Meta-integration of behavioral barriers to help-seeking in elderly abuse victims / 中国实用护理杂志

Objective:To systematically integrate qualitative studies of impediments to help-seeking behavior in victims of elder abuse.Methods:A computer search of PubMed, the Cochrane Library, Web of Science, PsyINFO, Scopus, China Biology Medicine disc, China Knowledge Network, Vipshop, and Wanfang was conducted to collect qualitative studies on help-seeking in abused older adults, with search time from establishment of the database to February 2022. The literature was evaluated using the Australian JBI Centre for Evidence-Based Health Care quality assessment criteria, and the results were integrated using the Meta integration method.Results:A total of 9 papers were included, 32 results were extracted and grouped into 9 categories, and 3 integrated results were synthesized including the role of personal factors, the influence of cultural values, and the lack of effective support networks.Conclusions:Seeking help after elder abuse is a complex process influenced by a variety of personal, social and cultural factors. Awareness of seeking help after abuse should be raised, attention should be paid to the physical and mental health of the elderly, and professional assistance and counseling services should be provided.

Research progress on risk factors and identification tools for child abuse / 中国学校卫生

Abstract@#Child abuse is a global public health problem, which has emerged as a neglected yet pressing issue in global development. Early and accurate identification of abuse at a lower-age group is of great significance for treatment, which might reduce the risk of re-maltreatment and promote children s physical and mental health development. Therefore, by reviewing the clinical characteristics, risk factors and existing abuse identification and screening tools of child abuse, the study aims at providing basic evidence for the development of child abuse risk identification tools and the establishment of child maltreatment system in China, so as to take timely intervention measures to prevent adverse outcomes or reduce their severity.

Violências relatadas por solicitantes de refúgio atendidos na Cáritas Arquidiocesana do Rio de Janeiro de 2010 a 2017 / Violence reported by asylum seekers assisted by the Archdiocesan Caritas of Rio de Janeiro from 2010 to 2017 / Violencias relatadas por solicitantes de asilo asistidos por la Cáritas Arquidiocesana de Río de Janeiro desde 2010 hasta 2017

Resumo Estima-se que no mundo, atualmente, haja 89,3 milhões de pessoas em deslocamentos forçados, incluindo 27,1 milhões de refugiados. Entre as razões para essas migrações forçadas estão a tortura e outras formas de violência, embora a prevalência de violências antes e durante a migração ainda seja pouco conhecida. O objetivo deste estudo é analisar a prevalência e alguns fatores associados às violências relatadas por solicitantes de refúgio no Rio de Janeiro. Foram coletados dados preenchidos nos formulários de solicitação de refúgio do Comitê Nacional para Refugiados de 2010 a 2017 e em entrevistas adicionais conduzidas na Cáritas Arquiocesana-RJ. Foram incluídos 1.546 solicitantes de refúgio com idade mediana de 30 anos (faixa 15-72 anos), dos quais 65% eram homens. Um terço informou ter sofrido violência antes de chegar ao Brasil, com chances de violência relatada entre 20 e 40 vezes maiores entre migrantes oriundos de Paquistão, Congo, Colômbia, República Democrática do Congo e Guiné. Violência física/tortura, ameaça e violência psicológica foram as mais frequentes (relatadas por 10%, 7% e 6% da população estudada, respectivamente). Entre as mulheres, a violência sexual foi a modalidade mais frequente (9%). Conclui-se que a história de violência entre os solicitantes de refúgio no Brasil é frequente, em particular para alguns grupos nacionais, aspecto a ser considerado no acolhimento e na prestação de serviços a essa população em situação de extrema vulnerabilidade.

Abstract Currently, the world has 89.3 million forcibly displaced people, including 27.1 million refugees. Among the reasons for displacement are torture and other forms of violence, but the real prevalence of violence before and during migration is poorly reported. The aim of this study is to analyze the prevalence of reported violence among asylum seekers in Rio de Janeiro and its associated factors. We collected secondary data from individuals who filled out the National Committee for Refugees' asylum application forms from 2010 to 2017 and responded to the social interview at Cáritas-RJ. We included 1,546 asylum seekers with a mean age of 30 (range 15-72), 65% of whom were men. One third reported experiencing violence before arriving in Brazil. Chances of experiencing violence were 20 to 40 times higher among refugees arriving from Pakistan, Congo, Colombia, the Democratic Republic of Congo and Guinea. Physical violence/torture and psychological threats were the most frequent forms (10%, 7% and 6% of the population, respectively). Among women, sexual violence was the most frequent form of violence (9% of women). We conclude that asylum seekers in Brazil frequently suffered violence before their arrival, particularly some groups. This needs to be addressed when providing services to this extremely vulnerable population.

Resumen Actualmente, hay en el mundo 89,3 millones de personas desplazadas por la fuerza, incluidos 27,1 millones de refugiados. Entre las razones de desplazamiento forzado están la tortura y otras formas de violencia, pero la prevalencia real de la violencia antes y durante la migración ha sido poco estudiada. El objetivo de este estudio es analizar la prevalencia de violencia reportada entre los solicitantes de asilo en Río de Janeiro y los factores asociados a esta. Recolectamos datos secundarios de personas que completaron los formularios de solicitud de asilo del Comité Nacional para Refugiados desde 2010 hasta 2017 y de entrevistas adicionales en Cáritas RJ. Incluimos a 1546 solicitantes de asilo con una edad media de 30 (15-72) años, de los cuales 65 % eran hombres. Un tercio informó haber experimentado violencia antes de llegar a Brasil, con posibilidades de violencia de entre 20 a 40 veces mayores para entre migrantes oriundos de Pakistán, Congo, Colombia, República Democrática del Congo y Guinea. Violencia/tortura física, amenazas y violencia psicológica son las formas más frecuentes (10 %, 7 % y 6 % respectivamente) relatadas. Entre las mujeres, la más frecuente fue la violencia sexual (9 % de los relatos). Concluimos que la historia de violencia entre los solicitantes de asilo en Brasil es frecuente, sobre todo en algunos grupos nacionales en particular, aspecto que se debe considerar al prestarle servicios a esta población extremadamente vulnerada.

