Produção textual de adolescentes acerca da saúde sexual e reprodutiva: subsídios para atuação de enfermagem

Trata-se de um estudo exploratório-descritivo, com abordagem qualitativa, que teve por objetivo analisar as mensagens, acerca da promoção da saúde sexual e reprodutiva, produzidas por adolescentes de escolas públicas e particulares da cidade do Rio Grande, num concurso de redação e música promovido pelo Grupo Gestor Municipal (GGM) do Projeto Saúde e Prevenção nas Escolas (SPE), nos anos de 2007 e 2008. Após autorização pelo GGM para realização deste estudo, foram disponibilizadas para reprodução, via xérox, as 29 redações e as três letras de músicas inscritas nos concursos. Para o tratamento dos dados utilizou-se a técnica de análise de conteúdo na modalidade temática. Participaram 35 adolescentes, sendo 25 moças e dez rapazes, com idades entre onze e dezessete anos. Quanto à escolaridade, dois frequentavam a quinta série; doze a sexta, doze a sétima e nove a oitava. Apreendeu-se que, em sua produção textual, os(as) adolescentes revelaram as vulnerabilidades e fortalezas referentes à saúde sexual e reprodutiva. Entre os inúmeros fatores que aumentam a vulnerabilidade individual, social e programática, discorreram sobre a carência de informações, a dificuldade para transformar o conhecimento em prática, a sensação de imunidade, a violência familiar, a conduta repressora de pais e mães, as mensagens de cunho sexual veiculadas pela mídia, a necessidade de serem aceitos(as) pelo grupo, preconceitos, e falta de ações governamentais direcionadas a adolescentes. No que se refere às fortalezas, sabem que a informação é uma importante aliada para a promoção da saúde sexual e reprodutiva citando, entre as fontes acessíveis, os serviços públicos de saúde, a família e a escola. Demonstraram conhecimento acerca da alarmante propagação da epidemia da AIDS entre jovens, conhecendo os sinais e sintomas das DSTs mais comuns e as formas de prevenção. As moças enfatizaram a necessidade de compartilhar a responsabilidade preventiva com os rapazes, bem como de amor próprio e respeito mútuo. O acesso aos serviços de saúde também foi apresentado como indispensável ao adolescer saudável. Os(as) jovens demonstraram conhecimento sobre drogas seus efeitos e consequências. Referem-se à adolescência como um período gostoso, repleto de dúvidas, mas também cheio de potencialidades. Assim, os mesmos componentes apresentados como desencadeadores de vulnerabilidade podem torná-los(as) fortes e capazes de superar os desafios comuns a essa etapa da vida. Para que tal superação ocorra, é necessário que tenham acesso à informação e a problematizem; que sejam capazes de incorporá-las ao cotidiano, adotando práticas protegidas e protetoras; que haja diálogo, despido de tabus, censuras e preconceitos no ambiente familiar; que as escolas adotem de forma transversalizada temáticas referentes à saúde sexual e reprodutiva; que os serviços de saúde tenham infraestrutura para assegurar os direitos contidos no Estatuto da Criança e do Adolescente; entre outras estratégias fortalecedoras.

Analysis of Self-Organization

The dissertation is devoted to the study of problems in calculus of variation, free boundary problems and gradient flows with respect to the Wasserstein metric. More concretely, we consider the problem of characterizing the regularity of minimizers to a certain interaction energy. Minimizers of the interaction energy have a somewhat surprising relationship with solutions to obstacle problems. Here we prove and exploit this relationship to obtain novel regularity results. Another problem we tackle is describing the asymptotic behavior of the Cahn-Hilliard equation with degenerate mobility. By framing the Cahn-Hilliard equation with degenerate mobility as a gradient flow in Wasserstein metric, in one space dimension, we prove its convergence to a degenerate parabolic equation under the framework recently developed by Sandier-Serfaty.

