Um olhar além do concreto: Formação Humana Mediada por Tecnologia para a Saúde no Sistema Prisional / A look beyond the concrete: Technology-Mediated Human Formation for Health in the Prison System

Este livro: UM OLHAR ALÉM DO CONCRETO: Formação Humana Mediada por Tecnologia para a Saúde no Sistema Prisional é fruto do trabalho da Pesquisadora e Doutora, Janaína Rodrigues, que mergulhou em uma imersão no Sistema Prisional Brasileiro para produzir a Trilha Formativa: "Além dos Muros". Neste trabalho a sua pesquisa aponta que para haver uma intervenção eficaz em grande escala na saúde prisional é preciso considerar a tríade do Sistema Prisional, ou seja, o policial penal, o privado de liberdade e o profissional de saúde. Para a autora, o que a motivou foi : "A oportunidade de transformar as vidas de pessoas que estão no ambiente do cárcere. Dar voz a elas, garantir os seus direitos e mostrar que a qualidade de vida delas repercute também na sociedade, foi de fundamental importância para o sucesso deste trabalho. Esse é um movimento que tem impactos sociais relevantes, e contribui com os Objetivos de Desenvolvimento Sustentável (ODS) da Agenda 2030 da Organização das Nações Unidas (ONU), da qual o Brasil é signatário."

Women's Shelter, a prison in reverse: when the protection of victims imprisons them. / Casa-abrigo, uma prisão às avessas: quando a proteção às vítimas as aprisiona.

This article aimed to know a Shelter for women in situations of intimate partner violence at imminent risk of death located in the state of Rio de Janeiro from the perception of its professionals. To this end, this qualitative research adopted semi-structured interviews with seven professionals directly involved with the care and assistance to the Shelter's user population. The findings were interpreted through Bardin's thematic content analysis. Moreover, the profile of the women and children sheltered in 2021 was drawn based on the data provided by the institution. In conceptual terms, this work focused on intersectional feminist theoretical references. Among the results, we argue that the shelter is permeated by contradictions, from its normative idealizations to institutional practices: on the one hand, the shelter represents the possibility of salvation, that is, of interrupting the escalation of violence and, therefore, preventing femicide. However, on the other hand, it appears as an upside-down prison, which "incarcerates" the victims. We highlight the importance of thinking about new ways to ensure protection for women who need this shelter.

O artigo teve como objetivo conhecer uma casa-abrigo para mulheres em situação de violência por parceiros íntimos (VPI) em risco iminente de morte localizada no estado do Rio de Janeiro a partir da percepção de seus profissionais. Para tanto, a pesquisa teve abordagem qualitativa e foram realizadas entrevistas semiestruturadas com sete profissionais envolvidos/as diretamente no atendimento e na assistência às mulheres atendidas pela casa-abrigo. A interpretação dos achados se deu por meio da técnica de análise de conteúdo temática preconizada por Bardin. Além disso, foi traçado o perfil das mulheres e crianças abrigadas no ano de 2021, com base nos dados disponibilizados pela instituição. Em termos conceituais, este trabalho debruçou-se sobre referenciais teóricos feministas interseccionais. Entre os resultados, argumenta-se que a casa-abrigo está permeada por contradições, desde suas normativas às práticas institucionais: por um lado, representa uma possibilidade de "salvação", isto é, de interrupção da escalada da violência e, portanto, de impedimento do feminicídio, mas, por outro, aparece como uma prisão "às avessas", que "prende" as vítimas. Aponta-se a importância e a urgência de pensar novas formas de garantir proteção às mulheres que necessitam desse tipo de abrigamento.

Insights into SARS-CoV-2 Surveillance among Prison Populations in Mato Grosso do Sul, Brazil, in 2022.

This study examines the epidemiological and genomic characteristics, along with the transmission dynamics, of SARS-CoV-2 within prison units I and II in Campo Grande, Mato Grosso do Sul, Brazil. Conducted between May and October 2022, it reveals how the virus spreads in the confined settings of prisons, emphasizing the roles of overcrowded cells, frequent transfers, and limited healthcare access. The research involved 1927 participants (83.93% of the total prison population) and utilized nasopharyngeal swabs and RT-qPCR testing for detection. Contact tracing monitored exposure within cells. Out of 2108 samples, 66 positive cases were identified (3.13%), mostly asymptomatic (77.27%), with the majority aged 21-29 and varying vaccination statuses. Next-generation sequencing generated 28 whole genome sequences, identifying the Omicron variant (subtypes BA.2 and BA.5) with 99% average coverage. Additionally, the study seeks to determine the relationship between immunization levels and the incidence of SARS-CoV-2 cases within this enclosed population. The findings underscore the necessity of comprehensive control strategies in prisons, including rigorous screening, isolation protocols, vaccination, epidemiological monitoring, and genomic surveillance to mitigate disease transmission and protect both the incarcerated population and the broader community.