The role of mobile phone addiction and anxiety symptoms in the association between childhood psychological abuse and depressive symptoms among college students / 中国学校卫生

Objective@#To explore the role of mobile phone addiction and anxiety symptoms in the relationship between childhood psychological abuse and depressive symptoms among college students, in order to provide a basis for mental health promotion.@*Methods@#From February to May 2023, a stratified random sampling method was used to select 1 799 freshmen to juniors from a university in Wuhu City, Anhui Province. The questionnaire survey was conducted using the 2-item Patient Health Questionnaire (PHQ-2), Child Psychological Maltreatment Scale (CPMS), Mobile Phone Addiction Tendency Scale (MPATS), 2-item General Anxiety Disorder (GAD-2). Correlations among each variable were analyzed, and the chain mediating effect of mobile phone addiction and anxiety symptoms was explored.@*Results@#The detection rate of depressive symptoms among college students was 9.7%, and the positive detection rate of childhood psychological abuse was 28.6%. Depressive symptoms were positively correlated with childhood psychological abuse, mobile phone addiction and anxiety symptoms ( r =0.28, 0.32, 0.27, P <0.01). Childhood psychological abuse was positively correlated with mobile phone addiction and anxiety symptoms ( r =0.29, 0.71, P <0.01). Mobile phone addiction and anxiety symptoms were positively correlated ( r =0.30, P <0.01). Childhood psychological abuse could effectively predict depressiove symptoms, mobile phone addiction and anxiety symptoms ( β =0.08, 0.06, 0.66, P <0.01). Mobile phone addiction and anxiety symptoms had a chain mediating effect between childhood psychological abuse and depression symptoms, with a total indirect mediating effect (effect=25.27%, P <0.05), accounting for 72.44% of the total effect.@*Conclusions@#Mobile phone addiction and anxiety symptoms play a chain mediating role between childhood psychological abuse and depressive symptoms. Focusing on childhood psychological abuse, mobile phone addiction and anxiety among college students are beneficial for depression symptoms prevention.

Impact of childhood sexual abuse on depression among young men who have sex with men in Guangzhou / 中国学校卫生

Objective@#To investigate the experience of child sexual abuse (CSA) and depressive symptoms among young men who sex with men (YMSM) in Guangzhou, and then to explore the impact of CSA on depressive symptoms.@*Methods@#A convenient sampling method was used to recruit MSM. YMSM who aged 18-24 and have lived in Guangzhou for more than 3 months were included in this study. Data on demographic characteristics, homosexual partners seeking behaviors, sexual orientation, CSA experience and depression were collected through an electronic questionnaire. χ 2 tests were used to compare the proportion of CSA and depressive symptoms among YMSM with different characteristics. Logistic regressions were preformed to assess the impact of CSA on depression.@*Results@#The proportion of CSA experience and depressive symptoms among participants were 31.51% (115/365) and 47.95% (175/365), respectively. Participants with junior high school education or lower and who sought homosexual partners offline reported(75.00%,62.22%) a higher proportion of depressive symptoms( χ 2=7.97，4.19， P <0.05). After adjusting for factors e.g. ethnicity, residence, resident duration in Guangzhou, studentship, education, monthly income, sexual orientation and homosexual partners seeking behaviors, the multivariable Logistic regression model showed that YMSM with CSA experience (a OR=1.81, 95%CI =1.12-2.93) were more likely to have depressive symptoms than those without CSA experience.@*Conclusion@#The prevalence of CSA experience and depressive symptom is relatively high among YMSM in Guangzhou, and CSA experience is associated with higher risk of depressive symptoms. More attention should be paid to strengthen the psychological intervention for YMSM, especially for those who experienced CSA, so as to reduce the risk of depression and improve mental health among YMSM.

Latent profile analysis on the association of psychological abuse and neglect with mobile phone dependence among adolescences / 中国学校卫生

Objective@#To identity patterns of psychological abuse and neglect among male and female adolescents, and to examine the relationship between psychological abuse and neglect with mobile phone dependence.@*Methods@#A total of 1 070 adolescents from 5 middle schools in Ganzhou and Wuhan were investigated with Child Psychological Abuse and Neglect Scale (CPANS), Mobile Phone Addiction Index Scale (MPAI) and demographic questionnaire. Latent profile analysis (LPA) was used to construct typologies of psychological abuse and neglect involvement in male and female adolescents.@*Results@#Three latent classes were identified for boys: low level psychological abuse and neglect group (56.68%), medium level psychological abuse and neglect group ( 29.80 %), high level psychological abuse and neglect group (13.52%). For girls, four latent classes were identified including low level psychological abuse and neglect group (49.38%), medium level psychological abuse and neglect group (29.01%), high level psychological abuse and neglect group (11.12%); high level psychological abuse group (10.49%). Adolescents who suffered from psychological abuse and neglect were more likely to be dependent on mobile phones. Among them, boys dependence on mobile phones was manifested as out of control, withdrawal, escape and inefficiency[Medium level： B(95%CI )=0.28(0.12-0.44)，0.29(0.11-0.46)，0.35(0.16-0.53)，high level： B(95%CI )=0.37(0.16-0.59)，0.42(0.19-0.65)，0.33(0.07-0.59)，0.50(0.25- 0.74 )， P ＜0.05], while girls showed evasion and inefficiency in high levels of psychological abuse[ B(95%CI )=0.34(0.01-0.67)，0.46(0.14-0.78)， P ＜0.05].@*Conclusion@#There are heterogeneous differences in psychological abuse and neglect between male and female adolescents, and the relationship between each category and mobile phone dependence varies. The results provide suggestions for adolescent mental health intervention.

Clínicas do Testemunho na elaboração do traumático: violência de Estado na ditadura civil-militar brasileira / Clínicas del Testimonio en la elaboración de traumatismos: la violencia de Estado en la dictadura cívico-militar brasileña / Testimony Clinic and trauma: State violence in Brazilian civil-military dictatorship

Na ditadura civil-militar brasileira (1964-1985) ocorreu uma violação sistemá-tica de Direitos Humanos por parte do Estado, o que impôs à sociedade medo e silenciamento. Pessoas vítimas dessas violências não tiveram espaço social que legitimasse a realidade e o sofrimento de suas vivências. Em 2012, foi lançado o projeto Clínicas do Testemunho, iniciando um trabalho de reparação psíquica dessas vítimas. Estudando as especificidades do trauma de violência de Estado e tortura política e apresentando os conceitos de espaço potencial e de testemunho, o objetivo do artigo é estabelecer um diálogo entre esses conceitos e o trabalho realizado pelas Clínicas do Testemunho, para compreender como esta reparação psíquica pode se dar na prática. Trata-se de um estudo teórico fundamentado na Psicanálise. Conclui-se que o testemunho é uma ferramenta potente para se trabalhar o traumático. Discutir o tema é um posicionamento político, de resgate da história, memória e verdade.

