Violência sexual e saúde mental de universitários: uma sistematização da literatura brasileira / Sexual violence and mental health of college students: a systematic review of Brazilian literature / Violencia sexual y salud mental de universitarios: una sistematización de la literatura brasileña

A presença da violência sexual nas universidades tem afetado diferentes esferas da vida de estudantes, inclusive a saúde mental. O artigo teve como objetivo investigar e categorizar os efeitos da violência sexual sobre a saúde mental de alunos/as, bem como identificar possíveis estratégias para lidar com o problema. Foi realizada uma sistematização da literatura brasileira dos últimos dez anos. Identificou-se que grande parte dos textos define a violência como um fenômeno sociocultural, e alguns explicam a violência a partir de definições jurídicas. Além disso, constatou-se que a violência sexual produz efeitos prejudiciais de ordem psicológica, física, acadêmica e inter-pessoal. Sobre as ações de enfrentamento, foi verificado que a maioria das intervenções mencionadas é remediativa. Por já estar instaladas e apresentar efeitos prejudiciais aos estudantes, as estratégias remediativas são necessárias para lidar com os problemas gerados na saúde mental das vítimas. No entanto, como a violência sexual foi considerada majoritariamente um fenômeno de natureza sociocultural, intervenções preventivas também são requeridas para que os determinantes responsáveis pela violência sexual sejam modificados. (AU)

The presence of sexual violence in universities has affected different spheres of students' lives, including their mental health. This paper aims to investigate and categorize the effects of sexual violence on the mental health of students and identify possible strategies for dealing with this problem. A systematic review of Brazilian literature from the past ten years was carried out. It was found that a large part of the texts defines violence as a sociocultural phenomenon, and some explain violence from legal definitions. In addition, it was found that sexual violence produces detrimental effects of a psychological, physical, academic, and interpersonal nature. As for the coping actions, it was found that most of the interventions mentioned are remedial. Because this type of violence is already installed and presents detrimental effects to students, reme-dial strategies are necessary to deal with the problems generated in the mental health of victims. However, as sexual violence was considered predominantly a sociocultural phenomenon, preventive interventions are also required so that the determinants responsible for sexual violence can be modified. (AU)

La presencia de la violencia sexual en las universidades ha afectado a diferentes ámbitos de la vida estudiantil, incluida la salud mental. El artículo tuvo como objetivo investigar y categorizar los efectos de la violencia sexual sobre la salud mental de los/las alumnos/as, así como identificar posibles estrategias para hacer frente al problema. Se realizó una sistematización de la literatura brasi-leña de los últimos diez años. Se identificó que la mayoría de los textos definen la violencia como un fenómeno sociocultural y algunos explican la violencia a partir de definiciones legales. Además, se ha constatado que la violencia sexual produce efectos perjudiciales de orden psicológico, físico, académico e interpersonal. Sobre las acciones de enfrentamiento, la mayoría son interven-ciones de remediación. Debido a los efectos nocivos de la violencia sexual en los estudiantes, son necesarias estrategias de remediación para hacer frente a los diversos problemas que se generan en la salud mental de las víctimas. Sin embargo, como la violencia sexual fue considerada mayoritariamente un fenómeno de carácter sociocultural, también se requieren intervenciones preventivas para que se modifiquen los determinantes responsables de la violencia sexual. (AU)

It's time to start asking all patients about intimate partner violence.

Many people endure a menacing or violent romantic partner--yet few physicians ask about this risk, or actual harm. Here is a roadmap for screening.

Sexual Violence in Adolescents.

Sexual violence and intimate partner violence are common among adolescents, especially for those who are developmentally disabled. Pediatricians have a critical role in treating and preventing sexual violence in adolescents. As medical providers, they possess trusted access to identify sexual violence in adolescents and to intervene to help prevent further violence and mitigate associated health effects. Therefore, it is imperative that pediatricians are aware of the scope of sexual violence in adolescents. Specific sexual violence screening recommendations for sexual assault, intimate partner violence, reproductive coercion, and sex trafficking are reviewed in this article. In addition, recommendations for the comprehensive treatment of adolescents exposed to sexual violence are examined. National and local resources for victims and promising strategies to prevent sexual violence, including sex trafficking, are identified. Through collaboration with community partners in multidisciplinary efforts, pediatricians can most effectively promote the health of adolescents and prevent further victimization. [Pediatr Ann. 2019;48(2):e58-e63.].

