T l chager pdf sexe-

Descubra todo lo que Scribd tiene para ofrecer, incluyendo libros y audiolibros de importantes editoriales. Vj Problems A Simple VAR 9. The Standard Error of the Median Testing the Restrictions

T l chager pdf sexe

T l chager pdf sexe

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Consistent condom use was defined as using condoms for every act of vaginal sex and correct use as consistent use without any of the following: beginning sex without a condom, taking it off before finishing sex, flipping it over, condom breakage, or condom slippage.

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Consistent condom use was defined as using condoms for every act of vaginal sex and correct use as consistent use without any of the following: beginning sex without a condom, taking it off before finishing sex, flipping it over, condom breakage, or condom slippage.

In the United States, approximately Many studies, as well as a recent National Institutes of Health report, have evaluated the effectiveness of condoms to prevent STIs. For example, inconsistency of or no condom use was assessed during unknown periods as a risk factor for infection, neither consistency of condom use nor condom use for each act of vaginal sex was assessed, and errors were not measured.

Even if condoms are used consistently and correctly, slippage and breakage can occur. Therefore, based on these studies, only limited conclusions about the effectiveness of condoms to protect women from chlamydia or gonorrhea can be made. Recently, recommendations have been made for measurement of condom use. In a group of sexually active adolescent girls, we ascertained correctness and consistency of condom use and tested for C trachomatis and N gonorrhoeae with nucleic acid amplification tests performed on urine samples to evaluate the effectiveness of condom use in preventing infection.

Enrollment for this study took place within a larger longitudinal sexually transmitted disease STD study with multiple diagnostic and epidemiologic objectives. Participants were recruited at an adolescent health care clinic at a public pediatric hospital in Atlanta, Ga.

Nonpregnant, human immunodeficiency virus HIV —negative, sexually active girls 13 to 19 years old were eligible if a pelvic examination was indicated. The indications were no Papanicolaou smear performed within 1 year, symptoms that required evaluation, or patient request.

Those who had received antibiotics in the previous month were excluded. After being informed about and agreeing to participate in the study, adolescents younger than 18 years provided assent and a parent or guardian provided consent; adolescents 18 or 19 years old provided their own consent.

Reimbursement was provided for time involved in study participation. Data collected at the first visit among participants enrolled between January and August were used in this analysis.

Trained interviewers administered a structured, face-to-face questionnaire in private before the physical examination. They obtained data on demographics, sexual and reproductive history, peer norms, attitudes toward and actual condom use, self-esteem, mental health, alcohol and other drug use, and partner characteristics.

Participants were asked about vaginal, anal, and oral sex for each of the partners they had had in the previous 90 days. We limited our analysis to vaginal intercourse. Possible condom errors included 1 starting sexual intercourse without a condom and then putting one on, 2 using a condom but taking it off before finishing sex, 3 putting a condom on inside out and flipping it over to put it on correctly, 4 condom breakage, and 5 condom slippage.

Condom errors were not partner specific. The information on condom use per sexual act was categorized into 3 groups: no use of condoms, inconsistent use, and consistent use condom use for every act of vaginal sex ; after finding no difference between no use and inconsistent use, these 2 groups were combined. We evaluated the association between consistent condom use and infection and the association between each condom error and infection.

All condom errors were then combined into 1 variable, and the interaction of correct use with consistent use was evaluated. We then created a new condom variable that incorporated information on consistency of condom use and condom errors and categorized it in 3 groups: inconsistent or no use, consistent but not correct use, and consistent and correct use.

We conducted separate analyses to determine risk factors for gonorrhea and chlamydia detection. We were specifically interested in assessing the effect of certain behaviors, such as correct and consistent condom use, drug use, and other contraceptive use, to evaluate their effect on infection status.

The condom use variables were considered as potentially protective against infection. Adolescents who reported vaginal sex in the 3 months before their first study visit were included in the analyses.

