Knowledge and attitudes of rural healthcare providers regarding domestic violence against women: a systematic review

ABSTRACT BACKGROUND: Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas. OBJECTIVE: This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia. METHODS: We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool. RESULTS: Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%. CONCLUSIONS: The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice. SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.

Vítimas indiretas dos homicídios: impactos; apoio recebido e estratégias de superação / Indirect homicide victims: impacts, support received, and coping strategies

Resumo O Brasil tem apresentado elevado percentual de homicídio e mortes por intervenção legal. Este artigo faz parte de um estudo qualitativo de casos múltiplos sobre vítimas indiretas que perderam parentes por homicídio devido à ação de agentes de segurança e de policiais no Rio de Janeiro. Os dados provêm de quatro entrevistas individuais com familiares de pessoas mortas por policiais e três familiares de policiais vítimas de homicídio, que foram submetidos à análise temática. Os depoimentos revelaram os impactos da perda do familiar na saúde das vítimas indiretas, como o intenso sofrimento mental e a repercussão negativa em ocupações humanas, como trabalho, lazer, sono e cuidado em saúde. Ante a experiência traumática, o apoio das instituições é limitado, ao passo que grupos ativistas e entidades ligadas aos direitos humanos são relatados, pelos entrevistados, como de grande ajuda na elaboração da dor da perda, sobretudo no grupo dos que perderam seus entes pela ação policial. O estudo indica a necessidade de pesquisas sobre as lacunas entre os equipamentos e políticas públicas e as necessidades das vítimas indiretas.

Abstract Brazil has recorded a high percentage of homicides and deaths due to legal intervention. This article is part of a qualitative multiple case study about indirect victims who lost relatives to homicide perpetraded by security agents and police officers in Rio de Janeiro. Data were collected in four individual interviews with family members of people killed by police officers and three family members of police officers who were victims of homicide, and then subjected to thematic analysis. The testimonies revealed the major impacts of the loss of a family member on the indirect victim's health, such as intense mental suffering and the negative impacts on human occupations such as work, leisure, health care, and sleep. Institutional support is limited in the face of the traumatic experience, whereas activist groups and entities tied to human rights advocacy are of great help in overcoming the pain of loss, especially for those who have lost their family members to the police. Further research is needed about the gaps between public facilities and policies and the needs of indirect victims.

Análisis dinámico de un equipo interprofesional que implementa un programa de atención psicosocial a víctimas de la guerra / Dynamic analysis of an interprofessional team implementing a psychosocial intervention program for war victims

Resumen Este estudio analiza los cambios estructurales experimentados por un equipo interprofesional que implementa un programa de intervención psicosocial dirigido a víctimas de la guerra en Colombia. Los equipos están compuestos por psicólogos, trabajadores sociales y facilitadores comunitarios que proporcionan atención a nivel individual, familiar y comunitario. Se aplicaron métodos de evaluación estructural para identificar cambios en la cohesión de las redes de reconocimiento entre profesionales, así como la preferencia para colaborar y el intercambio de información enviada y recibida. La recogida de información se produjo en dos series temporales -tiempo 1 (T1) y tiempo 2 (T2)- con un intervalo de tres meses. Se utilizó una estadística aplicada al análisis de datos relacionales para determinar los cambios en las redes en T1 y T2. En el período de referencia se incrementó la densidad en las redes de reconocimiento [. = 1.7105, (IC 95 %: -.0123 - .185), . < .0444] y de preferencia para trabajar [. = 2.0942, (IC 95 %: .005 - .1521), . < .0218]. Las redes de intercambio de información no experimentaron cambios significativos. Las regresiones múltiples a nivel diádico indican que la preferencia para trabajar e intercambiar información en T1, predicen el intercambio de información relativo tanto a peticiones de información recibidas como enviadas en T2. Se discuten los resultados para optimizar la implementación de programas de intervención psicosocial desarrolladas por equipos interprofesionales.

Abstract The study analyzes the structural changes experienced by an interprofessional team implementing a psychosocial intervention program for victims of war in Colombia. The program is called "PAPSIVI" (Programa de Atención Psicosocial y Salud Integral a Víctimas), which has been operating in Colombia since 2013, thanks to Law 1448 of 2011 to improve the quality of life and repair the damage of the victims of the armed conflict in Colombia. It only served people registered in the Single Registry of Victims (RUV), which had 9'165,126 records throughout the country until September 2021. This program follows a comprehensive and restorative approach that defines victims as protagonists of their own process of empowerment and positive change (Laplante and Holguin, 2006; Thompson, 1996). For this purpose, a multilevel intervention is carried out at the individual, family and community levels. The program is implemented by teams of professionals (psychologists, social workers and community facilitators) of varying sizes depending on the number of victims served in the municipalities. Psychologists provide individual psychological care and, to a lesser extent, family therapy is also offered to try to repair psychosocial damage from exposure to situations of violence (Oficina de Promoción Social, 2017). Social workers carry out community interventions to promote the associative fabric and social capital. Community promoters are facilitators and connect professionals with the potential beneficiaries of the intervention. The latter are very important, having themselves the status of victims, which increases the ecological validity of the intervention. Due to the characteristics of the implementation of this initiative, which takes into account the difficulties of the context (with situations of deprivation and vulnerability), as well as the particularities of the participants, it is valid to ask in this research what are the structural changes experienced by the teams of professionals who implement PAPSIVI. For this, structural evaluation methods were applied to identify changes in the cohesion of recognition networks among professionals, the preference to collaborate and the exchange of information sent and received. Data collection took place in two time series (T1 before - T2 after) with an interval of three months. Statistics applied to relational data analysis were used to determine changes in the networks at time T2. In the results it was found that in the baseline period the density in the recognition [t = 1.7105, (95 % CI: -.0123 - .185), p < .0444] and work preference [t = 2.0942, (95 % CI: .005 - .1521), p < .0218] networks increased. Information exchange networks did not experience significant changes. Multiple regressions at the dyadic level indicate that the preference for working and exchanging information at T1 predicts information exchange relative to both information requests received and sent at T2. It is concluded that the results shed light for: (a) optimize the design of psychosocial intervention teams; (b) improve their functioning by introducing horizontal organizational communication tools (among the members of each team), transversal (among the members of the teams implementing the program in different municipalities), and vertical (by promoting communication between professionals and program managers/responsible persons), and (c) achieve that changes in the structure of the teams serve as a diagnostic tool for functional problems of the team associated with the exchange of professional information and the referral of users. Ultimately, better integration of the teams leads to better psychosocial profiles of the users of programs such as PAPSIVI and allows them to better adapt their activities to the needs of the users, which improves the effectiveness of the intervention (Virto, 2021).

