Caminhos e intermediações entre serviços do Sistema de Saúde e da Socioeducação / Paths and inter-mediations between Brazilian Health Services and Youth Detention Centers

Resumo A socioeducação é proposta educacional e de (re)socialização do jovem em conflito com a lei, na qual se prevê, igualmente, o direito à atenção à saúde garantido pelo Sistema Único de Saúde (SUS). O presente trabalho visa investigar como se dá a relação entre os serviços de saúde e as unidades socioeducativas no estado do Paraná a partir da perspectiva de trabalhadores e gestores dos serviços. A pesquisa qualitativa e de cunho exploratório consistiu na realização de dezesseis entrevistas semiestruturadas em cinco municípios do estado, com posterior categorização das narrativas a partir de análise hermenêutica. Como resultado evidenciou-se considerável fragilidade na articulação entre os equipamentos da rede para promoção da assistência à saúde em geral e, mais notoriamente, à saúde mental dos jovens. Os quesitos de segurança exercem forte influência na regulação das ações, até mesmo de saúde, na socioeducação. A política atual de atenção integral à saúde na socioeducação, implantada no Brasil em 2014, representa, contudo, um importante contraponto na reordenação e na indução das ações nesse âmbito.

Abstract Socio-education is an educational and (re)socialization proposal for young people having troubles with the law, a law which also includes the right to health care guaranteed by the Unified Health System (SUS). This study aims to investigate the relationship between health services and socio-educational units in Paraná state, from the perspective of service workers and managers. The qualitative and exploratory research consisted of sixteen semi-structured interviews in five municipalities in the state, with subsequent categorization of the narratives based on hermeneutic analysis. As a result, there was considerable weakness in the coordination between the network's facilities to promote overall health care, specifically the mental health of young people. Security issues have a strong influence on the regulation of actions, even health actions, in socio-education. The current policy of comprehensive health care in socio-education, implemented in Brazil in 2014, is, however, an important counterpoint for the reordering and nudging policies in this area.

Effect of Rosmarinus officinalis on Mental Disorder Symptoms in Incarcerated People and Prison Workers

Introduction: common mental disorders whose symptoms are not early identified can turn into more serious illnesses, such as depression, anxiety, and mood disorder. The literature presents the use of rosemary as a form of treatment of physical and mental illnesses, including depression. Objective: The objective of this study was to evaluate the effects of treatments with different doses of rosemary (Rosmarinus officinalis) extract on symptoms of Common Mental Disorders (CMD) in incarcerated people and prison workers. Methods: This is a randomized, double-blind, placebo-controlled clinical trial study. The intervention was carried out using rosemary extract doses at 100, 500, and 1000 mg day-1 in groups composed of 10 participants, for 3 months. A 20-item self-reporting questionnaire (SRQ-20) was used to assess the presence of CMD. The project was submitted and approved by the Research Ethics Committee under the number 4,973,589. Results: The treatments with rosemary extract at 500 and 1000 mg day-1 showed statistically significant results for reducing CMD symptoms when compared to the those found at the beginning of the research. Conclusion: The use of rosemary extract was effective to reduce CMD in the evaluated prison staff and incarcerated people, especially when used at doses of 500 and 1000 mg day-1, and presented safety, as the participants did not experience side effects.

Hernia vesical inguinoescrotal incarcerada: manejo quirúrgico / Incarcerated inguinoscrotal bladder hernia: surgical management

RESUMEN La hernia vesical es una entidad asociada a la hernia inguinal, con predisposición de lado derecho, en un porcentaje de 0,5 a 3%, hasta 10% en hombres, y a partir de la quinta a séptima década de vida1. La mayoría son pequeñas; la fisiopatología más común es la obstrucción mientras que la hiperplasia prostática es la principal etiología. La presentación clínica es poco específica, y el diagnóstico es en la mayoría de los casos transoperatorio. Se presenta el caso de un paciente de género masculino de 64 años, con antecedente patológico de enfermedad de Parkinson, hernia inguinal izquierda reducible hace 5 años. Acudió a consulta médica por manifestar dolor abdominal de moderada intensidad, más aumento de volumen en región inguinoescrotal izquierda. Al realizar el examen físico se constató una hernia inguinoescrotal izquierda no reducible. Con el diagnóstico de hernia inguinal incarcerada se realizó una exploración quirúrgica, con hallazgos de hernia inguinoescrotal de gran tamaño con contenido vesical y epiplón incarcerado con cambios de coloración. Se realizó entonces la reparación de la hernia. La evolución posoperatoria fue satisfactoria sin complicaciones.

