Comportamentos de Risco no Tráfego Rodoviário

O presente trabalho descreve um estudo exploratório sobre a temática “Comportamentos de Risco no Tráfego Rodoviário” realizado a condutores da cidade de Bragança. Os principais objetivos direcionam-se para a identificação dos fatores cognitivos que mais influenciam a condução, das atitudes gerais e específicas de maior ou menor risco nos condutores de Bragança, e das crenças normativas e a intenção comportamental face à condução e aos comportamentos de risco. Para obter a informação necessária, foi usado o “Questionário baseado no modelo do Comportamento Planeado para a predição do comportamento de condução”, que foi realizado para a população portuguesa, e que a autora, Doutora Cristina Pimentão, permitiu a adaptação do mesmo ao tema da presente investigação. De uma forma geral, os resultados que se obtiveram evidenciam que o fator cognitivo que mais influencia o processo da condução é a atenção. Quanto às atitudes gerais, os comportamentos apontados que evidenciam maior risco são “A confiança na resposta do carro” e o “Excesso de confiança”, e os comportamentos que revelam menor risco são o cumprimento da regra de paragem completa num sinal de STOP e a discordância de que as pessoas que conduzem de forma agressiva estão mais atentas à condução. Por sua vez, nos resultados das atitudes específicas registam-se atitudes de indiferença, por parte dos inquiridos que responderam “Não concordo nem discordo” nas questões sobre “As campanhas que alertam para os efeitos do álcool são eficazes” e “Se o ensino das escolas de condução fosse adequado não teríamos condutores a conduzir sob a influência do álcool”. Já no que diz respeito às crenças normativas, verificaram-se resultados que apontam para expectativas de menor risco, pois na ótica dos condutores as pessoas que lhe são importantes esperariam deles comportamentos de menor risco. Paralelamente, os resultados sobre as intenções comportamentais traduzem baixas intenções de praticar o comportamento de risco, excetuando no item “É provável que eu venha conduzir um automóvel sob o efeito do álcool”, em que um número considerável de inquiridos respondeu que seria provável e muito provável a intenção de praticar este comportamento de risco. Os resultados são claros relativamente ao consumo de álcool e à sua influência no comportamento dos condutores, sendo necessário e urgente uma intervenção coerente e direcionada para a prevenção da ocorrência deste comportamento.

Relatório de Estágio de Enfermagem Comunitária

O estágio de enfermagem comunitária, integrado no Mestrado em Enfermagem na área de especialização em enfermagem comunitária da ESSP decorreu no período de 14 de Fevereiro a 27 de Junho de 2011. Este foi desenvolvido em duas áreas de intervenção comunitárias distintas: a primeira na área da educação sexual na adolescência realizada aos alunos do 8.º, 9.º, 10.º ano e CEF das Escolas Secundárias Mouzinho da Silveira e São Lourenço; a segunda na área da promoção de hábitos de vida saudáveis nos adolescentes do 9.º ano e 12.º ano da Área Ciências e Tecnologia das escolas do Concelho de Portalegre integrada na promoção da imagem da Escola Superior de Saúde de Portalegre (realizada nas instalações da ESSP). Deste modo com este relatório pretendo:  Descrever e analisar de forma crítica os objetivos, intervenções e recursos utilizados durante o estágio;  Analisar o desenvolvimento das competências adquiridas;  Refletir sobre a prática do enfermeiro na intervenção comunitária; Para se atingir os objetivos propostos foram realizadas sessões e atividades de educação para a saúde quer no âmbito da educação sexual quer da promoção de estilos de vida saudáveis. Nestas sessões e atividades foram abrangidos 276 e 317 alunos respetivamente. Ao longo do estágio pude adquirir e desenvolver competências como enfermeiro especialista, para tal foi importantíssimo a utilização da metodologia de planeamento em saúde

Niveles de actividad física en escolares de instituciones distritales de Bogotá, Colombia.

