Barreras de acceso a los servicios primarios de salud sexual y reproductiva en adolescentes, de una comunidad urbano marginal del Perú

Introducción: Las barreras de acceso a los servicios de salud primario conforman estructuras sociales que agravan la situación de salud de los adolescentes, impactando negativamente en el ejercicio pleno de la salud sexual reproductiva, situando a los adolescentes en una población de riesgo social. Objetivo: Determinar las barreras en el acceso a los servicios primarios de Salud Sexual y Reproductiva de atención diferenciada a los adolescentes del Centro de Salud I - 4 Pampa Grande Tumbes 2018. Metodología: Estudio analítico de caso control, se entrevistaron a 288 adolescentes del tercero, cuarto y quinto de secundaria de la institución educativa pública Túpac Amaru del centro poblado Pampa Grande de Tumbes en el año 2019, entre experimento y control con una razón de 1 a 1. Se aplicaron cuestionarios anónimos para evaluar las barreras de accesibilidad a los servicios primarios de salud. Se recogieron variables: características sociodemográficas y culturales que son consideradas, como barreras de acceso a los servicios de salud. Se realizó un análisis descriptivo e inferencial con el programa SPSS® v.23. Resultados: La edad, sexo e ingreso económico están directa y significativamente relacionadas con la accesibilidad a los servicios de salud sexual y reproductiva (p<0.01 IC 95 %); La disposición de recursos económicos para asumir los costos de traslado al centro de salud (OR = 4,23); la utilización del transporte público (OR = 1,58), el conocimiento de los servicios de salud sexual y reproductiva (OR = 1,15) incrementan la probabilidad de acceder a los servicios de salud sexual y reproductiva de los adolescentes. Discusión: Las barreras socioeconómicas a los servicios de salud sexual y reproductiva de los adolescentes son modificables y dependen de la gestión en salud pública.

Introduction: The barriers to access to primary health services make up social structures that aggravate the health situation of adolescents, negatively impacting the full exercise of reproductive sexual health, placing adolescents in a population at social risk. Objective: To determine the barriers in the access to the primary services of Sexual and Reproductive Health of differentiated attention to the adolescents of the Health Center I - 4 Pampa Grande Tumbes 2018. Methods: Analytical case control study, 288 adolescents from the third, fourth and fifth grade of secondary school of the public educational institution Túpac Amaru in the Pampa Grande de Tumbes town center were interviewed in 2019, between experiment and control with a ratio of 1 to 1. Anonymous questionnaires were applied to assess accessibility barriers to primary health services. Variables were collected: sociodemographic and cultural characteristics that are considered as barriers to access to health services. A descriptive and inferential analysis was carried out with the SPSS® v.23 program. Results: Age, sex and economic income are directly and significantly related to accessibility to sexual and reproductive health services (p<0.01 95% CI); The availability of economic resources to assume the costs of transportation to the health center (OR = 4.23); the use of public transport (OR = 1.58), knowledge of sexual and reproductive health services (OR = 1.15) increase the probability of accessing sexual and reproductive health services for adolescents. Discussion: Socioeconomic barriers to sexual and reproductive health services for adolescents are modifiable and depend on public health management.

Factors associated with the health and reproductive autonomy of Quilombola women in Brazil / Factores asociados a la salud y la autonomía reproductiva de las mujeres quilombolas en Brasil / Fatores associados à saúde e autonomia reprodutiva de mulheres quilombolas no Brasil

Objective.To verify the association between reproductive autonomy and sociodemographic, sexual, and reproductive characteristics in Quilombola women (a term indicating the origin of politically organized concentrations of Afro-descendants who emancipated themselves from slavery).Methods. Cross-sectional and analytical study with 160 women from Quilombola communities in the southwest of Bahia, Brazil. Data were collected using the Reproductive Autonomy Scale and the questionnaire from the National Health Survey (adapted).Results. Out of the 160 participating women, 91.9% declared themselves as black, one out of every three were aged ≤ 23 years, 53.8% were married or had a partner, 38.8% had studied for ≤ 4 years, over half (58.1%) were unemployed, only 32.4% had a monthly income > R$ 430 (80 US dollars), 52.5% had their first menstruation at the age of 12, 70.7% had not accessed family planning services in the last 12 months, and over half used some method to avoid pregnancy (59.0%). The women had a high level of reproductive autonomy, especially in the "Decision-making" and "Freedom from coercion" subscales with a score of 2.53 and 3.40, respectively. A significant association (p<0.05) was found between the "Total reproductive autonomy" score and marital status, indicating that single or unpartnered women had higher autonomy compared to married or partnered women. Conclusion.The association of social determinants of health such as marital status, education, and age impacts women's reproductive choices, implying risks for sexual and reproductive health. The intergenerational reproductive autonomy of Quilombola women is associated with sociodemographic and reproductive factors.

Objetivo. Verificar la asociación entre autonomía reproductiva y características sociodemográficas, sexuales y reproductivas en mujeres quilombolas (término que indica procedencia de concentraciones de afrodescendientes políticamente organizadas que se emanciparon de la esclavitud). Métodos. Estudio transversal y analítico con 160 mujeres de comunidades quilombolas del sudoeste de Bahía, Brasil. Los datos fueron recolectados utilizando la Escala de Autonomía Reproductiva y el cuestionario de la Encuesta Nacional de Salud (adaptado). Resultados. De las 160 mujeres participantes 91.9% se declararon negras, una de cada tres tenía edad ≤ 23 años, 53.8% estaban casada o tenían pareja, 38.8% había estudiado por ≤ 4 años, más de la mitad (58.1%) no trabajaba, solo 32.4% tenía renta > R$ 430 mensual (87 $US dólares), el 52.5% tuvo la primera menstruación a los 12 años, 70.7% no había acudido a servicios de planificación familiar en los últimos 12 meses y más de la mitad usaba algún método para evitar embarazo (59%). Las mujeres tuvieron un alto nivel de autonomía reproductiva, especialmente en las subescalas "Toma de decisiones" y "Ausencia de coerción" con una puntuación de 2.53 y 3.40, respectivamente. Se encontró asociación significativa (p<0.05) entre la puntuación de "Autonomía reproductiva total" con el estado civil, indicando el análisis que las mujeres solteras o sin pareja tenían mayor autonomía en comparación con las casadas o con pareja. Conclusión. La asociación de determinantes sociales de la salud como el estado civil, la escolaridad y la edad interfieren en las opciones reproductivas de las mujeres, implicando riesgos para la salud sexual y reproductiva. La autonomía reproductiva intergeneracional de las mujeres quilombolas está asociada a factores sociodemográficos y reproductivos.

