Violencia intrafamiliar en familias con niños en edad prescolar de un consultorio médico / Intrafamily Violence in Families with Children at Preschool Aged from a Family Medical Office

Introducción: La violencia intrafamiliar ocurre en el interior de la familia y, por lo general, la ejercen uno o varios miembros contra otros; casi siempre las víctimas son mujeres, ancianos y niños. Objetivo: Caracterizar el estado actual de la violencia intrafamiliar en familias con niños en edad prescolar. Métodos: Se realizó un estudio descriptivo transversal en el Consultorio Médico de Familia No. 1, poblado de Cuatro Caminos perteneciente al Policlínico Docente Mártires del 10 de abril, Corralillo, Villa Clara, de enero del 2020 a junio del 2021. La población estuvo constituida por 66 familias y la muestra por 64, según muestreo no probabilístico por criterio. Para la recogida de la información se utilizaron cuestionario y observación a las familias en estudio. Resultados: Presencia de violencia intrafamiliar (32,8 por ciento), familias extensas (70,3 por ciento), hacinamiento (14,1 por ciento), malas relaciones entre los adultos (66,6 %), maltrato en la niñez (66,6 por ciento) manifestaciones psicológicas: padres ausentes físicamente (57,1 por ciento), violencia psicológica (100 por ciento), violencia física (66,6 por ciento) y violencia sexual (42,9 por ciento). Conclusiones: Las malas relaciones entre los adultos, el maltrato en la niñez y los padres ausentes físicamente son asociados a la violencia intrafamiliar. La violencia psicológica estuvo presente en la totalidad de las familias. Las mayores cifras de tipos de violencia fueron en la familia extensa(AU)

Introduction: Intrafamily violence occurs within the family and is generally exercised by one or several members against others; almost always, the victims are women, the elderly or children. Objective: To characterize the current state of domestic violence in families with preschool children. Methods: A cross-sectional and descriptive study was carried out in the family medical office 1, in the neighborhood of Cuatro Caminos, belonging to the Policlínico Docente Mártires del 10 de Abril, in Corralillo Municipality, Villa Clara Province, from January 2020 to June 2021. The population consisted of 66 families and the sample was made up of 64, according to nonprobabilistic sampling by criteria. For the collection of information, a questionnaire and the observation method were used with the families under study. Results: There was presence of intrafamily violence (32.8percent) extended families (70.3percent), overcrowding (14.1percent), poor relationships between adults (66.6percent) and child abuse (66.6percent). The psychological manifestations were related to physically absent parents (57.1percent), psychological violence (100%), physical violence (66.6percent) and sexual violence (42.9percent). Conclusions: Poor relationships between adults, childhood abuse and physically absent parents are associated with intrafamily violence. Psychological violence was present in all families. The highest numbers of types of violence occurred in the extended family(AU)

Physical violence against children with disabilities: A Danish national birth cohort prospective study.

Background: Children with disabilities are at heightened risk of violence compared to their non-disabled peers. However, extant research suffers from several limitations, focusing on child abuse and one or few types of disability, ignoring conventional violent crimes.Objective: The aim was to assess 10 disabilities and to examine whether different disabilities vary in their risk of criminal victimization.Method: Using the Danish Psychiatric Case Register, the Criminal Register, and other population-based registers, we included nine birth cohorts (n = 570,351) and followed them until 18 years of age. We compared children exposed to violence with non-exposed children. We estimated odds ratios (ORs) for the disabilities and adjusted the ORs for several risk factors.Results: We identified 12,830 cases of reported violence (2.25% of the population) towards children and adolescents. Children with disabilities were overrepresented, as were boys and ethnic minorities. After controlling for risk factors, four disabilities had heightened risk for criminal violence: attention-deficit hyperactivity disorder (ADHD), brain injury, speech, and physical disabilities. When we compared risk factors controlling for the various disabilities, parental history of violence, family break-up, out-of-home placement, and parental unemployment contributed especially to the violence, while parental alcohol/drug abuse was no longer a predictor. Having several disabilities increased the risk of violence.Conclusions: Criminal victimization of children and adolescents with specific disabilities was common. However, compared to the previous decade, a considerable reduction of one-third has taken place. Four risk factors contributed particularly to the risk of violence; therefore, precautions should be taken to further reduce the violence.

Based on data from nine full birth cohorts, followed for 18 years, the study concludes that disabled children are considerably more exposed to police-reported physical violence than non-disabled children.Four disabilities were especially exposed to physical violence when we controlled for risk factors.Four risk factors contributed particularly to physical violence when we controlled for diagnoses.

Tipos y circunstancias de unión conyugal en la violencia física de pareja en Chiapas, México, 2016

La violencia en contra de las mujeres en la pareja heterosexual, además de ser un tema muy complejo, es un problema de salud pública. Este trabajo contribuye a profundizar no solamente en el tipo de unión conyugal (cohabitación y matrimonio), sino también toma en cuenta las circunstancias en donde ocurre para explicar tanto en mujeres indígenas como no indígenas su relación con la magnitud y la gravedad de las expresiones de maltrato físico en Chiapas, México. El estudio fue realizado a través de un enfoque cuantitativo con base en los datos de la Encuesta Nacional sobre la Dinámica de las Relaciones en los Hogares 2016 (ENDIREH); se incluyeron 2604 mujeres de 15 a 49 años, actualmente unidas, indígenas y mestizas. Los resultados mostraron que la unión libre es más frecuente en las indígenas y se asocia significativamente con una mayor probabilidad de violencia física en sus distintas formas; adicionalmente, las circunstancias en las cuales esta se establece dan cuenta de la variación en la frecuencia de las agresiones, sobre todo cuando las mujeres son forzadas a unirse. La desventaja social de las mujeres subyace al tipo y las circunstancias de unión, destaca su participación o ausencia al decidir y los aspectos normativos que rigen la materia en Chiapas. Se discuten los hallazgos a la luz del cambio reproductivo y el compromiso de los varones en el establecimiento de la unión como elementos constitutivos de la cohabitación y el matrimonio, así como de la violencia íntima de pareja.

