Eliciting the child's voice in adverse event reporting in oncology trials: Cognitive interview findings from the Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events initiative.

BACKGROUND: Adverse event (AE) reporting in oncology trials is required, but current practice does not directly integrate the child's voice. The Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) is being developed to assess symptomatic AEs via child/adolescent self-report or proxy-report. This qualitative study evaluates the child's/adolescent's understanding and ability to provide valid responses to the PRO-CTCAE to inform questionnaire refinements and confirm content validity. PROCEDURE: From seven pediatric research hospitals, children/adolescents ages 7-15 years who were diagnosed with cancer and receiving treatment were eligible, along with their parent-proxies. The Pediatric PRO-CTCAE includes 130 questions that assess 62 symptomatic AEs capturing symptom frequency, severity, interference, or presence. Cognitive interviews with retrospective probing were completed with children in the age groups of 7-8, 9-12, and 13-15 years. The children/adolescents and proxies were interviewed independently. RESULTS: Two rounds of interviews involved 81 children and adolescents and 74 parent-proxies. Fifteen of the 62 AE terms were revised after Round 1, including refinements to the questions assessing symptom severity. Most participants rated the PRO-CTCAE AE items as "very easy" or "somewhat easy" and were able to read, understand, and provide valid responses to questions. A few AE items assessing rare events were challenging to understand. CONCLUSIONS: The Pediatric and Proxy PRO-CTCAE performed well among children and adolescents and their proxies, supporting its content validity. Data from PRO-CTCAE may improve symptomatic AE reporting in clinical trials and enhance the quality of care that children receive.

Concept-elicitation phase for the development of the pediatric patient-reported outcome version of the Common Terminology Criteria for Adverse Events.

BACKGROUND: Symptoms arising from disease or treatment are subjective experiences. Insight into pediatric oncology treatment side effects or symptoms is ideally obtained from direct inquiry to the ill child. A concept-elicitation phase in a patient-reported outcome (PRO) instrument design provides an opportunity to elicit children's voices to shape cancer symptom selection and terminology. METHODS: Through semistructured, one-on-one, voice-recorded interviews, symptom data were collected from 96 children with cancer between the ages of 7 and 20 years who were undergoing oncologic treatment at 7 pediatric oncology sites in the United States and Canada. RESULTS: The mean number of symptoms reported per child over the prior 7 days was 1.49 (range, 0-7; median, 1; standard deviation, 1.56). The most common symptoms across all age groups were tiredness or fatigue, nausea or vomiting, aches or pains, and weakness. There was not a statistically significant correlation between self-reported wellness and the number of reported symptoms (r = -0.156, n = 65, P = .215) or the number of symptoms reported by age group or diagnosis type. Forty participants reported experiencing a change in their body in the past week, with one-third of these changes unanticipated. Only through direct questions about feelings were emotional symptoms revealed because 90.6% of interviewees who discussed feelings (48 of 53) did so only in the context of direct questioning on feelings. Adolescents were more likely than younger children to discuss feelings as part of the interview. CONCLUSIONS: Concept elicitation from children and adolescents has the potential to enable researchers to develop age-appropriate, accurately representative PRO measures.

Predicting epidemic risk from past temporal contact data.

Understanding how epidemics spread in a system is a crucial step to prevent and control outbreaks, with broad implications on the system's functioning, health, and associated costs. This can be achieved by identifying the elements at higher risk of infection and implementing targeted surveillance and control measures. One important ingredient to consider is the pattern of disease-transmission contacts among the elements, however lack of data or delays in providing updated records may hinder its use, especially for time-varying patterns. Here we explore to what extent it is possible to use past temporal data of a system's pattern of contacts to predict the risk of infection of its elements during an emerging outbreak, in absence of updated data. We focus on two real-world temporal systems; a livestock displacements trade network among animal holdings, and a network of sexual encounters in high-end prostitution. We define the node's loyalty as a local measure of its tendency to maintain contacts with the same elements over time, and uncover important non-trivial correlations with the node's epidemic risk. We show that a risk assessment analysis incorporating this knowledge and based on past structural and temporal pattern properties provides accurate predictions for both systems. Its generalizability is tested by introducing a theoretical model for generating synthetic temporal networks. High accuracy of our predictions is recovered across different settings, while the amount of possible predictions is system-specific. The proposed method can provide crucial information for the setup of targeted intervention strategies.

