Opinions and attitudes regarding sexuality: Brazilian national research, 2005

OBJETIVO: Descrever opiniões e atitudes sobre sexualidade da população urbana brasileira. MÉTODOS: Inquérito de base populacional realizado em 2005, em amostra representativa de 5.040 entrevistados. Realizou-se análise das atitudes diante da iniciação e educação sexual de adolescentes, considerando sexo, idade, escolaridade, renda, estado civil, religião, cor, região geográfica e opiniões sobre fidelidade, homossexualidade e masturbação. Os resultados foram contrastados com pesquisa similar realizada em 1998, sempre que possível. RESULTADOS: A maioria dos entrevistados escolheu como significado para o sexo a alternativa: "sexo é uma prova de amor". Como em 1998, a maioria manifestou-se pela iniciação sexual dos jovens depois do casamento (63,9% para iniciação feminina vs. 52,4% para a masculina), com diferenças entre praticantes das diversas religiões. A educação escolar de adolescentes sobre o uso do preservativo foi apoiada por 97% dos entrevistados, de todos os grupos sociais. Foi elevada a proporção de brasileiros que concordaram com o acesso ao preservativo nos serviços de saúde (95%) e na escola (83,6%). A fidelidade permaneceu um valor quase unânime e aumentou, em 2005, a proporção dos favoráveis à iniciação sexual depois do casamento, assim como a aceitação da masturbação e da homossexualidade, em relação à pesquisa de 1998. As gerações mais novas tendem a ser mais tolerantes e igualitárias. CONCLUSÕES: Como observado em outros países, confirma-se a dificuldade de estabelecer uma dimensão única que explique a regulação da vida sexual ("liberal" vs "conservador"). Sugere-se que a normatividade relativa à atividade sexual deva ser compreendidas à luz da cultura e organização social da sexualidade ao nível local, auscultadas pelos programas de DST/Aids. A opinião favorável ao acesso livre ao preservativo na escola contrasta com resultados mais lentos no âmbito do combate ao estigma e à discriminação das minorias homossexuais. A formulação de políticas laicas dedicadas à sexualidade permitirá o diálogo entre diferentes perspectivas.OBJECTIVE: To describe opinions and attitudes concerning sexuality of the Brazilian urban population. METHODS: A population survey was carried out in 2005 on a representative sample of 5,040 interviewees. An analysis of the attitudes regarding sexual initiation and sexual education of teenagers, considering gender, age, schooling, income, marital status, color, geographic region and opinion on fidelity, homosexuality, and masturbation. The results were contrasted with a similar survey carried out in 1998, when possible. RESULTS: Most interviewees selected the "sex is evidence of love" option when describing the meaning of sex. As in 1998, the majority was in favor of sexual initiation after marriage (63.9% for women vs. 52.4% for men initiation); results differed among religions. School teenage education on the use of condoms was supported by 97% of the interviewees across all social groups. The proportion of Brazilians who agreed with having access to condoms in health services (95%) and at school (83.6%) was high. Fidelity remained an almost unanimous value and there was an increase, in 2005, in the proportion of those in favor of sexual initiation after marriage, and in the rate of acceptance of masturbation and homosexuality compared to the 1998 survey. The younger generations tend to be more tolerant and equalitarian. CONCLUSIONS: As observed in other countries, this study confirms the difficulty in establishing a single dimension that guides sexual life ("liberal" vs "conservative"). The study suggests that the normativity concerning sexual activity should be understood in the light of the local culture and social organization of sexuality, considered by the STD/Aids programs. Opinions in favor of free access to preservatives at school clash with the slower results obtained in fighting the stigma and discriminating against homosexual minorities. The design of laical policies on sexuality allow for the dialog across different perspectives.Ministério da Saúd

Large emissions from floodplain trees close the Amazon methane budget

Wetlands are the largest global source of atmospheric methane (CH4), a potent greenhouse gas. However, methane emission inventories from the Amazon floodplain, the largest natural geographic source of CH4 in the tropics, consistently underestimate the atmospheric burden of CH4 determined via remote sensing and inversion modelling, pointing to a major gap in our understanding of the contribution of these ecosystems to CH4 emissions. Here we report CH4 fluxes from the stems of 2,357 individual Amazonian floodplain trees from 13 locations across the central Amazon basin. We find that escape of soil gas through wetland trees is the dominant source of regional CH4 emissions. Methane fluxes from Amazon tree stems were up to 200 times larger than emissions reported for temperate wet forests6 and tropical peat swamp forests, representing the largest non-ebullitive wetland fluxes observed. Emissions from trees had an average stable carbon isotope value (δ13C) of −66.2 ± 6.4 per mil, consistent with a soil biogenic origin. We estimate that floodplain trees emit 15.1 ± 1.8 to 21.2 ± 2.5 teragrams of CH4 a year, in addition to the 20.5 ± 5.3 teragrams a year emitted regionally from other sources. Furthermore, we provide a ‘top-down’ regional estimate of CH4 emissions of 42.7 ± 5.6 teragrams of CH4 a year for the Amazon basin, based on regular vertical lower-troposphere CH4 profiles covering the period 2010–2013. We find close agreement between our ‘top-down’ and combined ‘bottom-up’ estimates, indicating that large CH4 emissions from trees adapted to permanent or seasonal inundation can account for the emission source that is required to close the Amazon CH4 budget. Our findings demonstrate the importance of tree stem surfaces in mediating approximately half of all wetland CH4 emissions in the Amazon floodplain, a region that represents up to one-third of the global wetland CH4 source when trees are combined with other emission sources