Violence against women in heterosexual couples is not only a very complex issue, but also a public health problem. The work contributes to the study not only in the type of conjugal union (cohabitation and marriage) but also taking into account the circumstances in which the union occurs, to explain both in indigenous and non-indigenous women their relationship with the magnitude and severity of the expressions of physical violence against women in Chiapas. The study was conducted through a quantitative approach taking as a basis data from the National Survey on the Dynamics of Household Relationships 2016 (ENDIREH); 2604 women aged 15 to 49 years, currently in union, indigenous and mestizo were included. The results show that free union is more frequent in indigenous women and that this type of union is significantly associated with a higher probability of occurrence of physical violence in its different expressions. Additionally, the circumstances in which the union is established provide evidence of differences in the frequency of physical violence in them, particularly when women are forced to join. The social disadvantage of women underlies the type and circumstances in which the union occurs, highlighting the participation or not of women in the decision to join and the normative aspects that govern unions in Chiapas, Mexico. Results are discussed in light of reproductive change and male involvement in the establishment of the union as elements underlying both cohabitation or marriage and intimate partner violence.

Maltrato en la gestante adolescente y su efecto en el peso del recién nacido en la altura geográfica peruana, Huancayo, Perú / Abuse in adolescent pregnant women and its effect on newborn weight in the Peruvian geographical altitude, Huancayo, Peru

INTRODUCCIÓN: La violencia en la gestante está asociada a muchos factores del recién nacido, pero esto casi no se ha reportado en la altura geográfica. OBJETIVO: Determinar si existe asociación entre el maltrato en la gestante adolescente y su efecto en el peso del recién nacido en la altura geográfica peruana. MÉTODO: Estudio de cohorte retrospectiva. Se tomó la información de 855 gestantes. La variable exposición fue que hubieran sufrido violencia, lo cual se asoció al peso y otros datos del recién nacido en la ciudad de Huancayo, Perú. RESULTADOS: Según el análisis multivariado, hubo más riesgo de que el niño tuviera un peso inadecuado cuando hubo violencia física (riesgo relativo ajustado [RRa]: 1,42; intervalo de confianza del 95% [IC95%]: 1,01-2,00; p = 0,045), cuando se tuvo un parto pretérmino según Capurro (RRa: 4,90; IC95%: 2,85-8,45; p < 0,001), cuando hubo complicaciones en el parto (RRa: 2,11; IC95%: 1,25-3,61; p = 0,006) y si el abuso inició en el primer trimestre (RRa: 14,74; IC95%: 4,70-46,27; p < 0,001), el segundo (RRa: 18,72; IC95%: 5,78-60,63; p < 0,001) o el tercero (RRa: 18,87; IC95%: 4,71-75,60; p < 0,001). CONCLUSIONES: Existe asociación entre sufrir violencia física durante la gestación y el bajo peso al nacer, y también se encontró asociación con otras variables.

INTRODUCTION: Violence in the pregnant woman is associated with many newborn factors, but this has hardly been reported in the geographical altitude. OBJECTIVE: To determine whether there is an association between adolescent pregnancy abuse and its effect on newborn birth weight in high altitude Peru. METHOD: Retrospective cohort study. Information was taken from 855 pregnant women. The exposure variable was whether they had suffered gender-based violence, the exposure variable was that they had suffered violence, which was associated with the weight and other data of the newborn in Huancayo city, Peru. RESULTS: In the multivariatee analysis it was found that there was a higher risk of the child having an inadequate weight when there was physical violence (adjusted relative risk [RRa]: 1.42; 95% confidence interval [95% CI]: 1.01-2.00; p = 0.045), when there was a preterm birth according to Capurro (RRa: 4.90; 95% CI: 2.85-8.45; p < 0.001), when there were complications in childbirth (RRa: 2.11; 95% CI: 1.25-3.61; p = 0.006) and if the abuse started in the first trimester (RRa: 14.74; 95% CI: 4.70-46.27; p < 0.001), second (RRa: 18.72; 95% CI: 5.78-60.63; p < 0.001) or third (RRa: 18.87; 95% CI: 4.71-75.60; p < 0.001). CONCLUSIONS: There is an association between suffering physical violence during gestation and low birth weight, and association was also found with other variables.

Violencia en las parejas adolescentes. Implicaciones del sexismo y la religión / Teen dating violence. Implications of sexism and religion

Resumen La violencia en las parejas adolescentes es un tema de especial importancia por la implicación en la salud y en las relaciones afectivas de los adolescentes. El propósito de este estudio fue determinar la influencia del género y de la religión en la violencia física, de comunicación/relación y psicológica, recibidas por los adolescentes, y en la satisfacción con la vida que estos presentan, además, del papel que juegan las conductas sexistas en esta violencia. Los participantes han sido 1 036 adolescentes pertenecientes a siete centros de educación secundaria del sudeste español, de edades comprendidas entre 14 y 19 años, de los que el 48.1 % eran hombres y el 51.9 %, mujeres. Para alcanzar los objetivos de la investigación, junto con los datos demográficos y personales, se aplicó la Escala de Satisfacción con la Vida (SWLS), la Escala de Violencia en la pareja desarrollada y validada para este estudio que recoge tres subescalas: violencia psicológica, violencia física, y violencia en la comunicación y relación con otros. Finalmente, el cuestionario sobre conductas sexistas da información sobre creencias falsas y conductas sexistas. Los resultados muestran niveles más altos de violencia física, psicológica y de comunicación/relación sufrida por los hombres. Aunque son los hombres los que se sienten más satisfechos con la vida y los que manifiestan más conductas sexistas. La creencia religiosa no interviene en la violencia ejercida, pero son los adolescentes practicantes los que se muestran más satisfechos con la vida.

