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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
131

Elevers förhållningssätt till Idrott och hälsa i årskurs 4 - En komparativ studie om påverkande faktorer

Daftner, Alexander, Larsson, Ludvig January 2010 (has links)
I vårt samhälle skiljer sig uppväxtvillkoren för barn och ungdomar mycket åt. Socioekonomiska förutsättningar påverkar barns liv och deras idrottsvanor. Syftet med vår studie är att belysa på vilket sätt elever från två olika klasser och områden med olika social status, har för förhållningssätt till idrotten på fritiden kopplat till skolämnet Idrott och hälsa. Undersökningen genomfördes som två olika fallstudier. Vi valde att undersöka en skola i varje område. Områdena vi undersökte skiljde sig markant åt på ett flertal punkter ur ett socioekonomiskt perspektiv och bildade två fallstudier där vi kunde utläsa de likheter och skillnader som fanns. Vårt arbete bygger på habitusteorin och smakbegreppet av Bordieau och kopplas till Evenshaugs socialisations och uppväxtteorier. Resultaten av undersökningen är baserade på de kvalitativa intervjuer och observationer vi gjort i båda våra fallstudier. Undersökningen gjordes i årskurs 4 i båda fallstudierna. Resultaten visade en stor skillnad i föreningsidrottande men likheter i förhållningssättet till skolidrotten. Studien påvisar även att ett elevinflytande måste sättas i centrum i undervisningen för att göra skolidrotten mer meningsfull för alla elever. / In our society there are big differences in children’s conditions of growing up. Socioeconomic conditions affect children’s lives and their sports habits. The purpose of this study was to illustrate the attitudes that pupils from two different classes and areas with different social status had on recreational sports connected to the Physical education. The study was presented as two different cases. We chose to examine one school in each area. The areas that we examined differed at several points in a socioeconomic perspective and created two cases from which similarities and differences could be presented. Our study is built on theories from Bordieau and Evenshaug that includes habitus and socialisation when growing up. The result of the study is based on qualitative interviews and observations from our cases. Our study was made in the fourth grade in both cases. The results showed a major difference in the participation of recreational sports, but there were big similarities in attitudes towards Physical education. The study also proves that student influence must be put in the centre of attention in order to make Physical education more meaningful for all students.
132

Guidelines for Psychological Practice for People With Low-Income and Economic Marginalization: Executive Summary

Juntunen, Cindy L., Pietrantonio, Kipp R., Hirsch, Jameson K., Greig, Astrea, Thompson, Mindi N., Ross, Denise E., Peterman, Amy H. 01 February 2022 (has links)
This is a summary of the guidelines for working with low-income and economically marginalized (LIEM) people developed by the American Psychological Association (APA) task force and approved by the APA Council of Representatives. The task force, consisting of psychologists from a range of psychological specialties and both practice and educational settings, created guidelines in four main categories: Education and Training, Health Disparities, Treatment Considerations, and Career Concerns and Unemployment. Each category includes specific guidelines and recommended interventions. Further, the task force identified two major assumptions that cut across all of the recommendations: (1) The intersection of economic status and other identities is critical to psychological and other aspects of health, and (2) biases and stigma exacerbate the negative experiences of living with LIEM, and must be acknowledged and confronted by psychologists and trainees. Many of the guidelines and corollary interventions reinforce the need for psychologists and trainees to engage in activities that increase their own self-awareness and knowledge of issues and concerns that are exacerbated by economic marginalization, as well as challenge their own implicit and explicit biases related to social class and poverty. The impact of economic marginalization on education, health, and career attainment are addressed, and adaptations to psychological interventions are recommended. The task force concludes with a call to engage psychologists in action that seeks and promotes economic justice. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
133

Leveraging Machine Learning for Pattern Discovery and Decision Optimization on Last-minute Surgery Cancellation

Liu, Lei January 2021 (has links)
No description available.
134

Intimate partner violence against women: exploring intersections of race, class and gender