A silent threat behind bars: Serosurvey and associated risk factors for strongyloidiasis in female inmates and correctional officers.

Strongyloidiasis has been a neglected parasitic infection caused by Strongyloides genus parasites. Despite assessment of S. stercoralis exposure in different vulnerable populations, seroprevalence in inmates worldwide remains to be fully established. Due to poor sanitation and lack of personal hygienic practices, incarcerated individuals have been considered prone to spread infectious illnesses. Accordingly, the present study has assessed exposure and associated risk factors for strongyloidiasis in women inmates and correctional officers at the Women's State Penitentiary of Parana, part of the third largest incarceration complex in Brazil at the time. Blood samplings were performed in 2020 and 2021from a total of 503 women inmates and 92 correctional officers. Participants voluntarily responded to an epidemiological questionnaire to assess associated risk factors to strongyloidiasis. Serological analysis was performed by ELISA for anti-S. stercoralis IgG detection. Statistical analysis was performed using R software, adopting a 5% level of significance. The data were submitted to univariate analysis by chi-square or Fisher´s Exact test for assessing the association among seropositivity and the variables. The variables with p-value < 0.2 in the univariate analysis were considered fit to be included in the logistic regression. In overall, 356/503 (70.8%; 95% CI: 66.7-74.6) inmates were seropositive for anti-S. stercoralis antibodies, with no statistically associated risk factor to seropositivity. A total of 57/92 (62.0%; 95% CI: 51.8-71.2) correctional officers were seropositive, and logistic regression revealed that individuals older than 50 years were more likely seropositive. In conclusion, the high endemicity observed herein has indicated a history of previous exposure to S. stercoralis and warned for a systematic strongyloidiasis screening for inmates, to prevent long term morbidity and disseminated infection during incarceration.

Ill-treatment in the Chilean prison system - an analysis of reports presented by the National Institute of Human Rights (INDH) and their handling by the legal actors.

INTRODUCTION: Prisons in Latin America are often described as violent and lawless places. This article analyses the Chilean case. We want to find out how complaints of ill-treatment are investigated if the victim is in prison. Our hypothesis is that the response to the phenomenon, both in the prose-cution of the perpetrators and in the protection of its victims, does not take into consideration the guidelines established in international standards, especially those contained in the Istanbul Proto-col. METHODS: We analysed a total of 124 complaints of ill-treatment filed by the Chilean National Human Rights Institute (INDH). RESULTS: An excessive amount of time elapses between the alleged ill treatment, the filing of complaints, the use of protective measures, and the termination of the cases. There are serious deficiencies in the investigations carried out by the Public Prosecutor's Office, and therefore, most of the complaints are not clarified and end up being shelved. We conclude that, through both the actions of the judges and the prosecutors in the processing of the complaints, when it comes to investigating acts of ill-treatment inside Chilean prisons, the standards of the Istanbul Protocol are not met.

Degradation as salvation: Reflections on El Salvador's punitive prison model.

The pictures of shaven men with naked upper bodies, sitting in rows back-to-back with fellow prisoners in close proximity, sur-rounded by heavily armed guards, encapsulates the essence of El Salvador's ongoing "war on gangs".

Paths and inter-mediations between Brazilian Health Services and Youth Detention Centers. / Caminhos e intermediações entre serviços do Sistema de Saúde e da Socioeducação.

Socio-education is an educational and (re)socialization proposal for young people having troubles with the law, a law which also includes the right to health care guaranteed by the Unified Health System (SUS). This study aims to investigate the relationship between health services and socio-educational units in Paraná state, from the perspective of service workers and managers. The qualitative and exploratory research consisted of sixteen semi-structured interviews in five municipalities in the state, with subsequent categorization of the narratives based on hermeneutic analysis. As a result, there was considerable weakness in the coordination between the network's facilities to promote overall health care, specifically the mental health of young people. Security issues have a strong influence on the regulation of actions, even health actions, in socio-education. The current policy of comprehensive health care in socio-education, implemented in Brazil in 2014, is, however, an important counterpoint for the reordering and nudging policies in this area.