Abstract Teen dating violence is defined as the physical, sexual, psycho-emotional violence that occurs within couple relationships during adolescence. These are relationships that threaten the well-being, health or integrity of the couple and that use mechanisms of control or domination of the couple through coactive or coercive tactics. With this research we have tried to find out about life satisfaction, the physical, psychological and communicative violence suffered by adolescent men and women who are religious or not. In addition, detect sexist behaviours in young people of both sexes and assess behaviours based on religious practice. A descriptive, cross-sectional and predictive study was carried out. Cluster random sampling was carried out when selecting secondary schools in South-eastern Spain. The study included 1 036 adolescents with ages between 14 and 19 years old, of whom 48.1 % were men and 51.9 % women. To fulfill the objectives together with demographic and personal data, the Satisfaction with Life Scale (SWLS) is applied, which assesses the cognitive aspects of well-being. The Psychological Violence Scale is applied with the objective of assessing the psychological and emotional violence. To know the physical violence and authoritarian behaviour, the Physical Violence Scale is applied. Finally, the Violence in Communication and Relationship with Others Scale is introduced for studying online violence and relationship violence. The three violence scales have been adapted, developed and validated by Soriano and Aguilera (2017). Finally, the questionnaire on sexist behaviours collects information on false beliefs and sexist behaviours. The data collection procedure followed the standards set out in the Helsinki Convention (2013) for scientific research involving human participants. Regarding the results, in the first of the logistic regression models, it is good for boys to go out with many girls, but not the other way around (Wald = 14.461; p = .000; OR = 4.047), it is observed to be that boys are 4.047 times more likely to agree with this attitude than girls. Also, it is statistically significant that sometimes you have to threaten others to know who is in charge, (Wald = 8.107; p = .004; OR = 2.173), which indicates that the boys are 2.173 times more likely in accordance with that conduct that the girls. It is also statistically significant that when a woman is assaulted by her partner she will have done something to provoke him, (Wald = 16.315; p = .000; OR = 3.538), making it 3.538 times more likely that boys support this attitude than girls. At the same time, it is statistically significant that the violence that occurs within the home is a family matter and should not leave there, (Wald = 4.132; p = .042; OR = 1.694), which also indicates that boys are 1.694 times more likely to adopt this behaviour than girls. Regarding the perception of violence, it is observed that men perceive more violence than women, being significant for the three types of violence studied (p < .05): Communication, psychological and physical. Personal satisfaction also shows significant results (Z = -2.61; p = .009). In this case, men perceive greatersatisfaction with their life than women. For students with religious beliefs and practices, statistically significant results were evident only in personal satisfaction (Z = -3.42; p = .001), showing that students who practice a religion have more satisfaction with life. The results show higher levels of physical, psychological and communication / relationship violence suffered by men. However, men feel more satisfation with life and show more sexist behaviour. Religious belief does not intervene in violence, but the practicing adolescents are those most satisfied with life.

Ocurrencia y factores asociados con la violencia física y psicológica a mujeres embarazadas atendidas en un hospital materno infantil / Occurrence and associated factors with physical and psychological violence on pregnant women users of a motherhood and children hospital

Resumen OBJETIVO: Estimar la ocurrencia y los factores asociados con la violencia física y psicológica ejercida a las embarazadas por parte de sus parejas. MATERIALES Y MÉTODOS: Estudio de cohorte, retrospectivo y transversal efectuado en las pacientes atendidas entre los meses de junio a noviembre de 2019 en el Hospital de la Madre y el Niño Guerrerense, México. Mediante un cuestionario electrónico (Abuse Assessment Screen), autoadministrado, se indagaron los datos sociodemográficos, de violencia física y psicológica y los antecedentes ginecoobstétricos. La estimación de factores asociados se hizo mediante razón de momios y análisis multivariado. RESULTADOS: Se reunieron 463 registros útiles para el análisis; 125 (27%) reportaron violencia psicológica y 7% (n = 32) violencia física. Los factores asociados con la violencia psicológica fueron: antecedente de este tipo de violencia en la infancia (razón de momios ajustada [RMa] 2.5; IC95%: 1.3-4.8) y antes del embarazo (RMa: 33.9; IC95%: 18.9-60.6). Los factores asociados con la violencia física fueron: antecedente de este tipo de violencia antes del embarazo (RMa: 24.6; IC95%: 10.4- 58.6) y en la infancia (RMa: 3.6; IC95%: 1.5-8.5) además, consumo de alcohol durante el embarazo (RMa: 5.5; IC95%: 1.3-24.4). Estar casada o en unión libre fue un factor protector en contra de la violencia psicológica (RMa: 0.33; IC95%: 0.11-0.97) y física (RMa: 0.29; IC95%: 0.08-0.99). CONCLUSIONES: La violencia psicológica fue mayor que la reportada para la física. Ambas se experimentaron durante los años de infancia o antes del embarazo e incrementaron el riesgo de sufrirla durante el proceso reproductivo. Las embarazadas casadas o en unión libre tuvieron menor riesgo de sufrir violencia física y psicológica.

Abstract OBJECTIVE: To estimate the occurrence and factors associated with physical and psychological violence exerted on pregnant women by their partners. MATERIALS AND METHODS: Cohort, retrospective and cross-sectional study carried out in patients attended from June to November 2019 at the Hospital de la Madre y el Niño Guerrerense, Mexico. An electronic questionnaire (Abuse Assessment Screen), self-administered, was used to inquire about sociodemographic data, physical and psychological violence and gynecological and obstetric history. The associated factors were estimated by odds ratio and multivariate analysis. RESULTS: We collected 463 records useful for analysis; 125 (27%) reported psychological violence and 7% (n = 32) physical violence. Factors associated with psychological violence were history of such violence in childhood (adjusted odds ratio [aOR] 2.5; 95%CI: 1.3-4.8) and before pregnancy (aOR: 33.9; 95%CI: 18.9-60.6). The factors associated with physical violence were history of this type of violence before pregnancy (aRI: 24.6; 95%CI: 10.4-58.6) and in childhood (aRI: 3.6; 95%CI: 1.5-8.5) and alcohol consumption during pregnancy (aRI: 5.5; 95%CI: 1.3-24.4). Being married or in union was a protective factor against psychological (RMa: 0.33; 95%CI: 0.11-0.97) and physical violence (RMa: 0.29; 95%CI: 0.08-0.99). CONCLUSIONS: Psychological violence was higher than that reported for physical violence. Both were experienced during the childhood years or before pregnancy and increased the risk of suffering it during the reproductive process. Pregnant women who were married or in union had a lower risk of suffering physical and psychological violence.

El empoderamiento de la mujer panameña y su relación con la violencia conyugal según la Encuesta Nacional de Salud Sexual y Reproductiva

Introducción. La Organización Mundial de la Salud reconoce que la violencia conyugal es una problemática que va más allá del ámbito familiar, afecta a todos los sectores de la sociedad convirtiéndose en un grave problema de salud pública y de derechos humanos. Objetivo: examinar la relación entre elementos del empoderamiento femenino y tipos de violencia conyugal. Métodos: con datos de la Encuesta Nacional de Salud Sexual y Reproductiva (2014-2015) se analizaron 3679 mujeres casadas/unidas. Se construyeron tres indicadores de empoderamiento como variable independiente, como variable dependiente se estudió la violencia física/sexual. Los datos fueron analizados con el programa SPSS utilizando descripciones de frecuencia, cruce de variables y pruebas de significancia estadística. Resultados: Aquellas mujeres que más justifican la violencia conyugal, son las que más sufren agresiones físicas como empujones y/o sacudidas (15%), las que no justifican la violencia por ninguna razón, solo 4.1% sufren ataques de este tipo (p=0.000). El 3.1% de las mujeres con menor participación en el hogar son las que menos agresiones sufren en comparación con las que toman más decisiones y sufren más agresiones (8.1%) (p< 0.000). El grado de participación en aspectos importantes de Salud Sexual y Reproductiva (SSR), muestra que aquellas que no tenían ningún tipo de intervención, padecen mayores agresiones de tipo sexual (7.3%), estas agresiones disminuyen cuando la mujer toma mayores decisiones en SSR (0.4%) (p=0.000). Conclusiones: Hay una asociación positiva entre una menor vivencia de violencia física/sexual con mayores niveles de autonomía en temas de SSR y Rechazo a la Violencia Conyugal. (provisto por Infomedic International)

