Interpersonal violence against people with intellectual disabilities in São Paulo, Brazil: characteristics of victims, perpetrators and referrals.

INTRODUCTION: Interpersonal violence is a phenomenon that can occur with different people and conditions. However, people with intellectual disabilities have increased vulnerability to this problem, with potential risks to their health and well-being. The aim of this study was to identify the sociodemographic characteristics of people with disabilities who have been victims of interpersonal violence, the profile of the perpetrators and the measures taken after the victims have been cared for. METHODS: This is an exploratory, descriptive, cross-sectional study using the Interpersonal Violence Notification Forms entered into the Brazilian Ministry of Health's Notifiable Diseases Information System. The city of São Paulo was chosen as the setting because it is the largest city in Latin America and has a faster data processing system than other cities. The period covered notifications made between 2016 and 2022. The information was collected between October and November 2023 and a univariate statistical analysis was carried out. Fisher's exact test was used, with a significance level of 5% (α = 0.05). RESULTS: There were 4,603 notifications against people with intellectual disabilities in the period. The forms of physical violence, neglect/abandonment and psychological/moral violence were more frequent in the 15-19 age group, while sexual violence was more frequent in the 10-14 age group (p < 0.001). The sex most often attacked was female in all the forms investigated (p < 0.001) and the skin colors of the most victimized people were black and/or brown, except in cases of neglect/abandonment (p = 0.058). Most of the victims had little schooling (p = 0.012). The aggressions were committed by one person (p < 0.001), known or related to the victim, such as mother or father, except in cases of sexual violence, where strangers were the main perpetrators (p < 0.001). The sex of the perpetrator was male, except in cases of neglect and/or abandonment (p < 0.001), and the age was between 25 and 29 (p = 0.004). In cases of sexual violence, rape was the most frequent and the procedures carried out were blood collection followed by prophylaxis for Sexually Transmitted Infections (STIs) were the main procedures carried out by health professionals (p = 0.004). The majority of referrals made after receiving care were to the health and social assistance network, with few referrals to bodies such as the human rights reference center, guardianship council and police stations (p < 0.001). CONCLUSION: People with intellectual disabilities are highly vulnerable to the forms of violence studied, especially children and adolescents, black or brown, with low levels of education. The perpetrators are usually close people, male and older than the victims. The referrals made by health professionals did not prioritize the victim's safety and the guarantee of human rights. Lines of care for the health of victims of violence should be implemented, taking into account special aspects, such as people with intellectual disabilities, whose search for help can be difficult.

Systematic Review of Platelet-Rich Plasma for Low Back Pain.

BACKGROUND: Low back pain (LBP) has a high economic burden and is strongly related to the degenerative process of the spine, especially in the intervertebral disc and of the facet joints. Numerous treatment modalities have been proposed for the management of LBP, and the use of platelet-rich plasma (PRP) has emerged as an innovative therapeutic option for degenerative disease of the spine. The present study aims to evaluate the efficacy of PRP injections in managing low back pain. METHODS: We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, a registered at PROSPERO Systematic Reviews Platform, under number CRD42021268491. The PubMed, Web of Science, and Scopus databases were searched to identify relevant articles, along with hand searching to identify gray literature articles, with no language restrictions. Randomized clinical trials (RCTs), nonrandomized trials (NRTs), and case series (CSs) with more than 10 patients were considered eligible. The quality assessment and the risk of bias of the randomized clinical trials were evaluated using the RoB II tool. An evaluation of the description of the preparation methods was performed using an adapted version of the MIBO checklist. RESULTS: An electronic database search resulted in 2324 articles, and after the exclusion of noneligible articles, 13 RCTs and 27 NRTs or CSs were analyzed. Of the 13 RCTs, 11 found favorable results in comparison to the control group in pain and disability, one showed no superiority to the control group, and one was discontinued because of the lack of therapeutic effect at eight-week evaluation. Description of the PRP preparation techniques were found in almost all papers. The overall risk of bias was considered high in 2 papers and low in 11. An adapted MIBO checklist showed a 72.7% compliance rate in the selected areas. CONCLUSIONS: In this systematic review, we analyzed articles from English, Spanish and Russian language, from large databases and grey literature. PRP was in general an effective and safe treatment for degenerative LPB. Positive results were found in almost studies, a small number of adverse events were related, the risk of bias of the RCTs was low. Based on the evaluation of the included studies, we graded as level II the quality of the evidence supporting the use of PRP in LBP. Large-scale, multicenter RCTs are still needed to confirm these findings.

