1.  Title: Spatial analysis of logistics indicator data for health commodities. Author: John Snow [JSI]. DELIVER Source: Arlington, Virginia, JSI, DELIVER, 2009 Jul. 6 p. Abstract: The USAID | DELIVER PROJECT has developed robust monitoring and evaluation tools to quantitatively and qualitatively assess the performance of logistics systems for essential health commodities. The purpose of this paper is to explore how analysis of stock indicators by location provides added value to these data sets, through a relatively minor investment in GPS devices and GIS software. Beginning with visual examination of logistics indicator data within a geographic context and progressing to network analysis, each of the spatial analysis methods presented in this paper presents its own set of strengths and weaknesses, yet they all excel in providing insights into the logistics system that might not otherwise be understood or even observed by simply looking at tabular data of stock levels for different facilities in the health system. Since a logistics system is inherently a geographically heterogeneous entity, using cartographic and spatial analysis tools may prove to be a crucial asset in assisting managers to identify key questions related to the performance of the logistics system and focus on potential causes and solutions. Moving forward, it will be useful to build off of the descriptive strengths of the spatial analysis methods described herein and begin building more robust statistical models that measure correlation between different components of the logistics system and commodity availability, while still accounting for the geographical variability of the data. (Excerpts) Language: English Keywords: ZAMBIA | PARAGUAY | SUMMARY REPORT | PILOT PROJECTS | DATA COLLECTION | DATA ANALYSIS | USAID | LOGISTICS | GEOGRAPHY | INFORMATION RETRIEVAL SYSTEMS | DISTANCE | STREETS AND ROADS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | South America, Central | South America | Latin America | Americas | Studies | Research Methodology | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Management | Organization and Administration | Social Sciences | Science | Data Storage and Retrieval | Information Processing | Information | Geographic Factors | Population | Transportation | Economic Factors Document Number: 331660 |
| 2. Title: Learn without fear. Youth in action against violence in schools. Author: Plan International Deutschland Source: Hamburg, Germany, Plan International Deutschland, 2009 May. 63 p. Abstract: Plan Germany brought together children from Colombia, Germany, Ecuador, India, the Philippines, Tanzania, and Uganda to create a manual with exercises and activities to address school violence. Activities include identifying areas in school grounds which are less safe, understanding stereotypes, and helping someone who has been hurt or bullied. Language: English Keywords: ECUADOR | COLOMBIA | GERMANY | TANZANIA | UGANDA | INDIA | PHILIPPINES | TEACHING MATERIALS | SCHOOLS | YOUTH | ADOLESCENTS | VIOLENCE | PHYSICAL ABUSE | SEXUAL ABUSE | DOMESTIC VIOLENCE | PREVENTION AND CONTROL | HUMAN RIGHTS | SAFETY | Developing Countries | South America, Western | South America | Latin America | Americas | South America, Northern | Europe, Central | Europe | Developed Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Asia, Southern | Asia | Asia, Southeastern | Education | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Crime | Social Problems | Sociocultural Factors | Diseases | Political Factors | Public Health | Health Document Number: 331826 |
3.  Peer Reviewed Title: Seroreversion in children born to HIV-positive and AIDS mothers from Central West Brazil. Author: Alcantara KC; Pereira GA; Albuquerque M; Stefani MM Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jun;103(6):620-6. Abstract: The spread of HIV-1 infection among women of childbearing age has led to increasing numbers of children at risk of vertical transmission. This study aimed to assess child outcomes among HIV-positive (n=19) and AIDS (n=22) mothers from Central West Brazil. CD4(+) T-cell counts (FACScount, BD) and viral loads (HIV-1 RT-PCR, Amplicor HIV-1 Monitor Roche) were assessed at delivery and during the first 6 months of life. Heteroduplex mobility assay identified env and gag HIV-1 subtypes. Frequencies and medians were calculated. HIV-positive and AIDS mothers did not differ with regard to age, antiretroviral prophylaxis, parity and viral load. AIDS mothers had lower CD4(+) T-cell counts. One vertical transmission and a neonatal death were observed. Gestational age, gender and oral zidovudine prophylaxis were similar regardless of maternal clinical status. Infants born to AIDS mothers had lower birthweight and shorter time to seroreversion. Eight infants were lost to follow-up, and two were breastfed due to delayed maternal diagnosis. HIV-1 B(env)/B(gag) subtype were 75.6%; discordant B(env)/F(gag) were 12.2%. Exposed uninfected infants born to AIDS mothers with lower CD4(+) T-cell counts seroreverted earlier than infants born to asymptomatic HIV-positive mothers. It is possible that maternal immunological status may impact on the time to seroreversion. Language: English Keywords: BRAZIL | RESEARCH REPORT | MOTHERS | PERSONS LIVING WITH HIV/AIDS | MOTHER-TO-CHILD TRANSMISSION | BREASTFEEDING | LABORATORY PROCEDURES | AIDS | HIV INFECTIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Transmission | Infections | Infant Nutrition | Nutrition | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 342742 |
| 4. Title: Interventions for pain with intrauterine device insertion. Author: Allen RH; Bartz D; Grimes DA; Hubacher D; O'Brien P Source: Cochrane Database of Systematic Reviews. 2009;(3):CD007373. Abstract: BACKGROUND: Fear of pain during intrauterine device (IUD) insertion is a barrier to use of this contraceptive method. Interventions for pain during IUD insertion include non-steroidal anti-inflammatory drugs (NSAIDs), local cervical anesthetics, and cervical ripening agents such as misoprostol. OBJECTIVES: To review all randomized controlled trials that have evaluated a treatment for IUD insertion-related pain. SEARCH STRATEGY: We searched the computerized databases MEDLINE, POPLINE, CENTRAL, and EMBASE for relevant trials. We also examined reference lists of pertinent articles and wrote to known investigators for information about other published or unpublished trials. SELECTION CRITERIA: We included all randomized controlled trials in any language that evaluated a treatment for IUD insertion-related pain. The intervention could be compared to a placebo or another active intervention. DATA COLLECTION AND ANALYSIS: Two authors independently abstracted data from relevant trials and data were entered into RevMan 5.0 for analysis. For dichotomous variables, the Peto odds ratios with 95% confidence intervals was calculated. For continuous variables, the mean differences with 95% confidence interval was computed. MAIN RESULTS: Four trials met the inclusion criteria; the total number of participants was 2204. Nonsteroidal anti-inflammatory drugs of varying types and doses were not effective for reducing pain during IUD insertion. Misoprostol for cervical ripening did not reduce pain with IUD insertion in nulliparous women. Two trials evaluated pain that occurs after IUD insertion using nonsteroidal anti-inflammatory drugs. In one trial, naproxen taken prior to IUD insertion was effective in reducing pain compared with placebo in the first two hours after IUD insertion in mostly nulliparous women. However, this trial utilized the Dalkon Shield, an IUD with a wider diameter than modern IUDs. In another trial, ibuprofen 600 mg taken before IUD insertion did not show evidence of an effect on pain four to six hours after IUD insertion. AUTHORS' CONCLUSIONS: No interventions that have been properly evaluated reduce pain during or after IUD insertion. One poorly controlled trial suggested that topical lidocaine gel may reduce insertion-related pain and warrants further investigation. Language: English Keywords: UNITED STATES OF AMERICA | CHILE | DENMARK | SWEDEN | LITERATURE REVIEW | CLINICAL TRIALS | IUD | INSERTION | PAIN | DRUGS | ADMINISTRATION AND DOSAGE | MISOPROSTOL | Developed Countries | North America | Americas | Developing Countries | South America, Southern | South America | Latin America | Europe, Northern | Europe | Clinical Research | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology Document Number: 342475 |
