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The goal of this paper is to describe the baseline characteristics of Live Well (intervention to prevent weight gain in recent immigrant mother-child dyads from Brazil, Haiti, and Latin America) participants, and to explore self-reported changes in diet and physical activity post-immigration. Baseline data from 383 mothers were used for this study. Dyads attended a measurement day where they completed self-administered surveys collecting information about socio-demographics, diet, physical activity, other psychosocial variables, and height and weight. Haitian mothers' socio-demographic profile differed significantly from that of Brazilians' and Latinas': they have been in the US for a shorter period of time, have higher rates of unemployment, are less likely to be married, more likely to have ≥3 children, more likely to be obese, and have immigrated for family or other reasons. In multivariate models, self-reported changes in diet and physical activity since migrating to the US were significantly associated with BMI with non-linear relationships identified. Future research is needed to understand how diet and physical activity change while acculturating to the US and explore the adoption of both healthy and unhealthy dietary changes. [ABSTRACT FROM AUTHOR]

Introduction Breastfeeding is an important determinant of child survival and normal growth and development, but breastfeeding prevalence is generally low in Brazil. Factors associated with infant feeding practices there are not well understood. This paper examines factors associated with breastfeeding cessation in a township in the western Brazilian Amazon. Methods A cross-sectional, population-based study was conducted among children younger than 25 months and collected information on maternal and child characteristics. Survival analysis based on a proximal-distal framework examined the association between breastfeeding duration and socioeconomic and maternal/child biological factors. Results The median breastfeeding duration among 101 children who were no longer breastfeeding was 120 days. Almost two-thirds (63 %) of these children stopped breastfeeding before 6 months of age. In the larger sample of 209 children, 74.6 % had previously been bottle-fed. Considering the full proximal-distal model, a child who had ever been bottle-fed was expected to cease breastfeeding about 88 % sooner than one who was never bottle-fed ( p < 0.001). Children in the second-poorest wealth quartile stopped breastfeeding sooner than children in the poorest quartile ( p < 0.05). Discussion Breastfeeding cessation in the study area occurred much earlier than the recommended 2 years of age. Factors associated with ending breastfeeding early included ever-use of a bottle, having a single mother, and belonging to the second-poorest wealth quartile. Further research is needed to better understand these factors and other barriers women face to continuing breastfeeding. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to measure the prevalence, to describe the trend over time, and to evaluate socioeconomic inequalities in the occurrence of episiotomies in 2007, 2010, 2013, and 2016 in the municipality of Rio Grande, in Southern Brazil. Methods: We included all women who had vaginal delivery in each of the studied years. All the information was obtained through a questionnaire applied at maternity wards within 48 h after delivery. The outcome consisted of episiotomy. A chi-square test was used to evaluate the linear trend. Absolute and relative inequalities were assessed from household income and schooling of the women through the Slope Index of Inequality and Relative Index of Inequality, respectively. Results: This study included 4,521 parturients. The episiotomy rate in the period fell from 71.0% (95%CI: 68.4–73.5) in 2007 to 40.1% (95%CI: 37.3–42.8) in 2016, and it was more frequent among women with higher income and higher schooling. We observed a reduction in the rate of episiotomy in all income and schooling levels, and this was more evident among women in the lowest socioeconomic levels. Absolute inequality declined, while relative inequality remained unchanged. Conclusions for Practice: Despite the significant reduction in the rate of episiotomy, its occurrence remains high. Women with higher income and education, therefore with lower risk for complications during childbirth, were the most frequently submitted to this procedure. Routine use of episiotomy must be reevaluated, especially among pregnant women with better socioeconomic status. [ABSTRACT FROM AUTHOR]