ABSTRACT Bladder hernia is a condition associated with inguinal hernia, usually right-sided, in 0.5 to 3% of the cases and up to 10% in men between the fifth and seventh decade of life. Most hernias are small; the most common pathophysiology is obstruction while prostatic hyperplasia is the main etiology. The clinical presentation is unspecific, and the diagnosis is usually made during surgery. We report the case of a 64-year-old male patient with a history of Parkinson's disease and reducible left inguinal hernia 5 years before, who sought medical advice due to abdominal pain of moderate intensity, with increased volume in the left inguinoscrotal region.On physical examination a diagnosis of left-sided non-reducible inguinoscrotal hernia was made. With the diagnosis of incarcerated inguinal hernia the patient underwent surgical exploration which showed a large inguinoscrotal hernia containing the bladder and incarcerated omentum with color changes. The hernia was repaired, and the patient evolved with favorable outcome.

Clinical management strategy of adult inguinal incarcerated hernia / 中华消化外科杂志

Inguinal incarcerated hernia in adults is a common acute abdomen in hernia and abdominal wall surgery. If not treated in time, it is easy to progress to constrictive hernia, lead to intestinal ischemic necrosis, cellulitis of tegmental tissue outside the hernia, hernia sac empyema, intestinal fistula, and even cause toxic shock, with significantly increased mortality. The types of incarceration are different and the corresponding management methods are different. Based on the proposal of the concept of musculopubic foramen hernia repair, inguinal incarcerated hernia includes incarcerated indirect hernia, incarcerated direct hernia, incarcerated femoral hernia, etc. At present, there is no uniform standard for the comprehensive treatment of different types of inguinal incarcerated hernia, and the clinical management strategies of adult inguinal incarcerated hernia still face serious challenges.

Maltrato infantil, diferencias de género y sus implicaciones clínicas y criminológicas en personas privadas de su libertad

Introducción: Diversos estudios muestran elevados índices de eventos traumáticos infantiles en sujetos detenidos en instituciones carcelarias. Objetivo: El objetivo del estudio es evaluar la prevalencia y las diferencias de género de los diferentes tipos de experiencias adversas infantiles y su correlación con variables psicopatológicas y criminológicas en personas detenidas. Material y métodos: Se realizó un estudio epidemiológico descriptivo-observacional en 2 instituciones psiquiátricas penitenciarias ubicadas en la República Argentina. Participaron 84 personas de ambos sexos. Se utilizó un cuestionario sociodemográfico, las escalas SCID I y II y el Cuestionario de Experiencias Adversas Infantiles. Resultados: El 91,7% de los participantes habían padecido alguna experiencia adversa en su infancia. Se encontró una elevada tasa de abuso físico (63%) y emocional (61%). Hallamos diferencias de género en el tipo de maltrato infantil y en los delitos cometidos. Se encontraron relaciones significativas entre algunos eventos adversos infantiles y trastornos psiquiátricos, delitos cometidos y reincidencia. Conclusiones: En concordancia con otros estudios, se observó elevada prevalencia de experiencias adversas infantiles en personas detenidas y diferencias de género significativas en el tipo de maltrato infantil, los trastornos psiquiátricos, los delitos cometidos y la reincidencia.

Introduction: Several studies show high rates of childhood traumatic events in subjects incarcerated in prison institutions. Objective: To assess the prevalence and gender differences of different types of childhood adverse experiences and their correlation with psychopathological and criminological variables in incarcerated individuals. Material and methods: An epidemiological, descriptive-observational study was conducted in two psychiatric prisons located in Argentina and 84 subjects of both sexes participated. A socio-demographic questionnaire was used, the SCID I and II scales and the Adverse Childhood Experiences questionnaire. Results: 91.7% of the participants had suffered some adverse experience in childhood. A high rate of physical (63%) and emotional abuse (61%) was detected. We found gender differences in the type of child abuse and the crimes committed. Significant relationships were found between some childhood adverse events and psychiatric disorders, crimes committed and recidivism. Conclusions: In accordance with other studies, there was a high prevalence of adverse childhood experiences in incarcerated individuals and significant gender differences in the type of child abuse, in psychiatric disorders, in the crimes committed and recidivism.