| 5. Title: Women's perspective in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth. Author: Almeida CA; Tanaka OY Source: Revista De Saude Publica. 2009 Feb;43(1):98-104. Abstract: OBJECTIVE: To analyze the importance of inclusion, from women's perspective, in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth, carried out by the Brazilian Ministry of Health. METHODOLOGICAL PROCEDURES: This qualitative study was based on primary data collected in 2003 in an evaluation of the Program conducted in seven towns spread out among Brazil's five geographic regions. These sites were selected from a Federal Government data base utilized for quantitative analysis. Women attended by the Program were considered key informants when primary data was collected. Sixteen focal groups were performed in the primary care units. The Collective Subject Speech (CSS) method was used for qualitative analysis. The theoretical concepts of accessibility and Paideia Health within the framework of public health were used to interpret the findings. ANALYSIS OF RESULTS: The Program standardizes procedures to be taken in antenatal care and childbirth for all health services in the country, including the flow among these services. However, analysis of women's discourse in the focal groups elucidated the existence of dissonances between their needs and desires and many of the program's recommendations. Pregnant women thus choose among available services and professionals and try to set up their own schedules which, in turn, do not correspond to those set up by the program. This discrepancy damages the bond women establish with the health services and creates obstacles for the control of the activities actually provided by the health services to the women. CONCLUSIONS: Analysis of the Program based on women's perspective identified aspects that might result in more humanized and effective antenatal care, if they are taken into account in the redefinition or correction of the Program schedule Miolo abstract Miolo abstract Miolo abstract. Language: EnglishPortuguese Keywords: BRAZIL | RESEARCH REPORT | FOCUS GROUPS | PREGNANT WOMEN | ANTENATAL CARE | MATERNAL-CHILD HEALTH SERVICES | DELIVERY OF HEALTH CARE | NEEDS | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Maternal Health Services | Primary Health Care | Health Services | Health | Economic Factors | Programs | Organization and Administration Document Number: 341988 |
| 6. Title: The role of education level in the intergenerational pattern of adolescent pregnancy in Brazil. Author: Almeida MC; Aquino EM Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):139-146. Abstract: Adolescent pregnancy has been associated with the early childbearing experience of the mothers of adolescents, and young people's education level is believed to be an important factor in this phenomenon. In 2002, a representative household survey collected data from 3,050 young men and women ages 20–24 in three Brazilian cities. The main measures were mother's age at first birth, daughter's age at first pregnancy, and son's age when he first impregnated a partner. Ages were dichotomized as younger than 20 and 20 or older. The distribution of respondents, by both their own and their mothers' reproductive experience, was analyzed in relation to various characteristics, and logistic regressions assessed possible associations between these variables and pregnancy experience. Thirty percent of women reported getting pregnant before age 20, and 21% of men said they were younger than 20 when they first impregnated a partner. Of these groups, 34% of women and 31% of men reported that their mothers had first given birth at the same age. Both women and men were more likely to have had an early pregnancy experience if their mother had had a child before age 20. Among women, this positive association disappeared in the final model after adjusting for their education level, whereas among men the association remained after similar adjustment. Spanish Abstract: Contexto: El embarazo durante la adolescencia se ha asociado con la experiencia de la maternidad temprana de las madres de los y las adolescentes; y se considera el nivel educativo de la gente joven como un factor importante en este fenómeno. Métodos: En 2002, una encuesta representativa de hogares recolectó datos de 3,050 hombres y mujeres jóvenes de 20-24 años en tres ciudades brasileñas. Las principales medidas fueron la edad de la madre de los encuestados en el momento de su primer parto, la edad de la joven en el primer embarazo y la edad del joven al embarazar por primera vez a una pareja; los grupos de edad se dividieron en menores de 20 y de 20 años o mayores. La distribución de las personas encuestadas (tanto por su propia experiencia reproductiva como la de su madre), se analizó en relación con varias características, y se valoró mediante regresiones logísticas las posibles asociaciones entre estas variables y la experiencia del embarazo. Resultados: Treinta por ciento de las jóvenes reportaron haberse embarazado antes de los 20 años; y 21% de los hombres dijeron que eran menores de 20 años cuando su pareja se embarazó. De estos grupos, 34% de las mujeres y 31% de los hombres reportaron que sus madres habían dado a luz por primera vez a la misma edad. Tanto las mujeres como los hombres tuvieron mayor probabilidad de experimentar un embarazo temprano si su madre había tenido un hijo antes de los 20 años (razones de momios, 2.0 y 2.3, respectivamente). En las mujeres, esta asociación positiva desapareció en el modelo final, después de ajustar por nivel de educación, mientras que entre los hombres la asociación permaneció después de un ajuste similar (1.8). Conclusiones: El nivel de educación de las hijas e hijos parece ser un factor importante en la repetición de la fecundidad adolescente a través de las generaciones. Se necesita esfuerzos para aumentar el acceso a la educación y para alentar a la gente joven a que permanezca en la escuela. French Abstract: Contexte: Les grossesses d'adolescentes ont été associées à l'expérience de la maternité précoce des mères des adolescents concernés et le niveau d'instruction des jeunes semble jouer un rôle important. Méthodes: En 2002, une enquête de ménages représentative a recueilli des données auprès de 3.050 jeunes hommes