The present study assessed the prevalence of sexually transmitted infections (STIs) in 90 transsexual men (female-to-male transsexual persons) from southern Brazil. A retrospective review of the medical records of all transsexual men who visited an outpatient clinic in Rio Grande do Sul from 1998 to 2017 was performed. Although the sample had a high prevalence of risk factors for contracting STIs, such as drug use, one-third of the participants had never been tested for STIs and, when screened, it was mostly for HIV, but not for syphilis or other STIs. Based only on laboratory-tested transsexual men, the prevalence of syphilis and hepatitis C was 3.4% and 1.6%, respectively, which is higher than the general population. It is clear that health professionals need to broaden their understanding of transsexual men, acknowledging STIs as a possible diagnosis. [ABSTRACT FROM AUTHOR]

Objective to evaluate women's knowledge about the best baby sleeping position and to identify factors associated with a greater probability of putting infants to sleep in an unsafe position, in Rio Grande, Southern Brazil. Method This is a cross-sectional population-based study that included all women who bore children in 2013 in this municipality. A single, standardized questionnaire was given within 48 h after delivery in the only two local maternity hospitals. The outcome was that women reported the lateral and the ventral decubitus as the best sleeping positions for babies. A Chi square test was used for proportions and Poisson regression was used with robust variance adjustment in the multivariate analysis. The prevalence ratio was the measure of effect used. Results We included 2624 women in this study. Of these, 82.1% (95% CI 80.6-83.6) stated that the baby should sleep in the lateral or ventral decubitus positions. 76.4% reported having acquired this knowledge from their mothers and 34.7% were willing to adopt the correct (supine) sleeping position for their child if recommended by doctors. The adjusted analysis showed that the lower the schooling of the mothers and the greater the number of people per bedroom and number of children, the greater the probability of women choosing an unsafe baby sleeping position. Conclusions for Practice This study showed that the percentage of women who are unaware of the correct baby sleeping position is very high, that doctors should be convinced to recommend the supine baby sleeping position, and that campaigns on this subject should also include grandparents as a priority intervention group. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the sensitivity and responsiveness to change for the Brazilian version of the Child Perceptions Questionnaire (CPQ8–10) after dental caries treatment.Subject and methods: Thirty children aged 8 to 10 years old with untreated dental caries were randomly selected from public schools. They responded to the CPQ8–10 before and 1 month after finishing treatment for dental caries. Sensitivity was assessed by determining distribution changes using paired t-tests and Wilcoxon signed-rank tests. Responsiveness to change was evaluated by effect size (ES) and standardized response mean (SRM). Minimally important differences (MIDs) were also evaluated.Results: Mean/median pre-treatment values for the total CPQ8–10 score and subscales were significantly higher than the post-treatment values (p < 0.05). ES was large (effect size ≥ 0.8) for the total CPQ8–10 score and oral symptoms (OS), functional limitations (FL) and emotional wellbeing (EW) subscales and moderate (effect size 0.3–0.7) for the social wellbeing (SW) subscale. SRM values were moderate (0.3–0.7) for the total CPQ8–10 score and FL, EW and SW subscales and high (≥ 0.8) for the OS subscale. MID values for the total CPQ8–10 score and all subscales were lower than the mean score change.Conclusion: The Brazilian version of the CPQ8–10 is sensitive and responsive enough to detect changes brought about by dental caries treatment. [ABSTRACT FROM AUTHOR]

Given the shortage of medical providers and the need for medical decisions to be responsive to community needs, including lay health providers in health teams has been recommended as essential for the successful management of global health care systems. Brazil's Unified Health System (UHS) is a model for delivering community-based care through Family Health Strategy (FHS) interdisciplinary teams comprised of medical and lay health providers-Community Health Agents (CHAs), nurses, and physicians. This study aims to understand how medical and lay health providers' perceptions and attitudes could impact the delivery of community-based care. The study compares perceptions and attitudes of 168 CHAs, 62 nurses, and 32 physicians across their job context, professional capacities, professional skills, and work environment. Descriptive and bivariate analysis were performed. CHAs reported being the most efficacious amongst the providers. Physicians reported incorporating consumer-input to a lesser degree than nurses and CHAs. CHAs reported using a lesser variety of skills than physicians. A significant proportion of physicians compared to CHAs and nurses reported that they had decision-making autonomy. Providers did not report differences that lack of resources and poor work conditions interfered with their ability to meet consumer needs. This study offers technocratic perspectives of medical and lay health providers who as an inter-professional team provide community-based primary health care. Implications of the study include proposing training priorities and identifying strategies to integrate lay health providers into medical teams for Brazil's Unified Health System and other health systems that aim to deliver community-based care through inter-professional health teams. [ABSTRACT FROM AUTHOR]