Objetivo. Verificar a associação entre a autonomia reprodutiva e características sociodemográficas, sexuais e reprodutivas em mulheres quilombolas (termo que indica a origem de concentrações politicamente organizadas de pessoas de ascendência africana que se emanciparam da escravatura). Métodos. Estudo transversal e analítico com 160 mulheres (80 mães e 80 filhas) de comunidades quilombolas no sudoeste baiano, no Brasil. Os dados foram construídos através da aplicação da Escala de Autonomia Reprodutiva e do questionário da Pesquisa Nacional de Saúde (adaptado). Resultados. das 160 mulheres participantes 91.9% se autodeclararam negra, a maioria com idade ≤ 23 anos (35.6%), 53.8% são casadas ou com companheiro, 38.8% com estudos ≤ 4 anos, mais da metade (58.1%) não trabalham, apenas 32.4% têm renda > R$ 430, a maioria teve a primeira menstruação até os 12 anos de idade (52.5%), não participou de grupo de planejamento familiar nos últimos 12 meses (70.7%), mais da metade utilizava método para evitar a gravidez (59%). Apresentaram elevada autonomia reprodutiva, com destaque para as subescalas "Tomada de decisão" e "Ausência de coerção" medindo 2.53 e 3.40, respectivamente. Encontrou-se associação significativa (p<0.05) entre o escore de "Autonomia reprodutiva total" e estado conjugal, com a análise indicando que mulheres solteiras ou sem companheiro apresentaram maior autonomia, comparadas às mulheres casadas ou com companheiro. Conclusão. A associação dos determinantes sociais de saúde como estado civil, menarca, escolaridade e idade interferem nas escolhas reprodutivas das mulheres, implicando em riscos à saúde sexual e reprodutiva. A autonomia reprodutiva intergeracional das mulheres quilombolas está associada a fatores sociodemográficos e reprodutivos.

Cuidado com a saúde sexual e reprodutiva: um olhar a partir da percepção de mulheres que fazem sexo com mulheres / Sexual and Reproductive Health Care: a look from the perspective of women who have sex with women / El cuidado de la salud sexual y reproductiva: una mirada desde la perspectiva de las mujeres que tienen sexo con mujeres

Objetivo: o presente estudo se destina a compreender a percepção das mulheres que fazem sexo com mulheres, referente ao cuidado que recebem nos serviços de saúde, no âmbito de sua saúde sexual e reprodutiva, a fim de verificar se o atendimento ofertado atende a integralidade de seu direito à saúde e, também, evidenciar o papel dos profissionais de saúde na garantia desses direitos. Metodologia: foi realizada revisão de literatura nacional para elaboração do instrumento de coleta de dados e pesquisa qualiquantitativa através de formulário e entrevista individual via internet. Resultados: Foram obtidas 287 respostas, as falas revelaram as seguintes categorias: A- Violência física sofrida em serviços de saúde, B- Negligência e falta de acolhimento em consultas ginecológicas e em serviços de saúde, C- Presunção da heterossexualidade nos serviços de saúde, D- Invisibilidade e violência moral e psicológica. Conclusão: evidenciou-se que mulheres que fazem sexo com mulheres ainda sofrem uma série de discriminações e violências nos serviços de saúde, ao buscarem cuidados integrais, principalmente no que tange aos seus direitos sexuais e reprodutivos.

Objective: this study is intended to understand the perception of women who have sex with women, regarding the care they receive in health services, within the scope of their sexual and reproductive health, in order to verify whether the care offered to them meets the integrality of their right to health and, also, highlight the role of health professionals in guaranteeing these rights. Methodology: A national literature review was carried out for the elaboration of the data collection instrument and qualitative and quantitative research through an individual form and individual interview via the internet. Results: 287 responses were obtained, the statements revealed the following categories: A- Physical violence suffered in health services, B- Negligence and lack of acceptance in gynecological consultations and health services, C- Presumption of heterosexuality in health services, D- Invisibility and, moral and psychological violence. Conclusion: it was evident that women who have sex with women still suffer a series of discrimination and violence in health services, when seeking comprehensive care, especially with regard to their sexual and reproductive rights.

Objetivo: este estudio tiene como finalidad conocer la percepción de las mujeres que tienen sexo con mujeres, respecto a la atención que reciben en los servicios de salud, en el ámbito de su salud sexual y reproductiva, con el fin de verificar si la atención que se les brinda cumple con la integralidad de su derecho a la salud y, además, destacar el papel de los profesionales de la salud en la garantía de estos derechos. Metodología: se realizó una revisión de literatura nacional para la elaboración del instrumento de recolección de datos e investigación cualitativa y cuantitativa a través de formulario individual y entrevista individual vía internet. Resultados: se obtuvieron 287 respuestas, los enunciados revelaron las siguientes categorías: A- Violencia física sufrida en los servicios de salud, B- Negligencia y falta de aceptación en las consultas ginecológicas y servicios de salud, C- Presunción de heterosexualidad en los servicios de salud, D- Invisibilidad y violencia moral y psicológica. Conclusión: se evidenció que las mujeres que tienen sexo con mujeres aún sufren una serie de discriminaciones y violencias en los servicios de salud, al momento de buscar atención integral, especialmente en lo que se refiere a sus derechos sexuales y reproductivos.

Estrategias usadas en la atención de la salud sexual de poblaciones rurales de bajos ingresos / Strategies Used in Sexual Health Care for Low-Income Rural Populations / Estratégias utilizadas na atenção à saúde sexual de populações rurais de baixa renda

Introducción: en la ejecución de políticas públicas de salud sexual, resultan cruciales las estrategias utiliza-das en la construcción de la relación agente de salud-usuario. En la literatura son pocos los artículos que exploran las estrategias que utilizan los agentes de salud para interactuar con pobladores rurales al abor-dar estas problemáticas. Este artículo se propone describir y comprender las estrategias que utilizan los agentes de salud en la atención de la salud sexual y reproductiva de pobladores rurales de bajos ingresos. Para ello, se conceptualiza la relación médico-paciente como una interfaz social, es decir, como un espacio de articulación entre los mundos de sentido de los actores involucrados. Materiales y métodos: se desarrolló un estudio de carácter exploratorio-descriptivo de tipo transversal. Se realizaron 21 entrevistas semiestruc-turadas a agentes del sistema de salud, y su análisis se hizo desde un enfoque cualitativo. Resultados: los agentes de salud utilizan un amplio repertorio de estrategias para abordar la salud sexual de los pobladores rurales. Se identificaron y caracterizaron dos tipos de estrategias (dialógicas y monológicas), con sus respectivos subtipos. Conclusión: el estudio visibiliza las estrategias dialógicas como modo alternativo de relación médico-paciente, en contraste con estrategias tradicionales, de tipo monológico. Además, contribuye a la formación de los agentes de salud, y en la conformación de los equipos que abordan la salud sexual y reproductiva en contextos rurales