Cuidados intensivos de enfermagem ao idoso com delirium: um protocolo de revisão de escopo / Intensive nursing care to older adults with delirium: a protocol of scoping review

OBJETIVO: explorar sistematicamente a literatura quanto aos cuidados de enfermagem prestados aos idosos internados com delirium, em unidades de terapia intensiva, sejam eles para prevenção, sejam eles para manejo do delirium. MÉTODO: protocolo de revisão de escopo, estruturado pelas recomendações do Manual do Instituto Joanna Briggs, utilizando as seguintes bases de dados: PubMed via MEDLINE, Scopus, Embase, Web of Science e Google Scholar. A bibliografia encontrada será organizada através do gerenciador EndNote. Após a exclusão dos estudos duplicados, as citações serão transferidas para o software Rayyan. Em seguida, será iniciada a triagem das referências por dois pesquisadores independentes. O processo da seleção de estudos será exibido no fluxograma adaptado do Checklist PRISMA-ScR. Os dados serão extraídos dos estudos através de uma planilha desenvolvida no programa Microsoft Excel pelos próprios autores, avaliando e interpretando as informações de acordo com o objetivo proposto. Os dados serão organizados em tabelas, quadros e fluxogramas, com discussão narrativa.

OBJECTIVE: to systematically explore the literature regarding the nursing care provided to the older adult hospitalized with delirium in intensive care units for the prevention or management of delirium. METHOD: scoping review protocol, structured by the recommendations of the Joanna Briggs Institute manual, utilizing the following database: MEDLINE via PubMed, Scopus, Embase, Web of Science, and Google Scholar. We will organize the citations found through the EndNote manager. After the exclusion of duplicated studies, we will transfer the citations to the Rayyan software. Afterward, two independent researchers will begin the screening of titles / abstracts. We will present the selection process of studies in the Checklist PRISMA-ScR adopted flowchart. The authors will extract the data of the studies through a spreadsheet developed in the Microsoft Excel, evaluating and interpreting the information according to the objective of the study. We will organize the data in charts, tables, and flowcharts with a narrative discussion.

Dependence in instrumental activities of daily living and its implications for older adults' oral health.

We aimed to assess the association between dependence in instrumental activities of daily living (IADL) and oral health in older adults. We conducted a cross-sectional study of 280 people aged ≥60 years served at public primary health care centers in Northeastern Brazil. Sociodemographic, oral discomfort and general health data were collected. The Lawton and Brody scale were used to assess IADL. This research adheres to the STROBE checklist. Most participants were married (n = 139; 49.6%), women (n = 182; 65.0%) and retired (n = 212; 75.7%). A total of 37 (13.2%) older adults had some degree of dependence in IADL. Dependence in IADL was associated with: retirement (p<0.040), poor general health (p = 0.002), speech problems (p = 0.014), use of medications (p = 0.021), difficulty chewing and swallowing food (p = 0.011), voice changes (p = 0.044), edentulism (p = 0.011), use of toothbrush (p<0.001), use of toothpaste (p<0.001), and visit to the dentist in the previous year (p = 0.020). Functional disability was associated with older age, cardiovascular diseases, speech problems, chewing and swallowing difficulties, use of medication and brushing deficiency. The functional dependence in IADL can be considered an indicator of oral health status in older adults.

Survival after Laparoscopic versus Abdominal Radical Hysterectomy in Early Cervical Cancer: A Randomized Controlled Trial.

BACKGROUND: Previous studies have reported the safety of laparoscopic radical hysterectomy for treatment of early cervical cancer, as option to laparotomy. This study aims to compare overall survival between laparoscopic versus abdominal radical hysterectomy for early cervical cancer. METHODS: A single-center randomized controlled trial enrolled 30 patients with clinically staged IA2 cervical cancer and lymphovascular invasion, IB and IIA, who underwent laparoscopic radical hysterectomy (16) or abdominal radical hysterectomy (14). RESULT: The mean overall survival time was 74.74 months (CI 95%: 54.15-95.33) for LRH 91.67 months (CI 95%: 74.97-108.37) for ARH (log-rank test = 0.30). The mean disease-free survival time was 81.07 months (CI 95%: 60.95-101.19) for LRH and 95.82 months (CI 95%: 80.18-111.47) for ARH (log-rank test = 0.371). The overall survival hazard ratio was 2.05 (CI 95%: 0.51-8.24), and the disease-free hazard ratio was 2.13 (CI 95%: 0.39-11.7). CONCLUSION: Our study suggests a non-significant trend of worse outcomes for LRH. In light of recent controversy and need for prospective studies, further studies in different populations are required for definite conclusions and until then, patients should be aware of risks and benefits, survival data and quality of life outcomes related to both surgical techniques.

