Temporal and spatial convergence: the major depressive disorder burden attributed to intimate partner violence against women.

Background: There is a strong causal relationship between intimate partner violence and major depressive disorder, which partly endangers women's safety across the life course and potentially affects the development of future generations. The international community has placed a high priority on addressing the intimate partner violence and the resulting burden of mental illness. Data collection needs to be captured across the temporal trend and spatial distribution for major depressive disorder attributed to intimate partner violence, to reflect the priorities and expectations of survivors.Method: This research obtained raw disability-adjusted life years (DALYs) information for major depressive disorder attributed to intimate partner violence from the Global Burden of Disease 2019. Using estimated annual percentage change and two-way fixed effects models, a secondary spatio-temporal analysis of the age-standardized DALYs rate from 1990 to 2019 was performed.Results: In 2019, DALYs lost among women experiencing major depressive disorder (3.16 million) accounted for 37.18% of the DALYs lost worldwide due to intimate partner violence. The age-standardized DALYs rate of major depressive disorder attributed to intimate partner violence was 108.57 per 100,000. The highest was concentrated in the menopausal transition (45-55), with 133.61 per 100,000, and particularly distributed in Uganda (429.31 per 100,000). The early reproductive period (15-19) showed the increasing age-standardized DALYs rate from 1990 to 2019, which was mainly driven by Malaysia (3.73% per year). Furthermore, countries with higher initial levels of the age-standardized DALYs rate were growing faster than those with lower levels.Conclusions: The burden of major depressive disorder attributed to intimate partner violence showed biological and spatial inequality, prioritized intervention should be targeted at vulnerable stage women in their early reproductive period and menopausal transition. Combined political, socio-cultural as well as medical measures to prevent violence and treat major depressive disorder should be implemented and developed.

Vulnerability to different biological stages of the burden of experiencing intimate partner violence leading to major depressive disorder in women. Women in their reproductive years and during the menopausal transition were more vulnerable.Intimate partner violence-induced depressive disorder is trending younger, with an increasing burden on girls aged 15­19 over the past 30 years.The burden of major depressive disorder attributed to intimate partner violence varies increasingly across countries.

Adult refugees' perspectives on the impact of trauma and post-migration hardships on learning.

Background: Research shows that adult refugees' well-being and future in the reception country heavily depend on successfully learning the host language. However, we know little about how adult learners from refugee backgrounds experience the impact of trauma and adversity on their learning.Objective: The current study aims to investigate the perspectives of adult refugee learners on whether and how trauma and other adversity affect their learning.Methods: We conducted in-depth interviews with 22 adult refugees (10 women) attending the Norwegian Introduction Programme (NIP). The participants came from six Middle Eastern, Central Asian, and African countries. Two questionnaires were included, one about past stressful life events (SLESQ-Revised), and one about mental health symptoms and current psychological distress following potentially traumatic experiences (PCL-5).Results: Participants held varying beliefs about trauma's impact on learning: that it had a constant impact, that it was situational, or that it had no impact. Other aspects they brought up as having an essential effect on learning and school attendance include psychological burdens from past and present school experiences, and post-migration hardships such as loneliness, depression, ongoing violence, and negative social control. Post-migration trauma and hardships exacerbated the burden of previous trauma and were frequently associated with a greater negative influence on learning.Conclusion: This study adds new insights from adult refugee learners themselves into how post-migration hardships as well as trauma can impact their learning, and the importance of recognising their struggles. A safe space is required for refugees to open up about their difficulties in life and with learning. This knowledge can be used to enhance teaching practices, foster better teacher-student relationships, and inform policy-making decisions, ultimately benefiting both individuals and society.

Adult refugee learners' own perspectives on the impact of trauma on learning varied from constant to situational to no impact at all.Other factors identified as impacting learning and school attendance included, amongst others, psychological burdens from past and present school experiences, ongoing violence, forced family separation, and negative social control.Post-migration trauma and hardships were frequently associated with a greater negative influence on learning than the burden of previous trauma.

Torture and its sequelae among prostituted women in the United States.

Background: Extreme violence and psychological abuse have been extensively documented and are pervasive in prostitution. Survivors of prostitution report high levels of posttraumatic stress disorder, dissociation, depression, and self-loathing. These are the same sequelae reported by torture survivors.Objective: Severe forms of violence have been categorized as torture by experts. The authors note that torture is commonly suffered during prostitution and should be appropriately named.Method: Using standardized measures and including a new measure of torture, we interviewed 45 women in the United States about their torture experiences in prostitution and their symptoms of PTSD, dissociation, childhood trauma, health status and somatic symptoms. The interviewees had exited prostitution and were in supportive programmes.Results: Formerly prostituted interviewees reported acts of physical, sexual, and psychological torture, including strangulation, rape, beatings, restriction of movement, denial of privacy, sleep, or food, and being forced to witness the torture of others. The 45 women had high levels of PTSD and dissociation. They endorsed needs for individual counselling, substance abuse treatment, and other medical care.Conclusions: A recognition of the physical, sexual, and psychological torture experienced in prostitution would strengthen psychological and medical interventions for survivors. Naming specific acts of prostitution as torture will reduce the survivor's shame and self-blame. Holistic treatment includes medical and psychological interventions and peer support, as seen in torture rehabilitation programmes for survivors of state-sponsored torture. This research supports the perspective that private or non-state-sponsored torture against women and marginalized populations should be clinically and legally understood in the same way as state-sponsored torture.

