Search Results (81)

Background: Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) globally, linked to severe complications such as pelvic inflammatory disease and infertility. In the Brazilian Amazon, socioeconomic vulnerability and the absence of screening policies exacerbate risks, particularly among female sex workers (FSWs). Objective: This study aimed to determine the seroprevalence of anti-C. trachomatis IgG antibodies among FSWs in five municipalities of Pará State, Brazilian Amazon, and identify epidemiological factors associated with infection. Methods: A retrospective cross-sectional study (2005–2007) included 348 FSWs recruited via convenience sampling. Sociodemographic and behavioral data were collected through questionnaires, and blood samples were analyzed by ELISA for anti-C. trachomatis IgG. Statistical analyses included Fisher’s exact tests, odds ratios (ORs), and 95% confidence intervals (CIs), using SPSS 21.0. Results: Overall seroprevalence was 93.9% (327/348; 95% CI: 83.1–90%). Significant associations included a household income of 1–3 minimum wages (98.4%; p = 0.0002), sexual partners from the same region (98.8%; p = 0.0421), and age >42 years (96.3%). Most reported inconsistent condom use (43.7%), multiple monthly partners (54.6%), and illicit drug use (53.4%). Discussion: The extremely high seroprevalence reflects chronic C. trachomatis exposure, driven by socioeconomic deprivation and limited healthcare access. Comparisons with global data underscore the urgent need for screening policies, absent in Brazil for FSWs, and highlight the vulnerability of this population. Conclusions: The findings reveal an alarming burden of C. trachomatis exposure among Amazonian FSWs. Integrated strategies, including routine screening, sexual health education, and inclusion of FSWs in priority health programs, are critical to reduce transmission and associated complications. Full article

In a society that advocates for human rights, a moralistic, needs-based approach is incompatible with policies and practices that ensure educational inclusion for all individuals regardless of gender identity or sexual orientation. This study analyses the perspectives of members of the educational community on sex–gender diversity. Specifically, it presents the views of 32 individuals from four primary schools located in southern Andalusia. A qualitative methodology based on interviews and content analysis was employed, supported by NVIVO12 software. The findings reveal differing understandings of sex–gender diversity; the school’s stance on such diversity and, particularly, on LGBTIQ+phobia; as well as the role of initial teacher training in this area. Full article

Background: Very preterm infants are at increased risk of impairment. The objective was to explore the effect of immediate parent–infant skin-to-skin contact at very preterm birth on cognition, motor, social, and language development during the two first years. Methods: The Immediate Parent-Infant Skin-To-Skin Study (IPISTOSS) was a clinical trial with inclusions between April 2018 to June 2021, in three Scandinavian neonatal intensive care units. Infants were randomised at gestational age 28 + 0 to 32 + 6 weeks plus days, to immediate and continuous skin-to-skin contact at birth or conventional care, during the first six hours of life. Results: At three months, 42 infants underwent a General Movement Assessment. At four and 12 months, 69 and 62 infants, respectively, were assessed with the Alberta Motor Infant Scale. At 24 months, language and cognition were tested in 62 infants with the Bayley Scales of Infant and Toddler Development, third edition. Parents completed the Modified Checklist for Autism in Toddlers for 57 infants. There were no significant differences in motor development, cognition, or autism spectrum disorders. A significant difference in language scores in favour of immediate skin-to-skin contact, was found, when adjusted for fathers’ education, mothers’ education, and infants’ sex, Beta (95% CI): 32.00 (7.57, 56.43) p = 0.01, 11.51 (8.94, 55.06) p = 0.007, and 32.00 (7.85, 56.15) p = 0.01, respectively. Conclusions: Skin-to-skin contact immediately at birth did not enhance cognition, motor, or social development during the first two years of life but may have been important for language skills. Our findings support the World Health Organisation guidelines recommending iSSC for preterm born infants in all settings. Full article