Ultrasonic wave reflection measurements on self-compacting pastes and concretes

The objective of this study was to extend the use of combined longitudinal (P-wave) and shear (S-wave) ultrasonic wave reflection (UWR) to monitor the setting and stiffening of self-compacting pastes and concretes. An additional objective was to interpret the UWR responses of various modified cement pastes. A polymeric buffer with acoustic impedance close to that of cement paste, high impact polystyrene, was chosen to obtain sensitive results from the early hydration period. Criteria for initial and final set developed by our group in a prior study were used to compute setting times by UWR. UWR results were compared with standard penetration measurements. Stiffening behavior and setting times for normal cement pastes, pastes modified with mineral and chemical admixtures, self-compacting pastes, and concretes were explored using penetration resistance, S-wave and P-wave reflection. All three methods showed that set times of pastes varied linearly with w/c, that superplasticizer and fly ash delayed the set times of pastes, and that differences in w/cm, sp/cm, and fa/cm could be detected. Final set times determined from UWR correlated well with those from penetration resistance. Initial set times from S-wave reflection did not correlate very well with those from penetration resistance. Final set times from P-wave and S-wave reflection were roughly the same. Pastes with different chemical admixtures were tested, and the effects of these admixtures on stiffening were determined using UWR. Self-compacting concretes were studied using UWR, and their response and setting times were largely similar to that of corresponding self-compacting pastes. The P-wave reflection response was explored in detail, and the phenomenon of partial debonding and the factors affecting it were explained. Partial debonding is probably caused by autogenous shrinkage at final set, and was controlled and limited by water. The extent of partial debonding was higher with the transducers placed on the side as opposed to the bottom, and the S-wave transducer seemed to promote debonding in the P-wave reflection, whereas the P-wave transducer seemed to reduce debonding in the S-wave reflection. Simultaneous formwork pressure testing and UWR were performed; however, no clear correlation was seen between the two properties.

Self-Presentation Styles, Status, and Influence

This research examined effects of individual self-presentation styles on influence in groups. Perceived competence and social acceptance both play a role in determining how much influence group members enjoy. Aggrandizing and deprecating self-presentation styles may affect perceived competence, social acceptance, and ultimately influence. I predicted that aggrandizing self-presentation would lead to perceptions of competence and that self-deprecation would lead to social acceptance. The anticipated strength of those trends, however, was unclear, and I proposed that they would vary depending on status. I conducted two studies designed to assess whether aggrandizing or deprecating self-presentation styles lead to differences in influence outcomes for high and low-status individuals. In Study 1, participants gave feedback and a promotion recommendation for a fictitious (male or female) job candidate based on employee evaluation information presenting the candidate as either deprecating or aggrandizing. The main findings from Study 1 were that aggrandizers were rated as less likable than deprecators. No other predictions were supported. Study 2 was an online experiment in which participants made hiring recommendations in reference to résumés from fictitious applicants that varied by race, gender, and presentation style (aggrandizing, deprecating, or neutral). Results provided some evidence that low-status candidates were punished for using aggrandizing self-presentation strategies. The results of the studies suggest no one- best technique for self-presentation and that there may be costs for aggrandizing or deprecating depending on race and gender.

Exploration du rôle modérateur des stratégies d’adaptation sur la relation entre les mauvais traitements perçus et les problèmes psychologiques d’adolescents à risque

