Regression In Stata Research Articles

Factors associated with the uptake of long-acting reversible contraception among female sex workers in post-conflict Northern Uganda: a cross-sectional study

BackgroundLong-acting reversible contraception (LARC) is the most effective and reliable contraception option for female sex workers (FSWs) who desire future fertility. Unlike the other reversible contraceptive methods, LARC use requires only periodic users’ involvement at the time of application and re-application. However, only a few studies on LARC uptake among FSWs are available in Uganda. To fill this knowledge gap, we examined factors associated with the uptake of LARC among FSWs in post-conflict Northern Uganda.MethodsWe conducted a cross-sectional study among adult FSWs operating in the post-conflict Gulu district in Northern Uganda. We collected quantitative data among 280 FSWs of reproductive ages (18–49 years) who were neither pregnant nor using permanent contraception. We utilized a pretested semi-structured questionnaire to gather information from each participant through face-to-face interviews. We collected data on socio-demographic characteristics, sex work-related characteristics, obstetric history, HIV status, and LARC uptake. Data were then entered into EPI INFO 7, cleaned, and analyzed using multivariable Poisson regression in STATA 14.0 to obtained adjusted prevalence ratios (PR).ResultsAmong the study participants: the mean age (SD, range) was 26.5 (5.9, 18–45) years, 48.6% reported at least one unintended pregnancy during sex work, and 37.4% had at least one induced abortion. Meanwhile, only less than two in three (58.6%) participants were using LARC. At multivariable level, factors that remained independently associated with LARC uptake included: longer duration of sex work (adjusted PR = 1.44, 95% CI: 1.03–2.02), higher parity (adjusted PR = 1.13, 95% CI: 1.02–1.26), history of unintended pregnancies during sex work (adjusted PR = 1.24 CI: 1.01–1.51), and being a brothel/lodge-based FSWs (adjusted PR = 1.28, 95% CI: 1.01–1.63).ConclusionsThe above findings revealed a gap in the uptake of LARC among FSWs in post-conflict Northern Uganda influenced by duration of sex work, parity, unintended pregnancies during sex work, and place of sex work. Interventions to improve LARC uptake should target the newly recruited FSWs with low parity and the non-brothel/lodge-based FSWs.

Are You Happy to Be a Farmer? Understanding Indicators Related to Agricultural Production and Influencing Factors: GAP-Şanlıurfa, Turkey

Recently, agricultural production areas and farmer numbers have been decreasing in Turkey, which has started to cause concern. This study aimed to analyze the satisfaction levels of farmers in different irrigation areas in the Southeastern Anatolia Project (GAP)-Şanlıurfa region, based on indicators related to agricultural production and influencing factors. The data were obtained through face-to-face surveys with farmers in 2020 and analyzed by logistic regression in STATA. According to the results, 43.3% of the farmers are happy to be farmers in the current situation, and 35.6% want their children to continue farming activities. It was determined that the area of irrigation, education level, income, and farming experience were statistically significant at different rates in terms of the happiness of the farmers. On the other hand, livestock, number of households, and land size were not statistically significant. While 27.5% of the participants were fully satisfied with the given public support, 15.7% were satisfied with the market selling prices of their products, and 43.5% stated that effective organizations are needed to live well. To ensure agricultural sustainability in the research area, there is a need for more agricultural support, effective extension services, and the development of rural tourism with the participation of the public and private sectors. This study was the first of its kind to be conducted in Turkey.

OC07.05: PAN‐COVID study: factors associated with preterm delivery in women with SARS‐CoV‐2 infection in pregnancy

Preterm delivery is more common in women with SARS-CoV-2 infection. We sought to determine which factors in a woman's history or symptoms were associated with either spontaneous or iatrogenic delivery prior to 37 weeks. Variables included demographics, symptomatology, pregnancy information and co-morbidities. Backward stepwise logistic regression in Stata 16.0 was used for modelling. Of 1606 women whose details were registered with the UK and international PAN-COVID study from January 1st to July 25th 2020, 1147 had complete records for the defined set of predictors for preterm delivery. Details of the prediction model is detailed in table 1. For a one-unit increase in the risk factor, the odds of preterm delivery increase or decrease by a factor equivalent to the value of the odds ratio (OR). Confidence intervals for co-morbidities were wide due to small number of women with these conditions. For ethnicity, the odds of preterm delivery decrease by a factor of 0.54 for European/North American compared to non-European/North American women. These data, for the first time, provide granular detail in relation to the likelihood of preterm delivery in SARS-CoV-2 infection This may help in risk assessing pregnant women for public health interventions. In terms of symptoms, anosmia and myalgia are associated with a decrease in the odds of preterm delivery. All co-morbidities are associated with an increase in the odds of preterm delivery, this risk being notably high for women with pre-existing diabetes.