Resko, Stella M. 16 July 2007 (has links)
No description available.
135

Sambandet mellan kariesminskning i världen och socioekonomiska faktorer

Bergström, DIjar, Kösanlioglu, Oskar January 2019 (has links)
AbstraktBakgrund: DMFT (Decayed, Missing, Filled Tooth) har minskat i många delar av världen under det senaste århundradet. Resultat från flera studier visar att DMFT kan vara beroende av socioekonomiska faktorer. Emellertid har de flesta studierna bara granskat några faktorer och på subnationell nivå medan studier på global nivå saknas.Syfte: Att undersöka om det finns ett samband mellan kariesminskning och socioekonomiska faktorer.Material och metod: Socioekonomiska faktorer har valts och data för varje variabel har erhållits med hjälp av World Bank. DMFT-värdena mellan 1960–2017 för olika stater och provinser har erhållits från Oral Health Country/area Profile Project (CAPP). Endast perioder då kariesminskning har inträffat inkluderades. DMFT har fastställts som en beroende variabel och socioekonomiska faktorer som oberoende variabler där linjär regression användes för att analysera insamlad data. P-värdet sattes till 0,05. Tidigare studier och forskning inom ämnet användes för att formulera hypoteser.Resultat: Totalt 6 st variabler visades ha samband med DMFT under perioder av kariesminskning och följande värden för signifikansen erhölls för dessa variabler: Fattigdom (p=0,027), Gini (6x 10-6), andel av jordbruk i Bruttonationalproduken (BNP) (p=0,017), andel av industri i BNP (p=7x10-7), förväntad livslängd (p=1,35x10-4), sockerkonsumtion (p=0,012). Bland de variabler som inte har visats samband med DMFT under perioder av kariesminskning erhölls följande värden av DMFT: BNP per capita (p=0,440), BNP per capita tillväxt per år (p=0,419), arbetslöshet (p=0,699), läskunnighet (p=0,304).Slutsats: De oberoende variablerna fattigdom, Gini, andel av industrin i BNP, andel av jordbruk i BNP och sockerkonsumtion hade en korrelation med DMFT, där större värde på dessa parametrar innebar ett högre DMFT under perioder då det skedde kariesminskning. Livslängden hade ett omvänt samband dvs ju större värde på livslängden, desto mindre DMFT under motsvarande perioder. BNP per capita, årlig BNP-tillväxt per capita, arbetslöshet och läskunnighet hade ingen korrelation med DMFT-värdena under de perioder det skedde kariesminskning. / AbstractBackground: The index Decayed, Missing, Filled, Tooth (DMFT) has declined in many parts of the world in the last century. Results from several studies indicate that DMFT can be dependent of socioeconomic factors. However, most of the studies have only examined a few factors and on a subnational level while studies on a global scale are lacking.Aim: The aim of this study was to investigate whether there is a correlation between caries decline and socio-economic factors. Material and method: Socioeconomic factors have been chosen and the data for each variable have been obtained using World Bank. DMFT- value between 1960-2017 for various states and provinces has been obtained using Oral Health Country/area Profile Project (CAPP). Only periods of time when decline of caries has occurred were included. Linear regression was used to analyze data. DMFT has been set as a dependent variable and socioeconomic factors as independent variables. P-value was set to 0.05. Previous studies and research in the subject were used to formulate hypotheses.Results: A total of six variables proved to have a correlation with DMFT during periods of caries decline, and the following statistical significance values were obtained for these variables: Poverty rate (p=0.027), Gini (6x 10-6), share of agriculture in Gross Domestic Product (GDP) (p=0.017), share of industry in GDP (p=7x10-7), life expectancy (p=1.35x10-4), sugar consumption (p=0.012). Among variables proved not to have a correlation with DMFT during periods of caries decline, the following significance values were obtained: GDP per capita (p=0.440), annual growth of GDP per capita (p=0.419), unemployment rate (p=0.699), literacy rate (p=0.304).Conclusion: The independent variables poverty rate, Gini, share of industry in GDP, share of agriculture in GDP and sugar consumption had a positive correlation with DMFT. That means the higher value of these variables, the higher DMFT, during the timespans of caries decline. Life expectancy had a conversely correlation during corresponding periods. GDP per capita, annual growth of GDP per capita, unemployment rate and literacy rate had no correlation with the DMFT-value, during periods of caries decline.
136

Using birth cohort data to assess the impact of the UK 2008-2010 economic recession on smoking during pregnancy

