RESUMO
Globally, children aged <5 years, including those living with HIV who are not receiving antiretroviral treatment (ART), experience disproportionately high mortality. Global mortality among children living with HIV aged <5 years receiving ART is not well described. This report compares mortality and related clinical measures among infants aged <1 year and children aged 1-4 years living with HIV with those among older persons aged 5-14, 15-49, and ≥50 years living with HIV receiving ART services at all clinical sites supported by the U.S. President's Emergency Plan for AIDS Relief. During October 2020-September 2022, an average of 11,980 infants aged <1 year and 105,510 children aged 1-4 years were receiving ART each quarter; among these infants and children receiving ART, 586 (4.9%) and 2,684 (2.5%), respectively, were reported to have died annually. These proportions of infants and children who died ranged from four to nine times higher in infants aged <1 year, and two to five times higher in children aged 1-4 years, than the proportions of older persons aged ≥5 years receiving ART. Compared with persons aged ≥5 years living with HIV, the proportions of children aged <5 years living with HIV who experienced interruptions in treatment were also higher, and the proportions who had a documented HIV viral load result or a suppressed viral load were lower. Prioritizing and optimizing HIV and general health services for children aged <5 years living with HIV receiving ART, including those recommended in the WHO STOP AIDS Package, might help address these disproportionately poorer outcomes.
Assuntos
Síndrome da Imunodeficiência Adquirida , Fármacos Anti-HIV , Infecções por HIV , Lactente , Humanos , Criança , Idoso , Idoso de 80 Anos ou mais , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Infecções por HIV/tratamento farmacológico , Antirretrovirais/uso terapêutico , Carga Viral , Organização Mundial da Saúde , Fármacos Anti-HIV/uso terapêuticoRESUMO
BACKGROUND: Pediatric tuberculosis (TB), human immunodeficiency virus (HIV), and TB-HIV co-infection are health problems with evidence-based diagnostic and treatment algorithms that can reduce morbidity and mortality. Implementation and operational barriers affect adherence to guidelines in many resource-constrained settings, negatively affecting patient outcomes. This study aimed to assess performance in the pediatric HIV and TB care cascades in Mozambique. METHODS: A retrospective analysis of routine PEPFAR site-level HIV and TB data from 2012 to 2016 was performed. Patients 0-14 years of age were included. Descriptive statistics were used to report trends in TB and HIV indicators. Linear regression was done to assess associations of site-level variables with performance in the pediatric TB and HIV care cascades using 2016 data. RESULTS: Routine HIV testing and cotrimoxazole initiation for co-infected children in the TB program were nearly optimal at 99% and 96% in 2016, respectively. Antiretroviral therapy (ART) initiation was lower at 87%, but steadily improved from 2012 to 2016. From the HIV program, TB screening at the last consultation rose steadily over the study period, reaching 82% in 2016. The percentage of newly enrolled children who received either TB treatment or isoniazid preventive treatment (IPT) also steadily improved in all provinces, but in 2016 was only at 42% nationally. Larger volume sites were significantly more likely to complete the pediatric HIV and TB care cascades in 2016 (p value range 0.05 to < 0.001). CONCLUSIONS: Mozambique has made significant strides in improving the pediatric care cascades for children with TB and HIV, but there were missed opportunities for TB diagnosis and prevention, with IPT utilization being particularly problematic. Strengthened TB/HIV programming that continues to focus on pediatric ART scale-up while improving delivery of TB preventive therapy, either with IPT or newer rifapentine-based regimens for age-eligible children, is needed.
