Estudo prospectivo e randomizado de 30 pacientes, submetidos a derivação cavopulmonar total com tubo extracardíaco. Os dados refletem o período de 2008 a 2011, com seguimento de dois anos, por meio de avaliação clínica, laboratorial, ecocardiográfica, angiotomográfica e cintilográfica. Neste estudo, procuramos comparar a eficácia do ácido acetil salicílico (AAS) e da Varfarina na profilaxia da trombose na população estudada. Para tanto, analisamos alterações nos fatores de coagulação (VII, VIII e Proteína C ); ou nos dados clínicos que predispusessem a ocorrência de trombo no pós-operatório. Além disso, no pós-operatório, após a randomização (15 pacientes randomizados para receber Varfarina, Grupo I, e 15 pacientes randomizados para receber AAS, Grupo II), estudamos a interferência da fenestração na ocorrência de trombo; alterações hemodinâmicas que pudessem contribuir com a ocorrência de trombo (fluxo lento pelo tubo extracardíaco), por meio de ecocardiograma transesofágico realizado com até 10 dias de pós operatório, 3, 6, 12 e 24 meses de pós operatório. A presença do fenômeno tromboembólico era pesquisada, além dos ecocardiogramas acima citados, por meio de consultas clínicas realizadas com a mesma periodicidade e que avaliavam, ainda, efeitos colaterais ou complicações no uso de cada uma das drogas. Avaliamos também a viabilidade e aderência ao uso de cada uma delas. O seguimento contou igualmente com a realização de angiotomografia aos 6, 12 e 24 meses de pós-operatório para avaliação de alterações na parede interna do tubo, bem como trombos e cintilografia pulmonar, ventilação-perfusão para avaliar possível tromboembolismo pulmonar. Durante o seguimento, ocorreram dois óbitos, ambos no grupo em uso de Varfarina. Ao todo, durante os dois anos de seguimento, 33,3% dos pacientes apresentaram fenômeno tromboembólico. Sendo que, entre os paciente em uso de AAS, 46,7% apresentaram tal complicação e 20% entre os pacientes em uso de Varfarina (p=0,121). Com relação a avaliação pré-operatória, a ocorrência prévia de trombo e baixos níveis de proteína C da coagulação foram os únicos fatores que influenciaram no tempo de sobrevida livre de trombo, com valores de p de 0,035 e 0,047 respectivamente. Ao final de dois anos de seguimento, na avaliação angiotomográfica, 35,7% dos pacientes em uso de AAS tinham material hiper-refringente depositado em tubo extracardíaco com espessura superior a 2mm ( p= 0,082). Já na avaliação por cintilografia de ventilação-perfusão, dois pacientes apresentaram sinais de tromboembolismo pulmonar, ambos em uso de AAS (p=0,483), e um deles com evolução desfavorável do circuito tipo Fontan. Com relação a segurança e aderência ao tratamento, cinco pacientes tiveram dificuldade de aderência (só viabilizada por tratar-se de protocolo de estudo), entre eles, quatro em uso de Varfarina e apresentando INR variando de 1 a 6,4. Para comprovação numérica, com força estatística dos dados encontrados, uma força tarefa deve ocorrer para que se consiga um grupo maior de pacientes incluídos neste estudo. No entanto, a diferença entre os dois grupos na evolução livre de trombo nos dois primeiros anos de pós-operatório não pode, e nem deve, ser ignorada / Prospective randomized trial of 30 patients who had undergone total cavopulmonary anastomosis via an extracardiac conduit. The data reflect the period between 2008 and 2011, with two-year follow-up, through clinical, laboratorial, echocardiographic, angiotomographic, and scintigraphic assessment. In this study, we aimed to compare the efficiency of ASA (Aspirin) and Warfarin in the preventive treatment of thrombosis in the tried population. For such, we\'ve analyzed changes in coagulation factors (VII, VIII and Protein C) or in the clinical data which would predispose the occurrence of postoperative thrombus. Moreover, during postoperative care, after randomization (15 patients randomly selected to be trated with Warfarin, referred to as Group I, and 15 patients randomly selected to be treated with ASA, referred to as Group II), we also studied the influence of fenestration in the occurrence of thrombus; hemodynamic variations which could contribute to the occurrence of thrombus (slow blood flow in the extracardiac conduit), with postoperative transesophageal echocardiogram being performed within 10 days, and thereafter 3, 6, 12 and 24 months. Besides the echocardiograms aforementioned, the presence of thromboembolic events was sought after by clinical appointments taking place with the same frequency, which evaluated, apart from thromboembolism, side effects or complications