Desire for a child among women living with HIV/AIDS in northeast Brazil

In Brazil, an increasing proportion of new HIV infections and AIDS cases involve women of reproductive age. To describe the reproductive desire of women with HIV/AIDS and to identify factors associated with the desire for motherhood, a cross-sectional study was carried out in the referral hospital for infectious diseases in Ceara State, northeast Brazil. In total, 229 women were included in data analysis. Median age was 32 years (interquartile range, 26-37), and 63% had a monthly family income of less than 210 USD. Forty-nine percent were using a contraceptive method, and 37% wished to undergo tubal ligation. Sixty-four percent of the latter women were motivated by the fear of having an HIV-positive child. Forty percent of the participants wanted to have a child. In the multivariate regression analysis, variables independently associated with women's desire to have a child were: younger age ( in years, odds ration [OR] = 0.94; 95% confidence interval [CI]: 0.90-0.98), number of children (OR = 0.73; 95% CI: 0.57-0.96), and partner's desire for a child (OR = 3.35; 95% CI: 1.75-6.39). Having a partner who did not know about the woman's positive serostatus was negatively associated with the woman's desire for a child (OR = 0.17; 95% CI: 0.04-0.69). No variable related to clinical status was significantly associated with the outcome variable. Our data showed that many unsterilized HIV-positive women in northeast Brazil, at whatever stage of illness, have a desire for children. We recommend that nondirective counseling, consisting of helping women evaluate their own feelings, goals and needs with respect to reproductive options be provided.21426126

Persons living with AIDS in nurses' social representations: analysis of central, contranormative and attitudinal elements

OBJECTIVES: to describe and analyze the centrality, the mute zone and the attitudes expressed in nurses' social representations of people with Human Immunodeficiency Virus. METHOD: the subjects were 30 nurses from a university hospital in Rio de Janeiro. The data was collected using a Likert scale. RESULTS: the data pointed to a process of representational change regarding Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome, with the assumption of a more positive attitude regarding living with this health issue. The hypothesis of the existence of a mute zone in the representation, comprising elements with a contranormative character, was strengthened. CONCLUSION: the influence of the dynamics of social normativity on how the social representations studied are expressed may contribute to a better understanding of its structuring process. It also helps in the analysis of possible gaps among the nurses' discourses and practices in relation to Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome.OBJETIVOS: describir y analizar la centralidad, la zona muda y las actitudes expresas en las representaciones sociales de enfermeros acerca de la persona con Virus de la Inmunodeficiencia Humana. MÉTODO: los sujetos fueron 30 enfermeros de un hospital universitario de Rio de Janeiro. Los datos fueron colectados utilizando escala tipo likert. RESULTADOS: indicaron un proceso de cambio representacional sobre el Virus de la Inmunodeficiencia Humana/Síndrome da Inmunodeficiencia Adquirida, con la Asunción de actitud más positiva sobre la convivencia con éste agravo. Fue reforzada hipótesis de existencia de zona muda en la representación compuesta por elementos de carácter contra normativo. CONCLUSIÓN: la influencia de la dinámica de normatividad social sobre el modo de expresión de las representaciones sociales estudiadas puede aportar para una mejor comprensión de su proceso de estructuración. Auxilia, también, en el análisis de eventuales desfases entre los discursos y las prácticas de los enfermeros con relación al Virus de la Inmunodeficiencia Humana/Síndrome da Inmunodeficiencia Adquirida.OBJETIVOS: descrever e analisar a centralidade, a zona muda e as atitudes expressas nas representações sociais de enfermeiros, acerca da pessoa com vírus da imunodeficiência humana. MÉTODO: os sujeitos foram 30 enfermeiros de um hospital universitário do Rio de Janeiro. Os dados foram coletados utilizando escala tipo Likert. RESULTADOS: os resultados indicaram um processo de mudança representacional sobre o vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida, com a assunção de atitude mais positiva sobre a convivência com esse agravo. Foi reforçada a hipótese da existência de zona muda na representação composta por elementos de caráter contranormativo. CONCLUSÃO: a influência da dinâmica de normatividade social sobre o modo de expressão das representações sociais estudadas pode contribuir para melhor compreensão do seu processo de estruturação. Auxilia, também, na análise de eventuais defasagens entre os discursos e as práticas dos enfermeiros em relação ao vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida

Experience of taking care of children exposed to HIV: a trajectory of expectations

OBJETIVO: conhecer a experiência do cuidador/mãe em relação ao cuidado para com a criança exposta ao vírus da imunodeficiência humana por transmissão vertical, na trajetória pós-natal. MÉTODO: pesquisa qualitativa, que utilizou o Interacionismo Simbólico como referencial teórico. Foram realizadas entrevistas com 39 cuidadores de crianças expostas ao vírus da imunodeficiência humana e em seguimento em um serviço especializado. Os dados foram analisados pela análise de conteúdo indutiva. RESULTADOS: apreenderam-se quatro categorias que reportam à experiência solitária de manuseio da terapia antirretroviral da criança, no que se refere principalmente à ausência ou incompletude de informações recebidas; estar atento aos cuidados, que incluem o uso da profilaxia para pneumonia, vacinas e outros restritos à interação mãe/criança; querer omitir a presença do vírus da imunodeficiência humana pelo medo do preconceito e olhar o futuro e temer a doença. CONCLUSÃO: a presença do vírus da imunodeficiência humana e a ameaça dessa infecção na criança são capazes de gerar apreensão e tantos outros sentimentos como medo, culpa e ansiedade no cuidador. Os profissionais de saúde precisam trabalhar conjuntamente com a mãe para o enfrentamento das demandas e sofrimentos. Assim, o tratamento para evitar a transmissão vertical será eficiente e a mãe, juntamente à criança, viverá essa trajetória com apoio, apesar da apreensão pelo resultado.OBJETIVO: conocer la experiencia del cuidador/madre en relación al cuidado de niño expuesto al VIH por transmisión vertical en la trayectoria posnatal. MÉTODO: investigación cualitativa, que utilizó el Interaccionismo Simbólico como referencial teórico. Fueron realizadas entrevistas con 39 cuidadores de niños expuestos al VIH y que eran acompañados en un servicio especializado. Los datos fueron analizados por el análisis de contenido inductivo. RESULTADOS: se encontraron cuatro categorías que informan sobre la experiencia solitaria de la administración de la terapia antirretroviral del niño, en lo que se refiere principalmente a: la ausencia o a informaciones incompletas recibidas; al estar atento a los cuidados, que incluyen el uso de la profilaxis para neumonía, vacunas y otros restringidos a la interacción madre-niño; al querer omitir la presencia del VIH por miedo al prejuicio; y al mirar al futuro y temer a la enfermedad. CONCLUSIÓN: la presencia del VIH y la amenaza de infectar al niño son capaces de generar preocupación y varios otros sentimientos en el cuidador, como miedo, culpa y ansiedad. Los profesionales de la salud precisan trabajar conjuntamente con la madre para el enfrentamiento de las demandas y sufrimientos. Así, el tratamiento para evitar la transmisión vertical será eficiente y la madre con el niño vivirán esa trayectoria con apoyo, a pesar de la preocupación por el resultado.'OBJECTIVE: to learn about the experience of caregivers/mothers providing care to infants exposed to HIV through vertical transmission. METHODS: this qualitative study used Symbolic Interactionism as the theoretical framework. A total of 39 caregivers of children exposed to HIV in follow-up at a specialized service were interviewed. Data were analyzed through inductive content analysis. RESULTS: four categories were identified that report on the lonely experience of handling the child's antiretroviral therapy, mainly due to a lack of information or incomplete information; being attentive to required care, such as the use of prophylaxis for pneumonia, vaccines, and other practices restricted to the mother-child interaction; the desire to omit the HIV out of fear of prejudice and fear of the disease, considering future prospects. CONCLUSION: the HIV and the threat this infection may affect the child cause apprehension and feelings such as fear, guilt and anxiety in the caregivers. Healthcare workers need to work together with mothers so they are able to cope with demands and distress. Only then will the treatment to avoid vertical transmission be efficient and will mother and child be supported during the process, despite apprehension with the outcome

Men’s artistic gymnastics: is the use of elastic surfaces systematic in the training process?