Differential treatment in the provision of medication abortion at pharmacies in Uttar Pradesh, India

BACKGROUNDAlmost 3 quarters of India's roughly 16 million annual abortions are done through medication abortion purchased from pharmacists outside of healthcare facilities. The quality of information provided by pharmacists about medication abortion is often poor.OBJECTIVETo determine whether pharmacists selling medication abortion provide different information or ask different, potentially stigmatizing questions to clients by gender and marital status.STUDY DESIGNMystery clients presenting as 4 profiles (unmarried woman, unmarried man, married woman, and married man) purchasing medication abortion interacted with 111 pharmacists in 3 districts around Lucknow, Uttar Pradesh in 2018. Data were collected immediately after the interaction. The differences in the information conveyed and the questions asked by the pharmacists by mystery client characteristics were analyzed using logistic regression in Stata 15 MP.RESULTSPharmacists very rarely asked intrusive, medically irrelevant questions and appeared willing to sell medication abortion to all the mystery clients regardless of gender, age, or marital status. However, the pharmacists were overall less likely to provide the female mystery clients with as comprehensive and correct information on medication abortion as they were to male mystery clients, particularly if female mystery clients presented as unmarried.CONCLUSIONPharmacists are observed to provide differential and poorer quality information about medication abortion to women, especially if they seem unmarried, potentially putting women at risk of having a lower-quality and less supported experience of using the medication. However, the pharmacists’ willingness to sell the medication to all mystery clients and the lack of intrusive questions and comments reinforces out-of-facility medication abortion as a way for individuals to access an often-stigmatized service. Interventions must find a way to either address this bias among pharmacists, or more practically, to provide high-quality information directly to the individuals seeking medication abortion.

Is Drought Caused by Fate? Analysis of Farmers’ Perception and Its Influencing Factors in the Irrigation Areas of GAP-Şanlıurfa, Turkey

This research aims to determine the belief-based drought perceptions and attitudes of farmers in Şanlıurfa, which is in a semi-arid climate regime, and the factors affecting them. The surveys were conducted through face-to-face interviews with farmers selected by a simple random sampling method in 2020. Analyses were performed with ordinal logit regression in STATA. According to the results, while the effects of settlement location, land size, age, and the size of the household were statistically significant to farmers seeing drought, which is the dependent variable, as caused by fate, the effects of income, experience, and education level were insignificant. For the probability of predicting drought for each independent variable in the sequence analysis, the highest probabilities were found among farmers in the Harran Plain, with 21–30 years of experience, from a household of one to four people, with the land area between 5.1 and 10.0 hectares, aged 61 and above, who were primary school graduates, and who had an annual income of less than 25,000 TL ($3561). The subject of drought should be given more place in religious education in the entire research area by prioritizing these groups. It would also be beneficial to organize workshops for the farmers by agricultural consultants, where Islamic scholars would be present to support science and knowledge in terms of faith. This study is the first in this context in Turkey and provides useful data to policymakers for drought-mitigation policies.

1072Mental health difficulties among adolescents in Ghana, coping mechanisms and the support systems: a mixed-methods study

