Coercion Authorship: Ubiquitous and Preventable.

Coercion authorship (CA), typically enforced by principal investigators, has detrimental effects on graduate students, young researchers, and the entire scientific endeavor. Although CA is ubiquitous, its occurrence and major determinants have been mainly explored among graduate students and junior scientists in Sweden, Norway, and Denmark where the ratio of CA ranged from 13 to 40%. In addition to lacking comparable figures, developing countries usually lack institutional plans for promoting integrity and effective deterrents against CA and other malpractices. Hence, universities and research centers therein must publish their authorship policies and implement specific strategies to instruct graduate students, junior scientists, and experienced researchers on integrity, publishing ethics, and responsible authorship. Finally, I remark that the primary responsibility of principal researchers to promote fair authorship practices and discourage unfair ones is even greater when it comes to CA due to the asymmetrical power relationship between senior authors and novice scientists.

Reproductive justice in the Colombian armed conflict.

This study explores the impacts of armed conflict on women's sexual and reproductive health in Colombia, building on a reproductive justice perspective to analyse original interviews with stakeholders in healthcare, women's rights, and peacebuilding. The analysis reveals that war affects women's sexual and reproductive health in three ways, through violent politicisation, collateral damage, and intersectional dimensions. First, multiple armed actors have used women's health as an instrument in politically motivated strategies to increase their power, assigning political meaning to sexuality and reproduction within the context of war. Second, women's health has also suffered from secondary damage of conflict resulting from a decay in healthcare service provision and an unmet need for healthcare services among those affected by sexual and reproductive violence. Third, marginalised women have been particularly affected by a discriminatory nexus of poverty, ethnicity, and geographic inequality. The paper concludes with a reflection on the opportunities for reproductive justice in Colombia.

[Coercion in psychiatric hospitalizations in Chile: madness and suffering in the 21st century]. / Coerción en las hospitalizaciones psiquiátricas en Chile: El sufrimiento de la locura en el siglo XXI.

This article reflects on the problem of coercion in Chilean psychiatric hospitalizations from the perspective of users who participate in mental health treatment programs in the public healthcare system. Qualitative research from a hermeneutical epistemic approach was carried out between 2019 and 2020, which included 25 interviews with individuals of both sexes (15 men and 10 women) who had a psychiatric diagnosis. The purpose of this research was to analyze their narratives and critically reframe intervention practices implemented in psychiatric hospitalizations in Chile, which constitute an important space for public health in the country as well as the rights of people with mental health problems. One of the principal findings of the study was that coercive practices still persist in Chile, despite being detrimental to the recovery of mental health care users, representing a negative impact on the quality of life and citizen freedoms of individuals with mental health problems.

Este artículo aborda el problema de la coerción en las hospitalizaciones psiquiátricas chilenas desde la perspectiva de personas usuarias que participan en un tratamiento en salud mental en la red pública de atención. Entre 2019 y 2020 se realizó un estudio cualitativo con enfoque epistémico hermenéutico, en el que se entrevistaron 25 personas de ambos sexos (15 hombres y 10 mujeres) con diagnóstico psiquiátrico, con el fin de analizar sus relatos y repensar críticamente las prácticas de intervención que se desarrollan al interior de las hospitalizaciones psiquiátricas en Chile, las cuales se constituyen como un espacio de importancia para la salud pública chilena y los derechos de las personas con problemas de salud mental. Uno de los principales hallazgos es que, en desmedro de la recuperación de las personas usuarias, las prácticas coercitivas siguen manteniéndose en Chile, lo que implica un impacto negativo en la calidad de vida y en la libertad ciudadana de las personas con problemas de salud mental.

Living the Process: Examining the Continuum of Coercion and Care in Tijuana's Community-Based Rehabilitation Centers.

In Mexico, community-based, non-biomedical treatment models for substance use are legally recognized in national drug policy, monitored by state-level Departments of Health, and in some cases publicly funded. Academic research on centers that utilize these forms of treatment have focused primarily on documenting their rapid spread and describing their institutional practices, particularly human rights abuses and lack of established biomedical efficacy. In Tijuana, these community-based therapeutic models are shaped by conceptions of health and illness from the local cultural context of the United States-Mexico border zone in ways that do not cleanly match western, biomedical notions of the illness "addiction." In this article, I examine treatment ethics by exploring the contextually understood need for coerced treatment (i.e., why centers are locked) along with experiences of compulsion in a women's 12 Step center. These discussions highlight the contested therapeutic value of coercion from multiple perspectives. Utilizing engaged listening around local care practices marks a path for global mental health researchers to understand and sit with difference in order to communicate across opposing viewpoints in the service of mental health equity and best care practices.