La Instalación del Trauma en dos comunidades de Colombia: Trauma Colectivo y Marcos Discursivos / The Installation of Trauma in Two Communities in Colombia: Collective Trauma and Discursive Frames

Resumen Las comunidades que enfrentan experiencias de violencia extrema sufren daños en su estructura social, que afectan relaciones interpersonales, sentimientos de integración social e identidades personales. Propusimos el concepto de instalación del trauma como construcción sociopolítica y eje de asignación de sentido, que permite a las comunidades explicar lo desconcertante. La instalación consiste en el andamiaje de recursos, materiales y simbólicos, que ofrecen interpretaciones situacionales de una experiencia; nos enfocamos en elementos simbólicos, específicamente en marcos discursivos, que son soportes de significación y organizan contenidos con el fin de comprender eventos. En esta investigación analizamos marcos discursivos de dos comunidades que enfrentaron situaciones de violencia extrema (masacres), con el objetivo de estudiar términos de instalación y elaboración del trauma colectivo. Identificamos marcos discursivos genéricos y específicos, que posibilitaron la construcción comunitaria de una narrativa del trauma. El concepto de instalación del trauma sirve para revisar estrategias de contención psicosocial ante eventos que alteran el tejido social de una comunidad.

Abstract Communities that experience extreme violence suffer damage in their social structure. This affects interpersonal relationships, feelings of social integration, and personal identities. In this article, we propose the concept of installation of trauma as both a sociopolitical construction and a strategy of meaning that allows a community to elaborate traumatic events. The installation consists of the scaffolding of resources, both material and symbolic, that offer situational interpretations of an experience. Focusing on symbolic elements, specifically on discursive frames, or structures of meaning with communicative purposes, we analyze the discursive frames of two communities that faced events of extreme violence (massacres), with the aim of studying the terms of installation and elaboration of collective trauma. This helped identify generic and specific discursive frames that allowed the community the construction of the trauma narrative. The concept of trauma installation serves to study psychosocial holding strategies in communities facing tragedy.

Somatización, ansiedad y depresión en mujeres víctimas de violencia de pareja íntima / Somatization, anxiety and depression in women victims of intimate partner violence

Resumen A pesar de que la violencia de pareja íntima (VPI) presenta en la mujer una variedad de síntomas evidenciables, varios de los actores involucrados en el sistema de salud no cuentan con mecanismos de evaluación temprana, ni de reconocimiento de los tipos de secuelas psicológicas, entre los que se incluye una diversa sintomatología psicofisiológica. Con el objetivo de conocer las características de somatización, ansiedad y depresión en mujeres víctimas de VPI, como parte de una investigación macro de corte transversal no experimental de campo, se realizó el presente estudio cuantitativo correlacional a través de las variables del Inventario de Evaluación de la Personalidad (PAI). Los datos obtenidos se sometieron a análisis estadístico con métodos descriptivos e inferenciales. La muestra consta de 50 mujeres de la población de víctimas de VPI de la sierra ecuatoriana. Los resultados obtenidos son bastante contradictorios en cuanto al bajo porcentaje de mujeres con afectación típica relacionada con este tipo de violencia, en comparación con los datos presentados por otros autores sobre los niveles de somatización, ansiedad y depresión en ellas. A pesar de esto, se obtuvieron tres factores independientes presentes en esta muestra: trastorno ansioso-depresivo, con elementos de estrés postraumático; trastorno obsesivo compulsivo, con elementos de ansiedad, y quejas somáticas. Al momento de finalizar este estudio, se puede concluir que el PAI, sin su validación previa en esta población, no muestra una idoneidad suficiente para evaluar mujeres víctimas de VPI en el Ecuador. Se recomiendan nuevas investigaciones en otras muestras, en las que se utilicen diversos esquemas empíricos que incluyan varios instrumentos y medios cualitativos.

Abstract Various studies have noticed that women victims of intimate partner violence (IPV) also report having various types of health-related problems. However, health systems do not appear to have established procedures to recognize these problems (i. e., psychophysiological) in women. This study assessed somatic symptoms, anxiety, and depressive characteristics in women who have been victims of IPV. These symptoms were assessed using the scales of the Personality Assessment Inventory (PAI). The sample consisted of 50 women victims of IPV from the Ecuadorian sierra. Group participants came from two different cities: the first group included 28 women victims of IPV from Riobamba. Their ages ranged from 15 to 58. These women were receiving psychological services from a not-for-profit organization in the city. The second group included 22 women with similar characteristics between the ages of 27-63. This group of women came from the southern regions of Quito, the capital city of Ecuador. Women in this group were receiving services from two different places offering help to women experiencing IPV. Sixteen percent of women reported having a medium level of "anxiety" (some level of stress), and 14 % reported having a high level of tension and stress. Thirty-four percent of women reported medium levels of "anxiety-related disorders". These women reported having specific fears, little confidence in themselves and negative perspectives of their future. Sixteen percent of the women reported high levels of anxiety. They reported imitations in daily life (i. e., specific fears and feelings of insecurity in social situations). Thirty percent of women reported having medium levels of "depression" (sensitivity, pessimism, and feeling unhappy part of the time). Eighteen percent of women reported having high levels of "depression" (notable unhappiness and dysphoria). Forty-four percent of women in this study reported having some type of physical problem. These findings suggest that women who are victims of IPV could benefit from receiving mental health services aimed at managing their tension, stress, specific fears, and symptoms of depression. They also suggest that women victims of IPV could benefit from receiving training to increase their social competency and medical assistance to address their somatic complaints. Findings in this study are somewhat divergent from the results observed in previous investigations. Previous studies identified that most women who experienced IPV report symptoms of depression and anxiety. However, in this study, only a relatively low percentage of women reported having these symptoms. The sole utilization of the PAI as a method of evaluation may not have been sufficient to identify these symptoms. These results suggest the importance of using qualitative methods (i. e., clinical interview) or more holistic methodologies (i. e., clinical interview and tests) to better assess mental health symptoms in this group of women. It is also possible that the PAI might not be the most adequate tool to assess these symptoms in this population. The results of this investigation do reveal the importance of evaluating other mental health symptoms in women victims of IPV: post-traumatic stress, and obsessive-compulsive disorder. Future studies should focus on assessing these symptoms using other assessment methodologies (e. g. instruments designed to assess post-traumatic stress and obsessive-compulsive disorder). The efficiency of health systems evaluations and interventions depends on the methodologies used to assess problems. The sole use of one instrument such as the PAI may not provide sufficient information about symptoms experienced by women experiencing IPV. Health systems should use batteries of instruments in conjunction with the clinical interviewing processes to readily assess symptoms. However, such an alternative may not be entirely feasible taking into account that such methodology requires more time and likely financial support to acquire tests.

