Prior history of sexually transmitted diseases in women living with AIDS in São Paulo, Brazil

OBJECTIVES: To describe the epidemiological profile, risk behaviors, and the prior history of sexually transmitted diseases (STDs) in women living with acquired immunodeficiency syndrome (AIDS). METHODS: Cross-sectional study, performed at the Centro de Referência e Treinamento em DST/AIDS of São Paulo. The social, demographic, behavioral, and clinical data such as age, schooling, marital status, age at first sexual intercourse, number of sexual partners, parity, use of drugs, time of HIV diagnosis, CD4 count, and viral load determination were abstracted from the medical records of women living with AIDS who had gynecological consultation scheduled in the period from June 2008 to May 2009. RESULTS: Out of 710 women who were scheduled to a gynecological consultation during the period of the study, 598 were included. Previous STD was documented for 364 (60.9%; 95% CI: 56.9%-64.8%) women. The associated factors with previous STDs and their respective risks were: human development index (HDI) < 0.50 (ORaj = 5.5; 95% CI: 2.8-11.0); non-white race (ORaj = 5.2; 95% CI: 2.5-11.0); first sexual intercourse at or before 15 years of age (ORaj = 4.4; 95% CI: 2.3-8.3); HIV infection follow-up time of nine years or more (ORaj = 4.2; 95% CI: 2.3-7.8)]; number of sexual partners during the entire life between three and five partners (ORaj = 2.2; 95% CI: 1.1-4.6), and six or more sexual partners (ORaj = 3.9; 95% CI: 1.9-8.0%); being a sex worker (ORaj = 1.9; 95% CI: 1.1-3.1). CONCLUSIONS: A high prevalence of a prior history of STDs in the studied population was found. It is essential to find better ways to access HIV infection prevention, so that effective interventions can be more widely implemented.

Comensalidade e cuidado: meninas-jovens-mulheres órfãs no contexto de HIV/Aids

O "monopólio da cozinha", histórica e culturalmente, é atribuído às mulheres, mães. Para cuidar da família, elas elegem alimentos, compram, cozinham e os servem. Sustentam a comensalidade. Em contextos de HIV/Aids, onde há perda da mãe, as filhas tornam-se responsáveis por esses cuidados. O que pensam as meninas do papel de cuidadoras com o qual, prematuramente, deparam-se? O que dizem seus irmãos sobre isso? Realizamos entrevistas semidirigidas com 14 jovens órfãos. Os dados foram analisados pela proposta de Mills (2009). As jovens não demonstram insatisfação por executarem novas tarefas, mas deploram o fato de impedirem o estudo e a vida além-casa. Seus irmãos entendem a lida da cozinha como coisa de mulher e, por isso, dificilmente colaboram. Essas jovens necessitam de cuidados direcionados à situação vulnerável em que vivem. As políticas de Saúde Pública poderiam pleitear macroestruturas que atuassem sobre essa demanda.

Orfandade por aids ou por homicídio apresenta efeitos sobre o estado nutricional das crianças?

O artigo tem como objetivos avaliar o estado nutricional de órfãos por aids ou homicídios residentes em São Paulo e estimar a associação de índices nutricionais com variáveis relacionadas à orfandade. Trata-se de estudo transversal de base domiciliar que utilizou amostra representativa de 484 indivíduos de 5 a 14 anos que perderam um ou ambos os pais durante os anos de 2000 e 2004 devido à aids ou a homicídio no município de São Paulo. A avaliação nutricional foi feita com o índice de massa corporal-para-idade (IMC) e da altura-para-idade (altura). A associação entre os índices nutricionais e as variáveis relacionadas à orfandade foi estimada em análise hierárquica, com uso de modelo de regressão linear múltiplo. Órfãos por aids ou homicídios diferiram quanto às características da orfandade e à idade média. As condições econômicas, domiciliares, o estado de saúde e o estado nutricional foram semelhantes entre os grupos. O déficit de IMC ocorreu em 1,3% das crianças abaixo de 10 anos e em 2,1% dos adolescentes. O déficit de altura ocorreu em 0,7% das crianças e em 4,0% dos adolescentes. O excesso de peso ocorreu em 19% e 20% das crianças e adolescentes, respectivamente. A análise hierárquica indicou ausência de efeito das variáveis relacionadas à orfandade sobre o IMC ou a altura; o principal determinante do estado nutricional foi de natureza econômica. Os órfãos por aids ou homicídio de São Paulo apresentaram estado nutricional semelhante e majoritariamente influenciado pela situação econômica. O perfil nutricional identificado no grupo, caracterizado pelo excesso de peso, sugere que os órfãos de São Paulo não apresentam riscos adicionais decorrentes da orfandade.