Difusão da Estratégia Saúde da Família: fatores explicativos da adesão dos municípios de São Paulo, Brasil, no contexto coercitivo de indução pela esfera federal / Dissemination of the Family Health Strategy: explanatory factors of the adhesion of municipalities in São Paulo, Brazil, in the coercive context of induction by the federal government

Resumo Este artigo tem como objeto de análise a adesão de municípios paulistas à Estratégia Saúde da Família (ESF). Os dados de adesão em SP demonstram que ela não ocorreu de forma unânime, imediata nem uniforme. Utilizou-se o referencial teórico de difusão de políticas públicas, tendo como objetivo conhecer de maneira específica o processo de adoção e implementação de programas e políticas públicas por entes subnacionais, em contextos em que haja coerção pela esfera federal. A partir das discussões teóricas relacionadas ao mecanismo de difusão chamado de coerção, respondeu-se à seguinte pergunta: o que explica a difusão da ESF nos municípios paulistas no contexto coercitivo de influência vertical? A técnica análise de sobrevivência foi aplicada para a identificação de fatores explicativos da difusão da ESF, considerando variáveis de desenho institucional, políticas e partidárias, efeito vizinhança, necessidade da política e fatores estruturais. Os resultados demonstram que as interações horizontais entre governos subnacionais, tanto ideológicas quanto regionais, e mais as questões sociais, econômicas e políticas locais foram importantes. Esse achado permite refletir sobre os limites da influência vertical na promoção de iniciativas para governos subnacionais.

Abstract The scope of this paper is to analyze the adhesion of municipalities in São Paulo to the Family Health Strategy (FHS). The adhesion data in SP showed that it did not occur unanimously, immediately or uniformly. The theory of policy diffusion was used, with the objective of studying the process of adoption and implementation of public policies by subnational entities, in contexts where coercion occurs in the federal sphere. From the discussions related to the diffusion mechanism called coercion, the following question was answered: what explains the diffusion of the FHS in the municipalities of SP, in the coercive context of vertical influence? The survival analysis technique was applied to identify explanatory factors for the diffusion of the FHS, considering political and party variables of institutional design, neighborhood influence, internal needs, and structural factors. The results reveal that horizontal interactions between both ideological and regional subnational governments, as well as the local social, economic and political issues are relevant to understand the research questions. This finding enables us to reflect on the limits of vertical influence in the promotion of initiatives for subnational governments.

Difusão da Lei Geral da Micro e Pequena Empresa em municípios paulistas / Difusión de la Ley General de las Micro y Pequeñas Empresas en los municipios de São Paulo / Diffusion of the Micro and Small Business Law in municipalities of São Paulo

Resumo Este artigo tem como objeto de análise a implantação da Lei Complementar nº 123, de 2006 (LC nº 123/2006), que instituiu o Estatuto Nacional da Microempresa e da Empresa de Pequeno Porte (MPE), por municípios paulistas. Utilizou-se o referencial teórico de difusão de políticas públicas tendo como objetivo estudar seu processo de adoção, observando os diferentes contextos e momentos de coerção previstos na legislação federal. Com base nas discussões teóricas relacionadas com o mecanismo de difusão chamado de coerção, respondeu-se a seguinte pergunta: qual é a influência do mecanismo de coerção vertical na difusão da Lei Geral da MPE nos municípios paulistas? A técnica "análise de sobrevivência" foi aplicada para identificar fatores explicativos da difusão da política, considerando variáveis de desenho institucional, políticas e partidárias, efeito vizinhança, necessidade da política, organizações/atores sociais e fatores estruturais. Os resultados demonstram que, conforme varia o desenho institucional de coerção, mudam os fatores explicativos da difusão dessa política na ponta, de modo que os aspectos locais, incluindo atores sociais, fatores regionais e questões estruturais, importam para a difusão, variando conforme o contexto coercitivo.

Resumen Este artículo analiza la implementación de la Ley General de las Micro y Pequeñas Empresas por parte de los municipios de São Paulo. Se utilizó la teoría de la difusión de políticas, con el objetivo de estudiar el proceso de adopción de esta política pública, observando los diferentes contextos y momentos de coerción previstos en la legislación federal. A partir de las discusiones teóricas relacionadas con el mecanismo de difusión denominado coerción, se respondió a la siguiente pregunta: ¿cuál es la influencia del mecanismo de coacción vertical en la difusión de la mencionada ley en los municipios de São Paulo? Se aplicó la técnica de análisis de supervivencia para identificar factores explicativos de la difusión de políticas, considerando variables institucionales, políticas y partidarias, efecto barrio, necesidad de políticas, organizaciones/actores sociales y factores estructurales. Los resultados muestran que a medida que varía el diseño institucional de coerción, los factores explicativos de la difusión de esta política al final cambian, de modo que los aspectos locales, incluidos los actores sociales, los factores regionales y los problemas estructurales importan para la difusión, variando de acuerdo con el contexto coercitivo.

Abstract This article analyzes the implementation of the General Law for Micro and Small Business by municipalities in São Paulo. The theory of policy diffusion was used to study the process of adopting this public policy in the different contexts of coercion. The article presents theoretical discussions on the diffusion mechanism "coercion" and answers the question: what is the influence of the vertical coercion mechanism in the diffusion of the General Law in the municipalities of São Paulo? The survival analysis technique was applied to identify explanatory factors of policy diffusion, considering institutional, political, and party design variables, neighborhood effect, internal needs, organizations/social actors, and structural factors. The results show that as the institutional rules of coercion vary, the explanatory factors of the diffusion change so that local aspects, including social actors, regional factors, and structural issues, matter for the diffusion, varying according to the coercive context.