et femmes de 20 à 24 ans dans trois villes du Brésil. Les principales mesures ont porté sur l'âge de la mère à la première naissance, l'âge de la fille à la première grossesse et l'âge du fils au moment de la fécondation d'une partenaire. Les âges ont été dichotomisés entre moins de 20 ans et 20 ans ou plus. La distribution des répondants en fonction de leur propre expérience génésique et de celle de leur mère a été analysée selon différentes caractéristiques, tandis que les associations possibles entre ces variables et l'expérience d'une grossesse étaient évaluées par régressions logistiques. Résultats: Trente pour cent des femmes ont déclaré avoir été enceintes avant l'âge de 20 ans, tandis que 21% des hommes déclaraient avoir eu moins de 20 ans au moment de la fécondation de leur partenaire. De ces groupes, 34% des femmes et 31% des hommes ont déclaré que leur mère avait accouché pour la première fois à ce même âge. Tant les femmes que les hommes sont apparus plus susceptibles d'avoir connu une grossesse précoce si leur mère avait eu un enfant avant l'âge de 20 ans (rapports de probabilités, 2,0 et 2,3, respectivement). Côté féminin, cette association positive disparaît dans le modèle final après correction du niveau d'instruction; côté masculin, elle se maintient après correction similaire (1,8). Conclusions: Le niveau d'instruction des filles comme des fils semble jouer un rôle important dans la répétition de la fécondité adolescente d'une génération à l'autre. Des efforts sont nécessaires pour accroître l'accès à l'éducation et encourager les jeunes à poursuivre leur scolarisation. Language: English Keywords: BRAZIL | RESEARCH REPORT | SURVEYS | MOTHERS | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | AGE FACTORS | FIRST BIRTH | EDUCATIONAL STATUS | REPRODUCTIVE BEHAVIOR | FERTILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Population Dynamics | Pregnancy History | Fertility Measurements | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 343004 |
| 7. Title: [Vulnerabilities in the use of contraceptive methods among youth: intersections between public policies and healthcare] Vulnerabilidades no uso de metodos contraceptivos entre adolescentes e jovens: Author: Alves CA; Brandao ER Source: Ciencia and Saude Coletiva. 2009 Mar-Apr;14(2):661-70. Abstract: This article discusses the moments of vulnerability in the utilization of contraceptive methods in the affective-sexual relations in adolescence and youth. The analyzed material consists of 17 semi-structured interviews with young people between 18 and 24 years (9 females and 8 males) of the middle-class of the city of Rio de Janeiro that had passed though at least one episode of pregnancy during adolescence. We also discuss the recent implementation of public policies focused on the sexuality and reproductive health of adolescents and the position of health professionals with respect to this subject within the scope of the Program of Integrated Healthcare for Women, Children and Adolescents (PAISMCA/SES-RJ). The results of the study show discontinuities in the use of contraceptive methods due to the strong gender hierarchy in the relationships between adolescents and the absence of appropriate sexual education in the family and school environments. There is little space for dealing with the sexual questions of the young in health services and schools. There are also cultural barriers that make it difficult for the society to approach the subject in a less prejudicial way, thus turning sexual initiation into a process full of silence and moral disapproval. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | INTERVIEWS | YOUTH | PRIMARY HEALTH CARE | HEALTH POLICY | CONTRACEPTIVE METHODS | ADOLESCENT PREGNANCY | Developing Countries | South America, Eastern | South America | Latin America | Americas | Data Collection | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics Document Number: 330130 |
| 8. Peer Reviewed Title: [Opinions by physicians from the Family Health Program on four health care priorities proposed by the Agenda for Commitment to Comprehensive Child Health and Reduction of Infant Mortality] Perspectivas de medicos do Programa Saude da Familia acerca das linhas de cuidado Author: Alves e Silva AC; Villar MA; Wuillaume SM; Cardoso MH Source: Cadernos De Saude Publica. 2009 Feb;25(2):349-58. Abstract: The aim of this study was to understand how physicians from a team in the Brazilian Family Health Program perceive their work in child health, as compared to the program's principles outlined in the Agenda for Commitment to Comprehensive Child Health and Reduction of Infant Mortality, under the Ministry of Health. The backdrop was the strategy for implementation of primary care under the Unified National Health System (SUS). Semi-structured interviews were held, and the material was submitted to content analysis. According to the findings, in general the Agenda is being met. However, there are difficulties with referral and counter-referral; the measures proposed by the Family Health Program require medical and sociological competence and face problems inherent to biomedical training; the infrastructure and inputs are precarious; and the training provided does not prepare physicians sufficiently for a more comprehensive approach. In conclusion, the primary care model in Brazil requires adjustments to the country's reality, and partnerships that transcend the system are necessary. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | PHYSICIANS | CHILD HEALTH | SELF-PERCEPTION | INFANT MORTALITY | PRIMARY HEALTH CARE | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Health Personnel | Delivery of Health Care | Health | Perception | Psychological Factors | Behavior | Mortality | Population Dynamics | Demographic Factors | Population | Health Services | Programs | Organization and Administration Document Number: 342669 |
| 9. Peer Reviewed Title: [Prevalence of intimate partner violence and associated factors: a population-based study in Lages, Santa Catarina State, Brazil, 2007] Prevalencia e fatores associados a violencia entre parceiros intimos: um estudo de base populacional em Lages, Santa Catarina, Brasil, 2007. Author: Anacleto AJ; Njaine K; Longo GZ; Boing AF; Peres KG Source: Cadernos de Saude Publica. 2009 Apr;25(4):800-808. Abstract: The aim of this study was to estimate the prevalence of intimate partner violence and associated factors in Lages, Santa Catarina State, Brazil. A population-based household study included 20-59-year-old women (n = 1,042) living in the urban area. The Conflict Tactics Scales - Form R was used to investigate verbal aggression, minor physical violence, and severe physical violence. A questionnaire covering socioeconomic and demographic variables was applied. Pearson qui-square and linear trend test were used to test associations. Prevalence rates for verbal aggression and minor and severe physical abuse within couples were 79.0%, 14.9%, and 9.3%, respectively. Couples under 30 years of age, with per capita income less than half the minimum wage (approximately U$90/month), and in households with more than two family members per bedroom were more likely to report all types of violence as compared to older couples, those with better incomes, and those living with less crowding, respectively. Preventive programs and qualitative studies could be effective strategies to shed further light on intimate partner violence. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | PREVALENCE | URBAN POPULATION | COUPLES | SEXUAL PARTNERS | WOMEN | AGE FACTORS | VIOLENCE | SOCIOECONOMIC FACTORS | INCOME | South America, Eastern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Sex Behavior | Behavior | Economic Factors Document Number: 341868 |