A socioeducação é proposta educacional e de (re)socialização do jovem em conflito com a lei, na qual se prevê, igualmente, o direito à atenção à saúde garantido pelo Sistema Único de Saúde (SUS). O presente trabalho visa investigar como se dá a relação entre os serviços de saúde e as unidades socioeducativas no estado do Paraná a partir da perspectiva de trabalhadores e gestores dos serviços. A pesquisa qualitativa e de cunho exploratório consistiu na realização de dezesseis entrevistas semiestruturadas em cinco municípios do estado, com posterior categorização das narrativas a partir de análise hermenêutica. Como resultado evidenciou-se considerável fragilidade na articulação entre os equipamentos da rede para promoção da assistência à saúde em geral e, mais notoriamente, à saúde mental dos jovens. Os quesitos de segurança exercem forte influência na regulação das ações, até mesmo de saúde, na socioeducação. A política atual de atenção integral à saúde na socioeducação, implantada no Brasil em 2014, representa, contudo, um importante contraponto na reordenação e na indução das ações nesse âmbito.

Access to health care among female prisoners in a penitentiary in Ceará, Brazil. / Acesso e cuidado a saúde de mulheres privadas de liberdade na penitenciária cearense.

This study investigated access to health care among female prisoners in the state of Ceará, Brazil, and screened for common mental disorders. We conducted an analytical cross-sectional study in the only female prison in the state. Ninety detainees participated in the study. All participants were either pregnant or postpartum women or had one or more of the following health problems: hypertension, diabetes mellitus, tuberculosis, syphilis, hepatitis B, HIV/AIDS. The data were collected using a structured questionnaire. The findings reveal that access to health care was limited, violating the fundamental rights of the prisoners. Screening for diseases on admission to prison was limited, especially among non-pregnant women. Differences in health care were found between health conditions, with priority being given to pregnant and postpartum women. Most of the inmates (68.24%) were found to be at risk for common mental disorders (SRQ score > 7). A positive correlation was found between age and mental health problems (p = 0.0002). Despite legislation guaranteeing access to health care in prisons, the prison system is unprepared to meet the health needs of female prisoners with comorbidities and pregnant and puerperal women.

O estudo analisa o acesso ao cuidado em saúde de mulheres encarceradas no estado do Ceará, rastreando transtornos mentais comuns. Estudo analítico, transversal, de natureza quantitativa, desenvolvido na única penitenciária feminina do Ceará. Participaram 90 detentas, todas com alguma das seguintes questões de saúde: gestantes, puérperas, portadoras de hipertensão arterial sistêmica, diabetes mellitus, tuberculose, sífilis, hepatite B ou HIV/Aids. Os dados foram coletados por entrevista estruturada. Evidenciou-se acesso limitado à atenção à saúde das detentas, violando direitos básicos sob tutela do Estado. Foram constatadas limitações de exames de rastreamento de doenças nas presidiárias na ocasião de seu acesso ao cárcere, principalmente as que não se encontravam grávidas no momento do encarceramento. Houve diferenças entre as distintas condições de saúde analisadas, com prioridade da atenção às gestantes e puérperas. Entre as detentas, 68,24% apresentavam risco de transtornos mentais comuns (SRQ > 7). Houve correlação positiva entre idade e saúde mental (p = 0,0002). Embora exista legislação pertinente de garantia de acesso à saúde no cárcere, o sistema prisional está despreparado para atender às necessidades de portadoras de comorbidades, gestantes e puérperas.

Generalized Resistance Deficits in inmates with hypertension: missing resources that limit health.

OBJECTIVE: to understand the Generalized Resistance Deficits of people deprived of liberty with hypertension in a Brazilian prison unit. METHOD: qualitative research, anchored in Salutogenesis, carried out with 38 people with hypertension from a Brazilian prison unit, from February to July 2022, with a semi-structured interview with open-ended questions, whose analysis was thematic, explaining the limitations to health in prison. RESULTS: 13 Generalized Resistance Deficits were reported, mostly related to the prison environment and, to a lesser extent, to the social group and the individual, respectively. Living in prison for people with hypertension implies living with a high number of Generalized Resistance Deficits, accentuating the movement towards the disease pole. FINAL CONSIDERATIONS: knowing Generalized Resistance Deficits allows directing health promotion to support the use of available Generalized Resistance Resources and contributes to the expansion of intersectoral policies.