Background: Mobility limitation is a pivotal but under-documented dimension of disability in Saudi Arabia. Leveraging the 2017 National Disability Survey, this cross-sectional study provides a population-wide profile of mobility-related physical difficulty. Objectives: Five research aims were pursued: (1) estimate national prevalence and severity by sex; (2) map regional differentials; (3) examine educational and marital correlates; (4) characterize cause, duration, and familial context among those with multiple limitations; and (5) describe patterns of assistive-aid and social-service use. Methods: Publicly available aggregate data covering 20,408,362 Saudi citizens were cleaned and analyzed across 14 mobility indicators and three baseline files. Prevalence ratios and χ² tests assessed associations. Results: Overall, 1,445,723 Saudis (7.1%) reported at least one functional difficulty; 833,136 (4.1%) had mobility difficulty, of whom 305,867 (36.7%) had mobility-only impairment. Severity was chiefly mild (35% of cases), with moderate (16%) and severe (7%) forms forming a descending pyramid. Prevalence varied more than threefold across the thirteen regions, peaking in Aseer (9.4%) and bottoming in Najran (2.9%). Mobility difficulty clustered among adults with no schooling (36.1%) and widowed status (18.5%), with sharper female disadvantage in both domains (p < 0.001). Among those with additional limitations, chronic disease dominated etiology (56.3%), and 90.1% had lived with disability for ≥25 years; women were overrepresented in the longest-duration band. Aid utilization was led by crutches (47.7%), personal assistance (25.3%), and wheelchairs (22.6%), while 83.8% accessed Ministry rehabilitation services, yet fewer than 4% used home or daycare support. Conclusions: These findings highlight sizeable, regionally concentrated, and gender-patterned mobility burdens, underscoring the need for education-sensitive prevention, chronic-care management, investment in advanced assistive technology, and distributed community services to achieve Vision 2030 inclusion goals. Full article

School readiness during early childhood is crucial for future academic success. Existing guidelines recommend a comprehensive approach. This concurrent validation study developed a School Readiness Index (SRI) with five readiness domains: early learning skills, approach to learning, cognitive skills, socioemotional development, and physical health. Through a cross-sectional comparative design, the school readiness skills of 119 Puerto Rican children (63 males, 56 females) aged 54–65 months were assessed using standardized tests (e.g., Batería IV Woodcock-Muñoz and NIH Toolbox Cognition Battery), parental questionnaires (e.g., Ages and Stages Questionnaire-3), and physical health assessments. Each measure was scored and classified using a binary coding system (0 and 1) based on participant abilities (e.g., 1 for expected performance, 0 if below expectations). A composite SRI score was calculated using 25 indicators. Discriminant validity was assessed by comparing children’s registration status in the special education program (SEP). Sex, household income, and maternal education are key determinants of school readiness. Children registered in the SEP had significantly lower composite scores than those not registered, supporting the SRI’s discriminant validity. The SRI is a reliable tool for identifying Hispanic children from Puerto Rico who may benefit from additional support. Inclusive and multidisciplinary assessment strategies are essential. Full article

Gender-independent, intersex, non-binary, and transgender (GIaNT) youth have puberty health and sex education needs that are different from cisgender youth. Unfortunately, this population has historically been excluded from curricula pertaining to these issues in schools throughout the U.S. and Canada. While sex education programs are limited for all youth, and navigating puberty can range from exciting to scary for all youth, GIaNT youth are particularly vulnerable to facing negative outcomes by being omitted from such curricula. Because they are not able to access adequate information in schools and in their family/friend networks, a majority of GIaNT youth turn to the internet to seek out resources for education on puberty health and sex education. To this end, our team is in the process of creating an online educational resource (OER) that is age-appropriate and affirming for GIaNT youth to be provided with resources that are personalized to users’ unique needs. This literature review discusses content suggestions for inclusion of comprehensive puberty health and sex education that caters to GIaNT youth and their unique needs. Full article

Background: Cardiovascular fitness has been proposed as a key factor influencing executive functioning and academic performance during childhood and adolescence. However, the extent and consistency of this relationship remain unclear across diverse populations and educational contexts. This systematic review aimed to evaluate whether cardiovascular fitness, particularly measured through VO₂max, is consistently associated with improvements in executive function and academic performance among students from early childhood to adolescence. Methods: A systematic search of PubMed, Web of Science, SPORTDiscus, and ProQuest Central was conducted up to 15 November 2022. Studies were included if they examined correlations between VO₂max and cognitive or academic outcomes in students from preschool to high school. Methodological quality was assessed using the MINORS checklist. Results: Out of 271 identified studies, 12 met all inclusion criteria. Evidence suggests that higher VO₂max is generally associated with improved executive function domains such as attention, working memory, and inhibitory control, as well as academic performance indicators including mathematics and reading scores. Neurophysiological studies also indicate links between cardiovascular fitness and brain structure/function. However, the strength and specificity of these associations vary across studies due to methodological differences, limited sample diversity, and inconsistent control for confounders. Conclusions: Cardiovascular fitness appears to have a positive, albeit complex, relationship with cognitive function and academic performance in youth. Future research should adopt longitudinal and experimental designs to clarify causal pathways and consider moderating factors such as sex, age, and psychosocial variables. Full article