Introduction: The strategies used for constructing health agent-user relationship are crucial for exe-cuting public policies on sexual health. In the literature, few articles explore the strategies used by health agents to interact with rural residents when addressing these problems. We aimed to describe and understand these strategies used by health agents for sexual health care in low-income rural resi-dents. To achieve this, the doctor­patient relationship is assumed to be a social interface and a space of articulation between the worlds of meaning of the actors involved. Materials and methods: An explor-atory, descriptive, and cross-sectional study was developed. Overall, 21 semistructured interviews were conducted with health agents, and the results were qualitatively analyzed. Results: Health agents use a wide repertoire of strategies to address the sexual health of rural residents. Two types of strategies (dia-logical and monological) and their respective subtypes were identified and characterized. Conclusion:Dialogic strategies are an alternative to the doctor­patient relationship and are contradictory to the traditional monological strategies. They impact the training of health agents and the formation of teams that address sexual and reproductive health in rural settings

Introdução: na execução das políticas públicas de saúde sexual, as estratégias utilizadas na construção da relação agente de saúde-usuário são cruciais. Na literatura são escassos os artigos que exploram as estratégias utilizadas pelos agentes de saúde para interagir com os moradores rurais na abordagem desses problemas. Este estudo se propõe a descrever e compreender as estratégias utilizadas pelos agen-tes de saúde na atenção à saúde sexual e reprodutiva de moradores rurais de baixa renda. Para isso, a relação médico-paciente é conceituada como interface social, ou seja, como espaço de articulação entre os mundos de sentido dos atores envolvidos. Materiais e métodos: foi desenvolvido um estudo transver-sal exploratório-descritivo. Foram realizadas 21 entrevistas semiestruturadas com agentes do sistema de saúde e sua análise foi feita a partir de uma abordagem qualitativa. Resultados: os agentes de saúde utilizam um amplo repertório de estratégias para abordar a saúde sexual dos residentes rurais. Dois tipos de estratégias (dialógicas e monológicas) foram identificadas e caracterizadas, com seus respecti-vos subtipos. Conclusão: este estudo torna visíveis as estratégias dialógicas como modo alternativo de relação médico-paciente, em contraste com as estratégias tradicionais de tipo monológico. Além disso, contribui para a formação de agentes de saúde e na formação de equipes que abordem saúde sexual e reprodutiva em contextos rurais.

Reproduction technologies in pig farming: artificial insemination - literature review / Tecnologias de reprodução na suinocultura: inseminação artificial - revisão de literatura / Tecnologías de reproducción en la porcicultura: inseminación artificial - revisión de literatura

This summary addresses the use of reproduction technologies in swine farming, with an emphasis on artificial insemination (AI). Brazilian swine farming has been growing significantly and seeks new technologies to achieve high productive indices sustainably and competitively. Pigs present favorable characteristics such as high prolificacy, fertility, rapid growth, feed efficiency, and carcass yield, which has led to intensive development of the activity with advanced genetic selection. AI is widely employed to disseminate genetic material among different regions and farms. Several AI techniques are used in modern swine farming: intrauterine insemination (IUI) allows semen deposition in the uterine region, reducing costs; fixed-time insemination (FTAI) synchronizes estrus in various females, facilitating management and increasing efficiency; deep intrauterine insemination (DIUI) deposits semen in the uterine horns, obtaining better results; and cervical insemination (CI), a traditional technique widely used, although it may be more time-consuming and present higher reflux rates. The success of AI is related to knowledge of the reproductive cycle of sows, proper nutrition, and genetic and environmental factors. Semen quality is essential, requiring collection by trained professionals and evaluation of sperm motility and morphology. Although it is a consolidated technique, there are issues to be further explored to optimize its application, defining the exact moment for insemination, reducing reflux, and adopting effective protocols. AI is an essential tool for the growth of Brazilian swine farming, but it requires continuous studies to maximize its efficiency and results, considering the farm's production goal and the size of the enterprise to achieve high reproductive and productive indices.

Este resumo aborda o uso de tecnologias de reprodução na suinocultura, com ênfase na inseminação artificial (IA). A suinocultura brasileira vem crescendo significativamente e busca novas tecnologias para alcançar altos índices produtivos de maneira sustentável e competitiva. Os suínos apresentam características favoráveis, como alta prolificidade, fertilidade, rápido crescimento, eficiência alimentar e rendimento de carcaça, o que levou ao desenvolvimento intensivo da atividade com seleção genética avançada. A IA é amplamente empregada para disseminar material genético entre diferentes regiões e granjas. Diversas técnicas de IA são utilizadas na suinocultura moderna: a inseminação intrauterina (IAIU) permite a deposição do sêmen na região uterina, reduzindo custos; a inseminação em tempo fixo (IATF) sincroniza o estro em várias fêmeas, facilitando o manejo e aumentando a eficiência; a inseminação intrauterina profunda (IAUP) deposita o sêmen nos cornos uterinos, obtendo melhores resultados; e a inseminação cervical (IAC), técnica tradicional amplamente utilizada, embora possa ser mais demorada e apresentar maiores taxas de refluxo. O sucesso da IA estar relacionado ao conhecimento do ciclo reprodutivo das matrizes, à nutrição adequada e aos fatores genéticos e ambientais. A qualidade do sêmen é essencial, exigindo coleta por profissionais treinados e avaliação da motilidade e morfologia dos espermatozoides. Apesar de ser uma técnica consolidada, há questões a serem aprofundadas para otimizar sua aplicação, definindo o momento exato para a realização da inseminação, a redução do refluxo e adoção de protocolos eficazes. A IA é uma ferramenta essencial para o crescimento da suinocultura brasileira, mas requer estudos contínuos para maximizar sua eficiência e resultados, considerando o objetivo produtivo da granja e o tamanho do empreendimento para alcançar altos índices reprodutivos e produtivos.

Este resumen aborda el uso de tecnologías de reproducción en la producción porcina, con énfasis en la inseminación artificial (IA). La producción porcina brasileña ha crecido significativamente y busca nuevas tecnologías para alcanzar altos índices de productividad de manera sostenible y competitiva. Los cerdos presentan características favorables, como alta prolificidad, fertilidad, rápido crecimiento, eficiencia alimentaria y rendimiento de la canal, lo que ha llevado al desarrollo intensivo de la actividad con selección genética avanzada. La IA se utiliza ampliamente para difundir material genético entre diferentes regiones y granjas. Diversas técnicas de IA son utilizadas en la producción porcina moderna: la inseminación intrauterina (IAIU) permite la deposición del semen en la región uterina, reduciendo costos; la inseminación a tiempo fijo (IATF) sincroniza el estro en varias hembras, facilitando el manejo y aumentando la eficiencia; la inseminación intrauterina profunda (IAUP) deposita el semen en los cuernos uterinos, obteniendo mejores resultados; y la inseminación cervical (IAC), técnica tradicional ampliamente utilizada, aunque puede ser más demorada y presentar mayores tasas de reflujo. El éxito de la IA está relacionado con el conocimiento del ciclo reproductivo de las hembras, la nutrición adecuada y los factores genéticos y ambientales. La calidad del semen es esencial, requiriendo la recolección por profesionales capacitados y la evaluación de la motilidad y morfología de los espermatozoides. A pesar de ser una técnica consolidada, hay aspectos que deben ser profundizados para optimizar su aplicación, como la definición precisa del momento de la inseminación, la reducción del reflujo y la adopción de protocolos eficaces. La IA es una herramienta esencial para el crecimiento de la producción porcina brasileña, pero requiere estudios continuos para maximizar su eficiencia y resultados, considerando el objetivo productivo de la granja y el tamaño del emprendimiento para alcanzar altos índices reproductivos y productivos.