En la dictadura militar brasileña (1964-1985), hubo violación sistemática de los Derechos Humanos por parte del Estado, que impuso miedo y silencio a la sociedad. Las personas víctimas de esta violencia no tenían un espacio social que legitimara la realidad y el sufrimiento de sus experiencias. En 2012, se lanzó el proyecto Clínicas del Testimonio, comenzando un trabajo de repa-ración psíquica de esas víctimas. Al estudiar las especificidades del trauma de la violencia del Estado e de la tortura política, y los conceptos de espacio potencial y testimonio, el objetivo de este artigo es dialogar eses conceptos con el trabajo echo por las Clínicas de Testimonio, para comprender cómo se podría practicar esta reparación psíquica. Es un estudio teórico basado en el Psicoanálisis. Se concluye que el testimonio es una herramienta potente para trabajar el traumático. Discutir el tema es una posición política, rescate de la historia, memoria y verdad.

During the Brazilian civil-military dictatorship (1964-1985), Human Rights were systematically violated by the State, inflicting fear and silence on the country's citizens. Victims of violence did not have a social space that legi-timized the reality and suffering of their experiences. In 2012, the project Clinicas do Testemunho, (Testimony Clinic) was launched, working with the psychological reparation of these victims. Studying the specificities of State violence trauma and political torture, and also the concepts of Potential Space and testimony, this article aims to establish a dialogue between these concepts and the work developed by the Clinicas do Testemunho to understand how this work could take place in practice. This is a theoretical study based on Psychoanalysis that concludes that the testimony of those who witnessed it all is a powerful tool to work with trauma. Discussing the topic is also political, reclaiming history, memory, and truth.

Aportes interdisciplinarios a la represión política: el caso del ex Fuerte "El Morro" (1973-1985), región del Biobío, Chile / Interdisciplinary contributions to the notion of political repression: the case of the former Fort "El Morro" (1973-1985), Biobío region, Chile

Resumen Esta investigación aborda la noción de represión política que, atendiendo a su complejidad, requiere un enfoque interdisciplinario que considera, además de las disciplinas de la historia, las ciencias políticas o la psicología social, los aportes de la filosofía. Interesa precisar que la represión política tiene entre sus objetivos desintegrar la cohesión social y política, mediante la modificación del vínculo del sujeto con el mundo, entendida, en este estudio, como resonancia. Para ello, se investiga el caso del ex Fuerte "El Morro" (1973-1985), centro clandestino de detención y tortura instaurado durante la dictadura chilena cívico militar (1973-1990). Como método, se realizan estudios de caso que consideran entrevistas semiestructuradas, así como la revisión de fuentes de información histórica y de testimonios de sobrevivientes del lugar. Las fuentes secundarias son de tipo académicas, de prensa y audiovisuales. Los principales resultados destacan la noción de resonancia como un modelo que permite comprender, en los vínculos sociales, la relevancia de valores políticos.

Abstract This research addresses the notion of political repression which, considering its complexity, requires an interdisciplinary approach that considers in addition to the disciplines of history, political science or social psychology, the contributions of philosophy. In this regard, the complexity is linked to the semantic richness of the word repression that allows formulating some philosophical questions that can be answered from social psychology regarding the notion of trauma and violence, and from political science considering the concept of social control. Thus, the relationships and distinctions between repression and associated concepts are established in a multidimensional way and through mutual influences. It is interesting to specify that political repression has among its objectives, to disintegrate social and political cohesion, by modifying the subject's bond with the world, which has three dimensions: orientation or disposition to action towards and with the other, values personal, social and political and the nexus with the collective. In this study, resonance is understood as the mutual influence or co-variation between the subject and the world in each of these dimensions in a complementary or synchronous way. To this end, the case of the former Fort "El Morro" (1973-1985), located in the coastal zone of the Biobío region, and with an important historical antecedent of military occupation, which functioned as a clandestine detention and torture center, is being investigated during the Chilean civic-military dictatorship (1973-1990). As a method, case studies are carried out, which consider semi-structured interviews, the objective of which was to account for the experience of repression as a form of harm justified by State agents. Historical information sources that detail the background on the civic military coup in the Biobío region, mainly in the city of Concepción, and testimonies of survivors of the place that relate the repressive events of which they were direct witnesses were also reviewed. The secondary sources are academic, which in this study constitute the interdisciplinary theoretical contributions to support the notion of repression. The secondary press and audiovisual sources used are of a recent nature and reveal other historical antecedents that allowed the declaration of the site as a historical monument. The main results highlight the notion of resonance as a comprehensive model that allows a broad and complex visualization of social and political phenomena such as the case of repression, emphasizing the interactions between the subjects and institutions that make up a socio-political network. The main finding is linked to the concept of resonance, understood not only as an identification of the group with political ideology but as a proposal that, from the contributions of philosophy, articulates social ties with political values. In this regard, the resonance that considers the social ties sustained in political relationships, favors reconsidering subjectivity and social ties in relation to transcendental political principles that guide subjectivities towards the restitution of social and political cohesion. In this sense, resonance can be considered a fundamental notion since it illuminates the nexus between the social and the political from another perspective. In this way, it can be affirmed that a projection of this study consists of exploring political phenomena attending to historical, spatial and temporal dimensions from different disciplines, particularly highlighting the contribution of philosophy, whose questions can collaborate with the study of historical events from new prospects.

