Pressão social do grupo de pares na iniciação sexual de adolescentes

Dado que a literatura enfatiza a estreita relação entre o início da vida sexual e a pressão exercida pelos pares, o objetivo deste trabalho foi identificar a presença da pressão social na iniciação sexual de adolescentes, com base nos relacionamentos com o grupo de iguais. Participaram 363 pessoas, com idade entre 15 e 19 anos, compreendendo uma amostra representativa dos adolescentes cadastrados em uma unidade do Programa de Saúde da Família da cidade de São Paulo. Foi utilizado um questionário estruturado e auto-aplicado. Os resultados mostraram associação entre a iniciação sexual e idade, já ter ficado com alguém sem vontade, ter a maior parte dos amigos com experiência sexual e estar namorando, o que revelou indícios de que os pares parecem exercer certa influência na opção pela iniciação sexual.

Atendimento à mulher vítima de violência sexual: protocolo de assistência de Enfermagem

O Ministério da Saúde preconiza o atendimento integral e humanizado às mulheres vítimas de violência sexual. Teve-se por objetivo descrever o Protocolo de Enfermagem na Assistência às Mulheres Vítimas de Violência Sexual do Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas, recentemente revisado. Para tanto, seguiram-se as etapas do processo de enfermagem e após a identificação dos principais diagnósticos da North American Nursing Diagnosis Association (NANDA) foram determinadas as intervenções, com base em normas técnicas nacionais e internacionais. O protocolo atual engloba o atendimento imediato e tardio, o acompanhamento ambulatorial e as ações relacionadas à interrupção legal da gravidez decorrente do estupro. O protocolo de enfermagem tem proporcionado à cliente um atendimento integral e humanizado e à enfermeira, maior autonomia na sua área de atuação, favorecendo o trabalho colaborativo e interativo com a equipe multidisciplinar.

Assessing AIDS/HIV prevention: what do we know in Europe?

An EC concerted action on the assessment of AIDS/HIV prevention strategies was conducted between 1989 and 1992. The aim of this concerted action (CA) was to bring together researchers who are active in this assessment field, make an initial appraisal of the results of AIDS prevention efforts, in various population groups in Europe and develop an assessment methodology. Five areas of study were selected for the CA: the population as a whole ("general population"), men who have sexual relations with other men, intravenous drug users, migrant populations, monitoring of sexually transmitted diseases (STDs) to determine changes in behaviour. For each of these areas, a working group composed of the leading researchers in the field in Europe was constituted and commissioned by the project administration and coordination team to collate and analyse data on prevention efforts and their assessment in different countries of Europe. This review presents the main results from the groups responsible in each area in the concerted action. A number of general conclusions from the results of this concerted action are drawn.

Vulnerabilidade ao HIV/AIDS e a prevenção da transmissão sexual entre casais sorodiscordantes

Este estudo descritivo e exploratório objetivou descrever e analisar a vulnerabilidade de casais sorodiscordantes ao HIV, e foi realizado em um Serviço Ambulatorial Especializado em aids de um município do estado de São Paulo. Os dados foram coletados através de entrevistas individuais com 11 portadores do HIV/AIDS, que convivem com parceria sabidamente sorodiscordante. Para organização e análise dos dados, empregamos o método de análise de Prosa e o conceito de vulnerabilidade como referencial teórico. A naturalização da infecção do HIV/aids como doença controlável por medicamentos, crença na impossibilidade de transmissão do HIV relacionadas com carga viral indetectável, sentimento de invencibilidade que surge com o tempo de convívio entre o casal, e sua influência na manutenção do sexo seguro são fatores de vulnerabilidade para a parceria sexual soronegativa. Serviços especializados no atendimento a indivíduos com HIV/aids necessitam incluir a parceria sexual nas ações educativas/preventivas promovidas pelos profissionais de saúde.

Do plants adjust their sex allocation and secondary sexual morphology in response to their neighbours?

BACKGROUND AND AIMS: Changes in the sex allocation (i.e. in pollen versus seed production) of hermaphroditic plants often occur in response to the environment. In some homosporous ferns, gametophytes choose their gender in response to chemical cues sent by neighbours, such that spores develop as male gametophytes if they perceive a female or hermaphrodite nearby. Here it is considered whether a similar process might occur in the androdioecious angiosperm species Mercurialis annua, in which males co-occur with hermaphrodites; previous work on a Spanish population of M. annua found that individuals were more likely to develop as males at high density. METHODS: Using a novel approach to treat plants with leachate from pots containing males or hermaphrodites of M. annua, the hypothesis that individuals assess their mating opportunities, and adjust their sex expression accordingly, was tested through an exchange of chemical cues through the soil. KEY RESULTS: For the population under study, from Morocco, no evidence was found for soil-signal-dependent sex expression: neither sex ratios nor sex allocation differed among experimental treatments. CONCLUSIONS: The results imply either that the Moroccan population under study behaves differently from that previously studied in Spain (pointing to potential geographical variation in plasticity for sex expression), or that our method failed to capture the signals used by M. annua for adjustment of sex expression.

