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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.
101

Prevalence of Tobacco Use among African-American College Students

Celestin, Michael 19 December 2003 (has links)
This study examined factors that may protect African-American young adults in college from early onset of cigarette smoking, and factors that may place them at risk for cigarette smoking, using the framework of the Social Cognitive Theory. It was hypothesized that existing regulation of smoking, positive attitude toward academics and school connectedness would be related to low cigarette-smoking rates, while exposure to pro-tobacco promotions would be related to high cigarette smoking rates. A convenience sample of 576 undergraduates at Dillard University of New Orleans completed a Harvard College Alcohol Study survey. Forty six percent (n=269) completed the survey. Ninetyone percent were African American, and 13% of them were ever-smokers. Chi Square analysis was used to test for a statistically significant difference in response rates between eversmokers and non-smokers. Results indicated no significant differences between respondents for any outcome measures. The Social Cognitive Theory constructs were not supported by the findings.The results of this study do not support any of the hypotheses. The Social Cognitive Theory constructs used to examine the hypotheses are not supported by the findings. Future studies should address the limitations of this research by using a random sampling technique, sampling across all academic classification levels, and assessing the validity and reliability of the Harvard College Alcohol Study survey measures for cigarette smoking.
102

Social capital and waterpipe smoking in a South African university.

Desai, Rachana 17 July 2014 (has links)
Waterpipe smoking (WPS) is a global epidemic. The prevalence of WPS threatens to surpass cigarette smoking in certain parts of the world. Although current WPS interventions have had some effect in creating awareness of the dangers of WPS, these interventions alone have not succeeded in reducing WPS among university students, despite them knowing the harmful effects of WPS. Since WPS is seen to be a social event, a more holistic perspective of reducing WPS through linking health psychology with social factors encountered such as emphasizing the influences of the collective group and social connections on individual smoking behavior. Thus, social capital is a useful concept, which focuses our attention on an important set of resources inherent in relationships, networks, associations and their norms; all of which have been given insufficient priority in the health literature. The aim of this research was to examine what cognitive and structural bonding social capital factors contributed towards the understanding of WPS behaviors. Thus, this study explored three questions: How has exposure to previous WPS campaigns and/ or interventions influenced participants behavior towards WPS? What was the association between structural factors of WPS and bonding social capital among university students in relation to WPS? What was the association between cognitive factors of WPS and bonding social capital among university students in relation to WPS? A qualitative evaluation using three focus group interviews were used to answer the questions. The study design followed an abductive approach. The data was analyzed using thematic content analysis. Results from the study suggested that even though there have been numerous health interventions to reduce WPS, such as education in schools, posters at the university and TV documentaries, people continue to smoke the waterpipe, despite knowledge of the dangers of WPS smoking. Instead, participants attributed their frequent smoking behavior to groups collectively influencing each other to smoke. Factors of hygiene, homogenous group composition (in terms of race, age and/ or education) and the type of organizational setting (familiar vs. unfamiliar), played a role in the way social relations and interactions influence permeability and mobility of WPS groups, reinforcing structural bonding social capital. Factors of cognitive bonding social capital were also highlighted, where prior contact and gender played a role in setting out conditions of exclusion. Cognitive bonding social capital, along with the structural aspects, is a useful way to understand how these connections may be linked to population health, especially in WPS. Thus, health promoters need to invest more energy into developing programs and policies that take into consideration the social dimensions within the broader context of the university, which social capital may have to offer, contributing to a more critical approach to health psychology when designing interventions and cessation programs.
103

Medical students' perceptions and attitudes to the role of doctors in tobacco control programmes

