Barreiras no acesso à Atenção Básica pela população LGBTQIA+: uma revisão integrativa / Barriers to access to Primary Care for the LGBTQIA+ population: an integrative review / Barreras de acceso a la Atención Primaria para la población LGBTQIA+: una revisión integradora

Introdução: A população LGBT constitui um grupo cujo acesso à saúde é historicamente limitado e ainda hoje é atravessado por questões complexas que envolvem desde a formação dos profissionais de saúde à própria estrutura organizacional do sistema assistencial. Apesar disso, a literatura científica acerca dos entraves que estes indivíduos enfrentam na Atenção Primária à Saúde (APS), porta de entrada e coordenadora do cuidado, é particularmente escassa. Objetivo: Caracterizar as barreiras envolvidas no acesso da população LGBTQIA+ à APS. Métodos: Trata-se de uma revisão integrativa de estudos científicos selecionados nas plataformas de busca PubMed e Portal Regional da Biblioteca Virtual em Saúde (BVS), sendo utilizados como descritores de busca os termos Minorias Sexuais e de Gênero, LGBTQIA+, APS e Acesso aos Serviços de Saúde. Foram incluídos artigos completos sem restrição de período nos idiomas inglês, português e espanhol. Foram excluídos textos do tipo: revisão bibliográfica; editorial; protocolos de estudo; opinião de especialistas e relato de experiência. Resultados: Foram selecionados 14 artigos, sendo seus conteúdos atribuídos a três eixos de discussão: barreiras físicas/organizacionais, barreiras sociais e barreiras relacionadas à educação/formação dos profissionais da saúde. Conclusões: É essencial expandir as discussões sociais acerca da temática de diversidade sexual e de gênero de modo a desconstruir os preconceitos instituídos; ademais, faz-se fundamental a revisão da estrutura física e organizacional ­ bem como da formação dos profissionais da saúde ­ para criar um ambiente assistencial inclusivo na atenção básica à população LGBTQIA+.

Introduction: The LGBT population is a group whose access to health care has historically been limited and is still crossed by complex issues ranging from the training of health professionals to the very organisational structure of the care system. Despite this, the scientific literature on the obstacles faced by these individuals in Primary Health Care, the gateway and coordinator of care, is particularly scarce. Objective: To characterize the barriers involved in the access of the LGBTQIA+ population to primary care. Methods: This is an integrative review of scientific studies selected from the PubMed and Virtual Health Library (VHL) Regional Portal search platforms, using as search descriptors the terms Sexual and Gender Minorities, LGBTQIA+, Primary Health Care, Health Services Accessibility. Complete articles were included without time restriction, in English, Portuguese and Spanish. Texts such as: literature reviews; editorials; study protocols; expert opinions and experience reports were excluded. Results: The review was composed by the selection of 14 studies, and their contents were assigned to three axes of discussion: physical/organizational barriers, social barriers, barriers related to education/training of health professionals. Conclusions: It is essential to expand the social discussions about the theme of sexual and gender diversity to deconstruct the established prejudices, moreover, it is essential to review the physical and organizational structure ­ as well as the training of health professionals ­ to create an inclusive care environment.

Introducción: La población LGTB es un colectivo cuyo acceso a la atención sanitaria ha estado históricamente limitado y sigue atravesado por complejas cuestiones que van desde la formación de los profesionales sanitarios hasta la propia estructura organizativa del sistema asistencial. A pesar de ello, la literatura científica sobre los obstáculos a los que se enfrentan estas personas en la Atención Primaria de Salud, puerta de entrada y coordinadora de la atención, es especialmente escasa. Objetivo: Caracterizar las barreras que supone el acceso de la población LGBT a la atención primaria. Métodos: Se trata de una revisión integradora de estudios científicos seleccionados de las plataformas de búsqueda PubMed y Portal Regional de la Biblioteca Virtual de Salud (BVS), utilizando como descriptores de búsqueda los términos Minorías Sexuales y de Género, LGBT, Atención Primaria de Salud, Accesibilidad a los Servicios de Salud. Se incluyeron artículos completos sin restriccíon de período, en inglés, portugués y español. Se excluyeron textos como revisiones bibliográficas, editoriales, protocolos de estudio, opiniones de expertos e informes de experiencias. Resultados: El corpus final de artículos se compuso de la selección de 14 artículos, y sus contenidos se asignaron a tres ejes de discusión: barreras físicas/organizativas, barreras sociales, barreras relacionadas con la educación/formación de los profesionales sanitarios. Conclusiones: Es esencial ampliar las discusiones sociales sobre el tema de la diversidad sexual y de género de manera que se deconstruyan los prejuicios institucionales, además, se hace fundamental la revisión de la estructura física y organizacional ­ así como la formación de los profesionales de la salud ­ para crear un ambiente asistencial inclusivo.