Aim: To describe the intake of macro- and micronutrients, verify its adequacy, and analyze their distribution by the socioeconomic and demographic profile of adults. Subject and methods: Longitudinal population-based study with a sample of 1222 people aged 22-63 years from Florianópolis, Southern Brazil. The dietary intake data were collected with a 24-h recall in the total sample, plus a second recall applied on a sub-sample of participants with subsequent adjustment of regular consumption. Diet composition and adequacy of intake were compared between the different educational groups and stratified by sex. Results: The mean energy consumption was 1851 Kcal [standard error (SE) = 15.0 Kcal] and 2259 Kcal (SE = 27.8 Kcal) in females and males, respectively ( p-value <0.001). With increasing education, women showed an increasing trend in energy consumption, carbohydrates, proteins, lipids, saturated, polyunsaturated and monounsaturated fat, cholesterol, and fiber. In men, the same differences were found only in saturated fat and cholesterol ( p-value <0.05 for all). Analyzing the adequate consumption of nutrients, differences were found regarding saturated fat and cholesterol in women and carbohydrates, saturated and polyunsaturated fat in men. The prevalence of inadequacy was up to 47% comparing the different educational groups. Conclusion: A lower percentage of adequacies in food consumption was found in both sexes for those with more years of schooling. Public policy should also target the group with higher education. [ABSTRACT FROM AUTHOR]

Purpose: A preference inversion occurs when "worse" health (instead of "better" health) along a scale or score is preferred. Our aim was to confirm past findings of EQ-5D-5L preference inversions among English-speaking respondents and to explore inversions among Portuguese-speaking respondents. Anecdotal evidence suggests that inversions may be more common in the Portuguese version, where the translation of the fourth level "severely" (gravemente) means "gravely."Methods: Through an infusion clinic in Tampa, Florida, United States and a cardiology clinic in Rio de Janeiro, Brazil, 740 respondents completed a tablet-based survey, which included the EQ-5D-3L and -5L followed by paired comparisons designed to assess preference inversions between the fourth and fifth levels of each of the five domains: Mobility (MO), Self-Care (SC), Usual Activity (UA), Pain/Discomfort (PD), and Anxiety/Depression (AD). An example from the AD dimension would be: "Which do you prefer? Starting today, 30 days with health problems: Severely anxious or depressed or Extremely anxious or depressed" (i.e., Level 4 AD vs. Level 5 AD).Results: In the English-speaking respondents, preference inversion was only observed to a substantial extent in the AD dimension (U.S. N = 470; 7% MO, 14% SC, 14% UA, 20% PD, and 45% AD). Inversions were more common among the Portuguese-speaking respondents (Brazil N = 270; 11% MO, 32% SC, 35% UA, 49% PD, and 65% AD). Specifically, 44 out of 68 Brazilian respondents (65%) preferred "extremamente" (Level 5 AD) over "gravemente ansioso (a) ou deprimido (a)" (Level 4 AD).Conclusions: This evidence confirms previous findings for the U.S. English version of the EQ-5D-5L and led to a relabeling on the Portuguese version. It demonstrates the usefulness of collaboration between psychometric, econometric, and linguistic experts in developing the wording for and translating preference-based measures of health-related quality of life. Further research may explore inversions in other translations. The authors recommend that preference inversion tests should be included in the development and translation process. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the influence of spirituality, religiosity, personal beliefs, and previous contact with health issues on the level of empathy in medical students. Jefferson Scale of Empathy-Student Version, WHOQOL-Spirituality, Religiousness and Personal Beliefs, and Duke University Religion Index were applied to 285 Brazilian medical students. The findings suggest that meaning of life and previous mental health treatment but not Religiosity were positively related to empathy. We suggest that more attention should be given for prevention and treatment of mental health issues, and further studies are needed to understand and replicate these findings. [ABSTRACT FROM AUTHOR]