Objetivo: Estimar los niveles de actividad física (AF) de escolares de básica primaria durante el recreo, a través del uso del Sistema de Observación de Juego y Tiempo Libre en niños. Metodología: Estudio descriptivo transversal. Cinco instituciones educativas de la localidad de Engativá de Bogotá participaron en el presente estudio. Se contó con una muestra a conveniencia de 2.415 escolares (1.093 niñas y 1.322 niños), los cuales cursaban de 2º a 5º de primaria. Se realizaron 261 observaciones en 87 áreas determinadas. La muestra presentó una confiabilidad del 95%. Resultados: El tiempo de recreo fue de 30 minutos, los niños mostraron mayores porcentajes de AF con respecto a las niñas, sin embargo no se encontraron asociaciones estadísticamente significativas (p=0,506). Las áreas eran totalmente accesibles y utilizables, pero ausentes de actividades organizadas. Se encontró un bajo nivel de AF 9,5% en áreas supervisadas. De los escolares; el 22,5% para niñas, y el 20,6% para niños, tuvieron comportamientos sedentarios durante el recreo. Menos del 15% de los escolares realizaron AF vigorosa en el recreo y un mayor porcentaje 62,8% para niñas vs 64,6% para niños realizaron AF moderada. Conclusión: Los escolares acumularon una cantidad valiosa de AF moderada y vigorosa durante el recreo. Es probable que se aumente el nivel de AF, si el patio de la escuela está equipado y con actividades organizadas. Es esencial que las estrategias específicas se estudien y evalúen para determinar cómo y en qué medida se fomenta la AF entre los escolares.

Predictors of adolescent sexual intentions and behavior: Attitudes, parenting, and neighborhood risk

The current study was a cross-sectional examination of data collected during an HIV risk reduction intervention in south Florida. The purpose of the study was to explore the relationships between neighborhood stress, parenting, attitudes, and adolescent sexual intentions and behavior. The Theory of Planned Behavior was used as a model to guide variable selection and propose an interaction pathway between predictors and outcomes. Potential predictor variables measured for adolescents ages 13–18 (n=196) included communication about sex, parent-family connectedness, parental presence, parent-adolescent activity participation, attitudes about sex and condom use, neighborhood disorder, and exposure to violence. Outcomes were behavioral intentions and sexual behavior for the previous eight months. Neighborhood data was supplemented with ZIP Code level data from regional sources and included median household income, percentage of minority and Hispanic residents, and number of foreclosures. Statistical tests included t-tests, Pearson's correlations, and hierarchical linear regressions. Results showed that males and older adolescents reported less positive behavioral intentions than females and adolescents younger than 16. Intentions were associated with condom attitudes, sexual attitudes, and parental presence; unprotected sexual behavior was associated with parental presence. The best fit model for intentions included gender, sexual attitudes, condom attitudes, parental presence, and neighborhood disorder. The unsafe sexual behavior model included whether the participant lived with both natural parents in the previous year, and the percent of Hispanic residents in the neighborhood. Study findings indicate that more research on adolescent sexual behavior is warranted, specifically examining the differentials between variables that affect intentions and those that affect behavior. A focus on gender and age differences during intervention development may allow for better targeting and more efficacious interventions. Adding peer and media influences to the framework of attitudes, parenting, and neighborhood may offer more insight into patterns of adolescent sexual behavior risk.

Predictors of Adolescent Sexual Intentions and Behavior: Attitudes, Parenting, and Neighborhood Risk

