Hui Lai Ling. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 180-204). / Abstracts in English and Chinese. / acknowledgements --- p.I / contents --- p.II / list of abbreviation --- p.IX / list of tables --- p.X / LIST OF FIGURES --- p.XII / abstract --- p.XIII / Chapter chapter 1 --- introduction --- p.1 / Chapter 1.1 --- Overview --- p.1 / Chapter 1.2 --- Objectives & Hypotheses --- p.2 / Chapter chapter 2 --- literature review --- p.6 / Chapter 2.1 --- Definition of obesity --- p.6 / Chapter 2.1.1 --- Densitometric measurement --- p.6 / Chapter 2.1.2 --- Anthropometric measurement --- p.6 / Chapter 2.1.2.1 --- Body circumferences --- p.7 / Chapter 2.1.2.2 --- Skinfold thickness --- p.8 / Chapter 2.1.2.3 --- Weight and height ratios --- p.8 / Chapter 2.1.3 --- Body Mass Index to define obesity --- p.9 / Chapter 2.1.3.1 --- In adults --- p.9 / Chapter 2.1.3.2 --- In children & Adolescents --- p.9 / Chapter 2.2 --- Epidemic of obesity --- p.13 / Chapter 2.2.1 --- Worldwide prevalence & trends of obesity --- p.13 / Chapter 2.2.2 --- Obesity rates in Hong Kong --- p.16 / Chapter 2.3 --- Consequences of obesity --- p.17 / Chapter 2.3.1 --- Health consequences --- p.77 / Chapter 2.3.1.1 --- Adulthood obesity --- p.17 / Chapter 2.3.1.2 --- Childhood & adolescent obesity --- p.19 / Chapter 2.3.1.3 --- Controversy of health risk studies --- p.20 / Chapter 2.3.2 --- Quality of life --- p.21 / Chapter 2.3.3 --- Economic consequences of obesity --- p.21 / Chapter 2.3.4 --- Persistence of childhood obesity into adulthood --- p.22 / Chapter 2.5 --- Risk factors for childhood obesity --- p.24 / Chapter 2.5.1 --- Genetic factors --- p.24 / Chapter 2.5.1.1 --- Parental weight status --- p.24 / Chapter 2.5.1.2 --- Birth weight --- p.28 / Chapter 2.5.2 --- Demographic factors --- p.30 / Chapter 2.5.2.1 --- Socio-economic Status --- p.30 / Chapter 2.5.2.2 --- Family environment --- p.31 / Chapter 2.5.3 --- Dietary factors --- p.33 / Chapter 2.5.3.1 --- Infancy diet --- p.33 / Chapter 2.5.3.2 --- Dietary intake --- p.34 / Chapter 2.5.3.3 --- Eating behaviour --- p.39 / Chapter 2.5.4 --- Physical activity factors --- p.42 / Chapter 2.5.4.1 --- Inactivity --- p.42 / Chapter 2.5.4.2 --- Determinants of physical activity level --- p.44 / Chapter 2.5.4.3 --- Television-watching --- p.46 / Chapter 2.5.5 --- Other risk factors --- p.47 / Chapter 2.6 --- Management of childhood obesity --- p.49 / Chapter 2.6.1 --- Goals & Difficulties in childhood obesity treatment --- p.49 / Chapter 2.6.2 --- Dietary approach --- p.50 / Chapter 2.6.2.1 --- General healthy eating --- p.50 / Chapter 2.6.2.2 --- Decrease fat intake --- p.51 / Chapter 2.6.2.3 --- Increase fibre intake --- p.52 / Chapter 2.6.2.4 --- Reducing meal Glycaemic Index --- p.53 / Chapter 2.6.3 --- Increase activity level --- p.56 / Chapter 2.6.3.1 --- Reinforce active behaviour --- p.56 / Chapter 2.6.3.2 --- Decrease sedentary lifestyle --- p.57 / Chapter 2.6.4 --- Roles of parents and schools in obesity managements --- p.58 / Chapter CHAPTER 3 --- METHODOLOGY --- p.59 / Chapter 3.1 --- Overview --- p.59 / Chapter 3.2 --- Study population --- p.59 / Chapter 3.2.1 --- Reason for selecting 6-7 years old children --- p.59 / Chapter 3.2.2 --- Classification of case and control groups --- p.60 / Chapter 3.2.3 --- Reasons for using BMI --- p.62 / Chapter 3.2.4 --- Development of BMI cut-offs --- p.63 / Chapter 3.3 --- Estimation of sample size --- p.64 / Chapter 3.4 --- Subject recruitment --- p.65 / Chapter 3.4.1 --- Sample Source --- p.65 / Chapter 3.4.2 --- Inclusion criteria --- p.61 / Chapter 3.4.3 --- Recruitment --- p.67 / Chapter 3.4.4 --- Pilot Testing --- p.70 / Chapter 3.5 --- Data collection --- p.70 / Chapter 3.5.1 --- Overview --- p.70 / Chapter 3.5.2 --- Lifestyle data --- p.77 / Chapter 3.5.2.1 --- Scope of data --- p.71 / Chapter 3.5.2.2 --- References for questionnaire