Behind prison walls: HIV vulnerability of female Filipino prisoners.

PURPOSE: The imprisoned population is increasing worldwide and is overrepresented in the HIV epidemic. The purpose of this paper is to explore the HIV vulnerability of female Filipinos who are pre-trial prisoners, as the specific needs of imprisoned women are poorly understood and fewer resources are granted to pre-trial detainees, especially in low and middle-income countries (LMICs). DESIGN/METHODOLOGY/APPROACH: This study was based on a Qualitative Descriptive Design. In total, 18 semi-structured interviews were conducted with prisoners and NGO directors. Data were analysed through Framework Analysis, using the individual, social and community categories of the Modified Socio-Ecological Model. FINDINGS: Results from this study suggest that the prison environment and management practices maximise the HIV vulnerability in the sample. This vulnerability is shaped by low HIV knowledge, combined with the existence of multiple social vulnerabilities prior to incarceration. SOCIAL IMPLICATIONS: HIV care in Filipino prisons needs urgent attention from government and international organisations, as it is a major public health and human rights concern. International goals of ending the epidemic by 2030 cannot be reached if efforts are not translated into action within this setting. ORIGINALITY/VALUE: In the Philippines, few studies have addressed this issue and little is known about the conditions of Filipino prisons. This paper aims to fill a gap in literature regarding the vulnerability of imprisoned women in LMICs, which is even more limited in examining pre-trial detention.

Levels of Myeloperoxidase and Metalloproteinase-9 in Gingival Crevicular Fluid from Diabetic Subjects with and without Stage 2, Grade B Periodontitis.

OBJECTIVE: The present study aimed to compare levels of matrix metalloproteinase-9 (MMP-9) and myeloperoxidase (MPO) in gingival crevicular fluid (GCF) from subjects with controlled and noncontrolled Type 2 Diabetes Mellitus (T2D), with and without stage 2 grade B periodontitis (POD2B) versus healthy (H) subjects. METHODS: The levels of both enzymes, from 80 GCF samples collected with PerioPaper strips, were analyzed by a Multiplex/Luminex assay. Five groups were formed, all current patients at the Institutional Dentistry Service, and distributed as follows: two groups of diabetics (one controlled and one poorly controlled); two groups with the previous conditions and diagnosed with POD2B; and one H group. RESULTS: The highest concentration of MMP-9 corresponded to the H group, while the lowest corresponded to the T2D controlled group. Regarding MPO levels, the highest levels were associated with the T2D controlled with POD2B group and the lowest with the T2D controlled group. CONCLUSIONS: No apparent relationship between the elevation of MMP-9 and MPO levels was observed among subjects with T2D, with and without POD2B, compared to H subjects.

Cognitive Interview-Based Validation of the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events in Adolescents with Cancer.

CONTEXT: The National Cancer Institute created the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) to allow direct input on symptomatic adverse events (AEs) from adult patients in oncology trials. OBJECTIVES: This study sought to determine the youngest age to complete the PRO-CTCAE, evaluated comprehension of PRO-CTCAE among adolescents, tested new items not currently in PRO-CTCAE, and tested a parent-proxy version. METHODS: From seven pediatric cancer hospitals, 51 adolescents (13-20 years) receiving cancer treatment participated, along with 40 parent proxies. We evaluated 55 AEs from the PRO-CTCAE library (97 questions) and seven new AEs not in PRO-CTCAE that assess symptom frequency, severity, interference, or presence. Questions were distributed across three forms to reduce burden. Cognitive interviews with retrospective probing were completed in age groups of 13-15 and 16-20 year olds. Proxies were interviewed independently. RESULTS: In general, the 16-20 year olds and the parent proxies were able to understand and complete the PRO-CTCAE and newly designed AE questions. Five PRO-CTCAE terms (bloating of the abdomen, anxiety, flashing lights in front of your eyes, hot flashes, and bed sores) and the wording of the questions about AE severity were challenging for a few adolescents and proxies. The 13-15 year olds had greater challenges completing the PRO-CTCAE. CONCLUSION: This study extends use of the adult PRO-CTCAE for adolescents as young as 16 years and proposes new questions for seven new symptomatic AEs and a parent-proxy version of PRO-CTCAE. Additional testing of the new questions and alternative language for more challenging PRO-CTCAE items is recommended in adults.