Relationship between abuse experience with suicidal ideation and behavior of junior middle school students in Chongqing / 中国学校卫生

Objective@#To explore the relationship between abuse experience with suicidal ideation and suicide attempts of junior middle school students, and to provide a reference for suicide prevention of junior middle school students.@*Methods@#Cluster sampling method were used to selct 10 289 junior middle school students from 25 districts and counties of Chongqing were included in the analysis of this study from July to September in 2020. And Questionnaire on Abuse in Childhood and Mental Health Scale for Middle School Students were applied to collect the data about demographic information, suicide ideation and behavior.@*Results@#The prevalence of suicidal ideation and suicide attempts among junior middle school students were 20.93% and 10.83%, respectively. Multivariate Logistic regression model found that after controlling for demographic variables and mental health, emotional abuse ( OR =2.07) and emotional neglect ( OR =2.03) showed higher correlations with suicidal ideation than the other three types of childhood abuse( OR physical neglect =1.19, OR physical abuse =1.60, OR sexual abuse =1.37, P <0.05); and sexual abuse ( OR =2.29) and physical neglect ( OR =1.87) showed higher associations with suicide attempt than the other three types of abuse( OR emotional abuse =1.63, OR emotional neglect =1.59, OR physical abuse =1.50, P <0.01).@*Conclusion@#All five types of child abuse were independent risk factors for suicidal ideation and suicide attempts, and emotional neglect and emotional abuse had a greater effect on suicidal ideation, sexual abuse and physical neglect had a greater effect on suicide attempts.

Effects of the psychological aggression and corporal punishment college students experienced before the age of 10 on anxiety and health related risky behaviors / 中国学校卫生

Objective@#To provide a basis for college students mental health education and guidance, the impact of psychological aggression and corporal punishment college students experienced before the age of 10 on anxiety and health risk behaviors was explored.@*Methods@#In April and May 2019, the convenience sampling method was used to conduct a questionnaire survey among all the freshman and sophomore students of some majors in two universities in Harbin, including a total of 2 150 students. The contents of the questionnaire included general information survey, Parent-Child Conflict Tactics Scale (CTSPC)，Self-Rating Anxiety Scale (SAS) and Adolescent Health related Risky Behavior Inventory (AHRBI).@*Results@#The percentage of college students who suffered psychological aggression and corporal punishment before the age of 10 was 80.05% and 58.37%. The detection rate of corporal punishment in boys and non-only child was significantly higher than that in girls and only child (P<0.05). The students who experienced psychological aggression and corporal punishment before the age of 10 had higher detection rates of anxiety state and six subscales of health risk behaviors than those who didn t experienced those (P<0.05). The Logistic regression analysis showed that, psychological aggression, place of residence, corporal punishment, and only child were positively associated with college students anxiety state (OR=1.85,1.53,1.49,1.34). The Logistic regression analysis showed that, psychological aggression, place of residence were positively associated with college students health-compromising behaviors (OR=1.60,1.26). Psychological aggression, gender factors, corporal punishment, and only child all influenced college students aggression and violence behavior (OR=1.75,1.66,1.63,1.28). Corporal punishment influenced college students suicide and self-injury behavior (OR=3.44). Gender factors and corporal punishment all influenced college students smoking and drinking behavior (OR=2.67,2.25).Corporal punishment and psychological aggression were positively associated with college students rule breaking behavior (OR=1.88,1.55). Corporal punishment, gender factors, and family income all influenced college students unprotected sexual behavior (OR=4.51,1.91,0.62).@*Conclusion@#Parental psychological aggression and corporal punishment college students experienced during childhood have a negative impact on their anxiety and health risk behaviors.

Estudio descriptivo de mortalidad en sobrevivientes de tortura y prisión política en el período de la dictadura militar en Chile, 1973-1990

Background: Studies on the long-term consequences of torture in survivors in Chile have only addressed the consequences for mental health, leaving aside the physical consequences. Aim: To report the causes of death in the universe of victims of the Chilean civic-military dictatorship recognized by the Reports of the National Commission for Political Prison and Torture (CNPPT) and the Advisory Commission for the qualification of Disappeared Detainees, Politically Executed individuals and Victims of Political Prison and Torture. Material and Methods: The causes of death, age at the time of death, sex, political context of death and opportunity of repair up to June 2016 are described in 38,254 victims of the Chilean civic-military dictatorship. Results: Of the universe of 38,254 victims, 9,152 (23.9%) died until June 2016. The median age at death was 68 years. The main causes of death were malignant tumors in 28%, cardiovascular diseases in 27%, respiratory diseases in 10%, digestive diseases in 9% and external causes in 8%. Conclusions: These results can inform prevention and treatment strategies for victims of the Chilean dictatorship.

Lesiones gravísimas causadas por la actuación ilegítima y el terrorismo de Estado en Uruguay. Reporte de diez años de valoración médico-legal y psiquiátrica a las víctimas / Severe lesions caused by illegitimate acts and state terrorism in Uruguay. 10-year report of the medico-legal psychiatric assessment of victims / Lesões gravíssimas causadas pela ação ilegítima e o terrorismo de Estado no Uruguai. Relato de dez anos de avaliação médico-legal e psiquiátrica das vítimas

Resumen: El rol de la Medicina Legal en derechos humanos y acción forense humanitaria es cada vez más visible. La ley Nº 18.596 indemiza a quienes acrediten haber sufrido lesiones gravísimas por el accionar de agentes del Estado. Objetivo: contribuir al conocimiento público de la actuación ilegítima y el terrorismo de Estado en Uruguay (13/6/1968 y 28/2/1985) y del aporte de la Medicina Legal en materia de verdad, justicia, memoria, reparación y garantía de no repetición. Material y método: se estudiaron las solicitudes de indemnización por lesiones gravísimas recibidas en los primeros diez años de vigencia de la ley. Resultados y discusión: de 166 peticiones, se admitieron 115. En el 95% fue requerido informe médico-legal o psiquiátrico, o ambos. Aunque fue dificultoso demostrar el nexo causal, en 55 casos se estableció un nexo con razonable grado de certeza. La edad media de las víctimas al momento de producirse las lesiones era de 26 años. La edad media al momento de la indemnización fue de 66 años. Las lesiones demostradas se corresponden con la referida en la bibliografía nacional y extranjera. Se destaca el hallazgo de una considerable presencia de trastornos psicóticos. Conclusiones: se indemnizaron 115 víctimas por lesiones gravísimas causadas en su amplia mayoría por prisión política prolongada y tortura. Se observó alta prevalencia de patologías osteoarticulares, trastornos por estrés postraumático crónico y depresión, pero también un alto número de psicosis crónicas. Los informes médico-legales fueron relevantes para demostrar las lesiones gravísimas y su nexo causal con el accionar de los agentes del Estado.