The latest Relationships Education, Relationships and Sex Education, and Health Education (RSHE) Draft Guidance seeks to reduce the inclusion of LGBT themes in English schools. Additionally, the Gender Questioning Draft Guidance for Schools and Colleges and the Cass Review overlook the rights of trans and non-binary young people, further intensifying the heated debates surrounding their lives. In response, the author draws upon research conducted in a primary school in Greater London in 2021, when statutory RSHE, including LGBT content, was first introduced. The research aimed to understand how teachers felt about teaching RSHE and to collaborate with them to enhance pupil learning within and beyond the RSHE curriculum. This paper critiques lesson observations and teachers’ reflections on their lessons using a Framework for Sexuality Education and Queer Theory. The researcher’s call to rethink how RSHE is taught should not be taken to mean it should not be taught. To the contrary, the findings suggest a need for the school to broaden its curriculum, teaching methods, and strategies to become a truly ‘LGBT-inclusive’ environment. However, the paper also illuminates the apprehensions these primary school teachers experienced, which in turn influenced pedagogical decisions. The article concludes by recommending specific whole-school approaches and effective pedagogical practices for RSHE in the school, which could be beneficial to other primary school settings. Effective teaching of LGBT themes requires clear support for educators, especially within the complexity of a primary school setting and given the changing political and social climate. Full article

Sexual health in cancer care is often overlooked. This study examines oncology nurses’ knowledge and practices regarding sexuality care, identifying barriers and facilitators. A Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)-guided search of Scopus, ScienceDirect, PubMed, and EBSCO focused on studies from 2014 to 2024. Of 1735 identified studies, only 11 met inclusion criteria. Findings revealed a lack of knowledge among nurses and dissatisfaction with sexual healthcare. Barriers include time constraints, cultural factors, and personal reservations. Routine discussions are often absent due to inadequate training. Education- and system-based strategies are needed to enhance nurses’ competence in addressing sexual concerns. Implementing training programs, structured records, evaluation tools, concept maps, and system support would improve patient care and oncology nursing practices. Addressing these gaps with practical measures can enhance communication, patient satisfaction, and quality of life. This unique analysis was conducted by two experienced advanced nurses in the Middle East, where discussions about sex are often regarded as taboo. Full article

Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p < 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM. Full article

Background: Brazil’s Unified Health System (Sistema Único de Saúde—SUS) has played a crucial role in reducing health disparities by providing universal and free healthcare to a diverse population. However, the COVID-19 pandemic exposed significant barriers to healthcare access among vulnerable groups, particularly due to the intersection of multiple vulnerabilities. This study aimed to examine how intersectionality—specifically sex/gender, race/ethnicity, and education level—has influenced inequalities in healthcare service utilization among vulnerable populations during the COVID-19 pandemic in Brazil. Methods: This cross-sectional study is part of the “COVID-19 Social Thermometer in Brazil” project, conducted between May 2022 and October 2023 in Brazil’s state capitals and the Federal District, focusing on populations considered socially vulnerable during the pandemic. Participants were selected using sequential sampling and completed a structured questionnaire. Statistical analyses—performed using Excel, RStudio (version 4.3.2), and ArcGIS—included sociodemographic profiling, the construction of the Jeopardy Index (a measure of social vulnerability), and binary logistic regression to explore associations between Jeopardy Index and healthcare service utilization. Results: 3406 participants, the majority were men (60%), aged 30 to 59 years (65.1%), and identified as Black or Brown (72.2%). Most participants were concentrated in the Northeast (26.6%) and North (22.3%) macroregions. A high reliance on public healthcare services (SUS) was observed, particularly in the Southeast (96%). According to the Jeopardy Index, the most socially vulnerable groups—such as women, transgender individuals, Black people, and those with no formal education—were significantly more likely to rely on SUS (OR = 3.14; 95% CI: 1.34–7.35) and less likely to use private healthcare (OR = 0.07; 95% CI: 0.02–0.20), reflecting a 214% higher likelihood of SUS use and a 93% lower likelihood of private service utilization compared to the most privileged group. Conclusions: Our findings reveal that individuals experiencing intersecting social vulnerabilities face marked inequalities in healthcare access. Without SUS, these populations would likely have been excluded from essential care. Strengthening SUS and implementing inclusive public policies are critical to reducing disparities and ensuring equitable healthcare access for historically marginalized groups. Full article