Uphoff, E.P., Small, Neil A., Pickett, K.E. 07 May 2018 (has links)
Yes / Introduction Despite the well-known link between stress and smoking, evidence for associations between economic recession, financial stress and smoking is contradictory. In this study we assess whether women were more likely to continue smoking during pregnancy if they were exposed to the UK 2008-2010 economic recession during pregnancy than those who were unexposed, and whether this relationship is mediated by financial stress. Methods We used cross-sectional data on 2775 pregnant women who were regular smokers before pregnancy and who were enrolled in the UK Born in Bradford cohort study between March 2007 and December 2010. The cut-off date for exposure to recession was set at August 1, 2008, based on local and national economic data. Multivariable logistic regression analysis included potential confounders: maternal age, parity, cohabitation, ethnicity and maternal age. The mediating role of financial stress was analysed using ‘worse off financially’ and a ‘difficult financial situation’ as indicators of financial stress in Sobel-Goodman mediation tests with bootstrap resampling. Results After taking into account potential confounders, exposure to recession was associated with continued smoking during pregnancy (OR 1.19, 95% CI 1.01; 1.41, p=0.03). A worse financial situation and difficult financial situation were identified as mediators, explaining 8.4% and 17.6%, respectively, of the relationship between exposure to recession and smoking during pregnancy. Conclusions Smoking during pregnancy is associated with exposure to the UK 2008-2010 economic recession during pregnancy, and this relationship is partly mediated by financial stress. / supported by the Born in Bradford study funding. The BiB study presents independent research commissioned by the National Institute for Health Research Collaboration for Applied Health Research and Care (NIHR CLAHRC) and the NIHR Programme Grants for Applied Research funding scheme [grant number RP-PG-0407-10044]. Core support for BiB is also provided by the Wellcome Trust [grant number WT101597MA]. All authors receive funding from the Big Lottery Fund as part of the “A Better Start” programme.
137

Fatores associados à cárie dentária e impacto das condições de saúde bucal nas atividades da vida diária em adolescentes de 15 a 19 anos de idade, Estado de São Paulo, 2015 / Factors associated with dental caries and dental impact on daily living in adolescents aged 15 to 19 years old, State of São Paulo, 2015

