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Among all the causes of hospital admissions due to mental and behavioral disorders, abusive use of alcohol and other drugs represents one of the main reasons for hospitalizations. The growing number of users, and especially of drug dependents, makes abusive use of alcohol and other drugs a global public health problem. Thus, the present study had as objective to analyze the evolution of hospital admissions, due to abusive use of alcohol and other drugs, carried out in the State of Alagoas, from 2008 to 2015. An analytical, observational study of the ecological type was carried out, based on the information found in the national databases Of the Hospitalization System of the Unified Health System (SIH / SUS). Averages, proportions and gross rates were calculated. Among the first ten causes of hospitalizations due to mental disorders, the use of some type of drug is the second largest responsible (15.10%), second only to hospitalizations by Schizophrenia (57.25%). When specifically observed hospitalizations due to the use of drugs, it is verified that the disorders generated by the abuse of alcohol and multiple drugs concentrate 99,17% of hospitalizations. There was a strong trend of growth in these hospitalizations (R² = 0.8419), an increase of 90.56% when compared to the extremes of the evaluated period, regardless of the sex considered. In population terms, when the population is considered as a reference, in relation to the number of hospitalizations, there is no shocking increase related to these causes. However, in comparison to the other causes of mental disorders, an important increase in the accomplishment of such hospitalizations has been observed. Comparatively, men are the majority among hospitalizations for alcohol abuse (p = 0.0000), while women are more susceptible to the use of hypnotic sedatives (p = 0.0000), cocaine (p = 0.0000), volatile solvents (p = 0.0000), stimulants (p = 0.0000) and the use of multiple drugs (p = 0.0000). No difference was observed regarding the use of cannabinoids (p = 0.6283) and opiates (p = 0.0080). The volume of hospitalizations for alcohol and other drugs abuse is increasing, and it is necessary to elaborate and implement multisectoral preventive strategies, since this situation is directly related to the Social Determinants of Health. / Dentre todas as causas de internações hospitalares, decorrentes dos transtornos mentais e comportamentais, o uso abusivo de álcool e outras drogas representa um dos principais motivos de hospitalizações. O número crescente de usuários e principalmente, de dependentes de drogas, faz com que o uso abusivo de álcool e outras drogas seja um problema de saúde pública mundial. Dessa forma, o presente estudo teve como objetivo analisar a evolução das internações hospitalares, por uso abusivo de álcool e outras drogas, realizadas no Estado de Alagoas, no período de 2008 a 2015. Foi realizado um estudo analítico, observacional, do tipo ecológico, a partir das informações constantes nas bases nacionais do Sistema de Internações Hospitalares do Sistema Único de Saúde (SIH/SUS). Foram calculadas médias, proporções e taxas brutas. Entre as dez primeiras causas de internações devido aos transtornos mentais, o uso de algum tipo de droga é o segundo maior responsável (15,10%), perdendo apenas para as internações por Esquizofrenia (57,25%). Quando observadas, especificamente, as hospitalizações devidas ao uso abusivo de drogas, verificam-se que os transtornos gerados pelo uso abusivo do álcool e múltiplas drogas concentram 99,17% das internações. Observa-se uma forte tendência de crescimento nessas internações (R²= 0,8419), sendo verificado um incremento de 90,56% quando comparados os extremos do período avaliado, independente do sexo considerado. Em termos populacionais, quando se considera a população como referência, em relação ao número de internações, não se observa um aumento impactante relacionado a tais causas. No entanto, em comparação às demais causas de transtornos mentais, tem-se observado um importante aumento na realização das internações por uso de álcool e outras drogas. Comparativamente, os homens são maioria entre as hospitalizações por uso abusivo de álcool (p=0,0000), enquanto que as mulheres são mais suscetíveis ao uso de sedativos e hipnóticos (p=0,0000), cocaína (p=0,0000), solventes voláteis (p=0,0000), estimulantes (p=0,0000) e ao uso de múltiplas drogas (p=0,0000). Não foi observada diferença frente ao uso de canabinóides (p=0,6283) e opiáceos (p=0,0080). É crescente o volume de internações hospitalares por uso abusivo de álcool e outras drogas, sendo necessário elaborar e implementar estratégias preventivas multissetoriais, uma vez que tal situação tem relação direta com os Determinantes Sociais da Saúde.