For Tuberculosis, Not "To Screen or Not to Screen?" but "Who?" and "How?"

Active case finding leveraging new molecular diagnostics and chest X-rays with automated interpretation algorithms is increasingly being developed for high-risk populations to drive down tuberculosis incidence. We consider why such an approach did not deliver a decline in tuberculosis prevalence in Brazilian prison populations and what to consider next.

Few Prison Systems Release Individual Death Data: Death in Custody Reporting Act Completeness, Speed, and Compliance.

The United States has one of the largest incarcerated populations per capita. Prisons are dangerous environments, with high in-prison and postrelease mortality. The Death in Custody Reporting Acts (DCRAs) of 2000 and 2013 require deaths of people in correctional custody or caused by law enforcement to be reported to the Bureau of Justice Assistance. These deaths must be reported within 3 months of the death and include 10 required fields (eg, age, cause of death). There is no public reporting requirement. Our Third City Mortality project tracks near-real-time data about individual deaths released publicly and prison system metadata, including data completeness and release speed, across (N = 54) US state, federal (N = 2; Bureau of Prisons, Immigration and Customs Enforcement), Washington, District of Columbia, and Puerto Rico prison systems. Twenty-one (38%) systems release no individual death data; 13 systems release incomplete data slower than 1 year; 19 release timely, but incomplete, death data; and only one system (Iowa) releases complete and timely data. Incomplete, untimely, public prison mortality data limit protective community responses and epidemiology.

Tuberculosis in prison: What about after release? The example of French Guiana.

INTRODUCTION: Tuberculosis is a major cause of mortality worldwide. Prisoners in Guiana have multiple risk factors. The primary objective of this study was to describe tuberculosis occurring in prison and after release in French Guiana between 2008 and 2020. Secondary objectives were to identify tuberculosis risk factors and determine annual incidences. METHODS: A retrospective cohort study of tuberculosis cases was carried out at the Guiana prison between 2008 and 2020. Data were collected from prison registers and cross-referenced with the list of tuberculosis notifications in French Guiana. RESULTS: A total of 36 cases of tuberculosis were studied. Incidence was high, at 263/100,000 per year, higher than elsewhere in France and comparable to that in Brazil. Despite visibly effective screening on entry, with little evidence of intra-prison circulation of tuberculosis, 39% of patients were diagnosed within two years of leaving prison (76% were symptomatic). This could be explained by the high prevalence of latent forms (LTI). DISCUSSION: Continued screening on entry, in combination with annual radiological and clinical screening, and reinforced follow-up on release seem indicated to improve patient management and the search for possible LTI.

Breastfeeding behind bars: Experiences of incarcerated mothers in the Spanish penitentiary system. / Lactancia materna entre rejas: experiencias de las madres encarceladas en el sistema penitenciario español.

This research aims to analyze the breastfeeding experiences of incarcerated mothers in the prisons of the Spanish penitentiary system. Additionally, it explores whether these mothers have perceived practices related to obstetric violence during pregnancy, childbirth, and the postpartum period. An exploratory-descriptive study was conducted using a qualitative approach and a critical ethnographic method. Fieldwork, including participant observation and semi-structured interviews, was carried out between December 2021 and April 2022. The study involved 30 adult women from Africa, Europe, Eastern Europe, and Latin America, all serving sentences with their infants in Mother Units located in the Spanish cities of Alicante, Barcelona, Madrid, and Seville. The main findings highlight the need for penitentiary policies with a gender and feminist perspective. These policies should aim to eliminate severe inequalities and discriminations faced by incarcerated women while protecting the basic rights of both mothers and infants.

Esta investigación tiene como objetivo analizar la experiencia con respecto a la lactancia materna de las madres encarceladas en las prisiones del sistema penitenciario español, así como estudiar si han percibido prácticas que aludan a la violencia obstetricia durante la gestación, el parto y el puerperio. Se realizó un estudio exploratorio-descriptivo con abordaje cualitativo y método etnográfico crítico. Entre diciembre de 2021 y abril de 2022, se efectuó el trabajo de campo con observación participante y entrevistas semiestructuradas a 30 de las mujeres mayores de edad procedentes de África, Europa, Europa del Este y Latinoamérica, que se encontraban cumpliendo condena junto a sus criaturas en las Unidades de Madres de las ciudades españolas de Alicante, Barcelona, Madrid y Sevilla. Las principales conclusiones señalan la necesidad de aplicar políticas penitenciarias con perspectiva de género y feminista, que consigan erradicar las graves desigualdades y discriminaciones que sufren las mujeres encarceladas y que sirvan para proteger los derechos básicos de madres y criaturas.

