ABSTRACT
Strengthening strategies to improve adherence to the use of pre-exposure prophylaxis (PrEP) in key populations constitutes a global health priority to be achieved across countries, especially in countries that share a high flow of people such as Brazil and Portugal. This study aimed to analyze the factors associated with adherence to PrEP among MSM from two Portuguese-speaking countries, highlighting the opportunities and preventive strategies for the global health scenario. This was a cross-sectional analytical online survey conducted from January 2020 to May 2021 with MSM in Brazil and Portugal. For analysis of the data, the Poisson regression model was used to estimate the prevalence ratio (PR) for developing a model to evaluate the associated factors in both countries in a comparative and isolated way. Adherence to PrEP use corresponded to 19.5% (n = 1682) of the overall sample: 18.3% (n = 970) for Brazil and 21.5% (n = 712) for Portugal. Having more than two sex partners in the last 30 days (aPR: 30.87) and routinely undergoing HIV tests (aPR: 26.21) increased the use of this medication. Being an immigrant (PR: 1.36) and knowing the partner's serological status (PR: 1.28) increased adherence to PrEP in Portugal, whereas, in Brazil, it was being an immigrant (PR: 0.83) and not knowing the serological status (PR: 2.24) that promoted the use of this medication. Our findings reinforce the need to invest in programs and strategies to improve access and adherence to PrEP, especially in key populations.
Subject(s)
Anti-HIV Agents , HIV Infections , Pre-Exposure Prophylaxis , Sexual and Gender Minorities , Male , Humans , Homosexuality, Male , HIV Infections/epidemiology , Portugal , Cross-Sectional Studies , Anti-HIV Agents/therapeutic use , Sexual BehaviorABSTRACT
Background: There is an inverse association between cardiorespiratory fitness and general anxiety levels in adolescents. Obesity also is associated with a higher risk of anxiety in this population. However, little is known about the association between other health-related fitness elements with anxiety symptoms in this population. The authors explored the relationship between health-related fitness and anxiety symptoms in a large sample of Brazilian youth. Methods: This was an observational cross-sectional study with a sample comprised of 257 school adolescents, who were 136 girls (52.9%) and 121 boys (47.1%). The health-related fitness elements were evaluated by FitnessGram® test and anxiety levels by Multidimensional Anxiety Scale for Children - 39. Hierarchical regression analyses were used to determine the association between health-related fitness elements and anxiety symptoms in both sexes. Results: In male adolescents, only the cardiorespiratory fitness was significantly associated with anxiety symptoms (F(1, 119) = 6.472; P = 0.012; R2 = 0.052; adjusted R2 = 0.044). In turn, the anxiety symptoms showed an inverse small relationship with cardiorespiratory fitness (r = - 0.227; P < 0.01). However, in female adolescents, no association was found between health-related fitness elements and anxiety symptoms. Conclusion: The level of cardiorespiratory fitness may represent a marker of anxiety in male adolescents.
ABSTRACT
Abstract In pediatrics, drug therapy is commonly performed through adaptations of the dosage forms to adult use, increasing the risk of adverse drug reactions. In this context, studies assessing the severity and avoidability of the adverse reactions in children, especially those caused by antimicrobials, are still scarce. This work aimed to investigate suspected antimicrobial adverse reactions (ATM-ADRs) in pediatric patients admitted to a public hospital in northeastern Brazil, focusing on causality and avoidability analysis. A cohort study was carried out over a period of six months in a 64-bed pediatric unit. The incidence of suspected adverse reactions caused by antimicrobials was 14.65%. Most reactions were rated as probable (89.13%), with moderate severity (84.78%) and possibly avoidable (45.65%). The analysis indicated that the use of a larger number of medications (p<0.0001) and longer hospital stay (p=0.004) were related to the occurrence of ATM-ADR. Our findings demonstrated that almost half of the suspected reactions could be prevented and that the antimicrobial's clinical management is relevant in this context. Besides, increasingly accurate adverse reaction classification instruments are essential. These results can support the development of therapeutic guidelines addressed to a safe and effective pharmacotherapy in the pediatric area
Subject(s)
Humans , Male , Female , Child, Preschool , Patients/classification , Pediatrics/classification , Drug-Related Side Effects and Adverse Reactions/complications , Anti-Infective Agents/adverse effectsABSTRACT
Depression represents a common public health problem in the world. Depression in the elderly appears to follow a vulnerability-stress model, with an interaction between individual vulnerabilities, including genetic factors, age-related cognitive and neurobiological changes, and a variety of stressful events that occur more frequently in advanced ages, such as grief, financial problems, and reduction in autonomy/functionality. In the last decades, several studies have indicated that exercise can be effective in preventing or reducing depressive symptoms, both in healthy and psychiatric populations. Due to the scientific community's interest in the efficacy and safety of physical exercise as complementary therapy for depressed elderly patients, we conduct an opinion study on the subject. Despite the researchers' efforts, in the last decades little progress has been made in verifying the efficacy of exercise in geriatric depression.
A depressão representa um problema comum de saúde pública no mundo. A depressão em idosos parece seguir um modelo de vulnerabilidade-estresse, com uma interação entre vulnerabilidades individuais, incluindo fatores genéticos, mudanças cognitivas e neurobiológicas relacionadas à idade, e uma variedade de eventos estressantes que ocorrem mais frequentemente em idades avançadas, como luto, problemas financeiros e redução da autonomia/funcionalidade. Nas últimas décadas, vários estudos indicaram que o exercício pode ser eficaz na prevenção ou redução dos sintomas depressivos, tanto em populações saudáveis como psiquiátricas. Devido ao interesse da comunidade científica na eficácia e segurança do exercício físico como terapia complementar para idosos deprimidos; realizamos um estudo de opinião sobre o assunto. Apesar dos esforços dos pesquisadores, nas últimas décadas pouco progresso foi feito na verificação da eficácia do exercício na depressão geriátrica.
La depresión representa un problema común de salud pública en el mundo. La depresión en los ancianos parece seguir un modelo de vulnerabilidad-estrés, con una interacción entre las vulnerabilidades individuales, incluidos factores genéticos, cambios cognitivos y neurobiológicos relacionados con la edad, y una variedad de eventos estresantes que ocurren con mayor frecuencia en edades avanzadas, como el duelo, problemas financieros y reducción de la autonomía/funcionalidad. En las últimas décadas, varios estudios han indicado que el ejercicio puede ser eficaz para prevenir o reducir los síntomas depresivos, tanto en poblaciones sanas como psiquiátricas. Debido al interés de la comunidad científica en la eficacia y seguridad del ejercicio físico como terapia complementaria para pacientes ancianos deprimidos, realizamos un estudio de opinión sobre el tema. A pesar de los esfuerzos de los investigadores, en las últimas décadas se ha avanzado poco en la verificación de la eficacia del ejercicio en la depresión geriátrica.