In Vivo Safety and Efficacy of Chalcone-Loaded Microparticles with Modified Polymeric Matrix against Cutaneous Leishmaniasis.

Current chemotherapy of cutaneous leishmaniasis (CL) is based on repeated systemic or intralesional administration of drugs that often cause severe toxicity. Previously, we demonstrated the therapeutic potential of biodegradable poly(lactic-co-glycolic acid) (PLGA) microparticles (MPs) loaded with 8% of the nitrochalcone CH8 (CH8/PLGA) prepared by a conventional bench method. Aiming at an industrially scalable process and increased drug loading, new MPs were prepared by spray drying: CH8/PDE with PLGA matrix and CH8/PVDE with PLGA + polyvinylpyrrolidone (PVP) matrix, both with narrower size distribution and higher drug loading (18%) than CH8/PLGA. Animal studies were conducted to evaluate their clinical feasibility. Both MP types induced transient local swelling and inflammation, peaking at 1−2 days, following a single intralesional injection. Different from CH8/PDE that released 90% of the drug in the ear tissue in 60 days, CH8/PVDE achieved that in 30 days. The therapeutic efficacy of a single intralesional injection was evaluated in BALB/c mice infected with Leishmania (Leishmania) amazonensis and golden hamsters infected with L. (Viannia) braziliensis. CH8/PVDE promoted greater reduction in parasite burden than CH8/PDE or CH8/PLGA, measured at one month and two months after the treatment. Thus, addition of PVP to PLGA MP matrix accelerates drug release in vivo and increases its therapeutic effect against CL.

Intervening on Burnout in Complex Organizations - The Incomplete Process of an Action Research in the Hospital.

Health professionals are at high risk for developing burnout symptoms. Directed at reducing the organizational variables affecting professionals' burnout, an action research was developed in a specific sector of a large hospital, with 59 doctors, 66 nurses, and 42 ancilliary professionals. Researchers conducted 11 interviews, one focus group, and 20 h of in loco observation. Professionals report demotivation and the need to address the emotional part of their job. Nonetheless, the hierarchy blocked the proposed intervention possibilities. Organizational factors are unequivocally relevant, particularly in complex settings with emotionally charged interactions, and the direct hierarchy is pivotal for facilitating organizational change.

Exploring patterns of multiple climates and their effects on safety performance at the department level.

INTRODUCTION: This paper represents a first attempt to fill a gap in research about different specific climates and safety outcomes, by empirically identifying patterns of climates and exploring the possible effect of different climates at the department level on some specific safety outcomes. The first objective was to explore how different specific climates (safety, communication, diversity and inclusion) can be associated to each other, considering the department level of analysis. The second objective was to examine the relationships between those patterns of climates with safety performance (compliance and participation behaviors). METHOD: A total of 429 blue-collar workers in 35 departments answered a questionnaire covering safety, diversity, inclusion, and communication climate measures. Cluster analysis was performed to identify clusters of departments with different climate patterns and their impact on safety compliance and safety participation behaviors. Subsequently, a hierarchical multiple linear regression was conducted at the individual-level to test the effect of climate patterns, by controlling for some sociodemographic variables. RESULTS: Results showed the existence of four differentiated clusters of departments. Three of those clusters showed homogenous patterns (coherent association among perceptions of low, medium and high climates) and one heterogeneous (low and medium perceptions). The findings also revealed that the higher the climates perceptions, the higher the levels of safety participation and safety compliance, with safety participation being more affected than compliance. CONCLUSIONS: The present research showed the associated effects of some organizational climate factors, such as fair treatment, inclusion, safety and communication within the organization, which had not been previously studied in their combined relationships, on safety behaviors. Practical applications: Several other organizational climate factors, such as fair treatment, inclusiveness and communication, may play an important role in safety, showing the importance of broadening the focus on safety climate as one of the main predictors of safety behaviors.

Immunomodulation From Moderate Exercise Promotes Control of Experimental Cutaneous Leishmaniasis.

