RESUMO
Abstract: Quality of work life (QWL) is a topic studied globally due to its relevance for workers' health and organizational results. This study investigated the effects of person-organization fit (POF) with regard to workers' perceived and desired organizational values (OV) on QWL. The sample consisted of 213 Brazilians working in companies of different sizes and from different sectors. The quadratic polynomial regression model with surface analysis charts was used. The hypothesis that QWL is affected by satisfaction with OV was confirmed. The surface analysis charts revealed that some of the relationships between variables are non-linear. The conclusion is that these findings can help organizations to reflect on declared values and those actually put into practice in order to develop strategies intended to promote greater congruence from the perspective of employees, positively affecting QWL.
Resumo: A qualidade de vida no trabalho (QVT) é estudada globalmente por sua importância para a saúde do trabalhador e para os resultados organizacionais. Este estudo investiga os efeitos da compatibilidade pessoa organização (POF) no que diz respeito aos valores organizacionais (VO) percebidos e desejados pelos trabalhadores sobre a QVT. Participaram 213 trabalhadores brasileiros de empresas de diferentes portes e setores. Utilizou-se o modelo de regressão polinomial quadrática com análise de gráficos de superfície. Comprovou-se a hipótese de que a QVT é impactada pela satisfação com os VO. A análise de gráficos de superfície permitiu compreender que alguns dos relacionamentos entre as variáveis são curvilíneos. Conclui-se que os achados podem contribuir para que as organizações reflitam sobre seus valores declarados e praticados, desenvolvendo estratégias que possam promover maior congruência na visão de seus funcionários, impactando positivamente na QVT.
Resumen: Se estudia la calidad de la vida laboral (CVL) por su importancia para la salud de los trabajadores y para los resultados organizacionales. Fueran investigados los efectos de la compatibilidad persona organización con respecto a los valores organizacionales (VO) percibidos y deseados por los trabajadores en la CVL. La muestra fue de 213 trabajadores brasileños de empresas de diferentes tamaños y sectores. Se utilizó el modelo de regresión polinómica de segundo grado con el análisis de los gráficos de superficie. Se comprobó la hipótesis que CVL se ve afectada por la satisfacción con los VO. Se entendió que algunas de las relaciones entre las variables son curvilíneas. Los hallazgos pueden ayudar a las organizaciones a reflexionar sobre sus valores declarados y practicados, y a desarrollar estrategias para promover una mayor coherencia en la visión de sus empleados, impactando positivamente en CVL.
Assuntos
Humanos , Masculino , Feminino , Análise de Regressão , Condições de TrabalhoRESUMO
Este estudo apresenta análises comparativas entre modelos de regressão linear múltipla e de regressão quadrática. Foram utilizados valores organizacionais reais e desejados como variáveis independentes e satisfação com o trabalho como variável dependente. A amostra contou com 213 trabalhadores de todas as regiões do Brasil, homens e mulheres, predominantemente com formação em nível superior, atuantes em empresas de diversos setores. A regressão quadrática possibilitou o encontro de explicações de variância de maior magnitude, quando comparada ao modelo linear. Análises de gráficos de superfície ampliaram o entendimento a respeito dos efeitos promovidos pelas variáveis independentes sobre as dependentes. São apresentadas considerações sobre a seleção de modelos de regressão tanto no contexto acadêmico, quanto na prática organizacional.
This study presents comparative analysis of multiple linear regression model and quadratic regression. Organizational values (actual and desired) were used as independent variables and job satisfaction as the dependent variable. The sample consisted of 213 workers from all regions of Brazil, men and women, mostly with higher education, working in various industries. The quadratic regression resulted in variance explanations of greater magnitude when compared to the linear model. Surface analysis charts expanded the understanding of the effects promoted by the independent variables on the dependent. Considerations regarding the selection of regression models in the academic context and in organizational practice are provided.
Este estudio presenta un análisis comparativo de los modelos de regresión lineal múltiples y la regresión cuadrática. Se utilizaron los valores organizacionales (reales y deseados) como variables independientes y la satisfacción en el trabajo como la variable dependiente. La muestra fue de 213 trabajadores de todas las regiones de Brasil, hombres y mujeres, en su mayoría con la educación superior, trabajando en diversos sectores. La regresión cuadrática resultó en explicaciones de varianza de mayor magnitud en comparación con lo modelo lineal. Gráficos de análisis de superficie ampliaron la comprensión de los efectos promovidos por las variables independientes sobre las dependientes. Se proporcionan consideraciones relativas a la selección de modelos de regresión en el contexto académico como en la práctica de la organización.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Trabalho/psicologia , Modelos Lineares , Análise de Regressão , Comportamento , BrasilRESUMO
Esta pesquisa verificou a força preditiva de 12 categorias de necessidades educacionais especiais sobre o repertório de habilidades sociais de crianças: Autismo, Deficiência Auditiva, Deficiência Intelectual Leve, Deficiência Intelectual Moderada, Deficiência Visual, Desvio Fonológico, Dificuldades de Aprendizagem, Dotação e Talento, Problemas de Comportamento Externalizantes, Problemas de Comportamento Internalizantes, Problemas de Comportamento Internalizantes e Externalizantes e TDAH. Cento e vinte estudantes de escolas regulares e especiais, com idades entre seis e 15 anos, foram avaliados por seus professores por meio do Sistema de Avaliação de Habilidades Sociais (SSRS-BR). As necessidades especiais mais fortemente preditoras para déficits de habilidades sociais foram: TDAH, Problemas de Comportamento Misto, Autismo, Problemas Externalizantes, Problemas Internalizantes e Dificuldades de Aprendizagem. Discutem-se as características específicas dessas categorias e as necessidades de aprimoramento de seu repertório de habilidades sociais. (AU)