from the usage of each of the drugs. We\'ve also evaluated the compliance to and feasibility of each of them. Postoperative angiotomography was also performed during the follow-up, within 6, 12 and 24 months, for the evaluation of changes on the inside wall of the extracardiac conduit, as well as thrombi, and pulmonary ventilation/perfusion scintigraphy for assessment of pulmonary thromboembolism possibility. During the follow-up, two deaths were registered, both in the group being treated with Warfarin. Overall, in the two-year follow-up, 33,3% of the patients presented thromboembolic events. Among the group being treated with ASA, 46,7% presented such complication, whereas in the group being treated with Warfarin, 20% had the same complication (p=0,121). Regarding the preoperative evaluation, prior occurrence of thrombus and low levels of coagulation factor Protein C were the only variables which influenced living time without thrombus, with p-values of 0,035 and 0,047. At the end of the two-year follow-up, in the angiotomographic evaluation, 35,7% of patients treated with ASA presented material accumulation inside the extracardiac conduit, with over 2mm of thickness (p=0,082). As for the ventilation/perfusion scintigraphy, two patients presented traces of pulmonary thromboembolism, both treated with ASA (p=0,483), one of whom with unfavorable development of the Fontan circuit. Concerning safety and compliance to the treatment, five patients had difficulty to comply with the treatment (only viable for its trial nature), among those, four under treatment with Warfarin and presenting INR values ranging from 1 to 6,4. For quantitative verification, providing statistic value to the data, an effort must be made for a larger number of patients to be gathered and tried with this treatment. However, the difference in results concerning thrombus-free recovery between the two groups during the two years following surgery cannot, and must not, be ignored

Diversos estudos epidemiológicos têm demonstrado que isoprenóides presentes em frutas e hortaliças possuem ação protetora contra o desenvolvimento de câncer. Objetivou-se, no presente trabalho, avaliar as eventuais atividades quimiopreventivas dos isoprenóides geraniol (GO) e beta-ionona (BI) quando administrados a ratos Wistar, isoladamente ou em associação, continuamente durante as etapas de iniciação e pós-iniciação de modelo de carcinogênese de cólon induzida por dimetilhidrazina. A atividade quimiopreventiva desses compostos foi observada microscopicamente por meio da análise de Focos de Criptas Aberrantes (FCAs) em cólons corados com azul de metileno (0,02%). Verificou-se que, em comparação ao grupo controle apenas os ratos tratados com GO, mas não com BI, apresentaram redução (p≤0,05) do número de lesões pré-neoplásicas (FCAs), no cólon distal, tanto em relação ao número de focos totais quanto aqueles com número maior ou igual do que quatro criptas. Por outro lado, somente tratamento com BI foi capaz de reduzir a concentração de colesterol plasmático total. Posteriormente, raspagem da mucosa colônica foi utilizada para a avaliação de danos no DNA pelo método do \"Cometa\". Em comparação ao grupo controle, tratamentos com GO, BI e GO+BI reduziram (p≤O,05) o comprimento dos cometas indicando, dessa forma, diminuição de danos no DNA. Avaliou-se, ainda, a expressão de Bcl-2, em nível de proteína, em mucosas colônicas dos animais dos diferentes grupos pela técnica Western Blot. Foi possível notar uma redução nos valores da expressão pelos tratamentos com GO (p≤0,05). Embora somente o tratamento com GO tenha inibido a formação de FCAs, tratamentos com BI e GO+BI podem ter apresentado efeitos protetores por inibirem os danos do DNA que não foram suficiente para a inibição da formação e crescimento de lesões pré-neoplásicas. / Several epidemiologic studies have shown consistently that isoprenoids presents in fruits and vegetables have a protective action against cancer. The objective of this study was to evaluate the chemopreventive effects of isoprenoids geraniol (GO) and beta-ionone (BI) during the initiation and pós-initiation phases of in rats submitted to model of chemical colon carcinogenesis induced by dimethylhydrazine (DMH). Aberrant Crypt Focus (ACFs) were detected using a light microscope in colons stained with 0,02% methylene blue. Treatment with GO significantly suppressed the total number of ACF and ACFs ≥ 4 crypts per colon compared with the control group com oil (p≤0,05), mainly in the distal colon. In other hand, only treatment with BI reduced total plasma cholesterol levels compared with the control group (p≤0,05). Subsequently colonic mucosa scraping was used for asses DNA damage through comet assay and expressed as comet length. DNA damage was inhibited in our study by all treatments (p≤0,05). Analysis of Bcl-2 protein from colonic mucosa scraping by Western Blot showed that treatment with GO reduced the values of expression de Bcl-2 (p≤0,05). Although the results of this study suggest that treatment with GO has chemopreventive effects, treatments with BI and GO+BI has initial protective action that maybe wasn\'t sufficient to reduce formation ACF.