| 10. Peer Reviewed Title: Menstrual blood loss in women using the frameless FibroPlant LNG-IUS. Author: Andrade A; Wildemeersch D Source: Contraception. 2009 Feb;79(2):134-8. Abstract: BACKGROUND: This study was conducted to report on a menstrual blood loss (MBL) study and iron stores in women with and without heavy menstrual bleeding using the frameless FibroPlant levonorgestrel-releasing intrauterine system (LNG-IUS) for contraception. STUDY DESIGN: An open, prospective, noncomparative MBL study, using FibroPlant releasing 14 mcg of LNG/day for contraception. MBL was assessed by the quantitative alkaline hematin (QAH) technique. RESULTS: The MBL study was conducted in 40 heavy and normally menstruating Brazilian women seeking contraception. MBL was reduced from a mean baseline menstrual volume of 29.7 mL to a mean volume of 1.5 mL after 24 months, while ferritin values increased from a mean value of 31.1 ng/mL (at baseline) to a mean level of 72.5 ng/mL (after 24 months of use). Differences were highly significant (p<.0005). There were no significant differences between those who had normal menstrual bleeding and the heavy bleeders. The heavy bleeders had comparable MBL to thenormal bleeders 3 months after insertion, and by 24 months post-insertion, their ferritin levels were comparable to those of the normal bleeders. Amenorrhea occurred in 80% of women out of 40 after 24 months of use. No pregnancies were recorded. CONCLUSION: The LNG-IUS is effective in reducing MBL in normally menstruating women as well as in women with heavy menstrual bleeding. The authors agree with the recommendations by the UK National Institute for Clinical Effectiveness and the new Finnish guidelines for heavy menstrual bleeding that the LNG-IUS should be positioned as first-line treatment prior to endometrial ablation or hysterectomy. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | MENSTRUATION | SERUM IRON LEVEL | IUD, HORMONE RELEASING | LEVONORGESTREL | MENORRHAGIA | TIME FACTORS | AMENORRHEA | PREVALENCE | CONTRACEPTIVE EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Reproduction | Hemic System | Physiology | Biology | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Menstruation Disorders | Diseases | Population Dynamics | Demographic Factors | Population | Measurement Document Number: 331016 |
| 11. Peer Reviewed Title: Changes in sexual behavior following a sex education program in Brazilian public schools. Mudancas no comportamento sexual de adolescentes de escolas publicas no Brasil apos um programa de educacao sexual. Author: Andrade HH; de Mello MB; Sousa MH; Makuch MY; Bertoni N; Faundes A Source: Cadernos de Saude Publica. 2009 May;25(5):1168-1176. Abstract: This paper describes an evaluation of possible changes in sexual behavior in adolescents who participated in a school-based sex education program in selected public schools in four municipalities in the state of Minas Gerais, Brazil. The program, given within the context of reproductive rights, dealt with risks involved in unsafe sexual practices, and focused on the positive aspects of sexuality. A quasi-experimental design with pre- and post-tests and a nonequivalent control group was used to evaluate the intervention. A total of 4,795 questionnaires were included in this analysis. The program succeeded in more than doubling consistent condom use with casual partners and in increasing the use of modern contraceptives during last intercourse by 68%. The intervention had no effect on age at first intercourse or on adolescents' engagement in sexual activities. The sex education program was effective in generating positive changes in the sexual behavior of adolescents, while not stimulating participation in sexual activities. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | SECONDARY SCHOOLS | ADOLESCENTS | SEX EDUCATION | PARTICIPATION | CHANGES | SEX BEHAVIOR | REPRODUCTIVE RIGHTS | SEXUALITY | RISK REDUCTION BEHAVIOR | CONDOM USE | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Schools | Education | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Social Behavior | Behavior | Social Change | Sociocultural Factors | Human Rights | Political Factors | Personality | Psychological Factors | Programs | Organization and Administration Document Number: 340176 |
| 12. Peer Reviewed Title: Changes in sexual behavior following a sex education program in Brazilian public schools. Author: Andrade HH; Mello MB; Sousa MH; Makuch MY; Bertoni N; Faundes A Source: Cadernos De Saude Publica. 2009 May;25(5):1168-76. Abstract: This paper describes an evaluation of possible changes in sexual behavior in adolescents who participated in a school-based sex education program in selected public schools in four municipalities in the state of Minas Gerais, Brazil. The program is inserted within the context of reproductive rights, deals with risks involved in unsafe sexual practices and focuses on the positive aspects of sexuality. A quasi-experimental design with pre and post-tests and a non-equivalent control group was used to evaluate the intervention. A total of 4,795 questionnaires were included in this analysis. The program succeeded in more than doubling consistent condom use with casual partners and in increasing the use of modern contraceptives during last intercourse by 68%. The intervention had no effect on age at first intercourse or on adolescents' engagement in sexual activities. The sex education program was effective in generating positive changes in the sexual behavior of adolescents, while not stimulating participation in sexual activities. Language: English Keywords: BRAZIL | RESEARCH REPORT | ADOLESCENTS | SEX BEHAVIOR | SEX EDUCATION | SCHOOLS | REPRODUCTIVE RIGHTS | RISK BEHAVIOR | INTERVENTIONS | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Education | Human Rights | Political Factors | Sociocultural Factors | Programs | Organization and Administration Document Number: 342612 |
| 13. Peer Reviewed Title: Improved sanitation and income are associated with decreased rates of hospitalization for diarrhoea in Brazilian infants. Author: Andrade IG; Queiroz JW; Cabral AP; Lieberman JA; Jeronimo SM Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 May;103(5):506-11. Abstract: Diarrhoeal diseases remain a major cause of morbidity and mortality in Brazilian children. However, from 1992 to 2001 there was a significant decline in hospitalizations for acute diarrhoea in children below 1 year of age in Brazil. A significant improvement in child health was also observed in the state of Rio Grande do Norte (RN), with a decrease in child mortality from 70 to 40 deaths per 1000. Using distributed lag analysis we analysed a number of factors possibly connected with decreased hospitalization in RN and found that hospitalization was correlated up to lag 3 with poverty (P<0.001) and inflation (P<0.001). Improvements in public health infrastructure such as better waste collection, presence of city water supply and increased sanitation, socio-economic variables such as education and literacy, and increased investment in health services were all important in reducing severe early childhood diarrhoeas and thus directly associated with the decrease in hospitalization. We also observed a positive seasonal correlation between rainfall and hospitalizations with an increased in rainfall impacting positively on hospitalization in all lags. The data suggests that increased buying power and reductions in poverty played a crucial role in reducing hospitalizations for acute diarrhoea in infants in RN. Language: English Keywords: BRAZIL | RESEARCH REPORT | INFANT | DIARRHEA, INFANTILE | POVERTY | INFANT MORTALITY | SANITATION | HOSPITALS | PUBLIC HEALTH | SOCIOECONOMIC FACTORS | PREVENTION AND CONTROL | South America, Eastern | South America | Latin America | Americas | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diarrhea | Diseases | Economic Factors | Mortality | Population Dynamics | Health | Health Facilities | Delivery of Health Care Document Number: 342512 |