Vivencias del profesional de enfermería en el cuidado humanizado a personas con diversidad de género

Introducción: La atención en salud de los profesionales de enfermería a personas con diversidad de género puede verse afectada negativamente por la heteronormatividad que ha regido históricamente la sociedad. Actualmente es un desafío resguardar y buscar acciones para entregar un cuidado humanizado inclusivo. Objetivo: Comprender las vivencias del profesional de enfermería al brindar el cuidado humanizado a personas con diversidad de género. Método: Investigación cualitativa, con un enfoque fenomenológico. Se entrevistó a cuatro profesionales de enfermería. La información se recopiló a través de entrevistas individuales y grupales semiestructuradas; los discursos fueron analizados y se realizó una triangulación de los conceptos principales. Resultados: El cuidado humanizado se manifiesta a través de tres dimensiones: vivencias al brindar cuidados humanizados, factores que facilitan la entrega del cuidado humanizado y factores que lo dificultan. Las categorías incluidas en la primera dimensión son igualdad, empatía, respeto y aprendizaje. Los factores que facilitan los cuidados humanizados tienen como categorías la acogida y la formación continua, y los factores que lo dificultan tienen las categorías de nombre social y recelo. Conclusión: El cuidado humanizado a personas con diversidad de género requiere valores de igualdad y empatía, junto con una formación inclusiva desde pregrado. La deficiencia en el desarrollo de habilidades blandas dificulta la relación enfermero-paciente, mientras que el recelo de la persona con diversidad de género obstaculiza las primeras consultas. La integración del nombre social y la formación continua son esenciales para promover un ambiente de confianza y reducir la sensación de vulnerabilidad y discriminación.

Introdução: O atendimento em saúde prestado pelos profissionais de enfermagem às pessoas com diversidade de gênero pode ser afetado negativamente pela heteronormatividade que historicamente rege a sociedade. Atualmente, é um desafio resguardar e buscar ações para proporcionar um cuidado humanizado e inclusivo. Objetivo: Compreender as vivências do profissional de enfermagem ao prestar o cuidado humanizado a pessoas com diversidade de gênero. Método: Pesquisa qualitativa, com abordagem fenomenológica. Foram entrevistados quatro profissionais de enfermagem. As informações foram coletadas por meio de entrevistas semiestruturadas individuais e em grupo; os discursos foram analisados e foi realizada uma triangulação dos principais conceitos. Resultados: O cuidado humanizado se manifesta por meio de três dimensões: vivências ao fornecer cuidados humanizados, fatores que facilitam a prestação de cuidado humanizado e fatores que a dificultam. As categorias incluídas na primeira dimensão são igualdade, empatia, respeito e aprendizado. Os fatores que facilitam os cuidados humanizados incluem acolhimento e formação contínua, enquanto os fatores que os dificultam incluem o uso do nome social e o receio. Conclusão: O cuidado humanizado a pessoas com diversidade de gênero requer valores de igualdade e empatia, juntamente com formação inclusiva desde o nível de graduação. A deficiência no desenvolvimento de habilidades interpessoais dificulta o relacionamento enfermeiro-paciente, enquanto o receio da pessoa com diversidade de gênero dificulta as primeiras consultas. A integração do nome social e a formação continuada são essenciais para promover um ambiente de confiança e reduzir a sensação de vulnerabilidade e discriminação.

Introduction: Health care by nursing professionals to people with gender diversity can be negatively affected by the heteronormativity that has historically governed society. It is challenging to safeguard and seek actions to provide inclusive humanized care Objective: To understand the nursing professional's experiences when providing humanized care to people with gender diversity. Method: Qualitative research with a phenomenological approach. Four nursing professionals were interviewed. The information was collected through semi-structured individual and group interviews; the discourses were analyzed, and central concepts were triangulated.Results: Humanized care is manifested through three dimensions: experiences in providing humanized care, factors that facilitate the delivery of humanized care and factors that hinder it. The categories included in the first dimension are equality, empathy, respect and learning. Factors that facilitate humanized care have the categories of welcoming and continuing education, and factors that hinder it have the categories of social name and suspicion. Conclusion: Humanized care for people with gender diversity requires values of equality and empathy, together with inclusive training from undergraduate level. Deficiency in the development of soft skills hinders the nurse-patient relationship, while suspicion of the gender-diverse person hinders first consultations. The integration of the social name and continuous training are essential to promote an environment of trust and reduce the feeling of vulnerability and discrimination.

Evidence of validity of a Jealousy Scale in Peruvian youth and adults: An item response theory approach / Evidencia de validez de una Escala de Celos en jóvenes y adultos peruanos: un enfoque de teoría de respuesta al ítem

Abstract Introduction/Objective: In romantic relationships, jealousy can influence how individuals feel emotionally and interact with their partners. This study analysed the metric properties of the Brief Jealousy Scale (BJS) in young adults from Peru using current methods. Method: A total of 297 individuals were selected to participate in the study. They averaged 26.52 years of age (with a variation of 7.75 years), and 74.10% were women. The study used a technique called Item Response Theory (IRT) with a two-parameter model to confirm the structure and reliability of the BJS. Result: The BJS demonstrated high reliability and fit through goodness-of-fit indices. DIF analysis indicated slight gender biases in some items, reflecting differences in the perception of jealousy between men and women. Conclusions: The study highlights the importance and usefulness of the Jealousy Scale in relationships, as it helps to understand relationship dynamics and guides interventions. Future studies should address issues such as participant selection and study design and examine whether the scale can be used in different cultures.