Condutas práticas e efetivas do cirurgião-dentista frente ao paciente em tratamento de câncer de cabeça e pescoço: revisão de literatura / Practical and effective conducts of the dental surgery in front of the patient in treating head and neck cancer: literature review

O objetivo do presente estudo é salientar através de uma revisão de literatura os possíveis cuidados que o cirurgião dentista precisa ter frente aos principais agravos bucais decorrentes do tratamento oncológico. Os trabalhos foram obtidos através dos sistemas de dados PUBMED, MEDLINE, BBO, SCIELO, LILACS, SCIENCE DIRECT, COCHRANE E BBO. A principal estratégia para o combate de tais neoplasias é na forma de prevenção, ainda que o câncer tenha como um dos fatores etiológicos a hereditariedade, a exposição a determinados agentes (fumo, álcool, HPV, etc.) podendo aumentar as chances de sua ocorrência. Os métodos tradicionais de tratamento oncológico são a cirurgia, a radioterapia e a quimioterapia. O tratamento a ser instituído estará na dependência da localização, do grau de malignidade e da condição de saúde do indivíduo. O cuidado dentário antes do tratamento oncológico visa a redução do risco e a gravidade das complicações orais, prevenir, eliminar ou reduzir a dor de origem bucal, preservar ou melhorar a saúde bucal, contribuindo para a melhoria da qualidade de vida. Conclui-se que diante dos efeitos colaterais importantes aos tecidos bucais, é de suma necessidade o conhecimento por parte do cirurgião dentista, para que possa atuar na prevenção e redução de tais danos(AU)

The aim of the present study is to highlight a literature review on the possible treatments that the dental surgeon needs to face the main oral health problems caused by cancer treatment. The work was carried out through the data systems PUBMED, MEDLINE, BBO, SCIELO, LILACS, CIÊNCIA DIRETA, COCHRANE AND BBO. The main strategy to combat these neoplasms is the form of prevention, but cancer has inherited etiological factors, exposure to dangerous agents (smoking, alcohol, HPV, etc.) that can increase the chances of its occurrence. Traditional methods of cancer treatment are surgery, radiation and chemotherapy. Treatment is instituted depending on the individual's location, degree of malignancy and health condition. Dental care before cancer treatment reduces the risk and severity of oral complications, prevents, eliminates or reduces pain of oral origin, preserves or improves oral health, contributes to improving quality of life. It is concluded that in view of the important effects on oral tissues, knowledge or knowledge on the part of the dental surgeon is necessary, so that it can perform the prevention and reduction of such damages(AU)

COVID 19: sexual vulnerabilities and gender perspectives in Latin America.

Epidemics have gender aspects that are usually rarely addressed in mitigation efforts. Particularly unequal societies, such as those in Latin America, have tended to experience a more drastic impact during the coronavirus disease 2019 (COVID-19) pandemic, thus deepening the inequalities.

Turn down - turn up: a simple and low-cost protocol for preparing platelet-rich plasma.

OBJECTIVE: To describe and analyze a new protocol for the extraction of platelet-rich plasma (PRP) for use in clinical practice and compare this technique with methods that have been previously described in the medical literature. METHODS: We extracted PRP from 20 volunteers using four different protocols (single spin at 1600 ×g, single spin at 600 ×g, double spin at 300 and 700 ×g, and double spin at 600 and 900 ×g). In another group of 12 individuals, we extracted PRP with our new technique (named 'turn down-turn up') consisting of a double spin (200 ×g and 1600 ×g) closed system using standard laboratory equipment (including an ordinary benchtop centrifuge), where the blood remained in the same tube during all processes, reducing the risk of contamination. Platelet counts adjusted to baseline values were compared using analysis of covariance (ANCOVA). RESULTS: Using the four previously described protocols (mentioned above), we obtained concentrations of platelets that were 1.15-, 2.07-, 2.18-, and 3.19-fold greater than the baseline concentration, respectively. With the turn down-turn up technique, we obtained a platelet count that was 4.17-fold (95% confidence interval (CI): 3.09 to 5.25) greater than the baseline platelet count (p=0.063 compared with the double spin at 600 and 900 ×g method). The total cost of the disposable materials used in the extraction process was less than US$10.00 per individual. CONCLUSION: In the present study, we described a simple and safe method for obtaining PRP using low-cost devices.