Background: Anxiety and mood disorders have been shown to be the most relevant psychiatric comorbidities associated with migraine, influencing its clinical course, treatment response, and clinical outcomes. Limited information is available on how specific anxiety and depression symptoms are related to migraine. Symptoms-based approach, a current trend in mental health research, may improve our understanding in migraine comorbidity. The purpose of this study was to analyze how anxiety and depression aspects are related to migraine through a symptom-based approach. Methods: We studied 782 patients from the general population who completed a self-administered questionnaire assessing demographics, headache features, anxiety and depression symptoms. A binary logistic regression analyses were conducted to test the association between all four ratings in GAD-7 (anxiety) and PHQ-9 (depression) scales subitems as covariates, and migraine vs no headache as the outcome. Results: The leading Odd Ratios (OR) observed in individuals with migraine relative to those without migraine were anxiety related, 'Not being able to stop or control worrying' on a daily basis [OR (CI 95%)] 49.2 (13.6-178.2), 'trouble relaxing' 25.7 (7.1-92.6), 'Feeling nervous, anxious or on edge' on a daily basis 25.4 (6.9-93.8), and 'worrying too much about different things' 24.4 (7.7-77.6). Although the hallmark symptoms of depression are emotional (hopelessness and sadness), the highest scores found were physical: apetite, fatigue, and poor sleep. Irritability had a significant increase in migraine risk [OR 3.8 (1.9-7.8) if experienced some days, 7.5 (2.7-20.7) more than half the days, and 22.0 (5.7-84.9) when experienced nearly every day]. Conclusions: Anxiety was more robustly associated with increase in migraine risk than depression. Lack of ability to properly control worrying and to relax are the most prominent issues in migraine psychiatric comorbidity. Physical symptoms in depression are more linked to migraine than emotional symptoms. A symptom-based approach helps clarifying migraine comorbidity and should be replicated in other studies. [ABSTRACT FROM AUTHOR]

Purpose: This study examined gender differences in the association between work-family conflict and self-rated health and evaluated the effect of educational attainment. Method: We used baseline data from ELSA-Brasil, a cohort study of civil servants from six Brazilian state capitals. Our samples included 12,017 active workers aged 34-72 years. Work-family conflict was measured by four indicators measuring effects of work on family, effects of family in work and lack of time for leisure and personal care. Results: Women experienced more frequent work-family conflict, but in both genders, increased work-family conflict directly correlated with poorer self-rated health. Women's educational level interacted with three work-family conflict indicators. For time-based effects of work on family, highly educated women had higher odds of suboptimal self-rated health (OR = 1.54; 95 % CI = 1.19-1.99) than less educated women (OR = 1.14; 95 % CI = 0.92-1.42). For strain-based effects of work on family, women with higher and lower education levels had OR = 1.91 (95 % CI 1.48-2.47) and OR = 1.40 (95 % CI 1.12-1.75), respectively. For lack of time for leisure and personal care, women with higher and lower education levels had OR = 2.60 (95 % CI = 1.95-3.47) and OR = 1.11 (95 % CI = 0.90-1.38), respectively. Conclusion: Women's education level affects the relationship between work-family conflict and self-rated health. The results may contribute to prevention activities. [ABSTRACT FROM AUTHOR]