Coerción en las hospitalizaciones psiquiátricas en Chile: El sufrimiento de la locura en el siglo XXI / Coercion in psychiatric hospitalizations in Chile: madness and suffering in the 21st century

RESUMEN Este artículo aborda el problema de la coerción en las hospitalizaciones psiquiátricas chilenas desde la perspectiva de personas usuarias que participan en un tratamiento en salud mental en la red pública de atención. Entre 2019 y 2020 se realizó un estudio cualitativo con enfoque epistémico hermenéutico, en el que se entrevistaron 25 personas de ambos sexos (15 hombres y 10 mujeres) con diagnóstico psiquiátrico, con el fin de analizar sus relatos y repensar críticamente las prácticas de intervención que se desarrollan al interior de las hospitalizaciones psiquiátricas en Chile, las cuales se constituyen como un espacio de importancia para la salud pública chilena y los derechos de las personas con problemas de salud mental. Uno de los principales hallazgos es que, en desmedro de la recuperación de las personas usuarias, las prácticas coercitivas siguen manteniéndose en Chile, lo que implica un impacto negativo en la calidad de vida y en la libertad ciudadana de las personas con problemas de salud mental.

ABSTRACT This article reflects on the problem of coercion in Chilean psychiatric hospitalizations from the perspective of users who participate in mental health treatment programs in the public healthcare system. Qualitative research from a hermeneutical epistemic approach was carried out between 2019 and 2020, which included 25 interviews with individuals of both sexes (15 men and 10 women) who had a psychiatric diagnosis. The purpose of this research was to analyze their narratives and critically reframe intervention practices implemented in psychiatric hospitalizations in Chile, which constitute an important space for public health in the country as well as the rights of people with mental health problems. One of the principal findings of the study was that coercive practices still persist in Chile, despite being detrimental to the recovery of mental health care users, representing a negative impact on the quality of life and citizen freedoms of individuals with mental health problems.

Autonomia da pessoa com problema de álcool: consentimento informado / Autonomy of individuals with alcohol-related disorders: informed consent / Autonomía de la persona con problema relacionado al alcohol: consentimiento informado

Resumo O consentimento livre e esclarecido, como forma de garantir envolvimento e participação em tratamento, é parte da abordagem terapêutica à pessoa com problemas relacionados ao uso de álcool. O valor ético central da autonomia e sua imanência para o consentimento informado apresenta desafios ético-clínicos no caso de pessoa que busca tratamento em situação de coerção, ansiedade ou depressão. Entre abril de 2018 e junho de 2019, conduziu-se estudo observacional longitudinal prospetivo que incluiu 150 pessoas com problemas relacionados ao uso de álcool assistidas em unidade especializada de tratamento. O objetivo foi verificar se o consentimento com interferência de coerção, perturbação de ansiedade ou depressão determina a participação terapêutica. A ausência de coerção judicial e sintomatologia ansiosa e a maior valorização da perceção de autonomia no consentimento informado relacionaram-se com a participação. Propõem-se contributos para reforçar a prática do consentimento informado assente no reconhecimento e promoção da autonomia.

Abstract Informed consent, as a way to ensure involvement and treatment adherence, is part of the therapeutic approach to individuals with alcohol-related disorders. Autonomy, as a core ethical value, and its immanence for informed consent presents ethical-clinical challenges in the case of individuals seeking treatment due to coercion, anxiety, or depression. Between April 2018 and June 2019, a prospective longitudinal observational study was conducted with 150 people with alcohol-related disorders attending a specialized treatment facility. The goal was to verify whether consent obtained under coercion, or influenced by anxiety disorder or depression determines therapeutic participation. Absence of judicial coercion and anxious symptomatology and the greater value placed on perceived autonomy in informed consent were related to participation. The study proposes contributions to strengthen the practice of obtaining informed consent based on the recognition and promotion of autonomy.

Resumen El consentimiento informado, que garantiza comprometimiento y participación en el tratamiento, forma parte del enfoque terapéutico del manejo de la persona con problemas relacionados al consumo de alcohol. El valor ético de la autonomía y su inmanencia para el consentimiento informado tiene desafíos ético-clínicos en el caso de personas que buscan tratamiento en situación de coerción, ansiedad o depresión. Entre abril de 2018 y junio de 2019 se realizó un estudio observacional longitudinal prospectivo con 150 personas con problemas relacionados al consumo de alcohol, asistidas por un centro de tratamiento especializado. Este estudio pretendió confirmar si el consentimiento por coerción, trastorno de ansiedad o depresión influye en la participación terapéutica. La ausencia de coerción judicial y de síntomas ansiosos, así como la mayor autonomía en el consentimiento se relacionaron con la participación. Se proponen aportes para reforzar la práctica del consentimiento informado desde el reconocimiento y promoción de la autonomía.