Assuntos
Infecções por HIV , Tuberculose , Antituberculosos/uso terapêutico , Criança , Infecções por HIV/tratamento farmacológico , Humanos , Incidência , Isoniazida , Moçambique , Estudos Retrospectivos , Tuberculose/tratamento farmacológicoRESUMO
(1) Background: The dark triad refers to a personality configuration mainly characterized by the presence of Machiavellianism, narcissism, and psychopathy. Even though adolescence is a critical stage in the development of dark triad traits, to date, this construct has not been studied among adolescents, mainly due to the lack of a measurement instrument adapted to this population. (2) Methods: Using a sample of 1642 adolescents, an adaptation of the Short Dark Triad (SD3) is proposed for this population. To this end, we performed a confirmatory factor analysis of the scale and examined its reliability and the intensity of the dark triad components by sex and sexual orientation. (3) Results: The adapted version of the scale (The Short Dark Triad-Adolescent Version; SD3-A) yielded good psychometric results. Confirmatory factor analysis corroborated the theoretical model of the three factors of dark personality. The results confirmed the greater presence of dark traits in male adolescents, and differences were observed based on sexual orientation. (4) Conclusions: The Short Dark Triad-Adolescent Version (SD3-A) is an effective and comprehensive instrument for the estimation of dark traits in adolescents and can be used as a screening test for this population.
RESUMO
The early period of the COVID-19 pandemic limited access to HIV services for children and adolescents living with HIV (C/ALHIV). To determine progress in providing care and treatment services, we describe viral load coverage (VLC) and suppression (VLS) (<1000 copies/ mL) rates during the COVID-19 pandemic in 12 United States President's Emergency Plan for AIDS Relief (PEPFAR)-supported countries. Data for children (0-9 years) and adolescents (10-19 years) on VLC and VLS were analyzed for 12 sub-Saharan African (SSA) countries between 2019 (pre-COVID-19) and 2020 (during COVID-19). We report the number of viral load (VL) tests, and percent change in VLC and VLS for patients on ART. For 12 countries, 181,192 children had a VL test during the pre-COVID-19 period compared with 177,683 December 2020 during COVID-19. VLC decreased from 68.8% to 68.3% overall. However, 9 countries experienced an increase ranging from a 0.7%-point increase for Tanzania and Zimbabwe to a 15.3%-point increase for Nigeria. VLS increased for all countries from 71.2% to 77.7%. For adolescents the number with a VL test increased from 377,342 to 402,792. VLC decreased from 77.4% to 77.1%. However, 7 countries experienced an increase ranging from 1.8% for Mozambique to 13.8% for Cameroon. VLS increased for all countries from 76.8% to 83.8%. This analysis shows variation in HIV VLC across 12 SSA countries. VLS consistently improved across all countries demonstrating resilience of countries during 2020. Countries should continue to improve clinical outcomes from C/ALHIV despite service disruptions that may occur during pandemic response.
RESUMO
BACKGROUND: The US President's Emergency Plan for AIDS Relief aims to address the higher risk of cervical cancer among women living with HIV by offering high-quality screening services in the highest burden regions of the world. METHODS: We analyzed the US President's Emergency Plan for AIDS Relief Monitoring, Evaluation, and Reporting data from Centers for Disease Control and Prevention-supported sites in 13 countries in sub-Saharan Africa for women living with HIV aged older than 15 years who accessed cervical cancer screening services (mostly visual inspection, with ablative or excisional treatment offered for precancerous lesions), April 2018-March 2022. We calculated the positivity by age, country, and clinical visit type (first lifetime screen or routine rescreening). We fitted negative binomial random coefficient models of log-linear trends in time to estimate the probabilities of testing positive and any temporal trends in positivity. RESULTS: Among the 2.8 million completed cancer screens, 5.4% identified precancerous lesions, and 0.8% were positive for suspected invasive cervical cancers (6.1% overall). The positivity rates declined over the study period among those women screening for cervical cancer for the first time and among those women presenting to antiretroviral therapy clinics for routine rescreening. CONCLUSIONS: These positivity rates are lower than expectations set by the published literature. Further research is needed to determine whether these lower rates are attributable to the high level of consistent antiretroviral therapy use among these populations, and systematic program monitoring and quality assurance activities are essential to ensure women living with HIV have access to the highest possible quality prevention services.