The current study was a cross-sectional examination of data collected during an HIV risk reduction intervention in south Florida. The purpose of the study was to explore the relationships between neighborhood stress, parenting, attitudes, and adolescent sexual intentions and behavior. The Theory of Planned Behavior was used as a model to guide variable selection and propose an interaction pathway between predictors and outcomes. Potential predictor variables measured for adolescents ages 13-18 (n=196) included communication about sex, parent-family connectedness, parental presence, parent-adolescent activity participation, attitudes about sex and condom use, neighborhood disorder, and exposure to violence. Outcomes were behavioral intentions and sexual behavior for the previous eight months. Neighborhood data was supplemented with ZIP Code level data from regional sources and included median household income, percentage of minority and Hispanic residents, and number of foreclosures. Statistical tests included t-tests, Pearson’s correlations, and hierarchical linear regressions. Results showed that males and older adolescents reported less positive behavioral intentions than females and adolescents younger than 16. Intentions were associated with condom attitudes, sexual attitudes, and parental presence; unprotected sexual behavior was associated with parental presence. The best fit model for intentions included gender, sexual attitudes, condom attitudes, parental presence, and neighborhood disorder. The unsafe sexual behavior model included whether the participant lived with both natural parents in the previous year, and the percent of Hispanic residents in the neighborhood. Study findings indicate that more research on adolescent sexual behavior is warranted, specifically examining the differentials between variables that affect intentions and those that affect behavior. A focus on gender and age differences during intervention development may allow for better targeting and more efficacious interventions. Adding peer and media influences to the framework of attitudes, parenting, and neighborhood may offer more insight into patterns of adolescent sexual behavior risk.

Sexual behavior and knowledge of sexually transmitted infections among university students in Sao Paulo, Brazil

Objective: To investigate the sexual behavior and knowledge about sexually transmitted infections (STIs) among undergraduate students in Sao Paulo, Brazil. Methods: Self-reported questionnaires were used. Results: Most of the 447 students in the study were single (97.3%), in their first year of university (87.7%), and the mean ages were 20.4 years (males) and 19.8 years (females). Vaginal intercourse was practiced by 69.7% of males and 48.4% of females, oral sex by 64.5% of males and 43.7% of females, and anal sex by 18.4% of males and 14.1% of females. Use of a condom during vaginal sex was practiced by 80.4% of males and 74.8% of females and during anal sex by 47.8% of males and 30.0% of females. Knowledge of transmission of STIs was greater than 90% for HIV, syphilis, genital herpes, and gonorrhea; 63%-76% for HPV and genital warts; 30%-34% for Trichomonas and only 16% for Chlamydia. Only 25%-34% knew that HIV was transmitted by breastfeeding; 56%-60% knew that HIV was transmitted by anal sex. Conclusion: Many students engage in high-risk sexual behavior with multiple partners and use condoms inconsistently. Knowledge of the acquisition and modes of sexual and vertical transmission of HIV are strikingly deficient. (C) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Influence of HIV positive status on sexual behavior among males

OBJECTIVE: To compare HIV seronegative (HIV-) and HIV seropositive (HIV+) males in terms of sexual behavior with female and male partners of different types. METHOD: Cross-sectional study. From August 1994 to February 1995, a sample of 236 respondents (150 HIV- and 86 HIV+) recruited from public health centers in the State of S. Paulo (Brazil), answered a questionnaire, including questions on demographic aspects, HIV and AIDS related knowledge, sexual orientation, use of alcohol and other drugs, sexual behavior with regular and casual female and male partners, and perceived risk of HIV infection. Sexual behavior with regular and casual female and male partners within the previous three months, was investigated. RESULTS: A lower proportion of HIV+ engaged in sexual contact with regular female partners (p < .01) and in vaginal intercourse with this type of partner (p < .01). A lower proportion of HIV+ engaged in overall sexual activity (p < .001) and reported lower frequency of penetrative sexual practices (p < .05). A high level of condom use with female and male partners was identified with no significant differences being found between the two serostatus groups. Some risky sexual behavior was identified, however, especially with regular partners, suggesting that some men were continuing to practice unsafe sex. CONCLUSIONS: The high level of condom use identified suggests that safer sex advice has been taken up. Condom use was not universal, however, and some men continue to place themselves at risk, especially with regular partners. Prevention programs should strive not only to encourage HIV- to practice safer sex, but also to encourage HIV+ to do so in order to prevent further transmission of the virus.

Closeness in relationships as a mediator between sexual abuse in childhood or adolescence and psychopathological outcome in adulthood.

