Conhecimentos e comportamentos vulneráveis em sexualidade entre adolescentes de um município do Oeste Goiano

Submitted by Luciana Ferreira ([email protected]) on 2014-11-06T11:51:30Z No. of bitstreams: 2 Dissertação - Brenda de Oliveira Monteiro Mendonça - 2014.pdf: 3161514 bytes, checksum: 65e1abf4a82107ceb80936e8b7220f52 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2014-11-06T14:31:53Z (GMT) No. of bitstreams: 2 Dissertação - Brenda de Oliveira Monteiro Mendonça - 2014.pdf: 3161514 bytes, checksum: 65e1abf4a82107ceb80936e8b7220f52 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Made available in DSpace on 2014-11-06T14:31:53Z (GMT). No. of bitstreams: 2 Dissertação - Brenda de Oliveira Monteiro Mendonça - 2014.pdf: 3161514 bytes, checksum: 65e1abf4a82107ceb80936e8b7220f52 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-03-27This cross-sectional study, analytical approach, was conducted between March 2012 to March 2014, with adolescent aged 12 to 18 stratified into two age groups, early stage - 12 to 14 years (G1) and middle and late stages - 15 to 18 years (G2), enrolled in seven institutions from primary state and municipal education in the municipality of São Luís de Montes Belos – Goiás, with the aim of investigating the risk behavior and knowledge of adolescent sexuality. The participants answered a structured questionnaire (USDHHS – CDC, 1999) and the data were analyzed using SPSS version 17. Of the 1230 adolescents, 623 belonged to female and 607 male. Most of described them self-declared brown colored, nearly half declared evangelicals, with an income equal to or less than three minimum wages and living with the family. Most males practiced physical activity as an occupation or extracurricular activity, while the girls attended religious groups. On sexual behavior and use of contraception in first sexual intercourse excelled in males; more than half cited condom use at first intercourse with female predominance (G1: 76,2%; G2: 64,4%); the reason for not using condoms most cited by the boys did not expect/not bothered (G1: 68,0%, G2: 60,9%), while for girls it was the confidence in partner (G1: 60,0%; G2: 43,7%); more than half of the adolescents did not use any other method of contraception beyond condoms at first sexual intercourse; condom use at last intercourse was also cited by over half of adolescents, highlighting the boys (G2: 67,0%). Regarding the number of lifetime sexual partners, most boys reported having had more than two sexual partners, while girls only one partner, though they have reported more experience of pregnancy (G2: 9,4%). The most used and best known contraceptive was the condom, where boys use (G1: 86,5%; G2: 73,3%) and know (G1: 98,1%; G2: 100%) more than girls, unlike the "pill" had greater knowledge among adolescents (G1: 61,8%; G2: 89,6%); HIV/Aids was the best known DST. Alcohol was the most commonly used drug. The school, friends (as) and the parents were cited as sources of information about sexuality and friends and parents were cited as the people most talked about sexuality. In relation to access to health services for adolescents, more than half reported being user; sought more for doctor visits and immunization. A small portion had access to condoms, making the most bought in the pharmacy; another small portion had access to nursing consultation and sexual orientation. Given our results, it is necessary to the proper use of school space for the development of education programs for adolescent health, intended for students, parents and teachers through interdisciplinary activities between segments of health and education.Estudo de corte transversal, analítico, realizado no período de Março de 2012 à Março de 2014 com adolescentes na idade de 12 a 18 anos estratificados em dois grupos etários, fase inicial – 12 a 14 anos (G1) e fases média e tardia – 15 a 18 anos (G2), matriculados em sete instituições da rede pública de ensino estadual e municipal no município de São Luís de Montes Belos – Goiás, com a finalidade de verificar os conhecimentos e comportamentos de risco em sexualidade entre os adolescentes. Os participantes responderam a um questionário padronizado (USDHHS – CDC, 1999) e os dados foram analisados pelo programa SPSS versão 17. Dos 1230 adolescentes, 623 pertencia ao sexo feminino e 607 masculino. A maioria se auto denominou de cor parda, aproximadamente a metade se declarou evangélicos, com renda igual ou inferior a três salários mínimos e que residiam com a família. A maior parte dos indivíduos do sexo masculino praticava atividade física como ocupação ou atividade extracurricular, enquanto as meninas participavam de grupos religiosos. Sobre os comportamentos sexuais e utilização de métodos contraceptivos, a sexarca sobressaiu no sexo masculino; mais da metade citou usar preservativo na sexarca com predomínio do sexo feminino (G1: 76,2%; G2: 64,4%); o motivo do não uso do preservativo mais citado pelos meninos foi que não esperava/não se preocupou (G1: 68,0%, G2: 60,9%), enquanto que para as meninas foi à confiança no parceiro (G1: 60,0%; G2: 43,7%); mais da metade dos adolescentes não utilizaram nenhum outro método de contraceptivo além do preservativo na sexarca; o uso do preservativo na última relação sexual também foi citado por mais da metade dos adolescentes, sobressaindo os meninos (G2: 67,0%). Em relação ao número de parceiros sexuais na vida, a maioria dos meninos relatou ter tido mais de dois parceiros sexuais, enquanto as meninas apenas um parceiro, apesar delas ter relatado mais experiência de gravidez (G2: 9,4%). O método contraceptivo mais utilizado e mais conhecido foi o preservativo masculino, onde os meninos utilizam (G1: 86,5%; G2: 73,3%) e conhecem (G1: 98,1%; G2: 100%) mais que as meninas, ao contrário da “pílula” que teve maior conhecimento entre as adolescentes (G1: 61,8%; G2: 89,6%); o HIV/Aids foi a DST mais conhecida. O álcool foi à droga mais consumida. A escola, os amigos (as) e os pais foram citados como as fontes de informações sobre sexualidade e os amigos e os pais foram citados como as pessoas com quem mais conversaram sobre sexualidade. Em relação ao acesso aos serviços de saúde dos adolescentes, mais da metade informou ser usuário; procuraram mais por consultas médicas e imunização. Uma pequena parcela teve acesso ao preservativo, fazendo com que a maioria comprasse na farmácia; outra pequena parcela teve acesso à consulta de enfermagem e a orientação sexual. Frente aos resultados obtidos, faz-se necessário a utilização apropriada do espaço escolar para o desenvolvimento de programas de educação para a saúde dos adolescentes, voltados para alunos, pais e professores por meio de ações interdisciplinares entre os segmentos da saúde e educação

