Cases of violence involving transvestites and transsexuals in a northeastern Brazilian city. / Situações de violência contra travestis e transexuais em um município do nordeste brasileiro.

Objective To analyze cases of violence against transvestites and transsexuals based on their sociodemographic profile. Method Cross-sectional, descriptive research performed in Cajazeiras / Paraíba, consisting of 16 transvestites and transsexuals. Data collection took place in April 2014 and was analyzed descriptively. Results The typology of violence that victimized transvestites and transsexuals were: verbal (91.96%), psychological (58.33%) and physical (33.33%), often between 24 hours and six months preceding the survey. Regarding the spatiality: the street, school and health services were all scenarios of aggression. With respect to the offending agent, the findings point towards neighbors, family members and health professionals. All forms of violence happened between agents and spaces of aggression. Conclusions Violence among this population, silence around the situations of abuse became more pronounced as did its invisibility in the social and institutional context, reflecting the inhibition of human rights and concealment of reality.

Depressive symptoms and associated factors among travestis and transsexuals: a cross-sectional study.

OBJECTIVES: to estimate the prevalence of depressive levels and their associated factors among transvestite and transsexual individuals. METHODS: this cross-sectional study involved 58 participants assisted by non-governmental organizations. The Beck Depression Inventory was utilized to assess levels of depression, complemented by a sociodemographic questionnaire and a questionnaire on experiences of violence. Data were analyzed using descriptive statistics and Poisson regression with robust variance. RESULTS: a prevalence of 27.6% (95% CI = 11.50-39.10) for moderate to severe levels of depression was observed. This prevalence was associated with being unmarried (PR = 1.19; 95% CI = 1.10-1.28) and experiencing violence in healthcare services (PR = 2.30; 95% CI = 1.10-4.81). CONCLUSIONS: the absence of a partner and experiences of violence in healthcare settings negatively impacted mental health, leading to an increased prevalence of depressive symptoms among transvestite and transsexual individuals. Advocating for transgender rights and providing ongoing education in health care for professionals are critical strategies in promoting the mental health of this population.

Experiences of mothers with early weaning: a grounded theory.

OBJECTIVE: To understand the experiences of mothers with early weaning. METHOD: Qualitative research with a theoretical-methodological contribution from Grounded Theory (Straussian perspective), carried out in the context of primary health care in a medium-sized municipality in the northeast of Brazil. 19 collaborators participated by theoretical sampling. Data collection took place between April and September 2018, with in-depth interviews, and was analyzed in three stages: open and axial coding, and integration. RESULTS: The central category "Women experiencing guilt and overload due to early weaning" was supported by three categories: a) conditions: "Showing the factors that limit breastfeeding"; b) actions/interactions: "Trying to balance motherhood and work during breastfeeding" and "Insufficient social support to keep exclusive breastfeeding"; and c) consequences: "Introducing formula and complementary foods before six months" and "Blaming oneself for the early weaning". FINAL CONSIDERATIONS: The theoretical model can give support to managers and health professionals to advocate for longer maternity leaves and confront gender disparities and inequities, professional performance with conflicts of interest, and abusive marketing regarding the use of formula.

Common mental disorders in hematopoietic stem cell transplant patients: a scoping review.

OBJECTIVE: to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation. METHODS: this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included. RESULTS: the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia. CONCLUSIONS: the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients' evolution.

Nurses and health care for gay adolescents.

OBJECTIVE: to analyze nurses' statements about health care for gay adolescents. METHOD: qualitative study, anchored on the Thematic Analysis of Clarke and Braun, with adoption of Symbolic Interactionism as a theoretical framework, since it favors the understanding of the relationship between behaviors, interactions, and social meanings. Twelve nurses recruited using the snowball sampling technique were remotely interviewed via the Google Meet® video-conferencing app. RESULTS: four themes were elaborated throughout the comprehensive-interpretative process: "Gay adolescents, agendas, and relation with health;" "The gay adolescent's family and care;" "Relationship with gay adolescents in care," and "Limits to nursing care for gay adolescents." CONCLUSION: the statements denounce stigmas and symbols derived from cisheteronormativity as intervening in the relationship and indicate the urgency of investing in the intersubjective encounter with gay adolescents and their families in a horizontal, affective, and empathic relationship, with chances of favoring public defense of the right to health. There are comments on the nurses' attitude and qualification of care for this population. KEYPOINTS: (1) Tendency towards "de-subjectifying" objectification in health practices. (2) Hegemony of cisheteronormative logic as a limitation to care. (3) Sex and sexually transmitted infections (STIs) as stigmas attached to gay adolescents. (4) Family and health care for homosexual adolescents: opportunities and obstacles. (5) The limits and powers of nursing to enable equity in care for gay adolescents.

Social representations of motherhood for women deprived of liberty in the female prison system. / Representações sociais da maternidade para mulheres em privação de liberdade no sistema prisional feminino.