Every man influences his health by his own life style. Our health is in 80% determined by the life style. Remaining 20% is determined by other influences, inheritance {--} above all, and health care. This thesis analyses the life style of students of South Bohemian University {--} Faculty of Health and Social Studies and Faculty of Economics and is focused on negative factors e.g. drug taking, alcohol consumption, smoking, obesity and stress. The thesis involves explanation of basic concepts that are the foundation stones of this work. The first part is focused on the definitions such as health and disease, life style, prevention, health support, psychology of health and health determinants that significantly influence health of a man. Great part of work deals with risks factors such as alcohol consumption, obesity, stress and other factors that can be influenced positively by a man himself. However, individuality of a man and his will play an important role. The objective of the thesis is to survey the life style of the students of the above mentioned faculties and to compare the results. The research part of the thesis, realised in the form of a questionnaire, is focused on diet, movement, smoking, drugs and alcohol. The first hypothesis - The students of Faculty of Health and Social Studies are better informed about risk life style, than the students of Faculty of Economics {--} was proved. The second hypothesis {--} The students of Faculty of Health and Social Studies are familiar with the principles of healthy lifestyle- has been confirmed partly. The third hypothesis {--} There are no differences in life style between the students of Faculty of Health and Social Studies and Faculty of Economics {--} was proved.

The thesis deals with the issue of addiction. The objective of the paper is to compare opinions and experience of university students of medical and economic specializations regarding narcotics and psychotropic substances. The issue of addictions is a frequently discussed and up-to-date subject that has big impact not only on health service and economics. The Annual Report of the Public Health Authority of the capital city of Prague in 2009 provides information about frequency of drug use among population. The first place belongs to methamphetamine (pervitin) which is mostly used by clients of K - centres and also by clients demanding treatment for the first time. The second place belongs to cannabis. The third place belongs to clients using opiates and demand treatment for the first time. (56) The theoretical part focuses on the issue of drug, alcohol and cigarettes addictions. The history and the development of every single type of addiction are mentioned here together with present knowledge and information. In the practical part of the thesis the method of quantitative research was applied. The data were obtained by means of a questionnaire. Students of the Third Faculty of Medicine of Charles University and students of the University of Economics were a quota for the selection. The objective of the research was to map and compare opinions of students of above mentioned specializations of the issue of addiction and also to find out what is the personal experience of these students with narcotics. The research shows that the first personal experience of students of medical specializations with narcotics and psychotropic substances is similar to experience of students of economic specialization. Over 60 % of respondents answered that they have already had experience with a narcotic and psychotropic substance. There is also the similarity of age. Both groups most frequently mentioned the age of 16 as the age of the first experience with narcotic and psychotropic substances. Marijuana was the drug that was most frequently mentioned and used by students. 97 % of the students of the third Faculty of Medicine and 100 % of the students of the University of Economics answered no to the question whether they use narcotics or psychotropic substances regularly. They have had experimental experience with narcotics or psychotropic substances, however are not regular consumers. The students of the University of Economics show bigger tolerance to the use of psychotropic substances than the students of the Faculty of Medicine, these students mostly condemn such an activity. The students of the Faculty of Economics distinguish soft and hard drugs more than the students of the Faculty of Medicine, these students mostly answered that all drugs are dangerous. One of the questions focused on a total ban of smoking in restaurants and on the attitude of the students to the ban. 78 % of all students think it is a good thing. They mind passive smoking above all. Respondents from both universities agreed that they would not establish a partnership with an addict. Most students would even not tolerate a partnership with a person who was once an addict and now abstains since they are afraid that he/she could return to the addiction. The hard drug addiction is found by the students the most serious. On the other hand, marijuana addiction is extremely underestimated.