design --- p.71 / Chapter 3.5.2.3 --- Questionnaire content --- p.72 / Chapter 3.5.2.4 --- Data validity --- p.73 / Chapter 3.5.3 --- Dietary data --- p.76 / Chapter 3.5.3.1 --- The assessment method --- p.76 / Chapter 3.5.3.2 --- Data validity --- p.76 / Chapter 3.6 --- Data entry & analyses --- p.77 / Chapter 3.6.1 --- Data entry --- p.77 / Chapter 3.6.2 --- Dietary data analyses --- p.78 / Chapter 3.6.2.1 --- Nutrient intake --- p.78 / Chapter 3.6.2.2 --- Meal Glycaemic response --- p.78 / Chapter 3.6.3 --- Risk factor analyses --- p.79 / Chapter 3.6.3.1 --- Univariate analyses --- p.79 / Chapter 3.6.3.2 --- Multivariate analyses --- p.79 / Chapter 3.6.3.3 --- Further analyses --- p.80 / Chapter 3.6.4 --- Childhood lifestyle descriptive analyses --- p.80 / Chapter CHAPTER 4 --- RESULTS --- p.81 / Chapter 4.1 --- Overview --- p.81 / Chapter 4.2 --- Descriptive analyses --- p.82 / Chapter 4.2.1 --- Sample Size & sample source --- p.82 / Chapter 4.2.2 --- Sample Characteristics --- p.83 / Chapter 4.2.3 --- Demographic background --- p.86 / Chapter 4.3 --- Risk factors identification --- p.90 / Chapter 4.3.1 --- Overview --- p.90 / Chapter 4.3.2 --- Univariate analyses --- p.90 / Chapter 4.3.3 --- Multivariate analyses --- p.90 / Chapter 4.3.3.1 --- Variable selection --- p.90 / Chapter 4.3.3.2 --- Test for Multicollinearity --- p.91 / Chapter 4.3.3.3 --- Logistic regression results --- p.91 / Chapter 4.3.4 --- Further analyses --- p.98 / Chapter 4.3.4.1 --- Purposes --- p.98 / Chapter 4.3.4.2 --- Parental BMI --- p.99 / Chapter 4.3.4.3 --- Child's birth weight --- p.102 / Chapter 4.3.4.4 --- Eating Behaviour --- p.105 / Chapter 4.3.4.5 --- Dietary intake --- p.108 / Chapter 4.3.4.6 --- Physical activity --- p.109 / Chapter 4.3.4.7 --- Parental smoking --- p.110 / Chapter 4.3.4.8 --- Socio-economic status --- p.111 / Chapter 4.4 --- Children lifestyle descriptive analyses --- p.113 / Chapter 4.4.1 --- Inactivity in young children --- p.113 / Chapter 4.4.1.1 --- Exercise time and frequency --- p.113 / Chapter 4.4.1.2 --- Exercise preference & encouragement --- p.115 / Chapter 4.4.1.3 --- Determinants of exercise time --- p.117 / Chapter 4.4.2 --- Weight beliefs & Nutrition knowledge --- p.118 / Chapter 4.4.2.1 --- Weight and health beliefs --- p.118 / Chapter 4.4.2.2 --- Nutrition knowledge --- p.121 / Chapter 4.4.3 --- Dietary habits & Nutrient intake --- p.123 / Chapter 4.4.3.1 --- Dietary practice --- p.123 / Chapter 4.4.3.2 --- Nutrient intake --- p.129 / Chapter CHAPTER 5 --- DISCUSSION --- p.137 / Chapter 5.1 --- Risk factors for childhood overweight development --- p.137 / Chapter 5.1.1 --- Overview --- p.137 / Chapter 5.1.2 --- Genetic factors --- p.138 / Chapter 5.1.2.1 --- Parental BMI --- p.138 / Chapter 5.1.2.2 --- Birth weight --- p.142 / Chapter 5.1.3 --- Dietary factors --- p.144 / Chapter 5.1.3.1 --- Eating behaviours --- p.144 / Chapter 5.1.3.2 --- Infancy diet --- p.150 / Chapter 5.1.3.3 --- Current dietary intake --- p.151 / Chapter 5.1.4 --- Physical activity --- p.154 / Chapter 5.1.4.1 --- Exercise --- p.154 / Chapter 5.1.4.2 --- Sedentary activities --- p.155 / Chapter 5.1.5 --- Family environment --- p.157 / Chapter 5.1.5.1 --- Social class & Custody --- p.157 / Chapter 5.1.5.2 --- Parental smoking --- p.159 / Chapter 5.2 --- Lifestyle in Hong Kong young children --- p.161 / Chapter 5.2.1 --- Childhood inactivity --- p.161 / Chapter 5.2.2 --- Weight perception & Nutrition knowledge --- p.163 / Chapter 5.2.3 --- Dietary habits & Nutrient intake --- p.165 / Chapter 5.3 --- Limitations --- p.169 / Chapter 5.3.1 --- Study sample --- p.169 / Chapter 5.3.2 --- Study method --- p.171 / Chapter 5.4 --- Implication of the study results --- p.173 / Chapter 5.4.1 --- Overview --- p.173 / Chapter 5.4.2 --- Strategies on obesity treatments and prevention --- p.173 / Chapter 5.4.3 --- Conclusion --- p.775 / Chapter 