This paper aimed to analyze the social representations of motherhood of pregnant women, breastfeeding women, and those who experienced pregnancy in deprivation of liberty in the prison system. This qualitative study was conducted with 42 women and is grounded on the assumptions of the Theoretical Paradigm of Social Representations. Most participants were young women aged 18-39 (90.5%; n=38) and single (50.0%; n=21); 61.9% (n=26) reported two or more pregnancies and 47.6% (n=20) reported one or more miscarriages. The possible representation of being a mother in prison was crystallized, in semantic terms, mainly by the terms "separation" (f=27; OME: 2.9), "sadness" (f=18; OME: 2.3), "horrible" (f=16; OME: 2.1) and "pain" (f=12; OME: 2.8). In the substitution and decontextualization zone, representations were objectified by the terms "separation" (f=18; OME: 3), "sadness" (f=13; OME: 2.5), "fear" (f=11; OME: 2.2) and "horrible" (f=10; OME: 1.5). It was evident that the centrality of social representations for the study participants reflects the suffering experienced by the separation of the mother-child dyad.

Neste artigo, objetivou-se analisar as representações sociais da maternidade de mulheres gestantes, lactantes e que vivenciaram a gestação em privação de liberdade no sistema prisional. Trata-se de estudo qualitativo, ancorado nos pressupostos do Paradigma Teórico das Representações Sociais, realizado com 42 mulheres. As participantes eram, em maioria, jovens entre 18 e 39 anos de idade (90,5%; n=38) e se encontravam solteiras (50,0%; n=21); 61,9% (n=26) relataram duas ou mais gestações e 47,6% (n=20) referiram um ou mais abortamentos. A possível representação do ser mãe na prisão se cristalizou, em termos semânticos, principalmente pelos termos "separação" (f=27; OME: 2,9), "tristeza" (f=18; OME: 2,3), "horrível" (f=16; OME: 2,1) e "dor" (f=12; OME: 2,8). Na zona de substituição e de descontextualização, as representações foram objetivadas pelos termos "separação" (f=18; OME: 3), "tristeza" (f=13; OME: 2,5), "medo" (f=11; OME: 2,2) e "horrível" (f=10; OME: 1,5). Evidenciou-se que a centralidade das representações sociais para as participantes do estudo reflete o sofrimento vivenciado pela separação da díade mãe-filho.

Mental health, art, and deinstitutionalization: an aesthetic-poetic-theatrical account of the city's occupation. / Saúde mental, arte e desinstitucionalização: um relato estético-poético-teatral de uma ocupação da cidade.

This study aimed to report the experience of an aesthetic, poetic, and theatrical production of the city's occupation from a device of the Psychosocial Care Network to offer space for sociability, production, and cultural intervention. This is an account of an experience from the Social and Cultural Center (CECCO) in Natal, Rio Grande do Norte, Brazil, within madness and mental health deinstitutionalization. The intervention "The Little Prince occupies the Ribeira" was inspired by the work of author Saint-Exupéry. The artistic and creative acts reported occurred in December 2019. We experienced in this intervention the reach of an aesthetic clinic that, when opened to the street and art, expanded and weaved in the territory, instrumentalized by theater, dance, poetry, percussion, crafts, and city's occupation. The movement led the community to "step down from the stage" to the streets and is connected with the twist of the asylum model and the production of the affection clinic that we seek to sustain in the daily service.

Objetivou-se relatar a experiência de uma produção estética, poética e teatral de ocupação da cidade a partir de um dispositivo da Rede de Atenção Psicossocial, com vistas a oferecer espaço de sociabilidade, produção e intervenção cultural. Trata-se de um relato de experiência a partir do Centro de Convivência e Cultura (CECCO) de Natal, Rio Grande do Norte, Brasil, dentro do campo da desinstitucionalização da loucura e da saúde mental. A intervenção urbana "O Pequeno Príncipe ocupa a Ribeira" foi inspirada na obra do escritor Saint-Exupéry. Os atos artísticos e criativos relatados aconteceram em dezembro de 2019. Experimentamos nessa intervenção os alcances de uma clínica-estética que, ao se abrir para a rua e para a arte, se amplia e se tece no território, instrumentalizado pelo teatro, dança, poesia, percussão, artesanato e ocupação da cidade. O movimento gerou no coletivo um "descer do palco" em direção à rua e se conecta com a desconstrução do modelo manicomial e produção da clínica dos afetos que buscamos sustentar no cotidiano do serviço.

Biographical ruptures by the COVID-19 pandemic on adolescent and young trans men and transmasculine people: demands for nursing.