Purpose: To identify gestational dietary patterns and evaluate the association between these patterns and the blood pressure (BP) rate of change during pregnancy and the postpartum. Methods: Prospective cohort study composed of 191 healthy pregnant women. Systolic BP (SBP) and diastolic BP (DBP) were obtained at the 5th-13th, 20th-26th, 30th-36th gestational weeks, and with 30-45 days postpartum. A food frequency questionnaire administered at the 30th-36th gestational week was used to measure dietary intake during pregnancy. Principal component analysis was performed to identify the dietary patterns. A longitudinal linear mixed-effects regression model was used to evaluate the association between the dietary patterns and BP (adjusted for time elapsed after conception and the women's age, education, parity, body mass index and total energy intake). Results: Three gestational dietary patterns were identified: healthy, common- Brazilian and processed. SBP/DBP mean values (SD) were 110.1 (9.0)/66.9 (7.5), 108.7 (9.0)/64.9 (6.7), 111.3 (9.2)/67.0 (6.9) and 115.0 (10.7)/73.7 (8.6) mmHg at the first, second and third gestational trimesters and postpartum, respectively. Women with higher/lower adherence to the processed pattern presented SBP of 117.9 and 113.0 mmHg ( P = 0.037), respectively, during postpartum. No association was found between any of the three dietary patterns and SBP in the multiple longitudinal linear regression models, whereas 1 SD increase in the common-Brazilian pattern was associated with a small change of DBP ( β = 0.0006; 95 % CI 4.66e-06, 0.001; P = 0.048). Conclusion: The three dietary patterns identified revealed no association with changes of SBP and DBP levels during pregnancy and at early postpartum in this sample of healthy Brazilian women. [ABSTRACT FROM AUTHOR]

HIV test-seeking behavior among blood donors has been observed worldwide and may pose a threat to the safety of the blood supply. We evaluated current test-seeking motivations and prior alternative HIV testing experiences among blood donors in São Paulo, Brazil. All candidate or potential blood donors were consecutively approached and recruited to participate in the study upon presentation at Fundação Pró-Sangue Hemocentro, the largest blood bank in Brazil. Participants were recruited between August 2012 and May 2013 after they were screened for donor eligibility. Questionnaires were administered through audio computer-assisted self-interview. Among 11,867 donors, 38 % previously tested for HIV apart from blood donation, of whom 47.7 % tested at public facilities and 2.7 % acknowledged getting tested for HIV as the primary reason for donating. Dissatisfaction with prior alternative testing experience was reported by 2.5 % of donors. Current test-seeking motivation was associated with dissatisfaction with prior alternative testing experience and testing at a public alternative facility. The most common reasons for dissatisfaction were too long of a wait to get tested and for results, counseling was too long, lack of privacy, and low confidence in the equipment and accuracy of the test. Lack of awareness about the availability of free and confidential public HIV testing services as well as dissatisfaction with past HIV testing and counseling experiences motivate some individuals to test at blood banks. Test-seeking behavior among blood donors may be best addressed by improving alternative testing programs, particularly with respect to time delays, privacy and perceptions about test accuracy. Educational campaigns on safe blood donation and HIV testing for diagnosis, risk counseling and referral to care are also needed for the general public and for health care providers. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To describe the experience of Ceará, Northeast of Brazil, state on improving child survival, over a 20 year period, and discuss its contribution to Brazil's progress toward the achievement of MDG 4. Five population-based, statewide household surveys, with children <3 years of age, known as PESMIC (Mother and Child Health Survey of Ceará), were conducted in 1987, 1990, 1994, 2001 and 2007. They aimed to investigate levels and causes of mortality and access to child health services. The cluster sampling of 8,000 households identified 2,000 children on average. They used the same methodological approach and indicators. Important changes occurred in demographic and health indicators in the 20 year period, including 81 % reduction in the infant mortality rate, 43 % increase in breastfeeding rate and the achievement of a 95 % immunization rate. The prevalence of chronic malnutrition declined from 28 to 13 % and acute malnutrition from 13 to 5 %. Diarrheal diseases contributed with 36.6 % to the infant mortality in 1986 and 3.9 % in 2007. The major improvements in child health contributed substantially to the progress on MDG 4 in Brazil. Results of the 5 surveys produced reliable information for planning and evaluation that contributed to the remarkable progress made by the state. [ABSTRACT FROM AUTHOR]