Background: Malaria continues to pose a complex public health problem amongst pregnant women in Africa (Schantz-Dunn & Nour 2009; Antwi 2010), accounting for over 90% of the global malaria burden (WHO 2002; Morel et al. 2005; Schantz-Dunn & Nour 2009). However, little is known about the impact of information, education and communication (IEC) strategies in malaria prevention and control among pregnant women in Africa. Aims and Objectives: The study sought to identify: evidence of impact of IEC strategies; feasibility, appropriateness, meaningfulness and effectiveness of the IEC strategies; challenges; best practices and key lessons to inform governments, policymakers, health partners, the academic community, directors, managers of health, frontline health professionals and health educators at institutional and community levels. Moreover, the study aimed to develop a theoretical framework to enhance the understanding of issues related to implementation of IEC strategies. Methods: A mixed method approach was adopted. This consisted of a systematic review of evidence within the African context and an evaluation methodology involving a contextually based survey of Ethiopia, Ghana, Nigeria and Tanzania. The systematic review involved a structured search of relevant databases and websites, and hand search strategies. Three sets of evidence were identified and aggregated using a narrative synthesis approach. A survey questionnaire reflecting the outcomes of the review was sent to health professionals and lay persons in the countries under study. Primary data were analysed using SPSS Version 15.0. Non-parametric tests and sensitivity analyses were conducted to assess the nature of opinions among respondents within and across countries. Findings: 3,440 studies were identified during the systematic review. Out of this number, 57 met the inclusion criteria. Following critical appraisal, 50 studies met the criteria for methodological quality. Ten IEC strategies were identified. These were: Staff training and orientation Advocacy Community mass education campaigns House-to-house sensitisation Health education in health units Visiting places of worship Women’s group meetings Integrated health education campaigns Symbolism versus message delivery Audience segmentation versus information delivery. The survey reveals a high level of awareness of IEC strategies among respondents in the African countries studied. The evidence of impact reported by respondents supported the findings of the systematic review. However, there were some differences, and some concerns still remain regarding the extent of impact. The study suggests that using an IEC strategy implementation equation could enhance the understanding of issues related to implementation of IEC strategies. Implications of the findings are outlined, including implications for professional practice in relation to IEC programme implementation, most especially among nurses and midwives. IEC roles and responsibilities of key actors are also proposed. Conclusions: Despite the challenges of adopting a mixed method approach, the study highlights an important relationship between evidence and practice. This approach also helped to ensure that a comprehensive multiperspective view of IEC strategies was achieved. In designing and implementing IEC programmes, clients must be involved in order to encourage community ownership and programme sustainability. Attitudinal change and commitment is required by all stakeholders in order to achieve and maintain impact on malaria in pregnancy. Finally, while recognising the essence of feasibility, appropriateness and meaningfulness of a given strategy, it is worth noting that the key message from this study is that no one single strategy on its own appears ideal. Therefore, there is the need to pay equal attention to both institutional and community-based strategies. Doing one thing alone will not work; more evidence of impact is required to know what works and in what context.