Avaliação do debriefing em cenário clínico simulado de atendimento a múltiplas vítimas no âmbito hospitalar com graduandos de enfermagem / Evaluation of debriefing in a simulated clinical scenario of care for multiple victims in the hospital with nursing students

Resumo: Trata-se de uma pesquisa vinculada a linha de pesquisa de Políticas e Práticas de Educação, Saúde, Enfermagem e ao projeto guarda-chuva intitulado "Simulação Clínica Multiprofissional: Criação e Validação de Modelos, Cenários e Instrumentos de Avaliação". A pesquisa foi desenvolvida por meio da avaliação do debriefing no cenário clínico simulado com múltiplas vítimas no âmbito hospitalar com graduandos de Enfermagem, cujo objetivo foi analisar a contribuição do debriefing no aprendizado do cenário simulado de atendimento a múltiplas vítimas com graduandos de enfermagem. O método utilizado foi quantitativo com delineamento descritivo e transversal como resultados destaca-se na caracterização do perfil dos participantes que a maioria se congratula no sexo feminino e com idade 20-30 anos. Na avaliação das escalas do debriefing: Escala de Experiência do Debriefing: aponta-se destaque na concordância que o debriefing ajudou a analisar seus pensamentos; ajudou a fazer conexões na aprendizagem; professor permitiu tempo suficiente para verbalizar os sentimentos antes dos comentários; que tiveram tempo suficiente para esclarecer os questionamentos e que o professor realizou uma avaliação construtiva da simulação durante o debriefing. Em relação a Escala de avaliação do debriefing associado a simulação: evidenciou-se que a maior parte dos graduandos concordaram que o debriefing identificou dificuldades na atuação; que foca nos aspectos importantes da atuação; refleti as minhas competências; identifica aspectos que se deve melhorar em atuações futuras e discordam em não querer participar em mais nenhuma simulação; em se sentir desrespeitado e em sentir que foi uma perda de tempo. Conclui-se que a contribuição a partir dos resultados das escalas de avaliação é importante para atuação dos futuros Enfermeiros através das boas práticas de Enfermagem conforme as normas de segurança do paciente. A relevância da contribuição do debriefing constatado a partir dos resultados das escalas de avaliação é importante para o desenvolvimento de habilidades técnicas e comunicativas, competências assistenciais de maneira interdisciplinar. O caráter inovativo da pesquisa: uso de metodologias ativas por meio da simulação clínica. A replicabilidade e impacto social do tema de atendimento de múltiplas vítimas no âmbito hospitalar pode ser aplicado em novas capacitações por meio da simulação clínica com graduandos e profissionais da área da saúde, para que consigam obter conhecimento sobre os cuidados em atendimento em massa com incêndio e como proceder nestas eventualidades.

Abstract: This research is linked to the research line of Education, Health, and Nursing Policies and Practices and to the umbrella project entitled "Multiprofessional Clinical Simulation: Creation and Validation of Models, Scenarios, and Assessment Instruments". The research was developed through the evaluation of debriefing in the simulated clinical scenario with multiple victims in the hospital environment with undergraduate nursing students, whose objective was to analyze the contribution of debriefing in learning the simulated scenario of care to multiple victims with undergraduate nursing students. The method used was quantitative with a descriptive and transversal design. The results highlight in the characterization of the participants' profile that most of them are female and aged 20-30 years. In the evaluation of the debriefing scales: Debriefing Experience Scale: it is highlighted in the agreement that the debriefing helped to analyze their thoughts; helped to make connections in learning; teacher will allow enough time to verbalize feelings before comments; that they had enough time to clarify the questions and that the teacher made a constructive evaluation of the simulation during the debriefing. In relation to the Rating scale of the debriefing associated to the simulation: it was evident that most undergraduate students agreed that the debriefing identified difficulties in the performance; that it focused on important aspects of the performance; that it reflected my skills; that it identified aspects that should be improved in future performances, and disagreed on not wanting to participate in any further simulation; on feeling disrespected, and on feeling that it was a waste of time. We conclude that the contribution from the results of the evaluation scales is important for the performance of future Nurses through good Nursing practices according to patient safety standards. The relevance of the contribution of the debriefing verified from the results of the evaluation scales is important for the development of technical and communicative skills, and care competencies in an interdisciplinary way. The innovative character of the research: use of active methodologies through clinical simulation. The replicability and social impact of the topic of multiple victim assistance in the hospital setting can be applied in new training courses through clinical simulation with undergraduate students and health professionals, so that they can obtain knowledge about care in mass care with fire and how to proceed in these eventualities.

Sexual violence against men in Brazil: underreporting, prevalence, and associated factors / Violência sexual contra homens no Brasil: subnotificação, prevalência e fatores associados

ABSTRACT OBJECTIVES Identifying and mapping the literature regarding sexual violence against Brazilian boys and men, as well as describing its underreporting, prevalence, and associated factors. METHODS We conducted a scoping review by searching PubMed, Biblioteca Digital Brasileira de Teses e Dissertações, Biblioteca Virtual em Saúde, Scopus, and Web of Science databases. The inclusion criteria were: (a) surveys including data on sexual violence; (b) inclusion of boys or men as victims of sexual violence; (c) presenting statistical data on prevalence, underreporting, and factors associated with sexual violence among Brazilian boys and men. RESULTS We found a total of 1,481 papers. Ultimately, 53 were included and had their data extracted. Most studies are quantitative in nature (n = 48). The total number of participants across studies was 1,416,480 and the prevalence of sexual violence ranged from 0.1% to 71%. It is important to note that underreporting statistical data was cited in several studies. The group with the highest prevalences was men who have sex with men and those with sexual dysfunctions. Increased tendency to drug use, social isolation, unprotected anal sex, suicidal ideation, sexual dysfunction, and post-traumatic stress disorder were statistically significant predictors for having experienced sexual violence. CONCLUSIONS Despite the prevalence of sexual violence being high against Brazilian boys and men, this area of is surprisingly understudied and there are few studies with this exclusive scope. Social cultural issues, such as sexism, contribute to the underreporting of sexual violence. Additionally, we identified issues related to mental, sexual and reproductive health to be associated with sexual violence. Based on our findings, we recommend the implementation and development of a structural infrastructure aimed at supporting boys and men who are victims of sexual violence, and preventing negative outcomes for this affected group.

RESUMO OBJETIVOS Identificar e mapear a literatura referente à violência sexual contra meninos e homens brasileiros, bem como descrever sua subnotificação, sua prevalência e os fatores associados. MÉTODOS Realizou-se uma revisão de escopo com buscas nas bases de dados: PubMed, Biblioteca Digital Brasileira de Teses e Dissertações, Biblioteca Virtual em Saúde, Scopus e Web of Science. Os critérios de inclusão foram: (a) pesquisas que incluíssem dados sobre violência sexual; (b) inclusão de meninos ou homens como vítimas de violência sexual; (c) apresentassem dados sobre prevalência, subnotificação e fatores associados à violência sexual entre meninos e homens brasileiros. RESULTADOS Foram encontrados 1.481 trabalhos. No total, 53 foram incluídos e tiveram seus dados extraídos. A maioria dos estudos é de natureza quantitativa (n = 48). O total de participantes em todos os estudos foi de 1.416.480 e a prevalência de violência sexual variou de 0.1% a 71%. A subnotificação foi um aspecto citado em vários estudos. Entre os grupos com maiores prevalências estão os homens que fazem sexo com homens e com disfunções sexuais. Maior tendência ao uso de drogas, isolamento social, sexo anal desprotegido, ideação suicida, disfunções sexuais e transtorno de estresse pós-traumático foram alguns dos fatores associados. CONCLUSÕES A violência sexual contra meninos e homens brasileiros é pouco estudada e existem poucos estudos com esse recorte exclusivo, apesar da prevalência de a violência sexual ser alta. Questões culturais, como o machismo, contribuem para a subnotificação da violência sexual. Em relação aos fatores associados, identificamos questões relacionadas à saúde mental, sexual e reprodutiva. Recomenda-se que seja estruturado acolhimento para meninos e homens vítimas de violência sexual, prevenindo ou minimizando desfechos negativos.