Corrêa, Lívia Litsue Gushi 28 June 2019 (has links)
dentária e ao impacto das condições de saúde bucal nas atividades de vida diária, podem instruir o planejamento de serviços odontológicos voltados aos adolescentes, além de ampliar as medidas de prevenção existentes. Objetivos: No primeiro artigo , o objetivo foi verificar a associação entre prevalência e severidade da cárie dentária e variáveis demográficas, socioeconômicas, comportamental e de condições de saúde bucal. No segundo artigo, foi verificada a a associação entre a percepção da saúde bucal e variáveis sociodemográficas e parâmetros bucais em adolescentes entre 15 a 19 anos de idade no Estado de São Paulo. Métodos: Foi realizado estudo transversal com dados da \"Pesquisa Estadual de Saúde Bucal de São Paulo - SB\", realizada em 2015. No estudo da cárie dentária, foram analisados os dados de 5558 adolescentes entre 15 a 19 anos de idade, para o estudo do impacto participaram 5409 adolescentes. Como desfecho do primeiro estudo, a cárie dentária foi avaliada pela prevalência e severidade medidas pelo índice CPOD. As variáveis independentes foram: idade, sexo, cor da pele, aglomeração domiciliar, renda mensal, atraso escolar, número de bens no domicílio, presença de sangramento gengival, presença de cálculo dentário e acesso à água fluoretada. A associação entre as variáveis e cárie dentária foi verificada através do modelo de regressão binomial negativa inflado de zeros. No segundo estudo, a percepção de saúde bucal foi avaliada pelo índice de impacto das condições de saúde bucal nas atividades de vida diária (OIDP), em termos de prevalência (presença ou ausência de impacto) e severidade do impacto (escores do OIDP). Como fatores da análise, foram consideradas condições demográficas (idade, sexo, cor da pele), socioeconômicas (renda familiar, aglomeração domiciliar, número de bens no domicílio), comportamentais (atraso escolar) e de condições de saúde bucal (cárie não tratada, sangramento gengival, cálculo dentário). Para o estudo de associação entre o OIDP e as variáveis de interesse utilizou-se o modelo de regressão binomial negativa inflado de zeros, considerando a amostragem complexa e os pesos amostrais. Foram calculadas as razões de prevalências (RP), identificando as variáveis associadas à manifestação do agravo, e as razões de médias (RM), indicando os fatores associados com o número de dentes afetados por cárie ou com o número de impactos das condições de saúde bucal nas atividades de vida diária e seus respetivos intervalos de confiança (IC). Resultados: Os resultados encontrados mostraram índice CPOD = 3,76, enquanto que a prevalência da cárie dentária foi de 71,7% . Verificou-se que sexo feminino (RP=1,09 e IC95%=1,04-1,15), atraso escolar (RP=1,11 e IC95%=1,03-1,18), apresentar cálculo dentário (RP=1,10 e IC95%=1,01-1,20) e não ter acesso à água fluoretada (RP=1,21 e IC95%=1,01-1,45) foram fatores associados com maior prevalência da cárie dentária, possuir 9 ou mais bens no domicílio foi associado com menor prevalência da doença (RP=0,94 e IC95%=0,88-0,99) Verificou-se também que apresentar sangramento gengival (RM=1,15 e IC95%=1,02-1,30) e não ter acesso à água fluoretada (RM=1,81 e IC95%=1,56-2,09) foram fatores associados com maior severidade da doença, a renda entre maior que R$1500,00 foi associada com menor severidade da cárie dentária. A prevalência de impacto nas atividades de vida diária foi de 37,4%. Após o ajuste do modelo, pode-se observar que o gênero feminino permaneceu com maior prevalência (RP=1,58 e IC95%=1,35-1,86) e severidade do impacto (RM= 1,45 e IC95%=1,22 - 1,73). Nas características socioeconômicas, a renda familiar maior que R$2501,00 foi associada com menor severidade do impacto (RM=0,81 e IC95%=0,67-0,98). Nas condições de saúde bucal, verificou-se que a cárie não tratada permaneceu associada com maior prevalência do impacto (RP=1,55 e IC95%=1,31-1,84), enquanto sangramento gengival e cálculo dentário não foram associados ao impacto . Conclusão: Portanto, os fatores estudados: gênero, idade, renda familiar, número de bens, atraso escolar, sangramento gengival, cálculo dentário e acesso à água fluoretada foram associados à cárie dentária, enquanto que ser do gênero feminino e possuir cárie não tratada foram associados ao maior impacto enquanto que possuir renda familiar maior que R$ 2.500,00 