Using international legal definitions of torture, we assessed the prevalence of acts of torture perpetrated against formerly prostituted women in the United States.We found an extremely high prevalence of acts of torture perpetrated against prostituted women, as well as symptoms of traumatic stress common to other torture survivors.Two-thirds of the prostituted women in this study were beaten by sex buyers.Torture has been well documented when it committed by a state government's military or prison system, but it has not been well documented when perpetrated as a private, non-state act, for example, incest, battering, rape, and prostitution.Prostitution's harm is increased when it is perpetrated against economically and ethnically marginalized women.

Wellbeing and illbeing in women exposed to physical and sexual violence during peripregnancy: a population-based longitudinal study.

Background: Physical and sexual violence against pregnant women have been associated with detrimental mental health outcomes for victims. Few studies have examined both positive (wellbeing) and negative (illbeing) mental health indicators in the same sample. Additionally, the literature assessing mental health based on different forms of violence is limited.Objective: To compare both wellbeing (life satisfaction) and illbeing (anxiety and depression) trajectories between non-victimized and victims of physical, sexual and both forms of violence that occurred during or shortly before pregnancy. Further, we analyse whether social support moderates these trajectories.Method: This longitudinal study is based on the Norwegian Mother, Father and Child Cohort, including the period from early pregnancy to toddlerhood (3 years). We compared wellbeing and illbeing trajectories of non-victims (n = 73,081), victims of physical abuse (n = 1076), sexual abuse (n = 683), and both forms of abuse (n = 107) using Growth Curve Modelling. Finally, social support was included as a moderator of wellbeing and illbeing trajectories.Results: Results indicated that victims scored systematically lower in wellbeing and higher in illbeing. Exposure to violence did not significantly change the wellbeing trajectory, pointing to similar developments in wellbeing among victims and non-victims for the considered period. On the other hand, different trajectories in illbeing occurred between victims and non-victims, as well as between victimized groups. Victims experienced greater change in illbeing scores, with a steeper decrease in illbeing compared to non-victims. Both victims and non-victims returned to respective baseline scores 3 years after birth. All women benefited from social support, but victims of physical abuse were particularly protected by social support.Conclusions: There is an alarming persistence of mental health problems in women exposed to violence during peripregnancy. Different forms of violence differentially impact women's mental health. Social support is beneficial among all pregnant women.

Victims of peripregnancy violence score systematic lower in wellbeing over time than non-victims. However, the wellbeing trajectories among victims and non-victims are similar.On the other hand, illbeing (anxiety and depression) trajectories differ for non-victims and victims of physical, sexual and both forms of violence. All women decreased their levels of illbeing from pregnancy to the first 6 months postpartum, but victims had a steeper decrease during this period compared to non-victims.All women benefited from social support, but victims of physical abuse were particularly protected by social support.

[Violence against healthcare workers in Spain: Invisible violence, unacceptable silences]. / Agresiones hacia el personal sanitario en España: violencias invisibilizadas, silencios inaceptables.

The aggressions suffered by healthcare personnel (HCP) is a growing problem in the field of public health in Spain that negatively affects the quality of care. The objective is to analyze the causes of the aggressions towards the HCP and what implications they have for the healthcare service and its personnel. The methodology is based on a systematic review in PubMed, Scopus, Web of Science and Medes. The triggers of the aggressions are multifactorial and can lead to post-traumatic stress disorder in the HCP. The most affected services are primary care, emergency care, emergencies, and psychiatry. Women are the most assaulted, while men are responsible for most of the assaults. Although professional associations, autonomous communities and the Ministry of Health and Social Services are making efforts to prevent the problem, it continues to be invisible due to the under-reporting of complaints, the lack of academic research and society in general.

[Job satisfaction and violence in the clinical relationship in Physical Therapists in Spain]. / Satisfacción laboral y violencia en la relación clínica en Fisioterapia en España.

OBJECTIVE: To assess the job satisfaction (JS) of physiotherapists in Spain and their relationship with occupational violence, as with other socio-demographic, health, and occupational factors. DESIGN: A cross-sectional study was conducted. Setting Primary, community, and hospital attention level at public and private care in Spain. PARTICIPANTS: Physiotherapists in Spain who have been working for at least 3months during the last year, and with complete answer to the required variables (n=2,590). MAIN MEASUREMENTS: Information was collected through a questionnaire distributed online. A descriptive quantitative analysis and 3 logistic regression models were performed. In the first model, sociodemographic and violence variables were included as independent variables, in the second, health-related variables, and in the third, occupational variables. RESULTS: The average JS of physiotherapists is 7.26 points, being 8 or more in 46.8% of the cases, with a higher percentage in men". Referring not having suffered psychological violence was related to a higher probability of having JS, even controlling for the rest of the variables studied (OR1=0.485; OR2=0.611; OR3=0.697, respectively for each model). Variables related to health (state of health, symptoms, consumption of tobacco/alcohol/other substances) and to the work environment (working day, work area, autonomy, relationship with superiors/colleagues) were statistically significantly related to JS. CONCLUSIONS: Almost 47% of the respondents had very high JS values. Certain areas of work as well as positive health factors have been linked to very high JS. Psychological violence is the form of violence that, independently of the other factors analysed, leads to lower JS.