La macroviolencia encubridora y la invisibilización de las víctimas del conflicto. Estudio etnográfico de la masacre de Cienaguita-Pita (Atlántico) / Macroviolence and the invisibilization of the victims of the conflict. Ethnographic study of the Cienaguita-Pita massacre (Atlántico) / Macro-violência e a invisibilização das vítimas do conflito. Estudo etnográfico do massacre de Cienaguita-Pita (Atlántico)

Este artículo argumenta que la macroviolencia ha invisibilizado buena parte de las masacres ocurridas en regiones donde el conflicto interno fue de menor intensidad, ha banalizado sus efectos en pequeñas poblaciones, y con ello, ha provocado una relación transaccional entre el Estado y victimarios con las víctimas de masacres de menor escala. Por esta razón, por medio de un estudio de caso, haciendo uso de entrevistas semiestructuradas, grupos focales y encuestas al universo de habitantes de Cienaguita-Pita (Atlántico), se ilustrará cuáles fueron los efectos de la masacre, las entradas diferenciadas del Estado y el acceso que tuvieron las víctimas a los derechos a la verdad, justicia, reparación, no repetición y dignificación. Por último, este artículo pretende visibilizar una de las masacres ocurridas en el Caribe, que ha sido oculta por cuenta de la macroviolencia que caracterizó a la región en las décadas de 1990 y 2000, y demostrar, además, que el Estado es quien ha asumido la carga de indemnizar a las víctimas y establecer algunos insumos para reconstruir la verdad en el conflicto armado.

This article argues that macro-violence has made invisible a good part of the massacres that occurred in regions where the internal conflict was of lesser intensity, has trivialized its effects in small populations, and with it, has provoked a transactional relationship between the State and victimizers with the victims of smaller scale massacres. For this reason, by means of a case study, using semi-structured inter-views, focus groups and surveys of the universe of inhabitants of Cie-naguita-Pita (Atlántico), we will illustrate the effects of the massacre, the State>s differentiated approaches and the victims> access to the rights to truth, justice, reparation, non-repetition and dignity. Finally, this article aims to make visible one of the massacres that occurred in the Caribbean, which has been hidden due to the macro-violence that characterized the region in the 1990s and 2000s, and also to demonstrate that the State has assumed the burden of compensating the victims and establishing some inputs to reconstruct the truth in the armed conflict.

Este artigo argumenta que a macro-violência tornou invisível uma grande parte dos massacres que ocorreram em regiões onde o conflito interno foi de menor intensidade, banalizou os seus efeitos em pequenas populações, e provocou assim uma relação transaccional entre o Estado e os perpetradores com as vítimas de massacres de menor escala. Por este motivo, através de um estudo de caso, utilizando entrevistas semi-estruturadas, grupos focais e inquéritos aos habitantes de Cienaguita-Pita (Atlántico), ilustraremos os efeitos do massacre, as abordagens diferenciadas do Estado e o acesso das vítimas aos direitos à verdade, à justiça, à reparação, à não repetição e à dignidade. Finalmente, este artigo visa tornar visível um dos massacres ocorridos nas Caraíbas, que foi escondido devido à macro-violência que caracterizou a região nos anos 90 e 2000, e também demonstrar que o Estado assumiu o ónus de compensar as vítimas e estabelecer alguns contributos para a reconstrução da verdade no conflito armado.

Women's perception of urban insecurity in the Monterrey metropolitan area during COVID-19 / Percepción femenina de la inseguridad urbana en el área metropolitana de Monterrey en tiempos de COVID-19 / A percepção das mulheres sobre a insegurança urbana na área metropolitana de Monterrey em tempos de COVID-19

The purpose of this paper it to explore women's perception of urban insecurity prevailing during the COVID-19 pandemic in the Monterrey metropolitan area (MMA) in Mexico. In recent decades, large cities have grown and with them, so has crime increased. As a result, the issue of urban insecurity has become important, particularly during this COVID-19 pandemic. For this purpose, a cross-sectional, descriptive, non-probabilistic study was conducted involving 69 women aged 18 to 58, with Universidad Autónoma de Nuevo León being taken as the sample frame. Our findings show that 74% of the participants indicate that urban safety near their homes, ranges fair to very bad, while 81% feel the same about safety near their workplaces. Ninety-three per cent say that crime has increased. Meanwhile, 55% say that the situation has affected their quality of life severely to very severely, denoting the MAM population's transition from one of social well-being to one of vulnerability, which has been further aggravated by the health contingency.

Este artículo investiga la percepción femenina de la inseguridad urbana que prevalece durante la pandemia de COVID-19 en el área metropolitana de Monterrey (MAM) en México. En las últimas décadas las grandes urbes han crecido y con esto también se favorece la delincuencia. Por lo tanto, el tema de inseguridad urbana se ha tornado pertinente y, particularmente, ha sido de interés abordarlo durante esta pandemia de COVID-19. Para esto, se realizó un estudio de carácter transversal y descriptivo, no probabilístico, en 69 mujeres de 18 a 58 años, y se consideró la Universidad Autónoma de Nuevo León como el sitio de muestreo. En el presente documento los hallazgos muestran que 74% de las participantes indica que la seguridad urbana cercana a sus casas es regular a muy mala. Similar situación se presenta en sus lugares de trabajo, según afirma el 81%. El 93% asevera que los actos delictivos aumentaron. Entre tanto, el 55% dice que esta situación afectó de grave a muy gravemente su calidad de vida. Esta situación denota la transición de la sociedad en el MAM de bienestar social a otra de vulnerabilidad, que se ha incrementado por el escenario de la contingencia sanitaria que ha padecido.

Este artigo investiga a percepção das mulheres sobre a insegurança urbana prevalecente durante a pandemia COVID-19 na área metropolitana de Monterrey (MMA), no México. Nas últimas décadas, as grandes cidades cresceram e, com isso, a criminalidade também aumentou. Portanto, a questão da insegurança urbana tornou-se relevante e, particularmente, tem sido de interesse abordá-la durante esta pandemia da COVID-19. Para este fim, foi realizado um estudo transversal, descritivo e não-probabilístico entre 69 mulheres de 18 a 58 anos, e a Universidade Autônoma de Nuevo León foi considerada como o local de amostragem. Neste documento, os resultados mostram que 74% dos participantes indicam que a segurança urbana perto de suas casas é justa a muito ruim. Uma situação semelhante é encontrada em seus locais de trabalho, de acordo com 81%. Noventa e três por cento dizem que a criminalidade aumentou. Enquanto isso, 55% dizem que esta situação tem afetado seriamente a qualidade de vida deles. Esta situação reflete a transição da sociedade no MMA de uma situação de bem-estar social para uma situação de vulnerabilidade, que tem aumentado devido ao cenário de contingência de saúde que experimentou.

