A criminalidade é um problema recorrente de grande relevância, o engajamento delituoso de jovens é um fenômeno preocupante e alarmante, de acentuado impacto na sociedade. A população, em geral, tende a acreditar que os jovens estão cada vez mais perigosos e envolvidos no agir antissocial. Faz-se necessário a realização de pesquisas que desvendem a problemática e busquem alternativas e possíveis soluções. No âmbito internacional, os questionários de delinquência autorrevelada são considerados o método mais seguro para indicar a prevalência e frequência de comportamentos delituosos entre os jovens. O objetivo do presente estudo foi, em termos gerais, conhecer o comportamento divergente e delituoso de adolescentes estudantes de instituições de ensino privadas, investigando a associação do fenômeno a variáveis potencialmente relacionadas e ampliar pesquisa anterior realizada junto a jovens de instituições de ensino públicas. Participaram do estudo 324 adolescentes, do sexo masculino, estudantes de três escolas particulares. Foi aplicado o Questionário sobre Comportamentos Juvenis, um instrumento de autorrelato que aborda questões relativas à família, escola, rotina, pares, local de residência e comportamentos divergentes e delituosos. Os resultados indicaram que 60,80% da amostra relatou já ter praticado algum comportamento delituoso e 68,88% algum comportamento divergente. O comportamento delituoso mais frequente foi a lesão corporal, seguido de dano. Quanto aos comportamentos divergentes 52,5% dos adolescentes declararam já ter consumido bebidas alcoólicas. Os adolescentes foram agrupados em 5 clusters de acordo com o nível de engajamento criminal, concluiu-se que 11,11% dos jovens são responsáveis por 81% dos delitos revelados praticados nos últimos 12 meses. Esses são aqueles de engajamento mais grave e que se diferenciaram dos outros agrupamentos pela idade de primeiro delito, pela diversidade e volume de delitos praticados. / Criminality is a relevant social problem. Juvenile delinquency is a worrying and alarming phenomenon with many impacts on society. The population, in general, Believes that young people are increasingly involved on antisocial behaviours. Studies about this, is necessary to looking for alternatives and possible solutions. In international level. Self-Reported delinquency are considered the best method to indicate the delinquency behaviors prevalence and frequency. The aim of the present study is to know the self-reported delinquency in private schools young boys; investigating the association of the phenomenon with potentially related variables and expanding previous research carried out with youngsters of public educational institutions. Thirty-four adolescents, male, private schoolss students from three participated in the study. The Self Reported Delinquency was applied; its a self-report questionnaire that investigating about family, school, routine, peers, place of residence and divergent and criminal behavior. The results indicated that 60.80% of the sample reported some delinquent behavior and 68.88% some problem behavior. The most frequent criminal behavior was hurt someone, followed by damage. Regarding divergent behaviors, 52.5% of adolescents reported having consumed alcoholic beverages. The adolescents were grouped into 5 clusters according to the level of criminal engagement, it was concluded that 11.11% of young people are responsible for 81% of de delinquency practiced in the last 12 months. These group (5) have more serious engagement and that differ from others, about age, diversity and frequency.

