Educa����o para a sexualidade: interven����o em um grupo de adolescentes assistidos pelo cras, a partir do conhecimento de suas representa����es sociais em rela����o ��s DST/Aids

The Socio-Historical Psychology Theory understands human development constituted by the social and historical relations, in whom the individual belongs, and understanding the meaning of adolescence as a time and built. The social psychology, in this theoretical approach, proposes, among others, the category Social Representations (SR) for analysis and discussion of psychosocial phenomena. This study aimed to investigate the SR of adolescents about sexually transmitted diseases (STD/SIDA), by means of a questionnaire in order to know their vulnerabilities to spread of STD/SIDA. After the identification of vulnerabilities, an intervention was performed through a group processes with adolescents 11 to 15 years, users of services CRAS of a city in S��o Paulo State, to provide subsidies in relation to education for sexuality. Based on data collected and discussed, it can be stated that among the multiple determinants of the increased incidence, as the Epidemiological Bulletin 2011/MS, the lack of safe sex practices contributes to the vulnerability of adolescents. Emphasizes the need to know their Social Representations proposing an intervention, not to reproduce the imposition of ���packages awareness of safe sex practices,��� homogeneous and universal, it does little to promote health and education of adolescents.

Interven����o do PET-Sa��de para a melhoria do conhecimento sobre doen��as sexualmente transmiss��veis e gravidez em adolescentes que frequentam a rede p��blica de ensino

A transmiss��o de Doen��as Sexualmente Transmiss��veis (DSTs) tem aumentado significativamente nos ��ltimos anos entre os adolescentes, como apresentam os dados do Boletim Epidemiol��gico de AIDS publicado pelo Minist��rio da Sa��de, juntamente com o aumento do n��mero de adolescentes gr��vidas. Dessa forma, o projeto de extens��o PET - Sa��de objetiva transmitir um conhecimento prevencionista aos jovens vulner��veis a essa situa����o, trabalhando com estudantes do ciclo II do ensino fundamental dos col��gios municipais de Nova Europa. Os alunos que participaram da atividade responderam voluntariamente um question��rio antes e ap��s a atividade, que avaliava qualitativamente o conhecimento que possu��am acerca do tema DSTs e gravidez na adolesc��ncia. Atrav��s da an��lise desses question��rios, foi poss��vel perceber que os jovens possu��am conhecimento sobre o uso de preservativo para a preven����o de DSTs e gravidez (86,9% e 82,8%), mas que o mesmo n��o se aplicava quanto ao conhecimento de sintomas de DSTs (66,8%), que foi aprimorado ap��s a atividade (80%). Al��m disso, as meninas apresentaram conhecimento acerca de outros m��todos contraceptivos diferentes do preservativo e import��ncia da vacina contra o HPV, provavelmente pelo fato dos meninos lidarem com a vida sexual de uma forma diferente. Apesar de conhecimento pr��vio sobre o assunto, a����es educativas cont��nuas podem aumentar o conhecimento dos jovens sobre DSTs e gravidez.

Interven����o do PET-Sa��de para a melhoria do conhecimento sobre doen��as sexualmente transmiss��veis e gravidez em adolescentes que frequentam a rede p��blica de ensino

A transmiss��o de Doen��as Sexualmente Transmiss��veis (DSTs) tem aumentado significativamente nos ��ltimos anos entre os adolescentes, como apresentam os dados do Boletim Epidemiol��gico de AIDS publicado pelo Minist��rio da Sa��de, juntamente com o aumento do n��mero de adolescentes gr��vidas. Dessa forma, o projeto de extens��o PET - Sa��de objetiva transmitir um conhecimento prevencionista aos jovens vulner��veis a essa situa����o, trabalhando com estudantes do ciclo II do ensino fundamental dos col��gios municipais de Nova Europa. Os alunos que participaram da atividade responderam voluntariamente um question��rio antes e ap��s a atividade, que avaliava qualitativamente o conhecimento que possu��am acerca do tema DSTs e gravidez na adolesc��ncia. Atrav��s da an��lise desses question��rios, foi poss��vel perceber que os jovens possu��am conhecimento sobre o uso de preservativo para a preven����o de DSTs e gravidez (86,9% e 82,8%), mas que o mesmo n��o se aplicava quanto ao conhecimento de sintomas de DSTs (66,8%), que foi aprimorado ap��s a atividade (80%). Al��m disso, as meninas apresentaram conhecimento acerca de outros m��todos contraceptivos diferentes do preservativo e import��ncia da vacina contra o HPV, provavelmente pelo fato dos meninos lidarem com a vida sexual de uma forma diferente. Apesar de conhecimento pr��vio sobre o assunto, a����es educativas cont��nuas podem aumentar o conhecimento dos jovens sobre DSTs e gravidez.