Abstract In Artistic Gymnastics, the area (the apparatus) represents the most relevant systemic component. Thus, when one strives to comprehend the internal logic of this sport, the gymnast-apparatus relationship warrants special attention. A change in the training paradigm was observed, showing that the use of Elastic Surfaces (ES) is an essential resource, due to the contemporary features of this sport, such as the hyper-valorisation of acrobatics and a greater presence of flight elements. Through a case study developed in a men’s artistic gymnastics high-performance gymnasium, this study analysed the use of different ES in the training process. Although coaches recognize the importance of ES in training programs, the record of daily activities showed that this use is still limited to select equipment and is not systematic. Such difficulties are due mainly to the lack of educational programs to the development of certain specific methodologies and the non-existence of national equipment suppliers certified by International Gymnastics Federation

A Field Guide to Pandemic, Epidemic and Sporadic Clones of Methicillin-Resistant Staphylococcus aureus

In recent years, methicillin-resistant Staphylococcus aureus (MRSA) have become a truly global challenge. In addition to the long-known healthcare-associated clones, novel strains have also emerged outside of the hospital settings, in the community as well as in livestock. The emergence and spread of virulent clones expressing Panton-Valentine leukocidin (PVL) is an additional cause for concern. In order to provide an overview of pandemic, epidemic and sporadic strains, more than 3,000 clinical and veterinary isolates of MRSA mainly from Germany, the United Kingdom, Ireland, France, Malta, Abu Dhabi, Hong Kong, Australia, Trinidad & Tobago as well as some reference strains from the United States have been genotyped by DNA microarray analysis. This technique allowed the assignment of the MRSA isolates to 34 distinct lineages which can be clearly defined based on non-mobile genes. The results were in accordance with data from multilocus sequence typing. More than 100 different strains were distinguished based on affiliation to these lineages, SCCmec type and the presence or absence of PVL. These strains are described here mainly with regard to clinically relevant antimicrobial resistance- and virulence-associated markers, but also in relation to epidemiology and geographic distribution. The findings of the study show a high level of biodiversity among MRSA, especially among strains harbouring SCCmec IV and V elements. The data also indicate a high rate of genetic recombination in MRSA involving SCC elements, bacteriophages or other mobile genetic elements and large-scale chromosomal replacements

A Field Guide to Pandemic, Epidemic and Sporadic Clones of Methicillin-Resistant Staphylococcus aureus

In recent years, methicillin-resistant Staphylococcus aureus (MRSA) have become a truly global challenge. In addition to the long-known healthcare-associated clones, novel strains have also emerged outside of the hospital settings, in the community as well as in livestock. The emergence and spread of virulent clones expressing Panton-Valentine leukocidin (PVL) is an additional cause for concern. In order to provide an overview of pandemic, epidemic and sporadic strains, more than 3,000 clinical and veterinary isolates of MRSA mainly from Germany, the United Kingdom, Ireland, France, Malta, Abu Dhabi, Hong Kong, Australia, Trinidad & Tobago as well as some reference strains from the United States have been genotyped by DNA microarray analysis. This technique allowed the assignment of the MRSA isolates to 34 distinct lineages which can be clearly defined based on non-mobile genes. The results were in accordance with data from multilocus sequence typing. More than 100 different strains were distinguished based on affiliation to these lineages, SCCmec type and the presence or absence of PVL. These strains are described here mainly with regard to clinically relevant antimicrobial resistance- and virulence-associated markers, but also in relation to epidemiology and geographic distribution. The findings of the study show a high level of biodiversity among MRSA, especially among strains harbouring SCCmec IV and V elements. The data also indicate a high rate of genetic recombination in MRSA involving SCC elements, bacteriophages or other mobile genetic elements and large-scale chromosomal replacements