Men's reproductive coercion of women: prevalence, experiences, and coping strategies-a mixed method study in urban health facilities in León, Nicaragua.

BACKGROUND: Reproductive coercion (RC) is a common form of violence against women. It can take several expressions aiming at limiting women's reproductive autonomy. Thus, the frequency and how reproductive coercion can be resisted must be investigated. There is limited research regarding RC in Latin America. Therefore, this study aimed to measure RC prevalence and associated factors and to explore the women experiences and coping strategies for RC. METHODS: A convergent mixed-methods study with parallel sampling was conducted in Nicaragua. A quantitative phase was applied with 390 women 18-35 years old attending three main urban primary health care facilities. Lifetime and 12 months of exposure to RC behaviors including pregnancy promotion (PP) and contraceptive sabotage (CS) were assessed. Poisson regression with a robust variance estimator was used to obtain adjusted prevalence rate ratios and 95% Confidence Intervals (CIs). In addition, seven in-depth interviews were collected and analyzed using qualitative content analysis. RESULTS: Ever RC prevalence was 17.4% (95% CI, 13.8-21.6) with similar proportions reporting ever experiencing PP (12.6%, 95% CI 9.4-16.3) or ever experiencing CS (11.8%, 95% CI 8.7-15.4). The prevalence of last twelve months RC was slightly lower (12.3%, 95% CI, 9.2-16.0) than above. Twelve months PP (7.4%, 95% CI 5.0-10.5) and CS (8.7%, 95% CI 6.1-12.0) were also similar. Women's higher education was a protective factor against ever and 12 months of exposure to any RC behaviors by a current or former partner. Informants described a broad spectrum of coping strategies during and after exposure to RC. However, these rarely succeeded in preventing unintended pregnancies or regaining women's long-term fertility autonomy. CONCLUSIONS: Our facility-based study showed that men's RC is a continuous phenomenon that can be enacted through explicit or subtle behaviors. Women in our study used different strategies to cope with RC but rarely succeeded in preventing unintended pregnancies or regaining their long-term fertility autonomy. Population-based studies are needed assess this phenomenon in a larger sample. The Nicaraguan health system should screen for RC and develop policies to protect women's reproductive autonomy.

[Mental health and human rights: The experience of professionals in training with the use of mechanical restraints in Madrid, Spain]. / Salud mental y derechos humanos: La experiencia de los profesionales en formación en el uso de sujeciones mecánicas en Madrid, España.

Mechanical restraint is a coercive procedure in psychiatry, which despite being permitted in Spain, raises significant ethical conflicts. Several studies argue that non-clinical factors - such as professionals' experiences and contextual influences - may play a more important role than clinical factors (diagnosis or symptoms) in determining how these measures are employed. The aim of this study is to understand how the experiences of mental health professionals in training relate to the use of mechanical restraints in Madrid's mental health network. Qualitative phenomenological research was conducted through focus groups in 2017. Interviews were transcribed for discussion and thematic analysis with Atlas.ti. Descriptive results suggest that these measures generate emotional distress and conflict with their role as caregivers. Our findings shed light on different factors related to their experiences and contexts that are important in understanding the use of mechanical restraint, as well as the contradictions of care in clinical practice.

La sujeción mecánica en psiquiatría es un procedimiento permitido en España que despierta importantes conflictos éticos. Diversos estudios sostienen que su uso depende de factores no clínicos, como las experiencias de los profesionales y las influencias del contexto, más que de factores clínicos (diagnósticos o síntomas). El objetivo del estudio es comprender las experiencias de profesionales de salud mental en formación en relación con el uso de sujeciones en la red de salud mental de Madrid. Es un estudio cualitativo de tipo fenomenológico mediante grupos focales, realizados en 2017. Las entrevistas fueron transcritas para su discusión y análisis temático mediante Atlas.ti. Los resultados descriptivos sugieren que estas medidas producen malestar y conflicto con relación al rol de cuidador y se observan estrategias de adaptación a los mismos. A partir de los hallazgos, se reflexiona acerca de aspectos de sus experiencias y del contexto que influyen en su uso, así como de las contradicciones del cuidado en la práctica clínica.

Sexual Coercion, Mate Retention, and Relationship Satisfaction in Brazilian and American Romantic Relationships.

