Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2018-01-15T18:57:41Z No. of bitstreams: 1 Tiago Borges Gouveia.pdf: 483640 bytes, checksum: f19f274ee2f989e62708d6d72f2f6362 (MD5) / Made available in DSpace on 2018-01-15T18:57:41Z (GMT). No. of bitstreams: 1 Tiago Borges Gouveia.pdf: 483640 bytes, checksum: f19f274ee2f989e62708d6d72f2f6362 (MD5) Previous issue date: 2013-08-28 / In the last 12 years there has been a considerable increase in notifications of AIDS cases in the category of men who have sex with men, especially among those who are in the age group 15 to 24 years, according to data from the Ministry of Health. This study seeks to evaluate the cultural, psychological and social factors that affect the risk behavior among young gay people between 18 and 24 years old. The theoretical and methodological proposal chosen for the study was a qualitative approach, justified by the complexity of the object and its peculiarities intertwined, such as the relationship between the individual and society, the structure of the subject with beliefs, values, meanings, and how they relate with the social history process. We interviewed 10 youngsters and by triangulating the theoretical framework that emerged with the axes of the material collected, we understand the social representations of young people in relation to HIV and sexuality, to list situations, practices and behaviors they consider safe for their sexuality and find what the impact of policies to prevent these young people is. The results show that all individuals feel vulnerable to HIV and point out that the way of life and subjectivity of gays in this age group would be one of the factors that affects the risk behavior. About the prevention campaigns, it has been reported that they may have a role in warning, but not decisively, since awareness actually only occurs when there is contact with the disease in a concrete way, either after a risky behavior or through close people who have been contaminated. / Nos últimos 12 anos houve um aumento considerável de notificações de casos de AIDS na categoria de homens que fazem sexo com homens, especialmente entre os que se encontram na faixa etária dos 15 aos 24 anos, segundo dados do Ministério da Saúde. O presente estudo procura avaliar os aspectos culturais, psicológicos e sociais que interferem no comportamento de risco entre jovens homossexuais de 18 a 24 anos. A proposta teórico-metodológica escolhida para o estudo foi a abordagem qualitativa, justificada pela complexidade do objeto e suas peculiaridades imbricadas, tais como as relações do indivíduo e a sociedade, sua estrutura de sujeito com crenças, valores, significados, e suas relações com o processo histórico social. Foram entrevistados 10 jovens e através da triangulação do referencial teórico com os eixos que emergiram do material coletado, procuramos conhecer as representações sociais dos jovens em relação ao HIV e à sexualidade, elencar situações, práticas e condutas que consideram seguras para sua sexualidade e verificar qual o impacto das políticas de prevenção nesses jovens. Os resultados mostram que todos os sujeitos se sentem vulneráveis ao HIV e apontam que o modo de vida e a subjetividade do homossexual nesta faixa etária seria um dos fatores que interfere no comportamento de risco. Sobre as campanhas de prevenção relatam que podem ter um papel de alerta, mas não decisivo, uma vez que a conscientização de fato só ocorre quando há contato com a doença de forma concreta, seja após um comportamento de risco ou através de pessoas próximas que se contaminaram.

Self-injury is a significant issue with a variety of psychological, social, legal and ethical consequences and implications (Froeschle & Moyer, 2004; McAllister, 2003; Nock & Mendes, 2008; White Kress, Drouhard, & Costin, 2006). Self-injurious behavior is commonly associated with the cutting, bruising or burning of the skin. It also can include trichotillomania, interfering with wound healing and extreme nail biting (Klonsky & Olino, 2008; Zila & Kiselica, 2001). In assessing severity, it is important to note that self-inflicted wounds typically do not require any medical attention, as those who engage in self-injury will usually care for any open wounds in order to prevent infection (Walsh, 2006). The typical duration of a self-injurious act is usually less than 30 minutes, resulting in immediate relief from the emotional turmoil precipitating the behavior (Alderman, 1997; Gratz, 2007). It is difficult to estimate the prevalence of self-injury for many reasons. Nock (2009) noted that reports indicating increased estimates in this behavior derive from “anecdotal reports and estimates from small cross-sectional studies” (p. 81). Given the many ethical and legal ramifications involved in working with clients that self-injure, it is important to understand how self-injury typically manifests itself, how it affects differing populations based on gender and cultural differences, and the level of danger it truly represents to the person choosing to utilize it.