| 14. Title: PRISM tools for assessing, monitoring, and evaluating RHIS performance. Author: Aqil A; Lippeveld T Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Mar. [32] p. (MS-09-34USAID Cooperative Agreement No. GPO-A-00-03-00003-00) Abstract: PRISM Framework and its tools applications have expanded since 2004. Now it has been applied in Pakistan, Uganda, South Africa, Mexico, Paraguay, Honduras, Haiti, China and Cote d'Ivore for assessment and evaluation. It has been applied in diverse countries of Africa, Asia, Latin America and Carribean continents. While these applications showed the strengths and appropriateness of PRISM Framework and its tools in identifying strengths and weaknesses of the routine information systems, they brought some challenges to attention. First, to make a distinction between RHIS performance indicators -accuracy, timeliness and completeness, from their counterpart processes. Second, to keep minimum variables in various tools for triangulation of information to avoid respondent's burden of filling the details. Third, better measurement of use of information. Thus, there was a need to revise the PRISM tools. Uganda PRISM evaluation in 2007 for testing its reliability and validity also helped to make the revisions. PRISM tools version 3.0 meets old and new challenges in assessing, monitoring and evaluation of RHIS. Language: English Keywords: PAKISTAN | MEXICO | HONDURAS | HAITI | CHINA | PARAGUAY | SOUTH AFRICA | UGANDA | SUMMARY REPORT | EVALUATION | INFORMATION PROCESSING | DATA COLLECTION | MANAGEMENT | PROGRAM ACTIVITIES | Developing Countries | Asia, Southern | Asia | North America | Americas | Central America | Latin America | Caribbean | Asia, Eastern | South America, Central | South America | Africa, Southern | Africa, Sub Saharan | Africa | Africa, Eastern | Information | Research Methodology | Organization and Administration | Programs Document Number: 339994 |
| 15. Peer Reviewed Title: Impact of the Family Health Project on infant mortality in Brazilian municipalities. Author: Aquino R; de Oliveira NF; Barreto ML Source: American Journal of Public Health. 2009 Jan;99(1):87-93. Abstract: The authors evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level. They collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. They performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables. The authors observed a statistically significant negative association between FHP coverage and infant mortality rate. After controlling for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period. The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities. Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | MATHEMATICAL MODEL | EVALUATION INDEXES | INFANT | URBAN POPULATION | INFANT MORTALITY | AGE SPECIFIC DEATH RATE | PRIMARY HEALTH CARE | HEALTH STATUS INDEXES | INEQUALITIES | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Theoretical Models | Quantitative Evaluation | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Death Rate | Health Services | Delivery of Health Care | Health | Socioeconomic Factors | Economic Factors Document Number: 328585 |
| 16. Peer Reviewed Title: [Sexual behavior and emergency contraception among adolescents from public schools in Pernambuco State, Brazil] Comportamento sexual e contracepcao de emergencia entre adolescentes de escolas Author: Araujo MS; Costa LO Source: Cadernos de Saude Publica. 2009 Mar;25(3):551-62. Abstract: This study examined knowledge and use of emergency contraception among 4,210 adolescents (14-19 years) enrolled in public schools in Pernambuco State, Brazil. The authors collected information with the Global School-Based Student Health Survey, previously validated. Knowledge, frequency, and form of use of emergency contraception were investigated. Independent variables were classified as sociodemographic and those related to sexual behavior. Most adolescents reported knowing and having received information about the method, but among those who had already used it, only 22.1% had done so correctly. Adjusted regression analysis showed greater likelihood of knowledge about the method among girls and the sexually initiated, while rural residents were 68% less knowledgeable. Rural residents showed 1.68 times higher odds of incorrect use, while girls showed 71% lower likelihood of incorrect use. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | SURVEYS | RURAL POPULATION | ADOLESCENTS | KNOWLEDGE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE USAGE | SEX EDUCATION | NEEDS ASSESSMENT | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Sociocultural Factors | Contraception | Family Planning | Education | Evaluation Document Number: 330737 |
| 17. Title: [The perception of domestic violence of pregnant and not pregnant women in the city of Campinas, Sao Paulo] Percepcao da violencia domestica por mulheres gestantes e nao gestantes da cidade Author: Audi CA; Correa AM; Turato ER; Santiago SM; Andrade Mda G; Rodrigues MS Source: Ciencia and Saude Coletiva. 2009 Mar-Apr;14(2):587-94. Abstract: This study sought to compare the perception of domestic violence of women, victims of this kind of violence, with the perception of pregnant women, victims or not of domestic violence, as well as to search for elements allowing for the planning and execution of a cohort study on domestic violence among pregnant women. A qualitative exploratory research was conducted using the technique of convenience sampling for selecting a focal group. The subjects were twenty four women divided into two groups: (1) thirteen women from a follow-up group from a Referral Center for victims of domestic violence, and (2) eleven pregnant women that were participating in the pre-natal care program in a primary care unit, selected independently of suffering domestic violence or not. The data collected were transcribed, conceptually decoded and qualified for qualitative analysis. The contents of the women's discourse were analyzed on the basis of thematic categories. It was observed that domestic violence was perceived in a similar way by both studied groups, independently from the fact of having or not experienced a situation of this kind. The understanding and discussion of the topics proposed for the groups allowed developing a more appropriate approach to the studied women. The way the questions were formulated in the questionnaire was considered of easy understanding by both groups of women. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | QUALITATIVE RESEARCH | WOMEN | PREGNANT WOMEN | PERCEPTION | DOMESTIC VIOLENCE | QUESTIONNAIRE DESIGN | STUDY DESIGN | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Demographic Factors | Population | Population Characteristics | Psychological Factors | Behavior | Crime | Social Problems | Sociocultural Factors | Survey Methodology | Surveys | Sampling Studies | Studies Document Number: 342097 |