Perinatal intimate partner violence among teen mothers and children's attachment disorders in Rwanda: potential mediating factors.

Background: The alarming prevalence of teen mothers' exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children's ADs.Method: This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1).Results: IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children's ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs.Conclusion: These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children's attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.

Parenting stress was identified as a significant mediator, fully mediating the relationship between perinatal IPV and children's attachment disorders.Postpartum depression, perceived social support, and maternal sensitivity partially mediated the link between perinatal IPV and children's attachment disorders.The study underscores the necessity for multifaceted support programmes for adolescent mothers to address IPV, alleviate parenting stress, and enhance maternal mental health and social support, promoting better attachment outcomes for their children.

How do young men narrate the redemption story of a sexual assault perpetrator?

Background: Little is known about how young men who have committed sexual assault might acknowledge wrongdoing and eventually change and make amends. There are practical barriers to seeking the real redemption stories of perpetrators.Objective: To explore hypothetical pathways to young men's accountability-taking and amends (i.e. redemption) after perpetration of sexual assault.Method: In a pre-registered, qualitative story completion study, we presented heterosexual, cisgender college men (N = 54) with a date-based sexual assault story written by a fictional male perpetrator. Participants were prompted to complete the story so that the protagonist, who initially denies wrongdoing, eventually changes and becomes a violence prevention advocate.Results: A thematic analysis of the redemption stories revealed that this study's speculative task was a challenging one. Half of the stories did not provide an explanation for how the perpetrator was able to acknowledge wrongdoing. Overall, individualistic themes (e.g. he introspected) were more common than relational, community, or societal facilitators of redemption.Conclusions: Without infrastructure for accountability-taking and repair, or narrative exemplars to draw from in public life, it is difficult to envision redemption from violence. Rare gender-based, structurally attuned analyses of sexual violence in the stories point the way towards a more transformative vision of redemption.

In this qualitative story completion study, college men wrote the redemption story of a fictional sexual assault perpetrator.Men had difficulty explaining how the perpetrator would acknowledge wrongdoing.Redemption themes tended to be individualistic versus rooted in community.

Defining military sexual trauma: establishing parameters and perspectives.

Background: The term military sexual trauma [MST] is increasingly used to describe instances of sexual harassment/assault that occur between serving personnel during military service. However, in the absence of a clear universal definition, MST is an increasingly contested term, with confusion about its scope, application to differing jurisdictions and implications for responses and treatment.Objective: This editorial provides a universal definition of MST, decoupled from any national system or framework.Method: Drawing on existing international evidence about the nature and impact of MST.Results and Conclusion: We argue that MST terminology provides a unique framing which recognises the institutional nature of MST victimisation and situates the context, behaviours, and impact on a continuum of violence.

MST terminology provides understanding and acknowledgement of the nuances of sexual harassment/assault in the military institution.MST terminology should encompass a continuum of sexual violence.Drawing on existing military health research, the authors contend that MST should be considered as a distinctive traumatic stressor.

Is there consensus on child violence exposure measures? A study of six recommended instruments.

Background: International research has established that children and adolescents are at high risk for being exposed to violence. A systematic review published in 2023 recommended six child and adolescent self-report violence against children (VAC) measures, based on their psychometric properties, in a systematic COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) review. However, the degree of overlap and heterogeneity was not part of the analysis.Objective: To compare the six measures with respect to item overlap and differences concerning specification of exposure dimensions.Method: A content analysis of the original 174 items resulted in a reduction to 38 unique items. These items were organized visually in a co-occurrence circle using an adapted version of Fried's R code. Furthermore, a pairwise comparison of event lists was performed using the Jaccard index.Results: There was a modest overlap among the six measures. Only one item was present in all six measures, only two items were present in four measures, and 78% of the items were present in just one or two measures. The overall overlap between the six measures was 25%.Conclusions: The lack of overlap among measures reflects a heterogeneity of definitions and purposes. It also impedes progress in research, as comparisons between various studies are difficult to make in a valid and reliable way. The lack of consensus also delays efficient political initiatives, because solid, consensual knowledge about the prevalence of VAC does not exist.

Violence against children (VAC) is a high political and professional priority. A recent systematic review recommended six self-report measures based on their psychometric qualities.The VAC items were very diverse. A content analysis reduced the original 174 items to 38 unique items. A Jaccard index showed an overlap of 25%.The lack of consensus in definitions and applied measures impedes progress in research and delays important political, prophylactic initiatives.

