Utilização de banco de dados policiais como perspectiva para redução do sub-registro da violência contra mulheres / Using police databases as a prospect to reduce under-recording of violence against women / Utilizar las bases de datos policiales como perspectiva para reducir el subregistro de la violencia contra las mujeres

Objetivo: buscou-se avaliar a concordância entre o Sistema de Informação de Agravo de Notificação (SINAN) e dados policiais para casos de violência física e sexual contra mulheres, bem como o perfil das mulheres agredidas, das agressões e dos agressores. Método: foi realizado estudo transversal com casos ocorridos em uma cidade de Minas Gerais, notificados no SINAN e/ou identificados na base policial, entre os anos de 2015 e 2016. Criou-se uma base consolidada, composta pelos casos elegíveis das duas fontes, tendo sido realizadas análises descritivas. Em uma base pareada contendo casos comuns aos dois bancos, foi realizada análise de concordância pelo teste Fleiss'Kappa. Resultados: 1.185 casos compuseram a base consolidada e 56 constituíram a base pareada. Houve sub-registro de 83,54% nos dados do SINAN, além de incompletude importante de informações. A base policial apresentou cerca de oito vezes maior captação. A concordância de informações foi elevada/moderada para sete de 11 características avaliadas para os casos comuns. Na base consolidada, as vítimas foram predominantemente negras, solteiras ou viúvas, com idade entre 18 e 39 anos. Os homens, especialmente (ex)parceiros e familiares, foram os principais agressores. Conclusão: o sub-registro e a incompletude de informações sobre violência contra mulher no SINAN é uma realidade que precisa ser tratada. O cruzamento com fontes de dados policiais é uma alternativa para melhorar a qualidade das informações, reduzindo o sub-registro. Apesar dos dados subestimados, percebeu-se que a violência física e doméstica, cometida por (ex)parceiro contra mulheres jovens e negras continua sendo prevalente, atentando para o fato que se deve manter foco de políticas públicas.(AU)

Objective: this study sought to evaluate the agreement between the Information System for Notifiable Health Problems (Sistema de Informação de Agravo de Notificação, SINAN) and Police data for cases of physical and sexual violence against women, as well as the profile of the assaulted women, the aggressions and the aggressors. Method: a cross-sectional study was conducted with cases in a city from Minas Gerais, notified to the SINAN and/or identified in the Police database between 2015 and 2016. A consolidated database was created, comprised by the eligible cases from both sources, with performance of descriptive analyses. An agreement analysis by means of the Fleiss Kappa test was performed in a paired database containing cases common to both databases. Results: a total of 1,185 cases comprised the consolidated database, whereas 56 were included in the paired one. There was 83.54% under-recording in the SINAN data, in addition to important information incompleteness. The Police database presented nearly eight times more recording of cases. Agreement of all the information was high/moderate for seven out of 11 characteristics evaluated for the common cases. In the consolidated databases, the victims were predominantly black-skinned, single or widowed, and aged between 18 and 39 years old. The main aggressors were men, mainly (former) partners and family members. Conclusion: under-recording and incompleteness of diverse information about violence against women in the SINAN is a reality that needs to be dealt with. Cross-referencing with Police data sources represent an alternative to improve quality of the information, reducing under-recording. Despite the underestimated data, it was noticed that physical and domestic violence, perpetrated by (former) partners against young and black-skinned women, continues to be prevalent, pointing to the fact that it should remain as the focus of public policies.(AU)

Objetivo: se buscó evaluar la concordancia entre el Sistema de Informação de Agravo de Notificação (SINAN) y los datos policiales para los casos de violencia física y sexual contra las mujeres, así como el perfil de las mujeres maltratadas, de las agresiones y agresores. Método...(AU)

Aids em cartazes: representações sobre sexualidade e prevenção da Aids nas campanhas de 1º de dezembro no Brasil (2013-2017) / El Sida en los carteles: representaciones sobre sexualidad y prevención del Sida en las campañas del 1º de diciembre en Brasil (2013-2017) / AIDS in posters: representations on sexuality and Aids prevention in December 1st campaigns in Brazil (2013-2017)