Abstract Background Despite their vulnerability, mental health of adolescents has received little attention in developing countries. We investigated the mental health difficulties faced by adolescents, their coping strategies and school-based support systems. Methods Design was a convergent mixed-methods study. Quantitative data was collected using the validated strengths and difficulties questionnaire to assess the mental health of 405 adolescents in four senior high schools (SHS) in the Techiman Municipality, Ghana. Qualitative data was collected through in-depth interview with 18 teachers and seven focused group discussions among 35 students. Adjusted odds ratio (OR) for mental health difficulties were estimated through ordinal logistic regression in Stata 14.2. Qualitative data were analysed by thematic content analysis using ATLAS.ti 7.1. Results Over half (58.5%) experienced abnormalities related to peer (20.5%), emotional (16.3%), conduct (13.3%) and hyperactivity (3.0%) problems and prosocial behaviours (5.4%). Significant determinants were being female (OR = 2.27, 95% confidence interval [CI]:1.47-3.50), bullied (OR = 1.72, CI:1.07-2.75), domestic violence (OR = 1.87, CI:1.10-3.17), substance abuse (OR = 8.14, CI: 1.41-46.8), academic pressure (OR = 2.40, CI:1.30-4.42), and perceived poor performance (OR = 7.36 CI:2.83-19.16). Mental health difficulties were attributed to financial challenges, spiritual influences, intimate relationships, bullying, and domestic violence. Coping strategies included isolation, substance abuse and spiritual help. Guidance and counselling unit, the main support system, was ineffective due to issues with trust, confidentially, and qualified counsellors. Conclusions As mental health difficulties were prevalent, school-based support systems, particularly guidance and counselling needs strengthening, including being manded by trained personnel. It is time to incorporate mental health education into school curricula. Key messages Mental disorders among adolescents are common. While guardians and religious bodies are critical, many of the triggers occur in school necessitating mental health-friendly school environments.

Mental health difficulties, coping mechanisms and support systems among school-going adolescents in Ghana: A mixed-methods study.

BackgroundAlthough adolescents are highly vulnerable to mental health challenges, they receive little attention, especially in developing countries. We investigated the mental health difficulties (MHDs) faced by adolescent students in four senior high schools in Ghana, their coping strategies and support systems.MethodsIn this convergent mixed-methods study, quantitative data was obtained using validated strengths and difficulties questionnaire to assess the mental health of 405 adolescents. Qualitative data was collected through in-depth interview with 18 teachers and seven focused group discussions with 35 students. Adjusted odds ratios (OR) for MHDs were estimated through ordinal logistic regression in Stata 14.2. Qualitative data was analyzed inductively and deductively using ATLAS.ti 7.1.ResultsOver half (58.5%) experienced peer (20.5%), emotional (16.3%), conduct (13.3%) and hyperactivity (3.0%) problems, whereas 5.4% exhibited prosocial behaviours. MHDs were associated with females (OR = 2.27, 95% CI: 1.47–3.50), bullying (OR = 1.72, CI: 1.07–2.75), domestic violence (OR = 1.87, CI: 1.10–3.17), substance abuse (OR = 8.14, CI: 1.41–46.8), academic pressure (OR = 2.40, CI: 1.30–4.42) and self-perceived poor school performance (OR = 7.36 CI: 2.83–19.16). Qualitatively, we identified financial challenges, spiritual influences, intimate relationships, bullying, and domestic violence as the main themes attributed to MHDs. Coping strategies included isolation, substance use and spiritual help. The main school-based support system was the guidance and counselling unit, but there were complaints of it been ineffective due to trust and confidentially issues, and non-engagement of qualified counsellors.ConclusionsAs many triggers of MHDs emanate in schools, we need mental health-friendly school environments where trained psychotherapists head counselling centres. We propose incorporating mental health education into school curricula and generating surveillance data on adolescent’s mental health.

Evaluation of the effect of border closure on COVID-19 incidence rates across nine African countries: an interrupted time series study.

BackgroundBorder closure is one of the policy changes implemented to mitigate against coronavirus disease 2019 (COVID-19). We evaluated the effect of border closure on the incidence rate of COVID-19 across nine African countries.MethodsAn interrupted time series analysis was used to assess COVID-19 incidence rates in Egypt, Tunisia, Democratic Republic of the Congo (DRC), Ethiopia, Kenya, Ghana, Nigeria, Senegal and South Africa (SA). Data were collected between 14 February and 19 July 2020 from online data repositories. The linear trend and magnitude of change were evaluated using the itsa function with ordinary least-squares regression in Stata with a 7-d deferred interruption point, which allows a period of diffusion post-border closure.ResultsOverall, the countries recorded an increase in the incidence rate of COVID-19 after border closure. However, when compared with matched control groups, SA, Nigeria, Ghana, Egypt and Kenya showed a higher incidence rate trend. In contrast, Ethiopia, DRC and Tunisia showed a lower trend compared with their controls.ConclusionsThe implementation of border closures within African countries had minimal effect on the incidence of COVID-19. The inclusion of other control measures such as enhanced testing capacity and improved surveillance activities will reveal the effectiveness of border closure measures.