Background: The rate of adolescent overweight and obesity has more than quadrupled over the past few decades, and has become a major public health problem [1]. In 2011, 55% of 12-19 year olds in the United States (U.S.) were overweight or obese [2]. Adolescence is a pivotal time in which many health risk behaviors such as tobacco, alcohol, and drug use are initiated. Such health risk behaviors have been significantly associated with overweight and obesity among adolescents. Objective: The purpose of this study is to evaluate the relationship between obesity and the health risk behaviors most commonly associated with premature morbidity and mortality among adolescents with a novel micro area estimate approach that uses weighted hierarchical logistic regression to nest individuals in classes, classes in schools, and schools in districts. Methods: This study is a secondary analysis of a state-wide representative sample of middle school students that participated in the 2010 Tennessee Middle School Youth Risk Behavior Survey (YRBS). Data was collected from 119 (85.6%) of Tennessee’s local education agencies (LEAs), 456 (95.2%) schools, and 64,790 of 78,441 (82.6%) students. The outcome variable was adolescent obesity (≥ 95th BMI percentile). Explanatory variables were divided into four levels [1] district level: use seatbelt/helmet, asked to show ID for tobacco purchase; [2] school level: ever tried smoking, received HIV education in school; [3] class level: average number of days smoked, having ever exercised to lose weight; [4] individual level: having ever been in fight, early onset of substance use, physical activity, and thought about, planed, or attempted suicide. Weighted hierarchical logistic regression analysis was performed to assess the association between risk factors or protective factors and obesity using effect size (ES) and odds ratio (OR) estimates. Results: The study sample included 64,790 middle school students in the state of Tennessee with a mean age of 12.8 years, of which (49.42%) were females and (50.58%) were males. Nearly one-fourth of the students had a BMI at or above the 95th percentile (22.30%). Weighted hierarchical logistic regression analysis shows that seatbelt and helmet use [ES: -2.161 OR: 0.020, 95% CI: (0.006, 0.070)], and weight misperception [ES: 1.256 OR: 9.720, 95% CI: (9.216, 10.251)], having ever exercised to lose weight [ES: -0.340 OR: 0.540, 95% CI: (0.446, 0.654)], having ever tried smoking [ES: 0.705 OR: 3.581, 95% CI: (2.637, 4.863)] and gender (male vs female) [ES: 0.327 OR: 1.810, 95% CI: (1.740, 1.880)] were strongly associated with adolescent obesity. Results from this study also showed that Black, Hispanic or Latino adolescents were more likely to be obese than Whites, Indian, and Asian adolescent [ES: 0.129 OR: 1.260, 95% CI: (1.200, 1.330)], students with grades of mostly C, D and F were more likely to be obese than those with grades of mostly A and B [ES: 0.189 OR: 1.409, 95% CI: (1.303, 1.523)], and that students having an eating disorder [ES: 0.251 OR: 1.576, 95% CI: (1.508, 1.648)] and/or engagement in sports teams [ES: -0.197 OR: 0.700, 95% CI: (0.674, 0.728)] had small or medium ES association with adolescent obesity. Conclusion:This study uses small area estimates in weighted hierarchical logistic regression models to describe the prevalence and distribution of health risk behaviors associated with adolescent obesity among middle school student subpopulations in Tennessee. The value of small area estimates has been demonstrated previously in a variety of other contexts, and again here offers important insights for intervention design and resource allocation at different micro-levels within small and large areas (i.e., district, school, and class). This work adds to the growing body of research that supports community-driven school-based lifestyle interventions targeting early-onset chronic disease and, more specifically, enhances the geographic resolution with which adolescent obesity can be addressed in middle school populations across Tennessee.