Summary: The role of Legal Medicine in human rights, forensic science and humanitarian action is increasingly visible. Act 18,596 compensates those who prove to have experienced severe lesions by state agents. Objective: to contribute to public awareness of the illegitimate actions and state terrorism in Uruguay (June 13, 1968 to February 28, 1985) and the input of Legal Medicine in terms of truth, justice, memory, reparation and guarantees of non-repetition. Method: the compensation requests for severe lesions received during the first 10 years the law was in force were studied. Results and discussion: 115 out of 166 requests were admitted. In 95% of cases, a medico-legal and or psychological report was requested. Despite it being hard to prove the causal link, a link with a reasonable degree of certainty was found in 55 cases. Average age of victims at the time the lesions were caused was 26 years old. Average age at the time of compensation was 66 years old. Lesions proved match those referred to in the national and international bibliography. The study points out the finding of a considerable number of psychotic disorders. Conclusions: 115 victims were compensated for severe lesions caused, in the wide majority of cases, by long imprisonment and torture. A high prevalence of osteoarticular diseases was observed, chronic post-traumatic stress disorders and depression, although a high number of chronic psychoses, too. Medico-legal reports were relevant to demonstrate severe lesions and the causal link with the action of state agents.

Resumo: O papel da Medicina Legal nos direitos humanos e ação forense humanitária é cada vez mais visível. A Lei Nº 18.596 indeniza aquelas pessoas que acreditem ter sofrido lesões gravíssimas causadas pela ação de agentes do Estado. Objetivo: contribuir para o conhecimento público da ação ilegítima e o terrorismo de Estado no Uruguai no período 13 de junho de 1968 a 28 de fevereiro de 1985 e da contribuição da Medicina Legal em termos de verdade, justiça, memoria, reparação e garantia de não repetição. Material e método: foram estudados os pedidos de indenização por lesões gravíssimas recebidas durante os primeiros dez anos de vigência da lei. Resultados e discussão: das 166 solicitações recebidas, foram incluídas 115. Em 95% dos casos o laudo médico-legal e/ou psiquiátrico foi exigido. Embora fosse difícil demonstrar a relação causal, em 55 casos foi estabelecida com um razoável grau de certeza. A idade média das vítimas no momento em que as lesões foram produzidas era de 26 anos. A idade média no momento da indenização era de 66 anos. As lesões demostradas correspondem às referidas na bibliografia nacional e estrangeira. Destaca-se o achado da presença considerável de transtornos psicóticos. Conclusões: foram indenizadas 115 vítimas por lesões gravíssimas causadas na grande maioria por prisão política prolongada e tortura. Observou-se uma alta prevalência de patologias osteoarticulares, transtornos por estresse pós-traumático crônico e depressão, mas também um número alto de psicoses crônicas. Os laudos médico-legais foram relevantes para demonstrar as lesões gravíssimas e sua relação causal com a ação dos agentes do Estado.

Socio-ecological factors of campus bullying in middle schools student in Nantong / 中国学校卫生

Objective@#To explore school bullying in middle school and the associated socio-ecological factors.@*Methods@#Totally 1 169 middle school students were selected from urban areas of Nantong and were selected to complete the Campus Bullying Questionnaire and a self-designed questionnaire.@*Results@#The bullying scores of junior school students were higher than senior school students( t=3.61, 2.53, P <0.05). The bullying scores of ordinary middle school students were higher than the key middle school students( t=12.52, 8.34, P <0.01). The bullying scores of students with poor peer relationship were higher than the students with good peer relationship( F=8.98, 25.89, P <0.01). The bullying scores of students with poor school discipline were higher than the students with good school discipline （F=8.50, 10.00, P <0.01). Students from schools with poor school bullying prevention and control policies reported higher rates of campus bullying than students from schools with general and perfect school policies( F= 8.30 , 2.67, P <0.05). The bullying scores of intervention type and neglect type students were higher than the negotiation type students( F=3.66, P <0.05). Multivariate Logistic regression analysis showed that high school section, key middle school, good peer relationship, deliberative education mode, good school style and discipline, and improvement of campus bullying prevention and control policies were the protective factors that affect middle school students’ Campus bullying( OR=1.68-4.28, P <0.05), gender and only child were risk factors for chool bullying( OR=1.54, 1.68, P <0.05). Structural equation model analysis showed that the path of campus bullying was centered on individual factors, through interaction with interpersonal, organizational and policy factors.@*Conclusion@#Campus bullying prevention and intervention should be considered from individual, interpersonal, organizational and policy levels of students, through the collaborative efforts of school, family and society.

Relationship among dark triad, peer relationship and cyber-bullying of middle school students / 中国学校卫生

Objective@#To explore the relationship among dark triad, peer relationship, and cyber bullying of middle school students, and to provide suggestions for intervention of cyberbullying behavior of middle school students.@*Methods@#Peer Relationship Scale (PRS), Dirty Dozen (DD) and Cyberbullying Questionnaire (CBQ) were administrated to 1 934 middle school students in Beijing and Yunnan by cluster sampling.@*Results@#Middle school boys scored significantly higher on the dark triad and cyber-bullying than girls ( F =13.45, 50.20, P <0.01). The dark triad of middle school students was positively correlated with cyber-bullying ( r =0.38, 0.40, 0.21, P <0.01), while negative dimensions of peer relationship were positively correlated with cyber-bullying ( r = -0.10 , -0.22, -0.16, P <0.01). Peer relationship had a moderating effect on the relationship between dark triad and cyber-bullying ( β =-0.07， t =-3.24，Δ R 2=0.00， P <0.01).@*Conclusion@#Positive peer relationship can reduce the cyber-bullying behavior of middle school students with high dark triad which should be emphasized among middle school students.