Madiebo, Kenneth Chukwuka 04 November 2008 (has links)
Introduction: The deleterious health effects of tobacco use and smoking in particular have been well documented. Anti-smoking campaigns have been in existence for decades. Doctors, generally perceived as role models by members of their societies, can play a significant role in anti-tobacco programmes. Objectives: The objectives were: to determine the prevalence of tobacco use among medical students, their knowledge of the health effects of tobacco use, their beliefs and perceptions about anti-tobacco legislation/restrictions and the role of doctors as advocates in tobacco-cessation programmes. Methodology: A cross-sectional census was carried out using the 3rd and 5th year students at the medical school of the University of the Witwatersrand (n = 357). Results: The total prevalence of smoking was 15.4% (n = 53), with 9.6% (n = 34) smoking occasionally and 6.2% (n = 22) smoking daily. Among the smokers, more of the 3rd year students smoked daily compared to the 5th years (64% vs 19.3%, p = 0.001). Overall, there were no major differences between the sexes with respect to prevalence of smoking (P= 0.312 Fischer exact test) across both classes. Within the male population (Africans, whites and Asians) overall differences ( 2- אל 11.1, p= 0.006) existed in their smoking patterns. Both the whites and the Asians smoked more than their African counterparts (5.8%, n = 3). There were however no differences in the smoking prevalence rates between the whites and the Asians ((20.9% vs 31.6%: p= 0.314). The females differed (P = 0.042 Fischer exact test) in their smoking behaviour across the races: Coloured (33.3%, n = 2), white (16.5%, n = 18), Asian (13.3%, n =9) and Africans (4.0%, n = 2). The prevalence of noncigarette tobacco use was 14%, with the majority smoking hookahs (7.1%, n=26). More of the 5th year students than their 3rd year students counterparts (23.5% vs 7.1%) had very good knowledge of tobacco cessation techniques and overall differences were observed ( 2אל -35.5, P <0.001). About 90% (n = 316) of the students knew about the dangers of smoking, but 12% (n = 41) did not associate smoking with heart disease. About 45% (n= 179) of the respondents believed that ban of smoking in public space had reduced prevalence rates and about 40% (n= 172) believed that taxation had reduced prevalence rates of tobacco use in South Africa. Almost 50% (n= 164) students believed that the ban of tobacco sales to minors had reduced prevalence rates and about 85% (n= 286) of the respondents agreed that pictorial health warnings should be placed on the packages of tobacco products. The students generally believed that doctors are seen as role models (84%, n= 286) by society and should not smoke (86.3%, n= 299). Even though 81% (n= 279) of the students were willing to speak to the community about the dangers of tobacco, only about 30% (n= 101) were willing to be members in an anti-tobacco organisation. Discussion and conclusion: The prevalence of smoking among the respondents was lower than national prevalence rates among adults but similar to that of South African young adults. The students had a low knowledge of tobacco cessation techniques. Less than half of the respondents believed that the current anti-tobacco legislation was effective and the majority supported the inclusion of pictorial warnings on the packages of tobacco products. The majority of the participants agreed that doctors were perceived as role models by members of their communities and should not smoke. There was a general willingness on the part of the respondents to advice their patients to quit smoking but majority of the participants however would not want to get involved in anti-tobacco organisations in the future.
104

Preditores da cessação de tabagismo em fumantes com periodontite: estudo de 24 meses / Predictors of smoking cessation in smokers with chronic periodontitis: a 24- month study

