[Literacy in sexual and reproductive health as well as associated variables: multicenter study]. / Alfabetización en salud sexual y reproductiva así como variables asociadas: estudio multicéntrico.

OBJECTIVE: Limited Health Literacy implies an insufficient understanding of relevant health information, being associated with various variables. The objective of the study was to measure the prevalence of the level of Limited Sexual and Reproductive Health Literacy (AS-SR), its associated variables and the differences in scores between levels of AS-SR, universities and science of study in Chilean university students. METHODS: A multicenter and cross-sectional study, which applied a validated scale to measure levels of AS-SR, was carried out in a sample of 2,186 Chilean university students, categorizing it as high, medium high, medium low and low. The level of Limited AS-SR was obtained by adding the medium-low and low categories. Tests were carried out: descriptive, psychometric and reliability; association, logistic regression and differences between variables of interest. RESULTS: The prevalence of Limited AS-SR was 52.7%. The variables most associated with the level of Limited AS-SR were: low interest in information about health care (OR=2.819; 95% CI: 2.132-3.726), prevention (OR=2.564; 95% CI: 1.941-3.388), sexuality (OR=2.497; 95% CI: 1.807-3.452) and health promotion (OR=1.515; 95% CI: 1.239-1.853); certain sources of Information (OR=1.915; 95% CI:1.614-2.272); low economic income (OR=1.661; 95% CI: 1.361-2.026), among others. There were statistically significant differences in scores between categories of AS-SR levels, universities and study science. The scale had a reliability of 0.940. CONCLUSIONS: More than half of the students have Limited AS-SR, mainly associated with low interest in health information. The scale presents excellent psychometric indicators, being recommended for diagnoses of health situations.

OBJECTIVE: La Alfabetización en Salud Limitada implica una comprensión insuficiente de la información relevante en salud, asociándose con diversas variables. El objetivo del estudio fue medir la prevalencia del nivel de Alfabetización en Salud Sexual y Reproductiva (AS-SR) Limitada, sus variables asociadas y las diferencias de puntajes entre niveles de AS-SR, universidades y ciencia de estudio en universitarios chilenos. METHODS: Se realizó un estudio multicéntrico y transversal, que aplicó una escala validada para medir niveles de AS-SR, en una muestra de 2.186 estudiantes universitarios chilenos, categorizándola en alta, media-alta, media-baja y baja. El nivel de AS-SR Limitada se obtuvo mediante el sumatorio de categorías media-baja y baja. Se realizaron pruebas: descriptivas, psicométricas y fiabilidad; asociación, regresión logística y de diferencias entre variables de interés. RESULTS: La prevalencia de AS-SR Limitada fue del 52,7%. Las variables mayormente asociadas al nivel de AS-SR Limitada fueron: bajo interés en información sobre atención en salud (OR=2,819; IC 95%:2,132-3,726), prevención (OR=2,564; IC 95%: 1,941-3,388), sexualidad (OR=2,497; IC 95%: 1,807-3,452) y promoción de la salud (OR=1,515; IC 95%: 1,239-1,853); ciertas fuentes de Información (OR=1,915; IC 95%:1,614-2,272); bajo ingreso económico (OR=1,661; IC 95%: 1,361-2,026), entre otras. Existieron diferencias estadísticamente significativas de puntajes entre categorías de niveles de AS-SR, universidades y ciencia de estudio. La escala presentó fiabilidad de 0,940. CONCLUSIONS: Más de la mitad de los estudiantes poseen AS-SR Limitada, asociada principalmente al bajo interés en información en salud. La escala presenta excelentes indicadores psicométricos, siendo recomendable para diagnósticos de situación de salud.

Adolescent Social Networks and Physical Intimate Partner Violence Among Colombian Rural Adolescents.

The current study analyzes individual and social network correlates of adolescent engagement in physical intimate partner violence (IPV) utilizing socio-centric data from a high-school population of 242 adolescents from rural Colombia. We studied self-reported victimization and perpetration for boys and girls. First, we used logistic regression to explore the relationship between adolescents' IPV engagement and school peers' IPV engagement, school violence victimization, and social network position, controlling for gender and age (N=111). Second, we used social network statistical methods to investigate if there were more friendships of similar IPV status to the adolescent than expected by chance in their social networks. Our results show that the proportion of friends perpetrating physical IPV increased the probability of adolescents' IPV perpetration. Contrarywise, the proportion of friends experiencing IPV victimization decreased with the adolescent's own victimization. Being a victim (a status significantly more common among boys) was also associated with reporting perpetration for both genders. Furthermore, our results contradicted the social network literature, as we found no preferential ties among perpetrators/victims (e.g., adolescents do not seem to befriend each other by IPV engagement). Our study is unique to the global adolescent IPV literature given the scarcity of research examining physical IPV among adolescents in the context of both girls and boys in the context of their school networks. We also add to the understanding of IPV in the case of the global majority of adolescents with the highest rates of IPV victimization (living in Low and Middle-Income Countries).

Reproductive behaviors among school-based health center clients in New Mexico.

Introduction: School-based health centers (SBHCs) are an evidence-based model for providing contraceptives to adolescents. SBHCs ability to provide reproductive health services is often limited by school district policies, state laws, and health center policies. Methods: We used data from the Teens Exploring and Managing Prevention (TEMPO) study to document demographic characteristics and birth control methods among patients at four SBHCs in New Mexico. A total of 264 teens were included in the baseline data collection at SBHCs in New Mexico. A baseline survey was administered via iPad, that specifically focused on questions related to sexual experiences and sexual health topics. Baseline questions included demographic questions, gender identity, sexual orientation, reasons for visits, reproductive practices, and birth control methods. Descriptive statistics were calculated, including means and standard deviations for continuous variables and categorical frequencies. Results: Our findings present reproductive health behaviors among New Mexican patients attending schools with SBHCs. More than 74% of respondents were Hispanic or Latino. The most common reason teens went to the SBHC was for birth control, and just 62% of teens reported using birth control methods in the past. Discussion: These behaviors are essential for policymakers to consider as they address policy gaps, the complex landscape of parental permission, reproductive rights, and health as a human right.