We describe the prevalence of infection and sexual behaviors among the study population. Analyses of continuous variables were assessed using the independent, 2-sample t test. Multivariate logistic regression was used to calculate the adjusted OR for the association between possible predictors and infection. We fit separate models for chlamydia and gonorrhea. The multivariate logistic regression models were developed by identifying, as potential predictors, all variables that attained a statistical significance level P value of.

We used backward stepwise elimination to remove variables that did not remain statistically significant from the model. In the last stage of model development, we addressed the possibility of interactions among the variables that remained in the final model. Correct and consistent condom use was entered into the model as a categorical variable for which we arbitrarily assigned 0 to irregular or no use, 1 to consistent but not correct use, and 2 to correct and consistent condom use. The number of partners was retained in the model irrespective of significance to adjust for sexual activity.

SAS statistical software, version 8. A total of adolescents were enrolled in the study from January to August The mean age was Mean age of first sexual experience was The mean number of lifetime partners was 5. Consistent and correct users were younger, reported fewer partners, reported fewer vaginal acts, were less likely to report alcohol use, and were less likely to report ever having been pregnant Table 2. Prevalence with either infection or both did not vary by age or race.

Adolescents who were not attending school had a higher prevalence of chlamydia and gonorrhea; however, this finding was not statistically significant Table 3. We examined whether the consistency of condom use was related to infection. Based on the findings from univariate analysis, the following variables were selected for the chlamydia model: age, number of lifetime partners, number of vaginal sex acts, having a child or children, ever douched, exchange of money or drugs for sex, having sold drugs, marijuana use, and correct and consistent condom use.

Variables selected for the gonorrhea model were age, number of partners in the last 3 months, ever douched, number of vaginal sex acts, and correct and consistent condom use. This study evaluated the relationship between self-reported correct and consistent condom use and chlamydial and gonococcal infection among high-risk adolescents. We found that consistent and correct use of condoms provided significant protection against both chlamydia and gonorrhea.

In fact, no adolescent girls were infected with gonorrhea if they and their partner s used condoms consistently and correctly. We also found that douching was associated with gonorrheal infection.

Douching has been found to be a risk factor for other STDs, including human papillomavirus, and recent douching has been associated with endometritis 21 in several cross-sectional studies. More prospective studies are needed to better define the relationship between douching and STIs.

Having a child was associated with a higher risk of chlamydia. Higher rates of STIs among pregnant teens have also been reported previously. They also documented that pregnant or recently pregnant adolescents were more likely to report having a new partner and higher numbers of lifetime partners. The higher STD rates could also be related to contraceptive choice, since many adolescents with a history of pregnancy are encouraged to use a hormonal contraceptive that does not protect against STDs.

National surveys in the United States that monitor contraceptive behaviors have documented increases in condom use throughout the s and s at the same time that HIV prevention efforts increased. Moreover, the groups in which condom use increased most rapidly were those at greatest risk for STIs ie, adolescents, young adults, and ethnic minorities.

In , the US National Institutes of Health released a report that summarized a federal interagency workshop on the scientific evidence for condom effectiveness in preventing STDs. Some of the controversy around condom effectiveness derives from the difficulty in measuring relevant exposures and behaviors and the limitations of studies in the literature.

Baeten et al 9 found a significant decreased risk of gonorrhea among Kenyan commercial sex workers who reported consistent condom use hazard ratio, 0.

Our study found that correct and consistent use of condoms, not consistent use by itself, was protective against gonorrhea and that no participants who used condoms consistently and correctly were infected.

Gonorrhea is easily transmissible from men to women. Following a single exposure to an infected male, the probability of infection is 0. This study adds to the data available on the protective effect of condoms against gonorrhea among women and provides new data on the importance of assessing both consistency and correctness of condom use. Protection from chlamydia for women is biologically plausible; the urethral opening of the penis is the main site from which chlamydia can be transmitted from an infected man to a woman, and correct use of a condom could easily provide a barrier during sexual intercourse.