OBJECTIVE: to understand the biographical ruptures caused by the COVID-19 pandemic on adolescent and young trans men and transmasculine people in the Brazilian context. METHOD: qualitative study - multicenter, online survey. A total of 97 self-identified trans men and 22 transmasculine people participated and completed a semi-structured form in two stages. The data was subjected to Reflective Thematic Content Analysis. The interpretation was made on a sociological basis, based on the concept of biographical rupture. RESULTS: five categories were derived: interruption of hormonization, surgeries and specialized follow-up; discomforts caused by the rupture of masculine characteristics, self-image, self-perception, and identity; vulnerability from the losses of family members and significant people, employment, and weakening of support networks; emergence of psycho-emotional problems, such as loss of meaning in life; demands for nursing care and valuing the life of transmasculine adolescents and young men in post-pandemic times. CONCLUSION: the biographical ruptures caused by the pandemic threatened the identities of trans and transmasculine people of adolescents and youth, degraded and interrupted biographies, leading them to the loss of meaning in life. Nursing professionals can be strategic and essential in overcoming threats by intervening early. KEYPOINTS: (1) Shows biographical ruptures in transmasculinities during the pandemic. (2) Elucidates threats to achieving the desired trans identity. (3) Reveals barriers in services that hinder hormone transition. (4) Presents the discourse of suicide and new stressors in mental health. (5) Raises calls for nursing practice/care in adolescent health.

Violence against children and adolescents: nurse's actions in primary health care.

OBJECTIVES: to analyze the role of nurses in suspected or confirmed cases of violence against children and adolescents in Primary Health Care. METHODS: an analytical research, with a qualitative approach. Thirty nurses participated in the study, and data were collected by means of an individual form and a semi-structured interview. The data received lexicographic analysis by the software IRaMuTeQ (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) organized by Bardin's content analysis. RESULTS: five categories emerged, in which it was possible to consider that the nurses' approach in cases of violence was based on the identification of violence through physical examination during nursing consultations, health promotion actions in the school environment, request for support from the multi-professional team, and transfer of responsibilities. FINAL CONSIDERATIONS: it is inferred that the fragility in the professional training of nurses to address situations of violence against children and adolescents produces deficits in comprehensive care for victims.

Factors associated with anxiety in multiprofessional health care residents during the COVID-19 pandemic.

OBJECTIVE: To estimate the prevalence and factors associated with anxiety among multiprofessional health residents during the COVID-19 pandemic. METHODS: Cross-sectional study, conducted in July 2020 with multiprofessional health residents (n = 67) from a university hospital. We used the Beck Anxiety Inventory to assess anxiety. Analyzing data through the chi-square test, likelihood ratio, and multiple analysis using Poisson regression with robust variance. RESULTS: The proportion of moderate/severe anxiety was 31.3%, which showed significant association with working in sectors involving COVID-19 and directly with suspected/confirmed cases of COVID-19. During the multiple analysis, we found prevalence of anxiety in participants who needed psychological support after entering their residence and those who used psychotropic meds. CONCLUSION: The results seem to indicate that residents had their mental health impaired during the pandemic, but the maintenance of the variables in the model also suggests that they sought help to control anxiety.

Factors associated with suicidal ideation among travestis and transsexuals receiving assistance from transgender organizations. / Fatores associados à ideação suicida entre travestis e transexuais assistidas por organizações não governamentais.

The aim of this study was to determine the prevalence of suicidal ideation and explore associated factors among travestis and transsexuals. A cross-sectional study was conducted between 2015 and 2016 with 22 travestis and 36 transsexuals who were members of the four transgender organizations operating in the state of Rio Grande do Norte, Brazil. Associations between suicidal ideation and the categorical variables were measured using the chi-squared test, Fisher's exact test, and likelihood ratios. Multivariate analysis was performed using robust Poisson regression. The suicidal ideation prevalence rate was 41.4% (95%CI 41.3-54.51%): 13.79% among travestis (95%CI 4.91-22.66%) and 27.61% in transsexuals (95%CI 16.08-39.08%). The prevalence of suicidal ideation was higher among respondents who reported suffering violence at school (PR = 2.05; 95%CI 1.08-3.87) and those experiencing moderate/severe depression (PR = 3.86; 95%CI 1.51-9.83). The findings suggest that unfavorable school contexts and the presence of depression compromise mental health and contribute to suicidal ideation among travestis and transsexuals.

Objetivou-se analisar a prevalência e os fatores associados à ideação suicida em travestis e transexuais. Estudo transversal, realizado entre 2015 e 2016 com travestis (n = 22) e transexuais (n = 36) associadas a quatro organizações civis do Rio Grande do Norte. Avaliou-se a diferença entre as categorias por meio dos testes qui-quadrado, exato de Fisher e de razão de verossimilhança. Realizou-se a análise múltipla por meio da regressão de Poisson com variância robusta. A prevalência de ideação suicida foi de 41,4% (IC 95%: 41,3-54,51%), sendo de 13,79% entre travestis (IC 95%: 4,91-22,66%) e 27,61% entre transexuais (IC 95%: 16,08-39,08%). Observou-se que apresentaram maior prevalência de ideação suicida os participantes com histórico de violência na escola (RP = 2,05; IC 95%: 1,08-3,87) e classificados com níveis depressivos moderado/grave (RP = 3,86; IC 95%: 1,51-9,83). Contexto escolar desfavorável e presença de sintomatologia depressiva parecem prejudicar a saúde mental e colaborar com a ideação suicida de pessoas transexuais e travestis.

Estimates of suicide mortality in women residents in northeast brazilian states from 1996 to 2018.