We investigated the relationships among men's sexual coercion, men's performance of mate retention behaviors, and their partner's relationship satisfaction in Brazil (Study 1) and the United States (Study 2). In addition, we adapted the Sexual Coercion in Intimate Relationships Scale (SCIRS) to the Brazilian context (Escala de Coerção Sexual em Relacionamentos Amorosos [ECSRA]; Study 1) and investigated the suitability of the adapted version in the American context (Sexual Coercion in Intimate Relationships Scale-Short Form [SCIRS-SF]; Study 2). Study 1 included 181 Brazilians, aged between 18 and 49 years (M = 23.5; SD = 5.1), mostly female (60.8%). Study 2 included 508 Americans, aged between 19 and 70 years (M = 34.7; SD = 9.7), mostly male (52.6%). Participants were in a heterosexual, romantic relationship for at least 3 months. Participants completed the SCIRS, a 34-item measure assessing how often participants experienced each sexually coercive behavior, the MRI-SF, a 38-item measure assessing how often participants performed each mate retention act, and several items regarding relationship satisfaction. The results indicated that American (but not Brazilian) men's sexual coercion is positively correlated with their performance of cost-inflicting and benefit-provisioning mate retention behaviors. Men's sexual coercion did not affect their partner's relationship satisfaction in either the American or Brazilian contexts. The SCIRS-SF (nine items) reliably represents the SCIRS (34 items) in the American context. We recommend the SCIRS-SF for assessing performance frequency of sexual coercion. The SCIRS-SF may be used as a screening tool to identify patterns of sexual coercion in couples from Brazil and the United States. We highlight limitations of the current research and identify directions for future research.

Salud mental y derechos humanos: La experiencia de los profesionales en formación en el uso de sujeciones mecánicas en Madrid, España / Mental health and human rights: The experience of professionals in training with the use of mechanical restraints in Madrid, Spain

RESUMEN La sujeción mecánica en psiquiatría es un procedimiento permitido en España que despierta importantes conflictos éticos. Diversos estudios sostienen que su uso depende de factores no clínicos, como las experiencias de los profesionales y las influencias del contexto, más que de factores clínicos (diagnósticos o síntomas). El objetivo del estudio es comprender las experiencias de profesionales de salud mental en formación en relación con el uso de sujeciones en la red de salud mental de Madrid. Es un estudio cualitativo de tipo fenomenológico mediante grupos focales, realizados en 2017. Las entrevistas fueron transcritas para su discusión y análisis temático mediante Atlas.ti. Los resultados descriptivos sugieren que estas medidas producen malestar y conflicto con relación al rol de cuidador y se observan estrategias de adaptación a los mismos. A partir de los hallazgos, se reflexiona acerca de aspectos de sus experiencias y del contexto que influyen en su uso, así como de las contradicciones del cuidado en la práctica clínica

ABSTRACT Mechanical restraint is a coercive procedure in psychiatry, which despite being permitted in Spain, raises significant ethical conflicts. Several studies argue that non-clinical factors - such as professionals' experiences and contextual influences - may play a more important role than clinical factors (diagnosis or symptoms) in determining how these measures are employed. The aim of this study is to understand how the experiences of mental health professionals in training relate to the use of mechanical restraints in Madrid's mental health network. Qualitative phenomenological research was conducted through focus groups in 2017. Interviews were transcribed for discussion and thematic analysis with Atlas.ti. Descriptive results suggest that these measures generate emotional distress and conflict with their role as caregivers. Our findings shed light on different factors related to their experiences and contexts that are important in understanding the use of mechanical restraint, as well as the contradictions of care in clinical practice

Prazer em ler e formação de leitores: uma abordagem analítico-comportamental / Pleasure of reading and readers' training: a behavioral analytical approach / Gusto de leer y formación del lector: un enfoque conductual

Este é um estudo teórico sobre formação de leitores em uma perspectiva analítico-comportamental. Objetiva-se discutir o prazer em ler, concretizado pela prática de leitura continuada e voluntária. São apresentadas diferentes qualidades de interações sociais e relações entre literatura, leitura e formação de leitores. Destacam-se aspectos cognitivos, emocionais e relacionais aí envolvidos, indicativos de que a compreensão ampla da formação social do sujeito leitor é favorecida pela ocorrência de não coerção e reforçamento natural em situação de leitura. Conclui-se que o exercício espontâneo e gratificante do papel de leitor traduz transições entre o literário e o extraliterário, com avanços positivos para o indivíduo e os contextos sociais dos quais participa.

This is a theoretical study regarding readers' training from a behavioral analytical perspective. The objective is to discuss the pleasure of reading, based on the practice of continuous and voluntary reading. The article presents different qualities of social interactions and relationships between literature, reading and readers' training. Additionally, it highlights cognitive, emotional and relational aspects involved in such interactions, indicating that the broad understanding of the social formation of reading competence is favored by non-coercion and natural reinforcement in reading situations. We conclude that by exercising spontaneous and rewarding readings, the reader's role translates transitions between the literary and the extraliterary, with positive advances for the individuals and their social contexts.

Este es un estudio teórico sobre la formación de lectores desde una perspectiva analítica del comportamiento. Su objetivo es discutir el placer de la lectura, materializado por la práctica de la lectura continua y voluntaria. Se presentan diferentes cualidades de las interacciones sociales y las relaciones entre literatura, lectura y formación de lectores. Se destacan los aspectos cognitivos, emocionales y relacionales allí involucrados, lo que indica que la comprensión amplia de la formación social del lector está favorecida por la no coerción y el refuerzo natural en una situación de lectura. Se concluye que el ejercicio espontáneo y gratificante del papel del lector traduce las transiciones entre lo literario y lo extraliterario, con avances positivos para el individuo y los contextos sociales en los que participa.