Proyecto de promoción de Salud "Mi Tesoro": El abuso sexual infantil o infanto-juvenil (ASI) / Health Promotion Project "My Treasure": Child sexual or child-juvenile abuse (ASI)

Introducción: El abuso sexual infantil o infanto-juvenil (ASI) es una forma de violencia a la infancia. Es toda acción que involucre a una niña o niño en una actividad de naturaleza sexual o erotizada, que no puede comprender totalmente ni está preparada para realizar o no puede consentir libremente. Es el 21% de las causales de ingreso a Programas de Protección de Derechos. Objetivo general: Promover el autocuidado de la integridad sexual en niños y niñas de 5 años del Colegio San Rafael de la comuna Lo Barnechea a través de la simbolización mediante obra de títeres. Metodología: Grupo de trabajo entre internos y equipo psicosocial de CESFAM: Planteamiento de la realidad del sector y comparación con la realidad nacional. Se diseña función de títeres basada en la simbología, articipación público, mediante diálogos pregunta-respuesta y el aprendizaje experiencial. Conclusión: Durante las actividades se verificó mediante la interacción títere-niños/as que los menores rápidamente incorporan el conocimiento sobre sí mismo y sus cuerpos. El análisis de resultados no nos permite cuantificar el impacto o aprendizaje posterior a la realización de la obra.

Child sexual abuse or child-juvenile abuse (ASI) is a form of violence against children. This is any action that involves a girl or boy in an activity of a sexual or erotic nature, who cannot fully understand or is prepared to perform or cannot consent freely. It is 21% of the grounds for admission to Rights Protection Programs. Course objective: Promote the self-care of sexual integrity in 5-year-old boys and girls of the San Rafael School in the commune of Lo Barnechea through symbolization through puppet work. Methodology: Working group between inmates and psychosocial team of CESFAM: Approach of the reality of the sector and comparison with the national reality. The puppet show is designed based on symbology, public participation, through question-answer dialogues and experiential learning. Conclusion: During the activities it was verified through puppet-children interaction that the children quickly incorporate knowledge about themselves and their bodies. The analysis of results does not allow us to quantify the impact or learning after the completion of the work.

Violence against the elderly: the conceptions of nursing professionals regarding detection and prevention. / Violência contra idosos: concepções dos profissionais de enfermagem acerca da detecção e prevenção.

OBJECTIVE: To analyze the conceptions of the nursing professionals working in Basic Health Units regarding the detection and prevention of violence against the elderly. METHODS: Descriptive, exploratory, qualitative study. Performed in two BHUs in Mossoró/RN, using a semi-structured interview script, from March to August of 2013. Sample composed of four nurses and six nursing technicians. The content analysis, pre-analysis, material exploration, and treatment of results were performed. RESULTS: Four categories were identified: Strategies used to identify violence against the elderly; Types of violence against the elderly; Conduct used after finding a suspicion of violence; SUS and the problem of violence against the elderly. Many professionals recognize/distrust possible cases, however, they do not know how to proceed. The dimension of the problem requires that pragmatic interventions be performed in the clinical setting and in the social context. FINAL CONSIDERATIONS: There is a need for continuing education for professionals and greater communication between the bodies responsible for reporting and embracement.

Treatment of Paraphilic Disorders in Sexual Offenders or Men With a Risk of Sexual Offending With Luteinizing Hormone-Releasing Hormone Agonists: An Updated Systematic Review.