BACKGROUND: Colorectal cancer (CRC) is the fourth most common and second most deadly cancer in the United States. However, it is highly preventable and treatable if detected at the precancerous or local stage of development. There exists multiple screening methods each with varying sensitivity, required effort, and recommended frequency of use. Complete adherence to screening guidelines by the recommended, at-risk population would halve the current mortality rate. Unfortunately, screening adherence remains the lowest of all screened cancers with a median state screening adherence rate of about 65%. To understand what individual-level factors influence an individual’s decision to be screened, health behavior theory is used. However, few studies have evaluated the performance of entire behavioral theories in their ability to explain CRC screening intentions and behaviors. METHOD: Health Belief Model, Theory of Reasoned Action, Theory of Planned Behavior, and Attribution Theory were evaluated within the context of colorectal cancer screening using an online national sample (N=403) of at-risk individuals age 50 and older. Confirmatory factor analyses were performed for each evaluated construct of the theory. Structural equation models were created using the estimated constructs for each theory. Each theory was evaluated for the following screening use: colonoscopy, sigmoidoscopy, fecal occult blood test (FOBT), and general screening use. Fit statistics were estimated for each model. Models with acceptable fit were examined for significant pathways within the model as well as consistency of the model with the behavioral theory. RESULTS: All models displayed adequate fit statistics. While not all pathways were significant in each model, no estimate was the inverse in directionality to that hypothesized. This provides support that each theory lends some explanatory power and none of the theories evaluated detract from understanding CRC screening intentions and behaviors. Comparison of the models illustrates advantages to each theory and suggests potential integration of theories. CONCLUSION: The constructs of the Health Belief Model, Theory of Planned Behavior, and Attribution Theory all provide adequate explanations of individual-level CRC screening behavior influences. Although, further review and refinement of the theories is warranted and recommended.

Research report submitted in partial fulfilment for MSc (Med) in Epidemiology and Biostatistics in the School of Public Health, 2013 / Concurrent sexual partnerships are a sexual network pattern that speeds the spread of HIV/AIDS and Sexual Transmitted Infections(1). Multiple and concurrent Sexual Partnerships (MCP) are part of behavioural drivers and are playing main role in the increase of HIV incidence(2). The main aim of the study is to identify the possible socio-demographic and behavioural factors that are associated with concurrent sexual partnership in 4 communities of South Africa(SA), so as to inform HIV prevention programmes in designing targeted interventions for addressing this problem in specific communities. The ultimate goal is to reduce the incidence of new HIV infections

Background: This study is located within a complex network of paradigmatical methodological, and institutional relationships, and draws concepts from a range of scholastic traditions. The hermeneutical tradition within Sociology, particularly as exemplified in the work of Jurgen Habermas, provides a starting point for exploring and interpreting the experiences of chronic illness and healthcare access. The concept of the lifeworld/ healthworld as a description of the complex of health beliefs and behaviours of individuals in relation to the ailing body is used to describe chronic illness and healthcare access, both as lived experience and as fields for public health intervention. Aim: To understand how women living with chronic illness experience their illness and access healthcare in an urban and rural context. Methods: This study is a mixed-methods comparative case study of the healthcare access experiences of women with chronic illness in an urban and rural area in South Africa. The core of the study methodology is a comparative qualitative case study, with quantitative methods serving to contextualise the findings. The urban