Physical exercise has been described as an important tool in the prevention and treatment of numerous diseases as it promotes a range of responses and adaptations in several biological systems, including the immune system. Studies on the effect of exercise on the immune system could play a critical role in improving public health. Current literature suggests that moderate intensity exercise can modulate the Th1/Th2 dichotomy directing the immune system to a Th1 cellular immune response, which favors the resolution of infections caused by intracellular microorganisms. Leishmaniasis is a group of diseases presenting a wide spectrum of clinical manifestations that range from self-limiting lesions to visceral injuries whose severity can lead to death. The etiological agents responsible for this group of diseases are protozoa of the genus Leishmania. Infections by the parasite Leishmania major in mice (Balb/c) provide a prototype model for the polarization of CD4+ T cell responses of both Th1 (resistance) or Th2 (susceptibility), which determines the progression of infections. The aim of this study was to evaluate the effect of exercise on the development of L. major experimental infections by scanning the pattern of immune response caused by exercise. Groups of Balb/c mice infected with L. major were divided into groups that preformed a physical exercise of swimming three times a week or were sedentary along with treatment or not with the reference drug, meglumine antimoniate. Animals in groups submitted to physical exercise did not appear to develop lesions and presented a significantly lower parasite load independent of drug treatment. They also showed a positive delayed hypersensitivity response to a specific Leishmania antigen compared to control animals. The IFN-γ/IL-4 and IFN-γ/IL10 ratios in trained animals were clearly tilted to a Th1 response in lymph node cells. These data suggest that moderate intensity exercise is able to modulate the Th1 response that provides a protective effect against the development of leishmanial lesions.

Safety training transfer: The roles of coworkers, supervisors, safety professionals, and felt responsibility.

The aim of this study is to identify the influence of social dimensions of the work environment and the employees' felt responsibility on the transfer of safety training. We tested a model in which responses and reactions from safety players such as coworkers, supervisors, and safety professionals are positively related to the transfer of training (TT), through the mediating effect of the employees' felt responsibility and the moderating influence of supervisor support and sanctions. A two-time data collection was implemented among blue-collar employees, all low qualified, from four city councils who attended a fundamental safety training program delivered by in-house safety trainers, all safety professionals (n = 203). Data analysis revealed that (a) supervisors' safety responses, coworkers' safety responses, and safety professionals' reactions positively influenced the TT, an effect (b) mediated by employees' felt responsibility and (c) moderated by supervisor sanctions, but not by supervisor support. The results suggest that high sanctions enhance the positive effect of high self-responsibility on TT, and, importantly, aggravate the negative effect of low self-responsibility on TT. This is the first study to empirically test both the influence of felt responsibility and the safety professionals' reactions in the transfer process. Research should continue to examine the former construct's influence on the transfer process including, for example, its effect on supervisor support, and the latter as a safety-related social dimension variable of the work environment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Do infants with cow's milk protein allergy have inadequate levels of vitamin D? / Lactentes com alergia à proteína do leite de vaca apresentam níveis inadequados de vitamina D?

Abstract Objective: To verify whether infants with cow's milk protein allergy have inadequate vitamin D levels. Methods: This cross-sectional study included 120 children aged 2 years or younger, one group with cow's milk protein allergy and a control group. The children were recruited at the pediatric gastroenterology, allergology, and pediatric outpatient clinics of a university hospital in the Northeast of Brazil. A questionnaire was administered to the caregiver and blood samples were collected for vitamin D quantification. Vitamin D levels <30 ng/mL were considered inadequate. Vitamin D level was expressed as mean and standard deviation, and the frequency of the degrees of sufficiency and other variables, as proportions. Results: Infants with cow's milk protein allergy had lower mean vitamin D levels (30.93 vs.35.29 ng/mL; p = 0.041) and higher deficiency frequency (20.3% vs.8.2; p = 0.049) than the healthy controls. Exclusively or predominantly breastfed infants with cow's milk protein allergy had higher frequency of inadequate vitamin D levels (p = 0.002). Regardless of sun exposure time, the groups had similar frequencies of inadequate vitamin D levels (p = 0.972). Conclusions: Lower vitamin D levels were found in infants with CMPA, especially those who were exclusively or predominantly breastfed, making these infants a possible risk group for vitamin D deficiency.