Turn down - turn up: a simple and low-cost protocol for preparing platelet-rich plasma

OBJECTIVE: To describe and analyze a new protocol for the extraction of platelet-rich plasma (PRP) for use in clinical practice and compare this technique with methods that have been previously described in the medical literature. METHODS: We extracted PRP from 20 volunteers using four different protocols (single spin at 1600 ×g, single spin at 600 ×g, double spin at 300 and 700 ×g, and double spin at 600 and 900 ×g). In another group of 12 individuals, we extracted PRP with our new technique (named 'turn down-turn up') consisting of a double spin (200 ×g and 1600 ×g) closed system using standard laboratory equipment (including an ordinary benchtop centrifuge), where the blood remained in the same tube during all processes, reducing the risk of contamination. Platelet counts adjusted to baseline values were compared using analysis of covariance (ANCOVA). RESULTS: Using the four previously described protocols (mentioned above), we obtained concentrations of platelets that were 1.15-, 2.07-, 2.18-, and 3.19-fold greater than the baseline concentration, respectively. With the turn down-turn up technique, we obtained a platelet count that was 4.17-fold (95% confidence interval (CI): 3.09 to 5.25) greater than the baseline platelet count (p=0.063 compared with the double spin at 600 and 900 ×g method). The total cost of the disposable materials used in the extraction process was less than US$10.00 per individual. CONCLUSION: In the present study, we described a simple and safe method for obtaining PRP using low-cost devices.

Sou homem e pai sim! (Re)construindo a identidade masculina a partir da participação no parto

[RESUMO]. Objetivo. Compreender como as experiências de participação ativa do homem no pré-natal e no parto influenciam a ressignificação das identidades masculinas. Métodos. Estudo de abordagem qualitativa, com análise antropológica interpretativa e suporte etnográfico para descrição densa. Foram incluídos no estudo nove homens que estiveram em um hospital de referência em parto humanizado e participaram do parto de seus filhos no período de abril de 2015 a novembro de 2016. Os dados foram coletados por meio de entrevistas semiestruturadas, de cunho etnográfico, com roteiro flexível elaborado de acordo com as seguintes temáticas: participação ativa no processo do parto, sensações de acompanhar a mãe da criança desde a gestação e significado de ser pai após participar do parto. Os participantes discorreram sobre os tópicos de forma espontânea. As narrativas foram transcritas e analisadas na forma de categorias e interpretação semântica contextualizada. Resultados. Foram realizados, em média, oito encontros com cada participante. A análise das entrevistas revelou duas categorias temáticas: ressignificação das masculinidades e promoção do autocuidado. As falas caracterizaram o impacto da compreensão de que a masculinidade não se perde se houver uma participação do homem no parto e cuidado dos filhos. Além disso, mostraram que a experiência de participar do parto abriu uma possibilidade de aproximação do homem aos sistemas de saúde para a manutenção do bem-estar, ao invés de necessariamente para o tratamento da doença. Conclusão. Os homens revelaram que podem ser conscientes do autocuidado e empoderados na condução de sua família, garantindo a construção de uma nova identidade masculina na sociedade contemporânea.

[ABSTRACT]. Objective. To study how the male experience of playing an active role in prenatal care and childbirth influences the resignification of male identity. Method. This is a qualitative study employing interpretive anthropological analysis supported by ethnographic methods to produce a thick description. The study included nine men attending a center of excellence in humanized childbirth and who played an active role in the birth of their child in the period from April 2015 to November 2016. Data were collected through semi-structured, ethnographically-oriented interviews, with a flexible script that explored the following themes: active participation in childbirth, feelings associated with standing by the child’s mother since pregnancy, and meaning of fatherhood after participation in childbirth. The participants talked about these topics freely. The narratives were transcribed and analyzed in terms of categories and contextual semantic interpretation. Results. On average, eight meetings were held with each participant. Analysis of the interviews revealed two theme categories: resignification of masculinity and promotion of self-care. The utterances reflect the participants’ understanding that masculinity is not lost if men play an active role in childbirth and care. In addition, they reveal that the experience of participating in childbirth opened a possibility for men to approach the healthcare system to maintain health, rather than to strictly treat disease. Conclusion. The men participating in this research revealed that they can be aware of self-care and become empowered to lead their families, ensuring the construction of a new male identify in contemporary society.