Inoue, Gislene 23 May 2017 (has links)
A proposta desse estudo de 24 meses foi identificar os preditores da cessação de tabagismo em um estudo de coorte em fumantes com periodontite crônica, atendidos em um programa antitabágico multidisciplinar. Dos 286 participantes triados, 116 foram incluídos no estudo e receberam tratamento periodontal não cirúrgico e terapia de cessação de tabagismo, que consistia em palestras, terapia cognitiva comportamental e farmacoterapia de acordo com as necessidades individuais. Durante o início do tratamento periodontal, os dentistas motivavam os participantes do estudo para parar de fumar, usando técnicas de entrevista motivacional. Além disso, aconselhamento e apoio a cessação do tabagismo também foram fornecidos pelos dentistas, durante as sessões de manutenção periodontal aos 3, 6, 12 e 24 meses de estudo. Tabagismo foi avaliado através de um questionário estruturado, e era validado pelas medidas de Monóxido de Carbono (CO) expirado. O teste de Fagerström para a Dependência do Cigarro foi utilizado para aferir a dependência. Dos 61 indivíduos que permaneceram até o final do estudo, 31, 21 e 18 declararam que não eram fumantes após 3, 12 e 24 meses, respectivamente. Foram utilizados teste de associação, teste de comparação de média e regressão logística univariada para identificar os preditores de cessação de tabagismo. Cessação de tabagismo após 24 meses esteve associada com gênero masculino (odds ratio [OR] = 3,77, intervalo de confiança [IC] 95% = 1,16-12,30), nível de CO no início do estudo < 10ppm (OR = 5,81, IC 95% 1,76 - 19,23), não conviver ou trabalhar com fumante (OR = 7,38, IC 95% 1,76 - 30,98) e uma média menor no teste de Fagerström (OR = 5,36, IC 95% 1,55 - 20,43). Pode ser concluído que cessação de tabagismo foi associada com variáveis demográficas, histórico de tabagismo e dependência do cigarro. / The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis attending a multidisciplinary smoking cessation program. Among the 286 screened subjects, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and it was validated by exhaled carbon monoxide (CO) measurements. Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Tests for association tests, tests for comparison of means and univariate logistic regression analysis were used to identify predictors of smoking cessation. Among the 61 individuals that remained up to the 24-months examination, 31, 21 and 18 declared that were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with male gender (odds ratio [OR] = 3.77, confidence interval [CI] 95% = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, CI 95% 1.76 - 19.23), not living or working with another smoker (OR = 7.38, CI 95% 1.76 - 30.98) and lower mean Fagerström test score (OR = 5.63, CI 95% 1.55 - 20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.
105

Fatores associados ao perímetro craniano ao nascer: comparação entre duas coortes de nascimento em Ribeirão Preto, SP, com intervalo de 30 anos / Factors associated with head circumference at birth: a comparison between two birth cohorts in Ribeirão Preto, SP, born 30 years apart