Role of the cannabinoid system in the effects induced by nicotine on anxiety-like behaviour in mice

Rationale: Acute behavioural effects and motivational responses induced by nicotine can be modulated by the endocannabinoid system supporting the existence of a physiological interaction between these two systems. Objectives: The present study was designed to examine the possible involvement of the cannabinoid system in the anxiolytic- and anxiogenic-like responses induced by nicotine in mice. Methods: Animals were only exposed once to nicotine. The acute administration of low (0.05, sc) or high (0.8 mg/kg, sc) doses of nicotine produced opposite effects in the elevated plus-maze, i.e., anxiolytic- and anxiogenic-like responses, respectively. The effects of the pretreatment with the CB1 cannabinoid receptor antagonist, rimonabant (0.25, 0.5 and 1 mg/kg, ip), and the cannabinoid agonist, 9-tetrahydrocannabinol (0.1 mg/kg, ip), were evaluated on the anxiolytic- and anxiogenic-like responses induced by nicotine. Results: Rimonabant completely abolished nicotine-induced anxiolytic-like effects and increased the anxiogenic-like responses of nicotine, suggesting an involvement of CB1 receptors in these behavioural responses. On the other hand, 9-tetrahydrocannabinol failed to modify nicotine anxiolytic-like responses, but attenuated its anxiogenic-like effects. In addition the association of non-effective doses of 9-tetrahydrocannabinol and nicotine produced clear anxiolytic-like responses. Conclusions: These results demonstrate that the endogenous cannabinoid system is involved in the regulation of nicotine anxiety-like behaviour in mice, and provide new findings to support the use of cannabinoid antagonists in the treatment of tobacco addiction.

Significado da violência sexual na manifestação da corporeidade: um estudo fenomenológico

Trata-se de pesquisa fenomenológica, que teve como objetivo compreender o significado da violência sexual na manifestação da corporeidade. Foi realizada no ambulatório de vítimas de violência sexual de um hospital universitário de Curitiba, de fevereiro a maio de 2007. Os discursos foram obtidos mediante a realização de entrevista aberta gravada com nove mulheres, e da análise emergiu o tema: Conviver com o medo no processo de coexistência. Constatou-se que o medo influenciou a vida social das mulheres, gerou insegurança, afetou o ser e estar no mundo, a sua corporeidade. Os profissionais da saúde devem ser capacitados, a fim de que possam perceber as mulheres vitimizadas em sua multidimensionalidade, para que suas ações de cuidado sejam não apenas instrumentais, voltadas à subjetividade, porque poderão ajudá-las a transcender o vivido e encontrar um novo sentido para a sua existência. Dessa forma, o atendimento será humanizado, ético e solidário.

Early maternal investment in mice: no evidence for compatible-genes sexual selection despite hybrid vigor.

Confronting a recently mated female with a strange male can induce a pregnancy block ('Bruce effect'). The physiology of this effect is well studied, but its functional significance is still not fully understood. The 'anticipated infanticide hypothesis' suggests that the pregnancy block serves to avoid the cost of embryogenesis and giving birth to offspring that are likely to be killed by a new territory holder. Some 'compatible-genes sexual selection hypotheses' suggest that the likelihood of a pregnancy block is also dependent on the female's perception of the stud's and the stimulus male's genetic quality. We used two inbred strains of mice (C57BL/6 and BALB/c) to test all possible combinations of female strain, stud strain, and stimulus strain under experimental conditions (N(total) = 241 mated females). As predicted from previous studies, we found increased rates of pregnancy blocks if stud and stimulus strains differed, and we found evidence for hybrid vigour in offspring of between-strain mating. Despite the observed heterosis, pregnancies of within-strain matings were not more likely to be blocked than pregnancies of between-strain matings. A power analysis revealed that if we missed an existing effect (type-II error), the effect must be very small. If a female gave birth, the number and weight of newborns were not significantly influenced by the stimulus males. In conclusion, we found no support for the 'compatible-genes sexual selection hypotheses'.