component of the study was conducted in Birth to Twenty (Bt20), a birth cohort study located in Johannesburg-Soweto. The rural component of the study was conducted in Agincourt, a sub-district of the Bushbuckridge district in Mpumalanga Province. The quantitative context for the Soweto case study uses secondary data collected by Bt20 to construct a historical overview of the use of formal and informal healthcare services in Soweto. It also uses the findings of a large scale cross sectional survey of the primary caregivers of the Bt20 cohort, conducted between November 2008 and June 2010. The rural case study is contextualised by a detailed review of research conducted in the Agincourt sub-district. For the qualitative case studies I employed a qualitative methodology incorporating serial narrative interviews to present an experience-based overview of concepts of disease causation, self treatment and coping. Results: The cross-sectional survey describes a low resource population with a high prevalence of chronic noncommunicable disease (NCDs). Over one third (37.3%) of the population in Soweto could be categorised as having a low socio-economic status, defined as access to only one or less of 5 socio-economic items. Slightly over half the respondents in Soweto (50.7%) reported having at least one chronic illness. Only around a third (33.3%) of the survey participants with chronic illnesses reported accessing formal healthcare services in the last 6 months. Similar trends were found in the review of research carried out in Agincourt. The qualitative case study in Soweto is characterised by a preoccupation with how the medicine from the clinic interacts with the body. The search for alternative remedies took place not as an attempt to cure disease, but to reach a deeper understanding of the diseased state of the body. The Agincourt qualitative case study highlights the importance of church membership, particularly of African Christian Churches, as the strongest factor motivating against the open use of traditional medicine. In both study sites there is evidence that traditional healers were consulted for social purposes rather than health-related purposes. Discussion: Soweto and Agincourt share similar patterns of healthcare utilisation and healthcare belief. Both study sites were characterised by increasing trends in formalisation. At the same time, only a small portion of individuals in both study sites with chronic illness utilised formal healthcare services. A consideration of the findings suggests five broad themes for further research: (1) Processes of constructing body narratives; (2) Encounters with purposive-rational systems; (3) Encounters with traditional medicine; (4) Encounters with contemporary informal medicine; and (5) Religion and healthcare. These five themes constitute the beginning of a comprehensive map of the lifeworld/ healthworld schema. Such a schema has implications for healthcare policy and practice, particularly with regard to the development of integrative paradigms in South Africa as exemplified by Community Oriented Primary Care (COPC). Conclusion: The aims and objectives of the study were met through the development of an initial lifeworld/ healthworld schema, which suggests that the coexistence of diverse public healthcare concerns of high NCD prevalence and low formal healthcare utilisation is best addressed through the adoption of integrated healthcare approaches based on lifeworld/ healthworld rationalistion.

A Dissertation submitted to the Faculty of Engineering, University of the Witwatersrand, Johannesburg, for the degree of Master of Science in Engineering. / Ignitions of methane and coal dust have caused considerable loss of life and damage to installations in South African collieries during the past century. The phenomenon of methane outbursts have also resulted in the creation of dangerous conditions underground. The dissertation examines the causes of methane outbursts and the seven main ignition sources leading to methane and coal dust explosions. These ignition sources were derived from an examination of Mines Department inquiries extending back to 1891. the date of the first known ignition of mine gas. Selected incidents were chosen from the official Inquiries for each ignition source and these are dealt with in detail. This includes an investigation into the many factors which developed prior to the individual explosions and the effects of the aftermath such incidents. Precautions to be adopted to prevent methane outbursts and minimise the risk of methane and coal dust explosions as a result of the seven ignition sources are detailed at the end of each chapter. / Andrew Chakane 2018