Experiencias de mujeres en la atención del parto institucional en tiempos de la primera y segunda ola de COVID en México / Women's experiences in institutional childbirth care in times of the first and second waves of COVID in Mexico

Resumen Estudio de tipo cualitativo que explora las perspectivas y experiencias de un grupo de mujeres mexicanas que vivieron la atención institucionalizada del parto en la primera y segunda ola de la pandemia por COVID-19. A través de un guión semiestructurado se entrevistó a nueve mujeres que vivieron la experiencia de la atención del parto entre marzo y octubre de 2020, en hospitales públicos y privados de la ciudad de San Luis Potosí, en México. Bajo la propuesta de análisis de la teoría fundamentada, se identificó que las estrategias sanitarias implementadas en el marco de la pandemia, trajeron consigo un retroceso en la garantía del parto humanizado, las mujeres se narraron desconfiadas en los protocolos que siguió el personal para la atención de sus partos en los hospitales del sector público y muy confiadas en los que se implementaron en el sector privado. La realización de cesáreas sin una justificación clara emergió como una constante, igual que la separación temprana de los binomios. Continúa frágil la disposición y el convencimiento del personal sanitario y las instituciones para garantizar, proteger y defender el derecho de las mujeres a vivir el parto libre de violencia. Persisten resistencias para repensar la atención del parto desde un paradigma no biomédicalizante.

Abstract This is a qualitative study that explores the perspectives and experiences of a group of Mexican women who experienced institutionalized childbirth care in the first and second waves of the COVID-19 pandemic. Through a semi-structured script, nine women who experienced childbirth care were interviewed between March and October 2020 in public and private hospitals in the city of San Luis Potosí, Mexico. Under the Grounded Theory analysis proposal, it was identified that the health strategies implemented during the pandemic brought with them a setback in the guarantee of humanized childbirth. Women described themselves as distrustful of the protocols that personnel followed to attend to their births in public sector hospitals and very confident in those implemented in the private sector. The intervention of cesarean sections without a clear justification emerged as a constant, as did early dyad separation. Healthcare personnel's and institutions' willingness and conviction to guarantee, protect and defend the right of women to experience childbirth free of violence remain fragile. Resistance persists to rethink childbirth care from a non-biomedicalizing paradigm.

Prevalence of reported violence in children and adolescents in the clinical work of health professionals: a systematic review and meta-analysis / Prevalência de relato de violência em crianças e adolescentes no trabalho clínico de profissionais da saúde: uma revisão sistemática e meta-análise

Abstract This article aims to analyze the prevalence of reporting and notification of violence in children and adolescents in the work of clinical health professionals. The search was performed in six electronic databases and the gray literature for studies published until June 1, 2022. Estimates of interest were calculated using random effects meta-analyses. Two reviewers independently evaluated the potentially eligible studies according to the following criteria: cross-sectional studies carried out with health professionals who provided clinical care for children and adolescents and dealt with violence cases. Two reviewers extracted data on included trial characteristics, methods, and outcomes. Expectations of interest were transformed using random effects meta-analyses. The meta-analysis of the prevalence of reports of violence performed with 42 articles was 41%. The notification meta-analysis occurred with 39 articles and was 30%. About one in two health professionals face situations of violence against children and adolescents in their clinical practice (41%), and approximately one in three health professionals report the cases (30%).

Resumo O objetivo do artigo é analisar a prevalência de relato e notificação de violência em crianças e adolescentes no trabalho de profissionais clínicos da saúde. A busca foi realizada em seis bases de dados eletrônicas e na literatura cinzenta para estudos publicados até 1º de junho de 2022. As estimativas de interesse foram calculadas usando meta-análises de efeitos aleatórios. Dois revisores avaliaram de maneira independente os estudos potencialmente elegíveis de acordo com os seguintes critérios: estudos transversais com profissionais da saúde que prestavam atendimentos clínicos voltados a crianças e adolescentes e que se depararam com casos de violência. Dois revisores extraíram dados sobre as características dos estudos incluídos, métodos e resultados. As estimativas de interesse foram calculadas usando meta-análises de efeitos aleatórios. A meta-análise de prevalência de relato de violência realizada com 42 artigos foi de 41%. A meta-análise da notificação ocorreu com 39 artigos e foi de 30%. Aproximadamente um a cada dois profissionais da saúde se deparam com situações de violência contra crianças e adolescentes em sua prática clínica (41%) e cerca de um a cada três profissionais da saúde notificam os casos (30%).

Volvamos al parto humanizado / Let's go back to humanized childbirth

Actualmente, en la mayoría de los países, el parto se ha transformado en una práctica patológica requiriendo un seguimiento institucionalizado y conllevando acciones de violencia obstétrica sobre la mujer. El parto humanizado es un modelo de atención que considera las opiniones, necesidades y valoraciones emocionales de las mujeres y sus familias en los procesos de atención del embarazo, parto y puerperio. En el presente se describe el parto humanizado, historia, importancia, recomendaciones y beneficios para la familia gestante, así como la violencia obstétrica, priorizando la humanización y creando condiciones para que se cumplan las dimensiones espirituales, psicológicas y biológicas del ser humano. Se seleccionaron 12 artículos de investigación, siendo el español el idioma de mayor publicación. El modelo de parto humanizado incluye todo el proceso, desde el embarazo hasta el puerperio tardío, genera un impacto muy importante en el recién nacido y su desarrollo futuro(AU)

