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.

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.

<p>Contraception is said to be one of the vital determinants of fertility (Bongaarts, 1978). African nations, especially those in sub-Saharan Africa have a history of high fertility levels and low contraceptive use. However, contraceptive methods have been used one way or another throughout human history, although, due to improvements, these methods have evolved over the years. In Namibia, there tend to be a huge gap between women&rsquo / s knowledge of methods of contraception and usage thereof. For instance as per NDHS survey of 2000, 97 percent of married women knew of a contraceptive method, while 38 percent utilised them. This study aims at investigating knowledge and usage of contraceptives among women in union of reproductive age in an independent Namibia, 10 years after independence between 1992 and 2000. Socio-economic and demographic factors affecting contraceptive usage are examined in this study to determine their significance.</p>

Background: Breast and Gynecological cancers are a major public health problem. Smoking is associated with several chronic diseases including cancer. Other lifestyles of public health predispose many people to dyslipidemia, hypertension and obesity; risk factors for metabolic syndrome, and are associated with cancer. Objectives: The purpose of this study is to find if those who smoke, and have the metabolic syndrome, are more likely to have breast or gynecological cancers, and to find the distribution by education, having health insurance, race/ethnicity and socio-economic status. Methods: A case-control study of females aged 20 years and above who participated in the United States National Health and Nutrition Examination Survey (NHANES) 2001-2010. Results: Females who have smoked more than hundred cigarettes in life and still smoke; a) have a 42 percent less chance of having a breast cancer diagnosis (OR 0.58; 95% CI 0.36 – 0.93, p-value 0.025), and b) are 2.67 times as likely to report a cervical cancer diagnosis as females who have smoked less than hundred cigarettes in life (OR 2.67; 95% CI 1.72 – 4.13, p-value Conclusion: Smoking and metabolic syndrome are very important indicators of reproductive health and needs further study. Smoking cessation interventions should be an integral part of cervical cancer prevention programs especially targeted at younger females and females who live below the federal poverty level.

Syfte: Syftet med denna uppsats är att hitta samband mellan de demografiska faktorerna och en förändring i det privata pensionssparandet år 2015. Teoretisk och empirisk metod: Forskningsstrategin för denna studie har varit av kvantitaiv form, med en hypotetisk deduktiv ansats. En enkätundersökning låg till grund för insamling av empirin i denna forskning. Målgruppen för respondenterna var mellan 20-65 år, då det anses till största del vara dessa som pensionssparar. Enkäten bestod till största del utav frågor med alternativ som respondenterna fick fylla i. Resultat och Slutsats: Resultatet av denna forskning visar hur vissa av demografiska faktorer påverkar personers privata pensionssparande och även hur de agerat efter förändringen av avdragsrätt. De demografiska faktorer som kan påvisas påverka är en persons ålder och inkomst. Det fanns ett positivt samband mellan stigande ålder och summa pensionssparande och stigande inkomst och summa pensionssparande. Åldern och inkomsten sågs även påverka hur individer valde att ändra pensionssparandet efter borttagandet av avdragsrätt. / Purpose: The purpose of this paper is to find connections between demographic factors and a changing of the reduced deductibility year 2015. Theoretical och empirical method: The strategy for this empirical study has been in a quantitative shape with a deductive approach. A survey has been formed to collect the empirical material. The target group for this study has been individuals between 20-65 years old, because these are the people that should be saving for their retirement. The questionnaire was for the most part filled with beforehand given answers that the individual chose the answer that they felt represented themselves. Conclusion: The results of this paper shows how some of the demographic factors has an impact on how an individual acts when they are saving for their retirement and that there is some differences on how they have act after the reduced deductibility. The two factors that have an impact is a person’s age and their level of income. Where people in a higher age and with a higher income will save more for their retirement then others. People with a higher income and a higher age will have change their retirement plan after 2015.

This study evaluated the influence of academic, behavioral, and sociocultural variables on the implementation of Schoolwide Positive Behavior Support (SWPBS), a system intended to improve discipline in school buildings. The number of schools that are implementing SWPBS has been increasing dramatically over the years as school violence continues to rise and solutions are needed to improve school climate. This study examined the relationship between three categories of variables and the level of implementation of SWPBS in three multiple regression analyses. The categories were school demographic variables (i.e., ethnicity, socio-economic status, teacher: student ratio, percentage of teachers who are out-of-field), severity of need for change (suspensions, office referrals, percentage of students below grade level in reading), and team process variables (coaching, team functioning, administrative support). Of these variables, team functioning was the only one found to be sign ificantly related to implementation. A second component of the study involved collecting data relating to factors that were enablers or barriers to the implementation of SWPBS. Two-hundred and thirty-six school personnel completed a survey, Schoolwide Implementation Factor Survey (SWIF). The survey derived three factors through a factor analysis: school, staff, and students; principal; and assistant principal. These factors were all found to have a high Cronbach's alpha for internal consistency. There were significant differences between schools with a high, middle, and low level of implementation on all of these factors, with respondents from high implementing schools scoring the highest on all factors,and respondents from low implementing schools scoring the lowest. The item on the survey rated as the most helpful in the implementation process was "Expectations and rules that are clearly defined," while the item rated as the most problematic in the implementation process was "Adequat e funding for PBS." Overall, the results highlighted the complexity of implementing a system-wide change.(i.e., ethnicity, socio-economic status, teacher: student ratio, percentage of teachers who are out-of-field), severity of need for change (suspensions, office referrals, percentage of students below grade level in reading), and team process variables (coaching, team functioning, administrative support). Of these variables, team functioning was the only one found to be significantly related to implementation. A second component of the study involved collecting data relating to factors that were enablers or barriers to the implementation of SWPBS. Two-hundred and thirty-six school personnel completed a survey,Schoolwide Implementation Factor Survey (SWIF). The survey derived three factors through a factor analysis: school, staff, and students; principal; and assistant principal. These factors were all found to have a high Cronbach's alpha for internal consistency. There were signific ant differences between schools with a high, middle, and low level of implementation on all of these factors, with respondents from high implementing schools scoring the highest on all factors,and respondents from low implementing schools scoring the lowest. The item on the survey rated as the most helpful in the implementation process was "Expectations and rules that are clearly defined," while the item rated as the most problematic in the implementation process was "Adequate funding for PBS." Overall, the results highlighted the complexity of implementing a system-wide change.