Técnica mínimamente invasiva en paciente con multimorbilidad crónica y hernia inguinal complicada: reporte de caso / A minimally invasive technique in a patient with chronic multimorbidity and complicated inguinal hernia: case report

El paciente con multimorbilidad crónica forma parte de una población que se ha incrementado en los últimos años. La hernia inguinal incarcerada representa una emergencia. El abordaje transabdominal preperitoneal (TAPP) presenta ventajas para evaluar el contenido de la hernia. Se presenta el caso de un hombre de 77 años con múltiples comorbilidades y cirugías abdominales previas, que se presentó con cuadro de oclusión intestinal. En tomografía computada: asa de intestino delgado incarcerada en región inguinal. Se observó asas intestinales dilatadas con cambio de calibre en región inguinal izquierda. Se retiró asa intestinal atascada en hernia directa. Se disecó defecto herniario y se colocó malla de 10 x 15 cm en espacio preperitoneal. La técnica TAPP es eficaz y segura para la reparación de hernias complicadas en pacientes con multimorbilidad crónica, en manos de cirujanos experimentados.

The patient with chronic multimorbidity is part of a population that has increased in recent years. Incarcerated inguinal hernia represents an emer-gency. The preperitoneal transabdominal approach (TAPP) has advantages to evaluate the content of the hernia. A 77-years-old man with multiple comorbidities and previous abdominal surgeries presented with intestinal occlusion. Computed tomography: small bowel loop incarcerated in the inguinal region. The cavity is inspected by observing dilated intestinal loops with a change of caliber in the left inguinal region. The intestinal loop is removed observing a direct hernia. The hernia defect is repaired, and 10 x 15 cm mesh is placed in the preperitoneal space. The TAPP te-chnique is effective and safe for the repair of complicated hernias in patients with chronic multimorbidity, in the hands of experienced surgeons.

Psychopat hy Predicting Violent Criminal Behaviour among Adult Offenders / Psicopatía y predicción del comportamiento violento criminal en reclusos adultos

Abstract The aim of the present research was to examine the role of psychopathy in predicting violent offending within a sample of adult criminal inmates (N= 342) (M = 48.07, SD = 17.8) from the prisons of Khyber Pakhtunkhwa Pakistan (KPK). T-test and logistic regression was used to analyse the data. Logistic regression analysis revealed that a higher level of egocentricity and a higher level of antisocial behaviour predict a greater probability of committing violent offence. These findings provide important implications for future research in Pakistan, specifically concerning psychopathy as a risk factor for criminal and violent behaviour. The present findings will help to inform legal decisions as to whether inmates should be incarcerated as violent criminals or non-violent criminals. The conclusions of the present research are limited to incarcerated adult male offenders only; therefore, the present study remains unable to reflect the development of psychopathy in either females or the general population.

Resumen El objetivo de la presente investigación fue examinar el papel de la psicopatía en la predicción de delitos violentos dentro de una muestra de reclusos adultos (N = 342) de las prisiones de Khyber Pakhtunkhwa Pakistán (KPK). La prueba T y la regresión logística se utilizaron para analizar los datos. El análisis de regresión logística reveló que un mayor nivel de egocentricidad y un mayor nivel de comportamiento antisocial predicen una mayor probabilidad de cometer un delito violento. Estos hallazgos proporcionan importantes implicaciones para futuras investigaciones en Pakistán, específicamente sobre la psicopatía como factor de riesgo para el comportamiento criminal y violento. Los presentes hallazgos ayudarán a informar las decisiones legales sobre si los reclusos deben ser encarcelados como delincuentes violentos o criminales no violentos. Las conclusiones de la presente investigación se limitan a los delincuentes varones adultos encarcelados únicamente; por lo tanto, el presente estudio sigue siendo incapaz de reflejar el desarrollo de la psicopatía en mujeres o en la población general.

Should a laparoscopic repair be the first choice in incarcerated inguinal hernia

Background: An important part of the procedures for admission to emergency surgery is incarcerated inguinal hernia repair. Minimally invasive surgical procedures have led surgeons to perform these operations laparoscopically. The aim of this study was to demonstrate the safety of laparoscopic inguinal hernia repair in patients admitted to the emergency department with incarcerated inguinal hernia.Methods: The files of patients who underwent laparoscopic surgery for incarcerated inguinal hernia between January 2015 and June 2019 in Bandirma State Hospital General Surgery Clinic was retrospectively reviewed. Pearson Chi-Square test was used as statistical method. Version 18 of the SPSS program was used. P<0.05 was considered significant as it should be.Results: A total of 63 patients were included in the study. The mean age was 52.8 years. A total of 64 repairs were performed on the right side in 41 (65%) cases, on the left side in 21 (33.3%) cases and on both sides in one (1.58%) case. Four (6.25%) of 63 patients had strangulation. Three of these patients (4.68%) had strangulated hernia, and one (1.56%) had strangulated and incarcerated hernia. Four patients (6.25%) presented with ileus. The mean operation time was 65 minutes (35-110 minutes). Mean duration of hospitalization was 2.4 days. The rate of minor complications was 4.68%. Only one (1.56%) major complication was iatrogenic small intestinal perforation. The mean follow-up time was 25.2 months. There was no early recurrence in patients.Conclusions: We suggest that laparoscopic transabdominal preperitoneal hernia repair can be performed safely in emergency procedures in patients with incarcerated inguinal hernia.

