RESUMO
BACKGROUND: Little is known about socioeconomic status (SES) and its effects in childhood cancer survival. This study aims to discuss the association between SES and survival of patients with retinoblastoma (RB) from a tertiary treatment center. PROCEDURE: A retrospective cohort study was conducted, including all patients with RB referred to the Brazilian National Institute of Cancer in Rio de Janeiro (January 2000-December 2016). RESULTS: Data from 160 patients were analyzed with mean age at diagnosis of 22.85 months (SD ± 14.29). Eighty-three patients (51.9%) had an interval to diagnosis equal to or longer than six months, and 13 children (8.1%) abandoned treatment. Five-year overall survival rate for all patients was 78.8% (95% CI, 72.4%-85.9%). In a multivariate model, patients whose fathers had more than nine years of study had a lower death risk. Patients from families having more than one child under five years had a 213% higher risk of death compared with those living with no other small child. Treatment abandonment also had a profound effect on death risk. CONCLUSION: Childhood cancer is notably important considering the potential years of life lost. RB has even more important elements, as the possibility of vision loss in cases with delayed diagnosis. Family characteristics seem to be highly related to RB survival, especially in low- and middle-income countries, where inequalities are still a public health issue. Strategies to improve survival should focus not only on large-scale settings such as improving national healthcare systems but also on more personalized actions that might help to mitigate disparities.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Retina/mortalidade , Retinoblastoma/mortalidade , Classe Social , Centros de Atenção Terciária/estatística & dados numéricos , Protocolos de Quimioterapia Combinada Antineoplásica/economia , Brasil , Pré-Escolar , Atenção à Saúde , Feminino , Seguimentos , Humanos , Lactente , Masculino , Prognóstico , Neoplasias da Retina/tratamento farmacológico , Neoplasias da Retina/economia , Neoplasias da Retina/patologia , Retinoblastoma/tratamento farmacológico , Retinoblastoma/economia , Retinoblastoma/patologia , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
Within the scope of socio-cognitive theories, student engagement in school has been studied as a multidimensional construct. A four-dimensional perspective was adopted, with the dimensions: affective, cognitive, behavioural and agentic. The objective, to analyse how the variables age and parental education relate to student engagement in school. The sample consisted of 715 Portuguese public Higher Education students from the Lisbon area. The data was collected through an online survey, which included the Student Engagement in School: a Four-Dimensional Scale - Higher Education Version. Data analysis not only revealed that students of age 26 or older scored considerably higher results in engagement than younger colleagues, but also highlighted significant differences of engagement in the affective, behavioural and agentic dimensions, depending on parental education. The results, while partially corroborating the revised literature, suggest future in-depth studies.
No âmbito das teorias sociocognitivas, o envolvimento do aluno na escola tem sido estudado como um constructo multidimensional. Para este estudo, optou-se por uma perspetiva quadridimensional a partir das dimensões afetiva, cognitiva, comportamental e agenciativa. Pretendeu-se analisar como as variáveis idade e escolaridade dos pais aparecem associadas ao envolvimento dos estudantes na escola. A amostra foi constituída em 715 estudantes portugueses do Ensino Superior Politécnico público da região de Lisboa. Os dados foram recolhidos através de um inquérito online que incluiu a escala, Envolvimento dos Alunos na Escola: uma Escala Quadri-Dimensional - Versão para Ensino Superior. A análise dos dados destacou que estudantes com 26 ou mais anos mostraram resultados no envolvimento significativamente superiores aos colegas mais jovens e salientou diferenças significativas no envolvimento deles nas dimensões afetiva, comportamental e agenciativa em função do nível de escolaridade dos pais. Os resultados corroboraram parcialmente a literatura revista e sugerem futuros estudos de aprofundamento.