No presente estudo avaliou-se o potencial quimiopreventivo da goiaba vermelha (GV) e da goiaba branca (GB) quando administradas a ratos Wistar durante as etapas de iniciação e promoção do modelo de hepatocarcinogênese de Ito et al. (1988) (DEN-HP). De acordo com o Protocolo Experimental 3, os animais receberam durante 8 semanas consecutivas, continuamente durante as etapas de iniciação e promoção, água de beber (grupo AG= controle) ou suco com 10% de goiaba vermelha (grupo GV) ou goiaba branca (grupo GB). Um grupo permaneceu no mesmo local e não foi submetido ao modelo (grupo normal). Duas semanas após o início dos tratamentos, os grupos foram submetidos ao modelo de hepatocarcinogênese de lto (Ito et al., 1988) (DEN-HP), exceto pelo grupo normal. Esse modelo consistiu na aplicação intraperitoneal de uma dose do agente iniciante dietilnitrosamina (DEN, 20 mg/100 g de p.c.), seguida, 3 semanas após, de uma hepatectomia parcial (HP) a 70%. Decorridas 6 semanas após a iniciação com DEN, todos os animais foram sacrificados. De acordo com a análise morfométrica das lesões pré-neoplásicas (LPN) hepáticas positivas para a enzima glutationa S-transferase forma placentária (GST-P), não foram constatadas diferenças (p>0,05) entre os grupos controle, GV e GB quanto ao número bem como quanto à área média das LPN GST-P positivas e área agregada do corte ocupada por estas. Com relação ao índice de apoptose, também não foram constatadas diferenças (p>0,05) entre os grupos controle, GV e GB. Houve acúmulo de licopeno hepático por parte de ambos os grupos GV e GB em relação ao grupo AG constatado pela detecção e quantificação por meio da técnica por HPLC. De acordo com os resultados do estudo, quando administradas a ratos Wistar continuamente durante as etapas de iniciação e promoção do modelo de hepatocarcinogênese de Ito (DEN-HP), a GV ou a GB não foram capazes de apresentar atividade quimiopreventiva efetiva, apesar do acúmulo de licopeno hepático nos animais desses grupos. / Lack of chemopreventive activitie of white guava and red guava when administered to Wistar rats submitted to hepatocarcinogenesis model. In the present study, the chemopreventive activity of red guava (RG) and white guava 0NG) was evaluated when administered to Wistar rats during the initiation and promotion phases of Ito\'s hepatocarcinogenesis model (DEN-HP) (Ito et a/., 1988). In the Experimental Protocol 3, animals received during 8 consecutive weeks, continuously during the initiation and promotion phases, drinking water (control group= W) ar 10% red guava juice (group RG) or 10% white guava juice (group WG). A group was kept in the same place as the others and was not submitted to the model (normal group= N). Two weeks after the beginning of the treatments, the groups were submitted to Ito\'s hepatocarcinogenesis model (DEN-HP) (Ito et al., 1988) except by the normal group. Initiation was obtained by administration of a single intraperitoneal dose of diethylnitrosamine (DEN; 20 mg/100 g b.w.) followed, 3 weeks after, by a partial (70%) hepatectomy (PH). Six weeks after DEN initiation, the animals were anesthetized and sacrificed by exsaguination. According to morphometrical analysis of placental form of glutathione S-transferase (GST-P) positive PNL, no differences (p>0,05) were observed among the W, RG, and WG groups regarding the number, average area of GST-P positive PNL, and area of the liver section occupied by these GST-P positive PNL observed. According to apoptosis index, there where also no differences (p >0,05) observed among the W, RG, and WG groups. Lycopene was stored in the livers of animals from both RG and WG groups compared to W, as it was detected and measured using HPLC. According to the results of the study, RG and WG did not present chemopreventive activity when administered to Wistar rats continuously during the initiation and promotion phases of Ito\'s hepatocarcinogenesis model (DEN-HP) (Ito et al., 1988).