foi associada ao menor impacto nas atividades de vida diária em adolescentes do Estado de São Paulo. / Introduction: The knowledge of the epidemiological reality and the factors associated with dental caries and dental impact in the activities of daily living can instruct the planning of dental services for adolescents, in addition to expanding existing prevention measures. Objectives: In the first study, the objective was to verify the association between demographic, socioeconomic, behavioral and oral health conditions and prevalence and severity of dental caries in adolescents between 15 and 19 years in the São Paulo State. In the second study, the objective was to verify the association between oral health perception in adolescents between 15 and 19 years in the São Paulo State and demographic, socioeconomic, behavioral and oral health conditions. Methods: A cross-sectional study was conducted with data from the \"Oral Health Survey on São Paulo State\", conducted in 2015. In the study of dental caries, 5558 adolescents between 15 and 19 years were analyzed. In the study of oral health impact, 5409 adolescents participated. In the first study, dental caries was evaluated by the prevalence and severity measured by the DMFT index. The independent variables were: age, gender, skin color, household agglomeration, family income, school delay, number of household goods, gingival bleeding at probing, dental calculus and access to fluoridated water. The association between variables and dental caries was assessed using zero-inflated negative binomial regression. In the second study, the perception of oral health was evaluated by the Oral Impacts on Daily Performances (OIDP), in terms of prevalence (presence or absence of impact) and severity of the impact (OIDP scores). We assessed covariates on demographic factors (age, gender, and skin color), socioeconomic conditions (family income, household agglomeration, number of household goods), behavior (school delay) and oral health status (untreated caries, gingival bleeding, and dental calculus). For the study of association between the OIDP and interest variables, we used zero-inflated negative binomial regression analysis, considering the complex sampling and the sample weights. The prevalence ratio (PR) were calculated, identifying the variables associated with the manifestation of the disease, and the rate ratio (RR), indicating the factors associated with the number of teeth affected by caries or the number of impacts of health conditions in daily life activities and their respective confidence intervals (CI). Results: The results showed a DMFT index of 3.76, while the dental caries prevalence was 71.7%. Female gender (PR = 1.09 and 95% CI = 1.04-1.15), school delay (PR = 1.11 and 95% CI = 1.03-1.18), had a dental calculus (PR = 1.10 and 95% CI = 1.01-1.20) and no access to fluoridated water (PR = 1.21 and 95% CI = 1.01-1.45) were factors associated with higher caries prevalence. Having 9 or more goods at home was associated with a lower disease prevalence (PR = 0.94 and 95% CI = 0.88-0.99). Gingival bleeding (RR = 1.15 and (95% CI = 1.02-1.30) and not having access to fluoridated water (RR = 1.81 and 95% CI = 1.56-2.09) were factors associated with greater severity, and family income greater than R$ 1500.00 was associated with lower dental caries severity. The prevalence of dental impact in daily life activities was 37.4%. After adjustment, observed that the female gender remained with a higher prevalence (PR = 1.58 and 95% CI = 1.35-1.86) and severity oral health impact (RR = 1.45 and 95%CI = 1.22-1.73). In socioeconomic characteristics, family income greater than R $ 2501.00 was associated with a lower impact severity (RR = 0.81 and 95% CI = 0.67-0.98). In oral health conditions, untreated caries was associated with a higher impact prevalence (PR = 1.55 and 95% CI = 1.31-1.84), while gingival bleeding and dental calculus were not associated with oral health impact. Conclusion: Therefore, the factors studied: gender, age, family income, number of assets, school delay, gingival bleeding, dental calculus and access to fluoridated water were associated with dental caries, while female gender, family income lower than R$ 2,500.00, and having untreated caries were factors associated with oral health impact in adolescents of Sao Paulo State.
138