[RESUMEN]. Objetivo. Estudiar cómo la experiencia masculina de desempeñar un papel activo en la atención prenatal y el parto influye en la resignificación de la identidad masculina. Métodos. Estudio cualitativo que empleó el análisis antropológico interpretativo apoyado por métodos etnográficos para producir una descripción densa. El estudio incluyó a nueve hombres que asistieron a un hospital de referencia en partos humanizados y que participaron en el nacimiento de sus hijos entre abril de 2015 y noviembre de 2016. Los datos se recopilaron a través de entrevistas semiestructuradas, orientadas etnográficamente, con un guion flexible que exploró los siguientes temas: participación activa en el parto, sentimientos asociados con el acompañamiento de la madre desde el embarazo y el significado de la paternidad después de la participación en el parto. Los participantes hablaron sobre estos temas de manera espontánea. Las narraciones fueron transcritas y analizadas en términos de categorías e interpretación semántica contextual. Resultados. En promedio, se realizaron ocho reuniones con cada participante. El análisis de las entrevistas reveló dos categorías temáticas: resignificación de la masculinidad y promoción del autocuidado. Las respuestas reflejaron la comprensión de los participantes de que la masculinidad no se pierde cuando los hombres desempeñan un papel activo en el parto y el cuidado de los hijos. Además, revelaron que la experiencia de participar en el parto abrió la posibilidad de que los hombres se acercaran al sistema de salud de manera preventiva, en lugar de acudir para el tratamiento de una enfermedad. Conclusión. Los hombres que participaron en esta investigación revelaron que pueden ser conscientes del autocuidado y resultar empoderados en la conducción de sus familias, asegurando la construcción de una nueva identidad masculina en la sociedad contemporánea.

Mastectomy and the Meaning Attributed by Patients to Delay in Early Diagnosis of Breast Cancer

Background: Breast cancer is a major public health problem and its early detection (ED) can reduce the number of breast mutilations, morbidity and mortality rates, health costs and negative health outcomes. Given that, this study aimed to assess the meaning attributed by mastectomized women to delay in early detection of their breast cancers. Methods: Qualitative research was conducted with 26 mastectomized women who participated in semi-structured interviews about the meaning of delay in early detection of breast cancer in a reference oncology outpatient clinic in the city of Fortaleza, Ceará, Northeastern Brazil from December 2015 to January 2016. Information was analyzed on the basis of symbolic interactionism. Results: After noticing breast changes, women start to ponder about them and experience this moment according to interpretive particularities. Fear of disease, multiple roles in modern society, denial of breast changes, lack of information on the issue, and lack of professionals to encourage their involvement in health care, favor delay in the search for care and therefore in the early detection of breast cancer, which is a determinant of therapeutic success. Conclusion: Women receive limited information and professional support for breast health. Delay in early diagnosis occurred in all the women who participated in the study.

Qualification of the family caregiver to the application of the Educational Technology in Health.

OBJECTIVE: To evaluate the changes in the participation of the family caregiver in the treatment of the hypertensive person with the application of the Educational Technology in Health (ETH). METHOD: Participant research carried out in a Primary Health Care Unit with 11 family caregivers (FC). The ETH was elaborated based on health education and applied in ten meetings between June and August 2016. We organized the results into categories. RESULTS: FCs experienced learning experiences through the exchange of information, socialization of experiences, and linkage establishments. The FCs were encouraged to share their doubts and experiences, so that, supported by listening to the professional, they felt welcomed and determined to fulfill their role with hypertensive relatives. Final considerations: The changes that have taken place have been highlighted in the learning of FCs and their commitment to family and self-care, as well as to the conviction that the family environment is indicated to make these changes effective.

Qualification of the family caregiver to the application of the Educational Technology in Health / Capacitación del familiar cuidador con la aplicación de la Tecnología Educativa en Salud / Capacitação do familiar cuidador com a aplicação da Tecnologia Educativa em Saúde

ABSTRACT Objective: To evaluate the changes in the participation of the family caregiver in the treatment of the hypertensive person with the application of the Educational Technology in Health (ETH). Method: Participant research carried out in a Primary Health Care Unit with 11 family caregivers (FC). The ETH was elaborated based on health education and applied in ten meetings between June and August 2016. We organized the results into categories. Results: FCs experienced learning experiences through the exchange of information, socialization of experiences, and linkage establishments. The FCs were encouraged to share their doubts and experiences, so that, supported by listening to the professional, they felt welcomed and determined to fulfill their role with hypertensive relatives. Final considerations: The changes that have taken place have been highlighted in the learning of FCs and their commitment to family and self-care, as well as to the conviction that the family environment is indicated to make these changes effective.