5.5 --- Suggestions for further study --- p.176 / CONCLUSION --- p.178 / REFERENCES --- p.180 / APPENDICES --- p.205 / Chapter A. --- Communications for sample recruitment / Appendix A1 Invitation to Parents --- p.A-l / Appendix A2 Contact Details Form --- p.A-3 / Appendix A3 Letter of thanks to SHSC Nurses --- p.A-4 / Appendix A4 Second letter to parents --- p.A-12 / Appendix A5 Written consent from parents --- p.A-14 / Chapter B --- Study Tools / Appendix B1 The Questionnaire --- p.B-l / Appendix B2 3-day dietary record --- p.B-49 / Chapter C --- Childhood overweight risk factors - univariate analyses / Appendix C1 Genetic factors --- p.C-1 / Appendix C2 Demographic factors --- p.C-2 / Appendix C3 Custody & Home environments --- p.C-3 / Appendix C4 Infant feeding factors --- p.C-4 / Appendix C5 Dietary manipulation & Eating desire --- p.C-5 / Appendix C6 Eating habits & Food preference --- p.C-6 / Appendix C7 Physical activity factors --- p.C-7 / Appendix C8 Factors influencing physical activity --- p.C-8 / Appendix C9 Nutrition knowledge & weight perception --- p.C-9 / Appendix C10 Nutrients factors --- p.C-10 / Appendix C11 School life & unclassified factors --- p.C-11 / Chapter D --- Miscellaneous / Appendix D1 Research questions and related questions in the questionnaire --- p.D-l / Appendix D2 Food GI estimation list --- p.D-3

No Brasil, as doenças cardiovasculares constituem-se nas principais causas de mortalidade, sendo o infarto agudo do miocárdio a entidade nosológica mais freqüente dentre as doenças isquêmicas do coração. Os fatores de risco que predispõem as pessoas a essa doença estão relacionados a hábitos do estilo de vida e história familiar. Assim, esta investigação, de natureza descritiva, pretende identificar os fatores de risco relacionados ao meio ambiente, à biologia humana, estilo de vida, e sistema de saúde de pacientes internados em um hospital privado, até 48 horas após a ocorrência de infarto agudo do miocárdio, identificar o conhecimento quanto aos fatores de risco para o desenvolvimento de novos problemas de saúde e verificar se algumas variáveis, relacionadas aos fatores de risco de pacientes infartados em hospital público e privado, são semelhantes. O referencial teórico foi o Modelo de Campo de Saúde que compõe elementos relacionados ao meio ambiente, biologia humana, estilo de vida e sistema de saúde. Foram entrevistados 31 pacientes internados, em um hospital privado de uma cidade do interior do Estado de São Paulo, no período de janeiro a julho de 2003, após assinatura do termo de consentimento informado. Os resultados revelam que, quanto ao meio ambiente, a maioria dos pacientes era alfabetizada, 11 (35,5%) tinha o primeiro grau completo, 10 (32,2%) eram aposentados e donas-de-casa, 24 (77,4%) trabalhavam em torno de 8 a 10 horas por dia e tinham somente um emprego, e a renda familiar mensal, para 19 (61,3%), encontrava-se na faixa de 5 a 15 ou mais salários-mínimos, 22 (70,9%) eram casados e 15 (48,3%) tinham três ou mais filhos, 21 (67,7%) eram procedentes de Ribeirão Preto e região e todos residiam em zona urbana. Em relação à biologia humana, 19 (61,3%) eram do sexo masculino, aproximadamente metade 17 (54,8%) encontrava-se na faixa etária de 40 a 59 anos, 18 (58,1%) encontravam-se com sobrepeso ou obesidade classes I e II. Quanto aos antecedentes familiares, os dados mais expressivos apontam que 23 (74,2%) apresentavam hipertensão arterial sistêmica, 15 (48,3%) diabetes melittus, 17 (54,8%) infarto agudo do miocárdio e 6 (19,3%) acidente vascular cerebral. Das mulheres entrevistadas, 7 (22,6%) faziam uso algum tipo de terapia de reposição hormonal. No tocante ao estilo de vida relacionado aos hábitos alimentares, 29 (93,6%) utilizavam frituras nas refeições, 14 (45,2%) ingeriam doces e refrigerantes diariamente e 13 (41,9%) tomavam três xícaras ou mais de café ao dia, 18 (58,1%) faziam uso de bebidas alcoólicas, 10 (32,2%) eram fumantes, 9 (29,0%) ex-fumantes e 18 (58,1%) sedentários. Quanto ao estresse, 12 (38,7%) sentiam-se estressados no local de trabalho e 19 (61,3%) dormiam menos que oito horas por noite. Em relação ao sistema de saúde, 16 (51,6%) conheciam o diagnóstico, 12 (38,7%) apresentaram dúvidas acerca da doença, 21 (67,7%) utilizavam os serviços de saúde oferecidos pelo plano de saúde e 17 (54,8%) realizavam tratamento de hipertensão arterial sistêmica e diabetes melittus. Os dados revelam que os pacientes infartados estão expostos a hábitos autocriados que são passiveis de modificação havendo a necessidade de iniciar este processo educativo inclusive no período de internação hospitalar. / The cardiovascular diseases in Brazil, constitute nowadays death’s first cause and myocardial infarction is the most frequent nosological entity amonmg heart isquemical diseases. Among risk factors which predispose people committed by this disease are their life style’s and familiar history’s habits. This descriptive investigation intended to identify the risk factors related to the environment, human biology, life style and health systems of patients admitted in a private hospital, until 48 hours after the myocardial infarction; identify the knowledge’s blanket concerning to the risk factors related to new health problems’ development and verify if some variables are related to the risk factors which are similar to those of admitted patients in private and public hospitals. The theoretical referential used was the Health Model Field which constitutes the elements linked to the environment, human biology, life style an health system. We interviewed 31 internee patients in a private hospital in São Paulo’s interior, from January through July, 2003. Concerning to the environment 93,5% of the patients were literate; among them 11 (35,5%) had completed high school; related to their occupation 10 (32,2%) were retired and housewives; concerning to their working hours and job numbers, 24 (77,4%) work around 8 or 10 hours a day and have only one job; when referring to their familiar monthly income, 19 (61,3%) obtained from 5 to or more minimum salaries; 22 (70,9%) were married and 15 (48,3%) had three or more children; 21 (67,7%) were from Ribeirão Preto and its region and all of them lived in urban areas. When referring to the human biology, 19 (61,3%) were masculine and their ages varied between 40 and 59 years old; 18 (58,1%) were over weighted or fat, belonging to classes I and II; concerned to the familiar preceding, the most expressive data showed that 23 (74,2%) presented systemic arterial hypertension; 15 (48,3%) mellitus diabetes; 17 (54,8%) myocardial infarction and 6 (19,3%) cerebral vascular accident; 7 (22,6%) were feminine and were using hormones. Concerned to their life style, related to the feeding habits, 29 (93,6%) were accustomed to eat fried food; 14 (45,2%) used to eat sweeties and drink soft drinks daily; 13 (41,9%) used to drink 3 or more cups of coffee a day. When referring to the use of alcoholic drinks, 18 (58,1%) used to drink it; 10 (32,2%) were smokers and 9 (29,0%) were ex-smokers; 18 (58,1%) were sedentary. When referring to the stressing environment and sleeping patterns, 12 (38,7%) mention the work place and 19 (61,3%) sleep less than 8 hours a day. Concerning to the health system, 16 (51,6%) knew their diagnosis; 12 (38,7%) presented doubts about their diseases; 21 (67,7%) used the health services offered by their health insurance and 17 (54,8%) were under arterial hypertension and mellitus diabetes treatment. The data showed the patients who suffered by myocardial infarction are exposed to “selfcreated” habits, which may be modified and it is important to mention the necessity of raising educative programs including the patient’s permanence at the hospital.