Several prevalence and incidence studies 6 , 8 , 9 , 12 , 13 have shown a statistically significant relationship between condom use or lack thereof and chlamydial infection. In an incidence study in Kenya, Baeten et al 9 found that consistent condom use protected against new chlamydial infection hazard ratio, 0. Other studies have varied in their assessment of condom use; most assessed the risk of no condom use, and none assessed sex act—specific condom consistency or condom errors. Adolescents who reported this error had a higher risk of chlamydial infection.

Most transmission risks could be preventable if condoms are put on before genital contact, used throughout intercourse, and not removed until after ejaculation. Other errors, such as condom breakage and slippage, are also highly prevalent.

Our study had some limitations. We used cross-sectional data for this analysis and were, therefore, not able to calculate incident infections or determine the temporal relationship between infection and condom use. Male partners who experience problems with condoms may fail to communicate this information to their sexual partners; therefore, our female participants might not have been aware of all condom errors.

As in other studies of condom use, reports of condom use could have been inflated owing to social desirability bias. However, this would be a form of nondifferential misclassification that would tend to bias results to the null and underestimate the protective effect of condoms. We did not have information on infection status of partners, so we were not able to know if coital acts evaluated actually carried an STD risk.

This is one of the few studies that examined correct and consistent condom use with biological outcomes using a sensitive test; further studies on condom use should collect similar data to accurately assess the protective effect of condoms.

Studies that do not account for whether participants used condoms correctly may underestimate condom effectiveness. Various forms of incorrect use would suggest that user failure, rather than product failure, may contribute to the observed lack of condom effectiveness. We believe that condoms must be used correctly and consistently to achieve their protective effect.

Although messages directed at adolescents should encourage delaying initiation of sexual activity, many are already sexually active, and STDs are particularly common among this group.

We also thank Jim Braxton, AA, for his assistance in data management; Kay Stone, MD, for her careful review of the manuscript; and Lee Warner, PhD, for his ideas and assistance during the preparation of the manuscript.

Arch Pediatr Adolesc Med. All Rights Reserved. Save Preferences. Privacy Policy Terms of Use. Twitter Facebook Email. This Issue. Citations View Metrics. Black, PhD ; Lauri E.

Markowitz, MD. Data collection.

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T l chager pdf sexe

T l chager pdf sexe

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My car is one of the best I have owned. I would discuss all the features , including build quality, performance , good looks, and cool engine sound. I owned earlier Chargers, and my Charger is the best ever, with all the options Thoroughly enjoy my Charger. It has all the right equipment. I have been driving since I was 16, and have owned over 50 cars I am over 70 now, and my Charger gives me a chance to relive my youth.

I have owned over 50 cars It is stylish, performs well, very comfortable , great stability Mopar or no car! The paint is still sloughing off. The paint is a horrible failure! I'm seeing spots all over the car, especially, but not restricted to, areas with high sun exposure.

The paint in these sections has begun to wrinkle and slough off the car. It gets worse in hotter weather. The 8-speed automatic transmission does not decelerate smoothly, giving me a significant sense of impending failure.

Upon deceleration, it feels as though someone had thrown out an anchor. I find that very discomforting and unsettling, almost as if an impending transmission failure is due to occur. My vehicle has 1, miles, and although I truly like the vehicle, I feel that it has excessive and excessively complicated applications. It seems to be engineered to impress rather than for performance quality, convenience , and ease of operation. I'd like to see fewer electronic control systems and better engine performance.

A sound system with 30 to 40 percent more power and with more options to adjust sound quality would be great. Updated on Jan 28, Feb 19, This car is so much fun! The sound of the engine , the whine of the supercharger, the overall looks could be trimmed down on the weight issue are all the reason for purchase.

For improvements: In a car like the Hellcat consider the following adjustments: 1. Shave the weight. Go AWD. Heads up display , with this kind of power and ability to go from 0 to over MPH in a few short seconds, the driver should not be looking down at the dash for speed and RPM readings. Put a shift light on the drivers side A pillar. Side rearview mirrors need to be a little bit bigger to help with rear visibility.