Children's perception of food parenting practices: adaptation and validation of the comprehensive feeding practices questionnaire in Chilean adolescents.

Introduction: Assessment of the Comprehensive Feeding Practices Questionnaire in adolescents (CFPQ-Teen) is still limited, with no evaluation of the measurement invariance. The participants comprised 473 Chilean adolescents of both sexes from dual-income nuclear families. The aims of this study were: (1) to adapt to Spanish and validate a model of five-factor version the CFPQ-Teen; (2) to examine the psychometric properties, (3) to evaluate the measurement invariance according to the adolescents' gender; and (4) to compare the scores of each factor between female and male adolescents. Methods: The instrument was translated, back-translated, and adapted from the CFPQ-Teen, confirming the equivalence, conceptual, and face validity in a pilot sample of 40 adolescents. An exploratory factor analysis was performed on the five-factor model of the CFPQ-Teen: Monitoring, Adolescent Control, Restriction for weight control, Parental Modeling, and Environment. The Environment factor was eliminated as a result. Results: The confirmatory factor analysis presented good reliability, convergent, discriminant, and concurrent validity values. In addition, medium to high goodness-of-fit levels were obtained by eliminating an item from the Adolescent Control factor. These results confirm a final 20-item model representing four factors. The multigroup invariance analysis of the measurement model verified configural, metric, scalar, and partial strict invariance. No significant differences were found between females and males in the scores on the four factors. Discussion: These results enable comparisons by sex on the perceptions of Food Parenting Practices from the analyzed factors, primarily within the context of the Chilean sample.

Improving breastfeeding among adolescent mothers: a prospective cohort

ABSTRACT BACKGROUND: Exclusive breastfeeding is recommended for the first six months, and mother's age impact early weaning. Educational support and relevant information can increase breastfeeding rates. OBJECTIVE: To determine whether antenatal education enhances the maintenance, intention, and confidence in breastfeeding among adolescents. DESIGN AND SETTING: A prospective cohort study involving primiparous adolescents who gave birth at the Woman's Hospital (CAISM), Universidade Estadual de Campinas, Brazil. METHODS: Adolescent mothers were categorized into two groups based on the location of prenatal care: those at the Woman's Hospital (WH) who received antenatal education, and at the Primary Care (PC) who did not receive antenatal education. All adolescents received breastfeeding orientation during their postpartum hospital stay. The groups were compared using the Student's t-test, Mann-Whitney U test, and chi-squared test. Log-binomial models were used to compare the groups at different time intervals. RESULTS: The study included 132 adolescents: 59 in the WH group and 73 in the PC group. Six months postpartum, adolescents in the WH group demonstrated higher engagement in breastfeeding (P < 0.005) and exclusive breastfeeding (P = 0.04) than PC group. PC group showed greater lack of confidence in breastfeeding (P = 0.02) and felt less prepared (P = 0.01). Notably, all WH adolescents reported a stronger desire to breastfeed after antenatal education. CONCLUSION: Antenatal education significantly improves the maintenance, intention, and confidence of breastfeeding among adolescents. This education approach can be implemented across all healthcare levels and should be made accessible to all women throughout the pregnancy and postpartum period.

Escala de medición de resiliencia en adolescentes cubanos entre 15 y 19 años de edad / Scale for measuring resilience in Cuban adolescents between 15 and 19 years of age

Introducción: La resiliencia en la adolescencia se relaciona con la capacidad de resolver el problema de la identidad, en contextos en los cuales esta no posee las condiciones para construirse de modo positivo. Objetivo: Diseñar un instrumento para evaluar resiliencia en adolescentes de 15 a 19 años de edad. Métodos: Investigación de tipo instrumental, en el Instituto Preuniversitario Martín Dihigo de Cienfuegos, de marzo a septiembre de 2022. Muestreo no probabilístico (n= 450). La validez de contenido se llevó a cabo a través del criterio de expertos, la validez de constructo a partir del análisis factorial y la validez de criterio mediante correlación con la Escala de Resiliencia de Connor-Davidson. La fiabilidad se realizó a través de la consistencia interna y la estabilidad temporal mediante el test-retest. Resultados: El instrumento presenta validez de contenido. El análisis factorial arrojó 7 factores que explican el 64,8 por ciento de la varianza. La correlación con la Escala de Resiliencia de Connor-Davidson fue de 0,333 (p< 0,01). Se obtuvo un alfa de Cronbach global α= 0,839; se demostró la estabilidad temporal. Conclusiones: La Escala de Resiliencia en Adolescentes Cubana tiene adecuados criterios de validez y fiabilidad que justifican su aplicación en la población de adolescentes de Cuba(AU)

Introduction: Resilience in adolescence is related to the ability to solve the problem of identity in contexts where it does not have the conditions to be built in a positive way. Objective: To design an instrument to assess resilience in adolescents from 15 to 19 years of age. Methods: Instrumental research, at the Martín Dihigo Pre-University Institute in Cienfuegos, from March to September 2022. Non-probabilistic sampling (n= 450). Content validity was carried out through expert criteria, construct validity from factorial analysis and criterion validity through correlation with the Connor-Davidson Resilience Scale. Reliability was carried out through internal consistency, and temporal stability through test-retest. Results: The instrument presents content validity. The factorial analysis yielded 7 factors which explain 64.8 percent of the variance. The correlation of the instrument with the Connor-Davidson Resilience Scale was 0.333 (p< 0.01). A global Cronbach's alpha α= 0.839 was obtained; temporal stability was demonstrated. Conclusions: The Cuban Adolescent Resilience Scale has adequate validity and reliability criteria that justify its application in the population of Cuban adolescents(AU)

Individual, Family, and Social Factors Associated with Gestational Weight Gain in Adolescents: A Scoping Review.