| 19. Title: Inadequate use of prenatal services among brazilian women: the role of maternal characteristics. Author: Bassani DG; Surkan PJ; Olinto MT Source: International Perspectives On Sexual and Reproductive Health. 2009 Mar;35(1):15-20. Abstract: CONTEXT: To improve the uptake of prenatal care, it is important to know how the use of prenatal care varies by maternal attitudes and social and demographic factors. METHODS: Information about social and demographic variables, prenatal care, parity, pregnancy planning, abortion attempts, satisfaction with pregnancy and satisfaction with the relationship with the child's father was collected from 611 postpartum women in Porto Alegre in southern Brazil. Multinomial logistic regression was used to evaluate associations between these variables and whether the women's use of prenatal care was adequate, partially inadequate or inadequate. RESULTS: About 40% of women had inadequate or partially inadequate prenatal care. After adjustment for other covariates, including satisfaction with the pregnancy, women having an unplanned pregnancy were significantly more likely to have had inadequate care than women who had planned their pregnancy (odds ratio, 2.0). Not living with the child's father (2.8) and dissatisfaction with pregnancy (2.1) were also associated with inadequate use of prenatal care. Women having their second or higher order birth were significantly more likely to report inadequate use of prenatal care than women having their first birth (3.9-9.0). Household income was inversely associated with inadequate use of care. CONCLUSIONS: The study suggests that maternal attitudes may be important for adequate prenatal care. Interventions should be created to encourage women with negative maternal attitudes to use prenatal care and to ensure that they have access to the care they need. Language: English Keywords: BRAZIL | RESEARCH REPORT | STATISTICAL REGRESSION | POSTPARTUM WOMEN | ANTENATAL CARE | UTILIZATION OF HEALTH CARE | ATTITUDES | SOCIOECONOMIC STATUS | PARITY | LIVING ARRANGEMENTS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Analysis | Research Methodology | Puerperium | Reproduction | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Psychological Factors | Behavior | Socioeconomic Factors | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors Document Number: 341412 |
| 20. Title: Estimating HIV-1 incidence using the serologic testing algorithm for recent HIV infections at HIV counseling and testing centers in the city of Sao Paulo, Brazil. Author: Bassichetto KC; Bergamaschi DP; Veras MA; Sucupira MC; Mesquita F; Diaz RS Source: Brazilian Journal of Infectious Diseases. 2009 Feb;13(1):9-12. Abstract: The network of HIV counseling and testing centers in Sao Paulo, Brazil is a major source of data used to build epidemiological profiles of the client population. We examined HIV-1 incidence from November 2000 to April 2001, comparing epidemiological and socio-behavioral data of recently-infected individuals with those with long-standing infection. A less sensitive ELISA was employed to identify recent infection. The overall incidence of HIV-1 infection was 0.53/100/year (95% CI: 0.31-0.85/100/year): 0.77/100/year for males (95% CI: 0.42-1.27/100/year) and 0.22/100/ year (95% CI: 0.05-0.59/100/year) for females. Overall HIV-1 prevalence was 3.2% (95% CI: 2.8-3.7%), being 4.0% among males (95% CI: 3.3-4.7%) and 2.1% among females (95% CI: 1.6-2.8%). Recent infections accounted for 15% of the total (95% CI: 10.2-20.8%). Recent infection correlated with being younger and male (p = 0.019). Therefore, recent infection was more common among younger males and older females. Language: English Keywords: BRAZIL | RESEARCH REPORT | ESTIMATION TECHNIQUES | STATISTICAL STUDIES | CLIENTS | HIV TESTING | HIV INFECTIONS | INCIDENCE | LABORATORY PROCEDURES | EPIDEMIOLOGY | PREVALENCE | TIME FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Measurement | Public Health | Population Dynamics | Demographic Factors | Population Document Number: 342655 |
| 21. Peer Reviewed Title: High human herpesvirus 8 (HHV-8) prevalence, clinical correlates and high incidence among recently HIV-1-infected subjects in Sao Paulo, Brazil. Author: Batista MD; Ferreira S; Sauer MM; Tomiyama H; Giret MT; Pannuti CS; Diaz RS; Sabino EC; Kallas EG Source: PloS One. 2009;4(5):e5613. Abstract: BACKGROUND: Human herpesvirus 8 (HHV-8) is the etiological agent for Kaposi Sarcoma, which occurs especially in HIV-infected subjects. HHV-8 infection and its clinical correlates have not been well characterized in recently HIV-1-infected subjects, especially men who have sex with men (MSM). METHODOLOGY/ PRINCIPAL FINDINGS: We assessed the HHV-8 seroprevalence, clinical correlates, and incidence after one year of follow-up in a cohort of 228 recently HIV-1-infected individuals, of whom 83.6% were MSM, using indirect immunofluorescence assay. The prevalence of HHV-8 infection at the time of cohort enrollment was 25.9% (59/228). In the univariate model, there were significant associations with male gender, black ethnicity, MSM practice, and previous hepatitis B virus and syphilis infections. In the multivariate model we could still demonstrate association with MSM, hepatitis B, and black ethnicity. No differences in mean CD4+ cell counts or HIV viral load according to HHV-8 status were found. In terms of incidence, there were 23/127 (18.1%) seroconversions in the cohort after 1 year. CONCLUSIONS: HHV-8 is highly prevalent among recently HIV-1-infected subjects. Correlations with other sexually transmitted infections suggest common transmission routes. Language: English Keywords: BRAZIL | RESEARCH REPORT | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | MEN HAVING SEX WITH MEN | HERPES GENITALIS | PREVALENCE | INCIDENCE | IMMUNOLOGICAL EFFECTS | SEROCONVERSION | LABORATORY PROCEDURES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Sex Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement | Immunity | Immune System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342160 |