Risk factors of postoperative complications after laparoscopic transabdominal preperitoneal hernia repair / 中国基层医药

Objective To investigate the risk factors of postoperative complications after laparoscopic transabdominal preperitoneal hernia repair.Methods The clinical data of 481 cases of laparoscopic preperitoneal hernia repair in the Central People's Hospital of Tengzhou from March 2014 to February 2018 were retrospectively analyzed.The patients were divided into complications group and control group according to whether complications occurred.The clinical data of the two groups were compared and the risk factors of complications were summarized.Results Postoperative complications occurred in 78 cases of 481 patients(16.22％).The proportions of age,operation time,diameter of hernia sac,intraoperative bleeding volume,incarcerated hernia and recurrent hernia in the complications group were 65.3％,32.0％,29.5％,85.9％,20.5％ and 5.1％,respectively,which in the control group were 46.6％,2.4％,53.8％,30.7％,3.4％ and 1.4％,respectively,the differences were statistically significant(x2 =9.175,17.354,84.692,82.959,32.444,4.252,all P ＜ 0.05).The results showed that age ＞ 60 years,operation time ＞ 100 minutes,intraoperative bleeding ＞ 15 mL,hernia sac diameter ＞ 4 cm,incarcerated hernia were the risk factors of postoperative complications after laparoscopic transabdominal preperitoneal hernia repair.Conclusion Age ＞ 60 years old,operation time ＞ 100 minutes,intraoperative bleeding ＞ 15 mL,hernia sac diameter ＞ 4 cm,incarcerated hernia are the independent risk factors of postoperative complications after laparoscopic transperitoneal hernia repair.The patients combined with characteristics above should be given early intervention.

Risk factors of postoperative complications after laparoscopic transabdominal preperitoneal hernia repair / 中国基层医药

Objective@#To investigate the risk factors of postoperative complications after laparoscopic transabdominal preperitoneal hernia repair.@*Methods@#The clinical data of 481 cases of laparoscopic preperitoneal hernia repair in the Central People's Hospital of Tengzhou from March 2014 to February 2018 were retrospectively analyzed.The patients were divided into complications group and control group according to whether complications occurred.The clinical data of the two groups were compared and the risk factors of complications were summarized.@*Results@#Postoperative complications occurred in 78 cases of 481 patients(16.22%). The proportions of age, operation time, diameter of hernia sac, intraoperative bleeding volume, incarcerated hernia and recurrent hernia in the complications group were 65.3%, 32.0%, 29.5%, 85.9%, 20.5% and 5.1%, respectively, which in the control group were 46.6%, 2.4%, 53.8%, 30.7%, 3.4% and 1.4%, respectively, the differences were statistically significant(χ2=9.175, 17.354, 84.692, 82.959, 32.444, 4.252, all P<0.05). The results showed that age>60 years, operation time>100 minutes, intraoperative bleeding>15 mL, hernia sac diameter>4 cm, incarcerated hernia were the risk factors of postoperative complications after laparoscopic transabdominal preperitoneal hernia repair.@*Conclusion@#Age>60 years old, operation time>100 minutes, intraoperative bleeding>15 mL, hernia sac diameter>4 cm, incarcerated hernia are the independent risk factors of postoperative complications after laparoscopic transperitoneal hernia repair.The patients combined with characteristics above should be given early intervention.