About 56% to 84% of pregnant adolescents have inappropriate (insufficient or excessive) gestational weight gain (GWG); however, the factors associated with GWG in this age group have not been systematically identified. This scoping review aimed to synthesize the available scientific evidence on the association of individual, family, and social factors with inappropriate gestational weight gain in pregnant adolescents. To carry out this review, the MEDLINE, Scopus, Web of Science, and Google Scholar databases were searched for articles from recent years. The evidence was organized according to individual, family, and social factors. The analyzed studies included 1571 adolescents from six retrospective cohorts, 568 from three prospective cohorts, 165 from a case-control study, 395 from a cross-sectional study, and 78,001 from two national representative samples in the USA. At the individual level, in approximately half of the studies, the pre-pregnancy body mass index (pBMI) was positively associated with the GWG recommended by the Institute of Medicine of the USA (IOM). The evidence was insufficient for the other factors (maternal age, number of deliveries, and family support) to determine an association. According to the review, we concluded that pBMI was positively associated with the GWG. More quality studies are needed to assess the association between GWG and individual, family, and social factors.

Clinico-epidemiological profile of patients at children's psychosocial care centers in São Bernardo do Campo: a cross-sectional study

ABSTRACT BACKGROUDS: Child and Adolescent Psychosocial Care Centers (Centros de Atenção Psicossocial, CAPSI) are dedicated centers for persistent psychiatric disorders, which provide an individualized therapeutic approach based on extra-hospital services. OBJECTIVES: We aimed to describe the clinico-epidemiological profiles of the patients seeking interventions at the CAPSIs. DESIGN AND SETTING: A cross-sectional study was conducted in two CAPSI in São Bernardo do Campo, SP, Brazil. One CAPSI is dedicated to the treatment of alcohol- and drug-related disorders, and the other to the treatment of other mental disorders. METHODS: In July 2017, we reviewed all active medical records of these two CAPSI, and collected the patients information including sex, race, education, type of referral, initial complaints, psychiatric diagnoses, and medication utilization. RESULTS: Of the 233 patients, 69.5% were male and 42.5% lived with their immediate family. Most of the patients were referred from other health services. Complaints on admission included agitation and aggressive behavior (30.9%). Autism spectrum disorder (ASD) was the most prevalent diagnosis (46.8%), followed by depressive disorder (13.8%). Of the patients, 81.5% were on regular medical follow-up and 70.3% were on a single medication only. CONCLUSION: Aggression complaints are the most prevalent in CAPSI, and diagnoses of ASD and psychotic disorders are more common. This situation differs from most CAPSI that present school complaints as the most prevalent, in which diagnoses of attention-deficit/hyperactivity disorder and conduct disorders are likely to be more frequent. The epidemiological profile of each CAPSI should guide the implementation of human and structural resources targeting the most prevalent complaints and diagnoses.

Percepções de mães adolescentes acerca das expectativas e experiências da maternidade na adolescência / Perceptions of teenage mothers about the expectations and experiences of motherhood in adolescence

Conhecer as percepções das mães adolescentes sobre a gravidez na adolescência é importante subsídio para uma abordagem efetiva e integral pelos profissionais de saúde e para políticas de saúde. O estudo analisou as percepções de mães de 15 a 19 anos que frequentaram a Unidade Básica de Saúde em Divinolândia-SP para realização do pré-natal entre janeiro de 2016 à outubro de 2017. A pesquisa qualitativa foi realizada por meio de 17 entrevistas semiestruturadas, utilizando amostragem por exaustão. As entrevistas foram gravadas e transcritas na íntegra, e o material tratado por análise de conteúdo na modalidade temática. Foram identificadas 5 categorias de análise: (1) gravidez planejada durante a adolescência; (2) imaginário e realidades da gravidez na adolescência; (3) modificação dos projetos de vida; (4) motivação para a gravidez associada ao desejo de mudança de vida e fuga e (5) rede de apoio e proteção. As adolescentes relataram os desafios da maternidade e surpreenderam-se frente a uma realidade distinta da qual imaginavam, com modificação nos projetos de vida, no entanto as mães se confortaram perante o apoio social e familiar recebido, e apresentaram formas de lidar com as dificuldades e complexidades inerentes à maternidade. Os resultados deste estudo podem colaborar com programas de saúde que visem não só prevenir a gravidez não planejada, como também oferecer suporte à adolescente e apoiar o período puerperal, visto que é sentido como um período crítico na vida das mães.

It is relevant to know the perceptions of adolescent mothers about teenage pregnancy because it is a support for an effective and comprehensive approach by health professionals and health policies.The study analyzed the perceptions of mothers aged 15 to 19 years old who attended the Basic Health Unit in Divinolândia-SP for prenatal care, between January 2016 and October 2017. The qualitative research was carried out through 17 semi-structured interviews, using exhaust sampling. The interviews were recorded and transcribed, and the material was treated by content analysis in the thematic mode. Five categories of analysis were identified: (1) intended pregnancy during adolescence; (2) imaginary and realities of teenage pregnancy; (3) modification of life projects; (4) motivation for pregnancy associated with the desire for life change and escape and (5) support and protection network. Adolescents reported challenges and were surprised by a reality different from what they imagined, with changes in life projects, however, mothers were comforted by the social and family support received, and presented ways of dealing with the inherent difficulties and complexities of motherhood. The results of this study can collaborate with health programs, which aim not only to prevent unintended pregnancy, but also to support adolescents and support the puerperal period, as it is felt as a critical period in the lives of mothers.