Relationship between childhood sexual abuse and non suicidal self injury of female nursing students / 中国学校卫生

Objective@#To explore the relationships between the characteristics of childhood sexual abuse and non-suicidal self-injury in nursing female college students.@*Methods@#Two medical colleges and junior colleges were selected in Anhui province. A total of 2 549 female nursing students in grade 1 to 3 were asked to fill a questionnaire regarding sociodemographic information,childhood sexual abuse and non-suicidal self-injury.@*Results@#The reported rate of non-suicidal self-injury among female nursing students in the past six months was 8.2%. Sexual abuse at any time during childhood (primary school or earlier,middle school and high school) increased the risk of non-suicidal self-injury among female nursing students (P<0.05). Exposure to sexual abuse in all three periods was associated with 5.04(95%CI=1.73-14.62) times odds ratio than that of those who not exposed to sexual abuse (P<0.01). Only contact sexual abuse and both contact and non-contact sexual abuse in childhood were correlated with nonsuicidal selfinjury among female nursing students [OR(95%CI)=2.21(1.48-3.29), 3.56(2.13-5.96)] (P<0.05). Two patterns of sexual abuse experiences were identified,including persistent sexual abuse (3.1%) and the other group is occasional sexual (96.9%). Persistent sexual abuse in childhood was correlated to higher risk of non-suicidal self-injury compared with occasional sexual abuse (OR=2.61,95%CI=1.35-5.05,P<0.01).@*Conclusion@#The occurrence periods,types and patterns of sexual abuse in childhood are closely related to non-suicidal self-injury in female nursing students.

A decadência do amor: a clínica da crueldade / The decadence of love: the clinic of cruelty / La decadencia del amor: la clínica de la crueldad / La decadence de l'amour: la clinique de la cruauté

O presente trabalho tenta articular várias manifestações da crueldade, colocando-as sob um princípio comum. Freud afirmou que seu pessimismo sociopolítico era o resultado da sua investigação sobre as ilusões da humanidade. O processo sublimatório - que, por meio da literatura, da poesia e do teatro, constitui a arte, que integra a cultura - é atacado, enquanto a solução perversa é estabelecida. A traição, cuja existência Viktor Frankl mostra no campo de concentração de Auschwitz, apresentando o capo como algoz do seu próprio povo, é aqui estendida para todas as culturas como emergência da tirania inconsciente. A figura do inimigo é apresentada na consciência social como aparecimento da divisão egoica e narcisista entre Nós e Eles. A tática política dos partidários do sistema de crença e destruição é criar um abismo, em que o narcisismo da diferença estimula a paranoia do inimigo. O horror é banalizado para que a tolerância e o contraditório da vida democrática sejam enfraquecidos.

The present work tries to articulate several manifestations of the cruelty, placing them under a common principle. Freud stated that his sociopolitical pessimism was the result of his research into the illusions of humanity. The sublimatory process that through literature, poetry and theater constitute the art that integrates the culture is attacked, while the perverse solution is established. The betrayal, whose existence Viktor Frankl shows in the Auschwitz concentration camp, presenting the capo as an executioner of his own people is here extended to all cultures as the emergence of unconscious tyranny. The figure of the enemy is presented in the social consciousness as the appearance of the egoic and narcissistic division between Us and Them. The political tactics of supporters of the system of belief and destruction is to create an abyss, in which the narcissism of difference stimulates the enemy's paranoia. Horror is trivialized so that tolerance and contradiction of democratic life are weakened.

El presente trabajo intenta articular varias manifestaciones de la crueldad, colocándolas bajo un principio común. Freud afirmó que su pesimismo sociopolítico era el resultado de su investigación sobre las ilusiones de la humanidad. El proceso sublimatorio, que a través de la literatura, de la poesía y del teatro constituye el arte que integra la cultura, es atacado, mientras que la solución perversa es establecida. La traición, cuya existencia Viktor Frankl muestra en el campo de concentración de Auschwitz, presentando el capo como verdugo de su propio pueblo, es aquí extendida para todas las culturas como emergencia de la tiranía inconsciente. La figura del enemigo es presentada en la conciencia social como aparición de la división egoica y narcisista entre Nosotros y Ellos. La táctica política de los partidarios del sistema de creencia y destrucción es crear un abismo, en que el narcisismo de la diferencia estimula la paranoia del enemigo. El horror es banalizado para que la tolerancia y el contradictorio de la vida democrática sean debilitados.

Le présent ouvrage tente d'articuler plusieurs manifestations de la cruauté en les plaçant sous un principe commun. Freud a déclaré que son pessimisme socio-politique était le résultat de ses recherches sur les illusions de l'humanité. Le processus sublimatoire qui, à travers la littérature, la poésie et le théâtre, constitue l'art qui intègre la culture est attaqué, tandis que la solution perverse est établie. La trahison, dont Viktor Frankl témoigne dans le camp de concentration d'Auschwitz, et qui présente le capo comme un bourreau de son propre peuple s'étend à toutes les cultures comme l'émergence d'une tyrannie inconsciente. La figure de l'ennemi est présentée dans la conscience sociale comme l'apparition de la division égoïque et narcissique entre Nous et Eux. La tactique politique des partisans du système de croyance et de destruction est de créer un abîme dans lequel le narcissisme de la différence stimule la paranoïa de l'ennemi. L'horreur est banalisée, ce qui affaiblit la tolérance et la contradiction de la vie démocratique.

Métodos de tortura del terrorismo de Estado en Uruguay y valoración médico-legal de su idoneidad para causar lesiones graves o gravísimas / Methods of torture of State terrorism in Uruguay and medical legal assessment of its abililty to cause severe o very severe lesions / Métodos de tortura do terrorismo de Estado no Uruguai e avaliação médico-legal de sua idoneidade para causar lesões graves ou gravíssimas

