RESUMEN
BACKGROUND: This study investigates the extent to which friendship network, family relations, and school context are related to adolescent cigarette smoking. Friendship network is measured in terms of delinquent peers; family relations in terms of parental supervision; and school environment in terms of objective (eg, antismoking policy) and subjective (eg, school attachment) characteristics. METHODS: Findings are based on the secondary analysis of the health behavior in school-aged children, 2009-2010. Two-level hierarchical generalized linear models are estimated using hierarchical linear modeling 7. RESULTS: At the student level, ties to delinquent friends is significantly related to higher odds of smoking, while greater parental supervision is associated with lower odds. At the school level, antismoking policy and curriculum independently lower smoking behavior. Better within-class peer relations, greater school attachment, and higher academic performance are also negatively related to smoking. Last, the positive association between delinquent friends and smoking is weaker in schools with a formally enacted antismoking policy. However, this association is stronger in schools with better peer relations. CONCLUSIONS: Adolescent smoking behavior is embedded in a broader ecological setting. This research reveals that a proper understanding of it requires comprehensive analysis that incorporates factors measured at individual (student) and contextual (school) levels.
Asunto(s)
Conducta del Adolescente/psicología , Relaciones Familiares/psicología , Amigos/psicología , Fumar/psicología , Apoyo Social , Estudiantes/psicología , Adolescente , District of Columbia , Femenino , Humanos , Estudios Longitudinales , Masculino , Grupo Paritario , Influencia de los Compañeros , Instituciones Académicas/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Estados UnidosAsunto(s)
Fluorouracilo/administración & dosificación , Neoplasias Hepáticas/tratamiento farmacológico , Adulto , Cateterismo/efectos adversos , Quimioterapia del Cáncer por Perfusión Regional , Neoplasias del Colon/tratamiento farmacológico , Femenino , Humanos , Neoplasias Hepáticas/mortalidad , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia/tratamiento farmacológico , Neoplasias del Recto/tratamiento farmacológicoAsunto(s)
Antineoplásicos/administración & dosificación , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Cabeza , Neoplasias Cutáneas/tratamiento farmacológico , Factores de Edad , Anciano , Bleomicina/administración & dosificación , Bleomicina/uso terapéutico , Carcinoma Basocelular/tratamiento farmacológico , Carcinoma de Células Escamosas/tratamiento farmacológico , Cistoadenoma/tratamiento farmacológico , Sinergismo Farmacológico , Neoplasias del Ojo/tratamiento farmacológico , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/uso terapéutico , Humanos , Inyecciones Intraarteriales , Neoplasias Laríngeas/tratamiento farmacológico , Masculino , Mecloretamina/administración & dosificación , Mecloretamina/uso terapéutico , Metotrexato/administración & dosificación , Metotrexato/uso terapéutico , Persona de Mediana Edad , Neoplasias de la Boca/tratamiento farmacológico , Neoplasias/radioterapia , Neoplasias Faríngeas/tratamiento farmacológico , Remisión EspontáneaAsunto(s)
Neoplasias Laríngeas/epidemiología , Adulto , Anciano , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Femenino , Humanos , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/radioterapia , Neoplasias Laríngeas/cirugía , Laringectomía/efectos adversos , Metástasis Linfática , Masculino , Persona de Mediana EdadAsunto(s)
Neoplasias del Colon/tratamiento farmacológico , Fluorouracilo/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias del Recto/tratamiento farmacológico , Adulto , Anciano , Femenino , Humanos , Infusiones Parenterales , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Cuidados Paliativos , Factores de TiempoAsunto(s)
Adrenalectomía , Neoplasias de la Mama/terapia , Administración Oral , Adulto , Anciano , Castración , Cortisona/administración & dosificación , Femenino , Humanos , Hidrocortisona/administración & dosificación , Inyecciones Intramusculares , Menopausia , Persona de Mediana Edad , Metástasis de la NeoplasiaRESUMEN
PURPOSE: The aim of this study was to evaluate routine ophthalmic data to identify clinically useful risk factors for progressive visual field loss in patients with primary open-angle glaucoma (POAG) already receiving intraocular pressure-lowering treatments. METHODS: A retrospective cohort study design was used. Routine ophthalmic data for all subjects were obtained from case records with the knowledge that baseline clinical data had been collected in a standardised manner. Progression was defined according to the AGIS visual field defect scoring system. Variables evaluated as candidate risk factors for progression were assessed by survival analysis. Factors exerting a significant effect on survival were subsequently tested in a Cox proportional hazards model. RESULTS: A cohort of 108 eligible POAG patients was followed over an average of 3.6 years, with an average visual field intertest interval of 8 months. The incidence rate of progressive loss among the cohort was 5.4 cases per 100 person years. Increasing age was found to be independently associated with a small but significantly increased risk of glaucomatous visual field defect progression (hazard ratio 1.07, P=0.022), and a borderline association was also demonstrated with being male (hazard ratio 2.76, P=0.057). CONCLUSIONS: This retrospective investigation has provided preliminary information on factors associated with increased risk of progressive glaucomatous visual field loss that may inform clinical care strategies. Lack of concordance with other studies suggests that further prospective investigations are needed if risk stratification strategies are to be employed in caring for patients with chronic open-angle glaucoma.