Violencia en las parejas adolescentes. Implicaciones del sexismo y la religión / Teen dating violence. Implications of sexism and religion

Resumen La violencia en las parejas adolescentes es un tema de especial importancia por la implicación en la salud y en las relaciones afectivas de los adolescentes. El propósito de este estudio fue determinar la influencia del género y de la religión en la violencia física, de comunicación/relación y psicológica, recibidas por los adolescentes, y en la satisfacción con la vida que estos presentan, además, del papel que juegan las conductas sexistas en esta violencia. Los participantes han sido 1 036 adolescentes pertenecientes a siete centros de educación secundaria del sudeste español, de edades comprendidas entre 14 y 19 años, de los que el 48.1 % eran hombres y el 51.9 %, mujeres. Para alcanzar los objetivos de la investigación, junto con los datos demográficos y personales, se aplicó la Escala de Satisfacción con la Vida (SWLS), la Escala de Violencia en la pareja desarrollada y validada para este estudio que recoge tres subescalas: violencia psicológica, violencia física, y violencia en la comunicación y relación con otros. Finalmente, el cuestionario sobre conductas sexistas da información sobre creencias falsas y conductas sexistas. Los resultados muestran niveles más altos de violencia física, psicológica y de comunicación/relación sufrida por los hombres. Aunque son los hombres los que se sienten más satisfechos con la vida y los que manifiestan más conductas sexistas. La creencia religiosa no interviene en la violencia ejercida, pero son los adolescentes practicantes los que se muestran más satisfechos con la vida.

Abstract Teen dating violence is defined as the physical, sexual, psycho-emotional violence that occurs within couple relationships during adolescence. These are relationships that threaten the well-being, health or integrity of the couple and that use mechanisms of control or domination of the couple through coactive or coercive tactics. With this research we have tried to find out about life satisfaction, the physical, psychological and communicative violence suffered by adolescent men and women who are religious or not. In addition, detect sexist behaviours in young people of both sexes and assess behaviours based on religious practice. A descriptive, cross-sectional and predictive study was carried out. Cluster random sampling was carried out when selecting secondary schools in South-eastern Spain. The study included 1 036 adolescents with ages between 14 and 19 years old, of whom 48.1 % were men and 51.9 % women. To fulfill the objectives together with demographic and personal data, the Satisfaction with Life Scale (SWLS) is applied, which assesses the cognitive aspects of well-being. The Psychological Violence Scale is applied with the objective of assessing the psychological and emotional violence. To know the physical violence and authoritarian behaviour, the Physical Violence Scale is applied. Finally, the Violence in Communication and Relationship with Others Scale is introduced for studying online violence and relationship violence. The three violence scales have been adapted, developed and validated by Soriano and Aguilera (2017). Finally, the questionnaire on sexist behaviours collects information on false beliefs and sexist behaviours. The data collection procedure followed the standards set out in the Helsinki Convention (2013) for scientific research involving human participants. Regarding the results, in the first of the logistic regression models, it is good for boys to go out with many girls, but not the other way around (Wald = 14.461; p = .000; OR = 4.047), it is observed to be that boys are 4.047 times more likely to agree with this attitude than girls. Also, it is statistically significant that sometimes you have to threaten others to know who is in charge, (Wald = 8.107; p = .004; OR = 2.173), which indicates that the boys are 2.173 times more likely in accordance with that conduct that the girls. It is also statistically significant that when a woman is assaulted by her partner she will have done something to provoke him, (Wald = 16.315; p = .000; OR = 3.538), making it 3.538 times more likely that boys support this attitude than girls. At the same time, it is statistically significant that the violence that occurs within the home is a family matter and should not leave there, (Wald = 4.132; p = .042; OR = 1.694), which also indicates that boys are 1.694 times more likely to adopt this behaviour than girls. Regarding the perception of violence, it is observed that men perceive more violence than women, being significant for the three types of violence studied (p < .05): Communication, psychological and physical. Personal satisfaction also shows significant results (Z = -2.61; p = .009). In this case, men perceive greatersatisfaction with their life than women. For students with religious beliefs and practices, statistically significant results were evident only in personal satisfaction (Z = -3.42; p = .001), showing that students who practice a religion have more satisfaction with life. The results show higher levels of physical, psychological and communication / relationship violence suffered by men. However, men feel more satisfation with life and show more sexist behaviour. Religious belief does not intervene in violence, but the practicing adolescents are those most satisfied with life.