FundaÃÃo de Amparo à Pesquisa do Estado do Cearà / Introduction: Obstructive Sleep Apnea Syndrome (OSAS) in children, as defined by the American Thoracic Society, is a disorder of breathing during sleep characterized by prolonged partial airway obstruction and/or intermittent complete obstruction (obstructive apnea) that disrupts normal ventilation during sleep and normal sleep patterns. Objective: This study aimed to investigate retrospectively the prevalence of OSAS among children aged 6 to 12 years old, evaluated through polysomnography and sleep questionnaires between 2011 and 2012, analyzing severity, symptoms and associated risk factors. Methods: We evaluated 63 children referred to the Sleep Laboratory of the Dell Childrenâs Hospital in Austin, Texas (USA) with suspition of Sleep Disordered Breathing. The patients were submitted to a pre-sleep questionnaire and to polysomnography. Results: The mean age was 8,8 Â1,9 years old, and 55,6% of the children were male. Children without OSAS accounted for 30,2% of the sample. The OSAS observed in the remainder was mild in 49,2%, moderate in 11,1% and severe in 9,5%. Gender and age were not associated with OSAS. Hispanic and African-American children were at higher risk for OSAS. Twenty two hispanic children presented OSAS ( 88%) and ten African-american children presented OSAS (83,3%). In children with OSAS, the most common symptoms were: snoring (86%), periodic limb movements (64,3%), arousals during sleep (60,5%) and restless sleep (58,1%). Excessive daytime sleepiness was reported in only 33,3% of the patients. Bruxism was more prevalent among the patients without OSAS (52,6%) than in the patients with OSAS (31%). Overweight children were at higher risk for OSAS. Conclusions: Overweight children are at a higher risk for developing OSAS. Hispanic and African American children presented a higher risk for developing OSAS. Age and gender were not associated to the diagnose of OSAS. Bruxism was more prevalent among the children who did not present OSAS. / IntroduÃÃo: Em crianÃas, a SÃndrome da Apneia Obstrutiva do Sono (SAOS) à um distÃrbio respiratÃrio caracterizado por obstruÃÃo parcial prolongada e/ou episÃdios intermitentes de obstruÃÃo completa da via aÃrea superior, que interrompe a ventilaÃÃo normal e o padrÃo normal de sono. Objetivo: Este trabalho buscou investigar a prevalÃncia de SAOS entre crianÃas de seis a doze anos de idade, avaliadas por meio de polissonografia e questionÃrio sobre o sono, no perÃodo de 2011 a 2012, avaliando gravidade, sintomatologia e fatores de risco associados. MÃtodos: Foram estudadas 63 crianÃas encaminhadas ao LaboratÃrio do Sono do Dell Childrenâs Hospital em Austin, Texas (EUA) com suspeita de Transtornos RespiratÃrios do Sono. Os pais preencheram um questionÃrio sobre o sono, jà rotineiramente utilizado como padrÃo para todos os pacientes encaminhados para polissonografia no Dell Childrenâs Hospital (ApÃndice A). Em seguida, as crianÃas foram submetidas ao exame polissonogrÃfico. Resultados: A idade mÃdia foi de 8,8Â1,9 anos, sendo 55,6% das crianÃas do sexo masculino. NÃo apneicos corresponderam a 30,2% dos investigados. SÃndrome da Apneia Obstrutiva do Sono em grau leve ocorreu em 49,2%, moderado em 11,1% e grave em 9,5%. NÃo foi encontrada diferenÃa entre a incidÃncia de SAOS entre meninos e meninas. Observou-se uma associaÃÃo estatisticamente significante entre raÃa e presenÃa/ausÃncia de SAOS, sendo que as crianÃas negras e hispÃnicas apresentaram maior risco de SAOS do que as crianÃas brancas. Entre os hispÃnicos, 88% dos pacientes apresentaram SAOS (n=22); nos negros 83,3% (n=10) e nos brancos 46,7% (n=7). Dentre as crianÃas diagnosticadas com SAOS, os sintomas mais frequentes foram: ronco (86%) movimentos periÃdicos de membros (64,3%), despertares durante o sono (60,5%) e sono agitado (58,1%). SonolÃncia excessiva foi relatada apenas em 33,3% dos casos. O bruxismo foi relatado com maior frequÃncia no grupo sem SAOS (52,6%) do que no grupo de pacientes com diagnÃstico de SAOS (31%). CrianÃas com sobrepeso apresentaram maior risco de desenvolver SAOS (100%) (Testes Qui quadrado e exato de Fisher). ConclusÃes: Sobrepeso à um fator de risco para SAOS. CrianÃas da raÃa hispÃnica e negra apresentaram maior risco a SAOS. Sexo e idade nÃo se associaram a SAOS. O bruxismo foi mais frequentemente relatado por pacientes que nÃo demonstraram SAOS.