Conhecimento, prática e opinião de odontolegistas sobre a marcação identificadora de próteses dentárias / Knowledge, practice and opinion of forensic dentists on denture marking

Introdução: A marcação ou identificação de próteses dentárias é feita através da incorporação de etiquetas metálicas, não metálicas ou outras no material da prótese, ou ainda pela marcação da superfície. Apesar de ser recomendada por organizações governamentais e forenses, ela não é amplamente empregada no Brasil. Objetivo: Analisar o nível de conhecimento e descrever a opinião e experiência de odontolegistas brasileiros com a marcação protética. Material e métodos: Foi aplicado um questionário semiaberto a odontolegistas sobre o conhecimento, opinião e prática com a identificação protética. A análise estatística foi feita no software Microsoft Excel. Resultados: Foram obtidas respostas de 43 especialistas das cinco regiões do Brasil. 76% afirmaram conhecer o termo, mas apenas 14% relataram possuir experiência prática e 95% julga ser importante. Dos que já realizaram a prática e a descreveram, todos a utilizaram em situações forenses com cadáveres. Os maiores obstáculos apontados para a implementação foram a falta de conhecimento, a falta de diretrizes oficiais e o custo. Sobre a necessidade de implementar a marcação na prática clínica, 77% responderam que é necessária em todos os casos, mas com relação à obrigatoriedade de implementá-la, 56% declararam que deve ser recomendada, mas não obrigatória e 39%, que deve ser obrigatória. Conclusão: O conhecimento dos odontolegistas sobre a marcação de próteses é considerável e a maioria julga importante, no entanto, poucos tiveram contato com a prática e nenhum a realiza na clínica. Evidencia-se a necessidade da elaboração de diretrizes ou recomendações por entidades odontológicas, ressaltando a importância sócio-legal da prática

Introduction: Denture marking or identification is done through the incorporation of metallic, non-metallic or other labels in the material of the prosthesis, or by marking the surface. Despite being recommended by governmental and forensic organizations, it is not widely used in Brazil. Objective: To analyze the level of knowledge and describe the opinion and experience of Brazilian forensic dentists with denture marking. Material and methods: A semi-open questionnaire about the knowledge, opinion and practice with denture identification was applied to forensic dentists. Statistical analysis was performed using Microsoft Excel software. Results: Responses were obtained from 43 experts from the five regions of Brazil. 76% said they knew the term, but only 14% reported having practical experience and 95% thought it was important. Of those who have performed the practice and described it, all of them used it in forensic situations with corpses. The biggest obstacles pointed out to the implementation of the practice were the lack of knowledge, the lack of official guidelines and the cost. Regarding the need to implement marking in clinical practice, 77% answered that it is necessary in all cases, but regarding the obligation to implement it, 56% declared that it should be recommended, but not mandatory and 39%, that it should be mandatory. Conclusion: The knowledge of forensic dentists about denture marking is considerable and most consider it important, however, few had contact with the practice and none performs it in the clinic. The need for the elaboration of guidelines or recommendations by dental entities emphasizing the socio-legal importance of the practice is evident

Consecuencias psicológicas del abuso sexual infantil cometido por representantes de la Iglesia Católica: Una revisión sistemática de la literatura / Psychological consequences of child sexual abuse by Catholic Church representatives: A systematic review of literature

El objetivo de esta revisión sistemática de la literatura sobre abuso sexual eclesiástico fue identificar el impacto psicológico de este tipo de violencia en las víctimas. Las búsquedas iniciales se realizaron entre el 10 de octubre de 2020 y el 17 de diciembre de 2020. Así, la actualización de búsquedas se realizó entre el 26 de octubre de 2020 y el 23 de enero de 2021. Los artículos incluidos se obtuvieron desde las bases de datos PsycINFO, Web of Science (WoS) y Scopus. Se establecieron criterios de inclusión, y se realizó una selección inicial por medio de los títulos y resúmenes, los cuales, fueron examinados por dos revisores de forma independientes. Los documentos seleccionados se examinaron utilizando el mismo proceso de revisores. Se incluyeron 18 estudios de 2.189 títulos y resúmenes revisados. En general, los estudios evidenciaron un impacto psicológico negativo posterior al abuso sexual infantil ocurrido en contextos eclesiásticos. Destacando el daño espiritual como una característica específica del abuso sexual eclesiástico, lo que, sumado, a las consecuencias habituales del abuso sexual, sitúa a las víctimas en una posición compleja al presentar un espectro más amplio de efectos negativos posteriores al abuso. Los hallazgos del presente estudio permiten una mejor comprensión de este problema y entregan antecedentes para el desarrollo de estrategias de recuperación adecuadas a las necesidades de estas víctimas.

The objective of this systematic review of the literature on ecclesiastical sexual abuse was to identify the psychological impacts of this type of violence on victims. The initial literature searches were conducted between October 10, 2020 and December 17, 2020. Thus, the update of searches was conducted between October 26, 2020 and January 23, 2021. The articles included were obtained from the PsycINFO, Web of Science (WoS) and Scopus databases. Inclusion criteria were established, and an initial selection was made by means of titles and abstracts, which were examined by two reviewers independently. The selected papers were examined using the same reviewer process. Eighteen studies were included out of 2,189 titles and abstracts reviewed. Overall, the studies evidenced a negative psychological impact following child sexual abuse occurring in church settings. Highlighting spiritual harm as a specific feature of ecclesiastical sexual abuse, which, in addition to the usual consequences of sexual abuse, places victims in a complex position of presenting a broader spectrum of negative effects following abuse. The findings of the present study allow a better understanding of this problem and provide background for the development of recovery strategies appropriate to the needs of these victims.

Rol del resentimiento en la reconciliación social: víctimas movilizadas en Colombia (2021) / Role of resentment in social reconciliation: Mobilisation of victims in Colombia (2021)

Resumen Introducción: diez años después de la implementación de la Ley 1448 de 2011 para la reparación integral de las víctimas en Colombia desarrollamos una investigación cuantitativa no experimental para explorar la interacción entre sentimientos hacia la reconciliación (coexistencia y reconstrucción de la confianza) y resentimiento duradero en víctimas del conflicto movilizadas colectivamente en escenarios de justicia transicional. Método: utilizamos datos de dos muestras de participantes de los departamentos de Caldas (N = 342) y Atlántico (N = 305). Resultados: confirmamos las escalas sobre sentimientos hacia la reconciliación y resentimiento duradero, cuya fiabilidad fue analizada mediante los coeficientes alfa de Cronbach y omega. Posteriormente, realizamos un análisis de ecuación estructural y confirmamos las siguientes hipótesis: (1) las víctimas experimentan más sentimientos de coexistencia que sentimientos para la reconstrucción de confianza, y (2) el resentimiento duradero es un obstáculo para desarrollar sentimientos de reconciliación. Conclusiones: los participantes experimentan más sentimientos de coexistencia y confianza que resentimiento duradero; y la coexistencia permite canalizar el resentimiento duradero. Estos hallazgos tienen implicaciones considerables en el desarrollo de sentimientos hacia la reconciliación en escenarios de justicia transicional.

Abstract Introduction: Ten years after the implementation of Law 1448 of 2011 for the comprehensive reparation of victims in Colombia, we developed non-experimental quantitative research to explore the interaction between feelings towards reconciliation (coexistence and reconstruction of trust) and the lasting resentment in victims of the conflict mobilized collectively in transitional justice scenarios. Method: We used data from two samples of participants from the departments of Caldas (N = 342) and Atlántico (N = 305). Results: We confirmed the scales on feelings toward reconciliation and lasting resentment, whose reliability was analyzed using Cronbach's alpha and omega coefficients. Subsequently, we performed a structural equation analysis and confirmed the following hypotheses: (1) victims experience more feelings of co-existence than feelings for rebuilding trust, and (2) Lasting resentment is an obstacle to developing feelings towards reconciliation. Conclusions: We highlight that participants experience more feelings of coexistence and trust than they do lasting resentment; and that coexistence allows for the channeling of lasting resentment. These findings have considerable implications for the development of feelings towards reconciliation in transitional justice settings.