Sex education goes far beyond merely conveying biological facts; it encompasses the psychological, social, and cultural aspects of sexuality. A gender-sensitive approach to sex education for boys* aims to address their specific needs and challenges, critically reflect on hegemonic norms of masculinity, and develop alternative, non-toxic models of masculinity. This article explores the foundations and core elements of such a gender-sensitive sex education for boys*, considering theoretical concepts such as sexual socialization, hegemonic masculinity, and sexual scripts, as well as sexual health and rights for boys*. An intersectional perspective enables a nuanced analysis of the diverse social inequalities that shape boys’* sexual development. This paper argues for four key elements of gender-sensitive sex education for boys*: (1) empowerment and self-determination to strengthen boys* in their formation of sexual identity; (2) the development of alternative masculinities to challenge stereotypical gender constraints; (3) the promotion of gender justice by raising boys’* awareness of their societal responsibility; and (4) fostering critical competencies in dealing with media and social norms. These approaches contribute to establishing a holistic and inclusive form of sex education that acknowledges boys* in their diversity and helps create a more just society. Full article

Teacher education is paramount for nurturing democratic, critical, and participative citizenship. Educators should approach identity formation from an intersectional perspective, encompassing sex–gender, racial, and cultural diversities. This perspective highlights social inequalities and challenges the power structures that sustain them. Teachers play a crucial role in shaping and reflecting on these identities since their responsibilities extend beyond knowledge transmission. Their ability to incorporate intersectional perspectives into teaching influences students’ understanding of intersectionality, thereby supporting the development of inclusive identities and promoting democratic citizenship. This article opens with the results of research on how trainee teachers acquire competencies in feminist critical visual literacy. Following this review, we analyzed educational materials to examine stereotypes, racism, and the invisibility of racialized and cultural minority communities. We also addressed the identification and counteraction of hate speech targeting the LGTBIQ+ community as well as different gender-based violence. Comparative data from participating universities provide insights into the critical skills of pre-service teachers across international contexts. This study highlights an urgent need for further research into integrating intersectionality in teacher training, supported by educational policies that strengthen critical competencies through a holistic, gender- and race-sensitive approach aimed at social justice. These initiatives would promote an education system responsive to multifaceted diversities. Full article

This paper presents a scoping review of the qualitative research (N = 125) on the use of online dating sites and applications for adults pursuing relationships, including sex, love, and romance, from 2014 to 2023. Our review supports previous literature reviews’ findings, which reveal that research on the topic is predominantly focused on young, well-educated, ethnic-majority, and primarily female heterosexuals or men seeking men in Western societies. Hence, a sample-selection bias shapes our scientific understanding of online dating, leaving other user groups underrepresented. Despite the diversity of scientific fields involved in qualitative research, the methods used are notably similar, indicating a relatively narrow scope in both demographic variables and research approaches. Although the researched themes and perspectives appear diverse at first glance, the research often centers on problem-oriented topics, such as the risks and emotional aspects of online dating, insecurities in self-presentation, negative technological communication traits, and the de-romanticization of society. We conclude that, despite the growing body of research on online dating, significant areas of the topic remain unexplored. There is a need for broader, more inclusive research to fully understand the complexities of online dating in the digital age. Full article

Guided by the Health Belief Model (HBM), this cross-sectional quantitative study investigated the relationship between key factors and HPV vaccine uptake among Chinese international students (CISs). The sample consisted of 105 CISs attending a southwestern U.S. public university. Participants completed English or Chinese surveys consisting of questions about HPV vaccination status, sociodemographics, perceived risks, facilitators, barriers, knowledge, and cultural beliefs about HPV and HPV vaccination. Findings showed that being female, receiving HPV education, and perceiving higher risks of contracting HPV were associated with receiving at least one dose of HPV vaccination among CISs. Given the current suboptimal HPV vaccination rate among CISs, universities might consider enhancing accessibility to HPV education, making it more inclusive and sex-neutral, and addressing the high risks of HPV infection to encourage their vaccination. Full article