Made available in DSpace on 2014-12-17T15:39:05Z (GMT). No. of bitstreams: 1 BrunoCP_DISSERT.pdf: 1270594 bytes, checksum: a901d6b1446ceadc0e80979db6a71338 (MD5) Previous issue date: 2014-03-31 / The harm reduction HR is the official policy of Ministry of Public Health to deal with problem derived from alcohol consumption and other drugs AD. The HR refers to policies and support programs whose purpose is to reduce the risks related to the use of AD, without necessarily decrease individual consumption. This research aim was to analyze the HR conceptions and practices at two specialized institutions for AD users: 1) Psychosocial Care Center Alcohol and Drugs III (CAPSad III); 2) Therapeutic Community Fazenda da Esperan?a (FE) Dom Bosco. This is a qualitative research that used the following methodological tools: semi-structured interview with 21 professionals; socio demographic file and rounds of conversation with 63 participants users; participant observation and field journal. The interviews with professionals have characterized HR as a less complex and cheap treatment. At FE the HR proposal does not make part of their actions, being considered ―against the human being dignity‖. At CAPSad III is understood as an ―inevitable‖ guideline to service, once users do not remain abstinent. The users understand RD as an improvement in healthy conditions, social relations and work that occurs with the decreasing consumption of AD. They use the HR when they avoid situations that facilitate AD consumption, share relapse prevention strategies and, exclusively at CAPSad III, decrease psychotropic consumption. Stands out as an analyzer the HR comprehension as a less efficient treatment that opposes to the objective of both institutions, which is abstinence. The HR is not operationalize in daily routine by professionals and users as a healthy promotion strategy, however, the users are more affected to HR and produce strategies to face the difficulties arising from the AD consumption / A Redu??o de Danos/RD ? a diretriz oficial do Minist?rio da Sa?de para lidar com os problemas decorrentes do consumo de ?lcool e outras drogas/AD. A RD refere-se ?s pol?ticas e programas de interven??o cujo objetivo ? reduzir os riscos associados ao uso de AD, sem necessariamente diminuir o consumo individual. Nessa pesquisa buscou-se analisar as concep??es e pr?ticas de RD em duas institui??es de atendimento especializado a usu?rios de AD: 1) Centro de Aten??o Psicossocial ?lcool e Drogas III (CAPSad III), 2) Comunidade Terap?utica Fazenda da Esperan?a (FE) Dom Bosco. Trata-se de uma pesquisa qualitativa que utilizou as seguintes ferramentas metodol?gicas: entrevista semiestruturada com 21 profissionais; ficha s?cio demogr?fica e roda de conversa com 63 usu?rios participantes; observa??o participante e di?rio de campo. A partir das entrevistas com profissionais tem-se compreens?o da RD como um tratamento menos complexo e barato. Na FE a proposta da RD n?o faz parte das suas a??es, por ser considerada contra dignidade do ser humano . No CAPSad III ? compreendida como uma diretriz inevit?vel ao servi?o, pois os usu?rios n?o permanecem abstinentes. Os usu?rios compreendem a RD como a melhora nas condi??es de sa?de, rela??es sociais e trabalho que ocorre com a diminui??o do consumo de AD. Utilizam a RD ao evitar situa??es que facilitem o consumo de AD, compartilhar estrat?gias de preven??o ? reca?da e, exclusivamente no CAPSad III, diminuir o consumo de psicotr?picos. Destaca-se como analisador a compreens?o da RD como um tratamento menos eficaz que se contrap?e ao objetivo de ambas as institui??es, a abstin?ncia. A RD n?o ? operacionalizada no cotidiano por profissionais e usu?rios como estrat?gia de promo??o ? sa?de, contudo, os usu?rios s?o mais perme?veis ? RD e produzem estrat?gias para enfrentar as dificuldades decorrentes do consumo de AD. A Redu??o de Danos/RD ? a diretriz oficial do Minist?rio da