Buscou-se analisar as representações da sexualidade e prevenção em cartazes produzidos pelo Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis (DCCI) a partir da diretriz da prevenção combinada (PC), adotada em 2013. Realizou-se análise de conteúdo, de caráter descritivo e documental, dos cartazes de campanhas do dia 1º de dezembro (2013-2017). Resultados apontam que aspectos relacionais do uso do preservativo teriam menos relevância, ao passo que a individualização do cuidado vem se acirrando sob a lógica de "testar para se conhecer". Nota-se a oferta de alternativas de prevenção, por meio do símbolo do tripé "preservativo, teste e comprimido", ou de novas tecnologias como a profilaxia pré-exposição (PrEP) e Profilaxia Pós Exposição (PEP). Isso sugere que, desde seu lançamento, a PC passou a orientar as campanhas do DCCI, em oposição a campanhas anteriores que privilegiavam populações-alvo e o preservativo masculino.(AU)

El objetivo fue analizar las representaciones de la sexualidad y prevención en carteles producidos por el Departamento de Enfermedades de Condiciones Crónicas e Infecciones de Transmisión Sexual (DCCI, por sus siglas en portugués), a partir de la directriz de prevención combinada (PC), adoptada en 2013. Se realizó el análisis de contenido, de carácter descriptivo y documental de los carteles de campañas del día 1º de diciembre (2013-2017). Los resultados señalan que aspectos relacionales del uso del preservativo tendrían menos relevancia, mientras que la individualización del cuidado se recrudece bajo la lógica de "hacer test para conocerse". Se observa la oferta de alternativas de prevención a través del símbolo del trípode: "preservativo, test y comprimido" o de nuevas tecnologías como PrEP y PEP. Eso sugiere que, desde su lanzamiento, la PC pasó a orientar las campañas del DCCI, en oposición a campañas anteriores que privilegiaban a poblaciones-objetivo y el preservativo masculino.(AU)

The article sought to analyze representations of sexuality and prevention on posters produced by the Department of Chronic Conditions Diseases and Sexually Transmitted Infections (DCCI) stemming from the combination prevention (CP) guidelines adopted in 2013. A descriptive and documental content analysis of posters relative to the World Aids Day (December 1st) was carried out (2013-2017). Results indicate that relational aspects of condom use appear to be less relevant, and increments of the individualization of care under the logic of "know your status" are becoming stronger. It is also possible to notice preventive alternatives, by way of the tripod symbol: "condom, test and pill", or new technologies such as PrEP and PEP. This suggests that the CP has been guiding the DCCI campaigns since its launch, as opposed to previous campaigns focusing on target populations and male condoms.(AU)

O uso intensivo da internet por crianças e adolescentes no contexto da COVID-19 e os riscos para violências autoinflingidas / The intensive use of the internet by children and adolescents in the context of COVID-19 and the risks for self-inflicted violence

Resumo O presente ensaio busca discutir as implicações do isolamento social devido à pandemia do COVID-19 para o uso intensivo da internet entre crianças e adolescentes e suas possíveis consequências para a prática de violências autoinflingidas. Discutimos brevemente o potencial ansiogênico e a reprodução de um "medo global" que se consolidam com a exposição maciça e sem mediação dos conteúdos consumidos, que podem aumentar as vulnerabilidades para estresse e ideações suicidas. Centramos nosso debate sobre práticas "recreativas", denominadas de "desafios" com poder autolesivo, realizados por adolescentes no site Youtube. Essa prática revelou-se crescente a partir das medidas de isolamento social. Nossa reflexão sobre esses riscos é feita a partir da perspectiva teórica da sociabilidade digital, e suas implicações nas interações de adolescentes mediadas pela internet.

