Biomedical subjects

Maria Helena de Sousa

Publications and source records attributed to Maria Helena de Sousa.

9 recordsLinked to original sources

PubMed2005

Outcomes of three different models for sex education and citizenship programs concerning knowledge, attitudes, and behavior of Brazilian adolescents.

Three different school-based sex education and citizenship programs in public schools in Rio de Janeiro, Belo Horizonte, and Salvador, Brazil, were evaluated in a cross-sectional study comparing knowledge, attitudes, and practices in sexuality, citizenship, and gender issues among adolescents participating in the programs' activities as compared to adolescents enrolled in schools without such programs (controls). Results showed that Salvador's program achieved good results, with significant changes in knowledge on sexuality and reproductive physiology, attitudes regarding citizenship, and current use of modern contraceptives; Rio de Janeiro's program succeeded in improving students' knowledge of reproductive physiology and attitudes towards sexuality; Belo Horizonte's participants showed greater knowledge of reproductive physiology and STI/HIV prevention but had less positive attitudes towards gender issues, while reporting greater sexual activity. The main difference between Salvador's program and the others was the focus on creative and cultural activities; Belo Horizonte's main difference was its lack of interaction with health services and professionals. However, after the evaluation Belo Horizonte reframed its educational strategies and launched a scaling-up process in a joint effort with the health and school systems.

Adolescent↗

PubMed2005

Sonographic identification and measurement of the epiphyseal ossification centers as markers of fetal gestational age.

PURPOSE: This study was conducted to verify the predictive value of epiphyseal ossification center measurements in estimating gestational age. METHODS: Women with singleton pregnancies of 30-40 weeks gestation (n = 377) were enrolled in this prospective study. The distal femoral, proximal tibial, and proximal humeral ossification centers were identified and measured. A nomogram of fetal bone development was created using the sum of the three diameters. RESULTS: Gestational age correlated well with the diameters of the distal femoral and the proximal tibial epiphyseal ossification centers but even better with the sum of the three ossification centers. Positive predictive values of the fetus having gestational age of at least 37 weeks when the sum of the three centers was 7, 11, and 13 mm were 82%, 94%, and 100%, respectively. A nomogram was created using the sum of the ossification centers for 30-40 weeks' gestational age. CONCLUSIONS: Ultrasonographic visualization of the epiphyses ossification centers may be a useful marker of fetal gestational age.

Adolescent↗

PubMed2004

[Ideal number of children as a risk factor for tubal ligation].

The purpose of this paper was to evaluate the association between ideal number of children (INC) and female sterilization. A nested case-control study was performed through a secondary analysis of data from a cohort study on the reproductive health of women in Campinas, São Paulo, Brazil. A total of 3,878 women were included, 1,012 being sterilized (cases). The relationship between INC and number of live births (LB) was divided in two categories (INC > LB and INC < or = LB). The relative risks of performing tubal ligation were calculated (odds ratio) with their respective 95% confidence intervals for the relation INC/LB and all control variables. All predictor variables were included in a logistic regression model in order to identify the factors independently associated with female sterilization. The results showed that the risks of tubal ligation were higher among women with INC < or = LB, higher age, with partners, higher family income, more than two previous pregnancies, more deliveries, fewer abortions, and without paid work.

Adult↗

PubMed2004

[Brazilian women and physicians' viewpoints on their preferred route of delivery].

OBJECTIVE: To describe women's preferred route of delivery and physicians' viewpoint on that. METHODS: A total of 656 women who gave birth in the National Health System hospitals of the state of São Paulo and Pernambuco and were enrolled in the Latin American Cesarean Section Study (ELAC) were interviewed. Of them, 230 women were selected from three intervention hospitals where patients routinely sought a second opinion when faced with the decision of undergoing a cesarean section, and 426 women were selected from control hospitals. Also, 72 physicians in the intervention hospitals and 70 in the control hospitals filled out a self-administered structured questionnaire. Data analysis was carried out using Mantel-Haenszel's chi-square test, Yates' test and Fischer's exact test. RESULTS: The majority of women reported preferring vaginal delivery than a cesarean section in both groups of hospitals. This preference was significantly higher among women who had had both vaginal delivery and cesarean section (nearly 90% in both groups of hospitals) compared to those who had cesarean sections only (72.8% in intervention hospitals and 77.8% in control hospitals). According to 45% physicians from intervention hospitals and 55% from control hospitals, most women who underwent cesarean sections are satisfied with that; 81% and 85% physicians from intervention and control hospitals, respectively, believed women prefer a cesarean sections out of fear of vaginal deliveries. CONCLUSIONS: The belief that the main reason for increasing cesarean section rates is fulfilling women's desire by their doctors seems to have no support. Better communication between physicians and pregnant women could possibly contribute to improve the current situation.

Adult↗

PubMed2004

The closer you are, the better you understand: the reaction of Brazilian obstetrician-gynaecologists to unwanted pregnancy.