Sa?de para lidar com os problemas decorrentes do consumo de ?lcool e outras drogas/AD. A RD refere-se ?s pol?ticas e programas de interven??o cujo objetivo ? reduzir os riscos associados ao uso de AD, sem necessariamente diminuir o consumo individual. Nessa pesquisa buscou-se analisar as concep??es e pr?ticas de RD em duas institui??es de atendimento especializado a usu?rios de AD: 1) Centro de Aten??o Psicossocial ?lcool e Drogas III (CAPSad III), 2) Comunidade Terap?utica Fazenda da Esperan?a (FE) Dom Bosco. Trata-se de uma pesquisa qualitativa que utilizou as seguintes ferramentas metodol?gicas: entrevista semiestruturada com 21 profissionais; ficha s?cio demogr?fica e roda de conversa com 63 usu?rios participantes; observa??o participante e di?rio de campo. A partir das entrevistas com profissionais tem-se compreens?o da RD como um tratamento menos complexo e barato. Na FE a proposta da RD n?o faz parte das suas a??es, por ser considerada contra dignidade do ser humano . No CAPSad III ? compreendida como uma diretriz inevit?vel ao servi?o, pois os usu?rios n?o permanecem abstinentes. Os usu?rios compreendem a RD como a melhora nas condi??es de sa?de, rela??es sociais e trabalho que ocorre com a diminui??o do consumo de AD. Utilizam a RD ao evitar situa??es que facilitem o consumo de AD, compartilhar estrat?gias de preven??o ? reca?da e, exclusivamente no CAPSad III, diminuir o consumo de psicotr?picos. Destaca-se como analisador a compreens?o da RD como um tratamento menos eficaz que se contrap?e ao objetivo de ambas as institui??es, a abstin?ncia. A RD n?o ? operacionalizada no cotidiano por profissionais e usu?rios como estrat?gia de promo??o ? sa?de, contudo, os usu?rios s?o mais perme?veis ? RD e produzem estrat?gias para enfrentar as dificuldades decorrentes do consumo de AD

Made available in DSpace on 2014-12-17T15:39:05Z (GMT). No. of bitstreams: 1 AnaIOL_DISSERT.pdf: 3163839 bytes, checksum: 5153814b36c4bfcc26c77240b0c38fd8 (MD5) Previous issue date: 2014-04-11 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / National surveys indicate that 6.8 % of the brazilian population is dependent on alcohol and 1 % dependent on illicit drugs, representing a significant portion of the population affected by this issue . Primary Care becomes instrumental in expanding the coverage of this demand and in reducing unnecessary referrals for specialized care. This study aimed to investigate the responsiveness and institutional support of Primary Care Teams in relation to the demands of alcohol and drugs users. The research was conducted in a Family Health Unit in West Sanitary District of Natal City. With quantitative and qualitative nature, our study consisted of two stages. At first, we performed a mapping of alcohol and other drugs abusive use in a sample of the population assisted by Family Heath Teams, using sociodemographic questionnaire and ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). 406 questionnaires were completed. Of these questionnaires, 27.8% are men and 72.2% women, of which 56% are between 20 and 39 years-old, they are housewives, have a stable relationship and are consumers of tobacco (37.6%), marijuana (13%) and especially alcohol (57%). In second stage, two Conversation Circles with Family Health Teams and the referential Family Health Support Center were formed to discuss the data of the mapping realized in the previous phase. The circles, which had participation of 20 of the 37 professional teams from Family Health and 2 from Family Health Support Center, showed a lack of professional training in the subject; inability of the healthcare network in the user embracement; belief of professionals that nothing can be done when matter is alcohol and drugs; and referencing as the only care action performed by teams. Thus we point out the need to support an approach on issues of alcohol and drugs which consider gender issues, investing in Harm Reduction