The objective of this study was to analyze the temporal trend of suicide mortality in women in the states of Northeastern Brazil. This is an ecological study of a time series stratified by states in Northeast Brazil from 1996 to 2018, with data extracted from the Mortality Information System (SIM). The temporal trend was evaluated by negative binomial regression (p values≤0.05). There was a higher proportion of deaths in black and brown women (73.9%), single (57.3%), with the place of death occurring in the home (53.4%). Hanging and strangulation stood out as the perpetration means (47.6%). Most states showed an upward temporal trend, except for Pernambuco, Rio Grande do Norte, Sergipe and Maranhão, which showed a steady trend (p>0.05). An upward temporal trend was identified in the analysis of deaths by suicide in women in five states in northeastern Brazil between 1996 and 2018. The information presented can support planning and decision-making for the prevention of suicide among women in northeastern Brazil.

Mortality due to breast cancer in a region of high socioeconomic vulnerability in Brazil: Analysis of the effect of age-period and cohort.

INTRODUCTION: Breast cancer is an important public health problem worldwide, with important disparities in incidence, mortality, and survival rates between developed and developing countries due to inequalities regarding access to measures for the prevention and treatment of the disease. In Brazil, there are higher rates of incidence and a downward trend in mortality in regions of greater socioeconomic development. OBJECTIVE: To evaluate the effect of age, period, and birth cohort on breast cancer mortality in women aged 20 years and older in the states of the Northeast Region of Brazil, an area of high socioeconomic vulnerability, from 1980 to 2019. METHODS: The death records were extracted from the DATASUS Mortality Information System website (Department of National Health Informatics) from the Ministry of Health of Brazil. Estimable functions were used to estimate the age-period and cohort models (APC) using the Epi library from the R statistical software version 6.4.1. RESULTS: The average breast cancer mortality rate for the period was 20.45 deaths per 100,000 women. The highest coefficients per 100,000 women were observed in the states of Pernambuco (21.09 deaths) and Ceará (20.85 deaths), and the lowest in Maranhão (13.58 deaths) and Piauí (15.43 deaths). In all of the locations, there was a progressive increase in mortality rates in individuals over 40 years of age, with higher rates in the last five-year period (2015-2019). There was an increase in the risk of death for the five-year period of the 2000s in relation to the reference period (1995-1999) in the Northeast region and in the states of Alagoas, Bahia, Maranhão, Paraíba, and Piauí. In addition, there was an increased risk of death for women born after the 1950s in all locations. CONCLUSION: The highest mortality rates in all five-year periods analyzed were observed in states with greater socioeconomic development, with an increase in mortality rates in the 2000s, and a higher risk of death in the younger cohorts.

[Temporal effects of corrected female homicide mortality estimates in Northeast Brazil]. / Efeitos temporais das estimativas de mortalidade corrigidas de homicídios femininos na Região Nordeste do Brasil.

This study aimed to analyze the temporal effects (age, period, and cohort) on female homicide mortality in the states of Northeast Brazil from 1980 to 2017. This ecological time trend study used APC with a Bayesian approach and the deterministic method Integrated Nested Laplace Approximations (INLA) in the parameters' inference. The female homicide rates for each state of the Northeast were standardized by the direct method after correction of the death records for quality of information and underreporting. Data were also obtained on race/color, place of death, and means of perpetration. During the period analyzed, after correcting the death records, the Northeast region showed a mean rate of 5.40 female homicide deaths per 100,000 women, with a significant increase in all the states in the 2000s. In all the states, there was an increase in relative risk (RR) of homicide death in the second and third decades of life and a protective effect in older women. Except for the state of Sergipe, there was an increase in the risk of death in all five-year periods in the 2000s. The Northeast region as a whole and the states of Paraíba, Pernambuco, and Piauí showed a protective effect for women from older generations. There were also higher proportions of deaths in black women, homicides committed at home, and those perpetrated with firearms. The current study's findings may correlate with the spread of violence in Brazil in the 2000s and the Brazilian State's failure to protect women from violence.

O objetivo foi analisar os efeitos temporais (idade, período e coorte) na mortalidade por homicídios femininos nos estados da Região Nordeste do Brasil, no período de 1980 a 2017. Estudo ecológico de tendência temporal em que foram utilizados modelos APC com uma abordagem bayesiana e o método determinístico INLA (Integrated Nested Laplace Approximations) na inferência dos parâmetros. As taxas de homicídios femininos, para cada estado da região estudada, foram padronizadas pelo método direito, após correção dos registros de óbitos quanto à qualidade da informação e à subnotificação. Além disso, obtiveram-se dados segundo raça/cor, local de ocorrência e meio pelo qual a agressão foi perpetrada. No período estudado, após a correção dos registros de óbito, a Região Nordeste apresentou taxa média de 5,40 óbitos por homicídios a cada 100 mil mulheres, com aumento significativo em todos os estados nos anos 2000. Em todos os estados houve aumento do risco de óbito (RR) por homicídio na segunda e terceira década de vida e efeito de proteção para as mulheres mais velhas. Com exceção de Sergipe, constatou-se aumento do risco de óbito em quinquênios dos anos 2000. Na Região Nordeste e estados da Paraíba, Pernambuco e Piauí, verificou-se efeito protetor para mulheres de gerações mais antigas. Ainda, a maior proporção de óbitos ocorreu em mulheres negras, no domicílio, sendo perpetrado por arma de fogo. Os achados do presente estudo podem estar correlacionados ao processo de disseminação da violência ocorrido no Brasil, nos anos 2000, assim como a ineficiência do Estado brasileiro em proteger as mulheres vítimas de violência.