Violência em crianças, estudo de casos hospitalizados e seguidos nos serviços de Urgência de Pediatria e Medicina Legal no Hospital Central de Maputo em 2019 / Violence in children, a study of cases hospitalized and followed up in the pediatrics and forensic medicine emergency services at maputo central hospital in 2019

Introdução: Em Moçambique, anualmente, milhares de crianças são vítimas de violência, incluindo as suas formas mais extremas, como a violência física e sexual, o que compromete a saúde física e psicológica destas crianças. Objectivo: Analisar a violência nas crianças, em relação às características demográficas (da criança e do perpetrador), bem como descrever os aspectos clínicos da violência. Métodos: É um estudo transversal e retrospectivo, baseado em registos hospitalares dos serviços da Urgência de Pediatria e da Medicina Legal do Hospital Central de Maputo. Para a recolha de dados utilizámos o Formulário de Relatório de Casos Notificados. Foi utilizado o programa Excel® e testes de qui-quadrado para a análise dos resultados. Resultados: Identificámos um total de 329 casos de lesões relacionadas com a violência que afectaram crianças no Hospital Central de Maputo em 2019, dos quais 143 (43,5%) foram registados na Urgência de Pediatria e 186 (56,5%) na Medicina Legal. A violência sexual foi a forma de violência mais frequente (58% no total). Em ambos os serviços, as vítimas foram maioritariamente meninas do que meninos. As crianças mais velhas (11-14 anos) foram mais observadas na Medicina Legal (47,3% em comparação com 30,1% da Urgência de Pediatria) e as mais novas (0-5), na Urgência de Pediatria (37,1% em comparação com 28,6% a Medicina Legal). A violência sexual foi mais frequente entre as meninas em ambos os serviços, por outro lado, os meninos sofreram mais violência física. Os homens foram os principais perpetradores (81,8% no total) e a maioria deles eram conhecidos da família ou da vítima. As meninas sofreram lesões mais graves, exigindo cuidados médicos intensivos (12,0% em comparação a e 4,5% dos meninos). Em contrapartida, os meninos tiveram mais consultas médicas com alta imediata. As meninas tiveram de longe mais lesões genitais (66,4%) enquanto que os meninos tiveram mais lesões em todas as outras partes do corpo (cabeça, membros superiores, tórax e abdómen, membros inferiores e anal). Conclusões: A violência sexual foi a forma mais frequente de violência nos dois serviços. As meninas foram as vítimas de violência mais frequentemente descritas, tanto nos dois serviços como para a violência sexual em todas idades. Por outro lado, a violência física foi mais frequente entre os meninos. Os homens foram os principais perpetradores de violência especialmente da violência sexual, sendo estes, frequentemente conhecidos da família da vítima ou da própria vítima, é em vários casos um familiar. A casa da vítima ou do perpetrador é onde ocorreu a maioria dos eventos violentos. As crianças apresentaram várias lesões em consequência da violência sofrida, mas nem todos casos foram considerados graves. As meninas apresentaram lesões mais graves que exigiram cuidados médicos intensivos ou até cirurgia e os rapazes mais consultas médicas com alta imediata.

Introduction: In Mozambique, yearly, thousands of children are victims of violence, including its most extreme forms, such as physical and sexual violence, which hinders their healthy development. Objective: To analyze violence in children, in relation to demographic characteristics (child and perpetrator) as well as to describe the clinical aspects of violence-related injury. Methods: This study is cross-sectional and retrospective. Based on hospital records from the two services of Maputo Central Hospital, namely Pediatric Emergency and Forensic Medicine. For data collection we used a standardized Case Report Form. Excel® program and chi-square tests were used to analyze the results. Results: We identified a total of 329 cases of violence-related injuries affecting children at Maputo Central Hospital in 2019, of which 143 (43.5%) were registered at Pediatric Emergency and 186 (56.5%) at Forensic Medicine. Sexual violence was most common (58% in total). In both services, the victims were more frequently girls than boys. Also, older children (11-14 years) were more often seen at Forensic Medicine (47.3% compared with 30.1% at Pediatric Emergency) and younger ones (0-5), at Pediatric Emergency (37.1% compared with 28.6% at Forensic Medicine). Sexual violence was by far the most frequent among girls in both services, by contrast, boys suffered more physical violence. Males were the most common perpetrators (81.8%) and most of them were known to the family or the victim in both services. Girls also had more severe injuries, requiring intensive medical care than boys (12.0% and 4.5% respectively). By contrast, boys had more medical consultation with immediate discharge. Girls had by far more genital injuries (66.4%) while boys had more injuries in all other body parts (head, upper limbs, thorax and abdomen, lower limbs and anal). Conclusions: Sexual violence was the most common form of violence afflicting the children, most often girls, presenting at the two services. Sexual violence was most common among girls at all ages and physical violence, among boys. Men were identified as the main perpetrator, especially of sexual violence. The perpetrators were also very frequently known to the family of the victim, in several instances a relative. The victim's or perpetrator's home, is where most of the violent events take place. Multiple injuries were sustained but not all were severe. Girls had more severe injuries requiring intensive medical care and surgery, and boys, more medical consultations with immediate discharge.

Physical violence inside female prisons in Brazil: prevalence and related factors / Violência física dentro das prisões femininas no Brasil: prevalência e fatores relacionados

Abstract The present study aims to identify the prevalence of physical violence against female prisoners in Brazil, as well as related factors. This is a cross-sectional national survey conducted in 15 female prisons in five regions of Brazil selected in multiple stages. The following types of analysis were performed: univariate analysis; stratified analysis relating the outcome (suffer physical violence inside prison) to predictor variables, using the Pearson chi-square test; calculation of the Odds Ratio (O.R.); and multiple logistic regression. The Hosmer-Lemeshow test was used for analysis of goodness of fit and adequacy of the model. The prevalence of physical violence inside female prisons was 37.4%. There was a correlation between physical violence victimization in prison and the following variables: physical victimization prior to arrest (p = 0.013), solitary confinement (p = 0.000), mental suffering (p = 0.003), current or previous abusive intake of alcohol (p = 0.011), current or previous injection of cocaine (p = 0.002) and not performing prison labor (p = 0.003). Physical violence has become inherent in the Brazilian female prison system. Continued studies are needed to monitor the situation and to develop interventions to prevent physical violence inside the facilities.