The risk of adverse psychological outcomes in adult victims of childhood and adolescent sexual abuse (CSA) has been documented; however, research on possible mediating variables is still required, namely with a clinical perspective. The attachment literature suggests that secure interpersonal relationships may represent such a variable. Twenty-eight women who had experienced episodes of CSA, and 16 control women, were interviewed using Bremner's Early Trauma Inventory and the DSM-IV Global Assessment of Functioning; they also responded to Collins' Relationship Scales Questionnaire, evaluating adult attachment representations in terms of Closeness, Dependence and Anxiety. Subjects with an experience of severe abuse reported significantly more interpersonal distance in relationships (low index of Closeness) than other subjects. The index of psychopathological functioning was correlated with both the severity of abuse and attachment (low index of Closeness). Regression analysis on the sample of abused women revealed that attachment predicted psychopathology when abuse was controlled for, whereas abuse did not predict psychopathology when attachment was controlled for. Therefore, preserving a capacity for closeness with attachment figures in adulthood appears to mediate the consequences of CSA on subsequent psychopathological outcome.

Startegy selection during exploratory behavior: sex differences, uncertainty and risk managment

This study deals with the psychological processes underlying the selection of appropriate strategy during exploratory behavior. A new device was used to assess sexual dimorphisms in spatial abilities that do not depend on spatial rotation, map reading or directional vector extraction capacities. Moreover, it makes it possible to investigate exploratory behavior as a specific response to novelty that trades off risk and reward. Risk management under uncertainty was assessed through both spontaneous searching strategies and signal detection capacities. The results of exploratory behavior, detection capacities, and decision-making strategies seem to indicate that women's exploratory behavior is based on risk-reducing behavior while men behavior does not appear to be influenced by this variable. This difference was interpreted as a difference in information processing modifying beliefs concerning the likelihood of uncertain events, and therefore influencing risk evaluation.

Associations between online pornography and sexual behavior among adolescents: myth or reality?

This study aimed to compare the sexual behavior of adolescents who were or were not exposed to online pornography, to assess to what extent the willingness of exposure changed these possible associations, and to determine the profiles of youths who were exposed to online pornography. Data were drawn from the 2002 Swiss Multicenter Adolescent Survey on Health, a self-administered cross-sectional, paper and pencil questionnaire. From the 7529 adolescents aged 16-20 years, 6054 (3283 males) used the Internet during the previous month and were eligible for our study. Males were divided into three groups (wanted exposure, 29.2%; unwanted exposure, 46.7%; no exposure, 24.1%) whereas females were divided into two groups (exposure, 35.9%; no exposure, 64.1%). The principal outcome measures were demographic characteristics, Internet use parameters and risky sexual behaviors. Risky sexual behaviors were not associated with online pornography exposure in any of the groups, except that males who were exposed (deliberately or not) had higher odds of not having used a condom at last intercourse. Bi/homosexual orientation and Internet use parameters were not associated either. Additionally, males in the wanted exposure group were more likely to be sensation-seekers. On the other hand, exposed girls were more likely to be students, higher sensation-seekers, early maturers, and to have a highly educated father. We conclude that pornography exposure is not associated with risky sexual behaviors and that the willingness of exposure does not seem to have an impact on risky sexual behaviors among adolescents.

Classification, comorbidity, heredity, and risk factors of female sexual dysfunctions