Resumen Introducción/Objetivo: En las relaciones de pareja, los celos pueden influir en cómo se sienten emocionalmente y en cómo interactúan las personas con su pareja. Este estudio analizó las propiedades métricas de la Escala Breve de Celos en jóvenes y adultos de Perú utilizando métodos actuales. Método: Se seleccionaron 297 personas para participar en el estudio. Tenían en promedio 26.52 años (con una variación de 7.75 años) y el 74.10 % eran mujeres. El estudio utilizó una técnica llamada teoría de respuesta al ítem (IRT) con un modelo de dos parámetros para confirmar la estructura y fiabilidad del BJS. Resultados: El BJS demostró una gran confiabilidad y ajuste a través de índices de bondad de ajuste. El análisis DIF indicó ligeros sesgos de género en algunos ítems, lo que refleja diferencias en la percepción de los celos entre hombres y mujeres. Conclusiones: El estudio resalta la importancia y utilidad de la Escala de Celos en las relaciones, ya que ayuda a entender cómo funcionan y a saber cómo intervenir. En el futuro, los estudios deben ocuparse de problemas como la selección de participantes y el tipo de estudio realizado, y examinar si la escala se puede usar en diferentes culturas.

O (des)cuidado em saúde às pessoas LGBTQIAP+ dispensado por profissionais em unidades básicas de saúde / The (lack of)health care provided to LGBTQIAP+ people by professionals in primary care centers / El (des)cuidado en salud a las personas LGBTQIAP+ dispensado por profesionales en unidades básicas de salud

Objetivo: compreender o cuidado em saúde dispensado às pessoas LGBTQIAP+ por profissionais em Unidades Básicas de Saúde, a partir do referencial teórico da Política Nacional de Saúde LGBT (PNSILGBT) estabelecida pelo Sistema Único de Saúde (SUS). Método: estudo descritivo, com abordagem qualitativa, que entrevistou 12 profissionais de saúde da Atenção Básica. Os dados coletados passaram pela Análise Lexical utilizando-se do software IRAMUTEQ. Resultados: emergiram três categorias temáticas que possibilitaram compreender que os profissionais reconhecem as violências praticadas na assistência a essa população, as barreiras no acesso e as dificuldades enfrentadas por pessoas LGBTQIAP+. Considerações finais: o desconhecimento das políticas e a não percepção das consequências dessas ações para a saúde dessa população remete muito mais ao (des)cuidado do que efetivamente ao cuidado condizente as suas reais necessidades em saúde.

Objective: to understand the health care provided to LGBTQIAP+ people by professionals in Primary Care Centers, based on the theoretical framework of the National LGBT Health Policy (PNSILGBT) established by the Unified Health System (SUS). Method: a descriptive study with a qualitative approach, which interviewed 12 primary care health professionals. The data collected was subjected to Lexical Analysis using the IRAMUTEQ software. Results: Three thematic categories emerged which made it possible to understand that professionals recognize the violence practiced in assisting this population, the barriers to access and the difficulties faced by LGBTQIAP+ people. Final considerations: the lack of knowledge of the policies and the lack of perception of the consequences of these actions for the health of this population leads much more to (lack of)care than to care in line with their real health needs.

Objetivo: comprender el cuidado en salud brindado a las personas LGBTQIAP+ por profesionales en Unidades Básicas de Salud, partiendo del marco teórico de la Política Nacional de Salud LGBT (PNSILGBT) establecida por el Sistema Único de Salud (SUS). Método: estudio descriptivo, con enfoque cualitativo, que entrevistó a 12 profesionales de salud de la Atención Básica. Los datos recogidos fueron analizados mediante Análisis Léxico utilizando el software IRAMUTEQ. Resultados: surgieron tres categorías temáticas que permitieron comprender que los profesionales reconocen las violencias ejercidas en la asistencia a esta población, las barreras en el acceso y las dificultades enfrentadas por personas LGBTQIAP+. Consideraciones finales: el desconocimiento de las políticas y la no percepción de las consecuencias de estas acciones para la salud de esta población reflejan mucho más el (des)cuido que efectivamente el cuidado acorde a sus reales necesidades en salud.

Labor markets during COVID-19: gaps and challenges in Latin America.

Introduction: The effects of the COVID-19 pandemic on Latin American labor markets continue to be quantified, to identify the social and economic impacts that this pandemic had, and to design more efficient public policies that would protect the most vulnerable groups. For this reason, the research question was as follows: what were the changes in the labor formality rates before and two years after the main contingency measures of the COVID-19 pandemic were implemented? Methods: Using data from Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Peru, and Uruguay, the formality rate (τ) was analyzed, which was calculated using a weighted average between the formal employment rates of the number (i) of economic sectors (p) in a specific period (t). Results: The results suggest that the weighted labor formality rate increased in the countries of the region. These changes in formality could be the result of greater capital accumulation, the integration of productive processes, the integration of commercialization processes, and differentiated fiscal stimuli (i.e., the intrasectoral aspect), but it was not due to the displacement of workers from highly informal economic sectors to more formalized sectors (i.e., the intersectoral component). Discussion: The findings emphasized the precarious situation of women in the region, regardless of the country, particularly in Ecuador, Peru, Bolivia, and Argentina. These findings suggest the need to design public policies that reverse the current situation of the labor market and prevent future economic shocks, with special emphasis on the informal sector and women.