Somatoprótesis y Estallido Social Chileno 2019

Durante el Estallido Social en Chile 2019, la Odontología tomó un rol protagónico que nadie esperaba: La rehabilitación protésica de las víctimas de trauma ocular. Estos eventos dejaron al desnudo importantes fragilidades del sistema de salud Chileno.

During the social unrest in Chile in 2019, dentistry took a protagonist role that no one foresaw: The prosthetic rehabilitation of the ocular trauma victims. These events revealed important flaws on the Chilean Health system.

Sexual violence during pregnancy: cross-sectional study with women in puerperium / Violência sexual durante a gravidez: estudo transversal com mulheres no puerpério

Introduction: sexual violence during pregnancy is a serious violation of human rights and reproductive rights. Its prevalence is variable and multifactorial, depending on the analyzed territory and sociocultural and economic factors, requiring permanent monitoring. Methods: a cross-sectional study conducted at the Mandaqui Hospital, São Paulo, Brazil. The Abuse Assessment Screen (AAS) was applied to 350 puerperium women, with the outcome of suffering or not sexual violence during pregnancy, with data collected between September and December 2021. Sociodemographic and reproductive data were considered. We used an urn technique, with pre-coded data analyzed in EpiInfo® by Pearson's Chi-square and Mann Whitney test, adopting p<0.05 and 95% CI. Research approved by the Research Ethics Committee, CAAE No. 50580421.5.0000.5551. Results: we found eight cases of sexual violence (2.3%) and sample loss of 18.9%. Women who suffered sexual violence reported more physical violence in the last 12 months (25.0% x 6.1% - p=0.033, OR/CI 0.19: 0.03-1.03) and fear of the most frequent intimate partner (25.0% x 3.5% - p=0.002, OR/CI 0.10: 0.01-0.59), but we did not find a difference in the history of suffering violence before the age of 15 and by the partner throughout life. There was no difference in age, schooling, race/color, union, income and work. The same occurred for reproductive aspects, with no difference regarding the occurrence of prematurity, high-risk pregnancy, reproductive planning and tobacco/alcohol use during pregnancy. Conclusion: the prevalence of sexual violence during pregnancy was lower than in other Brazilian studies and populations from other countries. Women with sexual violence during pregnancy face a daily life of fear and more frequent physical violence. The high history of suffering violence before the age of 15 and experiencing physical or emotional violence by the intimate partner can aggravate the situation. The high history of violence and fear of the partner may have contributed to eventual understatement.

Introdução: a violência sexual durante a gravidez é grave violação de direitos humanos e de direitos reprodutivos. Sua prevalência é variável e multifatorial, dependendo do território analisado e de fatores socioculturais e econômicos, exigindo permanente monitoramento.Método: estudo transversal conduzido no Conjunto Hospitalar do Mandaqui, São Paulo, Brasil. Foi aplicado o Abuse Assessment Screen (AAS) para 350 puérperas, com desfecho de sofrer ou não violência sexual na gravidez, com dados coletados entre setembro e dezembro de 2021. Dados sociodemográficos e reprodutivos foram considerados. Empregamos técnica de urna, com dados pré-codificados analisados em EpiInfo® por Qui-quadrado de Pearson e teste de Mann Whitney, adotando valor de p<0,05 e IC de 95%. Pesquisa aprovada pelo Comitê de Ética em Pesquisa, CAAE nº 50580421.5.0000.5551.Resultados: verificamos oito casos de violência sexual (2,3%) e perda de amostra de 18,9%. Mulheres que sofreram violência sexual reportaram mais violência física nos últimos 12 meses (25,0% x 6,1% - p=0,033, OR/IC 0,19: 0,03-1,03) e medo do parceiro íntimo mais frequente (25,0% x 3,5% - p=0,002, OR/IC 0,10: 0,01-0,59), mas não constatamos diferença no antecedente de sofrer violência antes dos 15 anos e pelo parceiro ao longo da vida. Não observamos diferença quanto a idade, escolaridade, raça/cor, união, renda e trabalho. O mesmo ocorreu para aspectos reprodutivos, sem diferença quanto a ocorrência de prematuridade, gestação de alto risco, planejamento reprodutivo e uso de tabaco/álcool na gestação.Conclusão: a prevalência de violência sexual na gestação foi menor do que em outros estudos brasileiros e populações de outros países. Mulheres com violência sexual na gestação enfrentam um cotidiano de medo e de violência física mais frequente. O antecedente elevado de sofrer violência antes dos 15 anos e de experimentar violência física ou emocional pelo parceiro íntimo pode agravar a situação. O elevado antecedente de violência e de medo do parceiro pode ter colaborado para eventual subdeclaração.

Técnicas de marcação de próteses dentárias: revisão da literatura / Techniques of denture marking: review of literature

Indivíduos edêntulos representam um desafio na identificação humana, por isso, em 1931, a marcação identificadora de próteses dentárias foi proposta pela primeira vez, e várias técnicas e materiais têm sido testados ao longo dos anos. A marcação ou identificação de próteses é feita através da incorporação de materiais metálicos, não metálicos, microchips ou outros que são introduzidos no material da prótese removível, ou, ainda, pela marcação da superfície. O presente estudo teve como objetivo descrever as técnicas de marcação protética através de uma revisão narrativa da literatura com busca sistemática realizada nas bases de dados PubMed, Google Acadêmico e SciELO, além de uma busca manual nas referências dos trabalhos selecionados. É responsabilidade ética e legal do cirurgião-dentista auxiliar em investigações de identificação humana, assim, dado o amplo uso de próteses no Brasil, o valor de uma identificação, a relevância e comprovada eficiência em situações forenses, a marcação de próteses deve ser oferecida como opção a todos os pacientes

Edentulous people are a challenge in human identification, therefore in 1931, denture identification marking was proposed for the first time, and several techniques and materials have been tested over the years. The marking or identification of dentures is done through the incorporation of metallic, non-metallic materials, microchips or others that are introduced into the material of the removable prosthesis, or by marking the surface. The present study aimed to describe the techniques of denture marking in a narrative review of the literature with a systematic search using the databases PubMed, Google Scholar and SciELO, and also a manual search of the references of the selected works. It is the dentists ethical and legal responsibility to assist in investigations of human identification, so, given the wide use of dental prostheses in Brazil, the value of an identification, the relevance and proven efficiency of denture marking in forensic situations, the practice must be offered as an option for all patients

Facilitadores de la Violencia de Pareja Percibidos por Víctimas y Victimarios: Estudio Exploratorio en el Contexto de la Teoría del Aprendizaje Social / Facilitators of Intimate Partner Violence as Perceived by Victims and Perpetrators: An Exploratory Study in the Context of Social Learning Theory

Resumen Pocos estudios han documentado la percepción de víctimas y victimarios con respecto a los factores facilitadores e instigadores de la violencia de pareja. El objetivo del presente estudio fue evaluar la percepción de víctimas y victimarios de violencia de pareja con respecto a factores facilitadores e instigadores de la violencia. Participaron 27 víctimas de violencia de pareja con edades entre 18 y 71 años (media = 34.25) y 27 victimarios jurídicamente confirmados, con edades entre 19 y 62 años (media = 40), quienes respondieron un cuestionario integrado por una lista sobre factores facilitadores e instigadores de la violencia de pareja y de datos sociodemográficos. Ambos grupos coincidieron en señalar al estrés y consumo de sustancias como propiciadoras de violencia, así como a la madre de su pareja como instigadoras. El diseño de intervenciones para tratar o prevenir violencia de pareja requieren identificar los factores que la facilitan, incluyendo a las familias circundantes ya que podrían no sólo tolerar o justificar la violencia, sino incluso inducirla. Finalmente, se discuten algunas diferencias notorias entre perpetradores y víctimas respecto de otras variables propiciadoras de violencia en el contexto de la teoría del aprendizaje social.