Intervenciones para prevenir el síndrome metabólico en adolescentes / Interventions to Prevent Metabolic Syndrome in Adolescents

Introducción: El sobrepeso y la obesidad son actualmente problemas de salud pública de alto impacto a nivel mundial, que predisponen al ser humano a adquirir enfermedades crónicas no transmisibles como el síndrome metabólico, afecta a los adolescentes, un grupo etario vulnerable. Objetivo: Analizar la evidencia científica acerca de las intervenciones para prevenir el síndrome metabólico en adolescentes. Métodos: Revisión sistemática de artículos publicados entre 2010 y 2019, se realizó la búsqueda en bases de datos SciELO, BVS, PUBMED. Luego de aplicar los criterios de inclusión y exclusión se seleccionaron 11 artículos. Se utilizó el diagrama de flujo Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Conclusiones: En los 11 artículos analizados, se han encontrado diversos enfoques de intervención, que fueron desarrollados, principalmente, en aspectos educativos, nutricionales y actividades físicas. Los estudios en los que se abordaron más estrategias de prevención del síndrome metabólico en los adolescentes, aunado a un enfoque familiar e incorporando a docentes y un equipo multidisciplinario, presentaron cambios más significativos en las características antropométricas y parámetros bioquímicos relacionados a los factores de riesgo cardiometabólicos(AU)

Introduction: Overweight and obesity are currently high-impact public health problems worldwide, predisposing humans to acquire chronic non-communicable diseases such as metabolic syndrome, affecting adolescents, a vulnerable age group. Objective: To analyze the scientific evidence about interventions to prevent metabolic syndrome in adolescents. Methods: A systematic review was conducted of articles published between 2010 and 2019; a search was carried out in SciELO, BVS, PUBMED databases. After applying the inclusion and exclusion criteria, 11 articles were selected. The Preferred Reporting Items for Systematic Review and Meta-Analyzes (PRISMA) flow chart was used. Conclusions: In the 11 articles analyzed, various intervention approaches have been found, which were developed mainly in educational, nutritional and physical activities aspects. The studies in which more strategies for the prevention of metabolic syndrome in adolescents were addressed, together with a family approach and incorporating teachers and a multidisciplinary team, showed more significant changes in anthropometric characteristics and biochemical parameters related to cardiometabolic risk factors(AU)

Regras/rupturas do "contrato" amoroso entre adolescentes: o papel do abuso digital / Love "contract" rules/breaches: the role of digital abuse

Resumo O abuso digital nos relacionamentos íntimos constitui um tema ainda pouco estudado no Brasil, sendo tal prática muitas vezes naturalizada, especialmente entre jovens. O objetivo deste artigo é conhecer os sentidos atribuídos por adolescentes para o conjunto de regras e acordos, implícitos ou pactuados, que definem os contornos de um contrato amoroso e o papel do abuso digital nesses entendimentos estratégicos. Estudo qualitativo realizado com fontes orais primárias, a partir de quatro grupos focais com adolescentes de ambos os sexos, de 15 a 18 anos, de escolas públicas e privadas, totalizando 26 estudantes. A análise se pautou na perspectiva da interpretação de sentidos, com viés temático, ancorado na teoria de amor líquido de Bauman e na categoria de amor confluente de Giddens. Confiança, individualidade e intimidade foram valores considerados essenciais para a vigência de um relacionamento íntimo considerado sério. A exposição da intimidade e monitoramento sem permissão são atos que podem levar à ruptura desse contrato amoroso. Os adolescentes nos mostraram que é preciso tratar o abuso digital entre parceiros a partir da reflexão acerca das regras, dos valores e dos acordos que definem os contornos do contrato amoroso que estabelecem.

Abstract Digital abuse in intimate relationships is a topic that is still poorly studied in Brazil, and this practice is often naturalized, especially among young people. This article aims to know the meanings attributed by adolescents to the set of rules and agreements, implicit or agreed, that define the contours of a "love contract" and the role of digital abuse in these strategic understandings. Qualitative study conducted with primary oral sources, from four focus groups with adolescents from public and private schools, of both sexes, aged 15 to 18 years, totaling 26 students. The analysis was based on the perspective of the interpretation of meanings, with thematic bias, anchored in Bauman's theory of liquid love and Giddens' category of confluent love. Trust, individuality and intimacy were values ​​considered essential for the existence of an intimate relationship considered "serious". The "exposure of intimacy" and "monitoring" without permission are acts that can lead to the breakdown of this "love contract". The adolescents showed us that we need to treat digital abuse between partners by reflecting on the rules, values ​​and agreements that define the contours of the "love contract" they establish.

Association between handgrip strength and bone mass parameters in HIV-infected children and adolescents. A cross-sectional study

ABSTRACT BACKGROUND: Low bone mineral content (BMC) and bone mineral density (BMD) have been identified in human immunodeficiency virus (HIV)-infected children and adolescents. The direct adverse effects of HIV infection and combined antiretroviral therapy (ART) negatively contribute to bone metabolism. A direct relationship between muscle strength levels and BMD in HIV-infected adults and older adults has been described. However, it is unknown whether handgrip strength (HGS) is associated with bone mass in pediatric populations diagnosed with HIV. OBJECTIVE: To ascertain whether HGS levels are associated with BMC and BMD in HIV-infected children and adolescents. DESIGN AND SETTING: Cross-sectional study conducted in Florianãpolis, Brazil, in 2016. METHODS: The subjects were 65 children and adolescents (8-15 years) diagnosed with vertically-transmitted HIV. Subtotal and lumbar-spine BMC and BMD were obtained via dual-emission X-ray absorptiometry (DXA). HGS was measured using manual dynamometers. The covariates of sex, ART, CD4+ T lymphocytes and viral load were obtained through questionnaires and medical records. Sexual maturation was self-reported and physical activity was measured using accelerometers. Simple and multiple linear regression were used, with P < 0.05. RESULTS: HGS was directly associated with subtotal BMD (β = 0.002; R² = 0.670; P < 0.001), subtotal BMC (β = 0.090; R² = 0.734; P = 0.005) and lumbar-spine BMC (β = 1.004; R² = 0.656; P = 0.010) in the adjusted analyses. However, no significant association was found between HGS and lumbar-spine BMD (β = 0.001; R² = 0.464; P = 0.299). CONCLUSION: HGS was directly associated with BMD and BMC in HIV-infected children and adolescents.