In the era of highly active antiretrovirals, people living with HIV (PLWH) have resumed sexual activity in the context of longer and healthier lives, and thus the chances of transmitting the HIV virus, as well as the potential to be re-infected also increase. HIV treatment optimism has been found to be associated with sexual risk behaviors among PLWH in different settings. A cross sectional survey was conducted to examine the relationship between treatment optimism, safer sex burnout and consistent condom use as well as variables associated with treatment optimism in a sample of PLWH on antiretrovirals (ARVs) in Rio de Janeiro, Brazil (n = 604). Seventy-two percent of participants always used a condom in the last 6 months. Homosexual, bisexual, transexual persons were less likely to use condoms consistently than heterosexuals (AOR .58 CI .42-.78). Those who were treatment optimistic (AOR .46 CI .25-.88) were more likely not use a condom consistently in the past 6 months, as were participants who reported safer sex burnout (AOR .58 CI .36-.90). Sexual orientation, safer sex burnout, and lower education levels were significantly associated with higher treatment optimism in multivariate analysis. Study findings highlight the need to address psychosocial factors such as treatment optimism and safer sex burnout associated with lower consistent condom use among PLWH in Rio de Janeiro, Brazil. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to examine the prevalence and factors associated with sarcopenia in older residents in São Paulo, Brazil. Design: Cross-sectional study. Setting: São Paulo, Brazil. Participants: 1,149 older individuals from the second wave of the Saúde, Bem-Estar e Envelhecimento (SABE) study from 2006. Measurements: The definition of sarcopenia was based on the consensus of the European Working Group on Sarcopenia in Older People (EWGSOP), which include three components: low muscle mass, assessed by a skeletal muscle mass index of ≤8.90kg/m for men and ≤6.37kg/m for women; low muscle strength, assessed by handgrip strength <30kg for men and <20kg for women; and low physical performance, assessed by gait speed <0.8m/s. Diagnosis of sarcopenia required presence of low muscle mass plus low muscle strength or low physical performance. Socio-demographic and behavioral characteristics, medical conditions and nutritional status were considered as independent variables to determine the associated factors using a logistic regression model. Results: The prevalence of sarcopenia was 16.1% in women and 14.4% in men. Advanced age with a dose response effect, cognitive impairment, lower income, smoking, undernutrition and risk for undernutrition (p<0.05) were factors associated with sarcopenia. Conclusions: The EWGSOP algorithm is useful to define sarcopenia. The prevalence of sarcopenia in the Brazilian elderly population is high and several associated factors show that this syndrome is affected by multiple domains. No differences were observed by gender in any age groups. [ABSTRACT FROM AUTHOR]

The presence of chronic non-communicable diseases (NCDs) among vulnerable populations is a rarely discussed subject. Thus, the present cross-sectional descriptive study aimed to analyse the health conditions and access to public health services of 268 waste pickers in southern Brazil. Regarding NCDs, their prevalence of hypertension was 32.8 %, diabetes 11.4 %, dyslipidemia 16.4 %, overweight 51.1 %, obesity 25.7 % and abdominal obesity 57.8 %. Regarding access to health services, 36.9 % of the sample had not consulted with a doctor in more than 1 year, 15.7 % had no access to a healthcare unit, 7.5 % had never measured their blood pressure, 45.9 % had never had a glucose test, and 61.2 % had never had a triglyceride test. The statistical analysis showed that whereas men had gone longer since their last medical consultation and blood pressure measurement, women had increased frequencies of overweight, abdominal obesity, awareness of their hypertension and use of anti-hypertensive drugs ( p < 0.05). Therefore, the health profile of waste pickers is critical, with a high prevalence of NCDs and poor healthcare usage. Strategies to improve monitoring and treatment are recommended. [ABSTRACT FROM AUTHOR]