Use of Ionized Monocalcium phosphate and enameline derivatives to reduce dentin hypersensitivity after periondontal therapy / Uso de Fostato Monocálcio y derivados en Enamelina para reducir la hipersensibilidad dentaria después de terapia periodontal

Abstract This study aimed to evaluate the effectiveness of using an ionized monocalcium phosphate and enamelin derivatives (IMP+ED) based mouthwash for the treatment of dentin hypersensitivity (DH) after scaling and root planing (SRP). 47 patients who reported DH after SRP treatment were included in this prospective cohort study. The Schiff Cold Air Sensitivity Scale (SCASS) was applied to classify their degree of pain in mild, moderate or intense at two times: after SRP (T0), and after one month of using a IMP+ED-based mouthwash (T1). The McNemar-Bowker test was used to compare the correlated proportions between both times (p<0.05). After the SRP therapy (T0), all the sample members reported pain distributed in the following manner: 12.8% were mild, 27.6% moderate, and 59.6% intense. At one month since treatment and with the use of the IMP+ED-based mouthwash (T1), the distribution of pain levels changed to 83% mild, 12.8% moderate, and 4.3% intense, this change was statistically significant (p<0.001). IMP+ED-based mouthwash produces a positive effect in reducing painful responses caused by exposure of the dentin tubules to the oral environment after SRP therapy.

Resumen El objetivo de este estudio fue evaluar la efectividad de un enjuague bucal a base de fosfato monocálcico ionizado y derivados de enamelina (FCI+DE) para el tratamiento de hipersensibilidad dentinaria (HD) posterior al tratamiento de raspado y alisado radicular (RAR). 47 pacientes que reportaron tener HD posterior al tratamiento de RAR fueron incluidos en este estudio prospectivo de cohorte. Con el fin de clasificar la HD de los pacientes en leve, moderada o intensa se utilizó la Escala de Sensiblidad al Aire Frío de Schiff (ESAFS). Los pacientes fueron evaluados después del tratamiento de RAR (T0) y posterior al uso de un enjuague bucal basado en FCI+DE (T1). Para comparar las proporciones correlacionadas se utilizó la prueba de McNemar-Bowker (p<0.05). La distribución del dolor de los pacientes posterior al tratamiento de RAR (T0) fue la siguiente: 12.8% fueron leves, 27.6% moderado, and 59.6% intenso. Un mes después del uso del enjuague buccal basado en FCI+DE (T1) la distribución en los niveles de dolor cambio a 83% leve, 12.8% moderado, and 4.3% intenso, este cambio fue estadísticamente significativo (p<0.001). El uso del enjuague bucal basado en FCI+DE produce una reducción significativa a la respuesta de dolor causada por la exposición de la dentina al ambiente oral como consecuencia del tratamiento de RAR.

Discursos de profesionales de la salud sobre la salud sexual de mujeres lesbianas y bisexuales / Health professional discourse on the sexual health of lesbian and bisexual women / Discursos de profissionais de saúde sobre a saúde sexual de mulheres lésbicas e bissexuais

Mundialmente se han reconocido diversas problemáticas que afectan la salud sexual de las mujeres lesbianas y bisexuales, pero poco se conoce sobre la realidad en Colombia. Factores como la homofobia y el heterosexismo en la atención en salud retrasan el diagnóstico y el tratamiento, e impiden el acceso a este servicio. Por tanto, es importante comprender las perspectivas de los proveedores. Este estudio cualitativo explora los discursos y las prácticas de seis profesionales de la salud en Cali, Colombia sobre la salud sexual de esta población. Los participantes, provenientes de diferentes áreas de la salud, tenían entre 15 y 30 años de experiencia en su campo. Los resultados señalan brechas en el conocimiento y en la praxis en la atención en salud, que deben ser fortalecidas para proveer una atención de calidad y que reconozca las necesidades de las poblaciones diversas.(AU)

