O Mosteiro de Sta. Maria da Vitória e a vocação moralizante das gárgulas do panteão duartino

The Portuguese monument called Batalha’s monastery has occupied an important place in Art History especially the unfinished chapels destined to be the Pantheon of the King D. Duarte. There we observe some interesting gargoyles, moral representations as an approach to the late medieval imaginary in the national context, but also common with the thoughts of King D. Duarte. Gargoyles mirrored the daily life of medieval men and women and displayed the confrontation between the religious and the social spheres by criticizing the behaviour of the sinful body, taking on an important educational role amongst audiences. This article aims to understand the moral sense and sexual behaviour that can observe in these gargoyles and its relation with the book Leal Conselheiro, written by D. Duarte some decades before.

Crescer & saúde : desenvolvimento e comportamento dos adolescentes e jovens recém ingressados no 1º ano do ISCED de Benguela, ensino superior público

Ao abordarmos a temática “Crescer & Saúde-Desenvolvimento e Comportamento dos Adolescentes e Jovens Recém-Ingressados no ISCED de Benguela”, enfatizamos a relevância dos aspetos que constituem a sua génese, no sentido de sugerir ações que contribuam para uma educação para a saúde no âmbito do sistema educativo do ensino superior público em Benguela, e a sua promoção na formação de professores. A questão de partida do estudo foi: Qual é a situação dos adolescentes e jovens em matéria de comportamentos de saúde e seus contextos? Para responder à questão, foram desenvolvidos dois estudos: O estudo quantitativo realizado através de um questionário constituído, entre outras, por questões do Health Behaviour School Aged-Children (HBSC) (Currie, et al., 2001, Matos et al., 2002, 2010), contou com um universo estudantil distribuído por nove especialidades. Assim sendo, foi extraída uma amostra de 20% do total de indivíduos que frequentam o primeiro ano, num total de 255 estudantes. O estudo qualitativo, através de grupos focais, contou com 78 indivíduos, distribuídos entre a universidade pública e privada, e teve a finalidade de caracterizar os comportamentos sexuais e outros aspetos relacionados com a saúde nos adolescentes e jovens do 1º ano do ISCED de Benguela. Os resultados refletem a necessidade de uma educação com cariz formativo e informativo que desenvolva ações pedagógicas específicas de dimensão social, presente nas várias instâncias de socialização, através da interação social para que os jovens adquiram normas, atitudes, conhecimentos e comportamentos aceites socialmente. Esperamos que o presente sirva de ferramenta importante para melhor conhecimento dos seus comportamentos, estilo de vida, conhecimentos face ao VIH/SIDA e IST’s, comportamento de risco, saúde mental, atitudes face à diferença e às adversidades, entre outros aspetos, permitindo o exercício de uma influência positiva por parte dos trabalhadores da instituição, dos colegas, familiares e sociedade civil.

A cohort-based analysis of the evolution of lifetime prevalence of recourse to prostitution by men in the general population of Switzerland, 1987-2000

Background: Despite their relevance to the prevention of sexually transmitted infections, there are few data on the frequency of recourse to prostitution in the male population in Switzerland. Using data gathered for the evaluation of the Swiss AIDS prevention strategy, we analysed net aggregate change and cohort-based change in lifetime prevalence of recourse to prostitution. Methods: Seven repeated cross-sectional telephone surveys of the general population aged 17-45 years (17-30 years only for the 1987 and 1988 surveys) were undertaken from 1987 to 2000 providing information on sexual behaviour including men's recourse to prostitution (total n¼9318). Age categories were: 17-20, 21-25, 26-30, 31-35, 36-40 and 41-45 years. Prevalence at 17-30 years was available in all surveys and prevalence at 41-45 was available for 1989-2000, though not for the same cohorts. Intra-cohort increase in prevalence over 10 years was analysed using truncated information for cohorts aged 21-25 and 26-30 years in 1987 and 1990. Population estimates were computed with 95% confidence intervals (CI). Results: No net change occurred in the 17-45 years male population prevalence between 1989 (17.6%, CI ¼ 15.4; 20.0) and 2000 (17.7%, CI ¼ 15.6; 20.0). The median starting prevalence of recourse to prostitution at age 17-20 was 4.8% (in 1989, CI ¼ 2.0; 9.7) and the range was from 1.8 (in 1994) to 10.4% (in 1990). The median ending prevalence at age 41-45 was 21.9% (in 1994, CI 16.7; 27.9) and the range was from 17.9 (in 2000) to 26.1% (in 1992). No clear trend was observed in either starting or ending prevalence. Intra-cohort evolution of the 1997 and 1990 cohorts was very similar. Conclusions: Based on available data, there was no net (aggregate) change in the prevalence of recourse to prostitution by males in Switzerland between 1989 and 2000. Within the time frame available, intra-cohort evolution was also very similar.