BACKGROUND: Different pharmacologic agents are used in the treatment of paraphilic disorders in sexual offenders or men with a risk of sexual offending, with luteinizing hormone-releasing hormone (LHRH) agonists being the agents introduced more recently to treatment regimens. AIM: To summarize the relevant literature concerning LHRH agonist treatment of paraphilic disorders in sexual offenders and update the previously published systematic review by Briken et al (J Clin Psychiatry 2003;64:890-897). METHODS: The PubMed and Google Scholar databases were searched for literature published from January 2003 through October 2017 using the following key words: LHRH agonists, GnRH agonists, antiandrogens AND paraphilia, pedophilia, sex offenders. OUTCOMES: Evaluation of the effectiveness and side effects of LHRH agonist treatment of paraphilic disorders in sexual offenders. RESULTS: After screening for duplicates and applying specific selection criteria, the search yielded 24 eligible studies reporting on a sample of 256 patients. There is increasing evidence that LHRH agonists are more effective than steroidal antiandrogens in lowering paraphilic sexual thoughts and behaviors. Current research also is based on methods that might be less susceptible to faking (eg, eye-tracking, brain imaging, and viewing-time measures). Side effects occurring most frequently are fatigue, hot flashes, depressive mood, weight gain, high blood pressure, diabetes, gynecomastia, loss of erectile function, and loss of bone mineral density. CLINICAL IMPLICATIONS: Although LHRH agonists seem to be the most effective drugs in the treatment of paraphilic fantasies and behaviors, they should be reserved for patients with a paraphilic disorder and the highest risk of sexual offending because of their extensive side effects. STRENGTHS AND LIMITATIONS: This systematic review considers all types of research on LHRH agonist treatment in patients with paraphilic disorders, thereby providing a complete overview of the current state of research. However, most studies are case reports or observational studies and randomized controlled clinical trials have not been conducted or published. CONCLUSIONS: LHRH agonists are a useful treatment when combined with psychotherapy in patients with a paraphilic disorder and the highest risk of sexual offending. However, throughout treatment, close monitoring of side effects is needed and ethical concerns must always be kept in mind. Turner D, Briken P. Treatment of Paraphilic Disorders in Sexual Offenders or Men With a Risk of Sexual Offending With Luteinizing Hormone-Releasing Hormone Agonists: An Updated Systematic Review. J Sex Med 2018;15:77-93.

Rape Messaging.

When feminists began advocating for rape reform in the 1970s, the rape message was clear: rape was not a crime to be taken seriously because women lie. After decades of criminal law reform, the legal requirement that a woman vigorously resist a man's sexual advances to prove that she was raped has largely disappeared from the statute books, and, in theory, rape shield laws make a woman's prior sexual history irrelevant. Yet, despite what the law dictates, rape law reforms have not had a "trickle-down" effect, where changes in law lead to changes in attitude. Women are still believed to be vindictive shrews so police continue to code rape allegations as "unfounded," and prosecutors continue to elect not to prosecute many rape cases. To many, "no" can sometimes still mean "yes." In short, criminal law reforms have only marginally succeeded at deterring rape and increasing conviction rates for rape. At the same time, criminal law reforms have entrenched gender norms and endorsed the message that acquaintance rapes are less worthy of harsh punishment. This Article argues against further ex post criminal law reforms and posits that efforts should shift to ex ante public health interventions. This Article draws from recent successful experiences with public health interventions in destigmatizing AIDS and denormalizing tobacco and advocates for a robust public health campaign to denormalize rape. It presents a detailed proposal for changing rape messaging, denormalizing rape, and ensuring better outcomes for victims.