Abstract Few studies have documented the opinion of victims and perpetrators regarding the facilitating and instigating factors of intimate partner violence. The objective of this study was to evaluate the perception of victims and perpetrators of intimate partner violence regarding facilitating and instigating factors of violence. Participants were 27 victims of intimate partner violence aged between 18 and 71 years (mean = 34.25) and 27 legally confirmed offenders, aged between 19 and 62 years (mean = 40), who answered a questionnaire consisting of a list of facilitating factors and instigators of intimate partner violence and sociodemographic data. Both groups agreed in pointing to stress and substance use as propitiators of violence, as well as the mother of their partner as instigators. The design of interventions to treat or prevent intimate partner violence requires identifying the factors that facilitate it, including the surrounding families, since they may not only tolerate or justify the violence, but even induce it. Finally, some notorious differences between perpetrators and victims are discussed with respect to other variables that promote violence in the context of social learning theory.

¿En qué se diferencian las agresiones sexuales cometidas en solitario y en grupo? Una revisión sistemática / How are solo versus multiple perpetrator sexual assaults different? A systematic review

Resumen El estudio de las agresiones sexuales ha tenido una gran relevancia e interés en la literatura. Las agresiones sexuales en grupo representan una pequeña proporción de todas las agresiones sexuales cometidas, pero presentan unas características específicas. La presente revisión sistemática examinó las variables de los delitos de agresión sexual cometidos en solitario versus en grupo. Se realizó una búsqueda bibliográfica en las bases de datos Psycinfo, Academic Search (EBSCO) y Google Scholar, y se encontraron ocho documentos que cumplían las condiciones de inclusión. Los resultados muestran que existe evidencia de las diferencias cualitativas entre las agresiones sexuales cometidas según el número de infractores. Las dinámicas que se promueven en los grupos explican la participación de los sujetos en las agresiones sexuales en grupo. El comportamiento colectivo favorece las agresiones sexuales en grupo por los procesos inherentes a él. Los delincuentes son, en su mayoría, hombres. Los delincuentes solitarios tienen una mayor edad y, a medida que los grupos son más grandes, la edad de los agresores disminuye. En cuanto a las víctimas, son más jóvenes que los agresores, sobre todo en los casos perpetrados por múltiples sujetos, y ofrecen una mayor resistencia ante las agresiones en solitario. Se ha confirmado que en las agresiones en grupo se llevan a cabo más actos sexuales y se utiliza más la violencia. Por otro lado, no aparecen diferencias en cuanto al uso de alcohol y la presencia de armas en las agresiones. Estos resultados tienen implicaciones para la prevención del delito y el tratamiento de las víctimas.

Abstract The study of sexual assault has had great relevance and interest in the literature. Group sexual assaults represent a small proportion of all sexual assaults committed, but they have specific characteristics. Internationally, it is established that between 10 and 33 % of sexual assaults have been committed by multiple authors. Describing the differences between individual versus group sexual assaults has been a challenge for researchers. The literature has concluded that there is a difference in the etiology of sexual assaults committed according to the number of authors. While in solo sexual assaults personal vulnerability factors may explain why these crimes are committed, in group assaults group behavior dynamics explain the interaction between more subjects. This systematic review examined the variables of sexual assault crimes committed alone versus in a group. A literature search was conducted on the Psycinfo, Academic Search (EBSCO) and Google Scholar databases. In the first analysis a total of 34 studies were initially identified, and after filtering the reasons for exclusion the analysis was performed with eight investigations. The results show that there is evidence of qualitative differences between sexual assaults committed according to the number of offenders. The dynamics promoted in the groups explain the subjects' participation in group sexual aggressions. Collective behavior favors sexual aggressions in groups because of the processes inherent to the group. The most common group was two subjects (dyad) although the average group was usually composed of three subjects. The offenders are mostly men; the lone offenders are older, and as the groups become larger, the age of the offenders decreases. Research has shown that the majority of victims are female, both in single and group assaults. Victims are also younger than the perpetrators, especially in multi-subject attacks, and they are more resistant to single-aggression attacks. The place where the crime is committed presents significant differences. Some authors found that offenders in groups of three or more people often commit the assault in an indoor space, although others found that lone offenders were more likely than group offenders to rape the victim indoors, especially in the bedroom. It has been confirmed that in group aggressions more sexual acts are carried out and more violence is used. Vaginal penetration is the most committed sexual assault, followed by anal and oral rape. In all cases, vaginal rape is more prevalent among group sexual assaults, even more so when the assaults are committed by groups of three or more subjects. Studies of multiple perpetrator sexual assaults show that this type of act increases the probability of suffering more injuries and long-term health problems. Another conclusion that can be drawn is that there are significant differences in the timing of stranger assault, with a higher likelihood of a stranger assault in group rapes. On the other hand, there is also a relevance in the presence of other instrumental factors such as alcohol and weapons. As for alcohol, it showed a significant relationship in sexual assaults. Although the presence of weapons in sexual assaults is not very common, some research has confirmed that groups tend to threaten victims with a weapon to a greater extent, and the knife is often the most common weapon. The results found are particularly relevant to understanding sexual assault crimes and have implications for crime prevention and the treatment of victims.

Perfil epidemiológico das violências interpessoal e autoprovocada em Porto Velho: notificações pré e transpandemia Covid-19 / Epidemiological profile of interpersonal and self-inflicted violence in Porto Velho: Covid-19 pre and transpandemic notifications / Perfil epidemiológico de la violencia interpersonal y autoinfligida en Porto Velho: notificaciones pre y transpandémicas de la Covid-19

A violência é um fenômeno complexo e multicausal, que envolve dor, sofrimento e sequelas à vítima, reverberando na saúde pública. Nesse sentido, este estudo teve como objetivo descrever os dados epidemiológicos das violências interpessoal e autoprovocada em Porto Velho (RO), no período de 2009 a 2021. Trata-se de um estudo descritivo, realizado de forma transversal e com abordagem quantitativa, a partir dos registros sobre o número de casos, dados da vítima, ocorrência, provável agressor e encaminhamento no Sistema de Informação de Agravos de Notificação ­ obtidos por meio da ferramenta Tabnet, por meio do portal eletrônico do Departamento de Informática do Sistema Único de Saúde ­, posteriormente analisados por estatística descritiva. Foram notificados 3.136 casos de violências interpessoal e autoprovocada, sendo que a maioria das vítimas era do sexo feminino, cor/raça parda, com quinta a oitava série incompleta do ensino fundamental e faixa etária de 10 a 14 anos, sendo o local da ocorrência a residência, com repetição das agressões, predominando a violência física e força corporal/espancamento. O provável agressor era a própria pessoa, não tinha suspeita de uso de bebidas alcoólicas, era adulto e não constava o registro do encaminhamento da vítima. Diante dos resultados encontrados, identificou-se que as violências interpessoal e autoprovocada têm acometido, principalmente, vítimas em seus ciclos de vida considerados mais vulneráveis (infância e adolescência), dentro do local onde deveriam ser acolhidas e protegidas.