Sex, drugs and chronic illness: health behaviours among chronically ill youth.

BACKGROUND: A growing body of literature indicates that adolescents with chronic conditions are as likely, or more likely, to take risky behaviours than their healthy peers. The objective of this research was to assess whether adolescents with chronic illness in Catalonia differ from their healthy peers in risk-taking behaviour. METHODS: Data were drawn from the Catalonia Adolescent Health database, a survey including a random school-based sample of 6952 young people, aged 14-19 years. The index group (IG) included 665 adolescents (450 females) reporting several chronic conditions. The comparison group (CG) comprised 6287 healthy adolescents (3306 females). Personal, family and school-related variables were analysed to ensure comparability between groups. Sexual behaviour, drug use (tobacco, alcohol, cannabis, cocaine and synthetic drugs) and perception of drug use among peers and in school were compared. Analysis was carried out separately by gender. chi-square, Fisher's and Student's tests were used to compare categorical and continuous variables. RESULTS: The prevalence of chronic conditions was 9.6%, with females showing a higher prevalence than males. The IG showed similar or higher rates of sexual intercourse and risky sexual behaviour. For most studied drugs, IG males reported slightly lower rates of use than CG males, while IG females showed higher rates for every drug studied. No differences were found in the perceptions of drug use among peers or in their school. CONCLUSIONS: Similar to previous research, chronically ill adolescents in our sample are as likely, or more likely, to take risky behaviours than their healthy counterparts and should receive the same anticipatory guidance.

Evaluation of AIDS prevention among homosexual and bisexual men in Switzerland.

Attitudinal and behavioural change among gay men in Switzerland was measured between 1987 and 1990 to evaluate the effectiveness of AIDS prevention activities. The methodology used included a self-administered questionnaire published in Swiss gay magazines and distributed by gay organizations (N = 795 in 1987, N = 720 in 1990) and in-depth interviews with men recruited through advertisements and through the questionnaire (N = 42 in 1987, N = 24 in 1990). The two independent sampling procedures yielded similar samples with regard to socio-demographic characteristics, allowing comparisons to be made between the 1987 and 1990 data. Personal confrontation with AIDS (knowing someone who is HIV-positive, or who is ill or dead from AIDS) increased significantly during the period but more adequate ways of coping developed. Behavioural change towards safer sex began well before the first study. The majority of responding homosexuals have adapted their sexual behaviour to the new situation created by AIDS and generally maintain a protective behaviour. However, "exceptions" (condom rupture or episodes of non-protection) are not infrequent and should deserve more attention. Three indicators of sexual behaviour (number of sexual partners, anal sex and use of condom and oral sex with ejaculation), reported for the last 3 months before each study, exhibit few changes between 1987 and 1990: number of partners remained stable, unprotected oral sex decreased. Anal sex slightly increased, the use of condoms remaining stable. Sixty-seven percent of the sample knew their serostatus in 1990 (57% in 1987), and 13% of these stated that they were HIV+ (14% in 1987).