Valoración teórica de una estrategia para la preparación metodológica sobre el contenido de la prevención del abuso sexual en la adolescencia / Theoretical evaluation of a strategy for the methodological preparation on the content of prevention of sexual abuse in adolescence

Se elaboró una estrategia para la preparación metodológica sobre el contenido de la prevención del abuso sexual en la adolescencia en el colectivo docente de la disciplina Psicología Médica de la Facultad de Ciencias Médicas de Guantánamo, con el objetivo de optimizar la preparación metodológica en este colectivo docente para los fines antes descritos. En correspondencia, se utilizaron métodos y técnicas tales como: entrevista en profundidad, entrevista grupal, criterio de expertos y triangulación metodológica. Para la valoración teórica de esta estrategia se utilizó, fundamentalmente, el método criterio de expertos y como técnica psicológica la entrevista grupal. Los principales resultados obtenidos fueron contrastados a partir de una triangulación metodológica. Se arribó como conclusión más general a: la estrategia responde y se contextualiza a las potencialidades e insuficiencias identificadas en el colectivo de la disciplina Psicología Médica para ofrecer tratamiento al contenido de la prevención del abuso sexual en la adolescencia(AU)

A strategy was developed for the methodological preparation on the content of the prevention of sexual abuse in adolescence in the teaching group of the discipline "Medical Psychology", Faculty of Medical Sciences of Guantanamo, with the general objective of optimizing the methodological preparation in this group of teacher for the purposes described above. In correspondence, methods and techniques such as: in-depth interview, group interview, expert judgment and methodological triangulation were used. For the theoretical evaluation of this strategy was used fundamentally, the criterion method of experts and as a psychological technique in the group that was interviewed. The main results were obtained and contrasted with a methodological triangulation. It came as a more general conclusion to: the strategy responds and contextualizes the potentialities and inadequacies identified in the collective of the discipline Medical Psychology to offer treatment to the content of prevention of sexual abuse in adolescence(AU)

Violência contra idosos: concepções dos profissionais de enfermagem acerca da detecção e prevenção / Violencia contra ancianos: conceptos de profesionales de enfermería sobre la detección y prevención / Violence against the elderly: the conceptions of nursing professionals regarding detection and prevention

Resumo OBJETIVO Analisar as concepções dos profissionais de enfermagem atuantes em Unidades Básicas de Saúde quanto à detecção e prevenção de idosos violentados. MÉTODOS Estudo descritivo, exploratório, qualitativo. Realizado em duas UBS, Mossoró/RN, utilizando roteiro de entrevista semiestruturada, em março a agosto de 2013. Amostra composta por quatro enfermeiros e seis técnicos de enfermagem. Realizada análise de conteúdo. RESULTADOS Identificaram-se 4 categorias: Estratégias utilizadas para identificar a violência contra o idoso; Tipos de violências contra o idoso; Conduta utilizada após constatação de uma suspeita de violência; SUS e a problemática da violência contra o idoso. Muitos profissionais reconhecem/desconfiam dos possíveis casos, entretanto, não sabem como proceder. A dimensão do problema exige que sejam realizadas intervenções pragmáticas no meio clínico e no contexto social. CONCLUSÕES Há necessidade de educação permanente para profissionais e maior comunicação entre as instâncias responsáveis pela denúncia e acolhimento.

Resumen OBJETIVO Analizar los conceptos de enfermeros activos en unidades básicas de la salud sobre la detección y prevención del maltrato hacia personas ancianas. MÉTODOS Estudio exploratorio, descriptivo y cualitativo, realizado en dos UBS, en Mossoro/RN, por medio de entrevistas semiestructuradas entre marzo y agosto de 2013. Se realizó el estudio con cuatro enfermeros y seis técnicos de enfermería. Se llevó a cabo el análisis de contenido. RESULTADOS El análisis se divide en 4 categorías: Estrategias utilizadas para identificar la violencia contra ancianos; Tipos de violencia contra personas mayores; Acción utilizada luego de detectarse la violencia; y SUS y el tema de la violencia contra ancianos. Muchos profesionales reconocen/desconfían de los posibles casos, sin embargo, no saben cómo proceder. La magnitud del problema requiere de intervenciones pragmáticas que se lleven a cabo en el ámbito clínico y en el contexto social. CONSIDERACIONES FINALES Existe la necesidad de una educación continua para profesionales y una mayor comunicación entre los organismos responsables de la queja y acogida.