Female sexual dysfunctions, including desire, arousal, orgasm and pain problems, have been shown to be highly prevalent among women around the world. The etiology of these dysfunctions is unclear but associations with health, age, psychological problems, and relationship factors have been identified. Genetic effects explain individual variation in orgasm function to some extent but until now quantitative behavior genetic analyses have not been applied to other sexual functions. In addition, behavior genetics can be applied to exploring the cause of any observed comorbidity between the dysfunctions. Discovering more about the etiology of the dysfunctions may further improve the classification systems which are currently under intense debate. The aims of the present thesis were to evaluate the psychometric properties of a Finnish-language version of a commonly used questionnaire for measuring female sexual function, the Female Sexual Function Index (FSFI), in order to investigate prevalence, comorbidity, and classification, and to explore the balance of genetic and environmental factors in the etiology as well as the associations of a number of biopsychosocial factors with female sexual functions. Female sexual functions were studied through survey methods in a population based sample of Finnish twins and their female siblings. There were two waves of data collection. The first data collection targeted 5,000 female twins aged 33–43 years and the second 7,680 female twins aged 18–33 and their over 18–year-old female siblings (n = 3,983). There was no overlap between the data collections. The combined overall response rate for both data collections was 53% (n = 8,868), with a better response rate in the second (57%) compared to the first (45%). In order to measure female sexual function, the FSFI was used. It includes 19 items which measure female sexual function during the previous four weeks in six subdomains; desire, subjective arousal, lubrication, orgasm, sexual satisfaction, and pain. In line with earlier research in clinical populations, a six factor solution of the Finnish-language version of the FSFI received supported. The internal consistencies of the scales were good to excellent. Some questions about how to avoid overestimating the prevalence of extreme dysfunctions due to women being allocated the score of zero if they had had no sexual activity during the preceding four weeks were raised. The prevalence of female sexual dysfunctions per se ranged from 11% for lubrication dysfunction to 55% for desire dysfunction. The prevalence rates for sexual dysfunction with concomitant sexual distress, in other words, sexual disorders were notably lower ranging from 7% for lubrication disorder to 23% for desire disorder. The comorbidity between the dysfunctions was substantial most notably between arousal and lubrication dysfunction even if these two dysfunctions showed distinct patterns of associations with the other dysfunctions. Genetic influences on individual variation in the six subdomains of FSFI were modest but significant ranging from 3–11% for additive genetic effects and 5–18% for nonadditive genetic effects. The rest of the variation in sexual functions was explained by nonshared environmental influences. A correlated factor model, including additive and nonadditive genetic effects and nonshared environmental effects had the best fit. All in all, every correlation between the genetic factors was significant except between lubrication and pain. All correlations between the nonshared environment factors were significant showing that there is a substantial overlap in genetic and nonshared environmental influences between the dysfunctions. In general, psychological problems, poor satisfaction with the relationship, sexual distress, and poor partner compatibility were associated with more sexual dysfunctions. Age was confounded with relationship length but had over and above relationship length a negative effect on desire and sexual satisfaction and a positive effect on orgasm and pain functions. Alcohol consumption in general was associated with better desire, arousal, lubrication, and orgasm function. Women pregnant with their first child had fewer pain problems than nulliparous nonpregnant women. Multiparous pregnant women had more orgasm problems compared to multiparous nonpregnant women. Having children was associated with less orgasm and pain problems. The conclusions were that desire, subjective arousal, lubrication, orgasm, sexual satisfaction, and pain are separate entities that have distinct associations with a number of different biopsychosocial factors. However, there is also considerable comorbidity between the dysfunctions which are explained by overlap in additive genetic, nonadditive genetic and nonshared environmental influences. Sexual dysfunctions are highly prevalent and are not always associated with sexual distress and this relationship might be moderated by a good relationship and compatibility with partner. Regarding classification, the results supports separate diagnoses for subjective arousal and genital arousal as well as the inclusion of pain under sexual dysfunctions.

Risk-taking behaviours in adolescent boys and girls : sexuality and dietary health

This study examined adolescents' reported sexual and dietary health-risk behaviours and perceptions. Specifically, this study analyzed the data of 600 students (300 male~ 300 female) in grades 9, I 1, and OAC (mean, standard deviation). The mean age of the students in the sample is 16 with a standard deviation of 1.6. The study was a secondary analysis ofthe first-year data of a 3-year longitudinal study conducted by Youth Lifestyle Choices-Community University Research Alliance (YLC-CURA) on adolescents. To explore sexuality and dietary health, this study purposefully selected sections of the survey that represented sex and dieting behaviours of adolescents. Separate gender and age data analyses revealed different patterns among the variables. Specifically., findings revealed that adolescents who engaged in recent sexual activities were more likely to have a relatively more positive body image perception and were relatively more likely to engage in disordered eating. Across both genders and 3 age levels, adolescents reported that despite their unhealthy dietary habits they felt that dieting was not a high-risk behaviour. Results were discussed in terms of educational implication for sexual health programs.