Policy as a possibility of working in this context for recognizing each user in their uniqueness and strategizing with them to promote health in a broad and contextualized way / Pesquisas nacionais indicam que 6,8% da popula??o brasileira ? dependente de ?lcool e 1% dependente de drogas il?citas, representando uma parcela significativa da popula??o atingida por esta problem?tica. A Aten??o Prim?ria torna-se fundamental na amplia??o da cobertura dessa demanda e na diminui??o dos encaminhamentos desnecess?rios para a aten??o especializada. Este estudo objetivou investigar a capacidade de resposta e suporte institucional de equipes de Aten??o Prim?ria em rela??o ?s demandas de usu?rios de ?lcool e drogas. A pesquisa foi desenvolvida em uma Unidade de Sa?de da Fam?lia no Distrito Sanit?rio Oeste de Natal. De natureza quantitativa e qualitativa, nosso estudo foi composto de duas etapas. Na primeira, foi realizado um mapeamento do uso abusivo de ?lcool e outras drogas em uma amostra da popula??o adscrita das equipes de SF, utilizando question?rio sociodemogr?fico e o ASSIST (Alcohol, Smoking and Substance Involvement ScreeningTest). Foram aplicados 406 question?rios. Desses, 27,8% s?o homens e 72,2% mulheres, das quais 56% t?m entre 20 e 39 anos, s?o donas de casa, t?m relacionamento est?vel e consumidoras de tabaco (37,6%), maconha (13%) e principalmente ?lcool (57%). Na segunda etapa foram formadas duas Rodas de Conversa com as equipes de Sa?de Fam?lia e NASF de refer?ncia para a discuss?o dos dados do mapeamento realizado na fase anterior. As rodas, que contaram com a participa??o de 20 dos 37 profissionais das equipes de SF e 2 do NASF, evidenciaram a falta de capacita??o dos profissionais na tem?tica; incapacidade da rede em acolher o usu?rio; cren?a dos profissionais de que nada pode ser feito quando o assunto ? ?lcool e drogas e o encaminhamento como ?nica a??o de cuidado realizada pelas equipes. Diante disso, indicamos a necessidade de fundamentar de forma consistente uma abordagem nas quest?es de uso de ?lcool e drogas que leve em considera??o as quest?es de g?nero, investindo na pol?tica de Redu??o de Danos como uma possibilidade de atua??o nesse ?mbito por reconhecer cada usu?rio em sua singularidade e tra?ar com estrat?gias de promo??o a sa?de de forma ampla e contextualizada

This study compares lifetime prevalence and age of first use (onset) for alcohol, cannabis, and other drugs in six international sites. Data from seven epidemiologic field surveys that used compatible instruments and study designs were compiled for cross-site analyses by the International Consortium of Psychiatric Epidemiology (ICPE). The world health organization’s composite international diagnostic instrument (WHO-CIDI) and additional items were used to ascertain drug use in each site. Lifetime use rates were estimated for alcohol, cannabis, and other illicit drugs. Survival analyses were used to estimate age of onset. Study settings and main results: use of alcohol twelve or more times ranged in descending order from the Netherlands (86.3%), United States (71.7%), Ontario, Canada (71.6%); São Paulo, Brazil (66.1%), Munich, Germany (64.9%), Fresno, California (USA) (51.9%), to Mexico City (43.2%). Use of cannabis five or more times in a lifetime ranged from 28.8 in the United States to 1.7% in Mexico City, and other drugs ranged from United States (19.4%) to Mexico City (1.7%). Age of first use was similar across study sites. This study demonstrates the fundamental uniformity of onset patterns by age as contrasted with wide variations in lifetime prevalences across sites. Study findings suggest that drug use patterns may change among emigrating populations from low consumption nations as a consequence of international resettlement in nations with higher rates. Methodological limitations of the study along with recommendations for future international comparative research are discussed.