Abstract OBJECTIVE To analyze the conceptions of the nursing professionals working in Basic Health Units regarding the detection and prevention of violence against the elderly. METHODS Descriptive, exploratory, qualitative study. Performed in two BHUs in Mossoró/RN, using a semi-structured interview script, from March to August of 2013. Sample composed of four nurses and six nursing technicians. The content analysis, pre-analysis, material exploration, and treatment of results were performed. RESULTS Four categories were identified: Strategies used to identify violence against the elderly; Types of violence against the elderly; Conduct used after finding a suspicion of violence; SUS and the problem of violence against the elderly. Many professionals recognize/distrust possible cases, however, they do not know how to proceed. The dimension of the problem requires that pragmatic interventions be performed in the clinical setting and in the social context. FINAL CONSIDERATIONS There is a need for continuing education for professionals and greater communication between the bodies responsible for reporting and embracement.

Modelo comunitario para la promoción, prevención, asistencia y protección ante situaciones de abuso sexual contra niñas, niños y adolescentes / Community model for promoting, preventing, assisting and protecting children and adolescents from sexual abuse / Modelo comunitário para promoção, prevenção, assistência e proteção ante situações de abuso sexual de crianças e adolescentes

Resumen Presentamos aquí un modelo teórico para la construcción de respuestas comunitarias a problemas de salud integral adolescente. El mismo condensa el trabajo realizado por nuestro equipo a lo largo de los últimos 15 años, tanto en el ámbito de la investigación como en la asistencia técnica a programas de intervención en Argentina.El modelo está organizado en 3 ejes conceptuales de los cuales se desprenden 10 principios y 6 pasos, los cuales recuperan los debates de la promoción de la salud, la salud colectiva y la pedagogía crítica. Si bien el mismo puede ser utilizado para trabajar distintas problemáticas de salud integral adolescente, se muestra en este artículo aplicado a un tema concreto y de relevancia internacional: el abuso sexual contra niños, niñas y adolescentes. Esta modelización supone una dialéctica que, por un lado, da lugar para que lo singular y contingente de cada experiencia pueda aparecer. No obstante, reconoce que muchos problemas se repiten en distintas comunidades, ya sea cercanas o geográficamente alejadas, y que la experiencia en el abordaje de los mismos puede aportar a construir nueva acción informada en la práctica. Proponemos aquí un trabajo basado en la inclusión de las diferencias, donde se interroguen los mitos, las creencias, los prejuicios y los estereotipos que sostienen las múltiples discriminaciones que pueden sufrir las personas.

Abstract We present here a theoretical model for the construction of community responses to comprehensive adolescent health problems. It summarizes the work done by our team over the last 15 years, both in the field of research and in technical assistance to intervention programs in Argentina. The model is organized into 3 conceptual axes from which 10 principles and 6 steps emerge; it retrieves the debates of health promotion, collective health and critical pedagogy. Although it can be used to work on different problems of adolescent health, in this article it is applied to a specific topic of international relevance: sexual abuse against children and adolescents. This modeling implies a dialectic that, on the one hand, gives place so that the singular and contingent of each experience can appear. However, it recognizes that many problems are repeated in different communities, either close or geographically distant, and that the experience in dealing with them can contribute to build new action informed in practice. We propose here a work based on the inclusion of differences, where the myths, beliefs, prejudices and stereotypes that support the multiple discriminations that people can suffer are questioned.

Resumo Apresentamos um modelo teórico para a construção de respostas comunitárias a problemas de saúde integral do adolescente. O mesmo condensa o trabalho realizado por nossa equipe ao longo dos últimos 15 anos, tanto na área da pesquisa quanto na assistência técnica a programas de intervenção comunitária na Argentina. O modelo está organizado em três eixos conceptuais dos quais se desprendem dez princípios e seis passos, que recuperam os debates sobre a promoção da saúde, saúde coletiva e pedagogia crítica. Embora este possa ser utilizado para o trabalho com distintas problemáticas de saúde integral adolescente, é mostrado neste artigo aplicado a um tópico específico de relevância internacional: o abuso sexual contra crianças e adolescentes. O modelo supõe uma dialética que, por um lado, permite que o singular e contingente de cada experiência apareçam. Não obstante, reconhece que muitos problemas se repitam em comunidades distintas, sejam perto ou geograficamente longe, e que a experiência na abordagem dos mesmos pode construir uma nova ação informada na prática. Proporemos aqui um trabalho baseado na inclusão das diferenças, em que se interroguem os mitos, crenças, preconceitos e estereótipos que sustentam as múltiplas discriminações que as pessoas podem sofrer.