The public health challenges of female migration: the Venezuelan diaspora in Andean countries.

BACKGROUND: Venezuelan migration has experienced an unprecedented increase in the last decade, with approximately 7.7 million Venezuelan-born individuals residing in other countries as of 2024. Our study aims to identify the potential and actual demand for healthcare services (SRH) in the Venezuelan diaspora's four primary destinations within the Andean Countries: Colombia, Ecuador, Peru, and Chile. METHODS: Using official data from administrative records, censuses, and sample surveys reported by the host countries and international agencies, we estimate the annual evolution of Venezuelan-born women of reproductive age (WRA) and their offspring. Additionally, we conduct two case studies focusing on Colombia and Chile to analyse the groups most vulnerable to unmet health needs. RESULTS: The population of WRA has increased to between 5 and 6.8%, and births have risen to approximately 3-8% in host countries due to Venezuelan migration. Yet, we found a general decrease in health coverage for certain age groups of Venezuelan female migrants in host countries for the period 2017-2022, particularly in Chile. By 2022, an estimated 20% of healthcare needs remained unmet among children, girls, and younger Venezuelan women, contributing to greater health inequalities between Venezuelan-born adolescents and those from other countries of birth. CONCLUSIONS: Our findings highlight the escalating demand for and limited access to healthcare services among Venezuelan WRA in their destinations. Unmet healthcare needs are particularly prevalent among younger women by 2022, underscoring the urgency for health system to incorporate gender-responsive, equitable interventions and ensuring health rights for high-risk migrant groups such as infants, children, adolescents, and younger women. Addressing these challenges remains a critical task for the regional public health agenda in Latin America.

Musculoskeletal disorders, associated factors, and literature review for intervention according to gender.

Introduction: The relationship of risk factors with musculoskeletal disorders and their intervention is a topic of interest, given their prevalence among workers. Thus, analyzing risk factors from approaches such as the gender perspective may be an alternative. Objectives: To analyze risk factors in a health entity with a high prevalence of musculoskeletal disorders in upper limbs and to describe possible intervention measures according to scientific evidence, from a gender perspective. Methods: This is an analytical study. A questionnaire was applied to 93 workers on demographic aspects, presence of factors related to the environment, the task, and the organization, extra-work activities related to musculoskeletal disorders in the upper limbs. Chi-square was used to identify significant relationships between the sex variable and individual, occupational, and non-occupational factors, corroborated by Fisher's test and prevalence ratio. According to the associations identified, a literature review was carried out to establish possible strategies. Results: Significant relationships were found between the sex variable and task-related factors such as the presence of repetitive or sudden movements (p < 0.05), supporting postulates of labor segregation. According to the literature consulted, the effectiveness of activities such as physical preparation and adaptation of the workplace under professional guidance, training activities, and breaks is discussed. It is important to review organizational factors. Conclusions: By identifying significant relationships between the sex variable and task-related factors, the present study contributes to the postulate of labor segregation, in terms of concentration of female labor in activities with particular working conditions. Regarding literature and actions, it is important to generate more studies from this perspective.

Introducción: La relación de factores de riesgo con desordenes musculoesqueléticos y su intervención es tema de interés, dada su prevalencia entre trabajadores. Así, analizar los factores de riesgo desde enfoques como la perspectiva de género puede ser una alternativa. Objetivos: Analizar factores de riesgo en una entidad sanitaria con alta prevalencia de desordenes musculoesqueléticos en miembros superiores y describir posibles medidas de intervención según evidencia científica, desde la perspectiva de género. Métodos: Éste es un estudio de tipo analítico. Se aplicó un cuestionario a 93 trabajadores sobre aspectos demográficos, presencia de factores relacionados con ambiente, tarea y organización, y actividades extralaborales vinculadas con desórdenes musculoesqueléticos en miembros superiores. Mediante chi cuadrado, se realizó la identificación de relaciones significativas entre la variable sexo y factores individuales, intralaborales y extralaborales, corroboradas por prueba de Fisher y razón de prevalencias. Según las asociaciones identificadas, se efectuó revisión de literatura para establecer posibles estrategias. Resultados: Se encontraron relaciones significativas entre la variable sexo y factores de la tarea como la presencia de movimientos repetitivos o súbitos (p < 0,05), apoyando postulados de segregación laboral. Según la bibliografia consultada, se discute la eficacia de actividades como preparación física y adecuación del puesto de trabajo bajo orientación profesional, actividades de capacitación y pausas. Es importante revisar factores organizacionales. Conclusiones: Al identificarse relaciones significativas entre la variable sexo y factores de la tarea, se aporta al postulado de segregación laboral en cuanto a concentración de mano de obra femenina en actividades con condiciones de trabajo particulares. Sobre la literatura y las acciones, es importante generar más estudios desde esta perspectiva.

Perceived Emotional Self-Efficacy and Life Satisfaction of Elementary School Children on the US-Mexico Border.