Analizar los efectos temporales (edad, período y cohorte) en la mortalidad por feminicidios en los estados de la región Nordeste de Brasil durante el período de 1980 a 2017. Estudio ecológico de tendencia temporal en el que se utilizaron modelos APC con un abordaje bayesiano y el método determinístico INLA (Integrated Nested Laplace Approximations) para la inferencia de los parámetros. Las tasas de feminicidios, para cada estado de la región estudiada, fueron estandarizadas por el método directo, tras la corrección de los registros de fallecimientos, en cuanto a la calidad de la información y a la subnotificación. Asimismo, se obtuvieron datos según raza/color, lugar de ocurrencia y medio por el que se perpetró la agresión. Durante el período estudiado, tras la corrección de los registros por fallecimiento, la región Nordeste presentó una tasa media de 5,40 óbitos por feminicidio en cada 100.000 mujeres, con un aumento significativo en todos los estados a partir del año 2000. En todos los estados hubo un aumento del riesgo de óbito (RR) por homicidio en la segunda y tercera década de vida y efecto de protección para las mujeres mayores. Con excepción del estado de Sergipe, se observó un aumento del riesgo de fallecimientos en quinquenios de los años 2000. En la región Nordeste y estados de Paraíba, Pernambuco y Piauí se verificó un efecto protector para las mujeres de generaciones mayores. Asimismo, la mayor proporción de fallecimiento se produjo en mujeres negras, en el domicilio, siendo perpetrado por arma de fuego. Los resultados del presente estudio pueden estar correlacionados con el proceso de diseminación de la violencia, ocurrido en Brasil a partir del año 2000, así como la ineficiencia del Estado brasileño para proteger a las mujeres víctimas de violencia.

Analysis of the effects of the age-period-birth cohort on cervical cancer mortality in the Brazilian Northeast.

Cervical cancer (CC) is a public health problem with a high disease burden and mortality in developing countries. In Brazil, areas with low human development index have the highest incidence rates of Brazil and upward temporal trend for this disease. The Northeast region has the second highest incidence of cervical cancer (20.47 new cases / 100,000 women). In this region, the mortality rates are similar to rates in countries that do not have a health system with a universal access screening program, as in Brazil. Thus, this study aimed to analyze the effects of age, period and birth cohorts on mortality from cervical cancer in the Northeast region of Brazil. Estimable functions predicted the effects of age, period and birth cohort. The average mortality rate was 10.35 deaths per 100,000 women during the period analyzed (1980-2014). The highest mortality rate per 100,000 women was observed in Maranhão (24.39 deaths), and the lowest mortality rate was observed in Bahia (11.24 deaths). According to the period effects, only the state of Rio Grande do Norte showed a reduction in mortality risk in the five years of the 2000s. There was a reduction in mortality risk for birth cohorts of women after the 1950s, except in Maranhão State, which showed an increasing trend in mortality risk for younger generations. We found that the high rates of cervical cancer mortality in the states of northeastern Brazil remain constant over time. Even after an increase in access to health services in the 2000s, associated with increased access to the cancer care network, which includes early detection (Pap Test), cervical cancer treatment and palliative care. However, it is important to note that the decreased risk of death and the mortality rates from CC among women born after the 1960s may be correlated with increased screening coverage, as well as increased access to health services for cancer treatment observed in younger women.

[Male homicides in two regions of Brazil: analysis of the effect of age, period, and cohort]. / Homicídios masculinos em duas regiões brasileiras: análise do efeito da idade, período e coorte.

The objective was to assess the effect of age, period, and birth cohort on the time trend in mortality from homicides in men in the states of the Northeast and Southeast regions of Brazil from 1980 to 2014. This was an ecological time trend study. PCA models were estimated using estimable functions in inference of the parameters. Mortality and population data were obtained from the Brazilian Health Informatics Department. State-by-state mortality rates from homicide were standardized by the direct method, with the world population as the standard, as proposed by the World Health Organization. The Northeast region recorded 317,711 deaths from homicides and the Southeast 544,640 deaths, corresponding, respectively, corresponding to mean standardized rates of 58.68 and 64.68 deaths per 100,000 men. The highest mean standardized mortality rates were observed in the states of Alagoas (157.74 deaths) and Pernambuco (109.58 deaths). All the states showed an increase in mortality up to the third decade of life, with a progressive reduction in the other age brackets. There was an upward trend in all the states of the Northeast and in Minas Gerais and Espírito Santo in the Southeast, while in the other states there was a downward trend. All the states showed an increase in the risk of death in the younger age brackets, except for the state of São Paulo, which showed the inverse profile. The current study's findings may correlate with the process of discontinuity in the cohort, in which members of wide cohorts found less opportunity for access to employment, income, and education, thus increasing the risk of involvement in crime and death from homicide.