Lacunas e propostas de práticas educativas de saúde sexual e reprodutiva para população LGBTQIA+: revisão integrativa / Gap and proposals for educational practices of sexual and reproductive health for the LGBTQIA+ population: an integrative review / Lagunas y propuestas de prácticas educativas de salud sexual y reproductiva para la población LGBTQIA+: una revisión integrativa

Objetivo: analisar as publicações científicas nacionais sobre a atenção à saúde sexual e reprodutiva oferecida para população LGBTQIA+ com relação às principais lacunas e possibilidades das práticas educativas referentes a essa temática no contexto brasileiro. Método: revisão integrativa, em seis etapas, com busca dos estudos realizada em junho de 2022 nas bases de dados LILACS, MEDLINE, SCIELO e Web of Science e SCOPUS. Resultados: foram recuperados 5.643 estudos e selecionados 14 para análise e discussão. Destacaram-se os temas: saúde sexual e reprodutiva com foco na reprodução e nas técnicas reprodutivas, infecções sexualmente transmissíveis e educação em saúde sexual e, por fim, direitos sexuais e reprodutivos. Conclusão: foram evidenciadas as principais lacunas quanto ao tema de saúde sexual e reprodutiva, assim como sugestões para práticas educativas ligadas à temática.

Objective: to analyze national scientific publications on the attention to sexual and reproductive health offered to the LGBTQIA+ population about the main gaps and possibilities of educational practices referring to this topic in the Brazilian context. Method: integrative review in six stages, with two studies, carried out in June 2022 in the LILACS, MEDLINE, SCIELO Web of Science, and SCOPUS databases. Results: 5,643 studies were recovered 14 were selected for analysis and discussion. Highlights the topics: sexual and reproductive health with a focus on reproduction and techniques, sexually transmitted infections, education in sexual health, and finally sexual and reproductive rights. Conclusion: found highlighted the main gaps regarding the topics of sexual and reproductive health, as well as suggestions for educational practices.

Objetivos: analizar las publicaciones científicas nacionales sobre la atención a la salud sexual y reproductiva ofrecida para la población LGBTQIA+ con la relación con las principales lagunas y posibilidades de las prácticas educativas referentes a esa temática en el contexto brasileño. Método: revisión integrativa, en seis etapas, con búsqueda de estudios realizados en junio de 2022 en bases de datos LILACS, MEDLINE, SCIELO y Web of Science y SCOPUS. Resultados: foram recuperados 5.643 estudios y seleccionados 14 para análisis y discusión. Destacaram-se os temas: saúde sexual e reprodutiva com foco na reprodução e nas técnicas reproductivas, infecções sexualmente transmissíveis e educação em saúde sexual e, por fim, direitos sexuais e reprodutivos. Conclusión: foram evidenciadas como principales lagunas en cuanto al tema de salud sexual y reproductiva, así como sugerencias para prácticas educativas ligadas a temáticas.

Direitos sexuais e direitos reprodutivos na percepção de: mulheres privadas de liberdade / Sexual rights and reproductive rights in the perception of: women deprived of freedom / Derechos sexuales y derechos reproductivos percibidos por: mujeres privadas de libertad

Objetivo: analisar a percepção de mulheres privadas de liberdade quanto aos seus direitos sexuais e direitos reprodutivos. Método: pesquisa descritiva, com abordagem qualitativa. Foram realizadas entrevistas com mulheres que estavam vivenciando a gestação (9) e o puerpério (4), em duas unidades prisionais do Rio de Janeiro. O método de análise foi o Hermenêutico dialético. Resultados: foram elencadas duas categorias: 1) Violações institucionais como infração dos direitos sexuais e dos direitos reprodutivos e 2) Contradições entre a possibilidade de exercer os direitos e as limitações impostas pelo sistema carcerário. Conclusão: as violações que essas mulheres sofrem, não estão restritas a elas. A luta pelos direitos das mulheres é um movimento constante. Os avanços são significativos, contudo, há amarras reais que impedem que as mulheres usufruam seus direitos sexuais e seus direitos reprodutivos, mesmo que eles existam no plano legal e normativo

Objective: analyze the perception of women deprived of liberty regarding their sexual rights and reproductive rights. Method: descriptive research, with a qualitative approach. Interviews were conducted with women who were experiencing pregnancy (9) and the puerperium (4), in two prison units in Rio de Janeiro. The analysis method was the dialectic hermeneutic. Results: two categories were listed: 1) Institutional violations as infractions of sexual rights and reproductive rights and 2) Contradictions between the possibility of exercising rights and the limitations imposed by the prison system. Conclusion: the violations that these women suffer are not restricted to them. The fight for women's rights is a constant movement. The advances are significant, however, there are real obstacles that prevent women from enjoying their sexual rights and their reproductive rights, even though they exist in the legal and normative plan

Objetivos: respecto a sus derechos sexuales y derechos reproductivos. Método: investigación descriptiva, con un enfoque cualitativo. Las entrevistas fueron realizadas a mujeres en situación de embarazo (9) y de puerperio (4), en dos unidades penitenciarias de Río de Janeiro. El método de análisis fue la hermenéutica dialéctica. Resultados: se han dividido en dos categorías: 1) Violaciones institucionales como la infracción de los derechos sexuales y los derechos reproductivos y 2) Contradicciones entre la posibilidad de ejercer los derechos y las limitaciones impuestas por el sistema carcelario. Conclusión: las violaciones que sufren estas mujeres no se limitan a ellas. La lucha por los derechos de la mujer es un movimiento constante. Los avances son significativos, sin embargo, existen ataduras reales que impiden a las mujeres disfrutar de sus derechos sexuales y sus derechos reproductivos, aunque existan a nivel legal y normativo

Research progress on food-derived antioxidants for alleviating toxicity of endocrine disrupting chemicals / 环境与职业医学