No campo da prevenção ao HIV, a maior parte dos esforços se dedica as pessoas soronegativas que nos programas e pesquisas aparecem como sinônimo de todos. A noção de Prevenção Positiva produzida no âmbito da resposta brasileira , por outro lado, considerou que as PVHA também necessitam de cuidados preventivos únicos. A presente dissertação se propõe a examinar a produção científica que descreve intervenções de prevenção positiva, bem como as suas possíveis contribuições na resposta à epidemia de HIV/AIDS, analisadas na perspectiva informada pelo quadro das vulnerabilidades e dos direitos humanos, que possibilitou a produção de uma noção singular de prevenção positiva ao longo da 3a década de epidemia. Para tanto, utilizamos como método de pesquisa a revisão de escopo (scoping review) que permitiu sintetizar o conhecimento sobre intervenções de prevenção positiva disponibilizadas nas bases de dados escolhidas (CINAHL, ERIC, Lilacs, MedLine, PsycInf, Scopus, Web of Science e Google Acadêmico). Dos 700 artigos recuperados, foram selecionados 15 artigos, a partir dos critérios de busca. Entre outros achados, os estudos confirmaram o entendimento de que, historicamente, a prevenção do HIV se constituiu no campo sócio-comportamental. Não à toa, as intervenções centraram-se quase inteiramente na prevenção da transmissão do HIV e controle da epidemia, não no bem-estar das pessoas vivendo com HIV. Discutimos que as intervenções disponíveis na literatura, apesar da esperada inovação cunhada como prevenção positiva, sustentam a mesma prioridade de proteger as pessoas HIV negativas de serem infectadas por seus parceiros HIV positivos e perdem a oportunidade de inovar programas existentes, a partir do momento que não levam em conta os contextos diferentes de vulnerabilidade social e ação programática, que excluem os marcadores de [8] desigualdade (como classe ou gênero) e os projetos de cada pessoa vivendo com HIV na sua vida cotidiana e sua vulnerabilidade pessoal. Defendemos a maior produtividade de uma concepção que supere esse modelo que leva à culpabilização das PVHA e à sobreposição de estigmas que enfrentam, para fortalecer uma noção de prevenção solidária e compartilhada realizada em intervenções de prevenção positiva balizadas pela atenção integral à saúde e pela defesa e promoção dos direitos humanos das pessoas afetadas pela AIDS / In the HIV prevention field, most part of the emissions are dedicated as seronegative people that appear in programs and researches as synonymous of all. The notion of Positive Prevention produced within the scope of the Brazilian response, conversely, considered that PLWHA also need single preventive care. This thesis proposes to examine the scientific production that describes positive prevention interventions as well as their possible contributions for the response to HIV/AIDS epidemic, analyzed from an informed perspective by the vulnerability and human rights framework, which made possible the production of single notion about the positive prevention throughout the 3rd epidemics decade. For this purpose, was used as a research method, a scoping review that allowed synthesizing knowledge about positive prevention interventions available in the chosen databases (CINAHL, ERIC, Lilacs, MedLine, PsycInf, Scopus, Web of Science and Google Scholar). Of the 700 recovered articles, were selected 15 articles based on the search criteria. Among other discoveries, the studies confirmed the understanding that, historically, HIV prevention has been in the socio-behavorial field. Not by accident, the interventions focused almost entirely on preventing HIV transmissions and controlling the epidemic, not on the well-being of people living with HIV. Was discussed that interventions available in the literature, despite the expected innovation named as positive prevention, support the same priority in protecting HIV negative people from being infected by their HIV positive partners and miss the opportunity to innovate existing programs, from the moment that they dont consider the distinct contexts of social vulnerability and programmatic action that exclude markers of inequality (such as class or gender) and the projects of each person living with HIV in their daily lives and personal vulnerability. We defend the higher productivity of a conception that [10] overcome this model that blames the PLWHA and the overlapping of stigmas they face in order to strengthen the notion of solidarity and shared prevention carried out in interventions of positive prevention defined by integral health care and the defense and promotion of the Human Rights of people affected by AIDS