Factores de riesgo asociados a intento suicida en adolescentes. Unidad de cuidados intensivos pediátricos. 2018-2019 / Risk factors associated with suicide attempt in adolescents. Pediatric Intensive Care Unit. 2018-2019 / Fatores de risco associados à tentativa de suicídio em adolescentes. Unidade de terapia intensiva pediátrica. 2018-2019

RESUMEN El suicidio se considera un importante problema de salud y un verdadero drama existencial del hombre. Con el objetivo de identificar algunos factores de riesgo que se asociaron al intento suicida en adolescentes ingresados en la unidad de cuidados intensivos del Hospital Provincial Pediátrico Docente "General Luis Ángel Milanés Tamayo" en el período comprendido del 1ro enero 2018 al 31 diciembre 2019, en Granma, se realizó un estudio observacional analítico de caso y control que investigó la asociación entre el intento suicida y factores de riesgo demográficos, biológicos, socioambientales y otros relacionados con la familia. Se seleccionaron 30 casos y 60 controles. Se utilizaron métodos teóricos y empíricos y se calculó el Odd Ratio. En el análisis univariado la edad (OR=1,000, IC=0,371-2,694, p=1,000) y el sexo (OR=1,000, IC=0,334-2.991, p=1,000) no tuvieron relación con el riesgo de intento suicida. Los antecedentes personales de ansiedad (OR=6,000, IC=1,668-21.582, p=0,003) y depresión (OR=3,500, IC=1,345-9,107, p=0,008); los problemas de pareja (OR=25,375, IC=5,218-123,391p=0,000); el rechazo escolar (OR=39,333, IC=4,782-323,509, p=0,000) y los antecedentes familiares de depresión (OR=11,800, IC=1,310-106,217, p=0,007) y ansiedad (OR=14,500, IC=2,920-71,891, p=0,000) contribuyeron al riesgo de intento suicida en adolescentes. El antecedente personal de epilepsia, el antecedente familiar de alcoholismo y de suicidio en la familia no tuvieron relación estadística significativa. Los resultados obtenidos advierten sobre las posibilidades preventivas que pueden resultar viables para disminuir la incidencia de la entidad.

ABSTRACT Suicide is considered a major health problem and a true existential drama of man. In order to identify some risk factors that were associated with suicide attempts in adolescents admitted to the intensive care unit of the Provincial Pediatric Teaching General Hospital Luis Ángel Milanés Tamayo" in the period from January 1, 2018 to December 31, 2019, in Granma, an analytical observational case-control study was carried out that investigated the association between the suicide attempt and demographic, biological, socio-environmental and other risk factors. family related. 30 cases and 60 controls were selected. Theoretical and empirical methods were used and the Odd Ratio was calculated. In the univariate analysis, age (OR = 1,000, CI = 0.371-2.694, p = 1,000) and sex (OR = 1,000, CI = 0.334-2.991, p = 1,000) were not related to the risk of suicide attempt. The personal history of anxiety (OR = 6,000, CI = 1,668-21,582, p = 0.003) and depression (OR = 3,500, CI = 1,345-9.107, p = 0.008); relationship problems (OR = 25.375, CI = 5.218-123.391p = 0.000); school refusal (OR = 39.333, CI = 4.782-323.509, p = 0.000) and family history of depression (OR = 11.800, CI = 1.310-106.217, p = 0.007) and anxiety (OR = 14.500, CI = 2.920- 71.891, p = 0.000) contributed to the risk of suicide attempt in adolescents. The personal history of epilepsy, the family history of alcoholism and suicide in the family did not have a significant statistical relationship. The results obtained warn about the preventive possibilities that may be viable to reduce the incidence of the entity.

RESUMO O suicídio é considerado um grande problema de saúde e um verdadeiro drama existencial do homem. A fim de identificar alguns fatores de risco associados à tentativa de suicídio em adolescentes internados na unidade de terapia intensiva do Hospital Geral Provincial de Pediatria Luis Ángel Milanés Tamayo "no período de 1º de janeiro de 2018 a 31 de dezembro de 2019, no Granma, foi realizado um estudo observacional analítico caso-controle que investigou a associação da tentativa de suicídio com dados demográficos, biológicos, socioambientais e outros fatores de risco relacionados à família. 30 casos e 60 controles foram selecionados. Foram utilizados métodos teóricos e empíricos e calculada a Odd Ratio. Na análise univariada, idade (OR = 1.000, IC = 0,371-2,694, p = 1.000) e sexo (OR = 1.000, IC = 0,334-2,991, p = 1.000) não foram relacionados ao risco de tentativa de suicídio. A história pessoal de ansiedade (OR = 6.000, IC = 1.668-21.582, p = 0,003) e depressão (OR = 3.500, IC = 1.345-9,107, p = 0,008); problemas de relacionamento (OR = 25,375, CI = 5,218-123,391p = 0,000); recusa escolar (OR = 39,333, IC = 4,782-323,509, p = 0,000) e história familiar de depressão (OR = 11,800, IC = 1,310-106,217, p = 0,007) e ansiedade (OR = 14,500, IC = 2,920-71,891, p = 0,000) contribuiu para o risco de tentativa de suicídio em adolescentes. A história pessoal de epilepsia, a história familiar de alcoolismo e suicídio na família não tiveram relação estatística significativa. Os resultados obtidos alertam sobre as possibilidades preventivas que podem ser viáveis ​​para reduzir a incidência da entidade.