Approximately 2.2 million children and adolescents are arrested each year, and these youthful offenders often display serious psychosocial dysfunction across a wide spectrum of areas: family dysfunction, mental health distress, problems with drug use, risky sexual behaviors, and a history of traumatic experiences. Of particular interest, the rate of female adolescent arrest and incarceration has been on the rise over the past several decades, yet female juvenile offenders are understudied compared with their male peers. It is important to identify risk factors that predispose certain female adolescents to criminal behavior to inform future interventions. Given the associations of mental health problems, substance use, trauma, and family dysfunction with crime in adolescent girls, further study is warranted to more clearly understand the links between these psychosocial factors and criminality in adolescents, especially girls. The impacts of mental health disorders, family functioning, risky sexual behavior, trauma, and substance use on juvenile justice involved youths are of great public health and social importance because of the potential to intervene and to prevent criminal behavior in at-risk teens. However, the relationships between these risk factors and the severity of juvenile offending in girls have not been studied adequately. By analyzing data from interviews and follow-up criminal records for almost 500 arrested and detained adolescent girls, we first investigated the associations between concurrent substance use and psychosocial dysfunction in this population. Secondly, we examined which psychosocial domains (i.e., mental health disorders, substance use/abuse, trauma, sexual behavior, and family functioning) were most predictive of recidivism and violent recidivism during adolescence for this group of offending girls. Finally, we studied which psychosocial variables best predicted time to next arrest, thereby determining if psychosocial functioning can also predict the amount of time before a given adolescent reoffends. Our findings indicated that substance use and sexual risk behaviors are the most important psychosocial predictors of poor outcomes in adolescent female juvenile offenders.

The transmission and prevalence of Hepatitis C Virus (HCV) among those who use injection drugs is a major public health issue. Injection drug use has been identified as the main cause of transmission for HCV in Canada. Street youth are at risk for acquiring HCV due to injection drug use that is often a consequence of living in a street environment. Presently, research on prevalence trends, characteristics, and associated behaviors for injection drug use and HCV in street youth, is limited. <p>The purposes of this study were to determine prevalence of injection drug use and HCV in Saskatoon street youth, to identify demographic or other factors that may contribute to street youth using injection drugs, and to identify risk factors and other characteristics of street youth associated with HCV. This study utilized data from Phase III of the Enhanced STD Surveillance in Canadian Street Youth Study by Health Canada for those participants recruited from Saskatoon, Canada. Between February and July 2001, 186 Saskatoon street youth participants between the ages 14 and 24 years completed nurse-administered questionnaires and of these, 156 provided blood specimens. Analyses were conducted to compare population characteristics between street youth who have used injection drugs and those who had not. Similarly, population characteristics were analyzed among those street youth who were antibody-HCV positive and those that were antibody HCV negative.<p>In this study 32.3% of 186 participants had used injection drugs. Significant associations with injection drug use were found for older age (p = 0.01), having sexual partners that use injection drugs (p = 0.01), history of incarceration (p = 0.01), and history of living on the street (p = 0.02). Significant interactions were found for sex trade work by gender (p < 0.01) and by age (p = 0.03), and for living on the street by age (p = 0.02). A HCV prevalence rate of 9.3% of 156 participants was determined for Saskatoon street youth. Use of Ritalin by injection (p = 0.04) and history of living on the street (p = 0.05) were found to be significant risk factors associated with HCV. The interaction of living on the street by gender was also significantly associated with HCV (p = 0.05). <p>The relationship identified between HCV and injection drug use in Saskatoon street youth was a history of living on the street. This link between could serve as a valuable marker for use of injection drugs and developing HCV infection in street youth. Nurses are encouraged to seek out street youth social networks to provide health care and messages of health promotion and disease prevention. Strategies that are culturally, socially, and developmentally appropriate are needed to keep these youth off the streets in the first place.