Rectosigmoidectomía perineal (procedimiento de Altemeier) para el prolapso rectal encarcelado: reporte de un caso / Case report of perineal rectosigmoidectomy (Altemeier's procedure) for incarcerated rectal prolapse

Resumen Los reportes de prolapso rectal encarcelado son infrecuentes y suponen un reto para el cirujano. Para un prolapso encarcelado no estrangulado, los pacientes deben tratarse con analgésicos y colocarse en la posición de Trendelenburg; y deberían aplicarse medidas conservadoras al prolapso con presión manual simultánea. Si la reducción exitosa no se logra, entonces el paciente generalmente requiere una rectosigmoidectomía con abordaje perineal (procedimiento de Altemeier). Caso clínico: hombre de 57 años, sin una historia previa de síntomas o comorbilidades con predisposición para esta patología. Se presenta en el departamento de urgencias con un prolapso rectal encarcelado posterior a realización de esfuerzo 5 horas antes del ingreso. Se inician medidas conservadoras con colocación en Trendelenburg y aplicación de azúcar granulada tópica. Las medidas fueron infructuosas. El paciente requirió una rectosigmoidectomía con abordaje perineal e ileostomía de protección. El curso postoperatorio no tuvo complicaciones, hubo un excelente resultado después del cierre de la ileostomía y no hubo recurrencia. Discusión: el encarcelamiento conlleva a estrangulamiento a lo largo del tiempo, la cirugía generalmente está indicada si la terapia conservadora fracasa. Aunque tradicionalmente recomendada para los pacientes adultos mayores y pacientes con comorbilidades, los procedimientos perineales son una opción para todos los pacientes y la mejor opción para el prolapso rectal encarcelado.

Abstract Reports of incarcerated rectal prolapse are rare and pose a challenge to the surgeon. For a incarcerated prolapse that is not strangulated, patients should be treated with analgesics and placed in the Trendelenburg position. Conservative measures should be applied to the prolapse with simultaneous manual pressure. If successful reduction is not achieved, then the patient usually requires rectosigmoidectomy with a perineal approach (Altemeier's procedure). Case: The patient was a 57-year-old man with no previous history of symptoms or comorbidities that would predispose him to this pathology. He came to the emergency department with an incarcerated rectal prolapse after attempting to have a bowel movement five hours earlier. Conservative measures of placing the patient in the Trendelenburg placement and topical application of granulated sugar were used. These measures were unsuccessful, so the patient required a rectosigmoidectomy with a perineal approach and protective ileostomy. The patient's postoperative recovery was without complications and had excellent results after the ileostomy was closed. There has been no recurrence. Discussion: Incarceration leads to strangulation over time, so surgery is usually indicated if conservative therapy fails. Although traditionally recommended for elderly patients and patients with comorbidities, perineal procedures are an option for all patients, and this is the best option for incarcerated rectal prolapse.

Clinical features of Amyand's hernia in neonates: cases report and literature review / 中华实用儿科临床杂志

Objective To investigate the characteristics of Amyand's hernia (AH) in neonates in order to decrease the complications and to improve the prognosis.Methods Data about neonates with AH in Department of Neonatal Surgery,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology,were collected from January 2010 to February 2017,and the AH cases published from 1997 to 2017 in PubMed and Wanfang Data were also reviewed.Results Twenty-two cases were collected,including 8 cases treated in Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology,and 14 cases from literature reports.In this group,4 cases underwent traditional operation and 4 cases underwent laparoscopy,respectively.All the patients underwent appendix resection and the ligation of the hernia sac.Among the 4 cases who underwent laparoscopic operation,contra-lateral hernia was found in 2 cases and pyocelia in 1 case.However,the appendix had a solid adhesion with the inguinal canal in those 4 cases and it was difficult to return the appendix to the cavity.Thus,the laparoscopy had to be terminated and the traditional procedure was carried out to separate the adhesion.In those 4 cases to whom the traditional operation was applied,1 case presented inflammation in abdomen and the contra-lateral hernia after operation.According to the pathological results of appendix,in this group,there were 3 cases,4 cases,and 1 case that presented Ⅱ,Ⅲ,Ⅳ type,respectively.In literature cases,there were 13 cases and 1 case that underwent traditional operation and laparoscopy,respectively.There were 4 cases,9 cases,and 1 case that presented Ⅱ,Ⅲ,Ⅳ type,respectively.The complications included located peritonitis (1 case),testicular torsion (1 case) and orchitis (1 case).All cases recovered smoothly.Conclusion Most of the AH cases in neonates present appendix suppuration,gangrene or perforation.The neonatal cases with AH also present obvious local infection and they are prone to develop into pyocelia in inguinal canal and abdominal cavity.In AH cases,laparoscopy has its own advantages,which not only help to make it clear if there is the contralateral hernia,but also helps to treat the complicated pyocelia in abdominal cavity,which help to avoid the residual infection efficiently.