Cunha, Valeria Dias Sampaio da 30 May 2018 (has links)
Introdução: O perímetro cefálico (PC) é definido como o tamanho da cabeça da criança em sua maior área. O crescimento da caixa craniana está relacionado ao crescimento e volume cerebral e, por isso, deve ser rotineiramente medido e utilizado para seguimento individual, pois é um forte preditor do neurodesenvolvimento. Sabe-se que o PC é relacionado a condições ambientais e de saúde materna, e sua avaliação adquiriu grande importância após a recente epidemia de infecção pelo vírus Zika no Brasil e em outras partes do mundo, que se associou ao aumento da incidência de microcefalia. Objetivo: Avaliar a associação do perímetro cefálico de recém-nascidos com características sociodemográficas e hábitos maternos durante a gestação em duas coortes de nascimentos de Ribeirão Preto, SP, em 1978/79 e 2010. Método: foram analisados dados referentes a dois estudos de coortes de nascimento realizados em Ribeirão Preto, SP, um em 1978/79 e o outro em 2010. Foram incluídos recém-nascidos vivos de parto único hospitalar que tiveram a informação do PC ao nascer. Os dados foram coletados de forma semelhante nos dois momentos, utilizando questionário criado para o estudo e dados coletados nos prontuários. As variáveis utilizadas nas análises foram sexo do RN, restrição do crescimento intrauterino (RCIU), idade gestacional, idade e escolaridade maternas, tabagismo durante a gestação, situação conjugal, paridade, tipo de parto e tipo de hospital. Foram realizadas análises de regressão linear simples e múltipla para testar a associação da variável resposta \"perímetro cefálico\" com as variáveis independentes em cada ano, utilizando o pacote estatístico SAS 9.3. Resultados: Na coorte de 1978/79 participaram 2941 recém-nascidos e em 2010 participaram 7353. A média geral do PC em 1978/79 foi de 34,10 cm, um pouco menor do que a de 2010, de 34,29 cm. Nasceram mais meninos em 1978/79 e mais meninas em 2010. Excetuando a RCIU, as demais variáveis apresentaram mudanças na frequência nesse intervalo de tempo. A escolaridade materna aumentou, a proporção de mães adolescentes ficou estável, em torno de 12% e a de mães >=35 anos aumentou de 8,3% para 12,5%. Tabagismo materno na gestação se reduziu de 28,3% para 11,8% e a taxa de cesáreas mais que dobrou, de 27,5% para 58,6%. Todas as variáveis estudadas se associaram com o PC na análise não ajustada, exceto paridade em 1978/79. Nos dois momentos, as variáveis que foram mais fortes preditoras de maiores valores de PC foram sexo masculino e parto cesárea, e de menores valores de PC o tabagismo materno na gestação e RCIU. A RCIU foi o fator que mais impactou, sendo que essas crianças tiveram medida de PC reduzida em 1,30cm (IC95% -1,43; -1,18) em 1978/79 e em 1,74cm (IC95% - 1,87; -1,61) em 2010, quando comparadas com as nascidas sem restrição. Conclusão: Características maternas durante a gestação, apesar de terem melhorado com o passar dos anos, ainda precisam de atenção. Muitas mulheres ainda carecem de informações e de cuidados pré-natais. Esforços devem ser realizados para detecção precoce e intervenção visando a redução das taxas e dos efeitos da RCIU / Introduction: The head circumference (HC) is defined as the size of the child\'s head in its larger area. Cranial case growth is related to brain growth and volume and therefore should be routinely measured and used for individual follow-up as it is a strong predictor of neurodevelopment. It is known that HC is related to environmental and maternal health conditions, and its evaluation has acquired great importance after the recent epidemic of Zika virus infection in Brazil and in other parts of the world, which was associated with the increase in the incidence of microcephaly. Objective: To evaluate the association of the HC of newborns with sociodemographic characteristics and maternal habits during gestation period in two birth cohorts of Ribeirão Preto, State of São Paulo, Brazil, in 1978/79 and 2010. Method: Data were analyzed for two cohort studies of birth in Ribeirão Preto, SP, one in 1978/79 and the other in 2010. We included live births of single hospital delivery that had the information of the HC at birth. The data were collected in a similar way in both moments, using a questionnaire created for the study and data collected in the medical records. The variables used in the analysis were gender of the newborn, intrauterine growth restriction (IUGR), gestational age, maternal age and schooling, smoking during pregnancy, marital status, parity, type of delivery and type of hospital. Simple and multiple linear regression analyzes were performed to test the association of the response variable \"head circumference\" with the independent variables in each year, using the statistical package SAS 9.3. Results: In the 1978/79 cohort, 2941 newborns participated and 7353 participated in 2010. The general average of the HC in 1978/79 was 34.10 cm, slightly lower than that of 2010, 34.29 cm. More boys were born in 1978/79 and more girls in 2010. Except for IUGR, the other variables showed changes in the frequency in that time interval. Maternal education increased, the proportion of adolescent mothers remained stable at around 12% and that of mothers >=35 years increased from 8.3% to 12.5%. Maternal smoking in pregnancy decreased from 28.3% to 11.8% and the cesarean rate more than doubled, from 27.5% to 58.6%. All variables studied were associated with HC in the unadjusted analysis, except for parity in 1978/79. At the two moments, the variables that were the strongest predictors of higher HC values were male sex and cesarean delivery, and lower values of HC were maternal smoking in pregnancy and IUGR. The IUGR was the factor that most impacted, and these children had a HC reduced by 1.30 cm (95% CI -1.43; -1.18) in 1978/79 and 1.74 cm (CI 95% -1.87; -1.61) in 2010 when compared to those born without restriction. Conclusion: Maternal characteristics during gestation, although they have improved over the years, still need attention. Many women still lack information and prenatal care. Efforts should be made for early detection and intervention to reduce the rates and effects of IUGR.
106