Although factors affecting the sexual health of lesbian and bisexual women are widely recognized, little is known about the reality in Colombia. Attitudes such as homophobia and heterosexism in healthcare services delay diagnosis and treatment and hinder access to services. It is therefore important to understand the perspectives of the people who provide these services. This qualitative study explores the discourse and practices of health professionals working in different areas of healthcare in Cali, Colombia, in relation to this group. Six professionals with between 15 and 30 years of experience in their field took part in the study. The findings reveal gaps in knowledge and in the praxis of healthcare, which must be strengthened to provide the quality of healthcare and the recognition of the needs of diverse populations.(AU)

Embora o mundo todo reconheça várias questões que afetam a saúde sexual de mulheres lésbicas e bissexuais, pouco se sabe sobre a realidade na Colômbia. Fatores como a homofobia e heterossexismo na atenção à saúde retardam o diagnóstico e tratamento e impedem o acesso aos serviços, por isso é importante compreender as perspectivas dos provedores. Este estudo qualitativo explora os discursos e as práticas de seis profissionais de saúde em Cali, Colômbia sobre a saúde sexual dessa população. São profissionais de diferentes áreas da saúde, com idades entre 15 e 30 anos de experiência no seu campo. Os resultados apontam lacunas no conhecimento e na práxis da atenção à saúde, que deve ser fortalecida para prover uma atenção de qualidade e o reconhecimento das necessidades das diversas populações.(AU)

"La solución es la tijera": Programa de Salud Sexual para Mujeres Lesbianas y Bisexuales / "La solución es la tijera": Programa de Saúde Sexual Orientado a Mulheres Lésbicas e Bissexuais / "La Solución es la Tijera" (The Solution is Scissors): Sexual Health Programme Oriented to Lesbian and Bisexual Women

RESUMEN La inclusión de las mujeres lesbianas y bisexuales en las agendas de promoción de la salud sexual es escasa. Sin embargo, los riesgos en sus prácticas sexuales han sido reconocidos científicamente. Este artículo presenta los resultados principales del programa de intervención "La solución es la tijera" dirigido a mujeres lesbianas y bisexuales jóvenes de Cali, Colombia. Participaron 23 mujeres entre los 18 y los 25 años de edad (X= 21.7; DS=1.78). La evaluación se realizó de manera pre- post a través de una metodología mixta. Se encontró un cambio significativo en los niveles de conocimientos y las actitudes frente al VIH. Asimismo, se reportó el fortalecimiento de la identidad, el empoderamiento en su sexualidad y los conocimientos sobre derechos sexuales y reproductivos.

RESUMO A inclusão das mulheres lésbicas e bissexuais na agenda de promoção de saúde é escassa. No entanto, os riscos existentes em suas práticas sexuais foram cientificamente reconhecidos. Este artigo pretende apresentar os principais resultados do programa "La Solución es la Tijera" orientado para mulheres lésbicas e bissexuais de Cali, na Colômbia. Vinte e três mulheres entre 18 e 25 anos de idade (X = 21,7; DS = 1,78) participaram deste estudo. A avaliação do programa foi realizada com um design de pre-post, usando metodologias mistas. Foram encontradas alterações significativas nos níveis de conhecimento e atitudes em relação a HIV. Da mesma forma, relatou-se reforço em sua identidade e empoderamento em sua sexualidade e conhecimento sobre direitos sexuais e reprodutivos.

ABSTRACT The inclusion of lesbian and bisexual women on health promotion agenda is scarce. However, the existing risks in their sexual practices have been scientifically recognized. This article presents the main results of the program "La Solución es la Tijera" oriented to lesbian and bisexual women from Cali, Colombia. Twenty-three women between 18 and 25 years old ((X= 21.7; DS=1.78) participated in this study. The program evaluation was conducted with a pre-post design, using mixed methodologies. Significant changes in the knowledge level and attitudes towards HIV were found. Likewise, a strengthening in their identity and an empowerment in their sexuality and knowledge about sexual and reproductive rights was reported by the participants.

