Elementos de vulnerabilidade individual de adolescentes ao HIV/AIDS

Violence, discrimination, and sexual health practices among adolescent men who have sex with men, transgender women and travestis in three cities in Brazil

The HIV epidemic has a disproportionate impact on adolescent and young men who have sex with men (AMSM) and transgender women and travestis (ATGW), with an increased HIV prevalence over the last 10 years. Violence affects the lives of these populations, undermining their ability to self-care and making them more vulnerable to HIV infection. In this study, we aimed to examine the association between different types of victimization by violence and discrimination and sexual health practices of these adolescent populations in steady and casual relationships. We conducted a cross-sectional study using baseline data from the cohort of PrEP1519 project. We used the mean score of sexual health practices as our outcome and the cumulative score of discrimination (within family, community, education, religious, online and public spaces) and violence (physical, sexual and intimate partner) as our exposure variable. We performed linear regression analyses to estimate the association between exposure and outcome. We found that 90% of AMSM and 95% of ATGW experienced at least one form of violence in the three months prior to this study and about 45% of ATGW suffered sexual violence during the same period. Experiencing discrimination within healthcare settings (from facilities or providers) was negatively associated with sexual health practices. Discrimination and violence negatively affect sexual health practices. HIV prevention and care of AMSM and ATGW people should involve listening to their experiences and addressing discrimination and violence in this population.

Popular Health, Environmental and Occupational Surveillance: an integrative literature review

The objective is to identify concepts, experiences, methods, and techniques in Popular Health, Environmental and Occupational Surveillance (VPSAT). This is an integrative review that used the descriptors: Community Participation, Public Health Surveillance, Environmental Health, and Occupational Health, using five databases: Virtual Health Library, EBSCOhost, Embase, Scopus and Web of Science. The review selected 15 studies, based on the inclusion criteria: surveillance experiences with community protagonism; and exclusion criteria: research without primary data and developed only by the health service. The theoretical and methodological bases of the studies were identified as citizen science, popular education, and environmental justice; experiences such as participatory mapping and monitoring; methods such as action research, 'do-it-yourself', and community-based research; and techniques such as "Photovoice" and Community Journal. Low-income urban communities, indigenous peoples, young individuals, and workers stand out as the protagonists. The recognition of the VPSAT as an important source of data and intervention by public health systems and academia contributes to making health surveillance more dialogic and effective.

Factors Associated with HIV and Vulnerability Contexts for Women in Brazil

The purpose of this study was to identify factors associated with HIV and vulnerability contexts for women in Porto Alegre, Brazil. The participants were 1326 women recruited by complex sampling design, divided into two groups: 640 women with HIV (WLH) and 686 women who did not have HIV (WNLH). Gross and weighted statistical analyses were performed. Logistic regression models were used to estimate the odds ratio (OR) for 12 variables. The main results demonstrated that WLH had lower income (p < .001) and poorer education (p = .038), and few used condoms during their first sexual intercourse (p < .001). The occurrence of HIV was higher among the black population (p < .001). Sex in exchange for money (p < .001) and sexually transmitted infections (p < .001) were more frequent among WLH than among WNLH. The age of sexual debut and age difference from the partner at first sexual intercourse (FSI) were not associated with the outcome. The high percentage of non-use of condoms during the FSI shows how vulnerable individuals are right at the beginning of their sexual lives. More effective prevention strategies can be developed by nurses in view of the contexts of vulnerability surrounding women.

Blenderized tube feeding for children: an integrative review

OBJECTIVE

To analyze scientific evidence on the use of blenderized tube feeding in children regarding nutritional composition, family satisfaction, and health outcomes.

DATA SOURCE

Survey was conducted in the PubMed, Scopus, Embase, and Virtual Health Library (VHL) databases using the following search terms: blenderized tube feeding OR blended tube feeding OR homemade OR pureed AND enteral nutrition AND enteral tube. The methodological quality of the selected articles was evaluated using the Critical Appraisal Skill Programme and Hierarchical Classification of Evidence.

DATA SYNTHESIS

After analysis, 11 articles were included in the present review. Most studies demonstrated improvements in health outcomes and greater family satisfaction after replacing the commercial enteral feeding with blenderized tube feeding.

CONCLUSIONS

When guided and monitored by the healthcare team, a blenderized tube feeding ensures an adequate nutritional composition. The use of this method is also associated with positive health outcomes such as reductions in gastrointestinal symptoms and hospitalizations. Moreover, a high frequency of family satisfaction was verified.

Portable accelerometers for the evaluation of spatio-temporal gait parameters in people with Parkinson's disease: an integrative review

PURPOSE

The progression of Parkinson's disease causes an increase in motor dysfunctions, which makes it necessary to evaluate and monitor these changes. This integrative review aimed to gather studies - without any language restrictions - on the use, advantages and disadvantages of portable accelerometers for the evaluation of spatio-temporal gait parameters in people with Parkinson's disease published between 2014 and 2019.

METHODS

Articles were selected from the PubMed, Web of Science and Science Direct databases by combining descriptors from the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) - "accelerometry", "accelerometer", "ActiGraph", "gait", "gait analysis", "gait rehabilitation", "walking inertial sensors", "Parkinson disease", "Parkinson" and "Parkinson's disease" - using OR and AND. The adapted Critical Appraisal Skill Program was used to analyze the methodological quality.

