitais do Sistema Único de Saúde (SUS) associaram-se dois perfis distintos. Nos hospitais contratados/conveniados ocorreram os "óbitos passíveis de prevenção" (perfil 1) e na rede própria os "óbitos de prematuros" (perfil 3). A tipologia observada aponta para necessidade de adoção de políticas diferenciadas na rede SUS: prioritariamente, na rede contratada/conveniada, ações voltadas para credenciamento e avaliação da qualidade da assistência; e, em toda rede, adoção rotineira de protocolos assistenciais e medidas profiláticas, redutores da morbimortalidade neonatal.