Factores psicosociales asociados a los patrones de consumo de alcohol en adolescentes escolarizados / Psychosocial Factors Associated With Alcohol Consumption Patterns among Adolescent Students

Resumen Este estudio relaciona los factores psicosociales a los patrones de consumo de alcohol en adolescentes escolarizados. En él participaron un total de 284 adolescentes entre 12 y 18 años. El instrumento utilizado se construyó a partir del cuestionario FPACA, el cuestionario RUMBOS; el cuestionario FRP- SPA, el cuestionario de consumo de alcohol-RPGCA, el cuestionario APGAR y el cuestionario FACES. Los resultados muestran que existe una relación significativa entre el consumo y la jornada de estudio, el funcionamiento familiar y el grado escolar. Se resalta la importancia de fortalecer las relaciones familiares y enfocarse en los factores protectores para evitar que el adolescente presente un patrón de consumo de alcohol perjudicial o dependiente.

Abstract This article addresses psychosocial factors and alcohol consumption patterns in adolescent students. A total of 284 adolescents between 12 and 18, participated in the study. The instrument was built from the FPACA questionnaire, the RUMBOS questionnaire, FRP- SPA questionnaire, the questionnaire of alcohol consumption RPGCA, the questionnaire of family functioning APGAR and FACES. The main findings show a significant link between consumption and duration of school day, family functioning and grade. Therefore, it is important to strengthen family relationships and improve protective factors to prevent a harmful or dependent pattern of alcohol consumption in the population.

Sexualidad en hombres adolescentes escolarizados: un análisis comparativo entre instituciones públicas y privadas en Colombia / Sexuality in Schooled Men Adolescents: A Comparative Analysis between Public and Private Institutions in Colombia / Sexualidade em homens adolescentes escolarizados: uma análise comparativa entre instituições públicas e privadas na Colômbia

Resumen Introducción: caracterizar los conocimientos, actitudes, prácticas sexuales y procesos de comunicación familiar de hombres adolescentes de escuelas públicas y privadas, para visibilizar aspectos fundamentales en el abordaje de su salud sexual. Materiales y métodos: se realiza análisis descriptivo de datos correspondientes al subgrupo de hombres (n = 778) del estudio "Procesos de comunicación de sexualidad entre padres e hijos", realizado durante 2012 en 23 instituciones educativas de Cali, Colombia, donde participaron 1225 adolescentes de ambos sexos. Se utilizó un cuestionario específicamente diseñado para el estudio, los datos se procesaron mediante el programa SPSS V.20 y se utilizó la prueba t-Student, el Análisis de Varianza ANOVA y la prueba Chi-cuadrado, con un nivel de significación de 0.05 (5 %). Resultados: participaron 778 jóvenes entre 11-20 años de edad (media 15.3 años, DS = 1.6), de 12 instituciones públicas (n = 535) y 11 privadas (n = 123). Los jóvenes de instituciones privadas reportaron mayor acceso (p = 0.010) y recepción de información en sexualidad (p = 0.045). No se observó diferencia en edad de inicio de coito (media 13.2 años, DS 1.9) ni en no-uso sistemático del condón (p = 0.068), pero ambos grupos presentan dificultades en la comunicación en sexualidad con sus padres. Los estudiantes de instituciones públicas reportaron mayor frecuencia de prácticas sexuales anales (p = 0.002) sin uso adecuado de protección. Conclusión: el nivel de conocimiento de los jóvenes no se traduce en prácticas sexuales seguras, confirmándose la necesidad de diseñar programas con perspectiva de género que trasciendan la provisión de información y de crear acompañamientos que los empoderen en el autocuidado de su salud sexual.

Abstract Introduction: To describe knowledge, attitudes, sexual behavior and family communication among male teenagers from private and public schools, aiming to highlight key aspects for understanding their behavior and providing better sexual health care. Materials and methods: A descriptive analysis of the retrieved data corresponding to male participants (n = 778) in the study "Communication processed about sexuality between parents and teenage children" was made. This study was conducted in 2012, in 23 schools in Cali and 1225 adolescents of both genders participated. A specific questionnaire was built for this research. Data was processed through the software SPSS V. 20 (Statistical Package for the Social Sciences) and statistical test such as T-Student, ANOVA and Chi-square were used with a significant lever of 0.05 (5 %). Results: 778 male teenagers between 11- 20 years old (M = 15.3; SD = 1.6) participated in the study, from 12 from public schools (n = 535) and 11 private schools (n = 123). It was found that teenagers from private schools have more access (p = 0.010) and reception of information about sexuality (p = 0.045), but without difference in the age of sexual debut (m = 13.2 years; SD= 1.9) and systematic use of condom (p = 0.068). Likewise, both groups reported barriers in communication about sexuality with their parents. Those from public schools were more likely to report non-protected anal intercourse (p = 0.002). Conclusion: Sexual health knowledge does not imply safer sex behaviors in male adolescents, it was confirmed that programs must have a gender perspective that transcend knowledge provision and create strategies to empower male teenagers in their sexual health self-care.