Background: Persistent infection with high risk HPV is a necessary but insufficient cause of cervical cancer. Behavioural, viral and host factors modulate the risk of HPV persistence. In this thesis, I explore the role of the vaginal microbiota, a host factor and the presence of multiple HPV infections, a viral factor in HPV persistence. Considering the limited data on the epidemiology of HPV related diseases in low and middle-countries (LMIC), and the limited success of cervical cancer screening strategies in many LMIC, I provide data on the distribution of HPV related diseases in Nigeria and evaluate the acceptability of innovative strategies to increase cervical cancer screening uptake. Methods/Results: To achieve my aims, I implemented a longitudinal cohort study of 1,020 women in Nigeria. I begin my results chapters with two methodological papers. Attrition is an important consideration for every longitudinal cohort, particularly in LMIC, therefore, I present my findings on attrition, determinants of attrition and practical strategies to ensure low attrition in studies conducted in LMIC. Considering that sexual behaviour is an important potential confounder in all HPV studies, and the reliability of self-reported history is often questioned, I present findings on the test-retest reliability of self-reported sexual behaviour history collected in my study. Having found that attrition levels were low and that self-reported sexual behaviour history was generally reliable within my cohort, I present my findings on the association between the vaginal microbiota and persistent hrHPV; and the role of multiple HPV infections in viral persistence. I found that the vaginal microbiota was associated with persistent hrHPV in HIV negative women, but not in HIV positive women; and that multiple HPV infections did not increase the risk of viral persistence when compared to single HPV infections. Next, I present my findings on the prevalence and incidence of anogenital warts in Nigeria, with additional reports on the prevalence of cervical cancer and other HPV associated cancers using data from two population based cancer registries. Finally, I present my findings on the acceptability of innovative strategies to improve cervical cancer screening uptake in Nigeria. I found that Nigerian women had a favorable attitude to the use of HPV DNA based screening as part of routine antenatal care, however attitudes towards the use of self-sampling techniques for HPV based cervical cancer screening varied by religious affiliations. Conclusion: In my thesis, I was able to systematically investigate the epidemiology of HPV infections in a LMIC. I considered the distribution of HPV related diseases, host and viral determinants of HPV persistence and investigated control strategies to reduce the burden of cervical cancer in a LMIC. My results provide useful data for surveillance, monitoring and evaluation of control programs on HPV and cervical cancer in Nigeria and may be useful to cervical cancer control programs in other LMIC.

The effectiveness of treatments for degenerative spine conditions, where the primary symptom is back pain, is typically determined using patient-reported quality of life (QoL) measures. However, patients may adjust their internal standards when scoring QoL based on factors other than their health. This response shift phenomenon could confound the interpretation of study data and impact effectiveness conclusions. In the current study, response shift was examined using structural equation modeling (SEM) and previously collected clinical trial data comparing 2 minimally invasive medical devices in lumbar spinal stenosis patients through 1 year postintervention. In subject QoL results, reprioritization shift between 3 months and 12 months that could confound standard analysis was identified. Treatment group did not influence response shift identified at 12 months. SEM provided an effective and practical tool for clinical investigators to assess response shift in available clinical study data. As response shift could lead to invalid conclusions when QoL measures are analyzed, clinical investigators should include response shift assessment in the design of clinical trials. This research into how response shift phenomenon can impact clinical trial results improves the ability of clinical investigators to interpret clinical trial data, potentially preventing erroneous conclusions. This research may also assist researchers and government regulators in the identification and reimbursement of beneficial, cost-effective medical treatments for patients worldwide. For clinical research designers, this study demonstrates a practical application of response shift assessment.

Forty-nine Cache Valley residents, between the ages of 18 and 45, who volunteered to participate in an assertion training class were assigned to one of seven groups. Subjects were administered pre- and posttests and a two month follow-up evaluation. Measures included Rotter's Internal-External Locus of Control Scale, the Rathus Assertive Scale, and the Berger Self-Acceptance Scale. The results obtained indicate that self-acceptance and assertiveness changed as a result of assertion training and that these changes were maintained at follow-up. No difference between internals and externals was observed as a result of semi-structured assertion training.

<p><p>Självkänsla är något vi ständigt bär med oss och den inverkar på vårt agerande samt våra val i livet. Johnson (2003) delar in självkänslan i två delar den inre och yttre, vilka kan kombineras till fyra personligheter. Forskning har visat att självkänslan samvarierar med tendensen till att bruka self-handicapping. Self-handicapping innebär att människan skapar hinder för sig själv påhittade eller verkliga. Etthundrasju studenter fyllde i en enkät bestående av 58 påståenden, vilken mätte inre, yttre självkänsla samt self-handicapping. Deltagarna delades sedermera in i de fyra personligheterna, vilka ställdes mot dess uppmätta tendens till att bruka self-handicapping. Resultatet visade att låg inre och/eller hög yttre självkänsla ökar benägenheten till att använda self-handicapping. Avslutningsvis diskuteras och jämförs resultatets utfall.  </p><p> </p><p> </p><p> </p></p><p> </p>