Abstract This essay aimed to discuss the implications of social isolation due to the COVID-19 pandemic for the intensive use of the internet among children and adolescents and its possible consequences for the practice of self-inflicted violence. We briefly discussed the anxiogenic potential and the reproduction of a "global fear" that are consolidated with the massive and unmediated exposure of the content consumed, which can increase the vulnerabilities to stress and suicidal ideas. We centered our debate on "recreational" practices, called "challenges" with self-harm power, carried out by teenagers on the YouTube website. This practice has been shown to increase with the social isolation measures. Our reflection on these risks builds on the theoretical perspective of digital sociability, and its implications for the internet-mediated interactions of adolescents.

Búsqueda manual y electrónica de ensayos clínicos en revistas médicas cubanas: análisis de la terminología utilizada en su descripción / Manual and electronic search of clinical trials in Cuban medical journals: analysis of terminology

INTRODUCCIÓN Los ensayos clínicos se consideran la regla de oro para evaluar la eficacia y seguridad de las intervenciones. De manera independiente, pueden no ser suficientes para generalizar resultados, pero constituyen la base de revisiones sistemáticas que sintetizan sus resultados y suelen aportar evidencias de mayor calidad. Pero una vez publicados, la pobre descripción del método científico y el uso insuficiente de palabras clave, dificultan su recuperación por búsqueda electrónica y se requiere de la búsqueda manual. OBJETIVOS Comparar la capacidad de recuperación entre la búsqueda manual y estrategias múltiples de búsqueda electrónica para localizar ensayos clínicos en revistas médicas cubanas, y determinar la terminología utilizada para describir el ensayo clínico. Métodos Se combinó la búsqueda electrónica en la biblioteca virtual Scientific Electronic Library Online de Cuba (SciELO Cuba), y la base de datos de bibliografía médica cubana Cumed con la búsqueda manual utilizando la guía de búsqueda de Cochrane, para localizar los ensayos en tres revistas cubanas en el período 2000 a 2012. Se identificaron los términos significativos incluidos en título, resumen, palabras clave y métodos de cada artículo según la guía Cochrane, CONSORT y el tesauro de ciencias de la salud. RESULTADOS Se identificaron 50 ensayos en la búsqueda manual, de ellos cuatro coincidieron en la búsqueda electrónica; todos a través de SciELO Cuba (8%) y ninguno en Cumed. Las secciones menos descriptivas fueron el título y las palabras clave. Se utilizaron más palabras clave que descriptores autorizados; los únicos conceptos empleados en más de la mitad de los estudios fueron: "controlado" (60%) y "grupos de estudio" (52%); "aleatorizado" fue usado en el 50% de los artículos. Aunque son más específicos, no fueron muy usados los términos "ensayo clínico", "fase" y "código del ensayo". CONCLUSIONES La búsqueda electrónica es insuficiente para la identificación de ensayos clínicos respecto de la búsqueda manual. Por lo tanto, se precisa la combinación de ambos métodos para lograr un mayor índice de recobrado. La terminología usada para describir los ensayos clínicos en las revistas seleccionadas fue deficiente, debido a la subutilización del tesauro de ciencias de la salud.

INTRODUCTION Clinical trials are the gold standard for testing the efficacy and safety of interventions. On their own they may not be enough to reach definitive conclusions, but they are the basis for systematic reviews that synthesize the results of several studies. However, once clinical trials have been published, a poor description of the study design and lack of specific key words and descriptors make it difficult to retrieve them by electronic searches, thus requiring hand searching. OBJECTIVES To compare the retrieving capacity between hand search and the multiple strategies of electronic searches for identifying clinical trials in Cuban medical journals, and to determine the terminology used for describing these studies. METHODS We combined electronic searches in the Scientific Electronic Library Online of Cuba (SciELO Cuba) and Cuban database Cumed with hand search using the Cochrane guide to locate trials in three Cuban journals in the period 2000-2012. We identified the significant terms included in the title, summary, keywords and methods of each article according to Cochrane, CONSORT, and the health sciences thesaurus. RESULTS We identified 50 trials by hand search; four of them were retrieved by electronic search through SciELO Cuba (8%) while none was found through Cumed. The less descriptive sections were the title and the keywords. More keywords than authorized descriptors were used; the only specific concepts used in over half of the retrieved trials were "controlled" (60%), and "study groups" (52%); "randomized" was used in 50% of the retrieved documents. While more specific, the terms "clinical trial", "phase", and "clinical trial registration" were not used. CONCLUSIONS Compared to hand searching, electronic searches are insufficient to identify clinical trials. Therefore, the combination of the two meth-ods is necessary to reach higher retrieval rates. The terminology used to describe clinical trials in the selected journals was deficient due to underutilization of the health sciences thesaurus.

