Condom use at last sexual relationship among adolescents of Santiago Island, Cape Verde, - West Africa

Objective: To estimate factors associated with condom use at last sexual intercourse among adolescents. Methods: Cross-sectional study of a representative sample of 368 sexually active adolescents aged 13-17 years from eight public high schools on Santiago Island, Cape Verde, 2007. The level of significance was 5.0% obtained from logistic regression, considering the association between condom use and socio-demographic, sexual and reproductive variables. Results: The prevalence of condom use at last sexual intercourse was 94.9%. Factors associated with condom use at last sexual relationship were: non-Catholic religion (OR=0.68, 95%CI: 0.52; 0.88) and affective-sexual partnership before the interview (OR=5.15, 95%CI: 1.79; 14.80). Conclusions: There was a high prevalence of condom use at last sexual intercourse of adolescents.

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.

Alcances y limitaciones actuales de la actividad experimental en escuelas de Enseñanza Media de la provincia Santiago de Cuba: criterios de alumnos y profesores

El propósito de este estudio es explorar el estado actual de desarrollo de las actividades experimentales en la asignatura de Física en escuelas de Enseñanza Media de la provincia de Santiago de Cuba ya que constituye un aspecto medular en la construcción del conocimiento científico. Para la recogida de la información se utilizaron dos instrumentos: una encuesta y una entrevista que fueron aplicadas a 268 alumnos y 18 profesores de cinco escuelas con entornos socioculturales diferentes. Los datos obtenidos de las encuestas de ambos sujetos están referidos a: la existencia o no de infraestructura de laboratorio en las escuelas, las características de sus participaciones en los laboratorios y la frecuencia de realización de los mismos. Complementan esta información sus opiniones expresadas en las respuestas a las entrevistas, donde se destaca el papel que atribuyen a los experimentos en el proceso de enseñanza-aprendizaje. Los resultados indican un incremento en la motivación y en la asimilación de los contenidos por parte de los alumnos que participaron en las demostraciones experimentales en las escuelas con infraestructura de laboratorio. Se manifiestan también limitaciones en el orden material con énfasis en las escuelas más alejadas del centro de la ciudad de Santiago de Cuba y de preparación de los profesores para una eficiente utilización del instrumental que poseen en función de la docencia.