O objetivo foi avaliar o efeito da idade, período e coorte de nascimento na evolução temporal da mortalidade por homicídios em homens nos estados das regiões Nordeste e Sudeste do Brasil, entre o período de 1980 a 2014. Estudo ecológico de tendência temporal. Os modelos APC foram estimados usando funções estimáveis na inferência dos parâmetros. Os dados de mortalidade e os dados populacionais foram obtidos junto ao Departamento de Informática do SUS. As taxas de mortalidade por homicídio, segundo estados, foram padronizadas pelo método direto, tendo, como população padrão, a mundial, proposta pela Organização Mundial da Saúde. A Região Nordeste apresentou 317.711 óbitos por homicídios, e o Sudeste, 544.640 óbitos, correspondendo, respectivamente, a uma taxa média padronizada por 100.000 homens de 58,68 óbitos e 64,68 óbitos. As maiores taxas de mortalidade médias padronizadas foram observadas nos estados de Alagoas (157,74 óbitos) e Pernambuco (109,58 óbitos). Em todos os estados, observou-se aumento da mortalidade até a terceira década de vida, com redução progressiva para as demais faixas etárias. Verificou-se tendência ascendente para todos os estados da Região Nordeste, Minas Gerais e Espírito Santo; nos demais estados, houve descendência das taxas. Em todos os estados, observou-se aumento do risco de óbito nas gerações mais jovens, com exceção do Estado de São Paulo que mostrou perfil inverso. Os achados do presente estudo podem correlacionar-se com o processo de descontinuidade de coorte, no qual integrantes de coortes largas encontram menor oportunidade de acesso a emprego, renda e educação, aumentando o risco de envolvimento com a criminalidade e morte por homicídios.

El objetivo fue evaluar el efecto de la edad, período y cohorte de nacimiento, en la evolución temporal de la mortalidad por homicidios en hombres, en los estados de las regiones Nordeste y Sudeste, Brasil, entre el período de 1980 a 2014. Se realizó un estudio ecológico de tendencia temporal. Los modelos APC se estimaron usando funciones estimables en la inferencia de los parámetros. Los datos de mortalidad y los datos poblacionales se obtuvieron mediante el Departamento de Informática del Sistema Único de Salud. Las tasas de mortalidad por homicidio, según los diferentes estados, se estandarizaron mediante método directo, considerando como población patrón la mundial, propuesta por la Organización Mundial de la Salud. La Región Nordeste presentó 317.711 óbitos por homicidios y el Sudeste 544.640 óbitos, correspondiendo a una tasa media estandarizada por 100.000 hombres de 58,68 óbitos y 64,68 óbitos, respectivamente. Las mayores tasas de mortalidad medias estandarizadas se observaron en los estados de Alagoas (157,74 óbitos) y Pernambuco (109,58 óbitos). En todos los estados se observó un aumento de la mortalidad hasta la tercera década de vida, con una reducción progresiva para las demás franjas etarias. Se verificó una tendencia ascendente para todos los estados de la Región Nordeste, Minas Gerais y Espírito Santo, en los demás estados hubo un descenso de las tasas. En todos los estados, se observó un aumento del riesgo de óbito en las generaciones más jóvenes, con excepción del Estado de São Paulo, que mostró un perfil inverso. Los hallazgos del presente estudio pueden correlacionarse con el proceso de discontinuidad de cohorte, en donde integrantes de cohortes más grandes encuentran una menor oportunidad de acceso al empleo, renta y educación, así como un aumento el riesgo de implicación en la criminalidad y muerte por homicidios.

Common mental disorders in hematopoietic stem cell transplant patients: a scoping review / Trastornos mentales comunes en pacientes con trasplante de células madre hematopoyéticas: revisión del alcance / Transtornos mentais comuns em pacientes transplantados com células-tronco hematopoéticas: revisão de escopo

ABSTRACT Objective: to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation. Methods: this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included. Results: the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia. Conclusions: the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients' evolution.

RESUMEN Objetivo: mapear los trastornos mentales recurrentes comunes en pacientes sometidos a trasplante de células madre hematopoyéticas. Métodos: se trata de una revisión de alcance realizada en enero de 2022 en bases de datos electrónicas y repositorios de disertaciones y tesis. Se incluyeron publicaciones que respondieron a la pregunta de investigación, cumplieron con el objetivo del estudio y estaban disponibles en su totalidad en formato electrónico, en cualquier idioma. Resultados: la muestra estuvo compuesta por 28 estudios, 14 de los cuales fueron publicados en los Estados Unidos de América. Los trastornos mentales comunes encontrados fueron depresión, ansiedad, estrés postraumático y trastornos del estado de ánimo. Se mencionaron 20 síntomas, entre los más prevalentes se encuentran fatiga y trastornos del sueño/insomnio. Conclusiones: se destacó la dificultad e importancia de realizar el diagnóstico diferencial de estos trastornos, ya que sus síntomas pueden confundirse con otros problemas de salud y tienen un fuerte potencial de interferir en la evolución del paciente.