Impacto do encarceramento na incidência da tuberculose / Not available

Pelissari, Daniele Maria 03 June 2019 (has links)
Objetivo: A presente tese é apresentada no formato de três artigos que se articulam através do objetivo geral que foi estudar a associação entre o encarceramento e o risco de tuberculose ativa (TB) no Brasil. Os objetivos específicos dos artigos foram: (artigo-1) identificar um conjunto de macrodeterminantes socioeconômicos associados à incidência da TB, dentre eles, a proporção da população privada de liberdade (PPL) na população do município; (artigo-2) quantificar a importância relativa da exposição às prisões na incidência de TB e avaliar sua interação com a desigualdade da distribuição de renda; (artigo-3) estimar o efeito dos fatores ambientais dos presídios no tempo até o diagnóstico de TB. Métodos: Foram realizados dois estudos ecológicos (artigos-1 e 2) e um estudo de coorte retrospectiva (artigo-3). No artigo-1, relacionamos as taxas de incidência de TB (2010) dos 5565 municípios aos indicadores socioeconômicos e de saúde e à proporção de PPL. No artigo-2, as taxas de incidência de TB das populações prisional e não prisional dos 954 municípios com pelo menos uma unidade prisional (2014), foram relacionadas às variáveis contextuais dos municípios. Avaliamos também a interação da desigualdade da distribuição de renda nesta associação; e estimamos a fração atribuível à população (FAP). No artigo-3, analisamos os casos de TB na PPL do estado de São Paulo (2014 e 2015) segundo o tempo entre o encarceramento e o diagnóstico de TB. O efeito total das condições ambientais foi analisado por modelos de riscos de Cox. Todas as análises foram orientadas por diagramas causais para a seleção de variáveis de ajuste. Resultados: No artigo-1, após o ajuste por fatores individuais e região geográfica, esteve associada positivamente à incidência da TB, a proporção de PPL (razão de taxas de incidência [RTI]: 1,11; intervalo com 95% de confiança [IC95%]: 1,09-1,14), e fatores socioeconômicos e de saúde. No artigo-2, comparada com a população não prisional, a PPL apresentou (RTI) 22,07 vezes (IC95%: 20,38-23,89) o risco de TB em municípios com coeficiente de Gini <0,60; e 14,96 vezes (IC95%: 11,00-18,92) este risco onde o Gini foi >=0,60. A FAP foi gradativamente menor em municípios com maior desigualdade da distribuição de renda. No artigo-3, estimou-se que a cada aumento de 50% na taxa de ocupação carcerária, houve um aumento na velocidade de ocorrência da TB de 16% (IC95%: 8%-25%) nos modelos até dois anos. Um aumento de uma unidade do logaritmo da área da cela por pessoa resultou em uma redução na velocidade até o diagnóstico de TB de 13% (IC95%: 2%-23%) nos modelos até dois anos. Conclusão: Evidenciou-se a importância da PPL na ocorrência da TB nos municípios brasileiros; o potencial impacto que teriam intervenções para reduzir a exposição aos presídios, o qual varia segundo as condições socioeconômicas; e o efeito das condições ambientais dos presídios na velocidade do tempo até o diagnóstico de TB. Intervenções nas prisões como a redução drástica das condições de superlotação e o aumento do espaço físico, teriam elevado impacto na incidência de TB na população gerla, principalmente em municípios com menor coeficiente de Gini. / Objective: This thesis is presented in the form of three articles that are articulated through the general objective of studying the association between incarceration and the risk of active tuberculosis (TB) in Brazil. The specific objectives of the articles were: (article-1) to identify a set of socioeconomic macrodeterminants associated with the TB incidence, among them, the proportion of the prison population in the population of the municipality; (article-2) to quantify the relative importance of exposure to prisons in TB incidence and to assess their interaction with population income distribution inequality; (article-3) to estimate the effect of the environmental factors of prisons in time until the diagnosis of TB. Methods: Two ecological studies (articles-1 and 2) and one retrospective cohort study (article-3) were performed. In article-1, we related the TB incidence rates (2010) of the 5565 municipalities to socioeconomic and health indicators and to the proportion of prison population. In article-2, the TB incidence rates of the prison and non-prison populations of the 954 municipalities with at least one prison (2014) were related to the contextual variables of the municipalities. We also evaluated the interaction of the income distribution inequality in this association; and we estimated the fraction of tuberculosis in the population attributable to the exposure to prisons (PAF). In article-3, we analyzed the TB cases in the prison population of the São Paulo state (2014 and 2015) according to the time between incarceration and the diagnosis of TB. The total effect of the environmental conditions was analyzed by Cox risk models. All the analyzes were oriented by causal diagrams for the selection of adjustment variables. Results: In article-1, after adjustment for individual factors and geographic region, it was positively associated with the TB incidence, the proportion of prison population (incidence rate ratio [IRR]: 1.11, 95% confidence interval [ 95%CI: 1.09-1.14), and socioeconomic and health factors. In article-2, compared to the non-prison population, the prison population presented 22.07 times (95%CI: 20,38-23,89) the risk of TB in municipalities with a Gini coefficient <0.60; and 14.96 times (95%CI: 11.00-18.92) this risk where the Gini was >=0.60. The PAF was gradually lower in municipalities with greater income distribution inequality. In article-3, it was estimated that with each increase of 50% in the prison occupation rate, there was an increase in the speed of TB occurrence of 16% (95%CI: 8% -25%) in the models up to two years. An increase of one unit in the logarithm of the cell area per person resulted in a reduction in the speed to TB diagnosis of 13% (95%CI: 2% -23%) in the models up to two years. Conclusion: It was evidenced the importance of prison population in the occurrence of TB in Brazilian municipalities; the potential impact of interventions to reduce exposure to prisons, which varies according to socioeconomic conditions; and the effect of prisons\' environmental conditions on the speed of time to TB diagnosis. Interventions in prisons such as the drastic reduction of overcrowding conditions and the increase in physical space, would have a high impact on the TB incidence in general population, especially in municipalities with lower Gini coefficients.
139