Resumo Objetivo: Verificar se lactentes com alergia à proteína do leite de vaca (APLV) apresentam níveis inadequados de vitamina D. Métodos: Estudo transversal, envolveu 120 crianças de até dois anos, um grupo com APLV e outro de comparação, captadas dos ambulatórios de Gastroenterologia Pediátrica, Alergologia Pediátrica e Puericultura de um hospital universitário, no Nordeste brasileiro. Foi aplicado um formulário e foram coletadas amostras sanguíneas para a análise da vitamina D, foram considerados inadequados os níveis < 30 ng/mL. Níveis de vitamina D foram expressos em média e desvio padrão e a frequência dos graus de suficiência e demais variáveis, em proporções. Resultados: Lactentes com APLV, quando comparados com os saudáveis, apresentaram uma menor média do nível da vitamina D (30,93 vs. 35,29 ng/mL) (p = 0,041) e maior frequência de deficiência (20,3% vs. 8,2) (p = 0,049). Maior frequência de níveis inadequados de vitamina D foi observada nas crianças com APLV que estavam em aleitamento materno exclusivo/predominante (p = 0,002). Independentemente do período de exposição solar, a frequência de um status inadequado de vitamina D foi semelhante entre os grupos (p = 0,972). Conclusões: Menores níveis de vitamina D foram observados em lactentes com APLV, especialmente naqueles em aleitamento materno exclusivo/predominante, que configura esse como um possível grupo de risco para essa deficiência.

Do infants with cow's milk protein allergy have inadequate levels of vitamin D?

OBJECTIVE: To verify whether infants with cow's milk protein allergy have inadequate vitamin D levels. METHODS: This cross-sectional study included 120 children aged 2 years or younger, one group with cow's milk protein allergy and a control group. The children were recruited at the pediatric gastroenterology, allergology, and pediatric outpatient clinics of a university hospital in the Northeast of Brazil. A questionnaire was administered to the caregiver and blood samples were collected for vitamin D quantification. Vitamin D levels <30ng/mL were considered inadequate. Vitamin D level was expressed as mean and standard deviation, and the frequency of the degrees of sufficiency and other variables, as proportions. RESULTS: Infants with cow's milk protein allergy had lower mean vitamin D levels (30.93 vs.35.29ng/mL; p=0.041) and higher deficiency frequency (20.3% vs.8.2; p=0.049) than the healthy controls. Exclusively or predominantly breastfed infants with cow's milk protein allergy had higher frequency of inadequate vitamin D levels (p=0.002). Regardless of sun exposure time, the groups had similar frequencies of inadequate vitamin D levels (p=0.972). CONCLUSIONS: Lower vitamin D levels were found in infants with CMPA, especially those who were exclusively or predominantly breastfed, making these infants a possible risk group for vitamin D deficiency.

Assessing the coding reliability of work accidents statistical data: How coders make a difference.

INTRODUCTION: This study assesses the reliability of the coding procedure for a set of variables belonging to the European Statistics of Accidents at Work (ESAW). The work focused on the Portuguese data and experience with the system. In Portugal, this task has been systematically carried out by GEP (the governmental Cabinet for Strategy and Planning), here defined as the "reference group" or "expert group." However, it is anticipated that this coding task will be performed by non-expert people, since paper-forms will be replaced by e-forms, similarly to what happened in a few EU countries. OBJECTIVE: This study aims to: (a) assess the current situation, that is, to quantify reliability of data coded by GEP (reference group), and (b) assess the impact on the reliability level when the coding is carried out by non-experts (two different groups of coders). METHODS: The study comprises the estimation of both intercoder and intracoder reliability for a set of 8 nominal variables. The assessment applies 3 reliability coefficients calculated by 3 software packages. RESULTS: The results reveal that the expert group (GEP) holds good to excellent reliability (inter- and intracoder agreements), between 68-98%, while there is a considerable "loss of reliability" (-5% to -39%) when the coding process is transferred to other people, without special training or knowledge in this task. CONCLUSIONS: This work gives quantified evidence that reliability of coding accident data is substantially affected by the coders' profile. Moreover, certain variables, regardless of the coder, systematically hold a higher level of coding reliability than others, suggesting that certain codes may need improvement. Future studies should assess coding quality across the EU countries using the ESAW protocol. PRACTICAL APPLICATIONS: Directions for improving the quality of accident data and related statistics; data that is used by researchers and governmental decision-makers to derive prevention strategies.