Endocrine disrupting chemicals (EDCs) are a class of chemical substances widely present in daily-life environment, and can enter human body through various pathways, posing a threat to reproductive development and health. Oxidative stress (OS) is one of the most important fundamental mechanisms underlying the reproductive toxicity of EDCs. Numerous studies have found that exposure to EDCs can increase the levels of reactive oxygen species (ROS) in human reproductive system and reduce the activity and quantity of multiple enzymatic antioxidants, leading to oxidative stress and inducing damage to the reproductive system at various levels such as DNA and cells. Many research results have shown that supplementing food-derived non-enzymatic antioxidants can reduce ROS levels and increase the activity of enzymatic antioxidants, thereby reduce OS levels, and further repair EDCs-induced reproductive damage. In addition, many food-derived antioxidants are important elements involved in reproductive physiological activities and have protective effects on reproductive health. This paper summarized the reproductive toxicity of EDCs, including damage to reproductive cells, interference with hormone action, and influence on reproductive-related epigenetic regulation, elaborated the relationship between OS and reproductive toxicity of EDCs, and further summarized the alleviating effects and related mechanisms of food-derived antioxidants such as vitamins, trace elements, and plant polyphenols and pigments against reproductive toxicity of EDCs, aiming to provide a theoretical and scientific basis for prevention and treatment against reproductive toxicity of EDCs.

Staged Treatment with Chinese Herbal Medicine in a Controlled Ovarian Hyperstimulation of In Vitro Fertilization-Embryo Transfer Programme / 中医杂志

It is believed that kidney deficiency is the fundamental pathogenesis while liver constraint and spleen deficiency， and disharmony of chong （thorough vessel， 冲脉）and ren （conception vessel， 任脉） is the key pathogenesis of infertility patients who adopted controlled ovarian hyperstimulation of in vitro fertilization-embryo transfer （IVF-ET） programme. Therefore， the method of tonifying the kidneys dominantly and treating the liver and spleen simultaneously is proposed， and Chinese herbal medicine is suggested to be used in adjuvant treatment of staged IVF-ET controlled ovrian hyperstimulation. In the regulation stage， modified Liuwei Dihuang Pill （六味地黄丸） can be used to tonify kidney and supplement essence， fortify spleen and nourish liver； in the ovulation promotion stage， modified Wenjing Decoction （温经汤） should be used to warm kidney and assist yang， dispel stasis and nourish blood； in the pre-transplantation endothelial preparation stage， modified Shenling Baizhu Powder （参苓白术散） is suggested to fortify spleen and replenish qi， invigorate blood and resolve stasis； after the transplantation stage， modified Shoutai Pill （寿胎丸） or Taiyuan Decoction （胎元饮） can be taken to fortify spleen and tonify kidney， benefit qi and nourish blood.

Exploration of "Strengthening Kidney Yin" Method to Alleviate Female Reproductive Damage Caused by Glycosides of Tripterygium wilfordii Polyglycoside / 中国实验方剂学杂志

Tripterygium wilfordii polyglycosides are one of the most commonly used Tripterygium wilfordii preparations， which have anti-inflammatory and immune-regulating effects. Their unique therapeutic effect on some autoimmune diseases and kidney diseases is almost irreplaceable by other similar drugs， but the possible reproductive damage is the bottleneck that hinders their clinical application. In clinical use， female patients often suffer from menstrual cycle disorders， decreased menstrual flow， even amenorrhea， infertility， and other symptoms， and the main toxic mechanism lies in damaging the reproductive and endocrine functions of the ovary and inhibiting the growth and development of follicles. Therefore， it is particularly necessary to understand the toxic and side effects of Tripterygium wilfordii polyglycosides on female reproduction and master the detoxification methods during clinical use. However， there is no clear solution to these problems. According to the theory of traditional Chinese medicine， "kidney governs reproduction"， and the relationship between kidney Yin， kidney essence， and female ovum is close. Therefore， by considering that the damage to the reproductive system caused by Tripterygium wilfordii polyglycosides belongs to the category of kidney deficiency， Yin damage， and essence deficiency， the "strengthening kidney Yin" method is proposed. It points out that the reproductive toxicity damage of Tripterygium wilfordii polyglycosides on the female can be effectively alleviated by tonifying kidney and Yin essence in clinical use. The relevant research on traditional Chinese medicine， classical prescription， test prescription， and acupuncture is summarized to verify the necessity of the "strengthening kidney Yin" method， so as to provide a theoretical basis for the safe and rational clinical use of Tripterygium wilfordii.

Lycium barbarian seed oil activates Nrf2/ARE pathway to reduce oxidative damage in testis of subacute aging rats / 中国药理学通报

Aim To explore the effects of Lycium berry seed oil on Nrf2/ARE pathway and oxidative damage in testis of subacute aging rats. Methods Fifty out of 60 male SD rats, aged 8 weeks, were subcutaneously injected with 125 mg • kg"D-galactosidase in the neck for 8 weeks to establish a subacute senescent rat model. The presence of senescent cells was observed using P-galactosidase ((3-gal), while testicular morphology was examined using HE staining. Serum levels of testosterone (testosterone, T), follicle-stimulating hormone ( follicle stimulating hormone, FSH ) , luteinizing hormone ( luteinizing hormone, LH ) , superoxide dis-mutase ( superoxide dismutase, SOD ) , glutathione ( glutathione, GSH) and malondialdehyde ( malondial-dehyde, MDA) were measured through ELISA, and the expressions of factors related to aging, oxidative damage, and the Nrf2/ARE pathway were assessed via immunohistochemical analysis and Western blotting. Results After successfully identifying the model, the morphology of the testis was improved and the intervention of Lycium seed oil led to a down-regulation in the expression of [3-gal and -yH2AX. The serum levels of SOD, GSH, T, and FSH increased while MDA and LH decreased (P 0. 05) . Additionally, there was an up-regulated expression of Nrf2, GCLC, NQOl, and SOD2 proteins in testicular tissue ( P 0. 05 ) and nuclear expression of Nrf2 in sertoli cells. Conclusion Lycium barbarum seed oil may reduce oxidative damage in testes of subacute senescent rats by activating the Nrf2/ARE signaling pathway.