This study verified the predictive force of 12 categories of special educational needs on the social skills repertoire of children: Autism, Hearing Impairment, Mild Intellectual Disabilities, Moderate Intellectual Disabilities, Visual Impairment, Phonological Disorder, Learning Disabilities, Giftedness and Talent, Externalizing Behavior Problems, Internalizing Behavior Problems, Internalizing and Externalizing Behavior Problems and Attention Deficit Hyperactivity Disorder. One hundred and twenty students from regular and special schools, aged between six and 15 years, were assessed by their teachers using the Social Skills Rating System. The special needs which strongly predicted social skills deficits were: Attention Deficit Hyperactivity Disorder, Internalizing and Externalizing Behavior Problems, Autism, Externalizing Behavior Problems, Internalizing Behavior Problems and Learning Disabilities. Specific characteristics of these categories and the needs to improve their social skills repertoire are discussed. (AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Criança com Deficiência Intelectual/psicologia , Análise de Regressão , Educação Inclusiva , Habilidades Sociais , Modelos LinearesRESUMO
This study seeks, through a logistic regression model, to describe the pattern of breastfeeding duration in Guadalajara, Mexico, during 1993. A multistage random sample of children under 1 year of age (n = 1036) was studied; observational data regarding breastfeeding duration, obtained through a "status quo" procedure, were compared with prevalence rates obtained from the logistic regression model. Modeling the duration of breastfeeding during the first year of life rather than only analyzing observational data helps researchers to understand this process in a dynamic and quantitative way. For example, uncommon indicators of breastfeeding were derived from the model. These indicators are impossible to obtain from observational data. The prevalence curve estimated through the logistic model was adequately fitted to observed data: there were no significant differences between the number or distribution of breastfed infants observed and those predicted by the model. Moreover, the model revealed that less than 40% of the children were breastfed in the fourth month of life; the median age for weaning was 39.3 days; 55% of the potential breastfeeding in the first 4 months did not occur; and the greatest abandonment of breastfeeding in the first 4 months was observed in the first 60 days. Thus, logistic regression seems a suitable option to construct a population-based model that describes breastfeeding duration during the first year of life. The indicators derived from the model offer health care providers valuable information for developing programs that promote breastfeeding.
PIP: This study describes the pattern of breast-feeding duration in Guadalajara, Mexico, in 1993, using a logistic regression model. A multistage random sample of children under 1 year of age (n = 1036) was studied; observational data regarding breast-feeding duration, obtained through a "status quo" procedure, were compared with prevalence rates obtained from the logistic regression model. Modeling the duration of breast-feeding during the first year of life rather than only analyzing observational data helps researchers to understand this process in a dynamic and quantitative way. For example, uncommon indicators of breast-feeding were derived from the model. These indicators are impossible to obtain from observational data. The prevalence curve estimated through the logistic model was adequately fitted to observe data: there were no significant differences between the number or distribution of breast-fed infants observed and those predicted by the model. Moreover, the model revealed that less than 40% of the children were breast-fed in the fourth month of life. The median age for weaning was 39.3 days and about 55% of potential breast-feeding in the first 4 months did not occur. Lastly, the highest abandonment of breast-feeding in the first 4 months was observed in the first 60 days. Thus, logistic regression seems a suitable option to construct a population-based model that describes breast-feeding duration during the first year of life.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Interpretação Estatística de Dados , Modelos Logísticos , Adulto , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , México , Avaliação das Necessidades , Inquéritos e Questionários , Fatores de Tempo , Saúde da População UrbanaRESUMO
BACKGROUND: The Discontinuity Index (DI), which measures the percentage of infants who were exclusively breastfed (EBF) at the beginning of a given age interval and had abandoned this mode of feeding at its end, and the relative weight of this discontinuation, was introduced and employed in the National Survey on Breast Feeding and Infant Feeding Practices carried out in Cuba in 1990. The aim of this article is to illustrate, through a specific example, the quality of DI as a simple procedure for assessing breastfeeding trends. METHODS: The prevalence of EBF in the 14 provinces of Cuba at discharge from the maternity services and at 30, 60, 120, and 180 days of age, was obtained using data from a national sample of 6661 infants (4820 urban and 1791 rural) which were processed by means of a logistic regression model. Cumulative DI were calculated for the intervals 0-30, 0-60, 0-120 and 0-180 days, and partial DI for the terms 30-60, 60-120 and 120-180 days, for each province and for the whole country. RESULTS: Cumulative DI show the progress of cessation of breastfeeding and are strongly influenced by previous intervals. The Eastern provinces showed the lowest figures at most of the terms. Discontinuation during the first month of life was particularly high in two Western provinces. Partial DI are more specific and allow discrimination of the intervals at which EBF discontinuation is more frequent. The highest values were observed between 4 and 6 months. CONCLUSIONS: Discontinuity indices are useful complements to prevalence rates in epidemiological studies of breastfeeding. The separate analysis of discontinuation in different periods can be highly useful when comparing trends and in the study of the impact of breastfeeding promotion programmes focused on different age intervals.