Factores que influyen en los comportamientos sexuales de prevención frente al virus de inmunideficiencia humana (VIH) en los adictos a las drogas por vía parenteral (ADVP)

Los datos existentes sobre el progresivo incremento de la infección con el virus de inmunodeficiencia humana (VIH) entre los adictos a las drogas por via parenteral (ADVP) y sus parejas e hijos, plantean la necesidad urgente de elaborar programas preventivos con el mayor grado de eficacia posible. En el presente trabajo nos proponemos tres objetivos: 1) Poner de manifiesto algunas insuficiencias observadas en los modelos deprevención que se aplican al caso del SIDA. 2) Conferir un énfasis especial a la influencia sobre los comportamientos preventivos frente al SIDA, de ciertos factores que, en general, no se tienen 10 bastante en cuenta en los modelos actuales como son: la magnitud del reforzamiento contingente a un determinado comportamiento y la demora con la que éste se recibe. 3) Exponer los resultados de una investigación realizada con drogadictos por via parenteral (Planes, 1991), cuyos objetivos eran conocer las relacionesexistentes entre la magnitud y la demora del reforzamiento contingente a los comportamientos sexuales preventivos y la frecuencia de dichos comportamientos

Social and immunological differences among uninfected Brazilians exposed or unexposed to human immunodeficiency virus-infected partners

Understanding the social conditions and immunological characteristics that allow some human immunodeficiency virus (HIV)-exposed patients to remain uninfected represents an on-going challenge. In this study, the socio-demographic and sexual behaviour characteristics and immune activation profiles of uninfected individuals exposed to HIV-infected partners were investigated. A confidential and detailed questionnaire was administered and venous blood was tested using HIV-1/enzyme immunoassays, plasma HIV-1 RNA levels/bDNA and immunophenotyping/flow cytometry to determine the frequencies of CD4 and CD8 T cells expressing activation markers. The data analysis showed significant differences (p < 0.05) for immune parameters in individuals who were uninfected, albeit exposed to HIV-infected partners, compared with unexposed individuals. In particular, the exposed, uninfected individuals had a higher frequency (median, minimum-maximum) of CD4+HLA-DR+ (4.2, 1.8-6.1), CD8+HLA-DR+ (4.6, 0.9-13.7), CD4+CD45RO+ (27.5, 14.2-46.6), CD4+CD45RO+CD62L+ (46.7, 33.9-67.1), CD8+CD45RA+HLA-DR+ (12.1, 3.4-35.8) and CD8+CD45RO+HLA-DR+ (9.0, 3.2-14.8) cells, a decreased percentage of CD8+CD28+ cells (11.7, 4.5-24.0) and a lower cell-surface expression of Fcγ-R/CD16 on monocytes (56.5, 22.0-130.0). The plasma HIV-1 RNA levels demonstrated detectable RNA virus loads in 57% of the HIV-1+ female partners. These findings demonstrate an activation profile in both CD4 and CD8 peripheral T cells from HIV-1 exposed seronegative individuals of serodiscordant couples from a referral centre in Belo Horizonte, state of Minas Gerais.

Should screening for Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-men who have sex with men be recommended?

INTRODUCTION Sexually transmitted infections (STI) like Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) have been associated with increased risk of HIV acquisition (1). It has been also described as a high prevalence of asymptomatic CT and NG infections in men who have sex with men (MSM) (2). The aim of this study was to know the prevalence of CT and/or NG infections in asymptomatic HIV-MSM and the related factors. MATERIALS AND METHODS Prospective study of a cohort of asymptomatic HIV-MSM with follow-up in Malaga (southern Spain) during October 2012-May 2014. Patients with an opportunistic event or who received active antibiotic therapy for CT and/or NG in the previous month were excluded. All of them completed a questionnaire about sexual behaviour, barrier methods and recreational drugs use. Demographical, epidemiological, clinical, analytical and therapeutic data were also collected. Pharyngeal and rectal swabs, and urine samples were collected to be tested for CT and NG by nucleic acid amplification test (c4800 CT/NG. Roche Diagnostics, Mannheim, Germany) (3). STATISTICS ANALYSIS SPSS 17.0. RESULTS 255 patients were asked to participate and 248 of them accepted. Median age was 37.7 (30.6-46.3) years, median time since HIV diagnosis was 47.7 (10.5-104.1) months, and median CD4 cells count was 607 (440-824) cell/µL. There were 195 (78.6%) patients on antiretroviral therapy; 81.5% of them had undetectable viral load. 80.5% of the patients had a past history of STI. Infection by CT and/or NG was diagnosed in 24 (9.7%) patients. Overall four urine samples, two pharyngeal, and 15 rectal ones were positive for CT, and five pharyngeal and five rectal swabs were positive for NG. Two patients were co-infected by CT and NG: one with CT in urine and both in rectum, another with CT in urine and rectum and NG in pharynx. One patient presented CT in pharynx and rectum, and two patients NG in pharynx and rectum. Positive CT and/or NG tests were only related with detectable HIV viral load (OR 3.08, 95% CI 1.2-7.4; p=0.01). It was not related with sexual behaviour, nor with alcohol or recreational drugs use. CONCLUSIONS STI screening had a great acceptance in this population. There was a high prevalence of asymptomatic CT and/or NG infections. Rectum sample was the most effective one. Viral suppression could protect from these STI. Screening should be recommended in HIV-MSM.

