Awareness and knowledge of HPV, cervical cancer, and vaccines in young women after first delivery in São Paulo, Brazil - a cross-sectional study

Abstract Background The success of HPV vaccination programs will require awareness regarding HPV associated diseases and the benefits of HPV vaccination for the general population. The aim of this study was to assess the level of awareness and knowledge of human papillomavirus (HPV) infection, cervical cancer prevention, vaccines, and factors associated with HPV awareness among young women after birth of the first child. Methods This analysis is part of a cross-sectional study carried out at Hospital Maternidade Leonor Mendes de Barros, a large public maternity hospital in Sao Paulo. Primiparous women (15-24 years) who gave birth in that maternity hospital were included. A questionnaire that included questions concerning knowledge of HPV, cervical cancer, and vaccines was applied. To estimate the association of HPV awareness with selected factors, prevalence ratios (PR) were estimated using a generalized linear model (GLM). Results Three hundred and one primiparous women were included; 37% of them reported that they "had ever heard about HPV", but only 19% and 7%, respectively, knew that HPV is a sexually transmitted infection (STI) and that it can cause cervical cancer. Seventy-four percent of interviewees mentioned the preventive character of vaccines and all participants affirmed that they would accept HPV vaccination after delivery. In the multivariate analysis, only increasing age (P for trend = 0.021) and previous STI (P < 0.001) were factors independently associated with HPV awareness ("had ever heard about HPV"). Conclusions This survey indicated that knowledge about the association between HPV and cervical cancer among primiparous young women is low. Therefore, these young low-income primiparous women could benefit greatly from educational interventions to encourage primary and secondary cervical cancer prevention programs.

Vegetation mapping in an area of Ombrophilous Dense Forest at Parque Estadual da Serra do Mar, São Paulo State, Brazil, and floristic composition of the tree component of some physiognomies*

This study aimed to map phytophysiognomies of an area of Ombrophilous Dense Forest at Parque Estadual da Serra do Mar and characterize their floristic composition. Photointerpretation of aerial photographs in scale of 1:35,000 was realized in association with field work. Thirteen physiognomies were mapped and they were classified as Montane Ombrophilous Dense Forest, Alluvial Ombrophilous Dense Forest or Secondary System. Three physiognomies identified at Casa de Pedra streamlet's basin were studied with more details. Riparian forest (RF), valley forest (VF), and hill forest (HF) presented some floristic distinction, as confirmed by Detrended Correspondence Analysis (DCA) and Indicator Species Analysis (ISA) conducted here. Anthropic or natural disturbances and heterogeneity of environmental conditions may be the causes of physiognomic variation in the vegetation of the region. The results presented here may be useful to decisions related to management and conservation of Núcleo Santa Virgínia forests, in general.

Work and Inter-subjectivity: a theoretical reflection on its dialectics in the field of health and nursing

This theoretical reflection intends to show the inter-subjective relationship that takes place in health and nursing practices under the following theoretical perspectives: Institutional Analysis, Psychodynamics of Labor and the Theory of Communicative Action, with an emphasis on the latter. Linking these concepts to the Marxist approach to work in the field of health emerges from recognizing the need for its continuous reconstruction-in this case, with a view to understand the interaction and communication intrinsic to work in action. The theory of Communicative Action seeks to consider these two inextricable dimensions: work as productive action and as interaction. The first corresponds to instrumental action based on technical rules with a production-guided rationale. The second refers to the interaction that takes place as communicative action and seeks understanding among subjects. We assume that adopting this theoretical perspective in the analysis of health and nursing practices opens new possibilities for clarifying its social and historical process and inter-subjective connections.