Estudo de correlação das internações hospitalares por câncer, poluição relacionada ao tráfego e nível sócio-econômico no município de São Paulo / Correlation study of hospital admissions for cancer, air pollution related to traffic and socioeconomic status in the city Sao Paulo

Ribeiro, André de Almeida 02 September 2011 (has links)
Introdução - A exposição à poluição do ar é responsável por diversos efeitos à saúde e se distribui de forma diferenciada na população conforme o nível sócio-econômico. Objetivos - Explorar relações entre internações hospitalares por tipos de câncer e indicadores ambientais e sócioeconômico, na escala de áreas de pequeno tamanho, no município de São Paulo. Métodos - Revisaram-se estudos ecológicos sobre desigualdades sócio-econômicas em câncer e estudos sobre os efeitos da poluição ambiental do ar relacionada ao tráfego sobre o risco de câncer, publicados entre 1998 e 2008. Empreendeu-se a seguir estudo ecológico, com uso de unidade delimitada por grid (500 por 500 metros) e setor censitário, englobando todos os indivíduos internados em hospitais públicos ou privados com diagnóstico principal de neoplasia primária invasiva, no período de 2004 a 2006. As internações foram georreferenciadas e alocadas às unidades de estudo, sendo cada caso contado apenas uma vez. A densidade de tráfego foi calculada para cada unidade da grid a partir de dados de contagem veicular. Utilizaram-se modelos de regressão logística para explorar as associações entre densidade de tráfego, Índice de Desenvolvimento Humano e taxas de internação hospitalar. Resultados - O estudo de revisão mostrou que o nível sócio-econômico se associou de modo distinto de acordo com o tipo de neoplasia maligna. A maioria dos estudos observaram associação positiva da poluição ambiental do ar com câncer, com achados mais consistentes para exposição a material particulado inalável e câncer de pulmão. Do estudo ecológico verificou-se risco aumentado de internação por neoplasias respiratórias em adultos e hematológicas em crianças e adolescentes associado a morar em áreas com maior densidade de tráfego por veículos totais, movidos a gasolina e a diesel, com claro gradiente dose-resposta. O nível sócio-econômico da área 6 de moradia esteve associado positivamente e em gradiente com as medidas de densidade de tráfego e com os cânceres de mama e de próstata. Conclusões - Investigações se fazem necessárias em megacidades de países em desenvolvimento sobre os riscos à saúde relacionados à poluição ambiental do ar devida ao tráfego e sobre o modo como se desenvolveu a rede viária e o tráfego de veículos em sua relação com os locais ocupados historicamente pelas diferentes classes sociais. Estudos que contornem as limitações aqui encontradas poderão fornecer estimativas mais precisas e acuradas / Introduction - Exposure to air pollution is responsible for various health effects and is distributed differently in the population according to socioeconomic status. Objectives - To explore relationships between hospital admissions for cancers and socio-economic and environmental indicators, on a small-area scale, in São Paulo city. Methods - First we reviewed ecological studies on socioeconomic inequalities in cancer and studies on the effects of traffic-related air pollution on the risk of cancer, published between 1998 and 2008. Then an ecological study was undertaken, using a unit defined by grid (500 by 500 meters) and census tract, and embraced all individuals admitted to public or private hospitals with a main diagnosis of primary invasive cancer during the period 2004 to 2006. Hospitalizations were georeferenced and allocated to units of study, each case counted only once. The traffic density was calculated for each grid unit from vehicle count data. We used logistic regression models to explore the associations between traffic density, Human Development Index and rates of hospitalization. Results - The review showed that the socioeconomic status was associated differently according to the type of malignancy. Most studies found a positive association of environmental air pollution with cancer, the most consistent findings for exposure to inhalable particulate matter and lung cancer. The ecological study found an increased risk of hospitalization for respiratory cancers in adults and for hematologic cancers in children and adolescents associated with living in areas with higher total, gasoline and diesel traffic density, with a clear dose-response gradient. The socioeconomic status of the living area was positively associated in gradient with measures of traffic density and with breast and prostate cancers. 8 Conclusions - Investigations are necessary in megacities of developing countries about the health risks of traffic-related environmental air pollution and about how the development of the road network and vehicle traffic relates to sites historically occupied by different social classes. Studies that circumvent the limitations found here may provide more precise and accurate estimates
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Manifestações orais, classificação socioeconômica e qualidade de vida de crianças e adolescentes com doença do refluxo gastroesofágico / Oral manifestations, socioeconomic classification and quality of life in children and adolescents with gastroesophageal reflux disease