Are the health messages in schoolbooks based on scientific evidence? A descriptive study.

BACKGROUND Most textbooks contains messages relating to health. This profuse information requires analysis with regards to the quality of such information. The objective was to identify the scientific evidence on which the health messages in textbooks are based. METHODS The degree of evidence on which such messages are based was identified and the messages were subsequently classified into three categories: Messages with high, medium or low levels of evidence; Messages with an unknown level of evidence; and Messages with no known evidence. RESULTS 844 messages were studied. Of this total, 61% were classified as messages with an unknown level of evidence. Less than 15% fell into the category where the level of evidence was known and less than 6% were classified as possessing high levels of evidence. More than 70% of the messages relating to "Balanced Diets and Malnutrition", "Food Hygiene", "Tobacco", "Sexual behaviour and AIDS" and "Rest and ergonomics" are based on an unknown level of evidence. "Oral health" registered the highest percentage of messages based on a high level of evidence (37.5%), followed by "Pregnancy and newly born infants" (35%). Of the total, 24.6% are not based on any known evidence. Two of the messages appeared to contravene known evidence. CONCLUSION Many of the messages included in school textbooks are not based on scientific evidence. Standards must be established to facilitate the production of texts that include messages that are based on the best available evidence and which can improve children's health more effectively.

Talking about sexuality with the physician: are patients receiving what they wish?

QUESTIONS UNDER STUDY/PRINCIPLES: Little is known concerning patients' expectations regarding sexual history taking by doctors: to ascertain expectations and actual experience of talking about sexuality among male patients attending outpatient clinics, and their sexual behaviour. METHODS: Patients consecutively recruited from two outpatient clinics in Lausanne, Switzerland were provided with an anonymous self-administered questionnaire. Survey topics were: patients' expectations concerning sexual history taking, patients' lifetime experience of sexual history taking, and patients' sexual behaviour. RESULTS: The response rate was 53.0% (N = 1452). Among respondents, 90.9% would like their physician to ask them questions regarding their sexual history in order to receive advice on prevention (60.0% yes, 30.9% rather yes). Fifteen percent would be embarrassed or rather embarrassed if asked such questions. Nevertheless, 76.2% of these individuals would like their physician to do so. Despite these wishes, only 40.5% reported ever having a discussion "on their sexual life in general" with a doctor. Only one patient out of four to five was asked about previous sexually transmitted infections (STIs), the number of sexual partners and their sexual orientation. No feature of their sexual life distinguishes those who had discussed sexual issues with a doctor from those who had not, except a history of previous consultation for health problems related to sexuality. Conversely, being embarrassed about conducting this discussion was significantly associated with lack of discussion regarding sexuality. CONCLUSIONS: This study highlights the gap existing in the field of STI prevention in terms of doctors' advice and patients' wishes.

L'intégration de la sexualité en consultation gynécologique : discordances entre les perceptions des femmes et celles des gynécologues.