RESUMEN Objetivo: Evaluar los cambios en la participación del familiar cuidador en el tratamiento de la persona hipertensa con la aplicación de la Tecnología Educativa en Salud (TES). Método: Encuesta participante realizada en una Unidad de Atención Primaria en Salud con 11 familiares cuidadores (FC). La TES ha sido elaborada basada en la educación en salud y aplicada en diez encuentros entre junio y agosto de 2016.Organizamos los resultados en categorías. Resultados: Los FCs vivenciaron experiencias de aprendizaje a cambio de informaciones, socialización de experiencias, y establecimientos de vínculos. Los FCs eran incentivados a compartir sus dudas y sus experiencias, de manera que, amparados por la escucha del profesional, ellos se sintiesen acogidos y determinados a cumplir su papel junto a los familiares hipertensos. Consideraciones finales: Los cambios ocurridos se destacaron en el aprendizaje de los FCs y en el compromiso de estos con el familiar y con el autocuidado, así como en la convicción de que el ambiente familiar es indicado a la efectividad de esos cambios.

RESUMO Objetivo: Avaliar as mudanças na participação do familiar cuidador no tratamento da pessoa hipertensa com a aplicação da Tecnologia Educativa em Saúde (TES). Método: Pesquisa participante realizada em uma Unidade de Atenção Primária em Saúde com 11 familiares cuidadores (FC). A TES foi elaborada baseada na educação em saúde e aplicada em dez encontros entre junho e agosto de 2016. Organizamos os resultados em categorias. Resultados: Os FCs vivenciaram experiências de aprendizagem pela troca de informações, socialização de experiências, e estabelecimentos de vínculos. Os FCs eram incentivados a compartilhar suas dúvidas e suas experiências, de modo que, amparados pela escuta do profissional, eles se sentissem acolhidos e determinados a cumprir seu papel junto aos familiares hipertensos. Considerações finais: As mudanças ocorridas se destacaram na aprendizagem dos FCs e no compromisso destes com o familiar e com o autocuidado, bem como na convicção de que o ambiente familiar é indicado à efetivação dessas mudanças.

Suicidal ideation and attempt of older women in Northeastern Brazil.

OBJECTIVE: to associate the life experiences of older women from the Northeast of Brazil with their suicidal ideation and attempts. METHOD: Qualitative study with fourteen older adults from Piripiri (PI), Teresina (PI), Fortaleza (CE) and Recife (PE) who were interviewed between November 2013 and July 2014. The organization of data originated the themes: experiences of abuse throughout their lives; marital fractures and social isolation; weakened motherhood. RESULTS: The women were born and lived most of their life in the countryside, amid poverty and social exclusion. They had a history of abuse, physical and sexual violence, perpetrated by intimate partners and/or family members. They experienced social isolation, weakened emotional bonds and several suicide attempts. Final considerations: The life of these older women was affected by traumatic events that enhanced feelings of hopelessness, depressive symptoms and the absence of a plan for the future, making them consider suicide as a way to anticipate death.

[Yes, I am a man and a father! (Re)constructing male identity through engagement in childbirth¡Sí, soy hombre y padre! (Re)construir la identidad masculina a través de la participación en el parto]. / Sou homem e pai sim! (Re)construindo a identidade masculina a partir da participação no parto.

OBJECTIVE: To study how the male experience of playing an active role in prenatal care and childbirth influences the resignification of male identity. METHOD: This is a qualitative study employing interpretive anthropological analysis supported by ethnographic methods to produce a thick description. The study included nine men attending a center of excellence in humanized childbirth and who played an active role in the birth of their child in the period from April 2015 to November 2016. Data were collected through semi-structured, ethnographically-oriented interviews, with a flexible script that explored the following themes: active participation in childbirth, feelings associated with standing by the child's mother since pregnancy, and meaning of fatherhood after participation in childbirth. The participants talked about these topics freely. The narratives were transcribed and analyzed in terms of categories and contextual semantic interpretation. RESULTS: On average, eight meetings were held with each participant. Analysis of the interviews revealed two theme categories: resignification of masculinity and promotion of self-care. The utterances reflect the participants' understanding that masculinity is not lost if men play an active role in childbirth and care. In addition, they reveal that the experience of participating in childbirth opened a possibility for men to approach the healthcare system to maintain health, rather than to strictly treat disease. CONCLUSION: The men participating in this research revealed that they can be aware of self-care and become empowered to lead their families, ensuring the construction of a new male identify in contemporary society.