Guimarães, Késsia Suênia Fidelis de Mesquita 26 June 2015 (has links)
A Doença do Refluxo Gastroesofágico (DRGE), comumente observada em crianças e adolescentes, é uma das causas intrínsecas mais frequentes do desgaste erosivo. O objetivo dessa pesquisa foi realizar um estudo exploratório e analítico em crianças e adolescentes com idade entre 10 e 15 anos com DRGE e identificar possíveis diferenças entre grupos Casos e Controles quanto à presença de halitose, fluxo salivar, pH, capacidade tampão da saliva, lesões de desgaste erosivo e cárie dentária, classificação socioeconômica e qualidade de vida. Trinta voluntários participaram da pesquisa, sendo 15 do grupo Caso e 15 do grupo Controle. Informações sexo e idade foram coletadas durante a anamnese. A presença de halitose foi verificada por meio de avaliação organoléptica. A avaliação salivar foi realizada pelo fluxo salivar estimulado e o pH e a capacidade tampão (técnica de Ericsson), medidos com um pHmetro digital. Para a classificação econômica, utilizou-se o Critério de Classificação Econômica Brasil 2014 (CCEB/2014). Os voluntários responderam um questionário sobre qualidade de vida, validado no brasil (Child-OIDP) para faixa etária de 11-14 anos de idade. Além disso, foi realizado exame clínico para detecção de desgaste erosivo e cárie dentária de acordo com os índices BEWE e ICDAS, respectivamente. Os dados foram analisados pelo software STATA 9. As variáveis categorizadas sexo, idade, halitose e classificação socioeconômica e as variáveis numéricas fluxo salivar, capacidade tampão e pH não apresentaram diferença estatística entre os grupos (p > 0,05). O grupo Caso apresentou diferença significativa comparado ao grupo Controle para as variáveis BEWE e ICDAS. Apenas o desgaste erosivo e a presença de lesões de cárie foram associados a DRGE. O BEWE e o ICDAS podem ser considerados métodos auxiliares para o diagnóstico de pacientes com refluxo patológico. A relação interdisciplinar entre os profissionais de saúde, em especial, cirurgiões dentistas e médicos gastroenterologistas, é essencial para melhor conduta médica-odontológica de pacientes com Doença do Refluxo Gastroesofágico. / Gastroesophageal Reflux Disease (GERD), commonly observed in children and adolescents is one of the most common intrinsic causes of the erosive wear. The aim of this research was to conduct an exploratory and analytical study in children and adolescents aged between 10 and 15 years with GERD and to identify possible differences between Cases and Controls groups for the presence of halitosis, salivary flow, pH, saliva buffering capacity, erosive wear and dental caries, socioeconomic classification and quality of life. Thirty volunteers participated in this study, but fifteen were in the Case group and fifteen were in the Control group. Information about age and sex were collected during the anamnesis. The presence of halitosis was verified by organoleptic evaluation. The salivary tests were performed by saliva stimulated salivary flow; pH and buffering capacity (by Ericsson technique) were measured with a digital pH meter. Economic classification was evaluated by Economic Classification Criteria Brazil 2014 (CCEB/2014). The volunteers answered a questionnaire about quality of life, validated in Brazil (Child-OIDP) for the age group of 11-14 years. Furthermore, the clinical examination was conducted to erosive wear and caries detection in accordance with BEWE and ICDAS index, respectively. The data were analysed by Stata 9.0 software. Categorical variables sex, age, halitosis and socioeconomic classification and numeric variables salivary flow, buffer capacity and pH had not statistical difference between groups (p > 0.05). The Case group had significant difference compared to the Control group using BEWE and ICDAS variables. Only erosive tooth wear and carious lesions were associated with GERD. The BEWE and ICDAS can complement the methods for the diagnosis of patients with pathological reflux. The interdisciplinary relationship between dentists and gastroenterologists is essential for better medical and dental management of patients with Gastroesophageal Reflux Disease.

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