Effect of pH-induced nanopowder deagglomeration on sintering, microstructure and dielectric properties of Ba0.77Ca0.23TiO3 ceramics

Ba0.77Ca0.23TiO3 ceramics were produced in this work starting from nanopowders synthesized via a polymeric precursor method. By adjusting the pH values of the precursor solutions above 7, it was possible to prepare powders weakly aggregated and with a smaller particle size, both facts which traduced into an enhanced nanopowders' sintering process at comparatively lower temperatures. Irrespective of the initial pH value, highly-dense and second phase-free ceramics were obtained following optimal sintering parameters (temperature and time) extracted from dilatometric and density measurements. By considering these and other sintering conditions, moreover, polycrystalline materials with an average grain size varying from 0.35 to 8 mm were produced, the grain growth process involving liquid phase-assisted sintering for heat treatments achieved at 1320 °C. The study of grain size effects on the ferroelectric properties of these materials was conducted, the results being discussed in the light of previous debates, including grain size-dependent degree of tetragonal distortion in such materials, as verified in this work.

On Ti-18Si-6B and Ti-7.5Si-22.5B powder alloys prepared by high-energy ball milling and sintering

Recently, a new ternary phase was discovered in the Ti-Si-B system, located near the Ti6Si2B composition. The present study concerns the preparation of titanium alloys that contain such phase mixed with α-titanium and other intermetallic phases. High-purity powders were initially processed in a planetary ball-mill under argon atmosphere with Ti-18Si-6B and Ti-7.5Si-22.5B at. (%) initial compositions. Variation of parameters such as rotary speed, time, and ball diameters were adopted. The as-milled powders were pressureless sintered and hot pressed. Both the as-milled and sintered materials were characterized by X-ray diffraction, scanning electron microscopy and energy-dispersive spectrometry. Sintered samples have presented equilibrium structures formed mainly by the α-Ti+Ti6Si2B+Ti5Si3+TiB phases. Silicon and boron peaks disappear throughout the milling processes, as observed in the powder diffraction data. Furthermore, an iron contamination of up to 10 at. (%) is measured by X-ray spectroscopy analysis on some regions of the sintered samples. Density, hardness and tribological results for these two compositions are also presented here.

Association between muscle strength and the cardiopulmonary status of individuals living with HIV/AIDS

OBJECTIVE: The purpose of this study was to compare aerobic function [anaerobic threshold (%_VVO2-AT), respiratory compensation point (%_VVO2-RCP) and peak oxygen uptake (_VVO2peak)] between physically active patients with HIV/AIDS and matched controls and to examine associations between disease status, poor muscle strength, depression (as estimated by the profile of mood states questionnaire) and the aerobic performance of patients. METHODS: Progressive treadmill test data for %_VVO2-AT (V-slope method), RCP and (_VVO2peak) were compared between 39 male patients with HIV/AIDS (age 40.6¡1.4 years) and 28 male controls (age 44.4¡2.1 years) drawn from the same community and matched for habitual physical activity. Within-patient data were also examined in relation to CD4+ counts (nadir and current data) and peak isokinetic knee torque. RESULTS: AT, RCP and (_VVO2peak) values were generally similar for patients and controls.Within the patient sample, binary classification suggested that AT, RCP and (_VVO2peak) values were not associated with either the nadir or current CD4+ count, but treadmill test variables were positively associated with peak isokinetic knee torque. CONCLUSION: The aerobic performance of physically active patients with HIV/AIDS is generally well conserved. Nevertheless, poor muscle strength is observed in some HIV/AIDS patients, which is associated with lower anaerobic power and (_VVO2peak), suggesting the possibility of enhancing the aerobic performance of patients with weak muscles through appropriate muscle-strengthening activities.

Sintering and model of thermal residual stress for getting cutting tools from functionally gradient materials

Cutting tools with higher wear resistance are those manufactured by powder metallurgy process, which combines the development of materials and design properties, features of shape-making technology and sintering. The annual global market of cutting tools consumes about US$ 12 billion; therefore, any research to improve tool designs and machining process techniques adds value or reduces costs. The aim is to describe the Spark Plasma Sintering (SPS) of cutting tools in functionally gradient materials, to show this structure design suitability through thermal residual stress model and, lastly, to present two kinds of inserts. For this, three cutting tool materials were used (Al2O3-ZrO2, Al2O3-TiC and WC-Co). The samples were sintered by SPS at 1300 °C and 70 MPa. The results showed that mechanical and thermal displacements may be separated during thermal treatment for analysis. Besides, the absence of cracks indicated coherence between experimental results and the residual stresses predicted.