A infecção pelo vírus da hepatite C acomete cerca de 180 milhões de pessoas em todo mundo. Trata-se de doença com pouca manifestação clinica, onde cerca de 75% a 85% dos casos evolui para cronificação e aproximadamente 15% para hepatocarcinoma. Entre os fatores de risco mais conhecidos estão a realização de transfusões de sangue e hemoderivados anterior a 1993, uso de drogas endovenosas e relações sexuais desprotegidas. Este trabalho tem por objetivo estimar a prevalência de sorologia positiva para hepatite C e seus possíveis fatores de risco no distrito de Botafogo, município de Bebedouro, SP, onde a elevada freqüência de casos de hepatite chamou a atenção dos seus próprios moradores. Da população de 1318 habitantes, 353 foram sorteados para participar da pesquisa, sendo submetidos a questionário padronizado e coleta de sangue. Infecção pelo vírus da hepatite C foi pesquisada através de exames imunoenzimáticos e de PCR, no Instituto Oswaldo Cruz (Fiocruz), e por teste imunocromatográfico, no Laboratório de Sorologia do Hospital da Clínicas de Ribeirão Preto-USP . A prevalência encontrada foi de 8,8% (IC95%: 5,8 11,7). As variáveis que mostraram associação na análise univariada foram submetidas a um procedimento multivariado por aplicação do modelo de log binomial. As variáveis preditoras independentes de infecção pela hepatite C foram sexo masculino, tempo de residência acima de trinta anos e uso de medicações parenterais com material esterilizado por técnica de fervura. Uma possível explicação para a elevada prevalência nessa população reside na possibilidade de disseminação do vírus a partir de um antigo morador, que exercia informalmente atividades ligadas ao atendimento à saúde, especialmente aplicação de injeções, numa época anterior ao uso de seringas descartáveis. / Approximately 180 million people worldwide are infected by the hepatitis C virus. It is an illness with little clinical manifestation where about 75% - 85% of the cases evolve to chronification and about 15% to hepatocarcinoma. Among the bestknown risk factors are blood and blood by-product transfusions prior to 1993, use of intravenous drugs and unprotected sexual relations. This study has the objective of estimating the prevalence of positive serology for hepatitis C and its possible risk factors in the district of Botafogo, municipality of Bebedouro, São Paulo, where the high frequency of hepatitis cases caught the attention of the population itself. Out of a population of 1318 inhabitants, 353 were selected to participate in the research, being submitted to a standard questionnaire and blood collection. Hepatitis C infection was researched through immunoenzimatic and PCR exams at the Oswaldo Cruz Institute (FIOCRUZ), and by immunochromatographic tests at the Serology Laboratory of the Hospital das Clinicas in Ribeirão Preto USP. The prevalence found was of 8,8% (CI95%: 5,8 11,7). The variables that demonstrated an association in the univariate analysis were submitted to a multivariate procedure through the application of the binomial log model. The independent predictors for hepatitis C infection were male sex, local residence time over thirty years and use of parenteral medication with material sterilized through boiling technique. A possible explanation for the high prevalence in this population lies in the possibility of dissemination of the virus from an older inhabitant who informally exercised medical activities, especially the application of injections in a period before there was use of dischargeable syringes.