PIP: The Discontinuity Index (DI), which measures the percentage of infants who were exclusively breastfed (EBF) at the beginning of a given age interval and had abandoned this mode of feeding at its end, and the relative weigh of this discontinuation, was introduced and employed in the National Survey on Breast Feeding and Infant Feeding Practices carried out in Cuba in 1990. The aim of this article is to illustrate, through a specific example, the quality of DI as a simple procedure for assessing breastfeeding trends. The prevalence of EBF in the 14 provinces of Cuba at discharge from the maternity services and at 30, 60, 120, and 180 days of age, was obtained using data from a national sample of 6661 infants (4820 urban and 1791 rural) which were processed by means of a logistic regression model. Cumulative DIs were calculated for the intervals 0-30, 0-60, 0-120, and 0-180 days, and partial DIs for the terms 30-60, 60-120, and 120--180 days for each province and for the whole country. Cumulative DIs showed the progress of cessation of breastfeeding and were strongly influenced by previous intervals. The eastern provinces showed the lowest figures at most of the terms, and the opposite occurred in the central and western ones. Discontinuation during the first month of life was particularly high in the city of Havana and Matanzas, two western provinces. At 4 months, 74.9% of all the infants who started EBF had abandoned it. DIs were above 99% in two western provinces, Pinar del Rio and Matanzas, whereas the national mean for this age was 90.6%. Partial DI (between 2 given ages) were more specific and allowed discrimination of the intervals at which EBF discontinuation was more frequent. The highest values were observed between 4 and 6 months. Only the city of Havana showed the highest DI between 2 and 4 months. Discontinuity Indices are useful complements to prevalence rates in epidemiological studies of breastfeeding.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Inquéritos Epidemiológicos , Modelos Logísticos , Fatores Etários , Estudos Transversais , Cuba/epidemiologia , Interpretação Estatística de Dados , Humanos , Lactente , PrevalênciaRESUMO
A prospective study was undertaken in Ladakh, India, a high-altitude region of the Himalaya, to investigate the effects of small average birth size on neonatal mortality. While such studies exist from high-altitude regions of the New World and shed light on the adaptive status of high-altitude-dwelling populations there, this is the first to examine this relationship in the Himalaya. In a sample of 168 newborns, birthweight and other anthropometric measurements were reduced relative to Andean and Tibetan newborns. Logistic regression and hazard analysis showed that neonatal biological characteristics such as weight, fatness, and circumferences were important predictors of survival probabilities of infants, especially in the neonatal period. Low Rohrer's Ponderal Index (PI) was particularly strongly related to poor survival outcome. Males and females showed no significant differences in mortality risk. Data derived from reproductive histories revealed that neonatal mortality accounted for 70-80% of total infant mortality in Ladakh. Compared to other high-altitude studies, small newborn size in Ladakh was associated with much higher mortality risks; mortality risk rose dramatically with birthweights below the mean (2,764 grams), which characterized 50% of all newborns. It is argued that newborns in Ladakh are subject to strong directional selective forces that favor higher birthweights that incur lower risks of neonatal mortality, while Andean infants are subject to relatively mild selection pressure at both ends of the birthweight distribution. Given the overall small size at birth of Ladakhi newborns and the poor survival outcomes of newborns below the mean, it is suggested that this population is less well adapted in a biological sense to the stresses inherent in this high-altitude environment than are Andean populations, perhaps due to the relatively recent colonization of the area and the substantial genetic admixture that has occurred in the past.
Assuntos
Altitude , Antropometria , Peso ao Nascer , Mortalidade Infantil , Recém-Nascido , Antropologia Física , Declaração de Nascimento , Estudos de Coortes , Métodos Epidemiológicos , Feminino , Seguimentos , Humanos , Índia , Modelos Logísticos , Masculino , Prognóstico , Estudos Prospectivos , Fatores de Risco , Estações do Ano , Fatores Sexuais , América do SulRESUMO
To determine risk factors for HIV-1 among drug injectors in Rio de Janeiro, where cocaine is the dominant drug of injection, subjects were recruited using the criteria and interview instrument of the World Health Organization's Cross-National Study of HIV infection and risk behaviour in injecting drug users. HIV antibody test results were derived both from serum tests and from self-reports of previous tests (documented evidence of self-reported seropositivity was required). The analytical sample consists of 123 subjects, recruited both at drug abuse treatment sites and at street locations. Of 27 subjects with both serological and self-reported antibody status data, 20 reported previous negative tests; of these three had positive sera and may have seroconverted. Seven subjects reporting prior positive serostatus all tested positive. For the 123 subjects, seroprevalence was 34%. Independent significant risk factors in multivariate logistic regression with backwards elimination are: years of injection greater than 5; being a male who has had sex with men in the previous 5 years; and not having taken deliberate steps to protect oneself against AIDS. These findings indicate that homosexual/bisexual male drug injectors may be a bridge group through which HIV is entering drug-injecting networks in Rio de Janeiro. Efforts by drug injectors to reduce their risk of infection seem to have protective effects. This underscores the importance of HIV prevention efforts aimed at drug injectors.
Assuntos
Cocaína , Soropositividade para HIV/epidemiologia , HIV-1 , Abuso de Substâncias por Via Intravenosa/complicações , Brasil/epidemiologia , Comorbidade , Soropositividade para HIV/complicações , Soropositividade para HIV/diagnóstico , Humanos , Masculino , Fatores de Risco , Autoavaliação (Psicologia)RESUMO
From 1 July 1987 to 31 December 1988, a total of 317 animals (91% of which were dogs) were confirmed to have rabies in Hermosillo, Mexico. The median age of rabid dogs was 1 year, 69% were male, and 98% were owned. The epizootic started in the southern areas of the city, rapidly involved the entire city, and persisted mainly in lower socioeconomic status areas. The area of the city and mean household size were significant predictor variables for the population density of rabid dogs around household clusters (Poisson linear regression, P < 0.001 and P = 0.03, resp). Approximately 2.5% of city residents were bitten by dogs in 1987, with the rate of reported dog bite injuries being positively correlated with mean household size and the proportion of households that owned dogs. Visits to the city health centre for evaluation of possible exposures to rabies increased by 135% after the start of the epizootic; approximately 273 per 100,000 city residents were administered a full or partial course of rabies post-exposure prophylaxis in 1987. Children were at greatest risk for exposures to rabies, accounting for 60% of all reported animal bite injuries evaluated at the health centre. Also they were more likely than older persons to have received bite injuries to the head, face, and neck (odds ratio = 21.6, 95% confidence interval = 5.4, 186.5).