Resumo Introdução: caracterizar os conhecimentos, atitudes, práticas sexuais e processos de comunicação familiar de homens adolescentes de escolas públicas e privadas, para visibilizar aspectos fundamentais na abordagem de sua saúde sexual. Materiais e métodos: realiza-se análise descritiva de dados correspondentes ao subgrupo de homens (n = 778) do estudo "Processos de comunicação de sexualidade entre pais e filhos", realizado durante o 2012 em 23 instituições educativas de Cali, Colômbia, onde participaram 1225 adolescentes de ambos os sexos. Se utilizou um questionário especificamente criado para o estudo, os dados se processaram mediante o programa SPSS V.20 e se utilizou a prova t-Student, a Análise de Variância ANOVA e a prova Chi-quadrado, com um nível de significância de 0.05 (5 %). Resultados: participaram 778 jovens entre 11-20 anos (idade média 15.3 anos, DS = 1.6), de 12 instituições públicas (n = 535) e 11 privadas (n = 123). Os jovens de instituições privadas reportaram maior acesso (p = 0.010) e receção de informação em sexualidade (p = 0.045). Não se observou diferença em idade de início de coito (idade média 13.2 anos, DS 1.9) nem em não-uso sistemático do preservativo (p = 0.068), mas ambos os grupos apresentam dificuldades na comunicação em sexualidade com os seus pais. Os estudantes de instituições públicas reportaram maior frequência de práticas sexuais anais (p = 0.002) sem uso adequado de proteção. Conclusão: o nível de conhecimento dos jovens não se traduz em práticas sexuais seguras, confirmando-se a necessidade de desenhar programas com perspectiva de gênero que transcendam a provisão de informação e de criar acompanhamentos que os empoderem no autocuidado de sua saúde sexual.

Considerations for the design of Human Immunodeficiency Virus (HIV) prevention programs for lesbian and bisexual women / Considerações para a elaboração de programas de prevenção do Vírus da Imunodeficiência Humana (VIH) para as mulheres lésbicas e bissexuais / Consideraciones para la elaboración de programas de prevención del Virus de la Inmunodeficiencia (VIH) para las mujeres lesbianas y bisexuales

Several strategies and guidelines for HIV prevention in different population groups have been established throughout the epidemic. However, there is an urgent need to include lesbian and bisexual women (LB women) in prevention programs and address their particular health care needs. This paper discusses key aspects that must be considered in the design of HIV prevention programs oriented toward this specific population. Due to the lack of research assessing prevention strategies for LB women, these reflections emerged by reviewing literature in similar groups and by the direct work of the authors within this group. Their inclusion in the HIV prevention agenda is essential to safeguard their right to health care in terms of receiving accurate information about sexuality and health, participating in health care programs and being treated equally and without any discrimination.

Várias estratégias e diretrizes para a prevenção da epidemia do HIV foram estabelecidas para diferentes populações. No entanto, há uma necessidade de incluir as mulheres lésbicas e bissexuais (mulheres LB) em programas de prevenção e resposta às suas necessidades de saúde particulares. Este artigo discute os principais aspectos que devem ser considerados na elaboração de programas de prevenção do VIH voltadas para essa população específica. Devido à falta de pesquisas avaliando estratégias de prevenção para as mulheres LB, essas reflexões emergiram através da revisão da literatura em grupos similares e pelo trabalho direto dos autores nesse grupo. A sua inclusão na agenda da prevenção do VIH é essencial para salvaguardar o seu direito a cuidados de saúde em termos de receber informações precisas sobre sexualidade e saúde, participe de programas de saúde e ser tratados com igualdade e sem discriminação.