Tabagismo: uma busca da subjetividade no uso da droga permitida / Beliefs/representations about tobacco addiction a study on the vulneral adolescents to tobacco use

Sborgia, Renata Carone 03 February 2006 (has links)
O tabagismo é considerado um sério problema de saúde pública, estudos têm mostrado o início do consumo de cigarros na adolescência; pesquisas mostram os fatores que predispõem ao consumo e/ ou dependência da nicotina; já existem Leis regulamentando a propaganda, locais públicos ... para o uso do tabaco. Há a necessidade de abordagens interdisciplinares, buscando conexões metodológicas entre diversas áreas para compreender o processo. Há necessidade de superar a racionalidade entre as disciplinas, prevalecer a síntese de um processo que não seja feudo de uma área. Significa recuperar o humanismo, lutando contra a falta de eficácia, eficiência nos Programas de Controle do Uso do Tabaco; falta de elementos subjetivos na discussão das áreas do conhecimento e, em específico, do Direito. Torna-se necessária discussão mais ampla, alertar a relação dos males à saúde advindos do tabaco. Os conhecimentos produzidos poderão ter grande importância prática em termos individuais, assim como para a Saúde Pública. O objetivo geral deste trabalho é estudar as crenças e valores associados ao início do uso do tabaco entre jovens, buscando elementos subjetivos para colaborar na elaboração, aplicação e interpretação das Leis. Especificamente, pretende-se definir critérios e identificar crenças e valores relacionados ao uso do tabaco para compreensão do ato de fumar. O trabalho foi efetuado em etapas. A princípio, a construção do instrumento de medida: levantamento das crenças salientes modais sobre as categorias, como hábito de fumar em si e uso do tabaco entre os jovens. Foram entrevistados 12 jovens (entrevista semi-estruturada), coletando dados demográficos e, a seguir usando os procedimentos de evocação/enunciação/averiguação. Os conteúdos levantados pelas entrevistas, foram analisados com base em alguns procedimentos de síntese, no sentido de isolar e classificar as crenças salientes modais, características para cada uma das categorias estudadas. Para avaliar o componente cognitivo da atitude, as Escalas foram constituídas por conteúdos probabilísticos subjetivos como: ?verdadeiro/falso?, ?sempre/nunca?... associados à Escala do tipo Likert. Quanto ao componente valorativo da atitude, foi utilizada, também, a Escala do tipo Likert, com conteúdos expressos como: ?bom/ruim?, ?certo/errado? ... Para análise, foram realizados estudos descritivos de distribuição dos resultados das Escalas sobre as forças das crenças e valores a elas associadas. Quanto às expectativas das atitudes, foi utilizado o referencial teórico de Fishbein e Ajzen, fundamentado na distinção entre crenças, atitudes, intenções e comportamentos. O Projeto foi aprovado pelo Comitê de Ética da FFCLRP-USP. / The use of tobacco is the most serious problem in Public Health. Studies show the early consumption in adolescence and the factors that predispose this consumption and/or nicotine dependece. Currently, there are Laws, which regulate advertisements and public locations on tobacco use. Interdisciplinary approaches seeking methodological links among these diverse areas in order to be able to understand the process is indispensable. The rationality among the disciplines needs to be overcome, and the synthesis of a process, which is not feudal to one area, must prevail. This encompasses the recovery of humanism, tackling against the inefficiency of the Tobacco Control Programs, the lack of subjective elements in the discussions of the fields of knowledge, and specifically of Law. An ample discussion is relevant to warn on the health problems occurring from tobacco. The awareness yielded is of great practical importance regarding individuals, as well as public health. The broad aim of this work is to study the beliefs and values associated to the early use of tobacco among the young adults, seeking subjective elements to collaborate with the elaboration, application, and interpretation of the Laws. The criteria and identification of beliefs and values related to the use of tobacco in order to understand the act of smoking will be distinctively defined. This study carried out in stages. In principle, the construction of a measuring instrument, the collection of outstanding belief trends on the categories, such as, the habit of smoking and the use of tobacco among the young adults. The interviewees were comprised of twelve young adults with open-ended questions collecting demographic data, in addition to utilizing recalling/expressing/stating and investigating methods. The contents collected from the interviews were analyzed grounded on synthesis procedures, isolating and classifying the outstanding belief trends, and the characteristics for each of the categories studied. To assess the cognitive behavior component, the Scales constituted subjective contents of probability, such as, ??true/false??, ??always/never??, etc. associated with the Likert Scale. As for the value component of behavior, the Likert Scale was also used with contents expressing ??good/bad?? ??right/wrong??, etc. For evaluation, descriptive studies of the result distribution of the Scales on beliefs and values associated to them were performed. Concerning the behavior expected, Fishbein and Ajzen?s theoretical references were utilized basing the distinction among beliefs, attitudes, intentions, and behavior. This project approved by the Ethics Board at FFCLRP-USP.
107