Aim: This study describes the prevalence and socio-demographic characteristics of Brazilian self-reported never-drinkers aged 18 or over. Besides the investigation of prevalence, the hypothesis was that socio-demographic characteristics would be different when compared to drinkers of any severity. Subject and methods: Data on 2,190 adults (18+) were obtained from the First Brazilian National Alcohol Survey. Seven socio-demographic variables were included and logistic regression was used to assess their effects. Results: The rate of self-reported never drinking in Brazil was 30.6 % amongst men and 56.1 % amongst women. The analysis indicated a growing trend in abstinence as age rises, with 80.1 % of the interviewees in the 80-plus age group reporting they had never drunk. When looking at religious affiliations, Pentecostal evangelicals and other evangelicals and Protestants were 7.3, 4.4 and 6.3 times more likely never to have drunk than the interviewees from different religions or with no religious affiliation. Conclusion: Vicariate associations between lifetime abstinence and sociodemographics were found for gender, age group and religious affiliation. The analysis indicated a growing trend in abstinence as age rises. Pentecostal evangelicals, other evangelicals and Protestants were 7.3, 4.4 and 6.3 times more likely never to have drunk than the interviewees from different religions or with no religious affiliation. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study was to assess factors associated with unprotected receptive anal intercourse (URAI) in a sample of MSM recruited by respondent driven sampling in Brazil. Among 3,449 participants, 36.5 % reported URAI. Final logistic model indicated that living with a male partner, illicit drug use, having stable partnership, having sex with men only, having few friends encouraging condom use, and high self-perceived risk for HIV infection were characteristics independently associated with URAI. Intervention strategies should focus on the role of anal sex practices on HIV transmission, address illicit drug use, stigma and expansion of HIV testing and care. [ABSTRACT FROM AUTHOR]

Some research suggests that the risk of physical aggression by an intimate partner is related to marital status, but this relationship may vary across cultures and by gender. In the present study, we systematically examine the relationship between marital status and physical partner aggression by gender across 19 countries. Logistic and multilevel regression confirmed previous findings of lower rates of physical aggression for legally married versus cohabiting and separated/divorced women and men across most, but notably, not all countries. Single status was associated with higher risk in some countries and lower in others reflecting possible cultural differences in risk for different marital statuses. For example, single women had significantly lower rates of victimization than did married women in India where violence against wives is often accepted. The variation in the cross-cultural findings highlights the importance of examining both men and women and considering the cultural context when interpreting the relationship between partner aggression and marital status. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine which factors predict higher risk for mental health problems in children working on the streets. We studied a sample of families that had at least one child working on the streets, from October 2008 to March 2009. The instruments applied were the parent version strengths and difficulties questionnaire (SDQ), the childhood trauma questionnaire (CTQ) for children and caregivers, the WorldSAFE core questionnaire, the global assessment of relational functioning scale (GARF), the schedule for affective disorders and schizophrenia for school-age children (K-SADS), and a socio-demographic questionnaire. 191 children between 7 and 14 years of age were analyzed; 126 (66 %) were working on the streets, and 65 were siblings who did not work on the streets. Multivariate analysis showed that mental health problems in the caregivers, violent behaviors of the caregivers toward the children, absence of a partner living in the house, and lower levels of family functioning increased the risk of mental health problems in the children. Caregivers reported severe forms of physical punishment against their children in 62 % of cases. Caregivers who had suffered sexual abuse and emotional negligence in childhood were more violent with their children. Factors that increased risk for mental health symptoms in these children were caregivers' psychopathology, physical punishment at home, single-parent structure, and poor family functioning. Work on the streets did not influence the children's mental health, when multiple risk factors were considered; family characteristics were the most significant in this sample. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Despite the advances in asthma therapeutics, there are few data on the use and determinants of anti-asthmatic drugs in the general population of children. This study describes the use of asthma medications among children in the general population and in children with current asthma, living in a large urban center in Brazil. Methods: A population-based cross-sectional survey, aimed at analyzing asthma determinants, was conducted with 1,382 children aged 4-11 years, between February and May 2006, in Salvador, Brazil. At baseline, an extensive questionnaire was applied, including questions about the use of asthma medications in the last 12 months. Results: In all studied children ( n = 1,382) aged 4-11 years, oral beta2-agonists were the drugs most frequently used (9.8%), followed by short-acting inhaled beta2-agonists (4.3%) and systemic corticosteroids (1.6%). Anti-asthmatic drug use was higher among males than females, and it significantly decreased with age in both genders. A total of 312 children (22.6%) reported current asthma, and 62% of them were not being treated with any anti-asthmatic drugs. Of all those who reported following a certain type of treatment, 20% used oral beta2-agonists alone; 6.1%, short-acting inhaled beta2-agonists alone; and 4.8%, a combination of both drugs. Anti-asthmatic drug use did not differ according to socioeconomic status, except for the use of inhaled beta2-agonists and systemic corticosteroids. Conclusions: An overwhelming majority of asthmatic children were not using long-term medications for asthma, in particular inhaled corticosteroids, regardless of the severity of their disease. This result points to the deficiencies of the Brazilian public health system in recognizing this important pharmacological need for child care and thereby limiting the access of these children to a group of efficacious, available, and low risk therapeutic medications. [ABSTRACT FROM AUTHOR]