Hernia de Amyand. Reporte de caso / Amyand's hernia. Case report

La incidencia de la hernia de Amyand es muy baja. Siempre es diagnosticada en el transoperatorio, resulta casi imposible de realizar durante el pre-operatorio. Paciente femenina de 75 años de edad, con antecedentes de hernia inguinal derecha recidivante. Comenzó con dolor en epigastrio y en región inguinal derecha, además de náuseas y vómitos. Se identificó cicatriz quirúrgica y aumento de volumen en región inguinal derecha. Se decidió intervenir quirúrgicamente con el diagnóstico clínico de hernia inguinal derecha recidivante encarcelada. Durante el acto operatorio se identificó apendicitis aguda supurada como contenido del saco herniario inguinal. Se procedió a la realización de la apendicetomía y reparación de la hernia, en el mismo tiempo quirúrgico, y colocó la malla de polipropilenoe. Se aplicó antibióticos de amplio espectro. La paciente evolucionó de forma favorable. La biopsia confirmó el diagnóstico. El siguiente caso se presentó, pues a pesar de ser conocido, su incidencia es muy baja, por lo que existen dificultades para su diagnóstico (AU).

The incidence of Amyand's hernia is very low. It is always diagnosed in the trans-operatory period, being almost impossible during the pre-operatory period. This is the case of a female patient, aged 75 years, with antecedents of recidivist right inguinal hernia. It began with pain in epigastrium and in the right inguinal region in addition to nausea and vomits. Surgical scar and volume increase in the right inguinal region were identified. It was decided to make a surgery with the clinical diagnosis of incarcerated recidivist right inguinal hernia. During the surgery an acute suppurated appendicitis was identified as the content of the inguinal hernial sac. The appendectomy was carried out and hernia was repaired in the same surgical time; a polypropylene mesh was placed. Broad spectrum antibiotics were applied. The evolution of the patient was satisfactory. The biopsy confirmed the diagnosis. The case was presented because despite of being known, its incidence is very low, so there are difficulties for diagnosing it (AU).

Motivações do comportamento infrator e perspectivas do futuro de jovens reclusos da cidade de maputo/moçambique: uma visão bioecológica / The young offenders motivations for crime and their prospects for the future: an bioecological overview / Motivaciones del comportamiento violador y perspectivas del futuro en jóvenes detenidos de maputo/moçambique: una visión bioecológica

O estudo foi realizado na Cidade de Maputo, em Moçambique, e teve como objetivo investigar as motivações do comportamento infrator e as perspectivas do futuro de jovens reclusos. Para tal foram usados os construtos da Teoria Bioecológica de Urie Bronfenbrenner. Metodologicamente optou-se pela abordagem qualitativa e exploratória, na qual entrevistou-se seis jovensdos 16-25 anos internados em três penitenciárias.O cometimento dos crimes esteve relacionado à satisfação de necessidades básicas de sobrevivência no contexto das limitações socioeconômicas vividasno momento. Os jovens mostraram interesse em reintegrar-se à sociedade e desenvolver projetos pessoais após o cumprimento da pena. Estes resultados sugerem a necessidade de programas estruturados de acompanhamento psicossocial no período de retorno à comunidade.

The study took place in Maputo City, Mozambique, and investigated young offender´s motivations for crime and their expectations for the future. Bronfenbrenner´s Bioecological Theory was used to guide the research. Methodologically, qualitative and exploratory approaches were adopted, in which six young incarcerated men, with age range from 16-25 years old, from three prisons were interviewed. The committing of the crimes was related to meeting basic survival needs in the context of socio-economic limitations experienced at the moment. Participants showed interest in reintegrate into society and to develop personal projects. These results suggest the need for implementation of structured psychosocial programs for those people after release from prison.

El estudio fue realizado en la ciudad de Maputo, en Moçambique, y tuvo como objetivos investigar las motivaciones del comportamiento infractor y las perspectivas de futuro de jóvenes reclusos. Con ese fin fueron utilizados los constructos de la Teoría Bioecológica de Urie Bronfenbrenner. Esta es una investigación cualitativa y exploratoria, en la cual fueron entrevistados seis jóvenes entre 16-25 años de edad detenidos en tres penitenciarias. Cometer crímenes se relacionó a la satisfacción de necesidades básicas de sobrevivencia en el contexto de limitaciones socioeconómicas vividas. Los jóvenes mostraron interés en volver a la sociedad y desarrollar proyectos personales después de la sentencia. Estos resultados sugirieron la necesidad de programas estructurados de acompañamiento psicosocial durante el retorno a la comunidad.