Partindo de hipóteses básicas onde o processo saúde-doença no período perinatal apresenta-se, por um lado, como expressão de condições particulares ás quais famílias estão submetidas, de maneira diferencial, em função de sua adscrição de classe e, por outro, como expressão da articulação de um conjunto de condições biológicas e sociais em permanente relação, o presente trabalho procura, em uma amostra de parturientes e recém-nascidos de hospitais de São Luis do Maranhão, refletir sobre o assunto. Conclui pela pertinência do emprego do conceito sociológico de classe social ao estudo de eventos perinatais que, articulado a esquemas teóricos mais elaborados do campo da Perinatologia, permite ampliar o nível de explicação do fenômeno. / This work searches for empirical sustenance concerning reflection on basic hypotheses whereby the health dickness process in the perinatal periode expresses particular conditions which families are undergoing especially as to their insertion in social classes, on one hand, and especially on the other, articulation of biological and social conditions in permanent relation. It is based on a sample of women-in-labour and newborn children in hospitals in São Luis do Maranhão, Brazil. It is concluded that Sociological concept of social class is pertinent whilst studying perinatal events along with more elaborate theoretical schemes in the field of Perinatology.

Introdução: A varicela é uma doença exantemática benigna da infância, causada por uma infecção primária pelo vírus Varicela-zoster. No Estado de São Paulo, no ano de 2003, foram notificados 58.972 casos de varicela mediante ocorrências de surtos, configurando um ano hiperendêmico para a doença. De um total de 60 óbitos em todo o Estado, 47 ocorreram em menores de 4 anos. Mais da metade dos óbitos incidiu em moradores da Região Metropolitana da Grande São Paulo. Objetivos: Descrever e caracterizar os indivíduos residentes na Região Metropolitana da Grande São Paulo que evoluíram para gravidade ou óbito por varicela em 2003 e estudar os fatores preditores desses eventos. Métodos: Realizou-se um estudo descritivo das variáveis sociodemográficas, clínicas, antecedentes pessoais e epidemiológicos dos casos de varicela, além de uma análise exploratória dos fatores preditores de gravidade e óbito pela doença. A existência de associação entre as exposições de interesse e gravidade ou óbito por varicela foi investigada pelas estimativas não ajustadas e ajustadas do odds ratio, com os respectivos intervalos de confiança de 95%, utilizando-se a regressão logística não condicional. Resultados: As seguintes variáveis demonstraram associação independente com gravidade e óbito por varicela: complicações raras, pulmonares, hemorrágicas e neurológicas. Cirurgia realizada durante a internação por varicela também foi um fator preditor de gravidade. A taxa de mortalidade foi 36 vezes maior na faixa etária de menores de 15 anos em relação à faixa etária de adultos, e 5 vezes maior na faixa de menores de um ano em comparação à faixa de 1 a 14 anos. Conclusão: O amplo conhecimento da epidemiologia da varicela, suas complicações e fatores de risco para gravidade e óbito, é de extrema importância para fundamentar a implementação de estratégias de prevenção e controle deste agravo nos grupos de maior risco. / Introduction: Chickenpox is a benign exanthematous disease of childhood, whose primary infection is caused by the Varicella-zoster virus. In the State of São Paulo, in 2003, 58,972 chickenpox cases were notified following outbreaks, configuring a hyperendemic year for the disease. From a total of 60 deaths in the whole State, 47 happened in children up to 4 years old. More than half of the deaths occurred in residents of the Greater São Paulo Metropolitan Area. Objectives: To describe and characterize those individuals residents in the Greater São Paulo Metropolitan Area who developed chickenpox severity or death during the year 2003, and to study the predictive factors of these events. Method: A descriptive study was performed, analyzing clinical and social-demographic variables, personal and epidemiological records of the chickenpox cases. Besides, an exploratory analysis of the redictive factors of severity and death by the disease was made. Association between exposures of interest and chickenpox severity or death was investigated by unadjusted and adjusted odds ratio estimation, with 95% confidence intervals, using unconditional logistic regression. Results: The following variables keep an independent association with severity and death for chickenpox: development of rare, pulmonary, hemorrhagic and neurological complications. The need of surgery during the chickenpox hospitalization was an independent predictive factor for severity only. The mortality rate was 36 times greater in the age group from 0 to 14 years old than in the adult age group, and 5 times greater in children up to 1 year old than in the age group ranging from 0 to 14 years old. Conclusion: The comprehensive knowledge of the chickenpox epidemiology, its complications and risk factors for severity and death is extremely important to base the implementation of prevention and control strategies for groups at greater risk of infection.