Resumo O presente artigo objetiva identificar a prevalência de violência física no interior das prisões femininas brasileiras, bem como fatores associados. Estudo transversal de abrangência nacional, realizado em 15 unidades prisionais femininas nas cinco regiões do Brasil em amostra selecionada por múltiplos estágios. Realizou-se análise univariada; análise estratificada em relação ao desfecho (sofrer violência física dentro da prisão) e as variáveis preditoras através do teste de Chi-quadrado de Pearson; cálculo da Odds Ratio; e regressão logística múltipla. Utilizou-se o teste Hosmer-Lemeshow para análise de qualidade de ajuste e adequação do modelo. A prevalência de violência física dentro das prisões femininas brasileiras foi de 37.4%. Houve correlação entre a vitimização da violência física na prisão e as seguintes variáveis: vitimização física prévia (p = 0.013), isolamento (p = 0.000), sofrimento mental (p = 0.003), ingestão abusiva e/ou dependência alcoólica (p = 0.011), uso atual ou prévio de cocaína injetável (p = 0.002) e ócio prisional (p = 0.003). A violência física tornou-se inerente ao sistema prisional feminino brasileiro. Estudos futuros são necessários no intuito de fornecer propostas para intervenções efetivas de modo a prevenir a violência física dentro das instalações prisionais.

Exposición a la violencia durante la formación profesional de los residentes médicos / Exposure to violence during the vocational training of resident physicians

Resumen Las residencias médicas garantizan la formación y preparación de los futuros especialistas, no solo académica, sino también humana. Sin embargo, existe evidencia de maltrato, discriminación y abusos en los residentes médicos. El objetivo de este trabajo fue identificar experiencias de violencia física, psicológica o sexual de los residentes médicos del estado de Veracruz, México. Se realizó un estudio transversal descriptivo, mediante una metodología cuantitativa, de una población conformada por 656 médicos residentes de 16 unidades receptoras durante el año 2014. El 87 % reportó por lo menos una experiencia de agresión en su tiempo de formación como especialistas y hasta el 50.46 % refirió violencia psicológica. Sus principales agresores fueron jefes de servicio (33.5 %) y compañeros residentes (33.5 %), viéndose más afectados en el turno matutino (34.76 %). De la población total, 51.52 % son hombres y 48.48 % mujeres. En relación al análisis bivariado se obtuvieron los siguientes resultados: correlación entre sexo y violencia psicológica: X 2 = 9.740 6, p = 0.004; violencia fisica: X 2 = 4.876 4, p = 0.003; y violencia sexual: X 2 = 4.868 4, P = 0.001. Los varones presentaron tasas de agresión más altas en el grupo de médicos residentes sometidos a mayor nivel de violencia psicológica, física y sexual. Con este estudio se enfatiza la importancia de forjar valores institucionales en la práctica médica, como el respeto y la dignidad, entre los médicos residentes, superiores y/o profesionales que intervienen en la formación y perfeccionamiento de sus especialidades.

Abstract The Medical residencies guarantee the academic and human apprenticeship and training of the future medical specialists. Nevertheless, there is evidence of maltreatment, discrimination and abuse against the medical residents. The purpose of this work was to identify experiences of physical, psychological or sexual violence of medical residents in the state of Veracruz, Mexico. A cross-sectional quantitative analysis was carried out focusing on a population of 656 residents from 16 receiving medical centers during 2014. Results indicate that 87% reported at least one experience of physical violence during their medical internship as specialists. Additionally, and up to 50.46% it reported psychological violence. The main aggressors were reported to be chiefs of service (33T5 %) and resident partners (33.5 %) and participants were more affected during the morning shift (34.76 %). 51.52 % of the participating population are males and 48.48 % are fema les. As regards The bivariate analysis revealed the following results: correlation between gender and psychological violence: X2 = 9.740 6, p = 0.004; physical violence: X2 = 4.876 4, p = 0.003; and sexual violence: X2 = 4.868 4, p = 0.001. Males reported higher aggression rates in their medical internships since they were subject to higher levels of psychological, physical and sexual violence. The results of the study emphasize the importance of forging institutional values as an integral part of medical residency programs. Respect and the dignity among medical residents, superiors and health professionals who are involved in training and apprenticeships of specialists should be promoted.

Predictors of marital physical violence: personal and relational characteristics / Preditores da violência física conjugal: características pessoais e relacionais / Predictores de violencia física conyugal: características personales y relacionales

Conjugal violence is a complex phenomenon that deserves attention because of its prevalence. The aim of this study was to verify the predictive power of the family-of-origin experiences, early maladaptive schemas, love, marital adjustment and family climate to marital physical violence occurrence. In this quantitative, correlational and explanatory study 186 men and 186 women took part, aged from 19 to 81 (M=41,17; SD=12,75). The instruments used measured general information, family of origin (FBQ), maladaptive schemes (YSQs), love (TLS), marital adjustment (DAS), family climate (FCI) and marital conflicts (CTS2). The results showed an association between the studied variables. In addition, the variables family conflict and sexual abuse in childhood were predictive of physical violence committed by women, while marital dissatisfaction was the predictor of marital violence committed by men. In view of the results, it can be established that the phenomenon of violence in intimate relationships is multidetermined, requiring attention from health professionals. (AU)

A violência conjugal é um fenômeno complexo que merece atenção pela alta prevalência. O objetivo deste estudo foi verificar o poder preditivo de experiências na família de origem, esquemas iniciais desadaptativos, amor, ajustamento conjugal e clima familiar para a ocorrência de violência física conjugal. Participaram deste estudo, quantitativo, correlacional e explicativo, 186 homens e 186 mulheres, com idades entre 19 a 81 anos (M=41,17; DP=12,75). Os instrumentos utilizados mediram informações gerais, família de origem (FBQ), esquemas desadaptativos (IEDs), amor (ETAS), ajustamento conjugal (DAS), clima familiar (ICF) e conflitos conjugais (CTS2). Os resultados evidenciaram associação entre as variáveis estudadas. Além disso, as variáveis conflito familiar e abuso sexual na infância foram preditoras da violência física cometida pelas mulheres, enquanto que a insatisfação conjugal foi a variável preditora da violência conjugal cometida pelos homens. A partir dos resultados foi possível constatar quanto o fenômeno da violência em relacionamentos íntimos é multideterminado, exigindo atenção dos profisisonais da saúde. (AU)