Assuntos
Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Lesões Pré-Cancerosas , Neoplasias do Colo do Útero , Estados Unidos/epidemiologia , Humanos , Feminino , Idoso , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Detecção Precoce de Câncer , Centers for Disease Control and Prevention, U.S.RESUMO
The objective of this study was to evaluate, in a group of Galician inmates, if there were variations in the levels of physical and mental health and anxiety-depressive symptomatology, depending on the sports' practice performed. The relationship between these constructs was also investigated. The sample was composed of 509 people deprived of liberty in prisons in the Autonomous Community of Galicia, Spain. A quantitative methodology was used, with the questionnaire as an information collection instrument, Student's t-tests, Pearson's correlation analysis and a stepwise regression analysis were carried out. The results indicated that those who performed physical activity during their stay in prison had higher levels of physical and mental health, as well as lower indicators of anxiety-depressive symptoms. People who did not practice sports showed a decrease in their perceived health levels when compared to those perceived in their pre-prison stage. A negative association was shown between perceived health levels and anxiety-depressive symptomatology. Perceived physical health, alone, explained 35% of the variance in perceived mental health. These results add to knowledge about the relationships between perceived health, anxiety-depressive symptoms and sports practice in the group of people deprived of liberty, highlighting the importance of promoting physical activity in penitentiary institutions.
RESUMO
HIV-positive children and adolescents face gaps in viral load (VL) testing. To understand trends in pediatric/adolescent VL testing, 7 countries collected data from Laboratory Information Management Systems. Results showed increasing proportion of VL tests done through dried blood spot (DBS) and decreased sample rejection rates for DBS compared with plasma, supporting use of DBS VL when skilled phlebotomy is unavailable.
Assuntos
Infecções por HIV , HIV-1 , Humanos , Adolescente , Criança , Sensibilidade e Especificidade , Carga Viral/métodos , HIV-1/genética , Plasma , RNA ViralRESUMO
The home confinement caused by COVID-19 has caused university students to express feelings, negative experiences, and concerns about the confinement situation they were experiencing. This prompted the development of research on resilience, which shows that it is closely related to well-being. The general objective is to determine if resilience acts as a guarantor of personal growth and, therefore, of the self-perception of well-being. The research is developed with qualitative methodology and is framed in the interpretative phenomenological analysis approach and is framed in the hermeneutic-dialectical method. The selection of participants was carried out through an intentional sampling, by non-random methods, among university students. Fifty-two students participated, 41 are women (78.84%) and 11 men (21.15%), with an average age of 20.7 years. The information was collected through a diary card in which they had to collect their experiences and prepare a short speech identifying three temporal moments of confinement: beginning, during, and end. The information was collected between 16 April and 15 May 2020. An inductive analysis was carried out, and the emerging categories were defined: personal growth, resilience, and well-being. Personal growth materializes through three subcategories: personal changes, interpersonal changes, and changes in the philosophy of life. The university students showed that the vital transformation related with resilience acts as a guarantor of personal growth and self-perception of well-being. A voluntary, conscious, and intelligent evolution of people is detected, and personal changes, interpersonal changes, and changes in the philosophy of life are identified as factors of personal growth.
RESUMO
One of the measures adopted by the government of Spain during the COVID-19 pandemic has been the elimination of face-to-face classes in all universities, requiring that all teachers had to conduct their classes in an online mode. The objective of this article is to study how this adaptation among university teachers affected their job performance due to the technostress (objective and subjective) that they may have suffered. Based on the person-environment misfit theory (P-E fit theory), the sample consisted of 239 teachers from face-to-face and online universities in Spain who were asked to identify the type of technostress, feelings of technostress, and impact on job performance as a result of online teaching due to the COVID-19 pandemic. Results show that teachers who suffered the most from the negative consequences of technology have been female teachers from face-to-face universities who are older, have more years of experience, and consequently, hold a higher position. Despite previous results none of the above variables have been significant in explaining the decline in job performance during confinement. It was also observed that although the effect on job performance was similar for online teachers as well as face-to-face teachers, the variables that explained this effect were different. For the online teachers, there was a misfit between the demands and resources, which are explained based on the previous theory (P-E fit theory). Teachers from face-to-face universities pointed to the lack of instructions from their organization, along with subjective feelings of techno-inefficacy, as the reasons behind the decline in job performance during the lockdown period. Looking ahead to future research on the incorporation of information and communications technology in teaching work, it is necessary to consider variables associated with technostress, both objective and subjective, in order to increase the effectiveness of integrating emerging technology into teaching work.