Pterocarpanquinone LQB-118 induces apoptosis in Leishmania (Viannia) braziliensis and controls lesions in infected hamsters.

Previous results demonstrate that the hybrid synthetic pterocarpanquinone LQB-118 presents antileishmanial activity against Leishmania amazonensis in a mouse model. The aim of the present study was to use a hamster model to investigate whether LQB-118 presents antileishmanial activity against Leishmania (Viannia) braziliensis, which is the major Leishmania species related to American tegumentary leishmaniasis. The in vitro antileishmanial activity of LQB-118 on L. braziliensis was tested on the promastigote and intracellular amastigote forms. The cell death induced by LQB-118 in the L. braziliensis promastigotes was analyzed using an annexin V-FITC/PI kit, the oxidative stress was evaluated by 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA) and the ATP content by luminescence. In situ labeling of DNA fragments by terminal deoxyribonucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) was used to investigate apoptosis in the intracellular amastigotes. L. braziliensis-infected hamsters were treated from the seventh day of infection with LQB-118 administered intralesionally (26 µg/kg/day, three times a week) or orally (4,3 mg/kg/day, five times a week) for eight weeks. LQB-118 was active against the L. braziliensis promastigotes and intracellular amastigotes, producing IC50 (50% inhibitory concentration) values of 3,4±0,1 and 7,5±0,8 µM, respectively. LQB-118 induced promastigote phosphatidylserine externalization accompanied by increased reactive oxygen species production and ATP depletion. Intracellular amastigote DNA fragmentation was also observed, without affecting the viability of macrophages. The treatment of L. braziliensis-infected hamsters with LQB-118, either orally or intralesionally, was effective in the control of lesion size, parasite load and increase intradermal reaction to parasite antigen. Taken together, these results show that the antileishmanial effect of LQB-118 extends to L. braziliensis in the hamster model, involves the induction of parasite apoptosis and shows promising therapeutic option by oral or local routes in leishmaniasis.

Overcoming job demands to deliver high quality care in a hospital setting across Europe: The role of teamwork and positivity / La superación de las exigencias laborales para ofrecer una elevada calidad asistencial en el ámbito hospitalario en Europa: papel del trabajo en equipo y la positividad

Health care professionals deal on a daily basis with several job demands - emotional, cognitive, organizational and physical. They must also ensure high quality care to their patients. The aim of this study is to analyse the impact of job demands on quality of care and to investigate team (backup behaviors) and individual (positivity ratio) processes that help to shield that impact. Data was collected from 2,890 doctors and nurses in 9 European countries by means of questionnaires. Job demands have a negative impact on the quality of care delivered by health professionals. Backup behaviors had a mediating effect between job demands and quality of care. Also, the positivity ratio of professionals (ratio of positive and negative emotions experienced) was also found as a significant mediator between most job demands and quality of care dimensions. Finally, we found a double mediation between most job demands and quality of care, where backup behaviors influenced the positivity ratio. Quality of care in hospitals is closely related to job demands. Hospital managers should consider the importance of cooperation within health care professionals’ teams and ought to find ways to develop teamwork in order to promote patients’ safety (AU)