La violencia conjugal es un fenómeno complejo que merece atención por su alta prevalencia. El objetivo de este estudio fue verificar el poder predictivo de experiencias en la familia de origen, esquemas iniciales desadaptativos, amor, ajuste conjugal y el clima familiar para la aparición de violencia física conjugal. Participaron deste estudio cuantitativo, correlacional y explicativo 186 hombres y 186 mujeres, con edades entre 19 y 81 años (M = 41,17, SD = 12,75). Los instrumentos utilizados midieron informaciones generales, familia de origen (FBQ), esquemas desadaptativos (IEDs), amor (ETAS), ajuste conyugal (DAS), clima familiar (ICF) y conflictos conyugales (CTS2). Los resultados mostraron asociación entre las variables estudiadas. Además, las variables conflicto familiar y abuso sexual en la infancia fueron predictores de la violencia física cometida por las mujeres, mientras que la insatisfacción conyugal fue la variable predictora de la violencia conjugal cometida por los hombres. Los resultados muestran que el fenómeno de violencia en relacionamientos íntimos es multi-determinado, requiriendo atención de profesionales de la salud. (AU)

Analysis of contextual variables in the evaluation of child abuse in the pediatric emergency setting / Análise das variáveis contextuais na avaliação dos maus-tratos infantis a partir da realidade de uma urgência pediátrica

Abstract Objective: This article comprises a sample of abuse modalities observed in a pediatric emergency room of a public hospital in the Lisbon metropolitan area and a multifactorial characterization of physical and sexual violence. The objectives are: (1) to discuss the importance of social and family variables in the configuration of both types of violence; (2) to show how physical and sexual violence have subtypes and internal diversity. Methods: A statistical analysis was carried out in a database (1063 records of child abuse between 2004 and 2013). A form was applied to cases with suspected abuse, containing data on the child, family, abuse episode, abuser, medical history, and clinical observation. A factorial analysis of multiple correspondence was performed to identify patterns of association between social variables and physical and sexual violence, as well as their internal diversity. Results: The prevalence of abuse in this pediatric emergency room was 0.6%. Physical violence predominated (69.4%), followed by sexual violence (39.3%). Exploratory profiles of these types of violence were constructed. Regarding physical violence, the gender of the abuser was the first differentiating dimension; the victim's gender and age range were the second one. In the case of sexual violence, the age of the abuser and co-residence with him/her comprised the first dimension; the victim's age and gender comprised the second dimension. Conclusion: Patterns of association between victims, family contexts, and abusers were identified. It is necessary to alert clinicians about the importance of social variables in the multiple facets of child abuse.

Resumo Objetivo: Este artigo apresenta uma casuística de modalidades de maus-tratos numa urgência pediátrica (UP) de um hospital público na área metropolitana de Lisboa e uma caracterização multifatorial da violência física e violência sexual. Os objetivos são: 1) discutir a importância de variáveis sociais e familiares na configuração de ambos; 2) mostrar como violência física e violência sexual apresentam subtipos e diversidade interna. Métodos: Fez-se uma análise estatística de uma base de dados (1.063 registos de maus-tratos infantis, entre 2004-2013). Usou-se o formulário aplicado a casos com suspeita de maus-tratos, com dados sobre a criança, família, episódio de maus-tratos, agressor, história médica e observação clínica. Foi feita uma análise fatorial de correspondências múltiplas para identificar padrões de associação entre variáveis sociais e violência, física e sexual, bem como sua diversidade interna. Resultados: A prevalência de maus-tratos nessa UP foi de 0,6%. Predominam a violência física (69,4%) e a violência sexual (39,3%). Perfis exploratórios desses tipos foram construídos. Quanto à violência física, o sexo do agressor estrutura a primeira dimensão diferenciadora; sexo e grupo etário da vítima estruturam a segunda. No caso da violência sexual, a idade do agressor e corresidência com ele estruturam a primeira dimensão; idade e sexo das vítimas organizam a segunda dimensão. Conclusão: Identificaram-se padrões de associação entre vítimas, contextos familiares e agressores. É necessário alertar os clínicos para a importância das variáveis sociais nas múltiplas faces que os maus-tratos assumem.

Analysis of contextual variables in the evaluation of child abuse in the pediatric emergency setting.

OBJECTIVE: This article comprises a sample of abuse modalities observed in a pediatric emergency room of a public hospital in the Lisbon metropolitan area and a multifactorial characterization of physical and sexual violence. The objectives are: (1) to discuss the importance of social and family variables in the configuration of both types of violence; (2) to show how physical and sexual violence have subtypes and internal diversity. METHODS: A statistical analysis was carried out in a database (1063 records of child abuse between 2004 and 2013). A form was applied to cases with suspected abuse, containing data on the child, family, abuse episode, abuser, medical history, and clinical observation. A factorial analysis of multiple correspondence was performed to identify patterns of association between social variables and physical and sexual violence, as well as their internal diversity. RESULTS: The prevalence of abuse in this pediatric emergency room was 0.6%. Physical violence predominated (69.4%), followed by sexual violence (39.3%). Exploratory profiles of these types of violence were constructed. Regarding physical violence, the gender of the abuser was the first differentiating dimension; the victim's gender and age range were the second one. In the case of sexual violence, the age of the abuser and co-residence with him/her comprised the first dimension; the victim's age and gender comprised the second dimension. CONCLUSION: Patterns of association between victims, family contexts, and abusers were identified. It is necessary to alert clinicians about the importance of social variables in the multiple facets of child abuse.

Caracterización de mujeres víctimas de violencia intrafamiliar atendidas en sala psicosocial del movimiento comunal Nicaragüense Matagalpa en el Periódo 2014-2015

El objetivo de este estudio es Caracterizar a la mujeres víctimas de violenciaintrafamiliar que son atendidas en la sala psicosocial del Movimiento ComunalNicaragüense del departamento de Matagalpa en el periodo 2014 – 2015.Metodología: Para la recolección de información se contó con autorización demovimiento comunal nicaragüense de Matagalpa para la revisión de expedientesclínico de víctimas de violencia, la firma de consentimiento informado, la aplicación detest de autoestima y el desarrollo de un grupo focal con mujeres que participaron en elproceso.Los resultados del estudio reflejan que el 58% de las mujeres participantes delproceso 58% son afectadas por violencia psicológica, un 43% por violencia económicao patrimonial, un 38% por violencia física, y un 31% por violencia sexual, las mujeresque gozan de nivel de autoestima buena, muy buena o excelente han realizadoacciones para salir del circulo de la violencia, como buscar ayuda, denuncias anteautoridades competentes, o deciden dejar una relación de violencia.