| 22. Title: Sexual practices, drug use behaviors, and prevalence of HIV, syphilis, hepatitis B and C, and HTLV-1/2 in immigrant and non-immigrant female sex workers in Argentina. Author: Bautista CT; Pando MA; Reynaga E; Marone R; Sateren WB; Montano SM; Sanchez JL; Avila MM Source: Journal of Immigrant and Minority Health. 2009 Apr;11(2):99-104. Abstract: OBJECTIVE: To study socio-demographics, sexual practices, drug use behaviors, and prevalences of HIV, syphilis, hepatitis B and C, HTLV-1 and HTLV-2 in immigrant (foreigner) and non-immigrant (local/native) female sex workers (FSW). DESIGN: This was a cross-sectional study in immigrant and non-immigrant FSW living in Buenos Aires, Argentina. Participants were interviewed using a standardized questionnaire. RESULTS: A total of 625 FSW were enrolled, of whom 169 (27%) were immigrant FSW from Paraguay, the Dominican Republic, Brazil, Peru, and Uruguay. The prevalence of syphilis and hepatitis C was significantly higher among Argentinean FSW than among immigrant FSW. However, hepatitis B prevalence was higher among immigrant FSW. Adjusted risk factor analysis comparing immigrant FSW with Argentinean FSW indicated that marital status (single), occupation (none), fee per sex act ( Keywords: ARGENTINA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | COMPARATIVE STUDIES | EPIDEMIOLOGIC METHODS | SEX WORKERS | WOMEN IN DEVELOPMENT | IMMIGRANTS | HEPATITIS | SYPHILIS | PREVALENCE | DRUG USE AND ABUSE | HIV INFECTIONS | SEX BEHAVIOR | South America, Southern | South America | Latin America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Economic Development | Economic Factors | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement Document Number: 331118 |
| 23. Title: Approach in sexually transmitted diseases. Author: Belda Junior W; Shiratsu R; Pinto V Source: Anais Brasileiros de Dermatologia. 2009 Mar-Apr;84(2):151-9. Abstract: Nowadays, sexually transmitted diseases are one of the most common public health issues. Among its consequences are the possibility of transmission from mother to baby - which may cause miscarriages and congenital disease, male and female infertility, and the increase of HIV infection risk. Therefore, the main goal of these guidelines is to contribute to the improvement of the treatment for sexually transmitted diseases patients by presenting to the medical community how today's science stands on the matter and also what the recommendation for diagnosing and treating a patient are. Language: EnglishPortuguese Keywords: BRAZIL | RECOMMENDATIONS | SEXUALLY TRANSMITTED DISEASES | EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | TREATMENT | CHANCROID | GONORRHEA | South America, Eastern | South America | Latin America | Americas | Developing Countries | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342656 |
| 24. Peer Reviewed Title: Alcohol and illicit drug use and its influence on the sexual behavior of teenagers from Minas Gerais State, Brazil. Uso de alcool e drogas e sua influencia sobre as praticas sexuais de adolescentes de Minas Gerais, Brasil. Author: Bertoni N; Bastos FI; de Mello MV; Makuch MY; de Sousa MH; Osis MJ; Faundes A Source: Cadernos de Saude Publica. 2009 Jun;25(6):1350-1360. Abstract: This article summarizes the findings of a survey of 5,981 students from public schools in Minas Gerais State, Brazil. The analysis assessed the influence of drug use on sexual practices. Among the boys who stated having used illicit drugs and who were engaged in relationships with casual partners, 56% reported consistent condom use, as compared to 65% among those not reporting such habits. Among boys who reported illicit drug use and who were engaged in relationships with stable partners, consistent condom use was reported by 43%, versus 64% among those not reporting such habits. In the subgroup of boys engaged in stable relationships who did not report illicit drug use, consistent condom use was less frequent among those who used alcohol or cigarettes, compared to those who did not drink or smoke (61% versus 71%). Girls were less likely than boys to use condoms consistently, regardless of the nature of their relationships, without a noticeable influence of drug use. Policies to prevent drug abuse, sexually transmitted infections, and unplanned pregnancy should be fully integrated. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | SURVEYS | YOUTH | ADOLESCENTS | STUDENTS | DRUG USE AND ABUSE | ALCOHOL USE AND ABUSE | SEX BEHAVIOR | RISK BEHAVIOR | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | PREGNANCY, UNPLANNED | RISK FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Behavior | Risk Reduction Behavior | Reproductive Tract Infections | Infections | Diseases | Reproductive Behavior | Fertility | Population Dynamics | Health Document Number: 340175 |
| 25. Peer Reviewed Title: Judicialisation of the right to health in Brazil. Author: Biehl J; Petryna A; Gertner A; Amon JJ; Picon PD Source: Lancet. 2009 Jun 27;373(9682):2182-4. Abstract: This article examines Brazil's constitutional right to health and their pharmaceutical access. It states that Brazil must raise their funding for essential medicines and pursue strategies to ensure universal availability of medicines that the government has a legal responsibility to provide in order to reduce vulnerability to disease. Language: English Keywords: BRAZIL | SUMMARY REPORT | HUMAN RIGHTS | PUBLIC HEALTH | HEALTH POLICY | ANTIRETROVIRAL DRUGS | PHARMACY DISTRIBUTION | PROGRAM EFFICIENCY | FEES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Political Factors | Sociocultural Factors | Health | Policy | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Program Evaluation | Financial Activities | Economic Factors Document Number: 342054 |
| 26. Title: [Contraceptive compliance - why is contraceptive failure still so frequent?] Kontrazeptive Compliance - warum kommt es immer wieder zum Versagen der Author: Bitzer J Source: therapeutische Umschau. Revue therapeutique. 2009 Feb;66(2):137-43. Abstract: Contraceptive compliance is defined as the correct use (according to the method specific prescriptions given by a medical professional and/or in written form as patient information leaflet) of a contraceptive method. Non-compliance describes a mismatch between the real behaviour of a user and the correct or ideal behaviour. There are various indicators that in general contraceptive compliance is far from ideal. Many studies report a rate of unintended pregnancies of 50%, half of them terminating in abortion. The abortion rate remains high even in countries with availability of advanced contraceptive technology. Especially with hormonal contraception and barrier methods the gap between correct and real use is large. Discontinuation rates per year reach up to 50%. Reasons for Non Compliance are (a) Lack of motivation to prevent a pregnancy due to ambivalence regarding the wish for a child as well as sexual and relationship issues (b) Cognitive factors (False information, misconceptions, irrational fears) (c) Difficult or lacking access to contraceptive methods (d) Behavioral errors and mistakes (Forgetting, loosing etc.) and (e) Side effects of the methods used. Three strategies to improve compliance can be distinguished: (a) Improving counselling; (b) Developing contraceptive methods which demand a low level of compliant behaviour by the user; (c) Improving quality of life of users by minimizing the negative side effects and maximizing the non contraceptive health benefits. Language: German Keywords: BRAZIL | RESEARCH REPORT | CONTRACEPTION FAILURE | USER COMPLIANCE | PRESCRIPTIONS | CONTRACEPTIVE METHODS | QUALITY OF LIFE | PREGNANCY, UNPLANNED | CONTRACEPTIVE EFFECTIVENESS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Contraceptive Usage | Contraception | Family Planning | Behavior | Distributional Activities | Program Activities | Programs | Organization and Administration | Social Welfare | Economic Factors | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population Document Number: 329568 |