Social pressures and reactions of adolescent drug users in an outpatient clinic / Presiones sociales y reacciones de los adolescentes consumidores de drogas en tratamiento ambulatorio / Pressões sociais e reações de adolescentes usuários de drogas em tratamento ambulatorial

Abstract Coercive measures and social pressures may affect patients and the treatment for substance abuse disorder. This study analyzes the reactions of adolescents who use psychoactive substances to potentially coercive situations and its effects during treatment. The collected data were analyzed with mixed methods. Results show the prevalence of informal social pressures (48.1%). We classified patients' reactions as acceptance (17.5%), resistance (31.6%), and lack of motivation (14%). Resistance and lack of motivation can affect the treatment and patients' autonomy. The use of mixed methods was essential to analyze the medical records regarding senses and meanings and allowed us to quantify and compare the findings with the literature and the qualitative data.

Resumen Las medidas coercitivas y las presiones sociales pueden afectar a los pacientes y al tratamiento de los trastornos por consumo de sustancias psicoactivas. En este estudio se analizan las reacciones de los adolescentes consumidores de sustancias psicoactivas ante situaciones potencialmente coercitivas durante el tratamiento. Los datos reunidos se analizaron con métodos mixtos. Las presiones sociales informales (48,1%) fueron el tipo de presión más frecuente. Las reacciones de los pacientes se clasificaron como aceptación (17,5%), resistencia (31,6%) y falta de motivación (14%). La resistencia y la falta de motivación pueden perjudicar el tratamiento y la autonomía de los pacientes. El uso de métodos mixtos fue esencial para analizar los registros médicos en relación con los significados y las direcciones, y nos permitió cuantificar y comparar los hallazgos con la literatura y los datos cualitativos.

Resumo Medidas coercivas e pressões sociais podem afetar tanto pacientes como o tratamento para transtorno por uso de substâncias psicoativas. Este estudo analisa as reações de adolescentes usuários de substâncias psicoativas a situações potencialmente coercivas durante o tratamento. Os dados coletados foram analisados usando métodos mistos. Pressões sociais informais (48,1%) foram o tipo de pressão mais frequente. As reações dos pacientes foram classificadas como aceitação (17,5%), resistência (31,6%) e falta de motivação (14%). Resistência e falta de motivação podem prejudicar o tratamento e a autonomia dos pacientes. O uso de métodos mistos foi essencial para analisar os prontuários em relação a sentidos e significados, e nos permitiu quantificar e comparar os achados com a literatura e com dados qualitativos.

Depression, PTSD and alexithymia in victims of intimate partner violence: a case-control study

Abstract Background Intimate partner violence (IPV) regards millions of women worldwide and can lead to serious psychopathological consequences. Objective We aimed to evaluate differences between a group of abused women and controls, and potential predictors of depression and PTSD in the IPV group. Methods We recruited 57 women who experienced IPV and 57 age-matched controls from the general population. After collecting socio-demographic characteristics, we administered the following scales: Hamilton Depression Rating Scale (HDRS), Davidson Trauma Scale (DTS), Toronto Alexithymia Scale (TAS-20) and Revised-Conflict Tactics Scale (CTS-2). Results Our results showed differences between women who experienced IPV and controls in the socio-economic status, employment and educational levels, childhood abuse and early terminations of pregnancy. Notably, the rates of depression, PTSD, and alexithymia were significantly different between the two groups. Linear regression models revealed that sexual coercion was an independent positive predictor of depressive symptoms, while alexithymia played a role in the development of PTSD in the group of abused women. Discussion Given the prevalence of depression and PTSD in victims of IPV, it is important to always investigate for IPV in women seeking for help in mental health services. Alexithymia in victims of IPV deserves to be further investigated by researchers.

Percepção de coerção de pacientes submetidos a procedimento médico invasivo / Perception of coercion of patients subjected to invasive medical procedure / Percepción de coerción de pacientes sometidos a procedimientos médicos invasivos

Resumo Este estudo objetiva avaliar a percepção de coerção em adultos e idosos internados submetidos a procedimento médico invasivo. Utilizou-se método transversal quantitativo, com 300 pacientes internados após cirurgia, com escala de percepção de coerção. Compararam-se proporções e possíveis associações entre grupos, gêneros, procedimentos eletivos, de urgência e grau de complexidade. Foram realizadas análises estatísticas descritivas e inferenciais. Os resultados apontam que a maioria dos pacientes (82,7%) tem baixa percepção de coerção, independente do grau de complexidade das operações. Porém, a percepção aumenta nos procedimentos de urgência, quando comparados aos eletivos, independentemente da idade ( p <0,0001). A percepção de coerção, de modo geral, foi baixa, pois a maioria dos participantes sentiu-se envolvida na decisão de realizar o procedimento. Verificou-se respeito à autonomia dos pacientes, já que a equipe médica compartilhou com eles e a família a decisão de operar, resultado adequado do ponto de vista bioético.