Effects of Pictorial Health Warnings on Cognitive, Affective, and Smoking Behavior: A Mixed Methods Study in Four Cities in Indonesia.

While studies have shown the importance of pictorial health warnings (PHW) as a tobacco control strategy, empirical evidence on the efficacy of PHW in prompting smoking behavior remains inconclusive. The study aimed to examine the association between PHW and cognitive reactions, emotional/affective reactions, and smoking behavior. We conducted a mixed-methods study, which included a cross-sectional face-to-face survey of 401 smokers in four cities (Jakarta, Bandung, Semarang, and Yogyakarta) and three focus group discussions among 24 participants in Jakarta. We applied multiple logit regression in STATA for quantitative data analysis and explanatory sequential design for qualitative data analysis. Quantitatively, we found high (63-84% of respondents) understanding about PHW objectives (cognitive reactions), including to remind health risks and encourage smoking cessation. With only 40% PHW, we found relatively low (32%-39%) negative emotional reactions, including feeling scared, annoyed and disgusted and relatively low proportions (33-40%) of respondents that reported quit attempt. Consistent with the quantitative findings, qualitative data provided contexts, including in explaining that the professional worker group was the least affected by PHW, while the student and non-professional groups were the most vulnerable. All this is supportive of governments in Indonesia and other countries to increase the PHW size.

The prevalence and correlates of the double burden of malnutrition among women in Ghana.

Anaemia and underweight or overweight/obesity are major public health problems driving maternal and child mortality in low- and middle-income countries. While the burden of these conditions is recognised, the evidence for the co-occurrence of these conditions is fragmented and mixed, especially at the individual level. Further, many studies have focused on families and communities. The different pathways for the occurrence of anaemia and BMI challenges indicate that an individual can potentially live with both conditions and suffer the complications. This study examined the prevalence and factors associated with the co-occurrence of anaemia and BMI challenges among a cohort of women in Ghana. Data from the 2014 Ghana Demographic and Health Survey were used. The sample size was 4 337 women aged 15–49 years who were not pregnant during the survey. Women who suffered simultaneously from underweight or overweight/obesity and anaemia were considered as having the double burden of malnutrition. The data were analysed using descriptive statistics, Chi-square test and logistic regression in STATA. One-fifth of the participants were overweight (21%), 4% were underweight and about one-tenth were obese (12%). The prevalence of anaemia was 41%. Only one in three women had normal weight and was not anaemic (34%). About 14% of the women experienced the double burden of malnutrition. Being overweight and anaemic (57%) was the most common form of this double burden. Age, marital status, parity, and wealth were t key risk factors associated with the double burden of malnutrition. The findings from this study show that women experience multiple nutritional challenges concurrently and that only a few women had healthy nutritional status. This information is particularly important and can be introduced into health education programmes to help address misconceptions about body weight and health.

Demographic and Psychosocial Determinants of Life Satisfaction Among Youths in Nigeria: Evidence from the Multiple Indicators Cluster Survey

Subjective Wellbeing, implying an evaluation of one’s life has recently received intellectual attention, especially in developed countries. Measuring this concept entails both an effective and cognitive evaluation of life. Life satisfaction plays a vital role in positive life outcomes as a key part of the cognitive component of subjective wellbeing. Various factors could determine the current state of wellbeing on an individual. Leveraging on one of the surveys that collect data on subjective wellbeing in Nigeria, we examined the determinants of life satisfaction among youths in Nigeria, with a concentration on the demographic and psychosocial factors. Multiple Indicator Cluster Survey (MICS) data for Nigeria (n = 18,454) was analyzed using chi-square tests and binomial logistic regression in Stata 14. The result showed that gender, residence, and region significantly determined life satisfaction. For psychosocial factors influencing life satisfaction; health, family life satisfaction, friendship, treatment by others, and perceived improvement in comparison to last year, significantly determine life satisfaction. Specifically, male resident in rural areas of Nigeria were more likely to report satisfaction with life. Further, youths that reported satisfaction with family life were more likely to be satisfied with life in general, while satisfaction with health, friendships, treatment by others, and improved condition from last year influenced satisfaction with life. In conclusion, it has been shown that beyond the socio-demographic factors, psychosocial determinants play vital roles in determining life satisfaction among youths. It is therefore imperative that government agencies consider policies and interventions that address psychosocial support for youths in Nigeria.