Improvement of Older Women's Sexuality Through Emancipatory Education

The purpose of this action research (AR) was to explore the ways in which sexuality is experienced daily and to improve the expression of older women's sexuality. The pedagogy of autonomy as proposed by the Brazilian educator Paulo Freire theoretically supported this AR, with the participation of six older adult women living in a rural setting in southwest Brazil. The older women's experiences regarding sexuality, their concerns, and their educational demands could be summarized through five phrases: the improvement of self-esteem as a way to promote sexuality; sexuality impaired by loneliness and lack of affection; men's sexual satisfaction seen as a woman's obligation; women's sexuality controlled by the society; and relinquishment of the companion to attend to the expectations of family members. Dialogical and participative educational approaches and continuous observation-participation strategies were performed to support the women's care and educational requirements.

Why Are Women With Cervical Cancer Not Being Diagnosed in Preinvasive Phase? An Analysis of Risk Factors Using a Hierarchical Model

Objective: To assess the risk factors for delayed diagnosis of uterine cervical lesions. Materials and Methods: This is a case-control study that recruited 178 women at 2 Brazilian hospitals. The cases (n = 74) were composed of women with a late diagnosis of a lesion in the uterine cervix (invasive carcinoma in any stage). The controls (n = 104) were composed of women with cervical lesions diagnosed early on (low-or high-grade intraepithelial lesions). The analysis was performed by means of logistic regression model using a hierarchical model. The socioeconomic and demographic variables were included at level I (distal). Level II (intermediate) included the personal and family antecedents and knowledge about the Papanicolaou test and human papillomavirus. Level III (proximal) encompassed the variables relating to individuals' care for their own health, gynecologic symptoms, and variables relating to access to the health care system. Results: The risk factors for late diagnosis of uterine cervical lesions were age older than 40 years (odds ratio [OR] = 10.4; 95% confidence interval [CI], 2.3-48.4), not knowing the difference between the Papanicolaou test and gynecological pelvic examinations (OR, = 2.5; 95% CI, 1.3-4.9), not thinking that the Papanicolaou test was important (odds ratio [OR], 4.2; 95% CI, 1.3-13.4), and abnormal vaginal bleeding (OR, 15.0; 95% CI, 6.5-35.0). Previous treatment for sexually transmissible disease was a protective factor (OR, 0.3; 95% CI, 0.1-0.8) for delayed diagnosis. Conclusions: Deficiencies in cervical cancer prevention programs in developing countries are not simply a matter of better provision and coverage of Papanicolaou tests. The misconception about the Papanicolaou test is a serious educational problem, as demonstrated by the present study.

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

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

Fun����o sexual e qualidade de vida em gestantes de baixo risco

OBJETIVO: Avaliar em gestantes saud��veis no segundo trimestre a associa����o entre fun����o sexual e qualidade de vida, e fun����o sexual e satisfa����o sexual. M��TODOS: Estudo transversal com 51 gestantes em acompanhamento em ambulat��rio de pr��-natal de baixo risco. A fun����o sexual foi aferida por meio do Quociente Sexual - Vers��o Feminina (QS-F). A qualidade de vida e a satisfa����o sexual foram avaliadas pelo Instrumento Abreviado de Avalia����o de Qualidade de Vida da Organiza����o Mundial da Sa��de (WHOQOL-bref). Os crit��rios de inclus��o foram idade gestacional entre a 15�� e a 26�� semana, idade materna igual ou superior a 20 anos, m��nimo de 5 anos de educa����o escolar, ter parceiro fixo h�� pelo menos 6 meses, ter tido rela����o sexual com penetra����o vaginal nos ��ltimos 15 dias. Foram exclu��das mulheres v��timas de viol��ncia sexual, com hist��ria pregressa ou atual de depress��o, antecedente de aborto habitual ou complica����es na gesta����o atual (amniorrexe prematura, trabalho de parto prematuro ou hemorragia). Para a an��lise dos dados foram utilizados os testes do &#967;�� e exato de Fisher e p<0,05 foi considerado significante. A an��lise estat��stica foi realizada com o Statistical Package for the Social Sciences (SPSS). RESULTADOS: A maioria das gestantes (64,8%) obteve o QS-F de "regular a excelente" e 58,8% classificaram sua qualidade de vida como "boa". Assinalaram que estavam satisfeitas com a vida sexual 35,3% das gestantes, e 15,7% estavam muito satisfeitas. O estudo mostrou que existe associa����o entre QS-F "nulo a ruim" com qualidade de vida "ruim" (p=0,002) e que QS-F "regular a bom" e "bom a excelente" est��o associados com "satisfa����o" e "muita satisfa����o" sexual (p<0,001). CONCLUS��O: A fun����o sexual est�� associada �� qualidade de vida e �� satisfa����o sexual em gestantes saud��veis, no segundo trimestre da gesta����o.