RESUMO
For a long time, Staphylococcus aureus has been always thought to be the only pathogenic species among Staphylococcus, while coagulase-negative staphylococci (CNS) were classified as contaminant agents. However, molecular techniques have shown that these microorganisms also possess enterotoxin-encoding genes. The aim of this study was to analyze the frequency of genes for staphylococcal enterotoxins SEA, SEB, SEC, and SED in CNS strains isolated from Minas soft cheese and to assess the in vitro production of toxins. CNS were found in 65 (72.2%) samples of cheese: 23 were Staphylococcus saprophyticus, 16 Staphylococcus warneri, 10 Staphylococcus epidermidis, 9 Staphylococcus xylosus, 3 Staphylococcus haemolyticus, 2 Staphylococcus schleiferi subsp. schleiferi, and 1 each Staphylococcus capitis subsp. urealyticus and Staphylococcus caprae. Seventeen (26.2%) CNS strains had genes for enterotoxins, and sea was more frequently found (18.5%), followed by sec in three and seb in two strains, whereas the sed gene was not found. S. saprophyticus showed enterotoxin genes in 6 of 23 isolates, but only sea was observed. On the other hand, five strains of S. warneri showed the sea, seb, or sec gene. In spite of the presence of these enterotoxin genes, these strains did not produce enterotoxins in vitro. It is essential to understand the real role of CNS in food, and based on the presence of enterotoxin genes, CNS should not be ignored in epidemiological investigations of foodborne outbreaks.
Assuntos
Queijo/microbiologia , Coagulase/análise , Enterotoxinas/genética , Microbiologia de Alimentos , Reação em Cadeia da Polimerase , Staphylococcus/genética , Brasil , DNA Bacteriano/análise , Enterotoxinas/biossíntese , Staphylococcus/enzimologia , Staphylococcus/metabolismoRESUMO
The increasingly widespread use of technology has led to the emergence of phenomena harmful to users such as technostress. Although technostress has already been studied in other contexts, it is still pending study in a university education environment, where the use of information and communication technologies is increasingly widespread. Thus, the objective of this study was to adapt a technostress questionnaire for Spanish university students based on an instrument that had been designed in a Chinese university teaching population. A total of 1,744 Spanish university students from face-to-face and online universities completed the adapted Spanish technostress scale. Factorial analyses suggested the elimination of two items from the original scale and a model made up of five factors that fit, as in the original scale, within the person-environment misfit theory. The reduced scale also showed good internal consistency for all the items and the five resulting factors. These results support the psychometric properties of the reduced technostress scale in university students, and their validity when offering a complete view of the phenomenon in Spain.
RESUMO
BACKGROUND: The study of intimate partner violence has historically focused on violence perpetrated on females by males, but recent research suggests that, at least in teenage couples, the difference between genders is decreasing or even reversing. The objective of this study is to analyze the personality characteristics of adolescents who are violent with their partners. The sample consisted of 430 subjects (229 girls and 201 boys), between 14 and 19 years (M = 16.18, SD = 1.81), middle or high school students, which completed the Personality Assessment Inventory-Adolescents and the Conflict in Adolescent Dating Relationships Inventory. RESULTS: The results show that girls have higher personality scores on the scales that show problems of internal behavior (depression and anxiety), while boys show higher scores on the scales of external behavior problems (antisocial behavior and drug use). Through a regression analysis, the results show predictive weights in the aggression traits (ß = .331, p < .001), antisocial characteristics (ß = .202, p < .001), and mania (ß = .185, p < .05), as the scores on the scale of violence perpetrated increase in girls. For boys, personality variables do not seem to have such a decisive weight to explain the violence committed, since only heat and alcohol problems represent 5.4% of the variance found. These differences between boys and girls should be analyzed in future studies and, if the findings are maintained, taken into account when developing programs to prevent gender-based violence in adolescents. CONCLUSIONS: The results of this study show how the personality characteristics have a differential weight in the explanation of the teen dating aggression according to the gender of the aggressors, with a greater relevance in the prediction of the aggressive behaviors committed by the girls.