Introdução - A incidência das fendas lábio – palatinas, é de 1 para cada 700 nascidos vivos na população mundial, trata-se de uma má-formação congênita que pode ocorrer devido a fatores endógenos ou exógenos. Objetivo – Relacionar o índice de massa corporal (IMC) materno com o nascimento de bebês com fendas. Métodos – Trata-se de um estudo tipo caso-controle. Foram incluídas 800 mães com idade entre 18 e 35 anos, que não apresentaram suspeita ou confirmação de diabete mellitus ou gravídica e bebês com peso entre 2.500 e 4.500 gramas nascidos entre a 37ª e a 42ª semana de gestação que não apresentaram nenhum outro tipo de deficiência que não a estudada. Para a coleta dos dados aplicou – se questionários a 400 mães de crianças normais distribuídas em quatro postos de saúde da cidade de Santo André (controles), e 400 mães de bebês com fendas labiais e/ou palatinas que estavam em tratamento no FUNCRAF, que é um centro especializado no tratamento da deformidade estudada, nesta mesma cidade (casos). Resultados - Entre os casos encontrou - se 148 (37,00%) mulheres com IMC acima de 26 e entre os controles foram 132 (33,00%). Com relação ao uso de álcool/drogas observou-se que 82 (20,50%) mulheres entre os casos e 58 (14,50%) no grupo controle eram usuárias. Duzentas e onze (52,70%) mães de bebês com fendas relataram ter histórico de má - formação na família dela ou do pai da criança. Este número foi de 103 (25,70%) no grupo controle. No grupo controle observou-se que 330 (82,50%) eram brancas ou pardas, 43 (10,75%) negras e 27 (6,70%) amarelas, entre os casos foram 294 (73,50%) brancas ou pardas, 65 (16,25%) negras e 40 (10,00%) amarelas. Conclusões - O IMC alto não esteve relacionado ao nascimento de bebês com fendas. Ter sido usuária de álcool/drogas no primeiro trimestre de gestação relacionou-se ao nascimento de crianças com a má-formação. O risco de surgimento desta deformidade foi 3,6 vezes maior quanto existiu histórico de qualquer má-formação familiar; a raça/etnia da mãe também apresentou associação com a presença de fendas, a raça branca é a menos associada seguida pela parda e negra e, finalmente pela amarela que foi a que apresenta maior associação. / Introduction – The incidence of cleft lips and palate is 1 to 700 live births in the world population, it is a congenital malformation that can happens due to endogens or exogenesis factors. Objectives – Association between maternal body mass index (BMI) and the risk of cleft lips or palate. Methods – That is a case – control study. We include 800 mothers between 18 and 35 years old without suspicious of gestational or preexisting diabetes and babies between 2,500 e 4, 000 g was born between the 37 and 42 pregnancy week without other congenital malformation that is not the studied. Some questions were asked for 400 normal children’s mothers from four health centers from Santo André (controls), and 400cleft lips or palate children’s mothers from FUNCRAF that is a health center just to treatment of this malformation, from Santo André (cases). Results – Among the cases we have 148 (37.00%) mothers with BMI above 26 and among the controls it was 132 (33.00%). About alcohol and drugs use we have 82 (20.50%) women among cases and 58 (14.50%) on control group. Two hundred eleven (52.70%) malformations children’s mothers declare to have malformation parental history against 103 (25.70%) on control group. On control group we have 330 (82.50%) white , 43 (10.75%) black and 27 (6.70%) yellow, among the cases 294 (73.50%) white, 65 (16.25%) black and 40 (10.00%) yellow. Conclusions – The increase of BMI is not likely to be a risk factor for clefts, the consumption of alcohol/drugs is a risk factor for this malformation; the risk is 3.6 times highest for clefts when there is malformation history; a racial association with clefts was observed, the white women presents the lowest association and the yellow presents the highest one.