Currently, in most countries, childbirth has become a pathological practice, requiring institutionalized followup and leading to actions of obstetric violence against women. Humanized childbirth is a model of care that considers the opinions, needs and emotional evaluations of women and their families in the processes of pregnancy, childbirth and puerperium care. This paper describes humanized childbirth, history, importance, recommendations and benefits for the pregnant family, as well as obstetric violence, prioritizing humanization and creating conditions for the spiritual, psychological and biological dimensions of the human being to be fulfilled. 12 research articles were selected, with Spanish being the language with the most publications. The humanized birth model includes the entire process, from pregnancy to the late puerperium, it generates a very important impact on the newborn and its future development(AU)

Atenção primária à saúde e a violência contra pessoa idosa: revisão integrativa / Primary health care and violence against elderly people: an integrative review / Atención primaria de saludy violencia contra las personas mayores: unarevisión integrativa

Introdução:O envelhecimento populacional é uma realidade mundial. Trata-se de um processo natural do período de desenvolvimento humano, caracterizado por progressiva perda celular e declínio funcional do organismo, associado a maior probabilidade de convívio com doenças crônicas e violências. Objetivo:Analisara produção científica a respeito da violência contra pessoas idosas nos espaços da Atenção Primária à Saúde, posta como ordenadora do Sistema Único de Saúde. Metodologia:Trata-se de um estudo de Revisão Integrativa, cuja metodologia baseia-se na Prática Baseada em Evidências, utilizando as bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Medical Literature Analysis and Retrieval Sistem online (Medline) e Base deDados de Enfermagem (BDENF) e tendo como critério de inclusão os artigos publicados nos últimos 5 anos (2018-2023), em português, inglês e espanhol. Resultados:Oito artigos foram selecionados para síntese qualitativa. Os trabalhos selecionados indicam Nível de Evidência entre 2, 4 e 5, ou seja, 62,5% dos achados possuem Nível de Evidência 4, conforme Classificação de Oxford Centre for Evidence-based Medicine. Também, foram aglutinados em eixos temáticos, sendo: Violências e suas manifestações, Formação profissional e sua (des)continuidade, O cuidado na Atenção Primária à Saúdesobre situações de violência contra a pessoa idosa e seus impasses e a Saúde do cuidador invisibilizada. Conclusões:Foipossível observar que há políticas públicas destinadas a essaproblemática (de saúdee social), entretanto,os serviços públicos ainda executamde forma limitadao que está preconizadopela legislação. Verificamos que existem ações propostas para o cuidado desse grupo de risco, no entanto, há que ser mais efetiva e a estratégia da educação permanente nesses espaços poderá ser um recurso potente para melhor gestão do cuidado (AU).

Introduction:Population aging is a global reality. It is a natural process in human development, characterized by progressive cell loss and functional decline of the organism, associated with a higher probability of living with chronic diseases and violence. Objective:To analyze the scientific production regarding violence against elderly people in Primary Health Care settings, positioned as the coordinator of the Unified Health System.Methodology:This is an Integrative Review study, whose methodology is based on Evidence-Based Practice, using the databases: LatinAmerican and Caribbean Literature in Health Sciences (LILACS), Medical Literature Analysis and Retrieval System Online (Medline), and Nursing Database (BDENF), with inclusion criteria of articles published in the last 5 years (2018-2023), in Portuguese, English, and Spanish.Results:Eight articles were selected for qualitative synthesis. The selected works indicate Evidence Levels between 2, 4, and 5, with 62.5% of the findings having Evidence Level 4, according to the Oxford Centre for Evidence-Based Medicine Classification. They were also grouped into thematic axes, namely: Violence and its manifestations, Professional training and its (dis)continuity, Care in Primary Health Care regarding situations of violence against the elderly and its impasses, and Invisible caregiver health.Conclusions:It was observed that there are public policies aimed at addressing this issue (both health and social aspects). However, public services still implement what is recommended by legislation in a limited manner. We found that there are proposed actions for the care of this at-risk group; nevertheless, these actions need to be more effective. The strategy of continuing education in these spaces could be a powerful resource for better care management (AU).