RESUMO
This study deals with the characterization of sexual violence in children seen at the Services for the Assistance of Women Victims of Sexual Violence (SAMVVIS) from 2004 to 2007 in Teresina, PI. Data collected from 229 charts indicate that the age of the children varies from less than one year up to 12 years of age. The identification of the aggressor was the neighbor (29.7%), stepfather (11.4%), father (9.4%) and uncle with 8.4%. In regards to the occupation of the aggressor, 20.35% are students, unemployed (26.85%) and retired (3.89%). It follows that there is the need for more efficiency in the policy of child protection and a need for campaigns to alert the mothers when choosing the caretakers of their daughters.
Assuntos
Abuso Sexual na Infância/estatística & dados numéricos , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Violence against women has increased over the years and is a serious violation of human rights. This study aimed to evaluate public policies, women's rights legislation and health care for victims of sexual violence. This is an exploratory and descriptive study, with interviews to professionals of the Care Center for Women Victims of Violence of Teresina-PI, and collection of medical records data of victims. We analyzed data in the light of legislation and guidelines recommended by the Ministry of Health, according to the established public policies. We noted an improvement of the Brazilian legislation and increasing intervention of government in order to control the violence. The evaluated service calls for the humanization of care, the principles of dignity, non-discrimination, confidentiality and privacy, avoiding exposure and distress of victims. Physical and gynecological examination are conducted, besides laboratory tests such as serological tests and collecting traces aiming at identifying the offender, as well as pharmaceutical care and multi-professional support. We can conclude that the current legislation and the guidelines and procedures recommended by public policies to protect women are effective in the referral service studied.
Assuntos
Vítimas de Crime/reabilitação , Atenção à Saúde/legislação & jurisprudência , Política Pública , Delitos Sexuais/legislação & jurisprudência , Direitos da Mulher/legislação & jurisprudência , Brasil , Vítimas de Crime/legislação & jurisprudência , Feminino , Política de Saúde , Direitos Humanos/legislação & jurisprudência , Humanos , Saúde da MulherRESUMO
ABSTRACT Introduction: During pregnancy, estrogen and progesterone levels may favor vaginal colonization by pathogenic microorganisms that can be associated with obstetric complications and neonatal infections. These pathogens include Candida spp., Trichomonas vaginalis, Gardnerella vaginalis and Streptococcus agalactiae. Objective: To determine the frequency of such microorganisms amongst high-risk pregnant women receiving prenatal care at a hospital in Caruaru, Pernambuco. Material and method: Analytical study in which samples of vaginal discharge were collected from women experiencing high-risk pregnancies, without restriction of age or gestational period. The samples were submitted to Gram-stained direct smear, as well as to fresh wet-mount examination and to cultures in Sabouraud and blood agar. Results: From May to December 2018, 92 patients were selected for sampling. The frequency of Candida spp. was found to be 31.52%. Concerning Gardnerella vaginalis, the frequency was 1.25%. The rate of colonization by Streptococcus agalactiae was 3.23%. No cases of Trichomonas vaginalis were found in this study. Discussion: The frequency of Candida that was found corroborates the literature, as it is a common infection during pregnancy due to hormonal increase. However, the frequencies of colonization by G. vaginalis, T. vaginalis and S. agalactiae were lower than those found in other studies. Conclusion: Due to the risks that these microorganisms can bring to a pregnant woman and a fetus, health professionals should be alert to signs and symptoms, requesting the screening of these pathogens, as well as treating gestating women when necessary.