PIP: Almost all cases of human rabies result from bites by rabid dogs. Controlling dog rabies is therefore crucial for humans. 317 animals, 91% of which were dogs, were confirmed to have rabies in Hermosillo, Mexico, from July 1, 1987, to December 31, 1988. The dogs were of median age 1 year, 69% were male, and 98% were owned. The epizootic started in the southern areas of the city, spread quickly through the city, and persisted largely in lower socioeconomic status areas. Approximately 2.5% of city residents were bitten by dogs in 1987, with the rate of reported dog bite injuries positively correlated with mean household size and the proportion of households which owned dogs. Visits to the city health center for evaluation of possible exposures to rabies increased by 135% after the start of the epizootic over which approximately 273 per 100,000 city residents were administered a full or partial course of rabies post-exposure prophylaxis in 1987. Comprising 60% of all reported animal bite injuries evaluated at the center, children were at greatest risk for exposures to rabies. Children were also more likely than older people to have received bite injuries to the head, face, and neck.
Assuntos
Mordeduras e Picadas/complicações , Doenças do Cão/epidemiologia , Vigilância da População , Raiva/epidemiologia , Raiva/veterinária , Saúde da População Urbana , Adulto , Fatores Etários , Animais , Mordeduras e Picadas/epidemiologia , Criança , Pré-Escolar , Intervalos de Confiança , Coleta de Dados , Cães , Características da Família , Feminino , Humanos , Lactente , Modelos Lineares , Masculino , México/epidemiologia , Razão de Chances , Raiva/etiologia , Raiva/prevenção & controle , Fatores de Risco , Estações do AnoRESUMO
Wasting and stunting are widely used indices for describing the prevalence of malnutrition in childhood. Studies from Latin America, however, consistently show low prevalences of wasting in the presence of other indicators of poor health. A data base assembled by the World Health Organization, including 175 studies with information on wasting and stunting among 1-y-old children from four regions (Africa, Americas, Asia and Eastern Mediterranean), was used for examining the prevalences of the two indices and their associations. Whereas there was little variation in the median prevalences of stunting among the four regions, those of wasting showed a sevenfold differential. In Africa and Latin America, the correlations between the two prevalences were low; nevertheless, wasting was about three times higher in Africa, for any given level of stunting, than in Latin America. In Asia and the Eastern Mediterranean, there were strong positive correlations between stunting and wasting, but wasting was about twice as common in Asia for any given level of stunting. To interpret low prevalences of wasting as being indicative of a low intensity of malnutrition may be misleading; weight-for-height standards and cut-offs may have to be re-examined for use in different populations.
Assuntos
Saúde Global , Distúrbios Nutricionais/epidemiologia , África , Ásia , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , América Latina , Masculino , Análise de RegressãoRESUMO
Data from three fertility surveys are used to examined the probabilities and determinants of adolescent births among Dominican and Puerto Rican women. Young women in the Dominican Republic are the most likely to have had a child by each year of age from 14 through 24, followed by young women on the Island of Puerto Rico; the probability of an early birth is lowest for Puerto Rican women on the U.S. mainland. Eighteen percent of Dominican women have had a child before their 18th birthday, compared with 13% of women living in Puerto Rico, and 10% of Puerto Rican women in metropolitan New York. The cumulative probabilities that Puerto Rican women will have borne a child before their 20th birthday are almost identical, whether the women live on the island or the U.S. mainland, but the difference between Puerto Rican and Dominican women widens. The order is reversed, however, in the analysis of premarital births: The probability of a premarital birth during adolescence is highest for Puerto Rican women in New York, and lowest for Dominican women. In a separate logistic regression analysis, education and age at first sexual intercourse are shown to be important determinants of adolescent fertility in all three populations.
PIP: Researchers analyzed 1980s data on female adolescents including Puerto Ricans in the New York metropolitan area, those in Puerto Rico, and Dominicans in the Dominican Republic to determine the probabilities and determinants of adolescent births among these women. Female adolescents from the Dominican Republic had the highest probability of having delivered an infant by each year from 14-24 years followed by those in Puerto Rico and then Puerto Rican immigrants in the US. For example, the cumulative hazard rate at age 24 was .65 for the Dominicans compared to 0.5 for Puerto Ricans in Puerto Rico and in the US. Moreover 18% of Dominicans delivered an infant before 18 years old whereas this figure for the 2 Puerto Rican groups was 13% and 10% respectively. Further the cumulative probabilities that Puerto Rican female adolescents will have had a child before 20 years old were essentially equal (37.4% and 37.3% respectively) compared to 56.1% for the Dominicans. On the other hand, the order was opposite for premarital births. Puerto Rican women living in metropolitan New York were at greatest risk of having a premarital birth (cumulative hazard rate at age 24=.2) then those living in Puerto Rico (.1) followed by Dominican women (.05). Age at 1st intercourse was the strongest determinant of adolescent birth in all 3 countries (p=.001). Indeed the younger the adolescent was at 1st intercourse, the greater the likelihood she would deliver a child while an adolescent. Another strong determinant of adolescent birth was dropping out of school (p=.001 in US and Puerto Rico; p=.01 in the Dominican Republic). The fact that most women did not use contraceptives before 1st birth was only significant for the women not living in the US (p=.001). Further research is needed to identify regional and cohort differences in contraceptive use and attitudes toward early sexual activity and childbearing.
Assuntos
Comportamento do Adolescente , Fertilidade , Adolescente , Adulto , Fatores Etários , Dispositivos Anticoncepcionais/estatística & dados numéricos , Comparação Transcultural , Demografia , República Dominicana , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino , Humanos , Casamento , Pessoa de Meia-Idade , Gravidez , Porto Rico , Comportamento Sexual , Estados UnidosRESUMO
The authors examined sexual behaviors, the seroprevalence of human immunodeficiency virus type 1 (HIV-1), and condom use among 2,314 homosexual and bisexual men tested during 1988-1989 at the AIDS (acquired immunodeficiency syndrome) National Center in Mexico City. Bisexuals constituted 24% of the sample; the seroprevalence rate was lower for bisexuals than homosexuals (21 vs. 34%). In logistic regressions, HIV-1 seropositivity was independently related to age, education, pattern of insertive/receptive behavior in anal sex, lifetime number of male sex partners, having sex with someone with AIDS, homosexual versus bisexual behavior, and a history of condyloma. The same logistic regressions were found to fit bisexuals and homosexuals. The rate of HIV-1 was reduced in individuals who indicated always requiring their partners to use a condom when practicing receptive anal sex (1% of the total). The most common practice for both homosexuals and bisexuals was "mixed" behavior (i.e., both insertive and receptive anal sex); this was also the practice with the highest risk. Bisexuals practiced both vaginal and anal sex with women and reported little condom use. The substantial seroprevalence among bisexuals, their frequent sexual contact with women, and their low rate of condom use imply a continuing role as a bridge of infection to females. Whether this risk will lead to a sustained heterosexual epidemic remains to be determined.