Violence is a complex, multicausal phenomenon which results in pain, suffering and consequences for the victim, affecting public health. Thus, this cross-sectional quantitative study describes the epidemiological profile of interpersonal and self-inflicted violence in Porto Velho, Rondônia, Brazil, from 2009 to 2021. Data were collected from the records (number of cases, victim profile, occurrence, probable aggressor and referral) in Tabnet through the Notifiable Diseases Information System of the Unified Health System, and later analyzed by descriptive statistics. A total of 3,136 cases of interpersonal and self-inflicted violence were reported, of which most victims were female, mixed race, with incomplete 5th to 8th grade, between 10 and 14 years old, and the place of occurrence was the residence, with repetition of the aggressors, predominating physical violence and bodily force/beating. The likely aggressor was the person themself, not suspected of alcohol use, was an adult, and there was no record of the victim's referral. These findings show that interpersonal and self-inflicted violence mainly affect victims in their most vulnerable life cycles (childhood and adolescence), in the place where they should feel welcomed and protected.

La violencia es un fenómeno complejo y multicausal que implica dolor, sufrimiento y consecuencias para la víctima, repercutiendo en la salud pública. En ese sentido, este estudio tuvo como objetivo describir los datos epidemiológicos de la violencia interpersonal y autoinfligida en Porto Velho-RO, de 2009 a 2021. Se trata de un estudio descriptivo, realizado de forma transversal y con abordaje cuantitativo, a partir de registros de número de casos, datos de víctimas, ocurrencia, probable agresor y derivación en el Sistema de Información de Enfermedades de Declaración Obligatoria, a través de la herramienta Tabnet, a través del portal electrónico del Departamento de Informática del Sistema Único de Salud y, posteriormente, analizados en el Microsoft Excel programa de estadística descriptiva. Se reportaron 3.136 casos de violencia interpersonal y autoinfligida, siendo la mayoría mujeres, mestizas, con 5° a 8° grado de primaria incompleto, grupo etario de 10 a 14 años, y el lugar de ocurrencia fue la residencia, con reincidencia de agresión, predominante violencia física y fuerza física/golpes. El probable agresor era la propia persona, no era sospechoso de consumo de bebidas alcohólicas, era mayor de edad y no constaba la derivación de la víctima. Ante los hallazgos, se identificó que la violencia interpersonal y autoinfligida ha afectado principalmente a las víctimas en sus ciclos de vida más vulnerables (infancia y adolescencia), dentro del lugar donde deben ser acogidas y protegidas.

Do Protocolo de Palermo à compaixão-repressão: indefinições, vieses e idealizações da hegemonia antitráfico / From the Palermo Protocol to compassion-repression: undefinitions, biases and idealizations of anti-trafficking hegemony / Del Protocolo de Palermo a la compasión-represión: incertidumbres, sesgos e idealizaciones de la hegemonía antitrata

À escala globaltem ganhado clara ascendência um paradigma antitráfico associado ao chamado "Protocolo de Palermo", da Organização das Nações Unidas. Considerando as disposições deste protocolo, procuro caracterizar e compreender uma situação que suscita evidentes incongruências estruturais na hegemonia antitráfico: a convivência entre, por um lado, uma definição dilatada do tráfico de pessoas no texto do protocolo e das leis nacionais dele resultantes, e, por outro, a apertada seletividade ideológica que, oscilando de forma quase esquizofrénica entre a compaixão e a repressão, tende apermear os processos de operacionalização dosquadros legais, nomeadamente no que diz respeito ao reconhecimento e proteção das vítimas.

On a global scale, the paradigm of the fight against human trafficking, associated with the so-called "Palermo Protocol" of the United Nations Organization, has acquired a clear ascendancy. Considering the provisions of this protocol, I attempt to characterize and understand a situation that poses evident structural inconsistencies in the anti-trafficking hegemony: the coexistence between, on the one hand, a broad definition of trafficking in persons in the text of the protocol and the resulting national laws, and, on the other, the iron ideological selectivity that, oscillating almost schizophrenically between compassion and repression, tends to permeate the processes of operationalization of legal frameworks, specifically with regard to the recognition and protection of victims.

A escala mundial, el paradigma de la lucha contra la trata de personas, asociado al llamado "Protocolo de Palermo", de la Organización de las Naciones Unidas, ha adquirido una clara ascensión. Considerando las disposiciones de este protocolo, intento caracterizar y comprender una situación que plantea evidentes incoherencias estructurales en la hegemonía antitrata: la coexistencia entre, por una parte, una definición amplia de la trata de personas en el texto del protocolo y las leyes nacionales resultantes, y, por otra, la férrea selectividad ideológica que, oscilando de forma casi esquizofrénica entre la compasión y la represión, tiende a impregnar los procesos de operacionalización de los marcos legales, concretamente en lo que se refiere al reconocimiento y protección de las víctimas.

Relação entre violência interpessoal e discriminação: retrato de uma cultura de ódio / The relation between interpersonal violence and discrimination: a culture of hate portrait

RESUMO A violência é um problema de saúde pública e, historicamente, sempre foi registrada coexistindo com a experiência humana. O presente estudo teve como objetivo evidenciar a relação entre atos violentos e discriminação. Para alcançar este objetivo, utilizou-se um levantamento de caráter quantitativo, em plataforma online, com amostra composta por 137 sujeitos. Os dados foram analisados a partir de medidas estatísticas descritivas como média, frequência e desvio padrão. Os resultados apontaram que a natureza do ato violento mais lembrada foi a psicológica, com média de 60,58% dos episódios, a relação com algum tipo de discriminação ocorreu em 72,26% das respostas, dentre estas, o machismo foi a discriminação mais relacionada com média de 49,63%. Com os resultados obtidos, foi possível refletir sobre ações preventivas como a principal forma de superação da violência.

ABSTRACT Violence is a public health problem and historically has always been registered coexisting with the human experience. The current study has the aim to show the relation between violent acts and discrimination. To reach this goal, a quantitative survey in an online platform composed by 137 people was used. The information was analyzed from descriptive statistical measures like the mean, frequency and standard deviation. The results show that the most remembered violent act was the psicological violence, which was shown in around 60,58% of the episodes, the connection with some kind of discrimination occured in 72,26% of the answers, amongst them, sexism was the most common one, around 49,63%. With the results achieved, it was possible to reflect about preventive actions as the main form to overcome violence.