RESUMEN Introducción: Durante el embarazo, los niveles de estrógeno y progesterona pueden favorecer la colonización vaginal por microorganismos, incluyendo Candida spp., Trichomonas vaginalis, Gardnerella vaginalis y Streptococcus agalactiae, asociados o no a complicaciones obstétricas e infecciones neonatales. Objetivo: Estimar la prevalencia de eses microorganismos en mujeres embarazadas de alto riesgo de una maternidad en la ciudad de Caruaru, Pernambuco, Brasil. Material y métodos: Estudio analítico en el que se tomaron muestras de flujo vaginal de mujeres embarazadas de alto riesgo, sin restricción de edad o edad gestacional. Las muestras iban destinadas a la realización del frotis con tinción de Gram, examen de montaje en fresco y cultivos en agar Sabouraud y sangre. Resultados: En el periodo de mayo a diciembre de 2018, se eligieron 92 mujeres embarazadas. Se encontró una prevalencia de Candida del 31,52%. La prevalencia de Gardnerella vaginalis fue del 1,25%. La tasa de colonización por Streptococcus agalactiae fue del 3,23%. No se encontró ningún caso de Trichomonas vaginalis en este estudio. Discusión: La prevalencia de Candida está de acuerdo con la literatura, puesto que es una infección común durante el embarazo debido al aumento hormonal. Sin embargo, las prevalencias de G. vaginalis, T. vaginalis y S. agalactiae fueron bajas en comparación con otros estudios. Conclusión: Debido al riesgo que estos microorganismos representan para la mujer embarazada y el feto, los profesionales deben vigilar los signos y síntomas, solicitando investigación sobre esos patógenos, además de comenzar el tratamiento de la paciente, cuando necesario.
RESUMO Introdução: Durante a gestação, os níveis de estrogênio e progesterona podem favorecer a colonização vaginal por microrganismos, incluindo Candida spp., Trichomonas vaginalis, Gardnerella vaginalis e Streptococcus agalactiae, associados ou não a complicações obstétricas e infecções neonatais. Objetivo: Determinar a prevalência desses microrganismos em gestantes de alto risco de uma maternidade na cidade de Caruaru, Pernambuco, Brasil. Material e métodos: Estudo analítico em que amostras de secreção vaginal foram coletadas de gestantes de alto risco, sem restrição de idade ou período gestacional. As amostras foram destinadas à realização de esfregaço corado por Gram, exame a fresco e culturas em ágar Sabouraud e sangue. Resultados: No período de maio a dezembro de 2018, 92 gestantes foram selecionadas. A prevalência encontrada de Candida foi de 31,52%. Quanto à Gardnerella vaginalis, a prevalência foi de 1,25%. A taxa de colonização por Streptococcus agalactiae foi de 3,23%. Nenhum caso de Trichomonas vaginalis foi encontrado neste estudo. Discussão: A prevalência de Candida encontrada está de acordo com a literatura, visto que é uma infecção comum durante a gestação em razão do aumento hormonal. Entretanto, as prevalências de G. vaginalis, T. vaginalis e S. agalactiae foram baixas em comparação com outros estudos. Conclusão: Devido ao risco que esses microrganismos podem trazer à gestante e ao feto, os profissionais devem estar atentos aos sinais e sintomas, solicitando pesquisa desses patógenos, além de iniciar o tratamento da paciente, quando necessário.