Dès les années 2000, l'Office Fédéral de la Santé Publique recommande aux médecins de premier recours, dont les gynécologues, d'aborder activement la sexualité en consultation, en raison notamment de l'augmentation des infections sexuellement transmissibles asymptomatiques (1ST). Dans le même sens, comme le montrent nombre d'études, plus de 70% des patientes souhaiteraient être interrogées au sujet de leur sexualité en consultation gynécologique. Or, il semble que peu de médecins intègrent systématiquement des questions de sexualité dans leur anamnèse. La revue de la littérature relève que les recherches réalisées à ce jour ont été menées principalement à l'aide de questionnaire selon une perspective naturaliste, qui étudie la sexualité de manière décontextualisée et qui la conçoit comme un invariant biologique et par conséquent universel. Notre objectif est de saisir en profondeur les perceptions et le vécu des gynécologues et des femmes, face à l'intégration de la sexualité en consultation gynécologique. Nous avons adopté une perspective critique en psychologie de la santé (Santiago-Delefosse & Chamberlain, 2008 ; Murray, 2004a ; Lyons & Chamberlain, 2006) qui permet de privilégier d'une part, l'étude de la signification que les sujets donnent à la sexualité dans leur contexte socio-historique et, d'autre part, une vision de l'être humain comprenant des dimensions corporelles, psychologiques et sociétales (Santiago-Delefosse, 2011). Pour ce faire, nous avons utilisé un dispositif de méthodes mixtes en deux phases. Dans la première phase, nous avons mené 21 entretiens semi directifs avec des gynécologues hommes et femmes. Puis, nous avons réalisé 3 groupes focalisés (N=16) avec des femmes âgées de 23 à 65 ans. La seconde phase a consisté à créer un questionnaire, élaboré à partir des résultats de la première phase, afin d'élargir l'expérience de l'intégration de la sexualité en consultation, à une population plus diversifiée de femmes (N=421). Les données récoltées par le biais de ces trois méthodes nous ont permis d'esquisser un modèle présentant les processus en jeu dans la situation de non intégration de la sexualité en consultation gynécologique. Celui-ci relève non seulement des lacunes dans le cursus universitaire de médecine en matière de sexualité, mais également d'importantes discordances entre les gynécologues et les femmes interviewés concernant le rôle du gynécologue, la perception de l'intime, la perception d'introduire le sujet de la sexualité en consultation, ainsi que de la définition même de la sexualité. Nos résultats ouvrent sur des perspectives pratiques pour la consultation gynécologique, ainsi que sur des pistes pour des recherches futures dans l'étude de la sexualité, selon une perspective plus intégrative. -- Since the 2000's, the Swiss Federal Office of Public Health recommended primary care physicians, including gynaecologists, to actively address sexuality issues in consultation, namely because of the increasing incidence of Sexually Transmitted Infections (STI). In line with this, studies have shown that more than 70% of patients would like to be asked about their sexuality by their gynaecologist. However, physicians do not take systematically sexual histories from their patients. Literature in the field has highlighted that most research has been restricted to using questionnaires following a naturalist theoretical perspective according to which sexual behaviour is defined as biologically invariant, hence, universal. Our objective is to deepen understand perceptions from gynaecologists and women with regard to the integration of sexuality in consultations. A critical health psychology approach allows us to consider on the one hand sexuality as a construct that is inseparable from a given socio-historical context. On the other hand, this approach takes into consideration an embodied, social and psychological definition of human beings. Therefore, we used a mixed methods design that included two main research steps : First, we conducted 21 semi-structured interviews with male and female gynaecologists. In this phase, we also led 3 focus groups made up of 16 women aged from 21 to 65. Second, a survey was implemented (N= 421) based on findings stemming from the first phase. This allowed us to further analyse experiences on the integration of sexuality and to extend findings to a more diversified population of women. The data analysis allowed us to create a model that highlights the processes involved in the non integration of sexuality during gynaecological consultation. It shows a lack of training in sexology within medical programs. Moreover, it emphasises the mismatches on perceptions between gynaecologists and women concerning the gynaecologist's role ; intimacy, the issue of whether introducing sexuality topics, and finally, on the actual definition of sexuality itself. Our findings open new research perspectives for the study of sexuality by proposing a more integrative approach. They also provide practical and clinical perspectives concerning consultations in gynaecology.