Los profesionales de la salud tratan a diario con múltiples exigencias laborales -emocionales, cognitivas, organizacionales y físicas. También deben garantizar la máxima calidad de atención a sus pacientes. El objetivo de este estudio es analizar el impacto de las demandas laborales en la calidad de los cuidados y de investigar los procesos de equipo (backup behaviors) e individuales (positivity ratio) que ayudan a proteger al trabajador de ese impacto. Se recogieron datos de 2.890 médicos y enfermeros en 9 países europeos a través de cuestionarios. Las demandas laborales tienen un impacto negativo en la calidad de los cuidados proporcionados por profesionales de la salud. Los procesos de equipo (backup behaviors) tuvieron un efecto de mediación entre las demandas del trabajo y la calidad de los cuidados. Además, la ratio de positividad de los profesionales (proporción de emociones positivas y negativas) también se encontró como un mediador importante entre la mayoría de demandas de trabajo y la calidad del cuidado. Por último, se encontró una doble mediación entre la mayoría de las demandas de trabajo y calidad de la atención, donde los procesos de equipo influyeron en la ratio de positividad. La calidad de los cuidados proporcionados en los hospitales está muy relacionada con las exigencias del trabajo. Los directores de hospitales deben considerar la importancia de la cooperación entre equipos de profesionales de salud y encontrar formas de desarrollar el trabajo en equipo con el fin de promover la seguridad de los pacientes (AU)

Cellular growth and mitochondrial ultrastructure of leishmania (Viannia) braziliensis promastigotes are affected by the iron chelator 2,2-dipyridyl.

BACKGROUND: Iron is an essential element for the survival of microorganisms in vitro and in vivo, acting as a cofactor of several enzymes and playing a critical role in host-parasite relationships. Leishmania (Viannia) braziliensis is a parasite that is widespread in the new world and considered the major etiological agent of American tegumentary leishmaniasis. Although iron depletion leads to promastigote and amastigote growth inhibition, little is known about the role of iron in the biology of Leishmania. Furthermore, there are no reports regarding the importance of iron for L. (V.) braziliensis. METHODOLOGY/PRINCIPAL FINDINGS: In this study, the effect of iron on the growth, ultrastructure and protein expression of L. (V.) braziliensis was analyzed by the use of the chelator 2,2-dipyridyl. Treatment with 2,2-dipyridyl affected parasites' growth in a dose- and time-dependent manner. Multiplication of the parasites was recovered after reinoculation in fresh culture medium. Ultrastructural analysis of treated promastigotes revealed marked mitochondrial swelling with loss of cristae and matrix and the presence of concentric membranar structures inside the organelle. Iron depletion also induced Golgi disruption and intense cytoplasmic vacuolization. Fluorescence-activated cell sorting analysis of tetramethylrhodamine ester-stained parasites showed that 2,2-dipyridyl collapsed the mitochondrial membrane potential. The incubation of parasites with propidium iodide demonstrated that disruption of mitochondrial membrane potential was not associated with plasma membrane permeabilization. TUNEL assays indicated no DNA fragmentation in chelator-treated promastigotes. In addition, two-dimensional electrophoresis showed that treatment with the iron chelator induced up- or down-regulation of proteins involved in metabolism of nucleic acids and coordination of post-translational modifications, without altering their mRNA levels. CONCLUSIONS: Iron chelation leads to a multifactorial response that results in cellular collapse, starting with the interruption of cell proliferation and culminating in marked mitochondrial impairment in some parasites and their subsequent cell death, whereas others may survive and resume proliferating.

Meanings of quality of care: perspectives of Portuguese health professionals and patients.