Dental caries-related quality of life and socioeconomic status of preschool children, Bauru, SP

AIM: To evaluate oral health-related quality of life of preschool children of Bauru, State of S��o Paulo, Brazil, and associate it with socioeconomic profile of households. METHODS: The sample consisted of 229 preschool children between 3 and 5 years and the dmft (decayed, missing due to caries, filled teeth) index was adopted for assessment children's dental caries in accordance with the standards recommended by the World Health Organization. Questionnaires were used for evaluation oral health-related quality of life (Early Childhood Oral Health Impact Scale) and socioeconomic profile of parents or guardians of the preschool children. Statistical analysis was performed descriptively by relative and absolute frequencies and by Spearman's correlation and Kruskal-Wallis test (p <0.05). RESULTS: A dmft of 1.65 (�� 2.87) and a Sic Index 4.88 (�� 3.20) were found, indicating the polarization of dental caries in the studied group. It was verified low influence of oral health on quality of life of the children examined. With respect to socioeconomic classification, 66.38% of families were in the lower middle class. Linear and statistically significant correlation was found between dmft and oral health-related quality of life for the overall score and domains of the questionnaire (p<0.001). CONCLUSIONS: It was found low influence of oral health on quality of life of the preschool children and the assessment of socioeconomic conditions of the children's families may guide practices aiming to reducing inequalities in the distribution of dental caries in the population.

Post-partum testosterone administration partially reverses the effects of perinatal cadmium exposure on sexual behavior in rats

This study investigated the effects of perinatal cadmium exposure on sexual behavior, organ weight, and testosterone levels in adult rats. We examined whether immediate postpartum testosterone administration is able to reverse the toxic effects of the metal. Forty pregnant Wistar rats were divided into three groups: 1) control, 2) 10 mg kg-1 cadmium chloride per day, and 3) 20 mg kg-1 cadmium chloride per day. These dams were treated on gestational days 18 and 21 and from lactation 1 to 7. Immediately after birth, half of the offspring from the experimental and control groups received 50 &#956;l (i.p.) of 0.2% testosterone. Male sexual behavior, histological analysis and weight of organs as well as serum testosterone levels were assessed. Results showed that both cadmium doses disrupted sexual behavior in male rats, and postnatal treatment with testosterone reversed the toxic effects of 10 mg kg-1 cadmium and attenuated the effects of 20 mg kg-1 cadmium. Body weight and absolute testis, epididymis, and seminal vesicle weight were decreased by the higher cadmium dose, and testosterone supplementation did not reverse these effects. Serum testosterone levels were unaffected by both cadmium doses. No histological changes were detected in all organs analyzed. Maternal cadmium exposure effects in sexual parameters of male rat offspring were explained by the altered masculinization of the hypothalamus. We suggest that cadmium damaged cerebral sexual differentiation by its actions as an endocrine disruptor and supported by the changes discretely observed from early life during sexual development to adult life, reflected by sexual behavior. Testosterone supplementation after birth reversed some crucial parameters directly related to sexual behavior.

Prevalence of anxiety, depression and quality of life in HTLV-1 infected patients