OBJETIVO: Estudiar cómo la experiencia masculina de desempeñar un papel activo en la atención prenatal y el parto influye en la resignificación de la identidad masculina. MÉTODOS: Estudio cualitativo que empleó el análisis antropológico interpretativo apoyado por métodos etnográficos para producir una descripción densa. El estudio incluyó a nueve hombres que asistieron a un hospital de referencia en partos humanizados y que participaron en el nacimiento de sus hijos entre abril de 2015 y noviembre de 2016. Los datos se recopilaron a través de entrevistas semiestructuradas, orientadas etnográficamente, con un guion flexible que exploró los siguientes temas: participación activa en el parto, sentimientos asociados con el acompañamiento de la madre desde el embarazo y el significado de la paternidad después de la participación en el parto. Los participantes hablaron sobre estos temas de manera espontánea. Las narraciones fueron transcritas y analizadas en términos de categorías e interpretación semántica contextual. RESULTADOS: En promedio, se realizaron ocho reuniones con cada participante. El análisis de las entrevistas reveló dos categorías temáticas: resignificación de la masculinidad y promoción del autocuidado. Las respuestas reflejaron la comprensión de los participantes de que la masculinidad no se pierde cuando los hombres desempeñan un papel activo en el parto y el cuidado de los hijos. Además, revelaron que la experiencia de participar en el parto abrió la posibilidad de que los hombres se acercaran al sistema de salud de manera preventiva, en lugar de acudir para el tratamiento de una enfermedad. CONCLUSIÓN: Los hombres que participaron en esta investigación revelaron que pueden ser conscientes del autocuidado y resultar empoderados en la conducción de sus familias, asegurando la construcción de una nueva identidad masculina en la sociedad contemporánea.

Suicidal ideation and attempt of older women in Northeastern Brazil / Ideación e intento de suicidio de mujeres ancianas en el nordeste de Brasil / Ideação e tentativa de suicídio de mulheres idosas no nordeste do Brasil

ABSTRACT Objective: to associate the life experiences of older women from the Northeast of Brazil with their suicidal ideation and attempts. Method: Qualitative study with fourteen older adults from Piripiri (PI), Teresina (PI), Fortaleza (CE) and Recife (PE) who were interviewed between November 2013 and July 2014. The organization of data originated the themes: experiences of abuse throughout their lives; marital fractures and social isolation; weakened motherhood. Results: The women were born and lived most of their life in the countryside, amid poverty and social exclusion. They had a history of abuse, physical and sexual violence, perpetrated by intimate partners and/or family members. They experienced social isolation, weakened emotional bonds and several suicide attempts. Final considerations: The life of these older women was affected by traumatic events that enhanced feelings of hopelessness, depressive symptoms and the absence of a plan for the future, making them consider suicide as a way to anticipate death.

RESUMEN Objetivo: Analizar las experiencias de vida de mujeres ancianas nordestinas con ideación e intento de suicidio. Método: Estudio cualitativo con catorce ancianas de las ciudades de Piripiri (PI), Teresina (PI), Fortaleza (CE) y Recife (PE) que fueron entrevistadas entre noviembre del 2013 y julio del 2014. La organización de los datos originó las temáticas: vivencias de maltratos a lo largo de la vida; fracturas conyugales y aislamiento social; y maternidad frágil. Resultados: Las mujeres nacieron y vivieron buena parte de la vida en la zona rural, en la pobreza y exclusión social. Presentaban historias de maltratos, violencia física y sexual, perpetrada por parejas íntimas o familiares. Experimentaron aislamiento social, vínculos afectivos frágiles y varios intentos de suicidio a lo largo de la vida. Consideraciones finales: La vida de esas ancianas ha sido acometida por eventos traumáticos que agudizaron sentimientos de desesperanza, síntomas depresivos y ausencia de planes para el futuro, lo que las llevó a percibir el suicidio como forma de anticipar la muerte.

RESUMO Objetivo: analisar as experiências de vida de mulheres idosas nordestinas com ideação e tentativa de suicídio. Método: Estudo qualitativo com catorze idosas das cidades de Piripiri (PI), Teresina (PI), Fortaleza (CE) e Recife (PE) que foram entrevistadas entre novembro de 2013 e julho de 2014. A organização dos dados originou as temáticas: vivências de maus-tratos ao longo da vida; fraturas conjugais e isolamento social; e maternidade fragilizada. Resultados: As mulheres nasceram e viveram boa parte da vida na zona rural, na pobreza e exclusão social. Apresentavam histórias de maus-tratos, violência física e sexual, perpetrada por parceiros íntimos e/ou familiares. Vivenciaram isolamento social, vínculos afetivos fragilizados e várias tentativas de suicídio ao longo da vida. Considerações finais: A vida dessas idosas foi acometida por eventos traumáticos que aguçaram sentimentos de desesperança, sintomas depressivos e ausência de plano para o futuro, percebendo o suicídio como forma de antecipar a morte.