Les adolescents qui ont subi de la négligence ou des abus substantiels dans leur famille risquent de présenter des symptômes anxieux et dépressifs et des comportements antisociaux plus importants. Parmi les ressources internes qui pourraient contribuer à la résilience de ces jeunes, les stratégies qu’ils adoptent pour composer avec les situations stressantes ont été peu examinées. Dans cette thèse, nous examinons les stratégies d’adaptation utilisées par 336 adolescents placés en centre de réadaptation, avec pour objectif de vérifier leur rôle modérateur dans la relation entre les mauvais traitements qu’ils perçoivent et l’ampleur de leurs problèmes intériorisés ou extériorisés. Le premier chapitre présente une revue de la recherche sur les liens entre divers stresseurs, les stratégies d’adaptation des jeunes et leur condition psychologique. Ces études mettent en lumière combien les effets des stratégies qu’ils utilisent peuvent varier selon les stresseurs familiaux ou sociaux auxquels ils sont exposés. Les deux études empiriques aux chapitres 2 et 3 portent sur les interactions entre trois types de maltraitance (abus émotionnel ou physique, négligence émotionnelle) et quatre stratégies d’adaptation (centrées sur les problèmes, les émotions, la diversion sociale et la distraction). Dans la première étude, ces interactions sont testées pour leurs effets sur l’ampleur des problèmes intériorisés rapportés par les jeunes ou leurs éducateurs; la seconde étude explore leurs effets sur l’ampleur des problèmes extériorisés. Quand les problèmes intériorisés sont rapportés par les adolescents, les stratégies centrées sur les problèmes, la diversion sociale et la distraction avaient un effet protecteur sur l’ampleur des symptômes associés à la maltraitance émotionnelle, surtout chez les filles. Les stratégies centrées sur les problèmes ont aussi un effet protecteur sur la relation entre l’abus émotionnel et les comportements agressifs rapportés par les jeunes. Toutefois quand il s’agit des problèmes extériorisés, plusieurs interactions montrent plutôt que les effets adaptatifs de certaines stratégies diminuent quand les mauvais traitements augmentent. Il en est ainsi pour les stratégies centrées sur les problèmes ou la diversion sociale quand ces problèmes sont observés par les éducateurs, et pour les distractions, lorsqu’ils sont rapportés par les filles. Enfin la diversion sociale est associée à des comportements délinquants plus marqués rapportés par les jeunes et son effet modérateur chez les garçons montre que cette relation est plus forte quand ils sont moins maltraités. Les stratégies d’adaptation examinées contribuent donc surtout à atténuer la détresse émotionnelle des filles victimes de maltraitance psychologique, mais elles semblent avoir peu d’impact sur les comportements antisociaux des jeunes maltraités. Ces résultats sont discutés en lien avec les caractéristiques de notre échantillon. Les implications cliniques qui s’en dégagent permettent de suggérer des pistes pour mieux soutenir ces jeunes dans l’apprentissage de stratégies adaptatives pour réguler leur stress.

Deviant behavior variety scale: Development and validation with a sample of portuguese adolescents

This study presents the development and analysis of the psychometric properties of the Deviant Behavior Variety Scale (DBVS). Participants were 861 Portuguese adolescents (54 % female), aged between 12 and 19 years old. Two alternative models were tested using Confirmatory Factor Analysis. Although both models showed good fit indexes, the two-factor model didn’t presented discriminant validity. Further results provided evidence for the factorial and the convergent validity of the single-factor structure of the DVBS, which has also shown good internal consistency. Criterion validity was evaluated through the association with related variables, such as age and school failure, as well as the scale’s ability to capture group differences, namely between genders and school retentions, and finally by comparing a sub-group of convicted adolescents with a group of non-convicted ones regarding their engagement in delinquent activities. Overall, the scale presented good psychometric properties, with results supporting that the DBVS is a valid and reliable self-reported measure to evaluate adolescents’ involvement in deviance.

Intrusion Detection Systems in SDN-based Self-Healing PMU Networks

Nowadays, Power grids are critical infrastructures on which everything else relies, and their correct behavior is of the highest priority. New smart devices are being deployed to be able to manage and control power grids more efficiently and avoid instability. However, the deployment of such smart devices like Phasor Measurement Units (PMU) and Phasor Data Concentrators (PDC), open new opportunities for cyber attackers to exploit network vulnerabilities. If a PDC is compromised, all data coming from PMUs to that PDC is lost, reducing network observability. Our approach to solve this problem is to develop an Intrusion detection System (IDS) in a Software-defined network (SDN). allowing the IDS system to detect compromised devices and use that information as an input for a self-healing SDN controller, which redirects the data of the PMUs to a new, uncompromised PDC, maintaining the maximum possible network observability at every moment. During this research, we have successfully implemented Self-healing in an example network with an SDN controller based on Ryu controller. We have also assessed intrinsic vulnerabilities of Wide Area Management Systems (WAMS) and SCADA networks, and developed some rules for the Intrusion Detection system which specifically protect vulnerabilities of these networks. The integration of the IDS and the SDN controller was also successful. \\To achieve this goal, the first steps will be to implement an existing Self-healing SDN controller and assess intrinsic vulnerabilities of Wide Area Measurement Systems (WAMS) and SCADA networks. After that, we will integrate the Ryu controller with Snort, and create the Snort rules that are specific for SCADA or WAMS systems and protocols.