Lassopack: Model selection and prediction with regularized regression in Stata

In this article, we introduce lassopack, a suite of programs for regularized regression in Stata. lassopack implements lasso, square-root lasso, elastic net, ridge regression, adaptive lasso, and postestimation ordinary least squares. The methods are suitable for the high-dimensional setting, where the number of predictors p may be large and possibly greater than the number of observations, n. We offer three approaches for selecting the penalization (“tuning”) parameters: information criteria (implemented in lasso2), K-fold cross-validation and h-step-ahead rolling cross-validation for cross-section, panel, and time-series data (cvlasso), and theory-driven (“rigorous” or plugin) penalization for the lasso and square-root lasso for cross-section and panel data (rlasso). We discuss the theoretical framework and practical considerations for each approach. We also present Monte Carlo results to compare the performances of the penalization approaches.

Obesity and the possibility of conceiving a child during assisted reproduction treatment: An Argentinian experience

ObjectiveThe goal of this study was to assess the association between BMI and the possibility of conceiving a child through an assisted reproduction treatment.MethodsA study of cases and controls matched by age, with 394 patients that underwent treatment at GESTAR (assisted reproduction center), between 2013-2017. The association between BMI and the possibility of conceiving a child, analyzed through logistic regression.ResultsAmong the cases (successful treatments) 14% were obese, while in the control group (patients that did not get pregnant) the obesity rate was 21%. There was a significant difference (p<0,01) in the BMI, the number of recovered oocytes, normally fertilized oocytes and the number of transferred embryos. The Odds Ratio (OR) in SPSS was 0.26 ± (0.14, 0.50) - 95% CI, indicating that conceiving a child by assisted reproduction is 74 times lower in patients that are obese when compared to non-obese patients (p<0,001). And the Odds Ratio (OR) calculated by logistic regression in Stata 11 was 0.80 ± (0.76, 0.86), 95% CI, which indicates a 20% decrease in the possibility of conceiving for each point on the BMI scale.ConclusionObesity is associated with a lower conception likelihood through assisted reproduction technologies.

Associations between echocardiographic findings and prospective changes in residual renal function in patients new to peritoneal dialysis

Although echocardiograms are often performed when peritoneal dialysis is started, associations between commonly reported findings and prospective changes in renal function remain understudied. Ninety-nine of 101 patients in the Trio Trial had transthoracic echocardiograms within 6 months of dialysis initiation, and measurements of residual renal function every six weeks for up to two years. Generalized mixed modelling linear regression in STATA was used to examine associations between left atrial size, left ventricular hypertrophy, left ventricular ejection fraction, right ventricular systolic pressure, and left valvular calcification with subsequent slopes in renal function. After echocardiography (performed a median of 16 days following peritoneal dialysis initiation) right ventricular systolic pressure was associated with faster, while declining left ventricular ejection fraction and valvular calcification were associated with slower declines in residual renal function. Future studies could be conducted to confirm these findings, and identify pathophysiological mechanisms.

Smoke-free home initiative in Bantul, Indonesia: Development and preliminary evaluation.