Efficacy and Safety of Upadacitinib Treatment in Adolescents With Moderate-to-Severe Atopic Dermatitis

Importance: Atopic dermatitis onset usually occurs in childhood. Persistence of disease into adolescence and adulthood is common. It is important to evaluate new treatment options in adolescents because of the high unmet need in this population. Objective: To assess the efficacy and safety of upadacitinib to treat moderate-to-severe atopic dermatitis in adolescents. Design, setting, and participants: Prespecified analysis of adolescents enrolled in 3 randomized, double-blind, placebo-controlled phase 3 clinical trials in more than 20 countries across Europe, North and South America, Oceania, the Middle East, and the Asia-Pacific region from July 2018 through December 2020. Participants were adolescents aged 12 to 17 years with moderate-to-severe atopic dermatitis. Data analysis was performed from April to August 2021. Interventions: Patients were randomized (1:1:1) to once-daily oral upadacitinib 15 mg, upadacitinib 30 mg, or placebo alone (Measure Up 1 and Measure Up 2) or with topical corticosteroids (AD Up). Main outcomes and measures: Safety and efficacy, including at least a 75% improvement in the Eczema Area and Severity Index from baseline and validated Investigator Global Assessment for Atopic Dermatitis score of 0 (clear) or 1 (almost clear) at week 16 (coprimary end points). Results: A total of 552 adolescents (290 female; 262 male) were randomized. Mean (SD) age was 15.4 (1.8), 15.5 (1.7), and 15.3 (1.8) years for adolescents in Measure Up 1, Measure Up 2, and AD Up, respectively. In Measure Up 1, Measure Up 2, and AD Up, respectively, a greater proportion of adolescents (% [95% CI]) achieved at least 75% improvement in the Eczema Area and Severity Index at week 16 with upadacitinib 15 mg (73% [63%-84%], 69% [57%-81%], 63% [51%-76%]), and upadacitinib 30 mg (78% [68%-88%], 73% [62%-85%], 84% [75%-94%]), than with placebo (12% [4%-20%], 13% [5%-22%], 30% [19%-42%]; nominal P < .001 for all comparisons vs placebo). Similarly, a greater proportion of adolescents treated with upadacitinib achieved a validated Investigator Global Assessment for Atopic Dermatitis score of 0 or 1 at week 16 and improvements in quality of life with upadacitinib than with placebo. Upadacitinib was generally well tolerated in adolescents. Acne was the most common adverse event, and all acne events were mild or moderate. Conclusions and relevance: In this analysis of 3 randomized clinical trials, upadacitinib was an effective treatment for adolescents with moderate-to-severe atopic dermatitis, with an acceptable safety profile.info:eu-repo/semantics/publishedVersio

APOLO-Bari, an internet-based program for longitudinal support of bariatric surgery patients: study protocol for a randomized controlled trial

Background: Despite evidence of successful weight loss for bariatric surgery patients, some patients experience considerable weight regain over the long term. Given the strong association between post-surgery health behaviors and outcomes, aftercare intervention to address key behaviors appears to be a reasonable relapse-prevention strategy. As the burden of obesity rates increases in healthcare centers, an internet-based program appears to be a reasonable strategy for supporting bariatric surgery patients in the long term. The primary purpose of the current project is to develop and test the efficacy and perceived utility of APOLO-Bari.Methods/design: This study is a randomized control trial, which will be conducted in two hospital centers in the North of Portugal; it includes a control group receiving treatment as usual and an intervention group receiving the APOLO-Bari program for one year in addition to treatment as usual. A total of 180 male and female participants who underwent bariatric surgery (gastric sleeve or gastric bypass surgery) for 12 to 20 months will be recruited. Both groups will complete a similar set of questionnaires at baseline, every 4 months until the end of the intervention, and at 6 and 12 months follow-up. Assessment includes anthropometric variables and psychological self-report measures. The primary outcome measure will be weight regain measured at the end of treatment, and at 6 and 12 months follow-up. The secondary aims are to test the cost-effectiveness of the intervention and to investigate psychological predictors and trajectories of weight regain. APOLO-Bari was developed to address the weight regain problem in the bariatric population by offering additional guidance to bariatric patients during the postoperative period. The program includes: (a) a psychoeducational cognitive-behavioral-based self-help manual, (b) a weekly feedback messaging system that sends a feedback statement related to information reported by the participant, and (c) interactive chat sessions scheduled witThis research was partially supported by the Fundacao para a Ciencia e a Tecnologia through a European Union COMPETE program grant to Eva Conceicao (IF/01219/2014 and PTDC/MHC-PCL/4974/2012), a doctoral scholarship to Ana Pinto-Bastos (SFRH/BD/104159/2014), a doctoral scholarship to Sofia Ramalho (SFRH/BD/104182/2014), and a postdoctoral scholarship to Ana Rita Vaz (SFRH/BPD/94490/2013), co-financed by FEDER under the PT2020 Partnership Agreement (UID/PSI/01662/2013).info:eu-repo/semantics/publishedVersio