Effects of soybean isoflavones on the reproductive development of young mice / 中国药房

OBJECTIVE To investigate the effects of soybean isoflavones （SI） on the reproductive development of young mice. METHODS C57BL/6 young mice were randomly divided into control group， SI low-dose and high-dose groups （10， 100 mg/kg）， with 10 mice in each group （half male and half female）. The young mice in each group were given corresponding liquid intragastrically， once a day， for 2 consecutive weeks. After the last administration， the percentage of body weight increase was calculated； serum estradiol and testosterone levels， malondialdehyde （MDA） content， total antioxidant capacity （T-AOC）， superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px） activities in the reproductive organs of the young mice were determined. The histopathological changes in the reproductive organs were observed. The cell apoptosis of reproductive organs was detected. RESULTS Compared with the control group， the percentage of body weight increase in female mice was increased significantly in the SI high-dose group， while that of male mice was decreased significantly （P＜0.05 or P＜0.01）. Cystic follicles could be seen in the ovarian tissue in SI groups， a loose arrangement of spermatocytes could be seen in the testicular tissue， and partial epithelial cell shedding could be seen in epididymal tissue. The serum level of testosterone in female young mice and the serum levels of testosterone and estradiol in male young mice in SI groups， GSH-Px activity in the ovarian tissue of female young mice in the SI low-dose group， T-AOC activities in the ovarian tissue of female young mice in SI groups as well as the apoptotic rates of cells in testicular and epididymal tissue of male young mice in SI groups were increased significantly （P＜0.05 or P＜ 0.01）； the serum level of estradiol in female young mice in SI groups， SOD activity in the ovarian tissue of female young mice in the SI high-dose group， and MDA contents in the ovarian tissue of female young mice in SI groups as well as the apoptotic rates of cells in ovarian tissue of female mice in SI groups were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS SI can enhance the antioxidant stress capacity of ovarian tissue in female young mice and reduce their oxidative stress damage， but it has certain toxicity to reproductive organs in male mice.

Discussion on the Continued Use of Assisted Reproductive Technology for Widowed Single Women / 中国医学伦理学

Assisted Reproductive Technology(ART) as a medical technology to treat infertility is gradually increasing the applications in domestic and foreign countries. In fact, some single women have birth demands for the application of ART in China. This paper described the reasons why some single women in China have demands for the application of ART, and analyzed the relevant legal, ethical and social issues that may be faced in the applying of technologies. Besides, the paper suggested that the using of ART in single women should be banned in principle, but for some widowed single women who lost their husbands during the process of ART, considering allowing them to complete the unfinished applications at their request. Meanwhile, a self-assessment mechanism should be established for these widowed single women, and ethical principles and managements should be strictly followed in the process of ART application to prevent the abuse of technology and fully protect the interests of offspring.

Reflection on Assisted Reproductive Technology Cases based on WAS Syndrome Gene Mutation / 中国医学伦理学

With the development of assisted reproductive technology, there will be more and more complex conflicts of interest issues and challenges. This paper used clinical medicine, legal and ethical analysis of WAS syndrome gene mutation assisted reproductive technology cases, emphasized that the law is the bottom line of morality, strengthen the consulting duty of the ethics committee of reproductive medicine, and pointed out that medical staff must fully perform the obligation of notification, respect their autonomy and provide patients with best medical assistance.

Design and baseline characteristics of a population-based birth cohort in Shanghai / 上海预防医学

ObjectiveTo introduce the basic design， development plan and objectives of a population-based birth cohort in Shanghai， and further present the main data and baseline characteristics of enrolled participants in the cohort， and to provide key information for reproductive health-related studies. MethodsThe Shanghai population-based birth cohort initiated on January 1， 2005， included newborns born in Shanghai every year and their parents， and collected information on reproductive health， reproductive treatment， birth characteristics， growth and development status， as well as the incidence， treatment and death of diseases by employing data linkage technology and investigations. This formed a birth cohort spanning the entire life cycle. ResultsAs of October 2022， a total of 2 978 538 newborns and their parents were included in the cohort. Among them， 2 905 135 （97.54%） were naturally conceived （NC）， and 73 403 （2.46%） were born through assisted reproductive technologies （ART）. The average age of parents was （32.56±4.12） years old for females and （34.62±5.34） years old for males in the ART group， which was higher than （28.02±4.71） years and （30.07±5.54） years for parents in the NC group. Among parents， females and males aged 30 and above accounted for 77.12% and 85.08%， respectively， which were higher than that of parents （35.28% for females and 49.66% for males） in the NC group. Furthermore， the percentage of parents with a college degree or above in the ART group was 73.23% for females and 73.66% for males， which were higher than those in the NC group （49.98% and 50.91%， respectively）. The multiple births rate in the ART group was 33.81%， which was higher than that in the NC group （1.88%）. The incidence of premature birth and low birth weight in the ART group were 24.47% and 19.08%， respectively， which was higher than that in the NC group （5.47% and 3.73%）. ConclusionThe comprehensive collection of reproductive health-related information in the birth cohort in Shanghai can provide essential resources to determine the influence of genetics， environment， reproductive treatment and other related factors on the health of offspring after birth.

Histología testicular y morfología de la vejiga natatoria del pez neotropical Plagioscion magdalenae (Acanthuriformes: Sciaenidae): implicaciones en su taxonomía y distribución / Testicular histology and morphology of the swim bladder of the neotropical fish Plagioscion magdalenae (Acanthuriformes: Sciaenidae): implications in taxonomy and distribution

Introducción: La Pácora (Plagioscion magdalenae) es una especie nativa de Colombia y en categoría de casi amenazada a nivel del país, de la que poco se conoce acerca de las estructuras con aporte etológico en su historia de vida. Objetivo: Analizar el desarrollo gonadal relacionado con la espermatogénesis de P. magdalenae y las implicaciones taxonómicas a partir de la vejiga natatoria. Métodos: Realizamos siete muestreos en dos periodos climáticos: el primero en octubre de 2019 a febrero de 2020 de recolectas bimensuales y la segunda de octubre 2020 a enero 2021 de recolectas mensuales; con el fin de abarcar cada momento del pulso de inundación de la cuenca baja del Magdalena. Describimos la histomorfología testicular y las características macroscópicas de la vejiga natatoria de la especie. Además, analizamos aspectos como relaciones morfométricas, clases de tallas por sexos, la proporción sexual y la época de madurez sexual. Resultados: Analizamos 142 ejemplares y 4 intervalos de tallas fueron establecidos (entre 145 y 575 mm LE), 66 fueron machos y 73 hembras con una proporción sexual global 1.1:0.9 (hembra-macho) sin diferencias. Los machos tienen testículos de tipo tubular, protegidos por el peritoneo que se encuentra recubierto por la musculatura sónica de la vejiga natatoria, la cual posee forma de ''zanahoria'' sin apéndices, con dos bandas laterales de músculos intrínsecos (promedio entre 6.75 cm de largo y 1.48 cm de ancho) unidos por una aponeurosis y que solo se encuentran en machos sexualmente maduros. Conclusión: Los testículos poseen una organización de tipo lobular irrestricto y la espermatogénesis se da en lóbulos seminíferos. La vejiga natatoria de la Pácora es simple y no tiene estructuras accesorias. La distribución geográfica de P. magdalenae se restringe a la cuenca del río Magdalena en Colombia.