Introdução - A incidência das fendas lábio – palatinas, é de 1 para cada 700 nascidos vivos na população mundial, trata-se de uma má-formação congênita que pode ocorrer devido a fatores endógenos ou exógenos. Objetivo – Relacionar o índice de massa corporal (IMC) materno com o nascimento de bebês com fendas. Métodos – Trata-se de um estudo tipo caso-controle. Foram incluídas 800 mães com idade entre 18 e 35 anos, que não apresentaram suspeita ou confirmação de diabete mellitus ou gravídica e bebês com peso entre 2.500 e 4.500 gramas nascidos entre a 37ª e a 42ª semana de gestação que não apresentaram nenhum outro tipo de deficiência que não a estudada. Para a coleta dos dados aplicou – se questionários a 400 mães de crianças normais distribuídas em quatro postos de saúde da cidade de Santo André (controles), e 400 mães de bebês com fendas labiais e/ou palatinas que estavam em tratamento no FUNCRAF, que é um centro especializado no tratamento da deformidade estudada, nesta mesma cidade (casos). Resultados - Entre os casos encontrou - se 148 (37,00%) mulheres com IMC acima de 26 e entre os controles foram 132 (33,00%). Com relação ao uso de álcool/drogas observou-se que 82 (20,50%) mulheres entre os casos e 58 (14,50%) no grupo controle eram usuárias. Duzentas e onze (52,70%) mães de bebês com fendas relataram ter histórico de má - formação na família dela ou do pai da criança. Este número foi de 103 (25,70%) no grupo controle. No grupo controle observou-se que 330 (82,50%) eram brancas ou pardas, 43 (10,75%) negras e 27 (6,70%) amarelas, entre os casos foram 294 (73,50%) brancas ou pardas, 65 (16,25%) negras e 40 (10,00%) amarelas. Conclusões - O IMC alto não esteve relacionado ao nascimento de bebês com fendas. Ter sido usuária de álcool/drogas no primeiro trimestre de gestação relacionou-se ao nascimento de crianças com a má-formação. O risco de surgimento desta deformidade foi 3,6 vezes maior quanto existiu histórico de qualquer má-formação familiar; a raça/etnia da mãe também apresentou associação com a presença de fendas, a raça branca é a menos associada seguida pela parda e negra e, finalmente pela amarela que foi a que apresenta maior associação. / Introduction – The incidence of cleft lips and palate is 1 to 700 live births in the world population, it is a congenital malformation that can happens due to endogens or exogenesis factors. Objectives – Association between maternal body mass index (BMI) and the risk of cleft lips or palate. Methods – That is a case – control study. We include 800 mothers between 18 and 35 years old without suspicious of gestational or preexisting diabetes and babies between 2,500 e 4, 000 g was born between the 37 and 42 pregnancy week without other congenital malformation that is not the studied. Some questions were asked for 400 normal children’s mothers from four health centers from Santo André (controls), and 400cleft lips or palate children’s mothers from FUNCRAF that is a health center just to treatment of this malformation, from Santo André (cases). Results – Among the cases we have 148 (37.00%) mothers with BMI above 26 and among the controls it was 132 (33.00%). About alcohol and drugs use we have 82 (20.50%) women among cases and 58 (14.50%) on control group. Two hundred eleven (52.70%) malformations children’s mothers declare to have malformation parental history against 103 (25.70%) on control group. On control group we have 330 (82.50%) white , 43 (10.75%) black and 27 (6.70%) yellow, among the cases 294 (73.50%) white, 65 (16.25%) black and 40 (10.00%) yellow. Conclusions – The increase of BMI is not likely to be a risk factor for clefts, the consumption of alcohol/drugs is a risk factor for this malformation; the risk is 3.6 times highest for clefts when there is malformation history; a racial association with clefts was observed, the white women presents the lowest association and the yellow presents the highest one.

Our diploma thesis entitled ?The system of prevention of social and pathological phenomena and its implementation at elementary schools? engages in the analysis of possibilities and conditions for and approaches to the implementation of primary pre-vention at elementary schools. The objective of the present diploma is to describe how systems of primary prevention work on the regional and school levels; accordingly, we have performed a comparison of different approaches to this issue at selected schools in the regions of South Bohemia and Pardubice. We have analyzed programmes of the aforesaid regions on the conceptual level, observing the implementation of preventive programmes at particular schools (such as elementary or special). Furthermore, we have examined the assistance as actually pro-vided to schools during the formation of school preventive programmes and their influ-ence on pupils or students as such. We are also interested in how the possibilities that are on offer for the cooperation among schools are utilized and how schools make use of grant programmes provided by regional authorities. The present thesis is divided into two parts, theoretical and practical. The theo-retical part first characterizes and defines basic terms, explaining the most common so-cial and pathological phenomena with the largest impact on the young. Second, a men-tion is made of the system of prevention at both the school and regional levels. Accord-ingly, the practical part focuses on the analysis of school activities in the area of preven-tion, particularly the methodology of prevention, the support of the formation of preven-tive programmes and the influence such programmes have on children. The conclusion summarizes presuppositions and hypotheses which are men-tioned in the introduction. A sociological survey has been conducted at selected schools by means of questionnaires, which will be evaluated at the end of our thesis.