im: This study aimed to describe perceptions and experiences related to access and utilization of health care services of African and Brazilian immigrant women in Portugal. Subjects and methods: Six focus groups were conducted with 35 African and Brazilian women with low income and living in Lisbon, chosen through purposive sampling. Content analysis was undertaken through identification of themes and categories. Results: African and Brazilian women expressed different perceptions and patterns of use of health care services. Most participants pointed out several barriers to access and utilization of services related to legal issues, economic constraints or health professionals’ attitudes. Conclusion: These results highlight the challenges to providing health care within a multicultural setting and the need to assure the provision of integrated and comprehensive health care services. Improving access to general health care is essential in order to minimize disadvantages from vulnerable subgroups, like immigrant women. Supporting better integration into the health system may lead to improved health outcomes. [ABSTRACT FROM AUTHOR]

Our goal was to estimate prevalence of HIV among young women in labor. A national, probability-based, cross-sectional study was performed among pregnant women, aged 15-24 years, who were attending Brazilian public hospitals. The study included 2,071 of 2,400 women selected (86.3 % participation). Mean age was 20.2 years (SD = 2.7). HIV prevalence was 0.7 % (95 % CI, 0.4-1.1 %). Living in the North region of the country and having previous sexually transmitted infections were associated with HIV infection. Our survey of young pregnant women found higher prevalence than expected for women of all ages in Brazil (0.42 %), indicating that the epidemic persists among heterosexuals. [ABSTRACT FROM AUTHOR]

Assessment of health information systems consider different aspects of the system itself. They focus or on the professional who will use the software or on its usability or on the software engineering metrics or on financial and managerial issues. The existent approaches are very resources consuming, disconnected, and not standardized. As the software becomes more critical in the health organizations and in patients, becoming used as a medical device or a medicine, there is an urgency to identify tools and methods that can be applied in the development process. The present work is one of the steps of a broader study to identify standardized protocols to evaluate the health information systems as medicines and medical devices are evaluated by clinical trials. The goal of the present work was to evaluate the effect of the introduction of an information system for monitoring tuberculosis treatment (SISTB) in a Brazilian municipality from the patients’ perspective. The Patient Satisfaction Questionnaire and the Hospital Consumer Assessment of Healthcare Providers and Systems were answered by the patients before and after the SISTB introduction, for comparison. Patients from an outpatient clinic, formed the control group, that is, at this site was not implanted the SISTB. Descriptive statistics and mixed effects model were used for data analysis. Eighty-eight interviews were conducted in the study. The questionnaire’s results presented better averages after the system introduction but were not considered statistically significant. Therefore, it was not possible to associate system implantation with improved patient satisfaction. The HIS evaluation need be complete, the technical and managerial evaluation, the safety, the impact on the professionals and direct and/or indirect impact on patients are important. Developing the right tools and methods that can evaluate the software in its entirety, from the beginning of the development cycle with a normalized scale, are needed. [ABSTRACT FROM AUTHOR]