Convivendo com a diferença: o impacto da sorodiscordância na vida afetivo-sexual de portadores do HIV/AIDS

Este estudo descritivo exploratório e qualitativo objetivou descrever e analisar o impacto da sorodiscordância na vida afetivo-sexual de indivíduos com HIV/AIDS que convivem em parceria heterossexual e soronegativa ao HIV. Foram entrevistados 11 portadores do HIV/AIDS que realizavam acompanhamento clínico ambulatorial em um hospital universitário-referência do interior paulista. Os dados foram coletados através de entrevista individual gravada, e analisados segundo análise de Prosa. A vivência com a sorodiscordância ao HIV/AIDS impõe a esses casais o manejo de muitas dificuldades relacionadas à sua intimidade, diante da possibilidade de transmissão do HIV para o parceiro soronegativo, com impacto negativo na vivência da sexualidade entre parceiros sorodiscordantes, repercutindo em alterações da resposta sexual humana, favorecendo até mesmo a abstinência sexual. Apontamos a necessidade de atendimento por equipes interdisciplinares junto aos portadores do HIV/AIDS, e também de sua parceria sexual, proporcionando assistência integral, contemplando a sexualidade e as dificuldades advindas com a sorodiscordância.

Use of a multidimensional assessment tool in a psychiatric adolescent care unit.

AIMS: Adolescent mental health problems require treatment and care that are adapted to their needs. To evaluate this issue, it was decided to implement a multidimensional instrument focused on a global approach to adolescent social and behavioural functioning, combined with the ICD-10 classification. METHODS: The combination of an assessment interview and a classification tool enabled the method to integrate the measurement of several domains of patient-based outcome rather than focus on the measurement of symptoms. A group of 68 adolescents from an inpatient unit were compared with 67 adolescents from the general population. RESULTS: Results suggest that adolescents from the care unit adopt significantly riskier behaviour compared with adolescents from the control group. As expected, the main problems identified refer to the psychological and familial areas. A cluster analysis was performed and provided three different profiles: a group with externalizing disorders and two groups with internalizing disorders. On the basis of a structured interview it was possible to obtain information in a systematic way about the adolescents' trajectory (delinquency, physical and sexual abuse, psychoactive substance use). CONCLUSION: It was shown that treatment and care should not focus exclusively on mental health symptoms, but also upon physical, psychological and social aspects of the adolescent. A global approach helps in the consideration of the multitude of factors which must be taken into account when working with people with serious mental health problems and may help to turn the care unit's activity more specifically towards the needs of these adolescents.

Sexual dysfunctions among young men: prevalence and associated factors.

PURPOSE: The purposes of this study are to measure the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) among a population of Swiss young men and to assess which factors are associated with these sexual dysfunctions in this age-group. METHODS: For each condition (PE and ED), we performed separate analyses comparing young men suffering from the condition with those who were not. Groups were compared for substance use (tobacco, alcohol, cannabis, other illegal drugs, and medication without a prescription), self-reported body mass index, sexual orientation, physical activity, professional activity, sexual experience (sexual life length and age at first intercourse), depression status, mental health, and physical health in a bivariate analysis. We then used a log-linear analysis to consider all significant variables simultaneously. RESULTS: Prevalence rates for PE and ED were 11% and 30%, respectively. Poor mental health was the only variable to have a direct association with both conditions after controlling for potential confounders. In addition, PE was directly associated with tobacco, illegal drugs, professional activity, and physical activity, whereas ED was directly linked with medication without a prescription, length of sexual life, and physical health. CONCLUSIONS: In Switzerland, one-third of young men suffer from at least one sexual dysfunction. Multiple health-compromising factors are associated with these dysfunctions. These should act as red flags for health professionals to encourage them to take any opportunity to talk about sexuality with their young male patients.

Genetic causes of transitions from sexual reproduction to asexuality in plants and animals.

The persistence of sexual reproduction in the face of competition from asexual invaders is more likely if asexual lineages are produced infrequently or have low fitness. The generation rate and success of new asexual lineages will be influenced by the proximate mechanisms underlying transitions to asexuality. As such, characterization of these mechanisms can help explain the distribution of reproductive modes among natural populations. Here, we synthesize the literature addressing proximate causes of transitions from sexual to asexual reproduction in plants and animals. In cyclical and facultatively asexual taxa, individual mutations can cause obligate asexuality. The evolution of asexuality in obligately sexual groups is more complex, requiring the simultaneous acquisition of two traits generally controlled by different genetic factors: unreduced gamete formation and spontaneous development of unfertilized gametes. At least three 'pre-adaptations' could favour transitions to obligate asexuality in obligate sexuals. First, linkage among loci affecting separate key components of asexuality facilitates its spread, with evidence for these linkage blocks in plants. Second, asexuality should evolve more readily in haplodiploids; support for this hypothesis comes from two examples where a single locus causes transitions to asexuality. Third, standing genetic variation for the production of unreduced gametes could facilitate transitions to asexuality, but whether the ability to produce unreduced gametes contributes to the evolution of obligate asexuality remains unclear. We close by reviewing the associations between asexuality, hybridization and polyploidy, and argue that current data suggest that hybridization is more likely to play a causal role in transitions to asexuality than polyploidy.