Objectives. It has been established that an adult's perceived ability to effectively address negative emotions predicts their life satisfaction. To increase the understanding of ethnic minority children's mental health and quality of life, this study examined the relationship between perceived emotional self-efficacy and life satisfaction of Hispanic children. Methods. Using the nonexperimental-correlational research design and the convenience sampling method, a total of 176 fourth-, fifth-, and sixth-grade students (73 boys, 103 girls; 88% Hispanic) in one public elementary school on the US-Mexico border were recruited to participate in this study. Emotional self-efficacy was measured using the emotional subscale of the Self-Efficacy Questionnaire for Children and subjective well-being was measured using the Student Life Satisfaction Scale. Spearman correlation and ordinal regression analyses were used to test the study hypotheses. Results. Consistent with findings from the current literature, emotional self-efficacy was positively associated with subjective well-being. Children in lower elementary grades were more likely to report higher emotional self-efficacy than those in higher elementary grades. Boys were more likely to report higher life satisfaction than girls. Conclusions and Relevance. Using a sample of elementary school children with Hispanic backgrounds on the US-Mexico border, this study attested to the empirical link between emotional self-efficacy and life satisfaction. Our study findings stress the importance of early identification of students with low emotional self-efficacious beliefs and the early introduction of social-emotional learning programs in elementary schools to enhance students' emotional self-efficacy. This study contributes to positive psychology literature and provides insights for future school-based mental health practice and research.

Patterns and trends in melanoma mortality in Spain (1999-2022).

AIM: To examine melanoma mortality trends in Spanish Autonomous Communities from 1999 to 2022, focusing on gender and age differences. METHODS: Data from the National Statistics Institute were used to calculate age-standardized mortality rates (ASMRs). Joinpoint regression identified trend changes. RESULTS: Melanoma mortality varied significantly by region, gender, and age. Eastern Spain had higher male mortality, while western regions had lower rates. Asturias had higher female mortality, with lower rates in Andalusia, Extremadura, and Castilla-La Mancha. Men generally exhibited higher ASMRs than women, with variations across regions. While ASMRs remained stable in most areas, Madrid experienced a notable decline (AAPC: - 1.3%). A national trend reversal occurred in 2014 (AAPC: - 1.3%). For individuals aged 45-74 years, Catalonia saw a significant decrease (AAPC: - 1.1%, p < 0.05), whereas Andalusia experienced an increase (APC: 2.1% since 2007). Nationally, ASMRs for this age group declined (AAPC: - 0.7%). Among those aged 75 years and over, ASMRs varied considerably, with increases observed in Andalusia and Aragon. Nationally, male ASMRs rose (AAPC: 1.6% per year), while female rates were stable. Regional disparities were evident, with higher female mortality in the Balearic Islands and fluctuating rates in the Community of Madrid (an increase followed by a decrease after 2015). The gender gap in mortality varied across regions, with some areas showing a narrowing gap and others widening disparities. CONCLUSION: Continuous monitoring of melanoma mortality, especially among men and older adults, is crucial. Public health efforts should address regional disparities, improve early detection, and enhance treatment access to optimize outcomes nationwide.

"My Cross to Bear": Mothering in the Context of Intimate Partner Violence Among Pregnant Women in Mexico.

Intimate partner violence (IPV) during pregnancy negatively affects both maternal and infant health, yet gaps remain in understanding factors that maintain violence and/or promote resilience within the context of mothering. Nine focus groups were conducted with pregnant and/or IPV-exposed women (n = 17) and service providers (n = 26) working with these women in Nuevo León, Mexico. Thematic analysis of the focus group data revealed the detrimental impact of cultural norms that prioritize the relationship with women's partners, marriage, and family above women's dignity. Participants also identified ways that values regarding motherhood function as motivation for women to pursue a life without violence.

Trends in the incidence and prevalence of cirrhosis in Manitoba, Canada: A population-based study (2010-2019).

INTRODUCTION AND OBJECTIVES: The burden of chronic liver disease and cirrhosis continues to increase in North America. We sought to estimate the incidence and prevalence of cirrhosis in Manitoba, Canada over time and assess changes in trends between 2010-2019. MATERIAL AND METHODS: We performed a population-based study using Manitoba administrative health care data, and two validated case-finding algorithms. Annual incidence and prevalence rates were estimated using a generalized linear model with generalized estimating equations, adjusting for age and sex. Changes in estimates were tested using linear trend regression models. RESULTS: Two algorithms estimated the number of prevalent cirrhosis to be 16,140 and 29,943 respectively. The age- and sex-adjusted incidence rates increased over the study (from 149 to 264 cases per 100,000 population in 2010, to 177 to 388 cases per 100,000 population in 2019). Cirrhosis incidence increased annually by 2-6 %, with the largest increase (6-8 % 95 % CI 7-9 %, p <0.0001) in those aged 18-44 years. Irrespective of the algorithm used, females consistently exhibited higher cirrhosis incidence and prevalence compared to males over time (P <0.0001). Prevalence demonstrated an upward trend among all age groups over time for both algorithms (P < 0.0001). CONCLUSIONS: This population-based study highlights concerning temporal trends in cirrhosis, characterized by rising annual incidence and prevalence estimates, particularly among young adults and females. These findings underscore the urgent need for comprehensive strategies that encompass prevention, early detection, and the delivery of high-quality healthcare and public health initiatives to effectively tackle this escalating health burden.