Para medir o trabalho em saúde no Brasil: principais fontes de informações / To measure the workforce market in health: main information sources

Este artigo analisa as principais fontes de dados nacionais - Censos, Pesquisa Nacional de Domicílios (PNAD), Pesquisa Assistência Médico-Sanitária (AMS), CNES, RAIS e o CAGED - que podem ser utilizadas para medir e caracterizar o mercado de trabalho em saúde no Brasil, apresentando suas vantagens, fronteiras e limitações mais gerais. A discussão está focada por modalidades de pesquisas: domiciliares, estabelecimentos e registros administrativos. As autoras sugerem cautela ao comparar as bases entre si, tendo em vista que essas bases oficiais só pesquisam empregos formais, ou seja, deixam de fora os trabalhadores informais, desprecarizados e terceirizados existentes - uma parcela de cerca de 30% da força de trabalho em saúde.(

This article analyzes the main sources of national data - Census, Home National Research (PNAD), Sanitary Medical Assistance Research (AMS), CNES, RAIS and the CAGED - that can be used to measure and characterize the workforce market in health in Brazil, presenting their advantages, frontiers and more general limitations. The discussion is focused on kinds of research: home, establishments and administrative registers. The authors suggest to take care when comparing the bases among themselves as these official basis only research formal jobs, or leave out informal workers, unprecarious, and existing third-party - a sector of about 30% of the workforce in health.

Cancer screening literature in the period 2000-2002: pointers to future research avenues.

In order to determine which areas of cancer screening are currently receiving greatest emphasis in different parts of the world a Medline search of the literature for the period 2000-2002 was performed, concentrating attention on research into all aspects of efforts for early detection of tumours, with especial attention to methodology, motivation (including awareness of utility in the general populace and in minority groups), and intervention (professional training and general education). Focus on the skin, lung, cervix, breast, ovary + endometrium, oral cavity-oesophagus, gastric, colorectal, kidney + urinary tract and prostate, demonstrated large numbers of journals to be publishing papers in the field, with 10, 33, 130, 53, 24, 21, 6, 81, 12 and 58, respectively, in the period investigated, the grand total being 259. The average numbers of papers/journal ranged from 1.0-2.4 with only 15-35% appearing in journals with wide coverage. With the exception of oral, oesophageal and gastric cancer screening, an approximately 50% contribution in all areas was made by scientists in the US, followed by Europe (31% overall,) Asia (11%) then Australasia, Central and South America and Africa (3%, 2% and 1%, respectively). Clear differences were evident with the organ regarding specific topics receiving attention, most publications concerning the lung, ovary and urological tract dealing with detection methods. With the cervix and colorectum this topic accounted for half of the papers with especial attention to the relative advantages of the PAP smear, HPV testing and direct visual acetic acid (DVA) in the one, and FOBT and endoscopy in the other. Another major focus was found to be minority attitudes to breast, prostate and cervical screening in the US, whereas only few papers were found dealing with practical intervention, targeting professionals or screenees to increase participation in screening programs. The present approach suggested a number of areas requiring more attention, not least being the need for more comprehensive reviews across organs to allow the general reader a better understanding of the overall picture, and which avenues might best reward exploration in the future.