Background: Urinary incontinence (UI) and urgency are common conditions and can have a profound influence on many aspects of life. Approximately one in four women has UI and one in ten has daily symptoms. Knowledge is lacking, however, on the impact of UI and urgency on the lives of affected women and their partners and on the situation of women with urinary leakage one year postoperatively. Aims: To study the consequences of female UI and urgency for patients and their partners on quality of life (QoL), the partner relationship, and their sexual lives. Also to evaluate the success rates of three operation methods: tension-free vaginal tape (TVT), tension-free vaginal tape-obturator (TVT-O), and transobturator tape (TOT) for stress urinary incontinence (SUI), with a particular focus on women who still have urinary leakage one year after surgery. Methods: Women seeking healthcare for UI and/or urgency and their partners were invited to answer questionnaires. The women completed disease-specific questionnaires and both the women (n = 206) and their partners (n = 109) answered questions about their psychosocial situation, partner relationship, and sexual life. Patient-reported outcomes one year after surgery with TVT, TVT-O, or TOT (n = 3334) were derived from the Swedish National Quality Register for Gynaecological Surgery. Results: Most of the women reported that their urinary problems negatively affected their physical activities, and almost half reported negative consequences for their social life. Women aged 25–49 years were less satisfied with their psychological health, sexual life, and leisure than women aged 50–74 years. One third of both the women and their partners (all the partners were men) experienced a negative impact on their relationship, and sexual life was negatively affected in almost half of the women and one in five of their men. Coital incontinence was reported in one third of the women. Most of their men did not consider this a problem, but the majority of the affected women did. Satisfaction with outcome of the operation did not differ between TVT, TVT-O, and TOT, but TVT showed a higher success rate for SUI than TOT did. Higher age, higher body mass index, a diagnosis of mixed urinary incontinence, and a history of urinary leakage in combination with urgency each constitute a risk for a lower operation success rate. After one year, 29% of the women still had some form of UI, but half of these were satisfied with the outcome and most reported fewer negative impacts on family, social, working, and sexual life than before the operation. Conclusions: Female UI and/or urgency impaired QoL, particularly in young women, and had negative effects on partner relationships and on some partners’ lives. Sexual life was also affected, more often in women with UI and/or urgency than in their partners. At one-year follow-up after surgery, about one third of the women still had some form of UI, but the negative impact on their lives was reduced. A challenge for health care professionals is to initiate a dialogue with women with urinary symptoms about sexual function and what surgery can realistically be expected to accomplish.

Självkänsla är något vi ständigt bär med oss och den inverkar på vårt agerande samt våra val i livet. Johnson (2003) delar in självkänslan i två delar den inre och yttre, vilka kan kombineras till fyra personligheter. Forskning har visat att självkänslan samvarierar med tendensen till att bruka self-handicapping. Self-handicapping innebär att människan skapar hinder för sig själv påhittade eller verkliga. Etthundrasju studenter fyllde i en enkät bestående av 58 påståenden, vilken mätte inre, yttre självkänsla samt self-handicapping. Deltagarna delades sedermera in i de fyra personligheterna, vilka ställdes mot dess uppmätta tendens till att bruka self-handicapping. Resultatet visade att låg inre och/eller hög yttre självkänsla ökar benägenheten till att använda self-handicapping. Avslutningsvis diskuteras och jämförs resultatets utfall.