Violencia sexual: conocimientos y actitudes en adolescentes / Sexual Violence: Knowledges and attitudes in adolescents

Objetivo: Determinar los conocimientos y actitudes sobre violencia sexual que poseen los adolescentes de Centros Educativos Públicos en el departamento de Chimaltenango en febrero y marzo 2017. Material y métodos: Estudio descriptivo transversal realizado en una muestra aleatoria de 386 sujetos, mediante un cuestionario auto aplicable posterior a consentimiento y asentimiento informado. Resultados: De los sujetos de estudio, 214 (55%) correspondían al sexo femenino, en promedio tenían 12.6 años de edad, 184 (48%) profesaban religión evangélica, 349 (90%) provenían de familias integradas, 292 (76%) pertenecían a la etnia Kaqchiquel. Conocimientos: 132 (34%) refirieron que la violencia sexual se define únicamente como el contacto físico de las partes íntima de otra persona, 116 (30%) identificaron al machismo y el consumo de drogas como factores de riesgo para violencia sexual, 83 (22%) consideraron adecuado el embarazo en menores de edad, 191 (50%) indicaron que en la mayoría de los casos los agresores son personas desconocidas de la víctima; 145 (38%) y 49 (13%) identificaron la calle y el hogar, respectivamente, como los principales lugares en los que se da este fenómeno. Actitudes: 304 (79%) no denunciarían si un compañero/a estuviera sufriendo violencia sexual, 218 (56%) están en desacuerdo con que los padres hablen sobre sexualidad con sus hijos, 202 (52%) no consideran importante que se imparta educación sexual en los centros educativos. Conclusiones: dos terceras partes desconocen conceptos básicos sobre el tema. Se evidencia una marcada indiferencia ante la necesidad de aprender del mismo y apoyar la denuncia de casos de compañeros que sufran algún tipo de violencia sexual.

Objective: To identify the knowledge and attitudes regarding sexual violence of adolescents in public schools of Chimaltenango, between February and March of 2017. Material and Methods: A descriptive cross sectional study conducted in a random sample of 386 subjects, based in a self-applicable questionnaire after student assent and parental consent (from parents or legal guardians). Results: 214 of 386 were female; with an average age of 12.6 years; 184 (48%) profess evangelical religion; 349 (90%) belonged to an integrated household; 292 (76%) belonged to the Kaqchiquel ethnic group. Knowledge: 132 (34%) reported that sexual violence is defined only as physical contact in intimate parts; 116 (30%) identified male chauvinist and drug abuse as risk factors for sexual violence; 83 (22%) considered pregnancy in underage teenagers as adequate; 191 (50%) indicated that in most cases the aggressors are unknown by the victims; students identify the street with 145 (38%) and the house with 49 (13%) as the main places where sexual violence occurs. Attitudes: 304 (79%) of the students would not report if a schoolmate is suffering from sexual violence, 218 (56%) disagree that parents should talk about sexuality with their children, 202 (52%) don't consider important to provide sex education in schools. Conclusions: Two thirds of the students are not aware of basic concepts regarding sexual violence, there is a considerable indifference to the need of learning of this topic and do not support the reporting of cases of classmates who suffer any type of sexual violence.

Sexual violence screening practices of student health centers located on universities in Florida.