Better quality feeling dash and door materials. Exterior body panels fit and finish, lot to be desired. You guys could do way better. Interior door panels and door sill plate quality, plastic not fitting tightly, warped parts, low quality appearing panel craftsmanship. Updated on Oct 15, It's basically an SRT: It has it all the SRT equipment in it, and one thing it does BADLY is accelerate very poorly when cruising at level speeds such as level road 70 MPH, get on it slightly, and it bogs down, the motor starts lugging because the motor is in the wrong phase.

The same with slower speeds such as 35 MPH or 45 MPH, this motor is in a different phase, where it's running on cylinders. It cruises on four cylinders I believe, and when you try to accelerate, it bogs down and refuses to go without a heavy push on the gas pedal. Why did they not leave it alone as an 8- cylinder performance vehicle , which is what it was supposed to be, not a long distance cruiser?

They need to work on the suspension and low speed performance. The motor is set to run on fewer cylinders at lower speeds and causes extreme lugging at slow speeds. Tires and wheels need to be offered as an option with purchase to go with full thickness tires for a superior ride quality to what it has now. No Low Profile. Updated on Oct 24, Mostly love my Charger, some refinement could be made however, as the motion for using the "auto Stick" feature Should move the shift lever "up" to up shift and "Down to Down Shift.

The design now is opposite, to down shift the lever has to be moved "up" The rear doors could open more perpendicular to accommodate ease of entry. They are fine now but some older people have some degree of difficulty, especially if disabled. They got this one right. Not too much to criticize, however some minor inconveniences. I would prefer the "auto Stick" motion to be Side to Side movement Seems very unnatural to me.

The other is the option selection Wished some of the "Popular" opt package could be a little more flexible. Sunroof limits interior headroom for me. Had to opt for the lesser trim package of the RT instead of the RT Track Pack because all of them in or near my surrounding area had the sunroof package..

Updated on Dec 12, The Dodge Charger is a fun vehicle to drive, looks exceptionally sophisticated and sporty at the same time. The factory stereo amp and speakers are not satisfactory. Passenger seat has pronounced lumbar.

I put leather in my charger because the fabric was not comfortable and felt scratchy to my bare skin. I think the Dodge Charger is the most beautiful car made. I wish they put better sound systems in all cars.

The lumbar in the passenger seat is too pronounced and is not comfortable on long trips and especially when laying the seat down. Please keep and improve on the awesome exterior styling , I love the handling , and I now love the interior which I myself put leather in myself. Consider putting leather in all your vehicles or a more plush version of your cloth than the one you have now. Work needs to be done on the passenger lumbar and the sound system. Aug 26, I was very disappointed that in my Charger I could order a package that gave me Paddle Shifters on the steering column.

For , I had to order a package that changed the wheels and seats only black seats in order to get that feature. Just to rub it in Updated on Jan 14, Every time I walk out to my new Charger I just can't get over how good it looks. The front end is so well designed.

When I'm driving in my Charger I am always getting people staring at it and noticing how beautiful of car it is, the jazz blue color makes it look more sexy than other chargers with a different color when they are sitting side by side. I park next to a silver-ish colored one all the time, and the jazz blue really puts my car at a different level of sexy. I absolutely love the memory for the heated seats and steering wheel , the intelligence of the car is amazing, I don't even have to turn on my rear window defogger.

Updated on Jun 9, The Challenger is a sport sedan with power , handling , and style. Once you sit behind the wheel and push the engine start , you know your car is ready to take you wherever you need to go. It's powerful engine will remind you of a big cat purring and the paddle shifters will take you to a whole new level of driving. Thank you for refining a legend into the sport sedan of the decade. Thank you for making my dream come true by building this vision of extreme power and strength.

Jul 1, Expected it to be included. Very disappointed. Aug 27, May 10, I've had significant trouble with the rear window of this new vehicle. This problem usually resolves itself by the next day. Updated on Jul 15, Love it. The trunk is hard to close when open for short people. Front seat should move back by itself when you get out, and the sunroof should go all the way back when the button is pressed. Would like a CD player. Trunk is too high and heavy for some people to close.

T l chager pdf sexe