Sou homem e pai sim! (Re)construindo a identidade masculina a partir da participação no parto / Yes, I am a man and a father! (Re)constructing male identity through engagement in childbirth / ¡Sí, soy hombre y padre! (Re)construir la identidad masculina a través de la participación en el parto

RESUMO Objetivo. Compreender como as experiências de participação ativa do homem no pré-natal e no parto influenciam a ressignificação das identidades masculinas. Métodos. Estudo de abordagem qualitativa, com análise antropológica interpretativa e suporte etnográfico para descrição densa. Foram incluídos no estudo nove homens que estiveram em um hospital de referência em parto humanizado e participaram do parto de seus filhos no período de abril de 2015 a novembro de 2016. Os dados foram coletados por meio de entrevistas semiestruturadas, de cunho etnográfico, com roteiro flexível elaborado de acordo com as seguintes temáticas: participação ativa no processo do parto, sensações de acompanhar a mãe da criança desde a gestação e significado de ser pai após participar do parto. Os participantes discorreram sobre os tópicos de forma espontânea. As narrativas foram transcritas e analisadas na forma de categorias e interpretação semântica contextualizada. Resultados. Foram realizados, em média, oito encontros com cada participante. A análise das entrevistas revelou duas categorias temáticas: ressignificação das masculinidades e promoção do autocuidado. As falas caracterizaram o impacto da compreensão de que a masculinidade não se perde se houver uma participação do homem no parto e cuidado dos filhos. Além disso, mostraram que a experiência de participar do parto abriu uma possibilidade de aproximação do homem aos sistemas de saúde para a manutenção do bem-estar, ao invés de necessariamente para o tratamento da doença. Conclusão. Os homens revelaram que podem ser conscientes do autocuidado e empoderados na condução de sua família, garantindo a construção de uma nova identidade masculina na sociedade contemporânea.

ABSTRACT Objective. To study how the male experience of playing an active role in prenatal care and childbirth influences the resignification of male identity. Method. This is a qualitative study employing interpretive anthropological analysis supported by ethnographic methods to produce a thick description. The study included nine men attending a center of excellence in humanized childbirth and who played an active role in the birth of their child in the period from April 2015 to November 2016. Data were collected through semi-structured, ethnographically-oriented interviews, with a flexible script that explored the following themes: active participation in childbirth, feelings associated with standing by the child's mother since pregnancy, and meaning of fatherhood after participation in childbirth. The participants talked about these topics freely. The narratives were transcribed and analyzed in terms of categories and contextual semantic interpretation. Results. On average, eight meetings were held with each participant. Analysis of the interviews revealed two theme categories: resignification of masculinity and promotion of self-care. The utterances reflect the participants' understanding that masculinity is not lost if men play an active role in childbirth and care. In addition, they reveal that the experience of participating in childbirth opened a possibility for men to approach the healthcare system to maintain health, rather than to strictly treat disease. Conclusion. The men participating in this research revealed that they can be aware of self-care and become empowered to lead their families, ensuring the construction of a new male identify in contemporary society.

RESUMEN Objetivo. Estudiar cómo la experiencia masculina de desempeñar un papel activo en la atención prenatal y el parto influye en la resignificación de la identidad masculina. Métodos. Estudio cualitativo que empleó el análisis antropológico interpretativo apoyado por métodos etnográficos para producir una descripción densa. El estudio incluyó a nueve hombres que asistieron a un hospital de referencia en partos humanizados y que participaron en el nacimiento de sus hijos entre abril de 2015 y noviembre de 2016. Los datos se recopilaron a través de entrevistas semiestructuradas, orientadas etnográficamente, con un guion flexible que exploró los siguientes temas: participación activa en el parto, sentimientos asociados con el acompañamiento de la madre desde el embarazo y el significado de la paternidad después de la participación en el parto. Los participantes hablaron sobre estos temas de manera espontánea. Las narraciones fueron transcritas y analizadas en términos de categorías e interpretación semántica contextual. Resultados. En promedio, se realizaron ocho reuniones con cada participante. El análisis de las entrevistas reveló dos categorías temáticas: resignificación de la masculinidad y promoción del autocuidado. Las respuestas reflejaron la comprensión de los participantes de que la masculinidad no se pierde cuando los hombres desempeñan un papel activo en el parto y el cuidado de los hijos. Además, revelaron que la experiencia de participar en el parto abrió la posibilidad de que los hombres se acercaran al sistema de salud de manera preventiva, en lugar de acudir para el tratamiento de una enfermedad. Conclusión. Los hombres que participaron en esta investigación revelaron que pueden ser conscientes del autocuidado y resultar empoderados en la conducción de sus familias, asegurando la construcción de una nueva identidad masculina en la sociedad contemporánea.