Factores que inciden en el habito de fumar de escolares de educación basica y media del Chile

INTRODUÇÃO: Considerando a indiscutível evidência dos efeitos adversos do fumo para a saúde, milhões de pessoas continuam fumando. A situação é de maior gravidade, já que muitos dos fumantes e a maioria dos novos fumantes, tanto no Chile, como em outros países, são adolescentes. Dicidiu-se realizar estudo com o objetivo de determinar a prevalência do tabagismo em escolares chilenos e quantificar o impacto de fatores socioeconômicos, socioculturais, familiares, de exposição aos meios de comunicaçao de massa, demográficos, educacionais e psicosociais. MATERIAL E MÉTODO: Foi selecionada uma amostra aleatória representativa e proporcional de 2.967 escolares de educação básica e média, na Região Metropolitana do Chile, de acordo com o grau do curso (IV, VI e VIII básico de I e IV medio), sexo, tipo de escola e área geográfica. A prevalência de tabagismo foi determinada por meio de questionário auto administrado. O nível socioeconômico (NSE) foi avaliado pelo método de Graffar modificado determinando-se além das condições familiares, a exposicião aos meios de comunicação de massa e aos fatores psicosociais. O rendimento escolar foi determinado por um teste de idiomas e de matemáticas, além de outras variáveis educacionais. A análise estatística inclui análise de variância, teste "t" de Student e teste de Scheffe para comparar os médias, correlação, regressao múltipla, teste do qui-quadrado e o método de OPS/OMS para o cálculo de risco relativo(RR). RESULTADOS: A prevalência de tabagismo (10,6%) aumentou significativamente com a idade de 1,3% nos escolares menores de 13 anos, a 15,4 a 36,9% nos adolescentes entre 13-15 anos e ³ 16 anos, respectivamente (p < 0,001), e foi maior nos escolares de sexo feminino. Os níveis de plazer (r = 0,499 p < 0,001), rebeldía (r = 0,124 p < 0,001), recreação familiar (r = -0,131 pUNTRODUCTION: Despite the harmful effects of tobacco millions of people continue to smoke. Many of these smokers, including most news smokers, are adolescents - both in Chile and in other countries. This study sought to determine the prevalence of smoking among Chilean elementary and high school children and to quantify the relative impact of socioeconomic, socio-cultural, familial, mass media exposure, demographic, educational and psychosocial factors on smoking. MATERIAL AND METHOD: A representative sample of 2,967 elementary and high school children from Chile's Metropolitan Region were chosen at random, by grade (IV, VI, and VIII elementary school grades and I and IV high school grades), sex, type of school and geographical area. Prevalence of smoking was determined through an anonymous self-administered questionnaire. Socioeconomic status (SES) was measured by means of Graffar's modified method and family conditions, mass media exposure and psychosocial factors were registered. Scholastic achievement was measured by a language and mathematics test and other educational variables were considered. Statistical procedures included analysis of variance, Student's test and Scheffe's test for comparison of means, correlation, stepwise multiple regression, chi-squared and PAHO/WHO risk approach methodology. RESULTS: Prevalence of smoking (10.6%) increased significantly with age, from 1.3% in school children aged < 13 years to 15.4% and 36.9%, in adolescent students aged 13-15 years and ;³; 16 years, respectively (p< 0.001) and was higher in females than in males. Pleasure level (r= 0.499 p < 0.001), level of rebelliousness (r= 0.124 p < 0.0001), family recreation level (r=-0.131 p < 0.0001) and the percentage of school attendance (r=-0.118 p < 0.0001) were the independent variables with the greatest explanatory power in smoking variance (r²= 0.2860), but pleasure level was the variable with the greatest explanatory power in the explained variance (89.2%) and with the greatest RR (34.3). The relative impact of the independent variables on smoking varied according to age, sex and SES. CONCLUSIONS: The result demonstrate that pleasure level, level of rebelliousness, family recreation lvel and the percentage of school attendance were the independent variables with the greatest explanatory power in smoking. These findings may be useful in the implementation of education and health policies with a view to the reduction of this serious public health risk factor.INTRODUCCIÓN: Considerando la indiscutible evidencia de los efectos adversos del tabaco, para la salud, millones de personas continúan fumando. La situación es de mayor gravedad, ya que muchos de estos fumadores y la mayoría de los nuevos fumadores, tanto en Chile, como en otros países, son adolescentes. Los objetivos de este estudio fueron determinar la prevalencia de tabaquismo en escolares chilenos y cuantificar el impacto relativo que ejercen factores socioeconómicos, socioculturales, familiares, de exposición a medios de comunicación de masas, demográficos, educacionales y psicosociales, sobre la prevalencia de tabaquismo. MATERIAL E MÉTODO: Se seleccionó una muestra aleatoria, representativa de 2.967 escolares de educación básica y media de la Región Metropolitana de Chile, proporcional de acuerdo al curso(IV, VI, y VIII año básico y I y IV año medio), sexo, tipo de colegio y área geográfica. La prevalencia de tabaquismo se determinó mediante un cuestionario autoadministrado. El nivel socioeconómico(NSE) se midió por medio del método de Graffar modificado, midiéndose además, las condiciones familiares, la exposición a medios de comunicación de masas y factores psicosociales. El rendimiento escolar se determinó mediante un test de castellano y matemáticas, al mismo tiempo que se registraron otras variables educacionales. El análisis estadístico incluyó análisis de varianza, test de la t de Student y test de Scheffe para comparación de medias, correlación, regresión múltiple stepwise, chi-cuadrado y la metodología del enfoque de riesgo de OPS/OMS, para el cálculo del riesgo relativo simple (RR). RESULTADOS: La prevalencia de tabaquismo (10,6%) aumentó significativamente con la edad, de 1,3% en los escolares menores de 13 años, a 15,4% y 36,9%, en los adolescentes entre 13-15 años y ;³; 16 años, respectivamente (p< 0,001), a la vez que fue mayor en los escolares de sexo femenino. El grado de placer(r=0,499