Assuntos
Soroprevalência de HIV , HIV-1 , Comportamento Sexual , Adolescente , Adulto , Idoso , Bissexualidade , Nível de Saúde , Homossexualidade , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Fatores SocioeconômicosRESUMO
This prospective study investigated predictors of repeat pregnancies by 12 months after the delivery of a first child and their outcomes in inner-city adolescent mothers. The sample included four groups: those who had therapeutic abortions, miscarriages, full-term deliveries, and no repeat pregnancy. The therapeutic abortion group had more pregnancies before their first delivery (41%) than did full term (20%) and no repeat (15%), p less than .01. More delayed grade placement was found in therapeutic abortion -1.6 years (1.3) and full term -1.8 years (.9) than in no repeat pregnancy -.6 years (1.1), p less .001. Reading achievement scores were higher in no repeat 86.3 (17.1) than in full term 75.0 (16.5), p less than .05. School attendance was higher in no repeat (65%) than in therapeutic abortion (35%) and full-term (24%) p less than .01 groups. Depressive symptoms at baseline were higher among therapeutic aborters 18.9 (9.9) than among full term 10.2 (8.2) and no repeat pregnancy groups 12.2 (6.2). Logistic regression analyses identified delayed grade placement as the most important predictor of pregnancy outcome.
PIP: The purpose of this prospective study of 120 black and Puerto Rican adolescent mothers recruited from an urban adolescent health center was 1) to identify multiple predictors of repeat pregnancies and their outcomes, and 2) to assess the relative contribution of these predictors to repeat pregnancies. Variables include demographic factors, frequency of sexual activity, contraceptive method used, occurrence of pregnancies before the first delivery, educational attainment, and levels of depressive symptoms by 3 weeks postpartum. Pregnancy outcomes included mothers who terminated their pregnancy, who delivered a live birth, and who had a miscarriage; data were available 12 months postpartum. The mean age was 17.13 years. 52% were black and 44% were Puerto Rican and of low socioeconomic status. Reliability of self-reports was 95%. 60.3% had no repeat pregnancy and 39.6% became pregnant during the 1-year followup, of which 15.3% had a therapeutic abortion, 6.3% miscarried, and 18.1% carried to term. There were no significant differences in the characteristics of the repeat and nonrepeat pregnancy groups. The procedure involved interviews at 2-4 weeks (time 1), 6-7 months (time 2), and 12-13 months (time 3). Measures for delayed grade placement, reading achievement, career aspirations and socioeconomic status of the family, and school attendance are described. Multivariate analysis, univariate analyses, and Duncan multiple range tests were conducted as well as logistic regression model construction. The significant predictors of pregnancy outcome (repeat pregnancy) were having 2 or more previous pregnancies. The abortion group was twice as likely to have had a pregnancy before the birth of the first child (41%) than the full-term (20%) and the no-repeat groups (15%). There were no differences in frequency of sexual activity or contraceptive method used. In the no-repeat and miscarriage groups, grade placement was less delayed. In the no-repeat group, reading achievement scores were higher than in the full-term group. There were no differences in career aspirations. 65% of the no-repeat group were attending school at time 2 while only 35% of the therapeutic and 24% of the full-term groups were attending school. Depressive scores were significantly higher for the abortion group. Delayed grade placement was the only predictor independently associated with the increased log odds of repeat pregnancy.
Assuntos
Negro ou Afro-Americano/psicologia , Hispânico ou Latino/psicologia , Resultado da Gravidez/psicologia , Gravidez na Adolescência/psicologia , Logro , Adolescente , Aspirações Psicológicas , Depressão/psicologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Gravidez , Gravidez na Adolescência/etnologia , Estudos Prospectivos , Porto Rico/etnologia , Recidiva , Análise de RegressãoRESUMO
This article explores the hypothesis that formal education of women influences the use of maternal health-care services in Peru, net of the mother's childhood place of residence, household socioeconomic status and access to health-care services. The findings are consistent with the hypothesis; both cross-sectional and fixed-effects logit models yield quantitatively important and statistically reliable estimates of the positive effect of maternal schooling on the use of prenatal care and delivery assistance. In addition, large differentials were found in the utilization of maternal health-care services by place of residence, suggesting that much greater efforts on the part of the government are required if modern maternal health-care services are to reach women in rural areas.
PIP: The hypothesis that maternal education influences use of maternal health care services in Peru was analyzed by 4 logistic regression models, using data from the Peruvian Demographic and Health Survey of September-December 1986. Peru has one of the highest child-mortality rates in the region, with extreme variation across regions of the country, ranging from 34/1000 in Lima to 110/1000 in the Andean mountains. The conceptual framework for this study was the health-seeking model of Kroger who proposed that utilization depends on predisposing factors including education, characteristics of the illness, and of the health-care system. This study analyzed 1925 births, the last births to 4999 ever-married women in the 5 years before the survey. The 2 dependent variables were sources of prenatal care and assistance at delivery. 60.1% of the women had formal prenatal care, and 54.9% had formal delivery assistance for their last birth. The bivariate effects of maternal schooling were strongly associated with use of health care, with relative odds of 47.47 for delivery assistance, and 25.37 for prenatal care. Controlling for the woman's childhood background in Model 2 reduced the odds to 13.6 and 19.69, respectively. In model 3 access to care reduced relative odds to 8.33 for prenatal care and 10.70 for delivery assistance. Taking into account the household socioeconomic status in Model 4 reduced significance of the results. The results indicated that maternal education has a profound effect on seeking medical care, but in Peru the lack of access to care in the outlying rural areas supersedes maternal education.