| 27. Title: [Assessment of adherence to antiretroviral drugs in a municipality in southern Brazil] Avaliacao da adesao aos anti-retrovirais em um municipio no Sul do Brasil. Author: Blatt CR; Citadin CB; Souza FG; Mello RS; Galato D Source: Revista Da Sociedade Brasileira De Medicina Tropical. 2009 Mar-Apr;42(2):131-6. Abstract: The aim of this research is to assess predicting factors and adherence levels to antiretrovirals through self-report and the date of drug retrieval. It is a transversal study in which 67 patients were interviewed. Patients who used more than 90% of doses were considered to have complied with the treatment. Results of adherence were: self-reports (72.7%); calculated using dosage forgotten on the last day (70%); in three (76.1%) days; in seven (80.5%) days; and in fifteen (80.5%) days; calculated using the date of drug retrieval in a period of three (53.7%) months; and in six (47.8%) months. Variables significantly associated with adherence were: educational level, living with the family, refer good adherence, positive assessment of the antiretroviral therapy, a diagnosis of an opportunistic disease, NADIR greater than 200 cells/mm(3) and being in first-time treatment. To improve adherence rates individual and collective strategies should be elaborated taking into account factors which have been identified as negatively effecting adherence. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | INTERVIEWS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL DRUGS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | TREATMENT | ADMINISTRATION AND DOSAGE | PROGRAM EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Behavior | Drugs | Program Evaluation Document Number: 342167 |
| 28. Title: Effectiveness of an intervention to improve breastfeeding knowledge and attitudes among fifth-grade children in Brazil. Author: Bottaro SM; Giugliani ER Source: Journal of Human Lactation. 2009 Aug;25(3):325-32. Abstract: This cluster-randomized trial evaluated the effectiveness and residual effect of an educational intervention to improve breastfeeding knowledge and attitudes among fifth grade children of both sexes in Brazil. Schools were considered clusters and analysis of variance was used to compare an intervention group (n = 298) and a control group (n = 253) regarding knowledge, perceptions, and beliefs about breastfeeding before and after the intervention, measured through a standardized 25-item, multiple-choice questionnaire. The scores in the intervention group improved significantly, with the effect lasting at least 3 months. The intervention had greater impact on girls and on students between 9 and 11 years of age when compared with boys and students between 12 and 17 years old and also between students from public schools. Results suggest that pro-breastfeeding interventions in schools improve breastfeeding knowledge and attitudes. Language: English Keywords: BRAZIL | RESEARCH REPORT | INTERVENTIONS | CHILDREN | PRIMARY SCHOOLS | STUDENTS | BREASTFEEDING | KNOWLEDGE | ATTITUDES | PROGRAM EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Programs | Organization and Administration | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Schools | Education | Infant Nutrition | Nutrition | Health | Sociocultural Factors | Psychological Factors | Behavior | Program Evaluation Document Number: 342903 |
| 29. Title: [Assessment of factors associated with patients' comprehension of treatment at the start of antiretroviral therapy] Evaluacion de factores asociados a la comprension del tratamiento en pacientes Author: Braga Ceccato MG; Acurcio Fde A; Vallano A; Comini Cesar C; Crosland Guimaraes MD Source: Enfermedades Infecciosas Y Microbiologia Clinica. 2009 Jan;27(1):7-13. Abstract: OBJECTIVE: The aim of this study was to evaluate factors associated with patients' comprehension of antiretroviral therapy (ART). METHOD: Cross-sectional analysis in which patients at 2 HIV/AIDS public referral centers (Belo Horizonte, Brazil) were interviewed after initiating ART. Information was recorded on variables related to the patient's characteristics, the treatment prescribed, and the healthcare professional involved. A score indicating the patients' level of comprehension regarding the medications prescribed was obtained using a latent trait model estimated by the item response theory. RESULTS: A total of 406 patients were interviewed. Mean (SD) age was 35 (10) years, 227 were men (56%), 302 of Afro-American ethnicity (77%), and 213 had <8 years of education (53%). The regression model determined that 52.25% of the variability of comprehension was explained by the individual's characteristics. Variables associated (P<0.05) with poorest understanding about ART were lower education (<8 years), lack of knowledge about treatment duration and clinical severity, inadequate information provided by physicians, inability to understand pharmaceutical information, daily number of tablets, and the ART regimen prescribed. CONCLUSION: Comprehension of information about the ART regimen prescribed varies considerably between individuals. Nonetheless, several factors were found to be associated with the level of understanding: characteristics of the patient (education, clinical severity), characteristics of treatment (daily number of tablets, ART regimen prescribed), and contribution of healthcare professionals (information from physicians and pharmacists). Strategies to reinforce information about ART should be a priority for patients with a low level of understanding. Language: Spanish Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | INTERVIEWS | CLIENTS | ETHNIC GROUPS | PRESCRIPTIONS | EDUCATIONAL STATUS | KNOWLEDGE | TREATMENT | INFORMATION | PHYSICIAN-PATIENT RELATIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Data Collection | Program Activities | Programs | Organization and Administration | Cultural Background | Population Characteristics | Demographic Factors | Population | Distributional Activities | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Interpersonal Relations | Behavior Document Number: 341238 |
| 30. Title: [Challenges of youth contraception: intersections between gender, sexuality and health] Desafios da contracepcao juvenil: intersecoes entre genero, sexualidade e saude. Author: Brandao ER Source: Ciencia and Saude Coletiva. 2009 Jul-Aug;14(4):1063-71. Abstract: This qualitative paper discusses some of the difficulties young people have when dealing with contraception and also identifies circumstances in which they tend not to use contraceptive methods. The authors conducted 73 in-depth interviews with young men and women, ages 18 to 24, living in three state capitals in Brazil (Salvador, Rio de Janeiro, Porto Alegre), who went through at least one experience of teenage pregnancy. Data were analyzed by theme in order to assemble similar and repeated elements in the testimonies. The reasons young people have difficulty adopting continued use of contraceptive methods were listed according to the following themes: relationship context; relationship with the family regarding sexuality; side effects of hormonal contraceptive methods; negligence with contraception; problems with health services; failure of contraceptive methods; a strong sense of fatherhood; use of condoms with unknown female partners; and use of withdrawal with no knowledge of the partner’s menstrual cycle. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | QUALITATIVE RESEARCH | INTERVIEWS | YOUTH | SEXUALITY | ADOLESCENT PREGNANCY | CONTRACEPTION | ORAL CONTRACEPTIVES, SIDE EFFECTS | INTERPERSONAL RELATIONS | |