Recent Awareness and Use of the Great American Smokeout and Variation across Socioeconomic Status, Age and Gender

Unknown Date (has links)
The aim of this study was to investigate the current level of awareness and use of the Great American Smokeout (GASO) and the extent to which that may vary by lifetime smoking, socioeconomic status, age and gender. We hypothesized and found that the current levels of awareness and use were significantly less than the most recent reports available (over 13 years ago), and that awareness of the GASO was more likely in lifetime smokers, those with more education, and older age groups, but found no significant effect related to gender. The drop in awareness and use of the GASO was more than half and almost five times, respectively, compared to that of most recent previous reports. These findings highlight a critical need for more attention and resources to reinvigorate the GASO as a useful event for smokers. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection
108

An educational tobacco intervention: impact of the Health Belief Model on college students

Unknown Date (has links)
The purpose of this study was to determine whether an educational tobacco intervention impacted college students' perceptions relative to tobacco, self-efficacy, and perceived stress levels. The Health Belief Model (HBM) provided a theoretical framework to distinguish differences relative to tobacco between groups. Both the control (N=155) and intervention (N=184) group consisted of a convenience sample of students from a 2000-level health course. A pre- and post-test questionnaire was administered to both groups which included questions regarding demographics, tobacco use, HBM, self-efficacy, and perceived stress. Data analysis included frequency counts, confirmatory factor analysis, Cronbach's alpha, and two-way ANOVA. Two-way ANOVA results indicated statistically significant differences for the Health Belief Model questions (p=0.002) and self-efficacy items (p=0.03). No statistical significance was found regarding perceived stress. These findings provide evidence an educational tobacco intervention administered at the college level can have a significant impact on students. / by Kelley E. Rhoads. / Thesis (M.S.)--Florida Atlantic University, 2012. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2012. Mode of access: World Wide Web.
109

Fatores associados ao perímetro craniano ao nascer: comparação entre duas coortes de nascimento em Ribeirão Preto, SP, com intervalo de 30 anos / Factors associated with head circumference at birth: a comparison between two birth cohorts in Ribeirão Preto, SP, born 30 years apart