RESULTS

All the studies used portable wearable and wireless triaxial accelerometers. Among all types of accelerometers discussed, commercial wearable devices not based on smartphones and prototypes of wearable devices based and not based on smartphones can be pointed out. There was no standardization for the protocols of use, but the sensors were more often attached to the lower back (L3/L4/L5 vertebrae). The advantages included lower cost, possibility of use in outdoor environments and less complexity of data reading for non-specialized users. However, they still seem to show reduced precision and accuracy.

CONCLUSIONS

Due to the still insufficient number of articles published on the subject, we consider the need for further research, which should detail protocols of evaluation, advantages and disadvantages in stages of disease.

Leprosy educational practices with adolescents: an integrative literature review

ABSTRACT Objectives: to identify scientific evidence in the literature regarding educational actions on leprosy developed with adolescents. Method: an integrative review of the literature, with the following research question: what are the leprosy educational practices currently being developed with adolescents? The search was performed in the following databases: MEDLINE, Scopus, LILACS, CINAHL, BVS Hanseníase and other sources, using “adolescent”; “leprosy”; “health education”; “public health”, and “public health practice” as keywords. Results: the sample was comprised of nine studies. Leprosy educational practices with adolescents verifiably promote change in knowledge when they are based on constructivist methodologies. The nurse is recognized as a professional with potential for developing these educational practices. Final considerations: actions for leprosy education with adolescents do lead to changes in knowledge, but new research is needed to evaluate their effectiveness in further improving this knowledge as well as changing behaviors and practices.

Knowledge of nursing student on the prevention of sexually transmitted infections

OBJECTIVE

To identify the knowledge and self-care actions taken by nursing undergraduate students of a Federal University of the South of Brazil, against Sexually Transmitted Infections.

METHOD

Exploratory qualitative study, conducted 40 interviews with undergraduate students at the beginning and end of the course. The analysis was thematic, resulting in three categories.

RESULTS

Knowledge about the subject is a decisive factor for self-care, and the more knowledge, the greater the prevention. The dissemination of knowledge of students at the end of the course not only influences self-care but also health promotion in the social sphere.

FINAL CONSIDERATIONS

Knowledge is important in self-care and caring for others. The dissemination of knowledge becomes evident according to the complexity of the course. Stable relationships may interfere with the use or disuse of condoms in sexual relationships, a misnomer present in today's society.

Factors associated with the utilization of dental health services by the pediatric population: an integrative review

This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

[Elderly people living with HIV - behavior and knowledge about sexuality: an integrative review]

The scope of this study was to identify and analyze the scientific production on behavior and knowledge about the sexuality of elderly people living with HIV. An integrative review of scientific articles indexed in the Lilacs, IBECS, Medline, BDENF, PubMed and Scopus (Elsevier) databases was conducted, considering publications from January 2007 to December 2016, using the following key words: knowledge, behavior, sexuality, Elderly, HIV/AIDS. Of the 1493 articles located, 11 were included because they met the inclusion criteria and were analyzed through two instruments: Critical Appraisal Skill Program (CASP) and Agency for Healthcare and Research and Quality (AHRQ). The data suggest that HIV-positive elderly people are sexually active and are involved in risk behaviors of virus transmission. It transpires that there is a limited scientific production regarding the behavior and knowledge about sexuality among elderly people living with HIV. The conclusion drawn is that the study may contribute to the improvement of public health policies that promote the approach on sexuality among elderly people, as well as the emergence of new questions regarding this issue.

SEXUALLY TRANSMITTED DISEASES: KNOWLEDGE AND SEXUAL BEHAVIOR OF ADOLESCENTS

ABSTRACT Objective: to evaluate the sexual knowledge and behavior of adolescents about Sexually Transmitted Diseases. Method: a descriptive, observational and quantitative study with a convenience sample of 532 adolescents aged between 10 and 19 years old. An individual questionnaire on sexually transmitted diseases was applied. The STATA 11.1 program was used for data analysis. Results: 89.2% of the teenage girls and 90.3% of the teenage boys were able to properly define the concept of a STD. Condom use is the most efficient method for STD prevention for 98.5% of the girls and 98.9% of the boys. However, 37.1% of the girls and 30.5% of the boys mentioned the use of contraceptives as a preventive method for sexually transmitted diseases. Conclusion: it is important to carry out educational actions together with schools on topics such as sexuality and reproductive health.

Parenting style and practices in stepfamilies

There are several studies on the best way to raise a child, ie, what would be the consequences of our actions for our children. We tend to think of how to educate children in a traditional family, but society has undergone many changes and, hence, family structures have undergone changes too. Today, we find a large number of stepfamilies facing the same issues concerning how to educate a child. Stepfamily configuration often entails more than just the addition of a new parent figure. The objective of this study was to shed some light on how these stepfamilies deal with issues of parenting style and practices. We reviewed the Brazilian and international literature concerning parenting styles and practices in stepfamilies. The papers identified were organized and submitted to analysis. We identified very few papers addressing parenting styles and practices, pointing to an important but unaddressed social change as reflected in new family structures. There is a need for longitudinal studies aimed at understanding not only a particular moment in time, but also moments within a context, ie, an analysis with a holistic approach without preconceived ideas.

The potential of the concept of vulnerability in understanding transmissible diseases

This article presents the evolution and the contribution of the scientific production related to the concept of vulnerability and its potential to help studying transmissible diseases. It presents the concept of vulnerability and the production of knowledge in nursing, developed particularly by the CNPq Research Group Vulnerability, Adherence, and Health Needs. The purpose is to improve the understanding of health issues, based on this concept, and permit the proposition of coping interventions that surpass the individual domain, thus contemplating the organization of health care work and the social determination of the health-disease process.