OBJECTIVE: The purpose of this study is to describe current sexual violence screening practices of student health centers located on universities in Florida. PARTICIPANTS: Institutional level data was collected from 33 student health centers from November 2015 through January 2016. The student health centers were located on public or private universities. METHODS: A cross-sectional descriptive study design was used. Data was collected from student health center representatives through use of a telephone administered survey. RESULTS: Findings reveal that the majority of student health centers screen for sexual violence. However, not all use effective screening strategies. Further, the majority of screening questions used are not specific to sexual violence. CONCLUSIONS: Findings can be used to assist universities with responding to campus sexual violence among the college population. Recommendations for strengthening sexual violence screening practices and future research are provided.

Gonadotrophin-releasing hormone agonist treatment for sexual offenders: A systematic review.

BACKGROUND: Sexual offending is a significant international issue causing long-term consequences for victims, perpetrators and society. AIMS: The purpose of this study was to review the existing research data assessing the efficacy of gonadotrophin-releasing hormone agonists for treating adult, male, sexual offenders. METHOD: The method of this review involved the examination of studies involving participants prescribed at least one month of a gonadotrophin-releasing hormone agonist for the purposes of reducing sexual drive related to offending. The primary outcome measures were recidivism rates and sexual functioning. Secondary outcome measures included assessment of side effects and effects on interpersonal/psychiatric functioning. Studies in the English language that were dated 1969-2015 were included. RESULTS: Twelve eligible studies (323 participants) were identified. A reduction in a variety of measures of sexual functioning and/or risk was found in all studies. Robust recidivism data was limited. Medication was rarely described as ineffectual. All studies reported side effects. Reduction in bone density and potential long-term reduction in fertility in some subjects were issues of concern. CONCLUSION: Whilst identified studies showed promising results with respect to sexual functioning, challenges in performing randomised control trials in this subject group meant that included studies were methodologically limited. This review recommends that future research must be performed before the effectiveness and tolerability of gonadotrophin-releasing hormone agonists in this population can be confirmed.

Violências sexuais na perspectiva do campo da saúde / sexual violence on the perspective of the health field

Neste capítulo analisaremos a produção científica brasileira sobre violência sexual realizada pela área da saúde no período de 2001-2013.Esses documentos se concentram um três grandes temas ou interesses: o de conhecer os envolvidos nas situações de Violência sexual em seus diferentes contextos, levando em conta a produção de perfis epidemiológicos ou psicossociológicos dos autores; o de conhecer os fatores associados, seja como capazes de favorecer a ocorrência das violências sexuais, seja os decorrentes delas; e o de discutir a atuação do setor saúde diante do atendimento, da formação e atitudes de profissionais, da organização dos serviços, registro e do desafio da construção de capacidades coletivas para atuar em rede, de forma intersetorial e em parceria com os movimentos sociais. Entretanto, alguns temas e sujeitos permanecem na penumbra da produção do campo da saúde sobre Violência sexual, assunto que também discutiremos. (AU)

Review of gynecologic and reproductive care for women with developmental disabilities.

PURPOSE OF REVIEW: Care for women with developmental disabilities requires special consideration for unique needs related to their cognitive and physical abilities. These women and their caregivers require more support and guidance during reproductive health care. We review the literature and provide expert opinion surrounding gynecological issues for women with developmental disabilities to support healthcare providers better understand and care for this population. RECENT FINDINGS: Women with developmental disabilities are more vulnerable to abuse and experience poorer gynecological healthcare outcomes. Many women with developmental disabilities are fertile and participate in sexual activity without adequate knowledge. They are at higher risk of pregnancy and birth complications. They are less likely to receive appropriate preventive screening. SUMMARY: The review highlights important issues and practice suggestions related to the reproductive health care of women with developmental disabilities. Topics include clinic visits, menstruation, sexuality, sexual abuse, sexual health education, contraception, sexually transmitted infections, pregnancy, labor and delivery, and cancer screening/prevention. We emphasize the need for an individualized, comprehensive approach for these patients and review perceived and actual barriers to care. More education is needed on the aforementioned topics for women with developmental disabilities, their caregivers, and their providers.