Introducción:El envejecimiento poblacional es una realidad mundial. Se trata de un proceso natural del período de desarrollo humano, caracterizado por la pérdida celular progresiva y el declive funcional del organismo, asociado a una mayor probabilidad de convivencia con enfermedades crónicas y violencias. Objetivo: Analizar la producción científica respecto a la violencia contra las personas mayores en los espacios de Atención Primaria de Salud, posicionada como ordenadora del Sistema Único de Salud.Metodología: Se trata de un estudio de Revisión Integrativa, cuya metodología se basa en la Práctica Basada en la Evidencia, utilizando las bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Sistema de Análisis y Recuperación de Literatura Médica en Línea (Medline) y Base de Datos de Enfermería (BDENF), teniendo como criterio de inclusión los artículos publicados en los últimos 5 años (2018-2023), en portugués, inglés y español.Resultados: Se seleccionaron ocho artículos para la síntesis cualitativa. Los trabajos seleccionados indican un Nivel de Evidencia entre 2, 4 y 5, es decir, el 62,5% de los hallazgos tienen un Nivel de Evidencia 4, según la Clasificación del Centro Oxford de Medicina Basada en la Evidencia. También fueron agrupados en ejes temáticos, siendo: Violencias y sus manifestaciones, Formación profesional y su (des)continuidad, El cuidado en la Atención Primaria de Salud sobre situaciones de violencia contra la persona mayor y sus impases, y la Salud invisibilizada del cuidador.Conclusiones:Se pudo observar que existen políticas públicas destinadas a esta problemática (de salud y social), sin embargo, los servicios públicos aún ejecutan de forma limitada lo que está preconizado por la legislación. Verificamos que existen acciones propuestas para el cuidado de este grupo de riesgo, no obstante, es necesario que sean más efectivas y la estrategia de la educación permanente en estos espacios podría ser un recurso potente para una mejor gestión del cuidado (AU).

Caracterização epidemiológica de violência sexual no sudeste da região norte do brasil / Epidemiological characterization of sexual violence in southeast of northern Brazil / Caracterización epidemiológica de la violencia sexual en el sureste del norte de Brasil

Introdução: A violência sexual é qualquer ato físico, coercivo, de intimidação com potencial psicológico contra outra pessoa, ocorrendo, especialmente,no sexo feminino, em qualquer faixa etária.Objetivo: Apresentar uma caracterização epidemiológica dos casos de violência sexual referente ao número de casos, faixa etária e gênero entre período de 2014 a 2019 no município de Tucuruí-Pará.Métodos:Trata-se de um estudo de caráter descritivo, comparativo e retrospectivo de corte transversal. A coleta dos dados foi realizada através de notificações em protocolos dos órgãos do governo estadual e do governo municipal, na cidade de Tucuruí-Pará.Para análise dos dados, foram utilizados o teste Exato de Fisher e teste de Mann Whitney.Resultados:A instituição com maior número de notificações foi pelo instrumento Estadual, com 771 casos notificados durante o período de 2014 a 2019, (∆%=631%; p<0,001) em relação ao instrumento municipal, que apresentou o total de 140 casos notificados. Quanto a diferença de gênero, as mulheres são as mais atingidas por este tipo de violência em ambos os órgãos analisados, assim como, com respeito a faixa etária mais acometida, a infância, adolescência e adultos jovens são os que mais sofrem com o problema da violência sexual, de acordo com os dados de ambos os órgãos.Conclusão: O perfil da violência sexual no município de Tucuruí é predominante entre mulheres, da faixa etária que vai desde a infância até a fase adulta. Os dados utilizados das duas instituições durante o período de estudo apresentaram diferenças estatísticas, sendo o instrumento de notificações Estadual o órgão com maior número de notificações em todas as comparações realizadas (AU).

Introduction: Sexual violence is any physical, coercive act of intimidation with psychological potential against another person, occurring especially among females, in any age group.Objective: Present an epidemiological characterization of cases of sexual violence regarding the number of cases, age group and gender between 2014 and 2019 in the municipality of Tucuruí-Pará.Methods: This is a descriptive, comparative and retrospective cross-sectional study. Data collection was carried out through notifications in protocols of state and municipal government agencies, in the city of Tucuruí-Pará.For data analysis, Fisher's exact test and Mann Whitney test were used.Results: The institution with the highest number of notifications was by the State instrument, with 771 cases notified during the period 2014 to 2019, (∆%=631%; p<0.001) compared to the municipal instrument, which presented a total of 140 cases notified. As for the gender difference, women are the most affected by this type of violence in both bodies analyzed, as well as, with respect to the most affected age group, childhood, adolescence and young adults are the ones who suffer most from the problem of sexual violence, according to data from both bodies. Conclusion: The profile of sexual violence in the city of Tucuruíis predominant among women, in the age group that goes from childhood to adulthood. The data used from the two institutions during the study period showed statistical differences, with the State notification instrument being the body with the highest number of notifications in all comparisons performed (AU).

Introducción: La violencia sexual es cualquier acto físico y coercitivo de intimidación con potencial psicológico contra otra persona,que ocurre especialmente entre mujeres, en cualquier grupo de edad.Objetivo:Presentar una caracterización epidemiológica de los casos de violencia sexual en cuanto al número de casos, grupo etario y género entre 2014 y 2019 en el municipio de Tucuruí-Pará. Métodos:Se trata de un estudio transversal descriptivo, comparativo y retrospectivo. La recolección de datos se realizó a través de notificaciones en protocolos de organismos gubernamentales estatales y municipales, en la ciudad de Tucuruí-Pará. Parael análisis de los datos se utilizó la prueba exacta de Fisher y la prueba de Mann Whitney. Resultados:La institución con mayor número de notificaciones fue por el instrumento Estatal, con 771 casos notificados durante el período 2014 a 2019, (∆%=631%; p<0,001) frente al instrumento municipal, que presentó un total de 140 casos notificados. En cuanto a la diferencia de género, las mujeres son las más afectadas por este tipo de violencia en ambos cuerpos analizados, así como, respecto al grupo de edad más afectado, la infancia, la adolescencia y los adultos jóvenes son quienes más sufren el problema de la violencia sexual, según datos de ambos organismos. Conclusión:El perfil de violencia sexual en la ciudad de Tucuruí es predominante entre las mujeres, enel grupo etario que va desde la niñez hasta la edad adulta. Los datos utilizados de las dos instituciones durante el período de estudio mostraron diferencias estadísticas, siendo el instrumento de notificación del Estado el organismo con mayor número de notificaciones en todas las comparaciones realizadas (AU).