The transmission and prevalence of Hepatitis C Virus (HCV) among those who use injection drugs is a major public health issue. Injection drug use has been identified as the main cause of transmission for HCV in Canada. Street youth are at risk for acquiring HCV due to injection drug use that is often a consequence of living in a street environment. Presently, research on prevalence trends, characteristics, and associated behaviors for injection drug use and HCV in street youth, is limited. <p>The purposes of this study were to determine prevalence of injection drug use and HCV in Saskatoon street youth, to identify demographic or other factors that may contribute to street youth using injection drugs, and to identify risk factors and other characteristics of street youth associated with HCV. This study utilized data from Phase III of the Enhanced STD Surveillance in Canadian Street Youth Study by Health Canada for those participants recruited from Saskatoon, Canada. Between February and July 2001, 186 Saskatoon street youth participants between the ages 14 and 24 years completed nurse-administered questionnaires and of these, 156 provided blood specimens. Analyses were conducted to compare population characteristics between street youth who have used injection drugs and those who had not. Similarly, population characteristics were analyzed among those street youth who were antibody-HCV positive and those that were antibody HCV negative.<p>In this study 32.3% of 186 participants had used injection drugs. Significant associations with injection drug use were found for older age (p = 0.01), having sexual partners that use injection drugs (p = 0.01), history of incarceration (p = 0.01), and history of living on the street (p = 0.02). Significant interactions were found for sex trade work by gender (p < 0.01) and by age (p = 0.03), and for living on the street by age (p = 0.02). A HCV prevalence rate of 9.3% of 156 participants was determined for Saskatoon street youth. Use of Ritalin by injection (p = 0.04) and history of living on the street (p = 0.05) were found to be significant risk factors associated with HCV. The interaction of living on the street by gender was also significantly associated with HCV (p = 0.05). <p>The relationship identified between HCV and injection drug use in Saskatoon street youth was a history of living on the street. This link between could serve as a valuable marker for use of injection drugs and developing HCV infection in street youth. Nurses are encouraged to seek out street youth social networks to provide health care and messages of health promotion and disease prevention. Strategies that are culturally, socially, and developmentally appropriate are needed to keep these youth off the streets in the first place.

The prevalence of HIV/AIDS in the United States is still high despite advances in prevention and therapies. Among all races and ethnic groups, African Americans are the most severely affected and face a disproportionate burden. African Americans account for a higher proportion of HIV infections and deaths than other races and ethnicities. In addition, one of the fastest growing segments of AIDS cases is patients more than 50 years of age. This segment receives little attention concerning HIV infection and as the U.S. population continues to age, it is important to be aware of specific HIV-related risks faced by these older African Americans and to ensure that they get information and services to help protect them from infection. This study aims to understand and compare the social network characteristics, perceived risk of getting HIV infection and HIV risk behaviors between younger (18 to 49 years of age) and older (50 plus years of age) African Americans living in high HIV prevalence zip codes of Atlanta, Georgia. The study population included 897 African Americans. Controlling for socio-demographic variables, multivariate analyses revealed that older African Americans have significant higher proportion of injection drug use, are less likely to get tested for HIV and more likely to have a risky sex partner (i.e., exchange sex for money or drugs); however, older African Americans were less likely to engage in sexual risk behaviors. Groups did not differ in terms of their perceived risk for HIV and social network characteristics. More research is necessary to understand their HIV-related risk behaviors, both sexual and drug use, and the specific needs for primary prevention effort of HIV/AIDS transmission among older African Americans.