Aborto en la adolescencia, un reto como problema biopsicosocial actual para la Atención Primaria de Salud / Abortion in adolescence, a challenge as a current biopsychosocial problem for Primary Health Care / Aborto na adolescência, um desafio como problema biopsicossocial atual para a Atenção Básica à Saúde

RESUMEN El impacto del aborto como problema social y psicológico, es un tema tratado en todas sus dimensiones, así como su situación mundial y sobre todo la cubana actual. Trabajos de investigación, toman en cuenta diferentes latitudes tales como su caracterización, las justificativas para la toma de decisión de abortar además de su repercusión económica y biopsicosocial. La educación sexual y reproductiva puede ayudar a que el aborto no se convierta en un método anticonceptivo como tal, el cual representa un problema que compromete la salud reproductiva de las adolescentes tanto desde el punto de vista biológico, psicológico, como social, sino como otra elección en la toma de decisiones ante un embarazo no deseado que conlleva a la realización de este proceder teniendo como una de las principales razones no sentirse preparadas para ser madres en ese momento.

ABSTRACT The impact of abortion as a social and psychological problem is a subject dealt with in all its dimensions, as well as its world situation and especially the current Cuban one. Research works take into account different latitudes such as their characterization, the justifications for the decision to abort, as well as their economic and biopsychosocial repercussions. Sexual and reproductive education can help prevent abortion from becoming a contraceptive method as such, which represents a problem that compromises the reproductive health of adolescents both from a biological, psychological, and social point of view, but from another point of view, choice in decision-making in the face of an unwanted pregnancy that leads to the performance of this procedure, one of the main reasons being not feeling prepared to be mothers at that time.

RESUMO O impacto do aborto como problema social e psicológico é um assunto tratado em tod,as as suas dimensões, bem como a sua situação mundial e especialmente a cubana atual. Os trabalhos de pesquisa levam em consideração diferentes latitudes como sua caracterização, as justificativas para a decisão de abortar, bem como suas repercussões econômicas e biopsicossociais. A educação sexual e reprodutiva pode ajudar a evitar que o aborto se torne um método anticoncepcional propriamente dito, o que representa um problema que compromete a saúde reprodutiva dos adolescentes tanto do ponto de vista biológico, psicológico e social, quanto de outro ponto de vista, fazer frente a uma gravidez indesejada que leva à realização desse procedimento, sendo um dos principais motivos o fato de não se sentir preparada para ser mãe naquele momento.

Pregnant again? Perspectives of adolescent and young mothers who and do not experience a repeat pregnancy in adolescence.

Introduction: Teen pregnancy remains a major social and public health issue in developing countries. Each additional child compromises the development of both the mother and children. Scarce studies have been performed in Latin America.Purpose: This study explores and analyzes individual and family factors associated with repeat pregnancies during adolescence to better elucidate the phenomenon.Methods: Qualitative-descriptive study. Thirty semi-structured interviews were conducted with mothers 20 years of age or younger from urban areas of Santiago, Chile. Participants were divided into Repeat Pregnancy (RP) and No Repeat Pregnancy (NRP) groups. Qualitative data analysis was based on elements of grounded theory.Results: The RP group generally related life stories reflecting greater psychosocial vulnerability. Most of the RP group dropped out of school after their first pregnancy to focus on parenting and had a passive attitude towards contraception. In contrast, members of the NRP group actively sought long-term contraceptive methods, motivated largely by the desire to continue their education to improve their living conditions and achieve greater personal fulfilment. They tended to have family support networks that facilitated school retention.Conclusion: Key differences between groups included use of contraception, focus on life projects, and motivation to finish school. Prevention strategies should promote long-term contraceptive methods, offer strategies to help young mothers continue their education, facilitate achievement of personal projects, and provide support for parenting.

School Nurses on the Front Lines of Healthcare: A Guide in the Recognition of and Response to Teen Dating Violence in Your Schools.

Teen dating violence (TDV) has become more prevalent in our schools, exacerbated by the omnipotent presence of social media and portals of what dating and gender roles "should be" in Hollywood films and television shows. It is important to recognize that TDV is a threat to mental health, and potentially physical health, and school nurses should develop a framework for recognizing problematic social, physical, and emotional interactions between students. This article describes typical presentations of TDV through a case, providing a mnemonic for recognition and resources for prevention.

NM GRADS: Lessons Learned from Implementing a School-Based Program for Young Parents Across New Mexico.

PURPOSE: The New Mexico Graduation Reality and Dual-role Skills (GRADS) program provides services for expectant and parenting students at high schools. The GRADS program has operated since 1989, serving more than 17,000 youth. This study summarizes the GRADS program model and program administrators' lessons learned from implementing this comprehensive, large-scale program. DESCRIPTION: The GRADS program is a multicomponent intervention that can include a classroom intervention, case management, linkages to child care and health care, and support for young fathers. The program aims to support expectant and parenting youth in finishing high school, delaying a repeat pregnancy, promoting health outcomes for their children, and preparing for college and career. This study presents program administrators' lessons learned to increase understanding of how to implement a statewide program to support expectant and parenting students. ASSESSMENT: During the 2010-2017 school years, the GRADS program operated in 26-31 sites each year, serving a total of 2691 parenting youth. Program administrators identified lessons learned from implementing the GRADS program during that period of expansion, including allowing variation across sites based on resources and needs, providing centralized implementation support, fostering buy-in from school and district leaders, and collecting consistent data to better understand participant outcomes. CONCLUSIONS: Although not based on a rigorous impact or implementation study, this article provides lessons learned from a statewide, school-based program that may be a promising way to serve a large number of expectant and parenting youth and help them overcome challenges for completing high school.