La Medicina Legal tiene entre sus misiones el diagnóstico de la tortura como forma de contribución a las investigaciones judiciales y a la reparación de las víctimas. En Uruguay se desarrollan numerosos procedimientos administrativos y criminales referidos al período del terrorismo de Estado (entre el 27 de junio de 1973 y el 28 de febrero de 1985). Si bien el delito de tortura es un delito de lesa humanidad imprescriptible, se tipificó en la Ley Nº 18.026 de 26 de setiembre de 2006. La jurisprudencia nacional ha desestimado su tipificación en los casos del período del terrorismo de Estado en base al principio de no irretroactividad de la ley penal. Paralelamente, la Fiscalía Especializada en Crímenes de Lesa Humanidad ha requerido numerosos informes respecto de la posibilidad de que los métodos de tortura aplicados por el terrorismo de Estado en Uruguay pudieran causar lesiones graves o gravísimas. Objetivo general: contribuir al conocimiento de los crímenes del terrorismo de Estado en Uruguay, aportando así a la realización de los estándares internacionales de verdad, justicia, memoria y reparación. Objetivos específicos: 1. Describir los métodos de tortura empleados. 2. Determinar su idoneidad para producir lesiones graves o gravísimas. Metodología: el estudio se basó en las investigaciones históricas nacionales sobre el terrorismo de Estado, así como en la jurisprudencia en la materia, la revisión de la bibliografía internacional, la fisiopatología de situaciones análogas y los actuales consensos nacionales sobre los supuestos fácticos incluidos en los tipos penales de lesiones graves y gravísimas. Resultados: en el período del terrorismo de Estado en Uruguay ha sido característica la aplicación de torturas a gran escala y en forma sistemática. Los métodos más habitualmente aplicados fueron el encapuchamiento, la privación de agua, alimentos y reposo, la exposición al frío, las golpizas, incluido el teléfono, el plantón, el colgamiento, el caballete, el submarino húmedo y seco, la picana eléctrica y las agresiones sexuales. Los distintos métodos de tortura física incluyen un sufrimiento psíquico. A través de mecanismos específicos, todos resultan idóneos para ocasionar daños que encuadran en diversos supuestos de los delitos de lesiones graves y gravísimas. En las mujeres embarazadas, todos estos métodos de tortura son eficaces para provocar el aborto o adelantar el parto. Conclusiones: existió un patrón en los métodos de tortura sistemática empleados por el terrorismo de Estado que incluyó métodos omisivos, posicionales, traumáticos, eléctricos, asfícticos y sexuales. Todos ellos pueden determinar uno o más de los supuestos comprendidos en los delitos de lesiones graves y gravísimas. El peligro de vida y las secuelas psicológicas son inherentes a la tortura. En las mujeres embarazadas, todos los métodos de tortura reseñados son eficaces para provocar el aborto o el adelantamiento del parto. (AU)

Among other missions, Legal Medicine aims to diagnose torture, as a means of contributing to judicial investigations and repair victims. In Uruguay, several administrative and criminal procedures are developed in connection to the times of state terrorism (between June 27, 1973 and February 28, 1985). Despite torture being an indescribable crime against humanity, it was typified in Act 18,026 of September 26, 2006. National jurisprudence has dismissed its classification in the cases that occurred during the times of state terrorism, based on the non-retroactivity principle of criminal law. Simultaneously, the Prosecutor's Office Specialized in Crimes Against Humanity has requested several reports in connection with the possibility that torture methods applied by State terrorism in Uruguay may have caused severe or very severe lesions. General objective: To contribute to learning about state terrorist crimes in Uruguay, thus contributing to the creation of international standards for truth, justice, memory and repair. Specific objectives: 1. To describe the torture methods applied. 2. To determine their ability to cause severe or very severe lesions. Method: The study was based on national history investigations, as well as jurisprudence in the field, review of international bibliography, pathophysiology of similar situtaions and current national consensus on fact assumptions included in the criminal classification of severe and very severe lesions. Results: The times of state terrorism in Uruguay have been characterized by the application of large scale torture in a systematic way. The most frequently used methods were hooding, restriction of water, food and rest, exposure to the cold, beating up, including "the phone", sitting in, hanging, vaults, wet and dry submarine, electric shock baton and sexual assaults. The different methods of physical torture include psychological suffering. By means of specific mechanisms, they are all useful to cause harm that lie within several assumptions of severe and very severe harm crimes. I pregnant women, all of these methods of torture are effective to interrupt pregnancy or anticipate delivery. Conclusions: There is a pattern in the systematic methods of torture used by state terrorism, which included methods involving omissions, positions, trauma, and electrical shocks and, suffocating. All of them may result in one or more of the assumptions included in the severe or very severe lesions crimes. Risk of life and psychological consequences inherent to torture. In pregnant women, all the methods of torture described are effective to interrupt the pregnancy or anticipate delivery.

Entre as missões da Medicina Legal se inclui o diagnóstico da tortura como forma de contribuição às investigações judiciais e a reparação das vítimas. No Uruguai foram desenvolvidos numerosos procedimentos administrativos e criminais referidos ao período do terrorismo de Estado (entre 27 de junho de 1973 e 28 de fevereiro de 1985). Embora o delito de tortura seja um delito de lesa humanidade imprescritível, este foi tipificado na Lei Nº 18.026 de 26 de setembro de 2006. A jurisprudência nacional rejeitou sua tipificação nos casos do período do terrorismo de Estado baseados no principio de não retroatividade da lei penal. Paralelamente, a Procuradoria Especializada em Crimes de Lesa Humanidade solicitou numerosos relatórios sobre a possibilidade de que os métodos de tortura aplicados pelo terrorismo de Estado no Uruguai pudessem ter causado lesões graves ou gravíssimas. Objetivo general: Contribuir ao conhecimento dos crimes do terrorismo de Estado no Uruguai, ajudando dessa forma o estabelecimento de padrões internacionais de verdade, justiça, memoria e reparação. Objetivos específicos: 1. Descrever os métodos de tortura empregados. 2. Determinar sua idoneidade para produzir lesões graves ou gravíssimas. Metodologia: O estudo foi realizado utilizando informação de pesquisas históricas nacionais sobre o terrorismo de Estado, bem como a jurisprudência na matéria, a revisão da bibliografia internacional, a fisiopatologia de situações análogas e os atuais consensos nacionais sobre os supostos fáticos incluídos nos tipos penais de lesões graves e gravíssimas. Resultados: No período do terrorismo de Estado no Uruguai foi característica a aplicação de torturas a grande escala e de maneira sistemática. Os métodos habitualmente mais aplicados foram o "encapuchamiento" (uso permanente de capuz ou venda nos olhos), a privação de água, alimentos e repouso, a exposição ao frio (geladeira), agressões físicas incluindo o "telefone", "plantón" (ficar em pé por períodos prolongados), pendurar pelos membros, "caballete" (montar sobre uma superficie afiada), afogamento úmido e seco, choque elétrico e as agressões sexuais. Os distintos métodos de tortura física incluem sofrimento psíquico. Através de mecanismos específicos, todos resultam idôneos para ocasionar danos que enquadram em diversos supostos dos delitos de lesões graves e gravíssimas. Nas mulheres grávidas, todos estes métodos de tortura são eficazes para interromper a gravidez ou adiantar o parto. Conclusões: Existiu um padrão nos métodos de tortura sistemática utilizados pelo terrorismo de Estado, que incluía métodos omissivos, posicionais, traumáticos, elétricos, asfixiantes e sexuais. Todos podem determinar um ou mais dos supostos compreendidos nos delitos de lesões graves e gravíssimas. O perigo de vida e as sequelas psicológicas são inerentes à tortura. Nas mulheres grávidas, todos os métodos de tortura descritos são eficazes para interromper a gravidez ou adiantar o parto.