Introduction: The Pácora (Plagioscion magdalenae) is a species native to Colombia and in near-threatened category at the country level, of which little is known about the structures with ethological contribution in its life history. Objective: To analyze the gonadal development related to spermatogenesis of P. magdalenae and the taxonomic implications from the swim bladder. Methods: We collected seven samples in two climatic periods: the first from October 2019 to February 2020 of bimonthly collections, and the second from October 2020 to January 2021 of monthly collections; to cover every moment of the flood pulse of the lower Magdalena basin. We described the testicular histomorphology and macroscopic characteristics of the swim bladder of the species. In addition, we analyzed aspects such as morphometric relationships, size classes by sex, sex ratio and time of sexual maturity. Results: We analyzed 142 specimens and established 4 size intervals (between 145 and 575 mm SL), 66 were males and 73 females with an overall sex ratio of 1.1:0.9 (female-male) with no differences. Males have tubular testes protected by the peritoneum covered by the sonic musculature of the swim bladder, which has a ''carrot'' shape without appendages, with two lateral bands of intrinsic muscles (average between 6.75 cm long and 1.48 cm wide) connected by an aponeurosis and found only in sexually mature males. Conclusion: The testes have an unrestricted lobular organization and spermatogenesis occurs in the seminiferous lobes. The swim bladder of the Pácora is simple and has no accessory structures. The geographic distribution of P. magdalenae is restricted to the Magdalena River basin in Colombia.

Pulsão de Morte e Sublimação: A (Re)invenção da Vida nas Dobras da Racionalidade Técnico-Científica / Death Drive and Sublimation: The (Re)invention of Life in the Folds of Technical-Scientific Rationality / Pulsión de Muerte y Sublimación: (Re)invención de la Vida en las Doblas de la Técnica

O advento das biotecnologias no mundo contemporâneo, em particular das Novas Tecnologias Reprodutivas (NTR's), liberando a sexualidade dos antigos imperativos da procriação, nos oferece uma prova contundente da abertura ilimitada da vida à transformação das condições em que as normas vitais engajam os organismos no processo de individuação. Mais do que isso, evidencia o caráter essencialmente contingente da ligação entre vida, morte e sexualidade. O objetivo deste trabalho é examinar a fecundidade da concepção freudiana de sublimação - lida sob o registro das transformações que a ela se impõem com o advento do conceito de pulsão de morte (1920) - em subsidiar uma reflexão ética e política acerca dos efeitos da incidência das Novas Tecnologias Reprodutivas (NTR's) nos campos da reprodução, da sexualidade e do laço social. Nossa hipótese é a de que o fenômeno das biotecnologias desvela, sob a cobertura do temor, tão frequentemente evocado por alguns de nossos contemporâneos, de dilapidação das instituições e dos modos de vida sobre os quais acreditávamos poder fundar nossa fantasmática "humanidade", a infinita potência da vida em recriar-se diante d'isso que quer destruí-la.

The advent of biotechnologies in the contemporary world, particularly New Reproductive Technologies (NTRs), freeing sexuality from the old imperatives of procreation, offers us overwhelming proof of the unlimited opening up of life to the transformation of conditions in which vital norms engage the organisms in the individuation process. Even more so, it highlights the essentially contingent character of the connection between life, death, and sexuality. The aim of this study is, therefore, to examine the fruitfulness of the Freudian conception of sublimation, read under the register of the transformations imposed upon this notion with the advent of the death drive concept (1920), in subsidizing an ethical and political reflection on the effects of the incidence of NTRs in the reproduction, sexuality and social bond fields. Our hypothesis is that the biotechnologies phenomenon reveals, under the cover of fear, so often evoked by some of our contemporaries, of institutional dilapidation and ways of life in which we believed we could establish our fantastic "humanity", the infinite life's power to recreate itself in the face of that which wants to destroy it.

La llegada de las biotecnologías en el mundo contemporáneo, en particular de las Nuevas Tecnologías Reproductivas (NTR's), liberando la sexualidad de los imperativos de la procreación, nos ofrece una prueba contundente de la abertura ilimitada de la vida a la transformación de las condiciones en que las normas vitales capacitan el organismo a la individuación. Más allá de eso, se evidencia el carácter esencialmente contingente de la ligación entre vida, muerte y sexualidad. El objetivo de este estudio es examinar la fecundidad de la concepción freudiana de sublimación - leída bajo el registro de las transformaciones que a ella se imponen con la llegada del concepto de pulsión de muerte (1920) - en subsidiar una reflexión ética y política acerca de los efectos de la incidencia de las Nuevas Tecnologías Reproductivas (NTR's) en los campos de la reproducción, de la sexualidad y del lazo social. Nuestra hipótesis es que el fenómeno de las biotecnologías desvela, bajo la cobertura del temor, tan frecuentemente evocado por algunos de nuestros contemporáneos, de dilapidación de las instituciones y de los modos de vida sobre los cuales creíamos poder fundar nuestra fantasmática "humanidad", la infinita potencia de la vida en recrearse de ante d'eso que quiere destruirla.

Factores determinantes del éxito en la carrera de enfermeras actuantes en tecnología de reproducción asistida / Factors that affect career success of nurses who practice in assisted reproductive technology / Fatores que afetam o sucesso profissional de enfermeiros que atuam na área de tecnologia de reprodução assistida

Objetivo: examinar la relación entre éxito en la carrera y ambiente de trabajo con enfermeras actuantes en tecnología de reproducción asistida (TRA), e identificar factores que afectan su éxito en la carrera. Método: estudio transversal realizado en 53 centros de fertilidad de 26 provincias en la China Continental. Datos recolectados utilizando cuestionario de datos demográficos, un Cuestionario de Competencias de TRA para Enfermeras Especializadas, la Career-Success Scale (Escala de éxito profesional) y la Nursing Work Environment Scale (Escala del entorno de trabajo de enfermería). Se aplicó estadística inferencial y descriptiva. Resultados: 597 enfermeras actuantes en TRA participaron en nuestra encuesta, entregando 555 cuestionarios válidos. Los puntajes generales promedio de éxito en la carrera y ambiente de trabajo fueron 3,75 (desviación estándar, [DE]=1,01) y 3,42 (DE=0,77) respectivamente. Se observó fuerte correlación positiva entre éxito en la carrera y ambiente de trabajo (r=0,742; p<0,01). La regresión múltiple mostró que la concurrencia a conferencias académicas, atención psicológica, desarrollo profesional, apoyo y cuidado, salario y bienestar constituyeron factores significantes con influencia en el éxito en la carrera. Conclusión: la concurrencia a conferencias académicas, atención psicológica y ambiente de trabajo guardan relación positiva con el éxito en la carrera. Los gestores deberían considerar formas de abordar tales factores.

Objective: to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. Method: a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. Results: 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. Conclusion: attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors.