Health risk behaviors are responsible for the majority of morbidity and mortality among adolescents. Researchers have identified three sources of risk-taking in adolescents – dispositional, ecological and biological. The Bioecological Model incorporates these three sources of risk-taking, however it lacks explanatory power. For this reason, this thesis focused on explaining risk perception of health risk behaviors (smoking cigarette, alcohol and marijuana use), and health risk behaviors by integrating the Bioecological Model with a more specific Health Belief Model. The relationship between risk perception and health risk behavior was also investigated as a first step in understanding adolescent decision-making using the Health Belief Model. Adolescents from a suburban Indiana area were asked to complete the Adolescent Health Risk Behavior Survey which assessed egocentrism, self-esteem, social norms, risk perceptions, and the incidence and prevalence of health endangering behaviors. Hierarchical linear regression was used to determine the ability of the systems in the Bioecological Model and their specific variables to explain risk perception of health risk behaviors. Hierarchical logistic regression was used to determine the ability of the systems in the Bioecological Model and their specific variables to explain health risk behaviors and to moderate the relationships between risk perception and health risk behaviors. Based on the results, it was confirmed that the Bioecological Model is important in understanding adolescent’s risk perception of health risk behaviors, and their self-reported health risk behaviors. It is also important in understanding the relationship between risk perception and health risk behaviors. Adolescent Variables, Microsystem, and Mesosystem were significant in predicting adolescent risk perception of all health risk behaviors examined, and self-reported smoking cigarette behavior and marijuana use. Adolescent variables and Microsystem were the only systems to predict adolescent self-reported alcohol use. The relationship between risk perception and reported smoking cigarette behavior was moderated by Adolescent Variables, Microsystem and Mesosystem, however for alcohol use the path was moderated by Adolescent Variables and for marijuana use the path was moderated by the Mesosytem. Results of this thesis imply the importance of considering the contribution of Bioecological Model variables when implementing prevention intervention programs specific to adolescent health risk behaviors.

A 4-H impact evaluation study, conducted in Montana, Idaho, Colorado, and Utah, was replicated in the Nevada public schools. The purpose was to measure the impact of the 4-H experience on the lives of Nevada youth, and to provide impact data for accountability and improvement for University of Nevada Cooperative Extension 4- H Programs. The 1,492 respondents were; 47.6% male and 52.4% female; 34.6% 5th grade, 28.1% 7th grade, and 37.3% 9th grade; 63.1% urban and 36.9% rural; and 11.7% 4-H and 88.3% non 4-H youth. Eight youth development constructs were measured including; extracurricular activity involvement; school leadership positions held; close relationship with adults; caring for others; amount of negative behavior; personal identity; positive identity; and self-confidence, character and empowerment. ANOVA for constructs by independent variables, age groups gender, 4-H participation, and population density revealed that 4-H participation significantly contributed to the variance in extracurricular activity involvement (p = .000), school leadership positions held (p = .025), caring for others (p = .000), and self-confidence, character and empowerment (p = .004).

A 4-H impact evaluation study, conducted in Montana, Idaho, Colorado, and Utah, was replicated in the Nevada public schools. The purpose was to measure the impact of the 4-H experience on the lives of Nevada youth, and to provide impact data for accountability and improvement for University of Nevada Cooperative Extension 4- H Programs. The 1,492 respondents were; 47.6% male and 52.4% female; 34.6% 5th grade, 28.1% 7th grade, and 37.3% 9th grade; 63.1% urban and 36.9% rural; and 11.7% 4-H and 88.3% non 4-H youth. Eight youth development constructs were measured including; extracurricular activity involvement; school leadership positions held; close relationship with adults; caring for others; amount of negative behavior; personal identity; positive identity; and self-confidence, character and empowerment. ANOVA for constructs by independent variables, age groups gender, 4-H participation, and population density revealed that 4-H participation significantly contributed to the variance in extracurricular activity involvement (p = .000), school leadership positions held (p = .025), caring for others (p = .000), and self-confidence, character and empowerment (p = .004).