Medicine, torture, the death penalty and the democratic state: from collaboration to emancipation / Medicina, tortura, pena de muerte y estado democrático: de la colaboración a la emancipación / Medicina, tortura, pena de morte e o estado democrático: da colaboração à emancipação

Abstract Abuses of medicine have taken place over past decades in the context of torture and the death penalty. Serious and totally unacceptable breaches of medical ethics and human rights have occurred in institutions caring for vulnerable people. And yet there is still a need to make visible the whole spectrum of violence and breaches of human rights and to challenge them. This paper discusses a wide range of abuses in which medical professionals may take part whether as witnesses, bystanders or participants. It also addresses changes that are needed to benefit citizens at risk of abuse and to strengthen the ethical practice of medicine. The frequently-used term "empowerment" as applied to populations at risk signals a step in the right direction but usually involves the top-down giving of limited power to people. What oppressed people need is to claim their human rights - to emancipate themselves.

Resumen Los abusos de la medicina han tenido lugar en las últimas décadas en el contexto de la tortura y la pena de muerte. Faltas graves y totalmente inaceptables a la ética médica y a los derechos humanos se han producido en instituciones que atienden a personas vulnerables. E, incluso, existe además la necesidad de hacer visible todo el espectro de violencias y de violaciones a los derechos humanos que los ponen en entredicho. Este artículo analiza una amplia gama de abusos que los profesionales médicos pueden enfrentar ya sea como testigos, espectadores o participantes. También se ocupa de los cambios que son necesarios para beneficiar a los ciudadanos en riesgo de abuso y para fortalecer la práctica ética de la medicina. El frecuentemente utilizado término "empoderamiento", aplicado a las poblaciones en riesgo señala un paso en la dirección correcta, pero por lo general implica un movimiento de arriba hacia abajo, otorgando un poder limitado a las personas. Lo que las personas oprimidas necesitan es reivindicar sus derechos humanos para emanciparse.

Resumo Abusos médicos têm ocorrido nas últimas décadas no contexto da tortura e da pena de morte. Violações graves e totalmente inaceitáveis de ética médica e dos direitos humanos ocorreram em instituições que cuidam de pessoas vulneráveis. E, no entanto, ainda há uma necessidade de tornar visível todo o espectro de violência e violações dos direitos humanos e desafiá-los. Este artigo discute uma ampla gama de abusos que os profissionais médicos podem enfrentar, seja como testemunhas, espectadores ou participantes. Também são abordadas as mudanças necessárias para beneficiar os cidadãos em risco de abuso e fortalecer a prática ética da medicina. O termo "empoderamento", frequentemente aplicado a populações em risco, sinaliza um passo na direção certa, mas normalmente envolve a concessão limitada de poder às pessoas, "de cima para baixo". O que as pessoas oprimidas precisam é reivindicar seus direitos humanos - emancipar a si mesmas.

Strategy of the Causes of Death of Dependents / 法医学杂志

Objective To discuss the methods and strategies to identify the causes of dependents' deaths, as well as provide the experiences that can be used for reference and scientific basis for the forensic identification of the potentially growing deaths of the same kind in the future. Methods The 13 cases concerning death of dependents accepted by Sun Yat-sen University Forensic Center were collected, and the basic information of the dependents were statistically described. The nutritional status, environmental condition and medical care condition were evaluated according to dietary energy, living space, environment and medical treatment condition. Results Among the 13 dependents, there were 11 males and 2 females, with the oldest 74 and the youngest 9 and dwelling time was from 0.4 to 5.6 years. Forensic pathological examination showed that 13 dependents had infectious diseases and 11 were severely dystrophic. There were no fatal mechanical injuries or poisoning in dependents. Molecular pathological screening of 4 cases revealed no pathogenic variants of sudden death susceptible genes. The poor status of the diet, nutrition, living environment and medical care of these dependents were discovered. The direct cause of death of all 13 dependents was identified to be disease. The lack of nutrition, poor living environment and lack of medical care were thought to play a dominant role in causing the deaths of 12 dependants. Conclusion The death identification should follow the judicial procedure. In identification of the causes of death and analysis of the proportion of the affecting factors resulting in death, all factors, including nutrition,environment, medical care, injury and diseases, need to be considered.

Influence of childhood abuse on implicit and explicit self-esteem among children in Sichuan / 中国学校卫生

Objective@#To investigate association between childhood abuse and self-esteem among children in Sichuan.@*Methods@#A total of 700 students aged 10-16 years from four cities of Sichuan were selected through stratified random sampling method. All the participants were investigated with Screen Questionnaire of Child Abuse(SQCA), the Self-esteem Scale (SES) and the E-Prime based Implicit-Association Test(IAT).@*Results@#The prevalence of childhood abuse in Sichuan is 11.3%(65/574). Among them, 55.4% reported one type of abuse experience, 29.2% reported two types and 15.4% reported 3 or more types of abusive experiences. The average level of explicit self-esteem for the total sample children (x〖TX-*3〗=28.92, higher than 26) was in the medium level. For children with abuse experiences, explicit (t=-2.56, P<0.05) and implicit self-esteem (t=-2.40, P<0.05) was significantly lower than average level of the total sample. Educational background of primary caregivers was positively associated with explicit self-esteem(P<0.05). Gender and childhood abuse entered in the final regression model for implicit self-esteem(F=6.11, P<0.01), and childhood abuse negatively correlated with implicit self-esteem(t=-2.83, P<0.01).@*Conclusion@#Children with abuse experiences are more likely to have low implicit self-esteem.