Introdução: Comportamentos alimentares inadequados, inatividade física e maior tempo despendido na frente da televisão e/ou computadores são frequentes entre adolescentes e aumentam o risco para o ganho de peso. Destaca-se a importância em abordar adolescentes com estratégias de intervenção para a promoção da saúde. Objetivo: avaliar o efeito da intervenção sobre o estado nutricional, ingestão dietética, atividade física e comportamentos sedentários de lazer. Métodos: É um ensaio comunitário randomizado controlado com adolescentes do sexo feminino, matriculadas em 10 escolas técnicas públicas da cidade de São Paulo. O estudo está registrado na plataforma ClinicalTrials.gov e segue o checklist do CONSORT. A intervenção foi adaptada do estudo NEAT Girls em referência a Teoria Social Cognitiva e teve duração de seis meses. Foram avaliados o peso, a estatura e a circunferência da cintura, índice de massa corporal (IMC) e IMC z-score. O consumo alimentar foi avaliado com o questionário de frequência alimentar validado. A atividade física pelo questionário que avalia os três níveis de atividade física de lazer e os comportamentos sedentários de lazer por um questionário auto-relatado. Foi realizada estatística descritiva dos dados, os testes do qui-quadrado, t-student independe e o modelo linear misto para as análises dos dados com nível alpha de significância de 5 por cento . Todas as analises seguiram o princípio de intenção-tratamento. Resultados: Participaram 253 adolescentes (16.05 [EP 0.05] anos), 142 no grupo intervenção e 111 no grupo controle. Após os seis meses da intervenção, houve diferenças estatisticamente significantes a favor do grupo intervenção para o indicador da circunferência da cintura (-1.09cm; [0.51], p=0.027); consumo do grupo das frutas (0.23porção [0.11], p=0.006), das verduras e legumes (1.15porção [0.55], p=0.005) e dos açúcares e doces (-0.67porção [0.35], p=0.0.036); tempo despendido na frente dos computadores durante a semana (-0.39horas [0.21], p=0.039) e aos finais de semana (-0.54horas [0.22], p=0.030) e a soma de todas as atividades de tela durante o final de semana (-0.79horas [0.32], p=0.007). As diferenças proporcionais entre os níveis de atividade física leve (x2=20.95 p=0.007) e vigorosa (x2=8.09, p=0.017) favoreceram as meninas da intervenção. No geral, as meninas ficaram satisfeitas com o programa e o workshop de nutrição foi o componente que elas mais gostaram. Conclusão: O Hábitos Saudáveis, Meninas Saudáveis Brasil apresentou melhoria para o indicador circunferência da cintura, no consumo das frutas, verduras e legumes, dos doces, tempo despendido na frente dos computadores e na atividade física. / Introduction: Inadequate eating behaviors, physical inactivity and increase time spent on TV and computers are often among adolescents and increase the risk for weight gain. It highlights the importance to target adolescent in intervention strategies to promote health. Objective: evaluate the intervention effect on the nutritional status, dietary intake, physical activity and leisure sedentary behaviors. Methods: It is a group randomized controlled trial with female adolescents attending 10 public schools from São Paulo. The study is registered in ClinicalTrials.gov and follows the CONSORT checklist. The intervention was adapted from the NEAT Girls study in reference of the Social Cognitive Theory with 6 months duration. It was accessed weight, height, waist circumference, body mass index and body mass index Z-score. The food consumption was evaluated using a food frequency validated questionnaire. Physical activity was evaluated by a questionnaire that assesses the three levels of leisure-time physical activity and leisure sedentary behaviors using a self-reported questionnaire. Descriptive statistics, chi-squared, student-t and linear mixed models were used to analyze the data with a level of significance of 5 per cent . All analyses followed intention-to-treat principles. Results: Participated 254 adolescents (16.05 [EP 0.05] years), 142 and 111 from intervention and control groups, respectively. After six-month intervention, significant findings favoring intervention group were found for the waist circumference indicator (- 1.09cm; [0.51], p=0.027), fruits (0.23serving [0.11], p=0.006), vegetables (1.15serving [0.55], p=0.005), sweets (-0.67serving [0.35], p=0.0.036), time spent on computers during the weekdays (-0.39hours [0.21], p=0.039) and weekends (-0.54hours [0.22], p=0.030) and sum of the screen activities on the weekends (-0.79hours [0.32], p=0.007). Proportional differences in light (x2=20.95 p=0.007) and vigorous (x2=8.09, p=0.017) physical activity significantly favored the interventions girls. In general, girls were satisfied with the program and the nutrition workshop was the component most enjoyable. Conclusion: The Healthy Habits, Healthy Girls Brazil demonstrated an improvement on waist circumference indicator, fruit and vegetables, sweets, time spent on computers and physical activity levels.