Objetivo: examinar a relação entre o sucesso profissional e o ambiente de trabalho de enfermeiros da área de tecnologia de reprodução assistida e identificar os fatores que afetaram tal sucesso. Método: estudo transversal conduzido em 53 centros de fertilidade em 26 províncias da China Continental. Os dados foram coletados por meio de um questionário demográfico, um questionário sobre competências de enfermagem especializada em tecnologias de reprodução assistida, da Career-Success Scale (Escala de Sucesso Profissional) e da Nursing Work Environment Scale (Escala do Ambiente de Trabalho na Enfermagem). Aplicaram-se análises de estatística descritiva e inferencial. Resultados: participaram do estudo 597 enfermeiros da área de tecnologia de reprodução assistida, e 555 questionários válidos foram coletados. As pontuações globais médias para o sucesso profissional e o ambiente de trabalho foram 3,75 [desvio padrão (DP) = 1,01] e 3,42 (DP = 0,77), respectivamente. Verificou-se forte correlação positiva entre o sucesso profissional e o ambiente de trabalho (r = 0,742; p < 0,01). A análise de regressão múltipla mostrou que a participação em eventos acadêmicos, a assistência psicológica, o desenvolvimento profissional, o apoio e os cuidados, e o salário e o bem-estar foram fatores que influenciaram significativamente o sucesso profissional. Conclusão: a participação em eventos acadêmicos, a assistência psicológica e o ambiente de trabalho mostraram correlação positiva com o sucesso profissional. Os gestores deveriam considerar formas de abordar esses fatores.

Acceso y prácticas de higiene menstrual en América Latina: revisión de alcance / Menstrual hygiene access and practices in Latin America: scoping review / Acesso e práticas de higiene menstrual na América Latina: revisão de escopo

Objetivo: sintetizar la evidencia disponible relacionada con el acceso y las prácticas de higiene menstrual en América Latina y el Caribe. Método: revisión de alcance de la literatura con protocolo de investigación registrado en el Open Science Framework, realizada en las bases de datos bibliográficas: PubMed, Scopus, Web of Science y Portal Regional da Biblioteca Virtual em Saúde. Los datos fueron analizados mediante estadística descriptiva simple y análisis temático. Resultados: se incluyeron 15 publicaciones, la mayoría de las cuales trataban sobre adolescentes en Brasil: 12 artículos, dos informes técnicos y una monografía de trabajo de conclusión de curso. Como temas recurrentes en las publicaciones se destacan: acceso a condiciones dignas para el manejo de la higiene menstrual; necesidad de acceso a información sobre el manejo de la higiene menstrual; y prácticas para el manejo de la higiene menstrual. Conclusión: adolescentes informan dificultades para acceder a baños, agua y materiales absorbentes, y falta de información sobre la salud menstrual, incluso en las escuelas, lo que lleva al ausentismo escolar. De esta manera, las lagunas en la literatura científica latinoamericana revelan desigualdades y diversidad en las experiencias menstruales interseccionadas por categorías como género, clase social y etnia.

Objective: to synthesize available evidence related to menstrual hygiene access and practices in Latin America and the Caribbean. Method: literature scoping review with research protocol registered in the Open Science Framework, carried out in the bibliographic databases: PubMed, Scopus, Web of Science and Portal Regional da Biblioteca Virtual em Saúde. Data were analyzed using simple descriptive statistics and thematic analysis. Results: 15 publications were included, the majority of which addressed adolescents in Brazil: 12 articles, two technical reports and a course conclusion monograph. As recurring themes in the publications, the following stand out: Access to dignified conditions for managing menstrual hygiene; Need for access to information on menstrual hygiene management; and Practices for managing menstrual hygiene. Conclusion: adolescents report difficulties in accessing toilets, water and absorbent materials, and lack of information about menstrual health, including in schools, leading to school absenteeism. Thus, gaps in the Latin American scientific literature reveal inequalities and diversity in menstrual experiences intersected by categories such as gender, social class and ethnicity

Objetivo: sintetizar evidências disponíveis relacionadas ao acesso e práticas de higiene menstrual na América Latina e Caribe. Método: revisão de escopo da literatura com protocolo de pesquisa registrado no Open Science Framework, realizada nas bases de dados bibliográficas: PubMed, Scopus, Web of Science e Portal Regional da Biblioteca Virtual em Saúde. Os dados foram analisados por estatística descritiva simples e análise temática. Resultados: foram incluídas 15 publicações, cuja maioria abordava adolescentes no Brasil: 12 artigos, dois relatórios técnicos e uma monografia de trabalho de conclusão de curso. Como temas recorrentes nas publicações, destacam-se: acesso a condições dignas para o manejo da higiene menstrual; necessidade de acesso à informação sobre manejo da higiene menstrual; e práticas para manejo da higiene menstrual. Conclusão: adolescentes relatam dificuldades de acesso a sanitários, água e materiais absorventes, e falta de informação sobre saúde menstrual, inclusive nas escolas, levando ao absenteísmo escolar. Assim, lacunas na literatura científica latino-americana revelam desigualdades e diversidade nas experiências menstruais interseccionadas por categorias como gênero, classe social e etnia.

Os impactos da pandemia de COVID-19 na prática dos direitos sexuais e reprodutivos na América Latina / The impacts of the COVID-19 pandemic on the exercise of sexual and reproductive rights in Latin America / Los impactos de la pandemia de COVID-19 en la práctica de los derechos sexuales y reproductivos en América Latina

Este editorial apresenta o dossiê temático sobre os impactos da pandemia de COVID-19 na prática dos direitos sexuais e reprodutivos na América Latina. Nele, propomos uma reflexão sobre os efeitos da pandemia no exercício legal e vivencial dos referidos direitos. Ao mesmo tempo, consideramos importante recuperar, partindo dos debates de Veena Das, a ideia de extraordinário e de ordinário da violência de gênero e da violação dos direitos humanos. Por fim, os artigos deste dossiê são brevemente apresentados, mostrando como permitiram realizar um registro histórico e operar como denúncia de práticas e situações que não podem se repetir ou se manterem banalizadas.

This editorial introduces a thematic issue addressing the ramifications of the COVID-19 pandemic on the practice of sexual and reproductive rights in Latin America. We critically reflect on the pandemic's impact on both the legal and experiential dimensions of these rights. Drawing inspiration from Veena Das' debates, we emphasize the significance of reexamining the concepts of the extraordinary and the ordinary in gender violence and human rights violations. Furthermore, we provide a concise overview of the articles contributed to this dossier, highlighting their role in creating a historical record and serving as a denunciation of practices and situations that should neither be replicated nor trivialized.

Este editorial presenta el dossier temático sobre los impactos de la pandemia de COVID-19 en la práctica de los derechos sexuales y reproductivos en América Latina. En él proponemos una reflexión sobre los efectos de la pandemia en el ejercicio jurídico y vivencial de dichos derechos. Al mismo tiempo, consideramos importante recuperar, a partir de los debates de Veena Das, la idea de lo extraordinario y lo ordinario en la violencia de género y las violaciones de derechos humanos. Finalmente, se presentan brevemente los artículos escritos para este dossier, evidenciando cómo permitirán crear un registro histórico y también operarán como denuncia de prácticas y situaciones que no pueden repetirse ni banalizarse.