Violencia en la relación de pareja de los alumnos de enfermería, 2015 / Violence in the relationship of nursing students, 2015

Objetivo: Conocer y adentrarse en el estudio de violencia en las relaciones de pareja de los estudiantes de la ENEO-UNAM. Metodología: Se realizó un estudio descriptivo, la unidad de observación fueron alumnos de las carreras: Lic. en Enfermería y Lic. en Enfermería y Obstetricia, el muestreo fue no probabilístico. Se aplicó un cuestionario exprofeso “Detección de violencia en pareja”, de 15 reactivos. Resultados: Se estudiaron 112 alumnos, el 84.8% correspondió al género femenino, el 51% tienen menos 20 años, 37% tiene entre 20-23 y el 12% más de 23 años de edad. El 85.7% de las (os) alumnos, informo que tiene violencia emocional (controla su tiempo, celos y la acusa de ser le infiel), El 38.3% está en proceso de gestación de dependencia, el 15.8% tiene violencia económica, el 1.8% dijo tener violencia física, el 8.9% reportó violencia psicológica y solo se reportó un caso de violación por parte de su pareja. Conclusiones: Se confirma que existe violencia en las relaciones de pareja de tipo: emocional, dependencia, física, económica y sexual en los alumnos de enfermería, por lo que se debe de implementar y aplicar una intervención para disminuir esta. Es necesario fomentar que toda pareja llegue a acuerdos, donde se establezcan límites y distancias, sobre todo fomentar el mutuo respeto.

Introduction: The National Survey on the Dynamic of Household Relations (ENDIREH) 2011, reported that 46.1% of women over 15 have experienced violence by their partners. Objective: To determine and enter the study of violence in relationships of students ENEO-UNAM. Methodology: A descriptive study, the observation unit were students of the races: Lic. Nursing and Nursing and Midwifery, was non-probability sampling. a questionnaire exprofeso "Detection of violence as a couple" of 15 items was applied. Results: 112 students were studied, 84.8% were female, 51% are under 20 years, 37% are between 20- 23 and 12% over 23 years old. 85.7% of the (old) students reported having emotional violence (control your time, jealousy and accuses her of being unfaithful), 38.3% is in the making of dependence, 15.8% is economic violence, 1.8 % reported physical violence, 8.9% reported psychological violence and only one reported case of rape by an intimate partner. Conclusions: It is confirmed that there is violence in the relationships of type: emotional dependency, physical, economic and sexual in nursing students, so it must implement and apply an intervention to reduce this. It is necessary to encourage all couples reach agreements, which set limits and distances, especially foster mutual respect.

Violencia física en el embarazo: realidad en el extremo sur de Chile / Physical violence in pregnancy: reality in the southern tip of Chile

Objetivo: Describir el perfil de las mujeres adscritas al Programa de Violencia, Punta Arenas, Chile, y que han presentado violencia física durante el embarazo. Método: Estudio de abordaje cuantitativo, con diseño descriptivo y retrospectivo. Se entrevistó a 59 mujeres, utilizando el Instrumento de la OMS sobre la violencia contra las mujeres Versión 9.1 para Chile modificado. Resultados: La prevalencia de violencia durante el embarazo fue 28,8 por ciento. En su mayoría el agresor fue la pareja y el 52,9 por ciento declaró que los golpes o patadas fueron en el abdomen. El 100 por ciento presento violencia psicológica, física leve y grave y 70,6 por ciento violencia sexual. El 58,8 por ciento tenía entre 15 a 29 años al momento de vivenciar la violencia, el 35,5 por ciento completó la enseñanza media, de religión católica, trabajan fuera del hogar, convivían, tenían tres o más hijos y con estrato socioeconómico medio y medio bajo. Las manifestaciones de violencia que se relacionaron con violencia física en el embarazo fueron la presencia de manifestaciones de violencia física leve: abofeteado o tirado cosas que pudieran herirla (p=0,000) y violencia física grave: golpeado con su puño u otra cosa que pudiera herirla (p=0,006), pateado, arrastrado o dado una golpiza (p=0,004), estrangularla a propósito (p=0,010), presencia de lesiones (p=0,048). Los factores que se relacionaron con la presencia de violencia física en el embarazo fueron el nivel educacional de la pareja (p=0,047), condición laboral de la mujer (p=0,018) y antecedentes de peleas físicas en la pareja con otros hombres (p=0,046). Conclusión: Los hallazgos obtenidos permiten identificar precozmente a las embarazadas con mayor riesgo de violencia, y permiten ofrecer una intervención oportuna, minimizando las graves consecuencias que tiene para la mujer y los hijos.

Aim: To describe the profile of the women assigned to the Violence Program who have submitted physical violence during pregnancy in Punta Arenas, Chile. Methods: Retrospective descriptive study with a quantitative approach. 59 women were interviewed using the WHO instrument on violence against women, modified Version 9.1 for Chile. Results: Prevalence of violence during pregnancy corresponded to 28.8 percent. Most of the time, the aggressor was the intimate partner and 52.9 percent declared that the blows or kicks were in the abdomen. 100 percent presented severe and mild physical and psychological violence, and 70.6 percent presented sexual violence. 58.8 percent were between 15 and 29 years at the time of experiencing violence. 35,5 percent were catholic women who have finished high school, worked outside home, lived together with an intimate partner, had three or more children, and belonged to a middle and lower middle socioeconomic strata. Manifestations of violence which were related to physical violence during pregnancy were slapping or throwing things that could hurt them (p=0.000). Severe physical violence included punching or being hurt with something that could hurt them (p=0.006); kicking, dragging on the ground or being beaten (p=0.004); strangling on purpose (p=0.010), and appearance of injuries (p=0.048). Factors related to manifestations of physical violence in pregnancy were: intimate partner's educational level (graduated high school or less than high school education (p=0.047), employment status of women (p=0.018) and the intimate partner history ofphysical fights with other men (p=0,046). Conclusion: The findings obtained in this study give us the opportunity to visualize the phenomenon of physical violence during pregnancy, contributing to early identification of pregnant women at increased risk in order to provide timely intervention, minimizing the serious consequences for women and children.

[Forensic assessment of violence risk]. / Valoración forense del riesgo de violencia.