Estilos de vida na adolescência: comportamento sexual dos adolescentes portugueses

Estudos recentes têm demonstrado que actualmente os adolescentes iniciam a vida sexual cada vez mais cedo, sem contudo possuírem uma educação sexual consistente. Os objectivos deste estudo foram analisar o comportamento sexual de adolescentes do ensino secundário e identificar os hábitos de vigilância de saúde sexual em adolescentes, do ensino secundário, sexualmente activos. Realizou-se um estudo exploratório em que participaram 680 adolescentes, com idades entre 15 e 19 anos. Os resultados evidenciam que a maioria dos inquiridos ainda não iniciou a actividade sexual; são os rapazes os que mais reportam já ter tido relações sexuais; o preservativo não é um método utilizado por todos os adolescentes nas suas relações sexuais; a maioria dos adolescentes não faz vigilância de saúde sexual. É importante que os adolescentes sexualmente activos recebam cuidados de saúde e aconselhamento. As instituições de saúde e os seus profissionais necessitam de ser pró-activos tentando captar os adolescentes.

Do pornographic websites influence boys' sexual behavior?

Purpose: To compare the sexual behavior of adolescent males who do and do not watch pornographic websites. Methods: This study was presented as a school survey. Data were drawn from the 2002 Swiss Multicenter Adolescent Survey on Health (SMASH02) database, a survey including 7,548 adolescents age 16-20. The setting was post-mandatory schools in Switzerland. A total of 2,891 male students who connected to the internet in the last 30 days were enrolled and distributed into two groups: boys who deliberately watched pornographic websites in the last 30 days (n ¼ 942; 33%) and boys who did not (n ¼ 1,949; 67%). Socio-demographic characteristics; frequency of connection to the internet; sexual behavior parameters (having a girlfriend and if yes, for more or less than 6 months; having had sexual intercourse; age at first sexual intercourse; use of a condom at last sexual intercourse; number of sexual partners; having made a partner pregnant). Results: A logistic regression was performed using STATA 9.2. The only significant socio-demographic variable was having a low socioeconomic status (adjusted odds ratio [AOR] 1.66); no difference was found for age and academic track between the two groups. Boys who watch pornographic websites were also significantly more likely to connect frequently to the internet (one day a week: AOR 1.75; several days a week: AOR 2.36; every day: AOR 3.11), to have had sexual intercourse (AOR 2.06), and to have had their first sexual intercourse before age 15 (AOR 1.48). The stability of the relationship with their girlfriend did not appear to have any influence on the search for pornography on the internet. Conclusions: About one third of boys in our sample report having accessed pornographic websites in the last 30 days, a proportion similar to other studies. Watching such websites increases with the frequency of connection to the internet and seems to be correlated with an earlier sexual activity debut among adolescent males. However, having had first sexual intercourse before age 15 is the only sexual risk behavior that seems to be increased when watching pornographic websites among boys. Further studies should address the causality of this correlation and the factors influencing the search for pornography on the web among boys, in order to explore some new ways of prevention about sexual risk behaviors. Sources of Support: The SMASH02 survey was carried out with the financial support of the Swiss Federal Office of Public Health and the participating cantons.

The dermatophyte species Arthroderma benhamiae: intraspecies variability and mating behaviour.

Arthroderma benhamiae is a zoophilic dermatophyte belonging to the Trichophyton mentagrophytes species complex. Here, a population of A. benhamiae wild strains from the same geographical area (Switzerland) was studied by comparing their morphology, assessing their molecular variability using internal transcribed spacer (ITS) and 28S rRNA gene sequencing, and evaluating their interfertility. Sequencing of the ITS region and of part of the 28S rRNA gene revealed the existence of two infraspecific groups with markedly different colony phenotypes: white (group I) and yellow (group II), respectively. For all strains, the results of mating type identification by PCR, using HMG (high-mobility group) and α-box genes in the mating type locus as targets, were in total accordance with the results of mating type identification by strain confrontation experiments. White-phenotype strains were of mating type + (mt+) or mating type - (mt-), whilst yellow-phenotype strains were all mt-. White and yellow strains were found to produce fertile cleistothecia after mating with A. benhamiae reference tester strains, which belonged to a third group intermediate between groups I and II. However, no interfertility was observed between yellow strains and white strains of mt+. A significant result was that white strains of mt- were able to mate and produce fertile cleistothecia with the white A. benhamiae strain CBS 112371 (mt+), the genome of which has recently been sequenced and annotated. This finding should offer new tools for investigating the biology and genetics of dermatophytes using wild-type strains.