Assuntos
Serviços de Saúde Materna/estatística & dados numéricos , Mães/educação , Adulto , Estudos Transversais , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Peru , Gravidez , Análise de Regressão , Características de Residência , Fatores SocioeconômicosRESUMO
A health belief model of condom use was used to identify factors associated with condom use in 390 sexually active female adolescents, aged 12 through 19 years, recruited at the time of a visit for reproductive health care. Fifty-six percent were white and the remainder black. Nineteen percent had genitourinary infections with Chlamydia trachomatis. Forty-six percent reported having had more than one sexual partner in the preceding year. Reported condom use for at least one specific reason (prevention of pregnancy, sexually transmitted disease, or acquired immunodeficiency syndrome) increased as behavioral, emotional, and sexually transmitted disease risk decreased, and as cognitive maturity and positive condom attitudes increased. Although uses of condoms to prevent pregnancy, sexually transmitted disease, and acquired immunodeficiency syndrome were positively intercorrelated, each made a contribution to explaining condom use at most recent coitus (odds ratios 2.95, 3.96, and 2.81, respectively). After statistical adjustment for the reported reasons for previous condom use, behavioral risk was the only additional factor associated with condom use at the most recent sexual encounter; women who participated in more risk behaviors (substance and alcohol use and minor delinquency) were less likely to have used a condom (odds ratio 0.61). Knowledge about sexually transmitted disease and acquired immunodeficiency syndrome, and concurrent use of contraceptive pills, were not related to condom practices. The data suggest that adolescents' perceptions about condoms, including the individual functions of condoms for contraception and for prevention of sexually transmitted disease, may be important in determining their use. Engaging in unprotected intercourse may be part of a larger behavioral domain that includes other unhealthy behaviors.
Assuntos
Dispositivos Anticoncepcionais Masculinos , Psicologia do Adolescente , Comportamento Sexual , Adolescente , Adulto , Criança , Dispositivos Anticoncepcionais Masculinos/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Infecções Sexualmente Transmissíveis/prevenção & controle , Infecções Sexualmente Transmissíveis/psicologiaRESUMO
Data derived from the Encuesta Nacional de Fecundidad y Salud (ENFES) confirm that overall levels of infant mortality in Mexico have been steadily declining. However, a more specific analysis furnishes evidence that this decline has occurred at varying rates within different social groups, reflecting an increase in social inequalities. The analytical strategy used in this article leads to three basic conclusions: (1) the impact of the economic crisis on infant mortality is reflected not in a reversal of the declining trend but an increase in social inequalities; (2) certain variables universally accepted as determinants of infant mortality, such as mother's education, seem nonsignificant for some social sectors; and (3) certain biodemographic characteristics assumed to have a uniform mortality-related behavior vary among sectors, suggesting that even these constants are determined by social factors.
PIP: The characteristics and extent of and trends and differentials in infant mortality in Mexico are examined. Bivariate and multivariate analyses were based on data from the Encuesta Nacional de Fecundidad y Salud (ENFES) in 1987. The birth period was 1976-85, and the infant mortality reference period is June 1980. Analysis included breakdowns by social sector (agricultural and nonagricultural: middle-class nonmanual workers (25.5%), working-class manual workers (46.3%), salaried workers (33.5%), and nonsalaried workers (12.8%). Infant mortality is measured as the probability of death between birth and 2 years (2q0). The results show a decline in infant mortality, but the rate of decline is unequal among social strata. There was a 11.4% decline between 1976-85 in 2q0. The patterns were as follows: infant mortality is higher at 34 and 20 years; higher order pregnancies had higher infant mortality; longer average time between pregnancies yielded lower infant mortality; 2q0 is greater in towns of 20,000 population and lower in metropolitan areas; 2q0 is higher among women with little or no education; 2q0 among women with a negative score on the Index of Housing Services (INSEVI) is twice that of women in the middle and higher categories; and 2q0 is higher among women in the agricultural sector. There was a 17% rise in 2q0 (from 73.8 to 86.2 deaths/1000) between 1972-80 in the agricultural sector, and the nonagricultural sector showed uneven declines. Among women in the middle-class nonmanual sector there was a decline of 18% (27.9 deaths/1000; among working-class nonsalaried workers, 12%; and among working-class salaried workers, 5% (48.6 deaths/1000). In the analysis of differentials, 1) age of mother at time of birth, 2) mother's education, and 3) the INSEVI index of services available in the dwelling confirmed the presence of differentials in infant mortality. For total population, age of the mother at time of birth shows a typical U-shaped pattern, but the social sector analysis shows that the age mortality relationship is inverse when good services are available in the dwelling, with the exception of working-class nonsalaried workers. In the agricultural sector, 2q0 of mothers aged 15-19 is 10 times higher than women aged 35-39 with similar services in the homes. The multivariate model reveals that mother's education is not significant in all models. The relationship between size of place of residence is inversely related to mortality only among women in the middle-class nonmanual workers. In all nonagricultural sectors, availability of adequate services has a strong effect on reducing 2q0. Age of mother at time of birth and birth order are the only variables significant in all 4 models.