Factors affecting Chilean elementary and high school children's smoking Factores que inciden en el habito de fumar de escolares de education basica y media del Chile

Despite the harmful effects of tobacco millions of people continue to smoke. Many of these smokers, including most news smokers, are adolescents - both in Chile and in other countries. This study sought to determine the prevalence of smoking among Chilean elementary and high school children and to quantify the relative impact of socioeconomic, socio-cultural, familial, mass media exposure, demographic, educational and psychosocial factors on smoking. A representative sample of 2,967 elementary and high school children from Chile's Metropolitan Region were chosen at random, by grade (IV, VI, and VIII elementary school grades and I and IV high school grades), sex, type of school and geographical area. Prevalence of smoking was determined through an anonymous self-administered questionnaire. Socioeconomic status (SES) was measured by means of Graffar's modified method and family conditions, mass media exposure and psychosocial factors were registered. Scholastic achievement was measured

Food and nutrition knowledge of elementary and high school-age children from Chile's Metropolitan Region Conocimientos alimentarios y nutricionales de escolares de educación básica y media de la Región Metropolitana de Chile

Background: In Chile there is scarce food and nutrition knowledge among school age children. Aim: To determine the degree of food and nutrition knowledge of elementary and high school children and its relationship to socioeconomic status, sex, type of school and geographic area. Subjects and methods: Between 1986 and 1987, a representative and proportional sample of 4509 children was chosen from the Metropolitan Region. This sample was stratified according to school grade, sex, type of school and geographical area. Graffar's modified method was used to measure socioeconomic status. Food and nutrition knowledge was assessed by a specific test for each grade, based on the objectives pursued by the curricular programs of the Ministry of Education. Results: The test was applied to 4197 children. Food and nutrition knowledge was significantly lower in the second subcycle of elementary school, in males, in older children from each grade, in rural areas, in children of low socioeconomic stat

Nutrition and learning in Chilean school age children: Chile's Metropolitan Region survey 1986-1987