Correlates of Intimate Partner Violence, Including Psychological Partner Violence, in a Multisite U.S. Cohort of People in HIV Care.

We examined past-year intimate partner violence (IPV), including psychological violence without physical/sexual violence, and health outcomes among people with HIV (PWH) in care in a multi-site U.S. cohort. Between 2016 and 2022, PWH reported 12-month psychological, physical, and sexual IPV in a routine assessment. We used linear and logistic regression models adjusted for age, race/ethnicity, and site to examine relationships with health outcomes. Among 9748 PWH (median age 50 years, 81% cisgender male/16% cisgender female/1% transgender female; 44% non-Hispanic white/36% non-Hispanic Black/15% Hispanic), 9.3% (n = 905) reported any IPV in the past 12 months; half reported psychological IPV without physical/sexual IPV (n = 453). PWH reporting any type of IPV were on average younger than those who did not experience IPV. In adjusted models, any IPV was associated with increased likelihood of unstable housing, HIV viral load detection (HIV viral load ≥ 75 copies/mL), moderate-to-severe depressive symptoms, anxiety with panic symptoms, substance use (methamphetamines, cocaine/crack, illicit opioids, marijuana, heavy episodic/hazardous drinking), and concern about exposure to sexually transmitted infection. PWH reporting any IPV in the past 12 months had 4.2% lower adherence to antiretroviral therapy, 2.4 more HIV-related symptoms, a 1.9 point higher HIV stigma score, and a 9.5% lower quality of life score than those without IPV. We found similar associations among PWH reporting only psychological IPV, without physical/sexual IPV. IPV was common among PWH. Half reporting IPV reported only psychological IPV and had similarly poor outcomes as those reporting physical/sexual IPV, demonstrating the need to assess psychological as well as physical and sexual IPV.

RESUMEN: Examinamos la violencia de la pareja íntima (intimate partner violence, IPV) del año anterior, incluida la violencia psicológica sin violencia física y sexual, así como los resultados sanitarios entre las personas con VIH (people with HIV, PWH) que reciben atención en una cohorte multicéntrica de los Estados Unidos. Entre 2016 y 2022, las PWH informaron situaciones de IPV psicológica, física y sexual durante los 12 meses en una evaluación de rutina. Se utilizaron modelos de regresión lineal y logística ajustados por edad, raza/etnia y centro para examinar las relaciones con los resultados sanitarios. Entre 9748 PWH (mediana de edad de 50 años, 81% de hombres cisgénero/16% de mujeres cisgénero/1% de mujeres transgénero; 44% de blancos no hispanos/36% de negros no hispanos/15% de hispanos), el 9,3% (n = 905) informaron haber sufrido algún tipo de IPV en los últimos 12 meses; la mitad informó situaciones de IPV psicológica sin IPV física y sexual (n = 453). Las PWH que informaron de cualquier tipo de IPV fueron, en promedio, más jóvenes que las que no sufrieron IPV. En los modelos ajustados, cualquier IPV se asoció con una mayor probabilidad de vivienda inestable, detección de carga viral del VIH (carga viral del VIH ≥ 75 copias/ml), síntomas depresivos de moderados a graves, ansiedad con síntomas de pánico, consumo de sustancias (metanfetaminas, cocaína/crack, opioides ilícitos, marihuana, consumo excesivo episódico/peligroso de alcohol) y preocupación por la exposición a infecciones de transmisión sexual. Las PWH que informaron alguna situación de IPV en los últimos 12 meses tuvieron un 4,2% menos de cumplimiento de la terapia antirretrovírica, un 2,4% más de síntomas relacionados con el VIH, una puntuación de estigma del VIH 1,9 puntos más alta y una puntuación de calidad de vida un 9,5% más baja que las que no sufrieron IPV. Se encontraron asociaciones similares entre las PWH que informaron solo IPV psicológica, sin IPV física y sexual. La IPV fue común entre las PWH. La mitad de las personas que informaron IPV solo informaron IPV psicológica y tuvieron resultados igualmente deficientes que los que informaron IPV física y sexual, lo que demuestra la necesidad de evaluar la IPV psicológica, al igual que la IPV física y sexual.

Adverse childhood experiences of Korean mothers with young children: a latent class analysis.