In Brazil, abortion is legally restricted but highly prevalent. The objective of this study was to obtain data on the opinions of obstetrician-gynaecologists regarding abortion and to verify whether there is consistency between their personal opinion with respect to abortion and their private decision when confronted personally with an unwanted pregnancy or with a request for abortion from a patient or relative. A structured questionnaire was sent to obstetrician-gynaecologists, members of the Brazilian Federation of Gynaecological and Obstetrical Societies (FEBRASGO). A total of 4261 physicians responded, a 30% response rate. Almost a quarter of female physicians and a third of male physicians had had an unwanted pregnancy, and 80% of these were aborted. Even among those for whom religion was very important, almost 70% chose abortion when personally faced with an unwanted pregnancy Twice as many respondents accepted abortion as a solution for themselves or their partners as for their patients. The difference was much smaller only if the physician had personally experienced abortion. Thus, the closer physicians are to the problem of abortion, the greater their understanding that there are circumstances under which abortion is the best or only alternative. We expect the publication of these data to contribute towards liberalisation of the abortion law in Brazil.

Abortion, Induced↗

PubMed2003

Fertility and reproductive history of sterilized and non-sterilized women in Campinas, São Paulo, Brazil.

This article compares sterilized and non-sterilized women in relation to socio-demographic characteristics, reproductive history, and cohabitation status. Women from 30 to 49 years of age and residing in Campinas, São Paulo State, Brazil, were interviewed with a pre-tested and structured questionnaire: 236 women sterilized at least five years before the interview and 236 non-sterilized women. The sterilized women were significantly more likely to be married or cohabiting, to be younger when they began cohabiting, and to have been in the union longer than the non-sterilized women. They also began childbearing at an earlier age and had a history of more pregnancies and more live births than non-sterilized women. Factors associated with a history of 3 or more live births at the time of the interview were surgical sterilization, younger age at first childbirth, older age at the interview, recognition of fewer contraceptive methods, and lower per capita income. The article concludes that sterilization generally appears to be the consequence of higher fertility in a group of women who initiate childbearing early in life, although its role in preventing these women from having even larger families may also have a demographic impact.

Adult↗

PubMed2003

[Knowledge adequacy on contraceptives among women in Campinas, Brazil].

OBJECTIVE: An analysis of secondary data was carried out to evaluate the knowledge adequacy on contraceptives and its association with socioeconomic and demographic characteristics. METHODS: The sample consisted of 472 women from the city of Campinas, state of São Paulo, Brazil. Chi-square test was used to evaluate differences among variables and logistic regression was performed to identify independent variables associated with knowledge adequacy (evaluated through a score). RESULTS: Of the total, 47.6% women reached a score higher than six, which was classified as an adequate knowledge on contraceptives. Higher schooling and better socioeconomic status were associated to higher scores of knowledge. CONCLUSIONS: The results show that it is necessary to improve women's education in general, and on contraceptive methods specifically. In addition, professionals working in public health services should be capacitated to provide contraceptives as well as adequate information on contraceptive methods.

Adult↗

PubMed2003

[Estimates from a complex survey].

OBJECTIVE: To evaluate the impact of sampling design and the effect of weighting on data from the 1996 Brazilian National Survey on Demography and Health. METHODS: Secondary data analysis was performed using a sample of 1,355 interviewed women of the state of São Paulo. The sampling design of the National Survey of Household Sampling (PNAD) was used as a reference, and the municipality as primary sampling unit. The ratio estimator and Taylor's approximation for variance were calculated using the primary sampling units and several modalities of weighting. The indicators used to evaluate precision and validity were confidence intervals, design effects (Deff) and biases. RESULTS: For the four procedures, the differences between upper and lower point estimates for prevalence were not greater than 10%. The differences on ranges of confidence intervals were less than 20%. Use of condom and hormone injection were the variables that showed design effects greater than 1.5 and biases greater than 0.20. CONCLUSIONS: According to the results, it could be said that the cluster sampling had an impact on the precision of the estimates for two out of six variables. The impact of weighting was not significant.

Bias↗

PubMed2003

[Male participation in contraceptive methods use].

This study aimed to evaluate male participation in the use of contraceptive methods and to identify relevant variables. A secondary data analysis was conducted, and the sample size was estimated at 175 men using contraceptives methods that require male participation. The study used the qui-square test to evaluate differences between groups, as well as multiple logistic regression analysis. Some 38% of interviewees used some birth control method that required male participation. Higher level of schooling was associated with the use of some form of contraception requiring male participation, i.e., condom use or vasectomy. Considering the sample's characteristics, the study concluded that it is possible for important changes to take place in Brazilian society with regard to the male perspective on contraception. For these changes to be possible it is necessary to invest in education for both men and women, shown to be an important factor for a balance in gender relations.

Adult↗