Comportamentos agressivos entre pares e padrões de vinculação : Um estudo com jovens adolescentes

Embora de natureza radicalmente distinta, bullying e vinculação são fenómenos de natureza relacional. Se o bullying é descrito como um abuso sistemático de poder, que ocorre intencional e repetidamente entre pares, a vinculação refere-se ao estabelecimento de laços afectivos fortes com determinadas pessoas significativas, especialmente em momentos percepcionados como perigosos. A investigação, apesar do reduzido número de estudos, mostra uma relação entre estes conceitos. A agressão instrumental interpares parece estar relacionada com vinculações inseguras. O objectivo deste estudo é compreender a relação entre o bullying e os padrões de vinculação. Foi realizado em três escolas da zona de Évora, com os alunos do 7° ano (237 alunos). Utilizaram-se dois questionários de auto-relato: o QEVE - Questionário de Exclusão Social e Violência Escolar e o IVIA - Inventário sobre Vinculação para a Infância e a Adolescência. Os resultados deste estudo corroboram os estudos anteriores, relativamente aos comportamentos agressivos entre pares. Mostram que existem correlações estatisticamente significativas entre as dimensões da vitimação e da agressão e, ainda, verificou-se que a vinculação segura parece funcionar como um factor protector para a vitimação e a agressividade e a vinculação ansiosa parece relacionar-se com a vitimação. ABSTRACT: Although radically different, bullying and attachment are relational in nature phenomena. lf the bullying is described as a systematic abuse of power, which is intentionally and repeatedly between peers, attachment refers to the establishment of strong emotional ties with certain significant others, especially at times perceived as dangerous. The research, despite the small number of studies show a relationship between these concepts. Instrumental peer aggression seems to be associated with insecure attachments. The aim of this study is to understand the relationship between bullying and patterns of binding. lt was conducted in three schools in the district of Évora with the students of 7th Grade (237 students). We used two questionnaires self-report: the QEVE - Questionnaire of Social Exclusion and Violence in School and IVIA - lnventory on Attachment for Children and Adolescents. These results corroborate previous studies, for aggressive behavior among peers. Show that there are statistically significant correlations between the dimensions of victimization and aggression and also found that a secure attachment appears to be a protective factor for victimization and aggression and anxious attachment seems to relate to the victimization.

Cognitive control as a moderator of temperamental motivations toward adolescent risk-taking behavior

Few studies have directly examined whether cognitive control can moderate the influence of temperamental positive and negative affective traits on adolescent risk-taking behavior. Using a combined multimethod, latent variable approach to the assessment of adolescent risk-taking behavior and cognitive control, this study examined whether cognitive control moderates the influence of temperamental surgency and frustration on risk-taking behavior in a sample of 177 adolescents (Mage = 16.12 years, SD = 0.69). As predicted, there was a significant interaction between cognitive control and frustration, but not between cognitive control and surgency, in predicting risk-taking behavior. These findings have important implications and suggest that the determinants of adolescent risk taking depend on the valence of the affective motivation for risk-taking behavior.

Measuring the accuracy of self-reported height and weight in a community-based sample of young people

BACKGROUND: Self-reported anthropometric data are commonly used to estimate prevalence of obesity in population and community-based studies. We aim to: 1) Determine whether survey participants are able and willing to self-report height and weight; 2) Assess the accuracy of self-reported compared to measured anthropometric data in a community-based sample of young people.

METHODS: Participants (16-29 years) of a behaviour survey, recruited at a Melbourne music festival (January 2011), were asked to self-report height and weight; researchers independently weighed and measured a sub-sample. Body Mass Index was calculated and overweight/obesity classified as ≥25 kg/m². Differences between measured and self-reported values were assessed using paired t-test/Wilcoxon signed ranks test. Accurate report of height and weight were defined as <2 cm and <2 kg difference between self-report and measured values, respectively. Agreement between classification of overweight/obesity by self-report and measured values was assessed using McNemar's test.

RESULTS: Of 1405 survey participants, 82% of males and 72% of females self-reported their height and weight. Among 67 participants who were also independently measured, self-reported height and weight were significantly less than measured height (p=0.01) and weight (p<0.01) among females, but no differences were detected among males. Overall, 52% accurately self-reported height, 30% under-reported, and 18% over-reported; 34% accurately self-reported weight, 52% under-reported and 13% over-reported. More females (70%) than males (35%) under-reported weight (p=0.01). Prevalence of overweight/obesity was 33% based on self-report data and 39% based on measured data (p=0.16).