OBJECTIVES: The main goal of this study is to explore what is meant by "quality of care" (QoC) by both health professionals and patients. This research also intends to compare the perspectives of nurses, doctors and patients in order to understand whether these different actors share similar views on what represents QoC. DESIGN AND METHODS: A qualitative study was conducted. The study consisted in 44 semi-structured individual interviews (11 doctors; 23 nurses; 10 patients) and in three focus groups (20 participants: doctors, nurses, patients). Participants were doctors, nurses and patients from several Hospitals in Portugal. Data were analysed using content analysis methodology with MaxQDA software. RESULTS: The main content analysis' results revealed that all participants emphasize technical and interpersonal dimensions of QoC. Nevertheless, professionals stressed the availability of equipment and supplies and the conditions of health care indoor facilities. Patients focused more on their access to health services, namely the availability of health professionals, and on the health status outcome after care. In what the differences between doctors and nurses are concerned, the former tend to highlight the technical aspects of care more than the nurses, who tend to refer interpersonal aspects immediately. CONCLUSIONS: Although nowadays the importance of health care quality has become well-recognized, its definition is still complex. Given that specific aspects are more valued by certain groups than others, it is important to take in consideration all the stakeholder's perspectives when measuring QoC in order to continuously improve it in the 'real' settings.

Profiling safety behaviors: exploration of the sociocognitive variables that best discriminate between different behavioral patterns.

This study combines contributions from both safety climate literature and prominent social influence theories. It was developed to identify the combination of sociocognitive variables that differentiate between different profiles of safety behaviors. This empirical approach has hardly been explored in the literature on behavioral aspects related to safety. The research setting for this study was a transportation company (N = 356). The results of discriminant analysis showed that different combinations of dispositional and situational influences may lead to diverse profiles of compliance and proactive safety behaviors. Perceived behavioral control was revealed to be the variable that best differentiated the group with more safe behaviors from the others. However, results also revealed that high attitudes and perceived behavioral control are very important, but not sufficient, to promote proactive safety. Co-workers' descriptive safety norms were a major differentiating variable in proactive safety. Theoretical and practical implications of the findings are discussed.

Another look at safety climate and safety behavior: deepening the cognitive and social mediator mechanisms.

In this study, safety climate literature and the theory of planned behavior were combined to explore the cognitive and social mechanisms that mediate the relationship between organizational safety climate and compliance and proactive safety behaviors. The sample consisted of 356 workers from a transportation organization. Using a multiple mediation design, the results revealed that proactive and compliance safety behaviors are explained by different patterns of combinations of individual and situational factors related to safety. On the one hand, the relationship between organizational safety climate and proactive safety behaviors was mediated by coworkers' descriptive norms and attitudes toward safety. On the other hand, supervisors' injunctive safety norms and perceived behavioral control were the mediator variables between organizational safety climate and compliance safety behaviors. Theoretical and practical implications of the findings are discussed.

Social and moral norm differences among Portuguese 1st and 6th year medical students towards their intention to comply with hand hygiene.

This study examines social and moral norms towards the intention to comply with hand hygiene among Portuguese medical students from 1st and 6th years (N = 175; 121 from the 1st year, 54 from the 6th year). The study extended the theory of planned behaviour theoretical principles and hypothesised that both subjective and moral norms will be the best predictors of 1st and 6th year medical students' intention to comply with hand hygiene; however, these predictors ability to explain intention variance will change according to medical students' school year. Results indicated that the subjective norm, whose referent focuses on professors, is a relevant predictor of 1st year medical students' intention, while the subjective norm that emphasises the relevance of colleagues predicts the intentions of medical students from the 6th year. In terms of the moral norm, 6th year students' intention is better predicted by a norm that interferes with compliance; whereas intentions from 1st year students are better predicted by a norm that favours compliance. Implications of the findings highlight the importance of role models and mentors as key factors in teaching hand hygiene in medical undergraduate curricula.

Social influence, intention to smoke, and adolescent smoking behaviour longitudinal relations.