RESUMO Objetivo: mapear os transtornos mentais comuns recorrentes em pacientes submetidos ao transplante de células-tronco hematopoéticas. Métodos: trata-se de revisão de escopo realizada em janeiro de 2022 em bases de dados eletrônicas e repositórios de dissertações e tese. Foram incluídas publicações que respondessem à questão de pesquisa, atendessem ao objetivo do estudo e que estivessem disponíveis na íntegra em meio eletrônico, em qualquer idioma. Resultados: a amostra foi composta por 28 estudos, dos quais 14 foram publicados nos Estados Unidos da América. Os transtornos mentais comuns encontrados foram os transtornos depressivos, de ansiedade, estresse pós-traumático e de humor. Foram citados 20 sintomas, entre os mais prevalentes estão a fadiga e distúrbios do sono/insônia. Conclusões: evidenciaram-se a dificuldade e a importância de realizar o diagnóstico diferencial desses transtornos, uma vez que seus sintomas podem ser confundidos com outros problemas de saúde e têm forte potencial para interferir na evolução do paciente.

Depressive symptoms and associated factors among travestis and transsexuals: a cross-sectional study / Síntomas depresivos y factores asociados entre travestis y transexuales: estudio transversal / Sintomas depressivos e fatores associados entre travestis e transexuais: estudo transversal

ABSTRACT Objectives: to estimate the prevalence of depressive levels and their associated factors among transvestite and transsexual individuals. Methods: this cross-sectional study involved 58 participants assisted by non-governmental organizations. The Beck Depression Inventory was utilized to assess levels of depression, complemented by a sociodemographic questionnaire and a questionnaire on experiences of violence. Data were analyzed using descriptive statistics and Poisson regression with robust variance. Results: a prevalence of 27.6% (95% CI = 11.50-39.10) for moderate to severe levels of depression was observed. This prevalence was associated with being unmarried (PR = 1.19; 95% CI = 1.10-1.28) and experiencing violence in healthcare services (PR = 2.30; 95% CI = 1.10-4.81). Conclusions: the absence of a partner and experiences of violence in healthcare settings negatively impacted mental health, leading to an increased prevalence of depressive symptoms among transvestite and transsexual individuals. Advocating for transgender rights and providing ongoing education in health care for professionals are critical strategies in promoting the mental health of this population.

RESUMEN Objetivos: estimar la prevalencia de niveles depresivos y factores asociados entre personas travestis y transexuales. Métodos: estudio transversal con 58 participantes asistidos por organizaciones no gubernamentales. Se utilizó el Inventario de Depresión de Beck para la evaluación de los niveles depresivos y un cuestionario sociodemográfico y de experiencias de violencia. Los datos fueron analizados mediante estadística descriptiva y regresión de Poisson con varianza robusta. Resultados: se observó una prevalencia del 27,6% (IC95%=11,50-39,10) de niveles depresivos moderados a graves, asociada al estado civil soltero (RP=1,19; IC95%=1,10-1,28) y a la violencia en los servicios de salud (RP=2,30; IC95%=1,10-4,81). Conclusiones: vivir sin pareja y experimentar violencias en los servicios de salud perjudicaron la salud mental y aumentaron la prevalencia de síntomas depresivos entre personas travestis y transexuales. La defensa de los derechos de las personas trans y la educación permanente en salud para los profesionales son estrategias esenciales para promover la salud mental de esta población.

RESUMO Objetivos: estimar a prevalência de níveis depressivos e fatores associados entre pessoas travestis e transexuais. Métodos: estudo transversal com 58 participantes assistidos por organizações não governamentais. Utilizou-se o Beck Depression Inventory para avaliação dos níveis depressivos e um questionário sociodemográfico e de experiências de violência. Os dados foram analisados por meio de estatística descritiva e regressão de Poisson com variância robusta. Resultados: observou-se uma prevalência de 27,6% (IC95%=11,50-39,10) de níveis depressivos moderados a graves, associada ao estado civil solteiro (RP=1,19; IC95%=1,10-1,28) e à violência nos serviços de saúde (RP=2,30; IC95%=1,10-4,81). Conclusões: viver sem companheiro(a) e experienciar violências nos serviços de saúde prejudicaram a saúde mental e aumentaram a prevalência de sintomas depressivos entre pessoas travestis e transexuais. A defesa dos direitos de pessoas trans e a educação permanente em saúde para profissionais são estratégias essenciais para promover a saúde mental dessa população.