Gender Gap for Accelerometry-Based Physical Activity Across Different Age Groups in 5 Brazilian Cohort Studies.

OBJECTIVES: This study aims to evaluate the gender inequalities in accelerometer-based physical activity (PA) across different age groups using data from 5 Pelotas (Brazil) cohorts. METHODS: The data come from 4 birth cohort studies, covering all live births in the urban area of Pelotas for each respective year (1982, 1993, 2004, and 2015), and the Como vai? cohort study focusing on 60 years and above. Raw accelerometry data were collected on the nondominant wrist using GENEActive/ActiGraph devices and processed with the GGIR package. Overall PA was calculated at ages 1, 2, 4, 6, 11, 15, 18, 23, 30, and 60+ years, while moderate to vigorous PA was calculated from 6 years onward. Absolute (difference) and relative (ratio) gender inequalities were calculated and intersectionality between gender and wealth was also evaluated. RESULTS: The sample sizes per cohort ranged from 965 to 3462 participants. The mean absolute gender gap was 19.3 minutes (95% confidence interval, 12.7-25.9), with the widest gap at 18 years (32.9 min; 95% confidence interval, 30.1-35.7) for moderate to vigorous PA. The highest relative inequality was found in older adults (ratio 2.0; 95% confidence interval, 1.92-2.08). Our intersectionality results showed that the poorest men being the most active group, accumulating around 60 minutes more moderate to vigorous PA per day compared with the wealthiest women at age 18. CONCLUSIONS: Men were more physically active than women in all ages evaluated. PA gender inequalities start at an early age and intensify in transition periods of life. Relative inequalities were marked among older adults.

Health, economic and social impacts of the Brazilian cash transfer program on the lives of its beneficiaries: a scoping review.

BACKGROUND: The Bolsa Família cash transfer Program (BFP) aims to break the poverty cycle by providing a minimum income to poor families conditioned on their investment in human capital (such as, education and health) and currently is the largest Program in the world in terms of the number of beneficiaries. Because there is a scarcity of reviews grouping studies on the impacts of the BFP, the objective of this scoping review was to identify and describe studies which evaluate the impact of the BFP on poverty, health, education, and other related outcomes. METHODS: We searched for quantitative, qualitative, and mixed-method articles that assessed the impact of the BFP on any aspect of the beneficiaries' lives between 2003 and March 2021. We included quantitative articles that used experimental, quasi-experimental or pre and post comparison designs. We excluded articles that analyzed impacts on political outcomes. There was no age restriction for the participants. The search was done in seven electronic databases. RESULTS: One thousand five hundred forty-six papers were identified and 94 fulfilled the inclusion criteria. Poverty and health outcomes were the most common outcomes studied. We found consistent evidence of the positive impact of the BFP on poverty reduction, as well as employment outcomes. We also found positive impacts in relation to mortality rates for children and adults, school dropout and school attendance among children and adolescents, and violence related outcomes such as homicide, suicide, crime, and hospitalization. However, we also found some evidence that BFP increased intimate partner violence and gender stereotypes among women and no evidence of impact on teenage pregnancy. CONCLUSIONS: Overall, the studies included found that BFP showed positive impacts on most poverty, health and education outcomes. More studies are needed to confirm some results, especially about violence and stereotype against women as there were few evaluations on these outcomes.

Felicidad sexual y satisfacción con la seguridad sexual en hombres de Asunción y Central / Sexual happiness and satisfaction with sexual security in men from Asunción and Central

RESUMEN Introducción: la satisfacción y seguridad sexual son elementos clave para el bienestar masculino, integrando aspectos físicos y emocionales de la intimidad; estos conceptos engloban el disfrute pleno de las relaciones sexuales, junto con la comodidad y confianza en las prácticas de protección utilizadas. Objetivo: determinar la felicidad sexual y satisfacción con la seguridad sexual en hombres de Asunción y Central durante el 2023. Metodología: se realizó un estudio observacional, descriptivo de corte transversal en Asunción, y Central durante los meses de setiembre a noviembre del 2023. La población de estudio lo constituyeron los hombres elegibles que tenían mayor de 18 años, a quienes se les asignó el sexo masculino al nacer, residentes de las ciudades seleccionadas. Las variables del estudio fueron las demográficas, salud mental (ansiedad, depresión e ideación suicida). Resultados: el estudio incluyó 143 participantes. De estos, el 55,24 % (79) tenía entre 18 y 29 años, el 69,23 % (99) se identificó como gay, y el 12,59 % (18) como bisexual. Los Hombres que tienen sexo con hombres mostraron una mayor probabilidad de reportar satisfacción, con una odds ratio ajustada por edad de 2,82 (IC 95 %: 1,41-3,57, p=0,001) en comparación con los heterosexuales, tener tres o más parejas estables y once o más parejas no estables se asoció fuertemente con ser HSH (p=0,003 y p=0,001, respectivamente). Conclusión: los hombres que tienen sexo con hombres reportaron niveles más altos de satisfacción sexual, lo que sugiere una experiencia positiva en sus relaciones íntimas. Sin embargo, este grupo también mostró una tendencia a tener un mayor número de parejas sexuales, tanto estables como no estables. Estas diferencias en comportamientos sexuales pueden indicar distintas normas sociales o preferencias personales entre los grupos estudiados.