OBJECTIVES: There is a debate on the determinants of smoking behaviour, their relative impact, and how impacts are exerted. This longitudinal study is on the relations among social influence, intention to smoke, and smoking behaviour, controlling for attitude and self-efficacy. DESIGN AND METHODS: A model combining parents and peers with subjective and descriptive norms, resulting in four factors, was used to assess social influence. Data were collected at the beginning of the 7th(-T1), 8th(-T2), and 9th(-T3) school years, concerning 578 students (M(age) = 13.04 at T1). Structural Equation Modelling was used to test longitudinal effects. RESULTS: Variances explained by the model were high: R(2) (intention-T2) = .65, R(2) (behaviour-T2) = .67, and R(2) (behaviour-T3) = .76. Longitudinal analyses confirmed the effects of social influence on intention and behaviour. These effects on behaviour were direct and indirect (peers' and parents' descriptive norms in both cases). Descriptive norms had a stronger effect on behaviour than subjective norms. Peers' effect on behaviour was stronger than parents', but peers' effect was exerted only through descriptive norms while parents' effect was exerted through both norms. The intention effect on behaviour was not as detached as expected and its role of full mediator between other variables' effects on behaviour was not confirmed, since descriptive norms and self-efficacy had also a mediation role. CONCLUSIONS: Results show direct and indirect effects of social influence on behaviour. Descriptive norms are an important variable to operationalize social influence. Peers and parents exert influence on adolescents' intention and behaviour through different processes. The impact of intention on behaviour is not as important as expected.

An overview of occupational accidents notification systems within the enlarged EU.

This paper describes a comparative analysis of the official forms used for reporting occupational accidents within the EU-27 member states. The comparison is based on two analysis grids (coding schedule) created to that effect, which incorporate a set of evaluation criteria and an interpretation key. The results obtained in the analysis allowed for attention to be drawn to the relevant attributes of such forms in terms of their content and format/structure. It also revealed the main similarities and differences between each country, providing a complete assessment of the 27 member states. The discussion gives account of the level of implementation of the "new" Eurostat variables within the European Statistics of Accidents at Work (ESAW). Furthermore, the study shows that certain formats (structure of information fields) appear to facilitate completeness of the information collected. It has also demonstrated that the European harmonisation process is still far from completion, although the newcomer states seem to be adjusting quickly to the process. The findings of this study may bring useful insights to national authorities and European policy-makers, or to employers/enterprises wishing to implement their internal procedures aligned with the ESAW methodology. The scientific community is another interest group, whose research relies on official statistics, preferably comparable across all countries.

Avaliação longitudinal de programa de prevenção do tabagismo para adolescentes / Longitudinal evaluation of a smoking prevention program for adolescents

OBJETIVO: Avaliar programa de prevenção do tabagismo para adolescentes. MÉTODOS: O programa foi realizado entre 1999 e 2002 em escolas do Distrito de Lisboa, Portugal e integrou atividades na escola, na família e na comunidade. Estudo quasi-experimental, longitudinal, baseado em ensaio de intervenção comunitária, com condição de controlo (CC) e de intervenção (CI) definidas aleatoriamente. Foram aplicados quatro questionários, no início do 7º(T1), 8º(T2) e 9º(T3) e no fim do 9º(T4) anos de escolaridade a 1.205 adolescentes, com idade média de 13 anos, dos quais 57 por cento eram meninas e 55 por cento pertenciam à condição de intervenção. A exposição às atividades de prevenção, os determinantes psicossociais do comportamento e o comportamento tabágico foram as variáveis consideradas na avaliação do programa. Utilizou-se análise de variância e regressão logística para testar as diferenças nas duas condições do estudo. RESULTADOS: A CI obteve melhores resultados nos determinantes psicossociais do tabagismo e no comportamento. Ao final do projeto, 41,8 por cento dos participantes da CI e 53,3 por cento da CC iniciaram o consumo de tabaco (OR = 0,62; IC95 por cento 0,49;0,80), e passaram a ser fumantes regulares 8,0 por cento e 12,4 por cento, respectivamente (OR = 0,59; IC95 por cento 0,40;0,87). CONCLUSÕES: O programa diminuiu a iniciação e o tabagismo regular. Os resultados surgiram no segundo ano e melhoraram no terceiro. A efetividade de programas de prevenção do tabagismo depende de implementação continuada ao longo da adolescência e de integração de medidas dirigidas directamente aos adolescentes e indirectamente, por via do seu contexto social (escola, família e comunidade).(AU)