CONCLUSIONS: Self-reported measurements may underestimate weight but accurately identified overweight/obesity in the majority of this sample of young people.

Text message and internet support for coronary heart disease self-management: results from the text4heart randomized controlled trial

BACKGROUND: Mobile technology has the potential to deliver behavior change interventions (mHealth) to reduce coronary heart disease (CHD) at modest cost. Previous studies have focused on single behaviors; however, cardiac rehabilitation (CR), a component of CHD self-management, needs to address multiple risk factors. OBJECTIVE: The aim was to investigate the effectiveness of a mHealth-delivered comprehensive CR program (Text4Heart) to improve adherence to recommended lifestyle behaviors (smoking cessation, physical activity, healthy diet, and nonharmful alcohol use) in addition to usual care (traditional CR). METHODS: A 2-arm, parallel, randomized controlled trial was conducted in New Zealand adults diagnosed with CHD. Participants were recruited in-hospital and were encouraged to attend center-based CR (usual care control). In addition, the intervention group received a personalized 24-week mHealth program, framed in social cognitive theory, sent by fully automated daily short message service (SMS) text messages and a supporting website. The primary outcome was adherence to healthy lifestyle behaviors measured using a self-reported composite health behavior score (≥3) at 3 and 6 months. Secondary outcomes included clinical outcomes, medication adherence score, self-efficacy, illness perceptions, and anxiety and/or depression at 6 months. Baseline and 6-month follow-up assessments (unblinded) were conducted in person. RESULTS: Eligible patients (N=123) recruited from 2 large metropolitan hospitals were randomized to the intervention (n=61) or the control (n=62) group. Participants were predominantly male (100/123, 81.3%), New Zealand European (73/123, 59.3%), with a mean age of 59.5 (SD 11.1) years. A significant treatment effect in favor of the intervention was observed for the primary outcome at 3 months (AOR 2.55, 95% CI 1.12-5.84; P=.03), but not at 6 months (AOR 1.93, 95% CI 0.83-4.53; P=.13). The intervention group reported significantly greater medication adherence score (mean difference: 0.58, 95% CI 0.19-0.97; P=.004). The majority of intervention participants reported reading all their text messages (52/61, 85%). The number of visits to the website per person ranged from zero to 100 (median 3) over the 6-month intervention period. CONCLUSIONS: A mHealth CR intervention plus usual care showed a positive effect on adherence to multiple lifestyle behavior changes at 3 months in New Zealand adults with CHD compared to usual care alone. The effect was not sustained to the end of the 6-month intervention. A larger study is needed to determine the size of the effect in the longer term and whether the change in behavior reduces adverse cardiovascular events. TRIAL REGISTRATION: ACTRN 12613000901707; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364758&isReview=true (Archived by WebCite at http://www.webcitation.org/6c4qhcHKt).

Improving coronary heart disease self-management using mobile technologies (Text4Heart): a randomised controlled trial protocol

BACKGROUND: Cardiac rehabilitation (CR) is a secondary prevention program that offers education and support to assist patients with coronary heart disease (CHD) make lifestyle changes. Despite the benefits of CR, attendance at centre-based sessions remains low. Mobile technology (mHealth) has potential to reach more patients by delivering CR directly to mobile phones, thus providing an alternative to centre-based CR. The aim of this trial is to evaluate if a mHealth comprehensive CR program can improve adherence to healthy lifestyle behaviours (for example, physically active, fruit and vegetable intake, not smoking, low alcohol consumption) over and above usual CR services in New Zealand adults diagnosed with CHD.

METHODS/DESIGN: A two-arm, parallel, randomised controlled trial will be conducted at two Auckland hospitals in New Zealand. One hundred twenty participants will be randomised to receive a 24-week evidence- and theory-based personalised text message program and access to a supporting website in addition to usual CR care or usual CR care alone (control). The primary outcome is the proportion of participants adhering to healthy behaviours at 6 months, measured using a composite health behaviour score. Secondary outcomes include overall cardiovascular disease risk, body composition, illness perceptions, self-efficacy, hospital anxiety/depression and medication adherence.