RESUMO
Background: The study of intimate partner violence has historically focused on violence perpetrated on females by males, but recent research suggests that, at least in teenage couples, the difference between genders is decreasing or even reversing. The objective of this study is to analyze the personality characteristics of adolescents who are violent with their partners. The sample consisted of 430 subjects (229 girls and 201 boys), between 14 and 19 years (M =16.18, SD = 1.81), middle or high school students, which completed the Personality Assessment Inventory-Adolescents and the Conflict in Adolescent Dating Relationships Inventory. Results: The results show that girls have higher personality scores on the scales that show problems of internal behavior (depression and anxiety), while boys show higher scores on the scales of external behavior problems (antisocial behavior and drug use). Through a regression analysis, the results show predictive weights in the aggression traits (ß= .331, p < .001), antisocial characteristics (ß = .202, p < .001), and mania (ß = .185, p < .05), as the scores on the scale of violence perpetrated increase in girls. For boys, personality variables do not seem to have such a decisive weight to explain the violence committed, since only heat and alcohol problems represent 5.4% of the variance found. These differences between boys and girls should be analyzed in future studies and, if the findings are maintained, taken into account when developing programs to prevent gender-based violence in adolescents. Conclusions: The results of this study show how the personality characteristics have a differential weight in the explanation of the teen dating aggression according to the gender of the aggressors, with a greater relevance in the prediction of the aggressive behaviors committed by the girls.(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Personalidade , Violência/psicologia , Corte/psicologia , Violência de GêneroRESUMO
Resumo A violência contra mulheres tem crescido, constituindo-se grave violação dos direitos humanos. Objetivou-se avaliar as políticas públicas, a legislação de proteção à mulher e os atendimentos de saúde às vítimas de violência sexual. Realizou-se estudo exploratório e descritivo, com entrevistas a profissionais do Serviço de Atendimento à Mulher Vítima de Violência de Teresina-PI, além de coleta de dados de prontuários das vítimas. Os dados foram analisados à luz da legislação e das diretrizes preconizadas pelo Ministério da Saúde, consoante com as políticas públicas instituídas. Observou-se evolução da legislação brasileira e crescente intervenção do poder público no intuito de controlar a violência. O serviço avaliado preconiza a humanização do atendimento, os princípios da dignidade, não discriminação, do sigilo e da privacidade, evitando a exposição e o desgaste das vítimas. São realizados exames físico e ginecológico, outros complementares como testes sorológicos e coleta de vestígios em busca da identificação do agressor, além de assistência farmacêutica e acompanhamento multiprofissional. Pode-se concluir que a legislação vigente, bem como as diretrizes e os procedimentos preconizados pelas políticas públicas de proteção à mulher são eficazes no serviço de referência estudado.
Abstract Violence against women has increased over the years and is a serious violation of human rights. This study aimed to evaluate public policies, women’s rights legislation and health care for victims of sexual violence. This is an exploratory and descriptive study, with interviews to professionals of the Care Center for Women Victims of Violence of Teresina-PI, and collection of medical records data of victims. We analyzed data in the light of legislation and guidelines recommended by the Ministry of Health, according to the established public policies. We noted an improvement of the Brazilian legislation and increasing intervention of government in order to control the violence. The evaluated service calls for the humanization of care, the principles of dignity, non-discrimination, confidentiality and privacy, avoiding exposure and distress of victims. Physical and gynecological examination are conducted, besides laboratory tests such as serological tests and collecting traces aiming at identifying the offender, as well as pharmaceutical care and multi-professional support. We can conclude that the current legislation and the guidelines and procedures recommended by public policies to protect women are effective in the referral service studied.
Assuntos
Humanos , Feminino , Política Pública , Delitos Sexuais/legislação & jurisprudência , Direitos da Mulher/legislação & jurisprudência , Vítimas de Crime/reabilitação , Atenção à Saúde/legislação & jurisprudência , Brasil , Saúde da Mulher , Vítimas de Crime/legislação & jurisprudência , Política de Saúde , Direitos Humanos/legislação & jurisprudênciaRESUMO
Os flavonóides são um grupo de substâncias naturais com estrutura fenólica variável, e portanto, de considerável interesse científico e terapêutico. Assim, teve-se por objetivo realizar uma revisão bibliográfica, de forma extensa porém objetiva, sobre as principais ações terapêuticas e a toxicidade das principais classes de flavonóides. A partir desta revisão da literatura, verificou-se, em ensaios pré-clínicos, que estes compostos tem o potencial de modificar a biossíntese de eicosanoides (resposta anti-prostanoide e antiinflamatoria); de proteger o colesterol-LDL da oxidacão (inibindo formação de placa aterosclerotica); de prevenir a agregacão plaquetária tendo efeitos anti-trombóticos; de promover o efeito anti-hipertensivo e anti-isquêmico; de regenerar antioxidantes primários, como a vitamina C, no organismo; de ter efeito antipromocionais na carcinogênese de alguns tipos de câncer; de amenizar os sintomas da menopausa; de aumentar a lipólise; de desacelerar o processo degenerativo em bainhas de mielina; de aumentar a secreção de insulina; de aumentar a expressão de genes responsáveis pela produção de proteínas sinápticas; de estimular os linfócitos B a produzirem anticorpos e de possuir atividade leishmanicida. Quanto a toxicidade dos flavonóides, estudos demostram que em altas doses e em utilização crônica, estes compostos desencadeiam reações alérgicas em humanos; modificam as membranas de hepatócitos causando necrose e morte celular em ratos; causam mutagenicidade e clastogenicidade em medula óssea de camundongos; interferem de forma significativa no funcionamento da tireóide e inibe a ação de citocromos P450 causando alterações drásticas no funcionamento do fígado de roedores. Dessa forma, pode-se verificar que os flavonóides tem uma grande capacidade terapêutica quando bem utilizado, devendo-se sempre levar em consideração doses e tempo de exposição aos organismos aos quais são administrados. Essas considerações são importantes por servirão de base para o estabelecimento de doses seguras e eficazes de utilização dos flavonóides para a população.