INTRODUCTIONTobacco control policies in Indonesia are still limited. This study aims to describe the process of the implementation of the smoke-free home (SFH) program in rural areas in Indonesia and to conduct a preliminary evaluation of its implementation.METHODSThe development of SFH (or Rumah Bebas Asap Rokok) applies the theory of diffusion of innovation with the following stages: innovation, dissemination, adoption, implementation, and evaluation. The preliminary evaluation of the SFH program used an observational method combined with a cross-sectional survey. The population of this study was all houses in Karet hamlet, in Bantul district, Yogyakarta province with 378 houses as population, from which 196 houses were selected as sample using the proportional random sampling technique. Quantitative data analysis used multiple linear regression in Stata 15.1.RESULTSSFH is a community-based tobacco control innovation program that began with a community declaration. Preliminary evaluation after one-year implementation showed that 55% and 45% of respondents were smokers and non-smokers, respectively. Among smokers, 95%, 78% and 56% reported not smoking near pregnant women, children, and non-smokers, respectively. Moreover, 52% of respondents reported having a front-door ashtray, and 46% reported guests not smoking; among non-smokers, the corresponding values were 56% and 60%.CONCLUSIONSSFH implementation has an impact on the community’s smoking pattern. Awareness of smokers to protect women and children from secondhand smoke is very high. While the results are promising, more political and resource support is needed from the local and national policymakers to support SFH initiatives.

Sexual Maturation, social support and physical activity in adolescents

To analyze the moderating effect of maturation on the association between social support, received from parents and friends, on physical activity level in adolescents. Cross-sectional study conducted in 2014 with a representative sample of 855 adolescents (54% girls) enrolled in public school of São José dos Pinhais, Brazil. Adolescents reported weekly attendance who received different types of social support for physical activity, which was classified into three categories (“never," "sometimes," "always"). The social support score from each source was computed and classified in tertiles ("low", "intermediate", "high"). The moderate to vigorous leisure time physical activity was evaluated with a valid questionnaire and the score was classified as ≥300 min/wk. The maturation was self-assessed by pubic hairiness by photos and classified as "pubescent" and "post-pubescent". The associations were tested with Poisson regression in STATA 14. The fact that parents "sometimes" (PR: 2.51; 95% CI: 1.42-4.44) or "always" (PR: 4.60; 95% CI: 2.10-10.10) to attend the activities was positively associated with the physical activity of pubertal adolescents. While positive reinforcement for the activities ("always" commenting) was positively associated with the outcome in post-pubertal adolescents (PR: 2.60; 95% CI: 1.01-6.71). The fact that friends "always" watch activities (PR: 2.39; 95% CI: 1.01-5.76), the score "intermediate" (PR: 2.13; 95% CI: 1.28-3.58) and "high" (RP: 1.91; 95% CI: 1.11-3.28) were positively associated with the physical activity of pubertal adolescents. Maturation shows a moderating effect in the association between the social support and physical activity.

Performance of community health workers and associated factors in a rural community in Wakiso district, Uganda.

Community health workers (CHWs) continue to play a crucial role in supporting health service delivery globally. Several CHW programmes around the world face vast challenges which affect their performance. This study assessed the performance of CHWs and associated factors in a rural community in Wakiso district, Uganda. This was a cross-sectional study that employed a structured questionnaire to collect quantitative data from 201 CHWs in Wakiso district. The main study variable was CHW performance based on various roles carried out by CHWs. Multivariable logistic regression in STATA was used to establish the predictors of CHW performance. Only 40 (19.9%) of the CHWs had a high performance which was associated with having attended additional / refresher trainings [AOR=12.79 (95% CI: 1.02-159.26)], and having attained secondary level education and above [AOR=3.93 (95% CI: 1.17-13.24)]. CHWs who were married [AOR=0.29 (95% CI: 0.09-0.94)] were less likely to perform highly. Among CHWs who had received essential medicines for treatment of childhood illnesses, the majority 90.3% (112/124) had experienced stock-outs in the 6 months preceding the study. Despite the majority of CHWs, 198 (98.5%), stating that being motivated was very important in their work, only 91 (45%) said that they were motivated. Additional / refresher trainings are necessary to enhance performance of CHWs. In addition, level of education should be considered while selecting CHWs. The health system challenges of low motivation of CHWs as well as stock-out of medicines need to be addressed to support their work.