Over the last 20 years there have been steps forward in the field of scientific research on prediction and handling different violent behaviors. In this work we go over the classic concept of "criminal dangerousness" and the more current of "violence risk assessment". We analyze the evolution of such assessment from the practice of non-structured clinical expert opinion to current actuarial methods and structured clinical expert opinion. Next we approach the problem of assessing physical violence risk analyzing the HCR-20 (Assessing Risk for Violence) and we also review the classic and complex subject of the relation between mental disease and violence. One of the most problematic types of violence, difficult to assess and predict, is sexual violence. We study the different actuarial and sexual violence risk prediction instruments and in the end we advise an integral approach to the problem. We also go through partner violence risk assessment, describing the most frequently used scales, especially SARA (Spouse Assault Risk Assessment) and EPV-R. Finally we give practical advice on risk assessment, emphasizing the importance of having maximum information about the case, carrying out a clinical examination, psychopathologic exploration and the application of one of the described risk assessment scales. We'll have to express an opinion about the dangerousness/risk of future violence from the subject and some recommendations on the conduct to follow and the most advisable treatment.

La violencia psicológica en las relaciones de pareja: una problemática actual / Psychological violence in intimate relationships: a current problem

Se realiza una revisión bibliográfica sobre la violencia psicológica en las relaciones de parejas heterosexuales, con el objetivo de valorar el comportamiento de este fenómeno en la actualidad. Se hace énfasis en las características que la diferencian de las otras formas de violencia hacia las mujeres. Se constata que la violencia psicológica está presente en las relaciones de pareja sin que las personas sean conscientes de su presencia, naturalizándola y atribuyendo muchas de sus manifestaciones a comportamientos propios de la cultura patriarcal, lo cual garantiza su permanencia y la transmisión de patrones comportamentales anacrónicos a la hora de resolver conflictos en el marco de las relaciones de pareja a las presentes y futuras generaciones. Estos temas, sirven de análisis y discusión para los profesores y estudiantes que pertenecen a la Cátedra de Sexualidad de la Facultad de Ciencias Médicas Guantánamo(AU)

A literature review of psychological violence in the relationships of heterosexual couples, in order to assess the behavior of this phenomenon is performed today. Emphasis on the characteristics that differentiate it, from other forms of violence against women is done. It is found that psychological violence is present in relationships without making people aware of their presence, naturalizing and attributing many of his own behavior, manifestations of patriarchal culture, ensuring their stay and the transmission of behavioral patterns anachronistic when resolving conflicts within intimate relationships of the present and future generations. These themes serve as analysis and discussion for teachers and students belonging to the Department of Sexuality, Faculty of Medical Sciences Guantanamo

Trauma craniano violento pediátrico: uma revisão da literatura / Abusive head trauma in children: a literature review

OBJETIVO: Fornecer uma revisão de literatura científica sobre trauma craniano violento pediátrico enquanto forma de maus-tratos físicos contra bebês e crianças, ressaltando prevalência, sinais e sintomas, consequências, fatores de risco para sua ocorrência e, principalmente, estratégias de prevenção. FONTES DOS DADOS: Revisão nas bases de dados MEDLINE, SciELO, LILACS e Web of Science no período de 2001 a 2012 utilizando os termos "síndrome do bebê sacudido" e "trauma craniano violento" em inglês, espanhol e português. SÍNTESE DOS DADOS: O trauma craniano violento é definido como a lesão ao crânio ou ao conteúdo intracraniano de um bebê ou criança menor de cinco anos devido a um impacto brusco intencional e/ou a uma sacudida violenta. Ocorre principalmente com bebês e crianças menores de um ano de idade, e pode resultar em consequências graves, desde deficiências físicas ou mentais até a morte. Apesar de haver sinais específicos para esta forma de maus-tratos, eles podem se confundir com doenças comuns em crianças ou traumas cranianos acidentais, sendo imprescindível o preparo clínico dos profissionais envolvidos na avaliação dos casos para o diagnóstico correto. As estratégias de prevenção devem incluir tanto a identificação precoce dos casos, como a educação parental sobre o desenvolvimento infantil, especialmente sobre o padrão de choro do bebê. CONCLUSÕES: Considerando a gravidade do trauma craniano violento pediátrico, é fundamental que estratégias de prevenção sejam implementadas e avaliadas no contexto brasileiro. Sugere-se que indicadores de sua incidência sejam pesquisados nacionalmente.

OBJECTIVE: To review the scientific literature on pediatric abusive head trauma as a form of physical abuse against infants and young children, highlighting the prevalence, signs and symptoms, consequences, risk factors for its occurrence, and prevention strategies. DATA SOURCE: The MEDLINE, SciELO, LILACS, and Web of Science databases from 2001 to 2012 were reviewed, using the terms "shaken baby syndrome" and "abusive head trauma" in English, Spanish, and Portuguese. DATA SYNTHESIS: Pediatric abusive head trauma is defined as injury to the skull or intracranial contents of a infant or child younger than 5 years due to intentional abrupt impact and/or violent shaking. It occurs mainly in infants and children under 1 year of age, and may result in severe consequences, from physical or mental disabilities to death. Although there are specific signs for this form of abuse, they can be mistaken for common illnesses in children or accidental head injury; thus, clinical training of professionals involved in the assessment of cases to attain the correct diagnosis is crucial. Prevention strategies should include early identification of cases, as well as parental education on child development, especially on the infant's crying pattern. CONCLUSIONS: Considering the severity of abusive head trauma in children, it is critical that prevention strategies be implemented and evaluated in the Brazilian context. It is suggested that its incidence indicators be assessed at the national level.

Abusive head trauma in children: a literature review.

OBJECTIVE: To review the scientific literature on pediatric abusive head trauma as a form of physical abuse against infants and young children, highlighting the prevalence, signs and symptoms, consequences, risk factors for its occurrence, and prevention strategies. DATA SOURCE: The MEDLINE, SciELO, LILACS, and Web of Science databases from 2001 to 2012 were reviewed, using the terms "shaken baby syndrome" and "abusive head trauma" in English, Spanish, and Portuguese. DATA SYNTHESIS: Pediatric abusive head trauma is defined as injury to the skull or intracranial contents of a infant or child younger than 5 years due to intentional abrupt impact and/or violent shaking. It occurs mainly in infants and children under 1 year of age, and may result in severe consequences, from physical or mental disabilities to death. Although there are specific signs for this form of abuse, they can be mistaken for common illnesses in children or accidental head injury; thus, clinical training of professionals involved in the assessment of cases to attain the correct diagnosis is crucial. Prevention strategies should include early identification of cases, as well as parental education on child development, especially on the infant's crying pattern. CONCLUSIONS: Considering the severity of abusive head trauma in children, it is critical that prevention strategies be implemented and evaluated in the Brazilian context. It is suggested that its incidence indicators be assessed at the national level.