Se establecieron diversas estrategias y directrices para la prevención de la epidemia de VIH para diferentes poblaciones. Sin embargo, hay una necesidad de incluir a las mujeres lesbianas y bisexuales (mujeres LB) en programas de prevención y respuesta a sus necesidades particulares de salud. Este artículo discute los principales aspectos que deben considerarse en la elaboración de programas de prevención del VIH, enfocados para esa población específica. Debido a la falta de investigación que evalúe estrategias de prevención para las mujeres LB, esas reflexiones surgieron por medio de la revisión de la literatura en grupos similares y por el trabajo directo de los autores en ese grupo. Su inclusión en la agenda de la prevención del VIH es esencial para salvaguardar su derecho a cuidados de salud en lo que se refiere a recibir informaciones precisas sobre sexualidad y salud, participación en programas de salud y tratamiento con igualdad y sin discriminación.

HIV Risk Perception in Young Homosexual Women from Cali, Colombia / Percepção de risco de VIH em mulheres homossexuais jovens de Cali, Colômbia / Percepción de riesgo frente al VIH en mujeres homosexuales jóvenes de Cali, Colombia

Risk perception is a cognitive process that allows people to organize information and assess their exposure to a hazard. Therefore, this study aimed to describe the risk perception towards HIV in young homosexual women from Cali, Colombia. Six homosexual women participated in this research, which has a qualitative narrative design. Data was collected using semi-structured interviews and analyzed through Thematic Analysis. The findings indicate that women have low knowledge about HIV and the use of preventive methods was not reported. It was found that their beliefs about HIV have been built on their interaction with peers and health service providers. These results provide an initial understanding of how and why to develop comprehensive prevention strategies for this population

A percepção de risco é um processo cognitivo que permite organizar e avaliar a exposição a uma ameaça. Portanto, o objetivo deste estudo é descrever a percepção de risco para o HIV de um grupo de mulheres homossexuais de Cali, na Colômbia. Desta pesquisa, com desenho narrativo, participaram seis mulheres homossexuais. Os dados foram coletados através de entrevistas semiestruturadas e analisados por meio de uma análise temática. Os resultados indicam que as mulheres têm um baixo nível de conhecimento sobre o HIV e o uso de medidas preventivas não foi relatado. Verificou-se que suas crenças sobre o HIV foram construídas em interação com seus pares e seus provedores de serviços de saúde. Esses resultados fornecem uma compreensão inicial de como e por que estratégias adequadas de intervenção devem ser desenvolvidas para essa população

La percepción de riesgo es un proceso cognitivo que permite organizar y evaluar la exposición a una amenaza. Por tanto, el objetivo de este estudio es describir la percepción de riesgo frente al VIH de un grupo de mujeres homosexuales de Cali, Colombia. En esta investigación, con diseño narrativo, participaron seis mujeres homosexuales. Los datos fueron recogidos usando entrevistas semi estructuradas y analizados a través de un análisis temático. Los resultados indican que las mujeres tienen un bajo nivel de conocimientos sobre VIH y no se reportó el uso de medidas preventivas. Se encontró que sus creencias sobre el VIH se habían construido en la interacción con sus pares y sus proveedores de servicios de salud. Estos resultados proveen una comprensión inicial de cómo y porqué se deben desarrollar estrategias de intervención adecuadas para esta población

Consistencies and discrepancies in communication between parents and teenage children about sexuality / Consistências e discrepâncias na comunicação sobre sexualidade entre pais e filhos adolescentes / congruencias y discrepancias en la comunicación sobre sexualidad entre padres e hijos adolescentes

The family is one of the most important socializing agents in adolescent sex education. However, multiple barriers to communication within families have been identified. Therefore, this study aimed to characterize and understand the processes by which parents and their adolescent children communicate about sexuality. Two questionnaires were completed by 711 fathers/mothers and 566 male/female students in 21 schools in Cali (Colombia), and 15 discussion groups were formed. The results showed that conversations about sexuality focused on protection for women and on sexuality promotion for men. Furthermore, it was found that greater fluency exists in father/son and mother/daughter conversations. The largest discrepancy between parents and teenagers was the adults' belief that it is sufficient to mention certain topics in a directive manner and the children's expectations that parents will discuss the value and dynamics of the sexual experience. Embarrassment and lack of communication tools hinder communication processes.