ABSTRACT Introduction: sexual satisfaction and safety are key elements for male well-being, integrating physical and emotional aspects of intimacy. These concepts encompass the full enjoyment of sexual relationships, along with comfort and confidence in the protective practices used. Objective: determine sexual happiness and satisfaction with sexual safety in men from Asunción and Central during 2023. Methodology: a cross-sectional study was carried out in Asunción and Central during the months of September to November 2023. The study population consisted of eligible men who were over 18 years of age, who were assigned the sex male at birth, residents of the selected cities. The study variables were demographics, mental health (anxiety, depression and suicidal ideation). Results: the study included 143 participants. Of these, 55.24 % (79) were between 18 and 29 years old, 69.23 % (99) identified as gay, and 12.59 % (18) as bisexual. Men who have sex with men showed a higher probability of reporting satisfaction, with an age-adjusted odds ratio of 2.82 (95 % CI: 1.41-3.57, p=0.001) compared to heterosexuals. Having three or more stable partners and eleven or more non-stable partners was strongly associated with being MSM (p=0.003 and p=0.001, respectively). Conclusion: men who have sex with men reported higher levels of sexual satisfaction, suggesting a positive experience in their intimate relationships. However, this group also showed a tendency to have a higher number of sexual partners, both stable and non-stable. These differences in sexual behaviors may indicate distinct social norms or personal preferences among the studied groups.

Comunicando o incomunicável? Mulheres com endometriose, assimetrias e limites da empatia / Communicating the incommunicable? Women with endometriosis, asymmetries and limits of empathy / ¿Comunicar lo incomunicable? Mujeres con endometriosis, asimetrías y límites de la empatía

Neste artigo, analisamos o documentário Endometriose: uma vida moldada pela dor, material que tem como objetivo "mostrar, tirar da invisibilidade e dar voz" a mulheres que vivem com intensa dor crônica causada pela doença que dá título à obra. Discutiremos, preliminarmente, as dificuldades e potencialidades do testemunho da dor física, a partir de reflexões de Scarry, Sontag e Bourke. Em seguida, abordaremos três fatores de caráter histórico-social que podem ajudar a explicar o silenciamento da experiência das pacientes: os limites da compaixão médica, especialmente relacionados a questões de gênero, classe e raça; a construção da ideia do corpo feminino como inerentemente patológico e as complexidades na relação médico-paciente em sua interseção com o gênero. Por fim, no último tópico do trabalho, trataremos dos esforços das mulheres com endometriose no sentido de tornar sua dor inteligível e modular que resposta desejam receber de seus interlocutores.

In this essay, we analyze the documentary Endometriosis: a life shaped by pain, a material that aims to "show, remove from invisibility and give voice" to women who live with intense chronic pain caused by endometriosis. We will preliminarily discuss the difficulties and potentialities of witnessing physical pain, based on the work of Scarry, Sontag and Bourke. Next, we will address three socio-historical factors that can help explain the silencing of patients' experiences: first, the limits of medical compassion, especially related to issues of gender, class and race; second, the construction of the idea of the female body as inherently pathological; third, the complexities in the doctor-patient relationship as it intersects with gender. Finally, in the last topic of the work, we will examine the efforts of endometriosis patients to make their pain intelligible and modulate the response they want to receive from their interlocutors.

En este artículo analizamos el documental Endometriosis: una vida marcada por el dolor, material que pretende "mostrar, sacar de la invisibilidad y dar voz" a mujeres que viven con intensos dolores crónicos provocados por la endometriosis. Discutiremos preliminarmente las dificultades y potencialidades de presenciar el dolor físico, a partir del pensamiento de Scarry, Sontag y Bourke. A continuación, abordaremos tres factores histórico-sociales que pueden ayudar a explicar el silenciamiento de las experiencias de los pacientes: primero, los límites de la compasión médica, especialmente relacionados con cuestiones de género, clase y raza; segundo, la construcción de la idea del cuerpo femenino como inherentemente patológico; tercero, las complejidades de la relación médico-paciente en su intersección con el género. Finalmente, en el último tema del trabajo, discutiremos los esfuerzos de las pacientes con endometriosis por hacer inteligible su dolor y modular la respuesta que quieren recibir de sus interlocutores.

Sociodemographic, Occupational, and Health Profile of Brazilian Housekeepers and House Cleaners-A Hypothesis-Generating Study.