MÖJLIGHETER OCH HINDER INOM PREVENTIVT HIV/AIDS-ARBETE : En intervjuundersökning, i Zambia, om rådgivares upplevelser

HIV/Aids är ett av de största globala problemen och utmaningar av idag. Södra Afrika är särskilt drabbat och detta påverkar många olika delar av mänskligt liv. Syftet med denna uppsats har varit att söka ökad förståelse för hur maktstrukturer, utifrån fem rådgivares upplevelser, påverkar det preventiva HIV/Aids arbetet. Vilka faktorer som utgör möjligheter och hinder samt ifall maktstrukturer bidrar till att inte förändring av beteende sker trots kunskap om dess risker, har getts stort fokus. Det geografiska området för studien var södra Zambia. Det finns inget givet svar på vår forskningsfråga, utan resultatet visar snarare på motsatser och komplexitet. Vår utgångspunkt har varit att det inte finns något självklart rätt eller fel och inte heller en enda sanning. Dock är vår slutsats att de möjligheter som finns kan basera sig i att ta hänsyn till lokala förhållanden och maktstrukturer.

Grandparents Left with AIDS-orphans; Challenges and Strategies Handling Poverty and Stigma

By 2010 it is estimated that one third of the African children will be orphans as an effect of HIV/AIDS. The crisis is already a fact and most orphans are absorbed by the extended family where the grandparents become the primary caretakers. This qualitative study was carried out in Kenya to explore the situation of these grandparents and to define their current resources and needs. Eight grandparents living in rural village or urban slum caring for their orphaned grandchildren were interviewed. The results showed that these families live under extremely poor conditions lacking food, other vital neccesities and a basic social network. Local churches and support groups emerged as the grandparents main sources to enhance strength and support. Key factors causing the acute poverty is HIV-related stigma and lack of access to land.

Sjuksköterskans kunskap och attityder vid omvårdnad av HIV/AIDS patient

Abstract Bakgrund: Totalt har nästan 30 miljoner avlidit sedan första AIDS- fallet diagnostiserades år 1981. Ovissheten och hotet om sjukdom och för tidig död innebär stora psykiska påfrestningar på individen. Sjuksköterskans attityder och sätt att vara spelar en viktig roll för etablering av en terapeutisk relation. Syfte: Syftet var att belysa sjuksköterskans attityder till patienter med HIV- infektion. Metod: Genom en litteraturstudie av tidigare forskning har 16 vetenskapliga artiklar granskats. Dessa fann vi på databaserna PubMed och Cinahl. Resultat: Sjuksköterskor upplevde rädsla vid omvårdnad av patienter med HIV/AIDS på grund av dess smittrisk. De ansåg att de behövde mer utbildning och support och professionell support mellan kollegor för att orka med sitt arbete. Från forskarnas observationer sågs ett fysiskt undvikande av patienter, som att vårdpersonalen inte svarade på patientens ringningar, de undvek att gå in till patienten. Sjuksköterskestuderande som hade en rädsla för HIV/AIDS har mer homofobier, de ansåg att det var ett straff för deras oordnade sexliv och att de förtjänade sitt öde. Slutsats: Vi anser att många av dessa attityder skulle kunna undvikas om personalen får mer kunskap om smitta, sexuallitet och droger, hur sjukdomsförloppet ser ut, och vilka funderingar en HIV/AIDS smittad kan ha. Detta skulle bidra till att sjuksköterskor/vårdpersonal vågar möta patienten och utveckla en god relation till denne.

Spark Plasma Sintering of Si3N4-based Ceramics : Sintering mechanism-Tailoring microstructure-Evaluationg properties

Spark Plasma Sintering (SPS) is a promising rapid consolidation technique that allows a better understanding and manipulating of sintering kinetics and therefore makes it possible to obtain Si3N4-based ceramics with tailored microstructures, consisting of grains with either equiaxed or elongated morphology. The presence of an extra liquid phase is necessary for forming tough interlocking microstructures in Yb/Y-stabilised α-sialon by HP. The liquid is introduced by a new method, namely by increasing the O/N ratio in the general formula RExSi12-(3x+n)Al3x+nOnN16-n while keeping the cation ratios of RE, Si and Al constant. Monophasic α-sialon ceramics with tailored microstructures, consisting of either fine equiaxed or elongated grains, have been obtained by using SPS, whether or not such an extra liquid phase is involved. The three processes, namely densification, phase transformation and grain growth, which usually occur simultaneously during conventional HP consolidation of Si3N4-based ceramics, have been precisely followed and separately investigated in the SPS process. The enhanced densification is attributed to the non-equilibrium nature of the liquid phase formed during heating. The dominating mechanism during densification is the enhanced grain boundary sliding accompanied by diffusion- and/or reaction-controlled processes. The rapid grain growth is ascribed to a dynamic ripening mechanism based on the formation of a liquid phase that is grossly out of equilibrium, which in turn generates an extra chemical driving force for mass transfer. Monophasic α-sialon ceramics with interlocking microstructures exhibit improved damage tolerance. Y/Yb- stabilised monophasic α-sialon ceramics containing approximately 3 vol% liquid with refined interlocking microstructures have excellent thermal-shock resistance, comparable to the best β-sialon ceramics with 20 vol% additional liquid phase prepared by HP. The obtained sialon ceramics with fine-grained microstructure show formidably improved superplasticity in the presence of an electric field. The compressive strain rate reaches the order of 10-2 s-1 at temperatures above 1500oC, that is, two orders of magnitude higher than that has been realised so far by any other conventional approaches. The high deformation rate recorded in this work opens up possibilities for making ceramic components with complex shapes through super-plastic forming.