The Role of Optimism in Predicting Tobacco Smoking and Illicit Drug Use Among High School Students in Southeast of Iran, 2018

Background: Personality is associated with health behaviors, such as smoking and substance abuse, yet there is little information about the relationship between optimism and tobacco smoking or substance abuse among high school students. Objectives: The aim of the present study was to determine the association between optimism or pessimism in predicting tobacco smoking and substance abuse among high school students in southeast of Iran. Methods: In this study, 1094 students of high schools in Zahedan city, southeast of Iran, were selected using proportionally multi-stage sampling. Cigarette and hookah smoking status, substance abuse, optimism, and other potential confounders were measured using a self-administered questionnaire. The data were analyzed using chi-square, analysis of variance (ANOVA) tests and ordinal logistic regression in Stata.14 software. Results: According to the results of present study, the prevalence of cigarette smoking and ever hookah smoking was 32.7% and 36.1%, respectively. About 11.2% of students had used at least one illicit drug. After controlling potential confounders, optimism score was negatively related to cigarette smoking stages (OR = 0.90, 95% CI: 0.79 to 0.97) and illicit drugs use (OR = 0.91, 95% CI: 0.70 to 0.96) yet was not associated with hookah smoking (OR = 0.98, 95% CI: 0.82 to 1.31). Conclusions: Optimism and pessimism have an important role in tendency of students to tobacco smoking and substance abuse. On the other hand, the co-occurrence of smoking and substance abuse is high among students with low optimism scores. Therefore, educating and consulting students regarding positivism and promising could prevent from smoking and substance abuse and probably transition to higher stages.

Preenchimento da caderneta de saúde da criança na primeira infância

Objetivo: Avaliar o preenchimento da Caderneta de Saúde da Criança em uma capital da Região Norte do Brasil. Métodos: Estudo transversal e descritivo, realizado num hospital pediátrico de uma capital na Região Norte, com 420 crianças com idade inferior a cinco anos. A coleta de dados ocorreu no período de abril a outubro de 2017, em entrevista com o cuidador principal da criança, na qual se questionou informações referentes ao cuidador, à criança e orientações recebidas sobre a caderneta, bem como o seu preenchimento, utilizando-se um sistema de escore. A análise foi realizada por meio de estatística descritiva e cálculo da Razão de Prevalência, por meio de Regressão de Poisson, no software Stata®, versão 13. Resultados: Apenas 25,5% (n=111) das Cadernetas de Saúde da Criança tiveram preenchimento satisfatório. O preenchimento não satisfatório esteve associado (p=0,01) a casos em que o cuidador principal não era os pais ou avós, o cuidador possuía escolaridade menor que nove anos, a mãe não havia realizado o pré-natal ou o acompanhamento pelo Sistema Único de Saúde, e entre os cuidadores que não receberam orientações sobre a importância da caderneta. O maior índice de preenchimento da caderneta foi referente às vacinas aplicadas (99,3%, n=417), e um dos menores índices foi sobre o desenvolvimento neuropsicomotor (18,1%, n=202). Conclusão: O preenchimento insatisfatório da Caderneta de Saúde da Criança mostra as fragilidades no acompanhamento do crescimento e desenvolvimento integral, principalmente na primeira infância.

Faktor-faktor yang mempengaruhi kualitas hidup pasien kanker tiroid berdiferensiasi baik (DTC) paska tiroidektomi total di Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar

Background: Thyroid Cancer is the most common endocrine cancer. The majority of thyroid cancer (80-85%)Â is well differentiated. Surgery is the treatment of choice for Well-Differentiated Thyroid Cancer (DTC). This research aims to evaluate the quality of life of patients with thyroid cancer who have undergone total thyroidectomy compared to the general population and also assess the influencing factors.Methods: This research includes 50 patients suffering from DTC after total thyroidectomy and 50 participants were selected to represent the general population who are then asked to fill out a detailed questionnaire EORTC QLQ 30 Indonesia Version including demographic data and clinical data as the TSH levels, the type of histopathology and interval of time since diagnosis, taken from the patient's medical record. Data were analyzed using independent t-test and linear regression in STATA 14 for windows.Results: It is evident that the quality of life of patients with DTC after total thyroidectomy is significantly lower compared to the general population (P&lt;0.05). In addition, several factors such as age, educational level and income of the family give a strong influence as for gender, marital status, employment status, and the time interval since diagnosis gives a mild influence to the quality of life (P&lt;0.05). However, TSH levels and type of histopathology was not proven to affect the quality of life (P&gt;0.05)Conclusion: There are several factors related to quality of life among patients with DTC such as age, educational level and income of the family, gender, marital status, employment status, and the time interval since diagnosis