Abstract The objective of this study was to evaluate the perception of coercion in hospitalized adults and elderly people subjected to invasive medical procedures. A quantitative cross-sectional study method, with a coercion perception scale, was used with 300 inpatients after surgery. The proportions and possible associations between groups, genders, elective procedures, urgency and degree of complexity were compared. Descriptive and inferential statistical analyzes were performed. The results indicate that most patients (82.7%) presented low perception of coercion, regardless of the degree of complexity of the procedures. However, this perception increased in cases of urgent procedures, when compared to elective procedures, regardless of age ( p <0,0001). The perception of coercion was generally low, as most participants felt involved in the decision to perform the procedure. Respect for patients' autonomy was confirmed, as the medical team shared with them and their families the decision to operate, which was an appropriate result from the bioethical point of view.

Resumen Este estudio tiene como objetivo evaluar la percepción de coerción en adultos y ancianos internados sometidos a procedimientos médicos invasivos. Se utilizó un método transversal cuantitativo, con 300 pacientes internados después de cirugía, con una escala de percepción de coerción. Se compararon las proporciones y posibles asociaciones entre grupos, géneros, procedimientos electivos, urgencia y grado de complejidad. Se realizaron análisis estadísticos descriptivos e inferenciales. Los resultados indican que la mayoría de los pacientes (82.7%) presentaron baja percepción de coerción, independientemente del grado de complejidad de las operaciones. Sin embargo, la percepción aumenta en los procedimientos de urgencia en comparación con los electivos, independientemente de la edad ( p <0,0001). La percepción de coerción, de modo general, fue baja, pues la mayoría de los participantes se sintieron involucrados en la decisión de realizar el procedimiento. Se verificó el respeto a la autonomía de los pacientes, ya que el equipo médico compartió con ellos y con la familia la decisión de operar, un resultado apropiado desde el punto de vista bioético.

Revisión sistemática de procedimientos quirúrgicos usados para tratar patología aórtica en México.

INTRODUCTION: In Mexico, there are no appropriate statistical data on aortic disease, which can be treated with medical management or open or endovascular surgical approach. OBJECTIVE: To carry out a systematic search and review of the literature in electronic databases with regard to invasive management of aortic pathology in Mexico. METHOD: A systematic search and narrative review of available literature was carried out using different electronic databases: PubMed, Imbiomed, Clinical Key, Bibliat, Scielo, Sage Journals and Sciencedirect, as well as with the Google Scholar search engine. RESULTS: Ninety articles were found, out of which only 53 met the inclusion criteria. Observational studies and case reports were selected, emphasizing on patient demographics, clinical results, and 30-day postoperative survival. CONCLUSION: An elevated rate of complications is reported for aortic pathologies due to underdiagnosis, which results in management being more complicated and prognosis unfavorable. The creation of a national aortic disease registry is crucial to standardization in the approach and optimization of results.

INTRODUCCIÓN: En México no se cuentan con estadísticas adecuadas acerca de la enfermedad aórtica, que puede ser tratada mediante manejo médico o cirugía abierta o endovascular. OBJETIVO: Identificar la literatura en bases de datos electrónicas relativa al manejo invasivo de la patología aórtica en México. MÉTODO: Se realizó búsqueda sistemática y revisión narrativa de la literatura disponible en diferentes bases de datos electrónicas: PubMed, Imbiomed, Clinical Key, Bibliat, Scielo, Sage Journals, Sciencedirect y con el motor de búsqueda de Google Académico. RESULTADOS: Se encontraron 90 artículos, de los cuales 50 reunían los criterios de inclusión. Fueron seleccionados estudios observacionales y reportes de casos, con énfasis en los datos demográficos de los pacientes, resultados clínicos y la supervivencia posoperatoria a 30 días. CONCLUSIÓN: Se reporta elevada tasa de complicaciones de las enfermedades aórticas debido al infradiagnóstico de estas, que deriva en manejo más complejo y pronóstico desfavorable. La creación de un registro nacional de patología aórtica es crucial para la estandarización en el abordaje y la optimación de los resultados.

Revisión sistemática de procedimientos quirúrgicos usados para tratar patología aórtica en México / Systematic review of surgical procedures used to treat aortic pathology in Mexico

Resumen Introducción: En México no se cuentan con estadísticas adecuadas acerca de la enfermedad aórtica, que puede ser tratada mediante manejo médico o cirugía abierta o endovascular. Objetivo: Identificar la literatura en bases de datos electrónicas relativa al manejo invasivo de la patología aórtica en México. Método: Se realizó búsqueda sistemática y revisión narrativa de la literatura disponible en diferentes bases de datos electrónicas: PubMed, Imbiomed, Clinical Key, Bibliat, Scielo, Sage Journals, Sciencedirect y con el motor de búsqueda de Google Académico. Resultados: Se encontraron 90 artículos, de los cuales 50 reunían los criterios de inclusión. Fueron seleccionados estudios observacionales y reportes de casos, con énfasis en los datos demográficos de los pacientes, resultados clínicos y la supervivencia posoperatoria a 30 días. Conclusión: Se reporta elevada tasa de complicaciones de las enfermedades aórticas debido al infradiagnóstico de estas, que deriva en manejo más complejo y pronóstico desfavorable. La creación de un registro nacional de patología aórtica es crucial para la estandarización en el abordaje y la optimación de los resultados.