The objective of this study was to determine the interrelationship between the scholastic achievement (SA) test and nutritional status of a representative sample of 4,509 elementary and high school children from Chile's Metropolitan Region. Percentages of weight/age (W/A), height/age (H/A), and weight/height (W/H) were compared to WHO (World Health Organization) Tables, head circumference/age (HC/A) to the Tanner Tables, and brachial anthropometry to Frisancho's norms. Socioeconomic status (SES) was measured by means of Graffar's Modified Method; SA by means of a language and mathematics test. Statistical analysis included correlation, regression, and WHO risk-approach methodology. Results showed that HC/A was the anthropometric parameter with the greatest explanatory power in SA variance and was significantly greater in high school graduates who were 17 y old (r = 0.350; p &lt; 0.001; r2 = 0.122) than in elementary school children, who were 6 y old (r = 0.227; p &lt; 0.001; r'2 = 0.049), w

Scholastic Achievement: A Multivariate Analysis of Nutritional, Intellectual, Socioeconomic, Sociocultural, Familial, and Demographic Variables in Chilean School-Age Children

Artículo de publicación ISI.OBJECTIVE: We determined relative effects of nutritional status, intellectual ability, exposure to mass media, and socioeconomic, sociocultural, familial, demographic, and educational variables on scholastic achievement (SA). METHODS: This was a cross-sectional study. Exposure to mass media and nutritional, intellectual, socioeconomic, sociocultural, familial, demographic, and educational factors, including approximately 2000 variables, were measured in a representative and proportional sample of 4509 school-age children from elementary and high schools in Chile's Metropolitan Region. The field study was carried out between 1986 and 1987, and data processing, which lasted 15 y, was completed in 2002. RESULTS: Within the total sample, intellectual ability, level of maternal schooling, head circumference-for-age Z score, book reading, in-door plumbing, level of paternal schooling, type of school, quality of housing, height-for-age Z score, and calcium intake were the independent variables with the greatest explanatory power in SA variance (r(2) = 0.508). In most grades, IA was the independent variable with the greatest explanatory power in SA variance. In adolescents in their fourth year of high school and whose physical growth and intellectual development processes are consolidated, intellectual ability, age, head circumference-for-age Z score, book reading, type of school, and level of paternal schooling were the independent variables with the greatest explanatory power in SA variance (r(2) = 0.60). CONCLUSIONS: These findings show that SA is conditioned by multiple factors depending on the characteristics of school-age children, their families, and the educational system. Nutritional indicators of past nutrition are significantly associated with SA, especially head circumference-for-age Z score. This information may be useful for health and educational planning.This study was supported in part by grants 1841167 and 1880818 from the National Fund for Scientific and Technologic Development and grant S 2169-924F from the Research and Development Department, University of Chile

Lipoprotein(a) and Benefit of PCSK9 Inhibition in Patients With Nominally Controlled LDL Cholesterol

Background: Guidelines recommend nonstatin lipid-lowering agents in patients at very high risk for major adverse cardiovascular events (MACE) if low-density lipoprotein cholesterol (LDL-C) remains ≥70 mg/dL on maximum tolerated statin treatment. It is uncertain if this approach benefits patients with LDL-C near 70 mg/dL. Lipoprotein(a) levels may influence residual risk. Objectives: In a post hoc analysis of the ODYSSEY Outcomes (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) trial, the authors evaluated the benefit of adding the proprotein subtilisin/kexin type 9 inhibitor alirocumab to optimized statin treatment in patients with LDL-C levels near 70 mg/dL. Effects were evaluated according to concurrent lipoprotein(a) levels. Methods: ODYSSEY Outcomes compared alirocumab with placebo in 18,924 patients with recent acute coronary syndromes receiving optimized statin treatment. In 4,351 patients (23.0%), screening or randomization LDL-C was 13.7 mg/dL or ≤13.7 mg/dL; corresponding adjusted treatment hazard ratios were 0.82 (95% CI: 0.72-0.92) and 0.89 (95% CI: 0.75-1.06), with Pinteraction = 0.43. Conclusions: In patients with recent acute coronary syndromes and LDL-C near 70 mg/dL on optimized statin therapy, proprotein subtilisin/kexin type 9 inhibition provides incremental clinical benefit only when lipoprotein(a) concentration is at least mildly elevated. (ODYSSEY Outcomes: Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab; NCT01663402