Application of laparoscopy for special kinds of incarcerated uiguinal hernias in children: A report of 11 cases / 第二军医大学学报

Objective To explore the clinical value of trans-umbilicus two-port laparoscopic operation on the treatment for special kinds of incarcerated inguinal hernias in children. Methods A retrospective analysis of the clinical data of 11 children underwent transumbilicus two-port laparoscopic operation for a special kind of incarcerated inguinal hernia from Dec. 2012 to Nov. 2015 in Wuhan Children’s Hospital of Tongji Medical College of Huazhong University of Science & Technology. Then we analyzed the general data, operative methods, hospital stay and postoperative complications of the children. Results Four children with Amyand ' s hernia were curedby laparoscopic surgery. A Meckel’s diverticulum was found in 3 children, 2 ofthem underwentthe laparoscopic resection of Meckel’ s diverticulum, and one was Litter’s hernia and was cured with transumbilical incision for Meckel’s diverticulum resection and anastomosis. One case had direct inguinal hernia with greater omentum hernia and was cured by laparoscopy. Three cases had seromuscular tear of incarcerated intestine and were cured by aparoscopic intestinal repair surgery. The average hospital stay of all cases was (5. 9±2. 4) d, and no incision infection or postoperative scrotal hematoma were found. All the children were followed up for 10 months to 3 years, and recurrence or testicular atrophy were not seen. Conclusion Transumbilical two-port laparoscopic operation is safe, minimally invasive and quick has recovery for the special kinds of incarcerated inguinal hernias, making it of worthy popularizing widely.

The clinical effect of hysteroscopic IUD intrauterine surgery for inlaid incarcerated derviu / 中国基层医药

Objective To explore the clinical efficacy of hysteroscopic IUD intrauterine surgery for incarcerated ring,and to assess the safety.Methods 586 women with the incarcerated dervice remove under hysteroscope were selected in the hospital (study group),693 women during the same period used conventional methods of taking the dervice (control group ).The status of surgery,cervical relaxation,take the dervice and effect and safety were assessed.Results The operation time,amount of vaginal bleeding and take the dervice time of the study group were (19.36 ±3.14)min,(9.42 ±2.11)mL and (8.17 ±1.90)min,which were lower than those of the control group [(30.29 ±4.08)min,(15.67 ±2.38)mL and (11.35 ±2.26)min],the differences were statistically significant (t=13.16,11.51,9.76,P<0.05).The cervical relaxation goodand take part successfully of the study group were 490 cases(83.62%)and 435 cases(74.23%),which were higher than those of the control group[374 cases (53.54%)and 362 cases(52.24%)],the differences were statistically significant (χ2 =10.28,11.35,P<0.05). Waist lower abdominal pain (0-Ⅰ grade)and vaginal bleeding number (no vaginal flow or<1 day)of the study group were 509 cases (86.86%)and 362 cases (61.77%),which of the control group were 527 cases (76.05%) and 362 (46.23%),and the differences were statistically significant (χ2 =9.94,10.23,P<0.05 ).Conclusion Hysteroscopic IUD intrauterine surgery can shorten the operation time and take the dervice time,reduce the amount of vaginal bleeding and bleeding time.It can improve the success rate of taking the dervice and has fewer negative symptoms.It has high safety and clinical advantages are obvious.

Famílias de mulheres presas, promoção da saúde e acesso às políticas sociais no Distrito Federal, Brasil / Families of incarcerated women, health promotion and access to social policies in the Federal District, Brazil

Resumo O artigo discute as buscas e os acessos de famílias de mulheres presas na Penitenciária Feminina do Distrito Federal às políticas públicas. Busca contribuir para a construção de estratégias de promoção da saúde para a população feminina que vive em situação de prisão. Parte das afirmações trazidas na Política Nacional de Atenção Integral à Saúde das Pessoas Privadas de Liberdade no Sistema Prisional, especialmente aquelas que reconhecem que é preciso ações intersetoriais e que levem em consideração as redes de relações dessa população para promover a saúde. Para tanto, apresenta dados de uma pesquisa realizada na Penitenciária no ano de 2014 que utilizou a metodologia qualitativa por meio de observação participante e entrevistas semiestruturadas com familiares de mulheres presas no Distrito Federal. Podemos dizer que é necessário atentar para as formas diferenciadas produzidas na relação entre as presas e seus familiares e, especialmente, para as narrativas de cansaço e de dificuldade de acesso às políticas públicas. Um olhar mais apurado sobre a forma de organização dessa população poderia auxiliar na elaboração de políticas públicas de promoção da saúde e superação da vulnerabilidade social.