Assuntos
Mortalidade Infantil , Classe Social , Escolaridade , Humanos , Lactente , Mortalidade Infantil/tendências , México/epidemiologia , Modelos Estatísticos , Probabilidade , Análise de Regressão , Saúde da População RuralRESUMO
The main purpose of this study was to evaluate the role of multiple psychosocial and knowledge-related antecedent factors that may predict sexual and alcohol and drug use behaviors that are associated with the transmission of sexually transmitted diseases (STDs), including human immunodeficiency virus infection. Five hundred forty-four ninth-grade urban high school students were surveyed regarding knowledge, attitudes, and behaviors related to STDs and acquired immunodeficiency syndrome (AIDS). Results of multiple regression analyses indicate that higher levels of STD and AIDS knowledge were associated with lower levels of STD and AIDS anxiety (R2 delta = 0.09; p less than 0.001), fewer negative attitudes toward people with AIDS (R2 delta = 0.09; p less than 0.001), stronger perceptions of self-efficacy (R2 delta = 0.03; p less than 0.01), and stronger peer affiliation (R2 delta = 0.02; p less than 0.05). Negative attitudes toward people with AIDS were inversely related to knowledge (R2 delta = 0.08; p less than 0.001), social support (R2 delta = 0.02; p less than 0.01), and perceived self-efficacy (R2 delta = 0.01; p less than 0.05). Predictors of alcohol and drug use included perceived peer norms (R2 delta = 0.08; p less than 0.001) and strong peer affiliation (R2 delta = 0.05; p less than 0.001). The best predictor of sexual risk behavior was alcohol and drug use (R2 delta = 0.07; p less than 0.001). Lower levels of knowledge (R2 delta = 0.14; p less than 0.01) and perceived peer norms (R2 delta = 0.05; p less than 0.05) predicted nonuse of condoms. Our results indicate that several factors relate to adolescent risk for STDs: the connection between peer influence and adolescent risk behaviors, the link between alcohol and drug use and sexual risk behavior, and the role of knowledge in determining nonuse of condoms.
PIP: This study evaluated the impact of psychosocial and knowledge-related antecedent factors on adolescents' sexual, alcohol-use, and drug-use behaviors associated with the transmission of STDs, including HIV. Additionally, the study examined the role of peer influences in determining STD and HIV risk behaviors, relative to knowledge and other psychosocial factors. Researchers surveyed 544 freshmen (9th graders) at 4 urban high schools, collecting the data through anonymous, self-administered questionnaires. The report provides a tabulation of the students' demographic and other characteristics. In order to analyze the data, the researchers employed a multiple regression model. The results of this analysis indicates that higher levels of STD and AIDS knowledge were associated with lower levels of STD and AIDS anxiety, fewer negative attitudes towards people with AIDS, stronger perceptions of self-efficacy in preventing infection, and stronger peer affiliation. Moreover, negative attitudes toward people with AIDS were inversely related to knowledge, social support, and perceived self-efficacy. The study also found that perceived peer norms and strong peer affiliation served as predictors of alcohol and drug use, while lower levels of knowledge and perceived peer norms served as predictors for nonuse of condoms. The findings of this study reveal several factors related to adolescents' risk of acquiring STDs: the connection between peer influence and adolescent risk behaviors, the relationship between the use of alcohol and drugs and sexual risk behavior, and the role of knowledge in determining the specific risk behavior of nonuse of condoms.
Assuntos
Comportamento do Adolescente , Infecções por HIV/epidemiologia , Comportamentos Relacionados com a Saúde , Grupo Associado , Comportamento Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Síndrome da Imunodeficiência Adquirida/psicologia , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Atitude Frente a Saúde , Dispositivos Anticoncepcionais Masculinos , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Educação em Saúde , Humanos , Masculino , Análise de Regressão , Fatores de Risco , São Francisco/epidemiologia , Autoimagem , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/prevenção & controle , Infecções Sexualmente Transmissíveis/psicologia , Apoio Social , Abuso de Substâncias por Via Intravenosa , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , População UrbanaRESUMO
PIP: The author gathered 1965 and 1975 socioeconomic data on 71 developing countries from a variety of sources such as UNESCO and the World Bank. He applied these data to strict tests to confirm the nonlinear fertility literacy relationship. The total fertility rate (TFR) was the dependent variable. In 1975, the TFR was as low as 2.2 in Singapore and as high as 8.1 in Rwanda. The unweighted mean stood at 5.8. Independent variables included real gross domestic product/worker (earnings); ratio of female literacy over male literacy; natural logarithm of fraction of labor force engaged in agriculture, forestry, hunting, and fishing; population density; male literacy; and strength of the family planning program. The statistical regression revealed that fertility rose slightly (mean=0.25 of a child) with an initial growth in the literacy rate. In fact, it peaked when 25-50% of the adult male population were literate. As the adult male literacy rate increased to the point where almost everyone was literate, fertility fell swiftly to 2 children. These changes were stable across the board. Between 1965-1975, the male literacy rate increased from 46-57% which resulted in a reduction of .51 children in the TFR. Algeria, Nigeria, and Pakistan whose male literacy levels ranged only from 23-42% stalled at high fertility levels. Fertility decreased considerable in countries where family planning programs were valued at least 4.7, even when no significant changes occurred in literacy, earnings, density, or agricultural composition. Morocco, valued at 4, only experienced a change of -.561 whereas China, valued at 25, experienced a change of -1.506. Thus to reduce fertility, policy makers must set high literacy levels as goals recognizing, however, that fertility will 1st rise as literacy bigins its ascent. Further they should either estiablish or strengthen existing family planning programs.^ieng
Assuntos
Agricultura , Coeficiente de Natalidade , Comparação Transcultural , Coleta de Dados , Escolaridade , Fertilidade , Planejamento em Saúde , Densidade Demográfica , Dinâmica Populacional , Análise de Regressão , Salários e Benefícios , África , América , Ásia , América Central , Demografia , Países em Desenvolvimento , Economia , Emprego , Serviços de Planejamento Familiar , Fiji , Geografia , Mão de Obra em Saúde , América do Norte , Ilhas do Pacífico , Polinésia , População , Pesquisa , Classe Social , Fatores Socioeconômicos , América do Sul , Estatística como AssuntoRESUMO
The objective of the present project is to evaluate the relative importance of different governmental social programmes for health development during the 1970's. National statistics available for the whole period and disaggregated to district level were analyzed with particular regard to three indicators of infant health status when the infant mortality rate was used, increased access to secondary care and improved socio-economic status were related to improvement in infant health status. When the percentage of neonatal deaths or the percentage of deceased live births per woman was used, neither the socio-economic improvement nor the assess to secondary did explain the improvement. Moreover, the primary health programme did not seem to be of importance in explaining the changes in the three indicators of infant health status. A second phase of the project, currently ongoing, is aimed at the evaluation of other factors such as the degree of efficiency of some of the health programmes. This study is based on directly collected information, quantitative as well as qualitative. Structured interviews have been used together with anthropological information from in-depth interviews with individuals and groups. The preliminary results of this second phase indicate that the contradictions observed in the first phase might be due to shortcomings in the national registers. In one of the study areas the coverage of PHC developed earlier than indicated by the official information. In other areas it was found that different obstacles as access problems, lack of health centers, socio-economical problems and lack of cultural knowledge reduced the effectiveness and impact of the primary health programmes.