Infección del tracto urinario y amenaza de parto pretérmino en gestantes adolescentes de un Hospital peruano / Urinary Tract Infection And Threatened Preterm Delivery In Teenage Pregnancies Of A Peruvian Hospital

Introducción: La amenaza de parto pretérmino puede causar desenlaces graves, por lo que es necesario evaluar sus determinantes. Objetivo: Determinar si la infección del tracto urinario (ITU) es un factor asociado a amenaza de parto pretérmino en gestantes adolescentes del hospital Sergio E. Bernales 2018 ­ 2019. Métodos: Estudio observacional analítico de casos y controles. Conformado por gestantes adolescentes internadas en el servicio de ginecobstetricia del hospital Sergio E. Bernales en 2018-2019. Se calcularon los OR crudos y ajustados para los posibles factores con fusor es en base a modelos de regresión logística. Considerándose el valor p<0,05 como significativo. Resultados: Los resultados del modelo de regresión logística ajustado mostraron que la amenaza de parto se asoció significativamente con la ITU (OR=2,68, IC 95%: 1,3­5,3) y con la presencia de ruptura prematura de membranas (OR=15, IC 95%: 5,9­37,9). Conclusión: La infección del tracto urinario es un factor asociado a la amenaza de parto pretérmino en gestantes adolescentes.

Introduction: The threatened preterm delivery can cause serious outcomes, so it is necessary toevaluate its causes. Objective: to determine if urinary tract infection (UTI) is a factor associated withthe threatened preterm delivery in pregnant teenages at the Hospital Sergio E. Bernales 2018 ­ 2019.Methods: Observational analytical case-control study. The study included pregnant teenages admittedto the gynecology and obstetrics service of the Hospital Sergio E. Bernales 2018 ­ 2019. Crude andadjusted ORs were calculated for possible confounding factors based on logistic regression models.Considering the p <0.05 value as significant. Results: The median age was 18 years. The results ofthe adjusted logistic regression model were that the threatened preterm delivery had a significantassociation with UTI (OR = 2.68, 95% CI: 1.3­5.3) and RPM (OR = 15, 95 CI. %: 5.9­37.9). Conclusion:Urinary tract infection is a factor associated with the threatened preterm delivery in pregnant teens.

Patterns of perpetration and perceptions of teen dating violence / Padrões de perpetração e percepções de violência nas relações afetivo-sexuais na adolescência / Modelos de perpetración y percepciones de violencia en las relaciones afectivo-sexuales en la adolescencia

This study investigated patterns of perpetration and perceptions of teen dating violence (TDV) in a sample of 428 adolescents characterized as perpetrators (62.4% female, M=16.73 years of age, SD=1.20) from the metropolitan region of Porto Alegre, state of Rio Grande do Sul (RS), Brazil. There was also a comparison group of 132 non-perpetrators (51.5% female, M=16.54 years of age, SD=1.19). The research instruments were a sociodemographic questionnaire, 15 items about the perception of TDV and the Conflict in Adolescent Dating Relationships Inventory (CADRI). We found a rate of 76.43% for the perpetration of some type of TDV and the most frequent was verbal/emotional violence (91.1%). The data showed that adolescents (perpetrators and non-perpetrators) have difficulty recognizing abusive behaviors, legitimizing the use of violence in their romantic relationships. Considering dating violence is a predictor of adult marital violence, the need to raise awareness of the phenomenon and the possibility of preventing TDV is discussed in this study. (AU)

Este estudo investigou padrões de perpetração e percepções de violência nas relações afetivo-sexuais na adolescência (VRASA), em uma amostra de 428 adolescentes caracterizados como perpetradores (62,4% sexo feminino, M = 16,73 anos; DP = 1,20), da região metropolitana de Porto Alegre/RS. Foi adotado um grupo de comparação, composto por 132 adolescentes não perpetradores (51,5% sexo feminino, M = 16,54 anos; DP = 1,19). Os instrumentos utilizados foram questionário sociodemográfico, itens sobre percepção de VRASA e o Inventário de Conflitos nas Relações de Namoro na Adolescência. Foi observada uma taxa de 76,43% para perpetração de algum tipo de VRASA, sendo a mais frequente a violência verbal/emocional (91,1%). Os dados mostram que adolescentes perpetradores e não perpetradores têm dificuldade em reconhecer comportamentos abusivos, legitimando o uso da violência em suas relações amorosas. Considerando que a violência no namoro é preditora da violência conjugal adulta, discute-se a necessidade de uma maior visibilidade do fenômeno, assim como possibilidades de prevenção de VRASA. (AU)

Este estudio investigó los modelos de perpetración y percepciones de violencia en las relaciones afectivo-sexuales en la adolescencia (VRASA), en una muestra de 428 adolescentes caracterizados como perpetradores (62,4% sexo femenino, M = 16,73 años, DP = 1,20), de la región metropolitana de Porto Alegre/RS. Fue adoptado un grupo para comparación, compuesto por 132 adolescentes no perpetradores (51,5% sexo femenino, M = 16,54 años, DP = 1,19). Los instrumentos utilizados fueron cuestionario sociodemográfico, ítems sobre percepción de VRASA y el Inventario de Conflictos en las Relaciones de Enamorar en la Adolescencia). Fue observada una tasa de 76,43% para la perpetración de algún tipo de VRASA, siendo la más frecuente la violencia verbal/emocional (91,1%). Los datos muestran que adolescentes perpetradores y no perpetradores tienen dificultad en reconocer comportamientos abusivos, legitimando el uso de la violencia en sus relaciones amorosas. Considerando que la violencia en el noviazgo es predictora de la violencia conyugal adulta, se discute la necesidad de una mayor visibilidad del fenómeno así como posibilidades de prevención de VRASA. (AU)