Adesão de mulheres de 18 a 50 anos ao exame colpocitológico na estratégia saúde da família Adhesión de mujeres de los 18 a los 50 años a una prueba de Papanicolaou en la estrategia de salud de la familia Adherence of women aged 18 to 50 years to a cervical smear test in the Family Health Strategy

Estudo descritivo exploratório de natureza quantitativa que teve como objetivo avaliar a adesão das mulheres ao exame colpocitológico (COP) na Estratégia Saúde da Família (ESF) de Iporá, Goiás, Brasil. A amostra do estudo foi composta por 114 mulheres com idade mínima de 18 e máxima de 50 anos de idade que compareceram nas unidades de ESF para realizar o COP nos meses de outubro e novembro de 2010. A análise descritiva realizada pelo programa Epi Info 3.5.1 mostrou que a maior adesão está na faixa etária de 46 a 50 anos de idade (24%) e a menor nas de 18 a 20 e de 41 a 45 (10% cada). Entre as entrevistadas, 70% realiza o exame a cada dois anos ou menos e 12% nunca o realizou. A unidade de ESF com maior adesão foi a do Jardim Monte Alto, com 16%, e a de menor adesão foi a do bairro Umuarama, com 8%. Concluiu-se que a prevenção é a principal justificação das mulheres para a realização do COP.Estudio descriptivo exploratorio de corte cuantitativo, que tuvo por objeto evaluar la adhesión de las mujeres a las pruebas de rastreo de Papanicolaou en la Estrategia Salud de la Familia (ESF) de Iporá, Goias, Brasil. La muestra del estudio consistió en 114 mujeres con una edad mínima de 18 años y una edad máxima de 50 años que asistieron a centros de ESF para realizar la citología entre los meses de octubre y noviembre de 2010. El análisis descriptivo realizado con Epi Info 3.5.1, mostró que la mayor adhesión se encuentra entre los 46 a 50 años de edad (24%) y la menor entre los 18 a 20 y 41 a 45 (10% cada uno). Entre las entrevistadas, el 70% realiza el examen cada dos años o menos y el 12% nunca lo ha realizado. La unidad de ESF con mayor adhesión fue la del Jardim Monte Alto (16%) y la de menor adherencia fue la del barrio Umuarama con 8%. Se concluyó que la prevención es la razón principal de las mujeres para hacerse el examen.A descriptive exploratory study of quantitative nature with the aim of evaluating the adherence of women to the smear test in the Health Family Strategy of Iporá, Goiás, Brazil. The study sample consisted of 114 women from 18 to 50 years old who attended the Family Health Strategy to have a smear test in October and November 2010. The descriptive analysis performed using Epi Info 3.5.1 showed that the higher level of adherence is in the 46 to 50 years age group (24%) and the lower level is at 18 to 20 and 41 to 45 years (10% each). Among the interviewees, 70% had the test every two years or less and 12% had never had it. The Family Health Strategy unit with higher adherence was Jadim Monte Alto with 16%, and the lower was Umuarama district with 8%. It was concluded that prevention is the main reason for women to take the smear test

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research