Background: Adverse childhood experiences (ACEs) have negative impacts on women with children, including psychosocial and general health problems. However, there is limited research investigating ACEs identifying the characteristics of distinct subgroups according to the frequency of ACEs.Objective: Utilizing the national dataset of the Family with Children Life Experience 2017, this study aimed to classify patterns of ACEs based on the total number of types of ACEs and the types of predominant events, and to examine differences in general and psychological characteristics, as well as experiences of violence in adulthood among the classes identified.Method: A total of 460 Korean mothers raising infants or toddlers participated. Latent class analysis was performed to classify the patterns of ACEs, while t-tests and Chi-square tests were used to examine differences in general and psychological characteristics and experiences of violence between the ACEs subgroups.Results: The participants were classified into two subgroups: the 'high-ACEs group' and the 'low-ACEs group'. The high-ACEs group exhibited higher rates of child abuse, workplace violence perpetration and victimization, as well as lower self-esteem, higher depression levels, and increased suicidal thoughts compared to those of the low-ACEs group.Conclusion: The findings highlight the significant role of ACEs on the formation of an individual's psychological characteristics and their propensity to experience additional violence even into adulthood, as perpetrators and as victims. It is noteworthy how the influence of ACEs extends across generations through child abuse. These findings offer insights for developing interventions aimed at mitigating the negative effects of experiences of violence on mothers raising young children.

Two distinct subgroups were identified according to the frequency of ACEs: the 'high-ACEs group' and the 'low-ACEs group'.Compared to those of the low-ACEs group, the high-ACEs group presented higher rates of child abuse, workplace violence perpetration and victimization, lower self-esteem, higher depression levels, and increased suicidal thoughts.The low self-esteem induced by ACEs may contribute to the amplification of psychological vulnerabilities and the occurrence of additional violent experiences even in adulthood.

A importância da Atenção Primária à Saúde na prevenção e redução da violência / The importance of Primary Health Care in preventing and reducing violence

Este texto faz uma breve revisão histórica da inserção da violência como questão de saúde pública, destacando a importância da Atenção Primária à Saúde e a inovação estratégica com o Programa Nacional de Gênero, Raça, Raça e Valorização da Mulher Trabalhadora no SUS.

This text provides a brief historical review of the inclusion of violence as a public health issue, highlighting the importance of Primary Health Care and strategic innovation with the National Program for Gender, Race, Race and the Appreciation of Working Women in the SUS.

Perfil epidemiológico da violência contra mulheres no estado da Paraíba de 2009 a 2019 / Epidemiological profile of violence against women in the state of Paraíba from 2009 to 2019

O objetivo desse estudo é traçar o perfil epidemiológico das notificações de violência contra a mulher no estado da Paraíba, no período de 2009 a 2019. Trata-se de um estudo transversal, descritivo, realizado por meio de consulta online ao Sistema de Informação TabNet na seção de Doenças e Agravos de Notificação através do campo violência interpessoal. Como parte dos resultados, identificamos que a violência mais frequente é a física, 45,2%. Foi observado que o maior número de queixas envolve mulheres negras, com 60,11% dos casos; na faixa etária de 20 a 29 anos, 22,71%; com ensino fundamental incompleto, 14,21%. Ademais, 59,2% das situações de violência contra a mulher ocorrem, predominantemente, em locais residenciais. Quanto aos encaminhamentos ao setor de saúde, os achados revelam que, nesse item, em 54,15% dos registros é definido como ignorado. O estudo apontou uma grande fragilidade nos registros de dados sobre violência, tanto pela falta de informações quanto pelo preenchimento inadequado das fichas. Por isso, é crucial reforçar a importância do preenchimento adequado das fichas de notificação compulsória e a qualificação dos profissionais para fornecer evidências precisas sobre o problema e subsidiar a gestão para os enfrentamentos.

This study aims to trace the epidemiological profile of notifications of violence against women in the state of Paraíba from 2009 to 2019. This cross-sectional, descriptive study conducted an online consultation of the TabNet Information System in the Diseases and Notifiable Diseases section through the field of interpersonal violence. As part of the results, we identified that the most frequent form of violence was physical violence (45.2%). We found that the highest number of complaints involved black women, with 60.11% of cases; in the 20-29 age group, 22.71%; and with incomplete primary education, 14.21%. In addition, 59.2% of situations of violence against women occur predominantly in residential areas. As for referrals to the health sector, the findings reveal that 54.15% of the records were defined as ignored. The study pointed to a significant weakness in the recording of data on violence, both due to the lack of information and the inadequate filling out of forms. For this reason, it is crucial to reinforce the importance of correctly filling out compulsory notification forms and training professionals to provide accurate evidence of the problem and support management in dealing with it.

[Impact of gender violence on girls and adolescents]. / Impacto de la violencia de género en las niñas y las adolescentes.

Gender is an important determinant of health. Its relationship with inequality and violence allows us to consider being a woman as a risk factor for health. Girls and teenager girls are not exempt from this circumstance, which conditions their lives from before birth and can determine their health status throughout life. It can vary according to social contexts, as various factors intersect with gender, adding risk and vulnerability to being a woman. Gender-based violence is often identified as a problem for adult women; however, the experience of discriminatory gender-based violence is constructed throughout women's lives, producing serious individual and social consequences from childhood. Accepting this violence as a «private or domestic matter¼ often prevents seeing the true dimension of the problem, its consequences, and the need to address it as a global issue.