A família é um dos principais agentes de socialização na formação da sexualidade adolescente. No entanto, diferentes barreiras de comunicação são identificadas. Esta pesquisa tem por objetivo caracterizar e compreender os processos de comunicação sobre sexualidade entre os pais e seus filhos adolescentes na cidade de Cali, Colômbia. Dois questionários foram aplicados a 711 pais/ mães e 566 alunos homens/mulheres em 21 escolas em Cali (Colômbia). Foram também conduzidos 15 grupos focais. Foram encontrados discursos de proteção sobre a sexualidade, no caso das mulheres, e incitamento para os homens. Foram relatadas mais frequentemente as conversas entre pai/filho do que entre mãe/filha. A principal discrepância é que os adultos consideram que é suficiente apresentar de maneira imperativa alguns tópicos, enquanto os seus filhos/as esperam discussões reais sobre valores e dinâmicas da experiência sexual. A vergonha e a falta de ferramentas de comunicação impedem estes processos.

La familia es uno de los agentes socializadores más importantes para la formación en sexualidad de los adolescentes. Sin embargo, se han identificado múltiples barreras en los procesos de comunicación. Por este motivo, esta investigación tuvo como objetivo caracterizar y comprender los procesos de comunicación en sexualidad entre los padres de familia y sus hijos adolescentes en la ciudad de Cali, Colombia. Se aplicaron dos cuestionarios a 711 padres/madres de familia y 566 estudiantes hombres/mujeres en 21 colegios de Cali (Colombia) y se desarrollaron 15 grupos de discusión. Se encontraron discursos de protección frente a la sexualidad hacia las mujeres y de incitación hacia los hombres. Además, se identificó que existe mayor fluidez en las conversaciones entre padre/hijo y madre/hija. La mayor discrepancia es que los adultos consideran suficiente mencionar de manera directiva ciertos temas, mientras que sus hijos/as esperan discusiones en torno a valores y dinámicas de la experiencia sexual. La vergüenza y falta de herramientas de comunicación dificultan estos procesos.

Network analysis of Italian cattle trade patterns and evaluation of risks for potential disease spread.

Livestock movement data represent a valuable source of information to understand the pattern of contacts between premises which may determine the spread of diseases. Social network analysis techniques have been used to analyse the movement patterns of cattle in Italy in 2007. A description of the structure of the Italian cattle industry is presented and the main trade flows and the relations between premises in relation to the potential spread of cattle diseases are investigated. Epidemic simulations have been carried out on the network build out of movement data using a network-based meta-population model. The simulations show the influence of the network structure on the dynamics and size of a hypothetic epidemic and give useful indications on the effects of targeted removal of nodes based on the centrality of premises within the network of animal movements.

Terapia cognitiva grupal y entrenamiento en habilidades sociales en esquizofrénicos crónicos: Clínica Monserrat, septiembre 1993, septiembre 1994 segundo año / Cognitive group therapy and social skills retraining of schizophrenic patients

Este informe preliminar presenta los resultados del segundo año de una investigación sobre terapia cognitiva grupal y entrenamiento de habilidades sociales para pacientes esquizofrénicos, iniciada en 1992. Durante el primer año, se incluyen 18 pacientes entrenados en una serie de 3 módulos secuenciales: manejo de medicación y conocimiento de síntomas positivos y negativos. El segundo año incluye 15 pacientes (cuatro continuaron del primer año y once nuevos) con criterios diagnósticos de esquizofrenia o trastorno esquizoafectivo segun el DSM III_R y de cronocidad segun los parámetros del estudio, que recibieron tratamiento por medio de técnicas cognitivas y de entrenamiento en habilidades sociales siguiendo una secuencia de dos módulos: autocuidado y habilidades en la conversación y como complementarias al tratamiento psiquiátrico convencional. Los resultados de la intervención se midieron a través de escalas de síntomas (BPRS, PANSS), calidad de vida (SBS,GAF) y número de hospitalizaciones durante la permanencia en el estudio. El grupo control estaba constituído por los mismos pacientes que un año previo al estudio recibieron tratamiento psiquiátrico convencional. Los resultados muestran una mejoría general en las escalas de síntomas, mas evidente en los síntomas negativos y durante los primeros seis meses, que se sostiene a lo largo del estudio. Las escalas de la calidad de vida mejoraron a partir del sexto mes. Hubo una disminución significativa en el número y promedio de hospitalizaciones con respecto al año anterior