Abstract This paper assesses the options for accessing public policies available to families of women incarcerated in the female penitentiary of Brazil’s Federal District. It seeks to contribute to the construction of health promotion strategies for the female population living in the prison system. Some of the claims were revealed in the national comprehensive healthcare policy for individuals in the prison system, especially those that acknowledge the importance of intersectoral actions and relationship networks to promote health. Data are presented from research conducted at the penitentiary in 2014 that used qualitative methodology by means of participant observation and semi-structured interviews with family members of women incarcerated in the Federal District. It was detected that attention must be paid to the different types of relationship that exist between incarcerated women and their families, and especially to the allegations of exhaustion and difficulty of access to public policies. A more in-depth survey into how this population organizes itself could assist in the development of public policies to promote health and overcome social vulnerability.

Health issues of incarcerated women in the United States / A questão da saúde nas mulheres encarceradas nos Estados Unidos

Abstract Health care within jails and prisons in the United States is typically insufficient to meet the medical and psychological needs of female inmates. Health services are often of low quality, especially in the areas of reproductive medicine. Mental illness, substance abuse, a trauma history, and sexual victimization while incarcerated can predict a more difficult adjustment to a correctional environment. Incarcerated women who are able to maintain contact with family members, especially children, can have a better prison adjustment. Recommendations are made to improve the types and quality of health care delivered to women in jails and prisons in countries around the world.

Resumo A atenção à saúde em cadeias ou prisões nos Estados Unidos é claramente insuficiente para responder às necessidades médicas e psicológicas das mulheres encarceradas. Serviços de saúde são frequentemente de baixa qualidade, especialmente na área de medicina reprodutiva. Estresse, doença mental, uso de drogas, traumas psicológicos e abusos sexuais durante o encarceramento podem predizer maior dificuldade de adaptação ao ambiente prisional. Mulheres encarceradas que mantém contato com membros da família, principalmente crianças, tendem a melhor se adaptar. Recomendações têm sido feitas para melhorar o tipo e a qualidade da assistência oferecida às mulheres em cadeias ou prisões em países por todo o mundo.

Tension-free herniorrhaphy for incarcerated/strangulated inguinal hernia / 中华普通外科杂志

Objective To evaluate preperitoneal tension-free herniorrhaphy for incarcerated and (or) strangulated inguinal hernia.Methods During Mar,2008 to Mar,2015,89 incarcerated and (or)strangulated hernia patients(incarcerated hernia group) and 1 741 primary inguinal hernia patients (elective group) underwent preperitoneal tension-free herniorrhaphy.Results The operation time (42 ± 8 min),length of stay (4.0 ± 2.6 d) and the time return to work (9.0 ± 3.3 d) in incarcerated hernia group were longer than in elective group of (38 ± 4 min),(3.0 ± 0.6 d) and (8.1 ± 2.5 d),respectively (all P ＜0.01).Blood loss [(10 ± 14 ml) vs (7 ±4 ml)] was compareble,P =0.148.There were 1 infection case and 20 seroma cases (22.5％) vs 5 infection cases and 187 seroma cases (12.7％) all P ＞0.05.Followup found hernia recurrence in one case in elective group.Conclusion Preperitoneal tension-free herniorrhaphy is safe and effective for the treatment of incarcerated and(or) strangulated hernia.

Lichtenstein tension-free hernioplasty repair in adult patients with inguinal incarcerated hernia / 中华普通外科杂志

Objective To investigate the preoperative management and the clinical effeciency of Lichtenstein tension-free hernioplasty in adult patients with inguinal incarcerated hernia.Methods Clinical data of 86 patients with inguinal incarcerated hernia were analyzed retrospectively.Hernia was repaired with Lichtenstein tension free after reposition.Results There were 59 male patients and 27 female patients with median age of (63 ± 18) years.There were 8 patients with liver cirrhosis.The operation was performed successfully in all patients.Segmental bowel resection with end-to-end anastomosis was performed in 38 emergency cases.Operative time was 20-120 min,with an average time of 54 min.The postoperative hospitalization was 5-17 d,with an average of 8 d.There were 7 cases of skin ecchymosis at the scrotum,there were no intestinal perforation,hepatic encephalopathy and upper gastrointestinal hemorrhage after operation.In early series of 24 cases without drainage tube left in place,there were 10 cases of fat liquefaction,10 cases of hydrops of hernial sac,6 cases of seroma and 3 cases of wound infection after operation.After 12 to 48 months of follow-up,there was no mortality after 2 years,no hernia recurrence.Conclusions Tension free repair in the treatment of incarcerated inguinal hernia is safe and feasible.