Experiences of mothers with early weaning: a grounded theory / Experiencias de madres en el destete temprano: teoría fundamentada em los datos / Vivências de mães no desmame precoce: uma teoria fundamentada nos dados

ABSTRACT Objective: To understand the experiences of mothers with early weaning. Method: Qualitative research with a theoretical-methodological contribution from Grounded Theory (Straussian perspective), carried out in the context of primary health care in a medium-sized municipality in the northeast of Brazil. 19 collaborators participated by theoretical sampling. Data collection took place between April and September 2018, with in-depth interviews, and was analyzed in three stages: open and axial coding, and integration. Results: The central category "Women experiencing guilt and overload due to early weaning" was supported by three categories: a) conditions: "Showing the factors that limit breastfeeding"; b) actions/interactions: "Trying to balance motherhood and work during breastfeeding" and "Insufficient social support to keep exclusive breastfeeding"; and c) consequences: "Introducing formula and complementary foods before six months" and "Blaming oneself for the early weaning". Final considerations: The theoretical model can give support to managers and health professionals to advocate for longer maternity leaves and confront gender disparities and inequities, professional performance with conflicts of interest, and abusive marketing regarding the use of formula.

RESUMEN Objetivo: Comprenderlas experiencias de las madres enel destete precoz. Método: Teoría fundamentada em losdatos. La muestra teórica estuvo compuesta por 19 participantes: madres, familiares y profesionales de la salud de una Unidad Básica de Salud de la región Nordeste de Brasil. La recolección de datos ocurrió de abril a septiembre de 2018, con entrevistas enprofundidad, analizadas a través de codificación abierta, axial y de integración. Resultados: Emergió la categoría central "La mujer experimentando culpa y sobrecarga por el destete precoz", sustentada entres categorías: a) condicionantes: "revelando las limitaciones para lalactancia materna"; b) acciones/interacciones: "intentar conciliar la lactancia materna con la práctica profesional" y "recibir apoyo social insuficiente para mantener la lactancia materna exclusiva"; y c) consecuencias: "introducir fórmulas infantiles y alimentación complementaria antes de los seis meses de edad y culpabilizarse por el destete precoz". Consideraciones finales: Las madres experimentaron la falta de una red de apoyo, la insuficiencia del tiempo de licencia por maternidad y el sentimiento de culpa.

RESUMO Objetivo: Compreender vivências de mães no desmame precoce. Método: Estudo qualitativo orientado pelo referencial metodológico da teoria fundamentada nos dados. A amostragem teórica foi composta por 19 participantes: mães, familiares e profissionais da saúde de uma Unidade Básica de Saúde, todos da Região Nordeste, Brasil. A coleta de dados ocorreu de abril a setembro de 2018, com entrevistas individuais em profundidade, analisadas por meio da codificação aberta, axial e de integração. Resultados: Emergiu o fenômeno "A mulher vivenciando a culpa e a sobrecarga pelo desmame precoce", sustentado por cinco categorias inter-relacionadas. Considerações finais: As mães vivenciaram a carência da rede de apoio, a insuficiência do tempo da licença-maternidade e o sentimento de culpa.

Aspectos psicossociais do suicídio em mulheres do sertão do Rio Grande do Norte, Brasil / Psychosocial aspects of suicide in women from the backwoods of Rio Grande do Norte, Brazil

Resumo Introdução O suicídio é um grave problema de saúde pública mundial. No que tange aos estudos de suicídio em mulheres, há ainda que se avançar no conhecimento desse fenômeno, especialmente em municípios distantes das capitais brasileiras. Obejtivo Identificar os aspectos psicossociais do suicídio de mulheres no sertão do Rio Grande do Norte. Método Trata-se de pesquisa qualitativa com o método de autópsia psicossocial. A coleta dos dados ocorreu entre março e junho de 2018 por meio de um roteiro de entrevista semiestruturada. Foram entrevistados familiares de cinco mulheres que morreram por suicídio. O material coletado foi analisado por meio de análise temática de conteúdo. Resultados Emergiram três categorias analíticas: "comportamento suicida feminino", "transtornos mentais e relações com suicídio" e "violência de gênero e conflitos familiares". Ao longo da vida das mulheres que morreram por suicídio, constataram-se enunciação suicida, sinais depressivos, esquizofrenia, violência de gênero e cerceamento do modo de vida feminino. Conclusão No decorrer da vida dessas mulheres, observou-se o desejo de morrer vinculado a fatores emocionais, transtornos mentais, conflitos familiares e violência de gênero.

Abstract Background Suicide is a public health problem worldwide. Regarding the studies of suicide in women, it is still necessary to advance the knowledge of this phenomenon, especially in cities far from Brazilian capitals. Objective This study aimed to identify the psychosocial aspects of suicides of women in the country town of Rio Grande do Norte, Brazil. Method This is qualitative research using the psychosocial autopsy method. Data collection took place between March and June 2018 and a semi-structured interview script was used. Seven relatives of five women who died by suicide were interviewed. The collected material was analyzed through thematic content analysis. Results Three analytical categories emerged: "female suicidal behavior", "mental disorders and relationships with suicide" and "gender violence and family conflicts". Suicidal enunciation was found throughout the life of women who died from suicide, depressive signs, schizophrenia, gender violence, and curbing the female way of life. Conclusion Throughout the life of these women, there was a desire to die linked with emotional factors, mental disorders, family conflicts, and gender violence.