The HAM/TSP caused by HTLV-1 infection usually affects patients to disabling states, and sometimes can lead them to paraplegia presenting symptoms of depression and anxiety, impacting on quality of life. Objective: The purpose of this study was to evaluate the frequency of depression and anxiety and its impact on quality of life in HTLV-1-infected TSP/HAM patients. Material and Methods: This was a cross-sectional study including 67 asymptomatic (control group) and 63 with TSP/HAM subjects. The instruments used were a demographic questionnaire, scales for anxiety and depression diagnosis (BDI and BAI), questionnaire for the assessment of Quality of Life of the World Health Organization (WHOQOL-Brief) and neurological scale to measure the disability level (Osame���s Disability Status Scale). All patients had HTLV-I diagnosis by serological and molecular approaches, monitored at Instituto de Infectologia Em��lio Ribas from May 2008 to July 2009. Data were analyzed statistically by frequencies, the Mann-Whitney test and the Spearman correlation test. Data among groups were analyzed and correlated with functional and severity aspects. Results: The results showed that patients with HAM/TSP compared to asymptomatic carriers had higher rates of depression (p < 0.001) and anxiety (p < 0.001), and impairment on quality of life in the areas of: dissatisfaction with health (p < 0.001), physical (p < 0.001) and the environment (p = 0.003). The main factors that correlated with levels of depression and anxiety and the domains of the WHOQOL-brief were: education, family income and social class. Conclusion: A well conducted evaluation and counseling may help in treatment, for a better quality of life of these patients.

Lymphogranuloma venereum: a new face for an old disease. Our experience in the Bologna area.

Lymphogranuloma venereum (LGV) is a sexual transmitted infection due to Clamydia trachomatis biovar L, endemic in part of Africa, Asia, South America and the Caribbean, but rare in industrialized countries up to 10 years ago. In 2003, a cluster of cases of LGV among men who have sex with men (MSM) was reported in Rotterdam. Since then, several reports of LGV have been reported in the largest cities in Europe, the United States and Australia. They have usually occurred with an anorectal syndrome. The purpose of this study is to summarize the expertise provided by the international literature about the new LGV outbreaks and to offer the first data collected on the presence of this disease in the Bologna area. In fact, we examine 5 cases of LGV proctitis diagnosed and treated at the Clinic of Sexually Transmitted Disease (STD) of the Dermatology Section at Sant���Orsola-Malpighi Hospital, Bologna. Particular attention will be paid to the laboratory method that allows identification and typing of the microorganism C. trachomatis serovar L1, L2, L3, leading to an etiologic diagnosis of certainty. The diagnosed cases of LGV will be described and compared with the international literature, trying to assess the risk factors, the most effective diagnostic and therapeutic procedure and the best approach to the patient.

Interventions to increase rescreening for repeat chlamydial infection

Repeat infection with Chlamydia trachomatis following treatment is common and increases the risk of sequelae. Despite clinical guidelines recommending rescreening within 3 months of treatment, rescreening rates remain low. We undertook a systematic review to identify studies that compared rates of rescreening for repeat chlamydial infection between patients receiving and not receiving an intervention.

Timing of progression from Chlamydia trachomatis infection to pelvic inflammatory disease: a mathematical modelling study

Background Pelvic inflammatory disease (PID) results from the ascending spread of microorganisms from the vagina and endocervix to the upper genital tract. PID can lead to infertility, ectopic pregnancy and chronic pelvic pain. The timing of development of PID after the sexually transmitted bacterial infection Chlamydia trachomatis (chlamydia) might affect the impact of screening interventions, but is currently unknown. This study investigates three hypothetical processes for the timing of progression: at the start, at the end, or throughout the duration of chlamydia infection. Methods We develop a compartmental model that describes the trial structure of a published randomised controlled trial (RCT) and allows each of the three processes to be examined using the same model structure. The RCT estimated the effect of a single chlamydia screening test on the cumulative incidence of PID up to one year later. The fraction of chlamydia infected women who progress to PID is obtained for each hypothetical process by the maximum likelihood method using the results of the RCT. Results The predicted cumulative incidence of PID cases from all causes after one year depends on the fraction of chlamydia infected women that progresses to PID and on the type of progression. Progression at a constant rate from a chlamydia infection to PID or at the end of the infection was compatible with the findings of the RCT. The corresponding estimated fraction of chlamydia infected women that develops PID is 10% (95% confidence interval 7-13%) in both processes. Conclusions The findings of this study suggest that clinical PID can occur throughout the course of a chlamydia infection, which will leave a window of opportunity for screening to prevent PID.

Describing the progression from Chlamydia trachomatis and Neisseria gonorrhoeae to pelvic inflammatory disease: systematic review of mathematical modeling studies

Chlamydia screening is recommended to prevent pelvic inflammatory disease (PID). A systematic review was conducted to determine how the natural history of Chlamydia trachomatis or Neisseria gonorrhoeae infection and progression to PID have been described in mathematical modeling studies.

HIV infection among ethnic minority and migrant men who have sex with men in Britain

To examine human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) from different ethnic and migrant groups living in Britain.