Verificación del impacto de la educación sexual en adolescentes en la consulta externa de dos IPS de Bogotá

En este estudio se realizó una encuesta con el fin de evidenciar el conocimiento y la práctica de la Educación Sexual en adolescentes que acudieron al servicio de consulta externa de Medicina General en dos Instituciones Prestadoras de Servicios de Salud (IPS) de la ciudad de Bogotá, una de régimen contributivo y otra de régimen subsidiado. Se realizó un estudio observacional, descriptivo, de corte transversal, a 100 adolescentes, mujeres y hombres, a través de la aplicación de un instrumento prediseñado con un contenido de 17 preguntas donde se indagó acerca de: planificación familiar, conducta sexual, educación sexual, embarazo adolescente y conductas de riesgo en adolescentes. En relación al régimen de aseguramiento en salud que tenían los adolescentes, las diferencias encontradas en sus respuestas fueron a nivel de: educación sexual recibida, acceso a los servicios de planificación familiar de las Empresas Promotoras de Salud (EPS), presencia de embarazo adolescente y consumo de alcohol asociado a la práctica de relaciones sexuales. Tras el análisis de la información obtenida con la aplicación de la encuesta, se concluye que es indispensable crear en las instituciones educativas públicas y privadas de la ciudad de Bogotá, una nueva herramienta metodológica a través de la cual se realice promoción de la salud y refuerzo de prácticas protectoras en educación sexual para adolescentes, pues persiste desconocimiento de la misma.

Drug addictions and sexual violence in childhood and adolescence: analyzing life stories

The sexual abuse suffered in childhood and adolescence, in addition to damage to physical and psychological health of the victim, is considered as an important risk factor for alcohol and drugs addiction, development of psychopathology and psychosocial damage in adulthood. In addition to the pain and humiliation that are submitted by the abuse, children and adolescents also experience shame and guilt which require them to adopt coping strategies to endure those feelings. The use of psychoactive substances is a recognized way of dealing with the pains of living. This work, which is of narrative style, analyses and discusses, through five case reports, chemical dependency as a result of sexual abuse suffered in childhood and/or adolescence. The eight subjects in this study are male and have suffered sexual violence in this age period of life. Their ages range from 23 years to 39 years, and all are admitted to a therapeutic community in a city in the interior of Sao Paulo state, in Brazil, for treatment of chemical dependency, being met by the Department of Psychology. The reasons for the choice of the participants for treatment modality for patients are: difficult to stop using drugs, even unwilling to take it, they have easy access to it; the feeling of losing control over their lives; by successive losses as a result of drug use, and for fear that their lives had a tragic ending. With the exception of two participants, the others do not classify that as a child suffered sexual violence. However, all attribute that facilitated their entry into the world of drugs. Seven participants experienced such violence in childhood (between 7 years and 9 years) and adolescence (age 14). The attackers were people closed to the victims—in the case of two victims, their families, with the exception of one participant who was raped by a stranger. Six participants declared themselves as homosexual. Another participant does not claim to be homosexual, but presents difficulties in terms of sexuality. Two participants are HIV positive. The start of psychoactive substances use occurred during adolescence (12 years to 17 years). The participants see drugs as an anesthetic to the pain of the soul, a way to get pleasure, but they get charged expensively, as it increases the feeling of emptiness, guilt, helplessness, worthlessness and hopelessness. Although participants have sought help to deal with addiction, it is noted that throughout the life course the issue of sexual violence was not treated. It was noted that the patients have a double stigma in society: the issue of drugs addiction and the orientation of sexual desire, because the majority of participants are homosexual. The results reinforce the need for effective action geared to accommodate the victims of sexual violence and effective preventive measures to prevent children and adolescents from being abused.