A lombalgia, comum em muitas atividades profissionais acomete principalmente indivíduos que trabalham na condução de veículos motorizados. O objetivo deste estudo foi investigar a prevalência da lombalgia em motoristas de caminhão, bem como os fatores de risco relacionados à sua ocorrência. Para isso foi elaborado um questionário que abordou fatores como: idade, prática de atividade física e esportiva, hábitos gerais de saúde e questões relativas ao exercício profissional. Calculou-se também o índice de massa corpórea através da relação entre o peso corporal e o quadrado da estatura. Foram avaliados 489 caminhoneiros do sexo masculino e selecionados 410 para o estudo. Os resultados obtidos foram: a prevalência da lombalgia em 59% dos caminhoneiros; e dentre as variáveis estudadas apenas o número de horas de trabalho mostrou-se estatisticamente significante, sendo que o risco do caminhoneiro ter dor lombar aumenta 7% para cada hora de trabalho. / Low back pain is common in several kinds of professional activities mainly in people who drive a lot in their job. The aim of this study was to evaluate the prevalence of low back pain in truckers and the risk factors related to the occurrence of lumbar pain. For this, a questionnaire was elaborated including such as: age, physical and sports activities, general health habits and aspects related to the job. Besides, the index of corporal mass has been calculated, based on the relation between the truckers weight and his square height. 489 male truckers were evaluated and 410 have been selected for the study. The results showed that 59% of the truckers have suffered from low back pain, and among the different aspects which have been analysed, only the number of working hours has been more significant: for each working hour, the risk of truck driver in having lumbar pain increases 7%.

Adolescents today are faced with an array of risk factors including sexual activity and drug and alcohol use, as well as environmental factors that are beyond their control, such as parental divorce and poverty. The attribute of resilience is an extremely desirable quality that, if developed, has the capacity to reduce the effect of many of these risk factors that many adolescents are exposed to. Sport participation is a potential intervention that a large portion of adolescents can have access to through school and community programs that could potentially foster resilience. The current causal-comparative, non-experimental study sought to add to the limited existing research by examining resilience levels of adolescents who participate in sports compared to resilience levels of their peers who do not participate in sports. The Social Emotional Assets and Resiliency Scale - Parent form was used to calculate resilience levels of the students in the study sample. Participants (n = 276) reported that the overall mean resilience score of those youth who had participated on a sports team within the last year was significantly higher than the overall mean resilience score of those youth who had not. There was no significant difference in resilience ratings of those who played school-sponsored sports versus city/recreational sports. There was also a small, statistically significant, positive correlation between the number of sports played and resilience ratings. Implications and limitations of this study are included. Parents and educators are encouraged to offer a variety of opportunities for youth to participate in activities aligned with student interests. In budgeting and planning curricular and extracurricular activities to enrich students' social experiences, schools and communities must consider the importance of sports activities in strengthening youth resilience.

No description available.

Choanal atresia is a well-defined congenital malformation; however, little is known about its prevalence and risk factors. Data from the Iowa Registry for Congenital and Inherited Disorders were used to examine prevalence, infant, and maternal characteristics of choanal artesia. Data from the National Birth Defects Prevention Study (NBDPS) were used to examine selected risk factors for choanal atresia. Overall prevalence was estimated as number of choanal atresia cases per 10,000 live births with 95% confidence intervals (CI)s. Crude and adjusted odds ratios (OR)s and 95% CIs were estimated to investigate selected risk factors. The overall prevalence of choanal atresia among live born deliveries in Iowa from January, 1998 through December, 2005 was 0.46 (95% CI=0.27, 0.78) per 10,000 live births. Using data from the NBDPS, choanal atresia cases were compared to unaffected control infants for births from October 1997 through December 2005. Overall, case infants compared to control infants were more likely to be female, preterm, and a multiple birth. For all choanal atresia cases combined, odds of high maternal zinc (OR=2.1; 95% CI=1.2, 3.9) and vitamin B-12 (OR=2.4; 95% CI=1.4, 4.3) intake in the year prior to pregnancy, and maternal periconceptional (one month before through three months after conception) exposure to anti-infective urinary tract medications (OR=3.3; 95% CI=1.3, 8.4) were significantly elevated among case compared to control mothers. For isolated choanal atresia cases (those with no additional major malformations), odds of maternal periconceptional exposure to passive cigarette smoke (OR=2.3; 95% CI=1.0, 5.3) as well as maternal intake of 3 or more cups of coffee per day one-year prior to pregnancy were increased (OR=2.9; 95% CI=1.3, 6.4) for case compared to control mothers. The reverse was found for low maternal intake of pantothenic acid (OR=0.4; 95% CI=0.2,0.9) and vitamin A (OR=0.3; 95% CI=0.1, 0.8) one-year prior to pregnancy. The current study provided support for potential associations between maternal health behaviors before and during pregnancy and choanal atresia; however, the findings were based on a modest number of cases. The study needs to be replicated in a larger case sample, also examining the role of genetics in choanal atresia.