PIP: Costa rica has achieved considerable success in social development and attention to the marginalized poor. The aim of this study is to assess the impact of health and nutrition from social interventions of the 1970s and to provide an explanation. Archival data on vital statistics from 1970 to 1984 and coverage of the Rural Health and Community Health Programs were used. In general, data were analyzed on the district level and in zones where population was sparse. Dependent variables were infant mortality under 1 year/live births, neonatal deaths 1-11 months/infant mortality, and mortality of live births/live births of women 20-24 years. Independent variables were health coverage, access to medical assistance, environmental conditions, educational status, rural residence, and the presence of modern living conditions. The results showed that major changes occurred in access to different health programs in rural and backward regions. National coverage was 60% in 1978. In 1980, 70% were covered by social security and 95% of all deliveries were medically assisted by trained health personnel. Electricity, water, and sanitation also improved. Independent variables were closely and inversely related to infant mortality around 1974 and declined in effect about 1983. Socioeconomic factors and access to health care became else important. There was less geographic variation in infant mortality. The percentage of postneonatal mortality and the percentage of live birth deaths continued to be strongly associated by the end of the period (1983). Correlation coefficients were generated for the absolute changes in the 2 measures of infant mortality for the time periods: 1973-75, 1976-78, and 1979-81. The results were all highly significant. Regions with low socioeconomic development and low access to health care and regions with high primary health care (PHC) had greater reductions in infant mortality. When the analysis was repeated with changes in independent variables, infant, mortality was reduced in regions with increases in secondary health programs, larger PHC coverage, and greater increases in standard of living measures. In a socioanthropological approach in 1988, preliminary results continued to show inconsistencies in the 3 infant mortality measures. Data deficiencies are suspected to be the cause and analysis is ongoing to correct for doubtful figures.
Assuntos
Promoção da Saúde/normas , Mortalidade Infantil/tendências , Fenômenos Fisiológicos da Nutrição , Costa Rica/epidemiologia , Escolaridade , Morte Fetal/epidemiologia , Habitação/normas , Humanos , Recém-Nascido , Modelos Lineares , Saúde Pública/normas , Previdência Social/normas , Fatores SocioeconômicosRESUMO
In many regions of the world, women breastfeed one child while pregnant with the next. Among rural Guatemalan women participating in a nutrition-supplementation trial, lactation overlapped with pregnancy in 253 of 504 (50.2%) of the pregnancies. For cases where overlap occurred, 41.4% continued to breast-feed into the second trimester and 3.2%, in the third trimester. The maternal and fetal responses to the energetic stresses of overlap and of the duration of the recuperative (nonpregnant, nonlactating) interval were assessed. Overlap resulted in increased supplement intake. Short recuperative periods (less than 6 mo) resulted in increased supplement intake and reduced maternal fat stores. The energetic stresses of overlap and short recuperative periods did not significantly affect fetal growth. The mother appears to buffer the energetic stress, protecting fetal growth. This research demonstrates that evidence of depletion of maternal nutrient stores caused by a demanding reproductive history is found when reproductive stress is characterized adequately.
Assuntos
Ingestão de Alimentos , Desenvolvimento Embrionário e Fetal , Lactação/fisiologia , Fenômenos Fisiológicos da Nutrição , Gravidez/fisiologia , Antropometria , Peso ao Nascer , Feminino , Idade Gestacional , Guatemala , Humanos , Estudos Longitudinais , ParidadeRESUMO
In a case-control study conducted in Latin America, the relationship of injectable contraceptive (IC) use to risk of invasive cervical cancer was analyzed while controlling for a variety of other risk factors, including female and spouse sexual behavior and infection with human papillomaviruses (HPV). Thirty-two cases and 82 controls reported ever having used IC. Women reporting use of IC for less than 5 years had an adjusted RR of 0.5 (95% Cl = 0.3-0.9), but users for 5 or more years had an RR of 2.4 (95% Cl = 1.0-5.7). The effect of prolonged IC use was stronger for women reporting first use 10 or more years before interview (adjusted RR = 3.4, 95% Cl = 1.1-24.9) and more than 5 years since last use (adjusted RR = 5.3, 95% Cl = 1.1-10.0). Cervical cancer risk associated with prolonged IC use was particularly high among women who reported never having had a Pap smear or having had one 2 or more years before interview (adjusted RR = 6.3, 95% Cl = 2.1-18.7). The reduced cervical cancer risk associated with short-term use of IC may reflect intensive Pap smear screening as the method is initiated. Although hampered by small numbers, these results suggest an adverse effect of prolonged IC use on cervical cancer risk, particularly among women who cease participation in screening programs after terminating usage, and indicate that long-term IC users should be monitored for cervical disease until more conclusive results are available.