New lightweight optimization method applied in parts made by selective laser sintering and polyjet technologies

[EN]The continuous evolution of materials and technologies of Additive Manufacturing (AM) has led to a competitive production process even for functional parts. The capabilities of these technologies for manufacturing complex geometries allow the definition of new designs that cannot be obtained with any other manufacturing processes. An application where this capability can be exploited is the lightening of parts using internal structures. This allows to obtain more efficient parts and, at the same time, reduce the costs of material and manufacturing time. A new lightweight optimization method to optimize the design of these structures and minimize weight while keeping the minimal mechanical properties is presented in this paper.

Frauen und AIDS in Tansania /// Arbeitspapiere / Institut für Ethnologie und Afrikastudien ; 60

Mehr als die Hälfte aller HIV-positiven Tansanier sind Frauen. Ihre schwächere gesellschaftliche Stellung ist einer der Faktoren, der dazu beiträgt, dass sie einem erhöhten Infektionsrisiko ausgesetzt sind. Aufgrund geringerer Bildungschancen und einer anhaltenden gesellschaftlichen Idealvorstellung von der Frau als Mutter sind Frauen auch auf dem Arbeitsmarkt benachteiligt. Im Kontext von HIV/AIDS werden afrikanische Frauen häufig als passive Opfer der Epidemie dargestellt und es wird zu selten aufgezeigt, wie sie als Akteure eigene Strategien im Kampf gegen die Krankheit entwickeln. In letzter Zeit gewinnen Frauenorganisationen an Bedeutung, denn viele Frauen wollen ausdrücklich eigenverantwortlich und ohne Männer arbeiten. Eine solche Organisation ist die in meiner Arbeit vorgestellte NGO KIWAMWAKU („Kikundi cha Wanawake Mwanga kupambana na Ukimwi“ – Vereinigung von Frauen aus Mwanga zum Kampf gegen AIDS). Meine Forschung hat gezeigt, dass Frauen ihre gesellschaftliche Stellung durch das Engagement in einer NGO verbessern können. Sie können ein eigenes Einkommen erwirtschaften und nützliche Kenntnisse etwa in der Führung einer Organisation erlangen. Allerdings profitieren nicht alle Beteiligten gleichermaßen. Die drei Leiterinnen der erforschten NGO verfügten über die meisten Vorteile; sie profitierten finanziell, aber auch ideell, denn sie genossen durch ihre Arbeit hohes Ansehen im gesamten Mwanga-Distrikt. Dagegen konnten einige der Klientinnen nur in sehr geringem Maße von Interventionen profitieren. Letztlich bin ich jedoch überzeugt davon, dass durch solche Frauenorganisationen ein wichtiger Prozess angestoßen worden ist, durch den Frauen mittel- oder langfristig eine stärkere Stellung innerhalb der tansanischen Gesellschaft erlangen können, was sich wiederum positiv auf die immer noch steigenden HIV/AIDS-Infektionsraten auswirken kann.

Examining the Role of Vocational Rehabilitation on Access to Care and Public Health Outcomes for People Living with HIV/AIDS

The purpose of this study is to examine the role of vocational rehabilitation services in contributing to the goals of the National HIV/AIDS strategy. Three key research questions are addressed: (a) What is the relationship among factors associated with the use of vocational rehabilitation services for people living with HIV/AIDS? (b) Are the factors associated with use of vocational rehabilitation also associated with access to health care, supplemental employment services and reduced risk of HIV transmission? And (c) What unique role does use of vocational rehabilitation services play in access to health care and HIV prevention? Survey research methods were used to collect data from a broad sample of volunteer respondents who represented diverse racial (37% Black, 37% White, 18% Latino, 7% other), gender (65% male, 34% female, 1% transgender) and sexual orientation (48% heterosexual, 44% gay, 8% bisexual) backgrounds. The fit of the final structural equation model was good (root mean square error of approximation = .055, Comparative Fit Index=.953, Tucker Lewis Index=.945). Standardized effects with bootstrap confidence intervals are reported. Overall, the findings support the hypothesis that vocational rehabilitation services can play an important role in health and prevention strategies outlined in the National HIV/AIDS strategy.