Valeria Dias Sampaio da Cunha 30 May 2018 (has links)
Introdução: O perímetro cefálico (PC) é definido como o tamanho da cabeça da criança em sua maior área. O crescimento da caixa craniana está relacionado ao crescimento e volume cerebral e, por isso, deve ser rotineiramente medido e utilizado para seguimento individual, pois é um forte preditor do neurodesenvolvimento. Sabe-se que o PC é relacionado a condições ambientais e de saúde materna, e sua avaliação adquiriu grande importância após a recente epidemia de infecção pelo vírus Zika no Brasil e em outras partes do mundo, que se associou ao aumento da incidência de microcefalia. Objetivo: Avaliar a associação do perímetro cefálico de recém-nascidos com características sociodemográficas e hábitos maternos durante a gestação em duas coortes de nascimentos de Ribeirão Preto, SP, em 1978/79 e 2010. Método: foram analisados dados referentes a dois estudos de coortes de nascimento realizados em Ribeirão Preto, SP, um em 1978/79 e o outro em 2010. Foram incluídos recém-nascidos vivos de parto único hospitalar que tiveram a informação do PC ao nascer. Os dados foram coletados de forma semelhante nos dois momentos, utilizando questionário criado para o estudo e dados coletados nos prontuários. As variáveis utilizadas nas análises foram sexo do RN, restrição do crescimento intrauterino (RCIU), idade gestacional, idade e escolaridade maternas, tabagismo durante a gestação, situação conjugal, paridade, tipo de parto e tipo de hospital. Foram realizadas análises de regressão linear simples e múltipla para testar a associação da variável resposta \"perímetro cefálico\" com as variáveis independentes em cada ano, utilizando o pacote estatístico SAS 9.3. Resultados: Na coorte de 1978/79 participaram 2941 recém-nascidos e em 2010 participaram 7353. A média geral do PC em 1978/79 foi de 34,10 cm, um pouco menor do que a de 2010, de 34,29 cm. Nasceram mais meninos em 1978/79 e mais meninas em 2010. Excetuando a RCIU, as demais variáveis apresentaram mudanças na frequência nesse intervalo de tempo. A escolaridade materna aumentou, a proporção de mães adolescentes ficou estável, em torno de 12% e a de mães >=35 anos aumentou de 8,3% para 12,5%. Tabagismo materno na gestação se reduziu de 28,3% para 11,8% e a taxa de cesáreas mais que dobrou, de 27,5% para 58,6%. Todas as variáveis estudadas se associaram com o PC na análise não ajustada, exceto paridade em 1978/79. Nos dois momentos, as variáveis que foram mais fortes preditoras de maiores valores de PC foram sexo masculino e parto cesárea, e de menores valores de PC o tabagismo materno na gestação e RCIU. A RCIU foi o fator que mais impactou, sendo que essas crianças tiveram medida de PC reduzida em 1,30cm (IC95% -1,43; -1,18) em 1978/79 e em 1,74cm (IC95% - 1,87; -1,61) em 2010, quando comparadas com as nascidas sem restrição. Conclusão: Características maternas durante a gestação, apesar de terem melhorado com o passar dos anos, ainda precisam de atenção. Muitas mulheres ainda carecem de informações e de cuidados pré-natais. Esforços devem ser realizados para detecção precoce e intervenção visando a redução das taxas e dos efeitos da RCIU / Introduction: The head circumference (HC) is defined as the size of the child\'s head in its larger area. Cranial case growth is related to brain growth and volume and therefore should be routinely measured and used for individual follow-up as it is a strong predictor of neurodevelopment. It is known that HC is related to environmental and maternal health conditions, and its evaluation has acquired great importance after the recent epidemic of Zika virus infection in Brazil and in other parts of the world, which was associated with the increase in the incidence of microcephaly. Objective: To evaluate the association of the HC of newborns with sociodemographic characteristics and maternal habits during gestation period in two birth cohorts of Ribeirão Preto, State of São Paulo, Brazil, in 1978/79 and 2010. Method: Data were analyzed for two cohort studies of birth in Ribeirão Preto, SP, one in 1978/79 and the other in 2010. We included live births of single hospital delivery that had the information of the HC at birth. The data were collected in a similar way in both moments, using a questionnaire created for the study and data collected in the medical records. The variables used in the analysis were gender of the newborn, intrauterine growth restriction (IUGR), gestational age, maternal age and schooling, smoking during pregnancy, marital status, parity, type of delivery and type of hospital. Simple and multiple linear regression analyzes were performed to test the association of the response variable \"head circumference\" with the independent variables in each year, using the statistical package SAS 9.3. Results: In the 1978/79 cohort, 2941 newborns participated and 7353 participated in 2010. The general average of the HC in 1978/79 was 34.10 cm, slightly lower than that of 2010, 34.29 cm. More boys were born in 1978/79 and more girls in 2010. Except for IUGR, the other variables showed changes in the frequency in that time interval. Maternal education increased, the proportion of adolescent mothers remained stable at around 12% and that of mothers >=35 years increased from 8.3% to 12.5%. Maternal smoking in pregnancy decreased from 28.3% to 11.8% and the cesarean rate more than doubled, from 27.5% to 58.6%. All variables studied were associated with HC in the unadjusted analysis, except for parity in 1978/79. At the two moments, the variables that were the strongest predictors of higher HC values were male sex and cesarean delivery, and lower values of HC were maternal smoking in pregnancy and IUGR. The IUGR was the factor that most impacted, and these children had a HC reduced by 1.30 cm (95% CI -1.43; -1.18) in 1978/79 and 1.74 cm (CI 95% -1.87; -1.61) in 2010 when compared to those born without restriction. Conclusion: Maternal characteristics during gestation, although they have improved over the years, still need attention. Many women still lack information and prenatal care. Efforts should be made for early detection and intervention to reduce the rates and effects of IUGR.
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Preditores da cessação de tabagismo em fumantes com periodontite: estudo de 24 meses / Predictors of smoking cessation in smokers with chronic periodontitis: a 24- month study