<p>Contraception is said to be one of the vital determinants of fertility (Bongaarts, 1978). African nations, especially those in sub-Saharan Africa have a history of high fertility levels and low contraceptive use. However, contraceptive methods have been used one way or another throughout human history, although, due to improvements, these methods have evolved over the years. In Namibia, there tend to be a huge gap between women&rsquo / s knowledge of methods of contraception and usage thereof. For instance as per NDHS survey of 2000, 97 percent of married women knew of a contraceptive method, while 38 percent utilised them. This study aims at investigating knowledge and usage of contraceptives among women in union of reproductive age in an independent Namibia, 10 years after independence between 1992 and 2000. Socio-economic and demographic factors affecting contraceptive usage are examined in this study to determine their significance.</p>

Background: Breast and Gynecological cancers are a major public health problem. Smoking is associated with several chronic diseases including cancer. Other lifestyles of public health predispose many people to dyslipidemia, hypertension and obesity; risk factors for metabolic syndrome, and are associated with cancer. Objectives: The purpose of this study is to find if those who smoke, and have the metabolic syndrome, are more likely to have breast or gynecological cancers, and to find the distribution by education, having health insurance, race/ethnicity and socio-economic status. Methods: A case-control study of females aged 20 years and above who participated in the United States National Health and Nutrition Examination Survey (NHANES) 2001-2010. Results: Females who have smoked more than hundred cigarettes in life and still smoke; a) have a 42 percent less chance of having a breast cancer diagnosis (OR 0.58; 95% CI 0.36 – 0.93, p-value 0.025), and b) are 2.67 times as likely to report a cervical cancer diagnosis as females who have smoked less than hundred cigarettes in life (OR 2.67; 95% CI 1.72 – 4.13, p-value Conclusion: Smoking and metabolic syndrome are very important indicators of reproductive health and needs further study. Smoking cessation interventions should be an integral part of cervical cancer prevention programs especially targeted at younger females and females who live below the federal poverty level.

My dissertation sought to expand the study of victimization by examining non-linear relationships across victim, offender, and offense characteristics within a routine activities theory framework. Moreover, my goals were to assess victimization risk using a more realistic approach through the implementation of a situational perspective approach and conjunctive analysis. Conjunctive analysis is an analytical with both quantitative and qualitative properties, which allowed for interpretations that were detail oriented and summative. Utilizing data from the National Crime Victimization Survey, several victim (e.g., demographic factors), offender (e.g., victim-offender relationship), and offense (contextual factors) characteristics were analyzed. Conjunctive analysis was estimated for incidents by victimization type and by race/ethnicity. The results indicated the presence of main (linear) effects and interaction (non-linear) effects. Main effects by victimization type provided support for prior research on victimization risk, such as the majority of victims emerging as young, white, and male. Interaction effects revealed young and female victims were vulnerable to attacks from non-stranger offenders; whereas, older and male victims were prone to stranger attacks. When estimated by race and ethnicity, whites and blacks were also more likely to be attacked by someone with whom they were familiar; whereas, victims categorized as other were more likely to be attacked by strangers. Theoretical and policy implications were discussed.

Master of Public Health - MPH / A matched case-control study was carried out to identify the factors associated with the nutritional status of children in Livingstone district, Zambia. A trained field researcher collected data on demographic, feeding practices and socio-economic factors in matched groups of underweight children and normal weight children from the mothers/caregivers of the children. Interviews, using a structured pre-tested questionnaire, were used to obtain the data. All children aged from six to fifty-nine months admitted at Livingstone General Hospital during the months of October to December, 2003 with a weight for age below &ndash;2SD from the median of the reference population formed the underweight children (cases). The total was 47 children. The cases were then matched according to sex and age to 47 normal weight children attending the under five clinic at Livingstone General Hospital during the same months, with a weight for age above &ndash;2SD from the median of the reference population (controls). The final sample was 94 children. Weights were recorded using the same scale in the outpatient&rsquo;s department prior to admission and during the under five clinic session. Interviews then took place in a separate room after the clinic nurse had attended them. A separate visit was then made to the homes of the children on a different day. Odds ratios and 95% confidence intervals were used to measure strengths of associations. Results revealed that the basic causes of underweight were the poor economic state of the country, unfavorable policies and insufficient government support in the areas of health, education, agriculture, housing and employment. Underlying causes were inadequate access to food, inadequate care of children, poor access to health services and unhealthy living environments, while immediate causes were poor food intake and disease. Low educational and literacy levels of the mothers/caregivers, unemployment and lack of sufficient finances to access basic necessities such as food, housing and health contributed to underweight. / South Africa