DISCUSSION: This study is one of the first to examine an mHealth-delivered comprehensive CR program. Strengths of the trial include quality research design and in-depth description of the intervention to aid replication. If effective, the trial has potential to augment standard CR practices and to be used as a model for other disease prevention or self-management programs.

The HEART mobile phone trial: the partial mediating effects of self-efficacy on physical activity among cardiac patients

BACKGROUND: The ubiquitous use of mobile phones provides an ideal opportunity to deliver interventions to increase physical activity levels. Understanding potential mediators of such interventions is needed to increase their effectiveness. A recent randomized controlled trial of a mobile phone and Internet (mHealth) intervention was conducted in New Zealand to determine the effectiveness on exercise capacity and physical activity levels in addition to current cardiac rehabilitation (CR) services for people (n = 171) with ischemic heart disease. Significant intervention effect was observed for self-reported leisure-time physical activity and walking, but not peak oxygen uptake at 24 weeks. There was also significant improvement in self-efficacy.

OBJECTIVE: To evaluate the mediating effect of self-efficacy on physical activity levels in an mHealth delivered exercise CR program.

METHODS: Treatment evaluations were performed on the principle of intention to treat. Adjusted regression analyses were conducted to evaluate the main treatment effect on leisure-time physical activity and walking at 24 weeks, with and without change in self-efficacy as the mediator of interest.

RESULTS: Change in self-efficacy at 24 weeks significantly mediated the treatment effect on leisure-time physical activity by 13%, but only partially mediated the effect on walking by 4% at 24 weeks.

CONCLUSION: An mHealth intervention involving text messaging and Internet support had a positive treatment effect on leisure-time physical activity and walking at 24 weeks, and this effect was likely mediated through changes in self-efficacy. Future trials should examine other potential mediators related to this type of intervention.

Self-report use-of-time tools for the assessment of physical activity and sedentary behaviour in young people: systematic review

UNLABELLED: Regular physical activity and limiting extended periods of sitting are two behaviours critical for the prevention of obesity in young people. The purpose of the systematic review was to synthesize the psychometric evidence for self-report use-of-time tools that assess these behaviours. Articles were retrieved that reported reliability and/or validity for use-of-time tools in participants aged 18 years or under. Outcome variables were physical activity, sedentary behaviour and energy expenditure. Study quality was appraised, and the results summarized narratively. Sixteen studies and six different tools were identified. The tools were the Previous Day Physical Activity Recall, the Three-Day Physical Activity Recall, the Physical Activity Interview, the Computerized Activity Recall, the Activitygram, and the Multimedia Activity Recall for Children and Adolescents. Overall, tools indicated moderate validity compared with objective and criterion comparison methods. Generally, validity correlation coefficients were in the range of 0.30-0.40. Correlation coefficients for test-retest reliability ranged widely from 0.24 to 0.98. CONCLUSION: Use-of-time tools have indicated moderate reliability and validity for the assessment of physical activity and energy expenditure. Future research should focus on using criterion methods and on validating specifically for sedentary behaviour outcomes. Implementation of these tools for population surveillance should be considered.

Predicting physical activity intention and behavior in school-age children

Two studies were conducted to predict physical activity in school-aged children. Study 1 tested the utility of an integrated model in predicting physical activity (PA) intention and behavior-the theory of planned behavior (TPB) and self-efficacy theory. Six hundred and forty-five New Zealand children (aged 11-13 years) completed measures corresponding to the integrated model and a self-reported measure of PA one week later. Perceived behavioral control (PBC) and subjective norm were the two strongest predictors of intentions. Task efficacy and barrier efficacy were the two strongest predictors of PA. A second study (Study 2) was conducted to determine whether the self-efficacy measures could discriminate objectively measured PA levels. Sixty-seven Canadian children (aged 11-13 years) completed task and barrier self-efficacy measures. The following week, children classified as 'high' (n = 11) and 'lower' (n = 7) for both task and barrier efficacy wore an Actical® monitor for seven consecutive days to provide activity-related energy expenditure (AEE) data. Results showed that children with high efficacy expended significantly greater AEE than their lower efficacious counterparts. Findings from these two studies provide support for the use of self-efficacy interventions as a potentially useful means of increasing PA levels among school-aged children.