Gislene Inoue 23 May 2017 (has links)
A proposta desse estudo de 24 meses foi identificar os preditores da cessação de tabagismo em um estudo de coorte em fumantes com periodontite crônica, atendidos em um programa antitabágico multidisciplinar. Dos 286 participantes triados, 116 foram incluídos no estudo e receberam tratamento periodontal não cirúrgico e terapia de cessação de tabagismo, que consistia em palestras, terapia cognitiva comportamental e farmacoterapia de acordo com as necessidades individuais. Durante o início do tratamento periodontal, os dentistas motivavam os participantes do estudo para parar de fumar, usando técnicas de entrevista motivacional. Além disso, aconselhamento e apoio a cessação do tabagismo também foram fornecidos pelos dentistas, durante as sessões de manutenção periodontal aos 3, 6, 12 e 24 meses de estudo. Tabagismo foi avaliado através de um questionário estruturado, e era validado pelas medidas de Monóxido de Carbono (CO) expirado. O teste de Fagerström para a Dependência do Cigarro foi utilizado para aferir a dependência. Dos 61 indivíduos que permaneceram até o final do estudo, 31, 21 e 18 declararam que não eram fumantes após 3, 12 e 24 meses, respectivamente. Foram utilizados teste de associação, teste de comparação de média e regressão logística univariada para identificar os preditores de cessação de tabagismo. Cessação de tabagismo após 24 meses esteve associada com gênero masculino (odds ratio [OR] = 3,77, intervalo de confiança [IC] 95% = 1,16-12,30), nível de CO no início do estudo < 10ppm (OR = 5,81, IC 95% 1,76 - 19,23), não conviver ou trabalhar com fumante (OR = 7,38, IC 95% 1,76 - 30,98) e uma média menor no teste de Fagerström (OR = 5,36, IC 95% 1,55 - 20,43). Pode ser concluído que cessação de tabagismo foi associada com variáveis demográficas, histórico de tabagismo e dependência do cigarro. / The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis attending a multidisciplinary smoking cessation program. Among the 286 screened subjects, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and it was validated by exhaled carbon monoxide (CO) measurements. Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Tests for association tests, tests for comparison of means and univariate logistic regression analysis were used to identify predictors of smoking cessation. Among the 61 individuals that remained up to the 24-months examination, 31, 21 and 18 declared that were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with male gender (odds ratio [OR] = 3.77, confidence interval [CI] 95% = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, CI 95% 1.76 - 19.23), not living or working with another smoker (OR = 7.38, CI 95% 1.76 - 30.98) and lower mean Fagerström test score (OR = 5.63, CI 95% 1.55 - 20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.

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