Abstract Introduction: In Mexico, there are no appropriate statistical data on aortic disease, which can be treated with medical management or open or endovascular surgical approach. Objective: To carry out a systematic search and review of the literature in electronic databases with regard to invasive management of aortic pathology in Mexico. Method: A systematic search and narrative review of available literature was carried out using different electronic databases: PubMed, Imbiomed, Clinical Key, Bibliat, Scielo, Sage Journals and Sciencedirect, as well as with the Google Scholar search engine. Results: Ninety articles were found, out of which only 53 met the inclusion criteria. Observational studies and case reports were selected, emphasizing on patient demographics, clinical results, and 30-day postoperative survival. Conclusion: An elevated rate of complications is reported for aortic pathologies due to underdiagnosis, which results in management being more complicated and prognosis unfavorable. The creation of a national aortic disease registry is crucial to standardization in the approach and optimization of results.

Crimen organizado y corrupción: la ausencia de responsabilidad penal en la "corrupción por miedo" / Organized crime and corruption: absence of penal liability in the "corruption for fear" / Crime organizado e corrupção: a ausência de responsabilidade penal na "corrupção por medo"

Resumen Con bastante frecuencia, los grupos de crimen organizado pretenden un cierto grado de captura del Estado por corrupción. Este fenómeno acontece cuando un servidor público accede a actuar de forma contraria al deber jurídico, tradicionalmente a cambio de una dádiva o contraprestación. Pero puede suceder que la actuación ilícita del funcionario se presente porque obra guiado por el temor o por el miedo, debido a coacción ejercida en su contra. En estos casos, se habla de "corrupción por miedo". Así, se plantea como objetivo el de establecer las posibilidades de tratamiento jurídico-penal frente al servidor público que realiza un acto de corrupción cuando media coacción, violencia o fuerza en su contra. Metodológicamente, se trata de una investigación de dogmática jurídica, basada en los métodos de la investigación documental, con un enfoque hermenéutico-analítico. El principal resultado de investigación es que procede la declaratoria de insuperable coacción ajena como causal de ausencia de responsabilidad, y eventualmente se reconoce la circunstancia de menor punibilidad relativa al temor intenso, prevista en el numeral 3.º del artículo 55 del Código Penal. La principal conclusión es que el temor tiene en el ordenamiento penal colombiano una ubicación sistemática diversa, que depende de la intensidad de la emoción.

Abstract Quite frequently, the groups of organized crime intend certain level of capture of the State due to corruption. This phenomenon occurs when a public servant agrees acts contrary to his legal obligations, customarily in exchange for a gift or compensation. But, it can happen that the public servant's illegal act comes about because he proceeds for dread or fear due to a coercion exerted against him. In these cases, it is referred to "corruption for fear". Then, it is stated as objective to establish the possibilities of penaljuridical treatment for the public servant who commits a corruption act when coercion, violence or force are involved against him. Methodologically, it is a dogmaticjuridical investigation, based on the methods of the document investigation, with a hermeneutic-analytical approach. The main result of this research is that the declaration proceeds of insurmountable of external coercion as a causal of exoneration of responsibility. Eventually, it is recognized the circumstance of inferior punishability related to intense fear, in accordance with article 55 (3) of the Colombian Criminal Code. The main conclusion is that the fear in the Colombian criminal law has a diverse systematic position that depends on the emotion intensity.

Resumo Com bastante frequência os grupos de crime organizado pretendem certo grau de captura do Estado por corrupção. Esse fenômeno acontece quando um servidor público aceita agir de forma contrária ao deber jurídico, tradicionalmente em troca de uma propina ou contraprestação. Mas pode acontecer que a ação ilícita do funcionário se apresente porque age guiado pelo receio ou medo, devido à coação exercida em sua contra. Em esses casos se fala de "corrupção por medo". Assim, se apresenta como objetivo establecer as possibilidades de tratamento jurídico-penal perante do servidor público que realiza um ato de corrupção quando media a coação, violência ou força em sua contra. Metodologicamente, trata-se de uma pesquisa dogmática jurídica, baseada nos métodos da pesquisa documental, com uma abordagem hermenêuticoanalítica. O principal resultado de pesquisa é que procede a declaração de insuperável coação alheia como causal de ausência de responsabilidade, e eventualmente se reconhece a circunstância de menor punibilidade relativa ao medo intenso, prevista no numeral 3.º do artigo 55 do Código Penal. A principal conclusão é que o medo tem no ordenamento penal colombiano uma localização sistemática diversa, que depende da intensidade da emoção.