Learning of courtship components in Drosophila mercatorum (Paterson & Wheller) (Diptera, Drosophilidae)

In Drosophila, courtship is an elaborate sequence of behavioural patterns that enables the flies to identify conspecific mates from those of closely related species. This is important because drosophilids usually gather in feeding sites, where males of various species court females vigorously. We investigated the effects of previous experience on D. mercatorum courtship, by testing if virgin males learn to improve their courtship by observing other flies (social learning), or by adjusting their pre-existent behaviour based on previous experiences (facilitation). Behaviours recorded in a controlled environment were courtship latency, courtship (orientation, tapping and wing vibration), mating and other behaviours not related to sexual activities. This study demonstrated that males of D. mercatorum were capable of improving their mating ability based on prior experiences, but they had no social learning on the development of courtship.

Resurgence of HIV infection among men who have sex with men in Switzerland: mathematical modelling study.

BACKGROUND: New HIV infections in men who have sex with men (MSM) have increased in Switzerland since 2000 despite combination antiretroviral therapy (cART). The objectives of this mathematical modelling study were: to describe the dynamics of the HIV epidemic in MSM in Switzerland using national data; to explore the effects of hypothetical prevention scenarios; and to conduct a multivariate sensitivity analysis. METHODOLOGY/PRINCIPAL FINDINGS: The model describes HIV transmission, progression and the effects of cART using differential equations. The model was fitted to Swiss HIV and AIDS surveillance data and twelve unknown parameters were estimated. Predicted numbers of diagnosed HIV infections and AIDS cases fitted the observed data well. By the end of 2010, an estimated 13.5% (95% CI 12.5, 14.6%) of all HIV-infected MSM were undiagnosed and accounted for 81.8% (95% CI 81.1, 82.4%) of new HIV infections. The transmission rate was at its lowest from 1995-1999, with a nadir of 46 incident HIV infections in 1999, but increased from 2000. The estimated number of new infections continued to increase to more than 250 in 2010, although the reproduction number was still below the epidemic threshold. Prevention scenarios included temporary reductions in risk behaviour, annual test and treat, and reduction in risk behaviour to levels observed earlier in the epidemic. These led to predicted reductions in new infections from 2 to 26% by 2020. Parameters related to disease progression and relative infectiousness at different HIV stages had the greatest influence on estimates of the net transmission rate. CONCLUSIONS/SIGNIFICANCE: The model outputs suggest that the increase in HIV transmission amongst MSM in Switzerland is the result of continuing risky sexual behaviour, particularly by those unaware of their infection status. Long term reductions in the incidence of HIV infection in MSM in Switzerland will require increased and sustained uptake of effective interventions.

Low prevalence of Chlamydia trachomatis infection in asymptomatic young Swiss men

BACKGROUND: Prevalence and risk factors for Chlamydia trachomatis infection among young men in Switzerland is still unknown. The objective of the present study was to assess prevalence and risk factors for C. trachomatis infection in young Swiss men. METHODS: 517 young Swiss men were enrolled in this cross-sectional study during their compulsory military recruitment. Participants completed a questionnaire and gave urine samples which were screened for C. trachomatis DNA by PCR. Genotyping of positive samples was done by amplification and sequencing the ompA gene. RESULTS: The prevalence of chlamydial infection among young Swiss male was 1.2% (95% confidence interval [95%CI], 0.4-2.5%). C. trachomatis infection was only identified among the 306 men having multiple sexual partner. Although frequent, neither unprotected sex (absence of condom use), nor alcohol and drug abuse were associated with chlamydial infection. Men living in cities were more frequently infected (2.9%, 95%CI 0.8-7.4%) than men living in rural areas (0.5%, 95%CI 0.1-1.9%, p = 0.046). Moreover, naturalised Swiss citizens were more often positive (4.9%, 95%CI 1.3-12.5%) than native-born Swiss men (0.5%, 95%CI 0.1-1.7%, p = 0.003). CONCLUSION: In comparison with other countries, the prevalence of chlamydial infection in men is extremely low in Switzerland, despite a significant prevalence of risky sexual behaviour. C. trachomatis infection was especially prevalent in men with multiple sexual partners. Further research is required (i) to define which subgroup of the general population should be routinely screened, and (ii) to test whether such a targeted screening strategy will be effective to reduce the prevalence of chlamydial infection among this population.