Flavonoids are a group of natural substances with variable phenolic structure and therefore, considerable scientific interest and therapeutic. Thus, the objective was to conduct a literature review of but objective extensively on major therapeutic actions and on the toxicity of flavonoids class. In this literature review, it was found that, in preclinical studies, these compounds have the potential to modify the biosynthesis of eicosanoids; protect LDL cholesterol from oxidation; prevent platelet aggregation with antithrombotic effects; promote the antihypertensive and anti-ischemic effect; regenerate primary antioxidants like vitamin C in the body; not to promote some carcinogenic effects on certain types of cancer; alleviate menopausal symptoms; increase lipolysis; slow down degenerative process in myelin sheaths; increase insulin secretion; increase the expression of genes responsible for the production of synaptic proteins; stimulate lymphocytes B to produces antibodies and have leishmanicydal activity. About the toxicity of flavonoids, studies show that, at high doses and in chronic use, these compounds trigger allergic reactions in humans; modify the membranes of hepatocytes, causing necrosis and cell death, in rats; cause mutagenicity and clastogenicity in mouse bone marrow, interfere significantly on thyroid function and inhibit the action of cytochrome P450, causing drastic changes in the function of the liver in rodents. Thus, it can be seen that the flavonoids have a wide therapeutic capacity when properly used, taking into account doses and exposure times to whom they are administered. These considerations are important because they set the bases for the establishment of safe and effective doses of flavonoids on the population.
Assuntos
Flavonoides/toxicidade , Flavonoides/química , Flavonoides/farmacologiaRESUMO
Este trabalho teve por objetivo avaliar a ação dos aditivos alimentares urucum e cúrcuma em células meristemáticas de pontas de raízes de Allium cepa nas doses de 5 e 10 g, nos tempos de exposição de 24 e 48 horas. Utilizou-se para cada dose um grupo de cinco bulbos de cebolas, que primeiramente foram enraizados em água destilada, e em seguida transferidos para as suas respectivas doses. Analisaram-se células em todo ciclo celular, totalizando 5.000 para cada controle e tempo de exposição. Os dados obtidos foram submetidos à análise estatística do Qui-quadrado (p<0,05). A partir dos resultados observou-se que as doses do urucum e do cúrcuma tiveram efeito antiproliferativo significativo sobre o ciclo celular deste sistema-teste. Também foi verificado número significativo de aberrações celulares nos dois tempos de exposição avaliados de todas as doses estudadas. Portanto, nas condições analisadas, o urucum e o cúrcuma mostraram-se citotóxicos e genotóxicos.
This study aimed to evaluate the effect of food additives annatto and turmeric tip cells of Allium cepa roots in doses of 5 or 10 g in exposure times of 24 and 48 hours. A group of five onion bulbs was used for each dose. Each dose was first embedded in distilled water and then transferred to their respective doses. Cells were analyzed throughout the cell cycle, totaling 5000 for each control and exposure time. The obtained data were subjected to statistical analysis Chi-square (p <.05). From the results it was observed that the doses of turmeric and annatto had significant antiproliferative effect on the cell cycle of this test system. They also found a significant number of cellular aberrations in the two exposure times evaluated all doses studied. Therefore, under the conditions studied, annatto and turmeric proved cytotoxic and genotoxic.