In Healthy People 2010, mental health is listed as a major public health concern as evidenced by an alarming increase in the number of individuals who suffer from mental disorders. Mental disorders are a treatable public health condition. However, health disparities in the treatment of mental disorders are evident. The purpose of this study was to examine factors that affected health outcomes of persons with mental disorders. Two specific aims were addressed: Aim 1: to examine the relationships of population characteristics (predisposing factors and enabling resources), health behaviors (health services use and health practice); and health outcomes (physical health status and mental health status); Aim 2: to determine the differences in the usual source of care and health outcomes between individuals with self-reported mental disorders and individuals without mental disorders. This study was a secondary analysis of existing data collected from 2006 Medical Expenditure Panel Survey Household Component Consolidated file. A sample of U.S. civilian non-institutionalized adults (N=622) was grouped according to three self-reported health conditions: mental disorders (MD), physical illnesses (PI) and co-morbid mental disorders and physical illnesses (CM). This sample was predominantly male, White non-Hispanic and married; had a high school diploma, middle to high income, and private insurance; and preferred office-based clinics as the usual source of care, F(2,29)=5.94, p = .007. No statistically significant differences between groups in usual source of care (p=.069) and physical health status (p=.490) but there was a significant difference in mental health status (p=.001). Participants with CM had a poorer mental health status than those with PI and MD, F (2,619) =21.8, p= .000. The mental health status of individuals with PI was significantly better than that of participants with MD. Awareness of disparities in the usual source of care, health services use, and health outcomes among individuals with mental health conditions is imperative if barriers to care are to be eliminated. Innovative interventions pertinent to decreasing barriers to accessing health care and improving the health outcomes among individuals with MD must be tested. Advocating for mental health care policies that reduce health care services disparities among individuals with self-reported MD must be encouraged.

Background: The prognostic significance of chest pain is well established in patients with coronary artery disease, but still ill defined in primary prevention. Therefore, the aim of our analysis was to assess the prognostic value of different forms of chest pain in a large cohort of primary care subjects under the conditions of contemporary modalities of care in primary prevention, including measurement of serum levels of the biomarker NT-pro-BNP. Design: We carried out a post-hoc analysis of the prospective DETECT cohort study. Methods: In a total of 5570 unselected subjects, free of coronary artery disease, within the 55,518 participants of the cross-sectional DETECT study, we assessed chest pain history by a comprehensive questionnaire and measured serum NT-pro-BNP levels. Three types of chest pain, which were any chest pain, exertional chest pain and classical angina, were defined. Major adverse cardiovascular events (MACEs = cardiovascular death, myocardial infarction, coronary revascularization procedures) were assessed during a 5-year follow-up period. Results: During follow-up, 109 subjects experienced a MACE. All types of reported chest pain were associated with an approximately three-fold increased risk for the occurrence of incident MACEs, even after adjusting for cardiovascular risk factors. Any form of reported chest pain had a similar predictive value for MACEs as a one-time measurement of NT-pro-BNP. However, adding a single measurement of NT-pro-BNP and the information on chest pain resulted in reclassification of approximately 40% of subjects, when compared with risk prediction based on established cardiovascular risk factors. Conclusions: In primary prevention, self-reported chest pain and a single measurement of NT-pro-BNP substantially improve cardiovascular risk prediction and allow for risk reclassification of approximately 40% of the subjects compared with assessing classical cardiovascular risk factors alone.

The purpose of the current study was to investigate the structural relationships among self-reported mathematics achievement, attitudes toward statistics, and statistics outcomes by testing a structural model. The current study utilized a survey design. The participants of study consisted of 247 undergraduate and graduate students enrolled in statistics courses in a university in Turkey. The participants were from different disciplines such as engineering, education, and economics. The Turkish version of the Survey of Attitudes toward Statistics-36&copy / (SATS-36&copy / ) was used to collect data. The SATS-36&copy / assessed six components of statistics attitudes: cognitive competence, value, difficulty, effort, interest, and affect. Higher scores of the six components referred to the more positive attitudes. In addition, the SATS-36&copy / involved additional items to measure students&rsquo / self-reports of mathematics achievement and statistics outcomes. Results of the descriptive statistics analyses revealed that participants of the study had positive attitudes toward statistics except that they had neutral perceptions about the difficulty of statistics and neutral interest in statistics. Statistics outcomes variable was significantly correlated with mathematics achievement, affect, value, interest, and effort variables. Structural equation modeling was used to test the hypothesized structural regression model. Results indicated that affect, value, cognitive competence, and interest variables had large total standardized effects on statistics outcomes variable. Mathematics achievement and the effort variables had small total effects on explaining statistics outcomes. Difficulty had no statistically significant total effect on explaining statistics outcomes. Overall, the hypothesized structural regression model explained 66% of the total variance in statistics outcomes, which was statistically significant.