Avaliação longitudinal de programa de prevenção do tabagismo para adolescentes / Evaluación longitudinal del programa de prevención del tabaquismo para adolescentes / Longitudinal evaluation of a smoking prevention program for adolescents

OBJETIVO: Avaliar programa de prevenção do tabagismo para adolescentes. MÉTODOS: O programa foi realizado entre 1999 e 2002 em escolas do Distrito de Lisboa, Portugal e integrou atividades na escola, na família e na comunidade. Estudo quasi-experimental, longitudinal, baseado em ensaio de intervenção comunitária, com condição de controlo (CC) e de intervenção (CI) definidas aleatoriamente. Foram aplicados quatro questionários, no início do 7º(T1), 8º(T2) e 9º(T3) e no fim do 9º(T4) anos de escolaridade a 1.205 adolescentes, com idade média de 13 anos, dos quais 57 por cento eram meninas e 55 por cento pertenciam à condição de intervenção. A exposição às atividades de prevenção, os determinantes psicossociais do comportamento e o comportamento tabágico foram as variáveis consideradas na avaliação do programa. Utilizou-se análise de variância e regressão logística para testar as diferenças nas duas condições do estudo. RESULTADOS: A CI obteve melhores resultados nos determinantes psicossociais do tabagismo e no comportamento. Ao final do projeto, 41,8 por cento dos participantes da CI e 53,3 por cento da CC iniciaram o consumo de tabaco (OR = 0,62; IC95 por cento 0,49;0,80), e passaram a ser fumantes regulares 8,0 por cento e 12,4 por cento, respectivamente (OR = 0,59; IC95 por cento 0,40;0,87). CONCLUSÕES: O programa diminuiu a iniciação e o tabagismo regular. Os resultados surgiram no segundo ano e melhoraram no terceiro. A efetividade de programas de prevenção do tabagismo depende de implementação continuada ao longo da adolescência e de integração de medidas dirigidas directamente aos adolescentes e indirectamente, por via do seu contexto social (escola, família e comunidade).

OBJETIVO: Evaluar el programa de prevención del tabaquismo para adolescentes. MÉTODOS: El programa fue realizado entre 1999 y 2002 en escuelas del Distrito de Lisboa, Portugal. El programa integró actividades en la escuela, en la familia y en la comunidad. Estudio quasi-experimental, longitudinal, basado en ensayo de intervención comunitaria, con condición de control (CC) y de intervención (CI) definidas aleatoriamente. Se aplicaron cuatro cuestionarios, en el inicio del 7º(T1), 8º(T2) y 9º(T3) e al final del 9º(T4) años de escolaridad a 1.205 adolescentes, con edad promedio de 13 años, de los cuales 57% eran niñas y 55% pertenecían a la condición de intervención. La exposición a las actividades de prevención, los determinantes psicosociales del comportamiento y el comportamiento tabáquico fueron las variables consideradas en la evaluación del programa. Se utilizó análisis de varianza y regresión logística para evaluar las diferencias en las dos condiciones de estudio. RESULTADOS: La CI obtuvo mejores resultados en los determinantes psicosociales de tabaquismo y en el comportamiento. Al final del proyecto, 41,8% de los participantes de la CI y 53,3% de la CC iniciaron el consumo de tabaco (OR= 0,62; IC95% 0,49;0,80), y pasaron a ser fumadores regulares 8,0% y 12,4%, respectivamente (OR=0,59; IC95% 0,40;0,87). CONCLUSIONES: El programa disminuyó la iniciación y el tabaquismo regular. Los resultados surgieron en el segundo año y mejoraron en el tercer. La efectividad de programas de prevención del tabaquismo depende de implementación continuada a lo largo de la adolescencia y de integración de medidas dirigidas directamente a los adolescentes e indirectamente, por vía de su contexto social (escuela, familia y comunidad).