For many women, house cleaning is an important way to participate in the labor market. In Brazil, there are 2 types of domestic workers: housekeepers have relatively secure employment and house cleaners are day laborers. The aim of this hypothesis-generating study was to describe the sociodemographic, occupational and health profile of a sample of domestic workers in Brazil. House cleaners received lower wages, had longer daily working hours and worked in a larger number of homes each week in comparison to housekeepers. About 51% of the domestic workers in this sample reported the use of pain medication and 34% reported spinal problems. Musculoskeletal symptoms were frequent in the lower back and upper limbs. Forty-seven percent reported high blood pressure. This study highlights the vulnerability of domestic workers, especially house cleaners, regarding workload, salary, and health conditions. Level of education is a contributing factor to this vulnerability.

Educating gender: The economic and spiritual battles over land and Mapuche children in Araucanía, Chile, 1897-1922.

This article examines the role of gender as an embodied site of political control and resistance within Mapuche-Capuchin relations in the early period of Bavarian Capuchin mission-building in Chile (1897-1922). The study frames agricultural science education as a civilizing method employed in the Capuchin mission schools, targeting Mapuche children. The aim was to educate Mapuche children in Christian and Western gender roles, moral behavior, and rural economic occupations. Amid the overarching conflict over land rights and privatization between Mapuche communities and the Chilean government, the state's support for the Capuchin order's evangelizing mission was perceived as a long-term strategy to appropriate Indigenous lands and assimilate the Mapuche into the rural and urban workforce. The article illustrates how the conflict over embodied gender roles disrupted Mapuche socioeconomic relations.

The gender productivity gap in Biochemical and Biophysical sciences. Some evidence to solve the productivity puzzle.

This paper studies the gender productivity gap in biochemical and biophysical sciences in Argentina for the period 2011-2018. Women publish less papers than men due to academic and non-academic differences. We define the former as the individual characteristics related to research activity, that are developed in the public sphere, and non-academic as the ones related to the private sphere (such as housework and breeding). The later tend to negatively impact on the academic characteristics of female researchers, even when they are not supposed to be related. We test whether the gender productivity gap persists even when academic characteristics between men and women are alike, and to what extent these characteristics contribute to reduce the gap. The methodological approached is based on an extension of the Oaxaca-Blinder decomposition, named multivariate decomposition for nonlinear response models. Results show that both observable (academic) and unobservable factors (both academic and non-academic) explain the gender productivity gap and that the former contribute to the reduction but not the elimination.

Enhancing cognitive control of our decisions: Making the most of humor during the IGT in females and males.

We studied the impact of humor on the Iowa Gambling Task (IGT) decision-making performance and the cognitive control exerted during this task, considering sex as a moderator, and examined whether cognitive control mediated the influence of humor on decision-making. Sixty participants (30 females) performed an extended version of the IGT (500 trials divided into 20 blocks). We randomly assigned them to either an experimental group (Humor Group; Hg; n = 30), where humorous videos were interspersed in the decision-making trials or a control group (Non-Humor Group; NHg; n = 30), where nonhumorous videos were interspersed in the decision-making trials. We recorded participant performance and feedback-related negativity (FRN) and P3b event-related potentials (ERP) during IGT feedback as task monitoring and attention allocation indicators, respectively. We expected that whereas humor would improve IGT decision-making under risk in females during the last blocks (17-20) as well as cognitive control (specifically attention allocation and task monitoring) across the entire IGT, it would impair them in males. Contrary to our expectations, humor improved IGT decision-making under risk for both sexes (specifically at blocks 19 and 20) and attention allocation for most IGT blocks (P3b amplitudes). However, humor impaired IGT decision-making under ambiguity in males during the block six and task monitoring (FRN amplitudes) for most IGT blocks. Attention allocation did not mediate the beneficial effect of humor on decision-making under risk in either sex. Task monitoring decrements fully mediated the humor's detrimental influence on men's decision-making under ambiguity during block six.

Prevalence and Correlates of Intimate Partner Violence Among Women and Men in Mexico: A Systematic Review and Meta-analysis.

This article presents the first systematic review and meta-analysis of the prevalence and correlates of different forms of intimate partner violence (IPV) among women and men in Mexico. To identify studies, a comprehensive search strategy was developed and executed across 11 databases (Academic Search Complete, APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, International Bibliography of the Social Sciences, LILACS, MEDLINE, SciELO, Sociological Abstracts, Web of Science). From the 1,746 studies screened, 155 full-text articles were reviewed, and this systematic review included 27 studies involving 249,557 participants to determine the prevalence of physical, psychological, sexual, threats, and other forms of IPV, according to gender and other sociodemographic characteristics. Overall IPV prevalence was 16.4%, with significant differences across pregnant and non-pregnant women. Physical IPV prevalence was 14.7%, revealing higher rates in men (29.5%) compared to women (14.2%). Psychological IPV prevalence was 27.3% and sexual IPV was at 6.6%, with differences across evaluation periods. Threats and other IPV forms showed a prevalence rate of 14.2% and 21.5%. Meta-regression analyses included gender, education, marital status, rural residency, pregnancy, age, and evaluation period. This study demonstrates that IPV is a critical public health concern in Mexico, impacting both women and men. It shows the vulnerability of rural residents, youth, and pregnant women. However, understanding IPV complexities in Mexico requires nuanced considerations of demographic and situational contexts. Urgent initiatives from municipal, state, and federal governments are needed to combat IPV, focusing on prevention and support for affected individuals.