Serial Mass Screening for Tuberculosis Among Incarcerated Persons in Brazil.

BACKGROUND: An active search for tuberculosis cases through mass screening is widely described as a tool to improve case detection in hyperendemic settings. However, its effectiveness in high-risk populations, such as incarcerated people, is debated. METHODS: Between 2017 and 2021, 3 rounds of mass screening were carried out in 3 Brazilian prisons. Social and health questionnaires, chest X-rays, and Xpert MTB/RIF were performed. RESULTS: More than 80% of the prison population was screened. Overall, 684 cases of pulmonary tuberculosis were diagnosed. Prevalence across screening rounds was not statistically different. Among incarcerated persons with symptoms, the overall prevalence of tuberculosis per 100 000 persons was 8497 (95% confidence interval [CI], 7346-9811), 11 115 (95% CI, 9471-13 082), and 7957 (95% CI, 6380-9882) in screening rounds 1, 2, and 3, respectively. Similar to our overall results, there were no statistical differences between screening rounds and within individual prisons. We found no statistical differences in Computer-Aided Detection for TB version 5 scores across screening rounds among people with tuberculosis-the median scores in rounds 1, 2, and 3 were 82 (interquartile range [IQR], 63-97), 77 (IQR, 60-94), and 81 (IQR, 67-92), respectively. CONCLUSIONS: In this environment with hyperendemic rates of tuberculosis, 3 rounds of mass screening did not reduce the overall tuberculosis burden. In prisons, where a substantial number of tuberculosis cases is undiagnosed annually, a range of complementary interventions and more frequent tuberculosis cases screening may be required.

Board game on sexually transmitted infections for imprisoned women.

INTRODUCTION: The board games is an educational technology that represents an appealing, active and playful pedagogical strategy and may be capable of motivating imprisoned women to learn about Sexually Transmitted Infections. METHODS: A methodological study to develop and evaluate a board game, following these stages: 1. Integrative literature review to identify educational technologies on Sexually Transmitted Infections used by imprisoned women; 2. Development of the board game; and 3. Content validation performed by 23 evaluators and semantic evaluation carried out with 10 imprisoned women who were enrolled in a school located within a female prison unit in the city of Recife, state of Pernambuco, Brazil. RESULTS: The board game consisted of the following: 01 board; 01 instructions manual; 05 pawns; 52 cards; and 01 dice. A global Content Validity Index of 0.966 was reached in the content validation process performed by health and education professionals. In the validation of the board game content regarding appearance, performed by designers/developers, most of the items obtained a Content Validity Coefficient below 0.85, which resulted in the need for adjustments and a new validation round with these professionals, in which Content Validity Coefficient = 0.917 was obtained. In the semantic evaluation, all the women stated that they improved their knowledge, increased their motivation to attend the class and would like to play the board game again. CONCLUSIONS: The "Previna" board game has been validated and can be considered an important pedagogical tool in the construction of knowledge in relation to the prevention, treatment and control of Sexually Transmitted Infections in the female prison context. The quality of this educational technology is directly related to its development based on an appropriate theoretical and methodological framework, in addition to satisfactory feedback from the target audience. TRIAL REGISTRATION: Not applicable.

Seroprevalencia de SARS-CoV-2 en dos instituciones penitenciarias de Paraguay en el periodo abril-mayo del 2022 / Seroprevalence of SARS-CoV-2 in two penitentiary institutions in Paraguay in the period April-May 2022

Introducción. La pandemia de COVID-19 ha puesto al descubierto muchas de las desigualdades en la sociedad y una de las poblaciones vulnerables más desatendidas son las privadas de libertad. Objetivo. Determinar la seroprevalencia de SARS-CoV-2 en población privada de libertad (PPL) en dos instituciones penitenciarias de Paraguay entre abril a mayo de 2022. Materiales y métodos. Estudio descriptivo transversal en dos instituciones penitenciarias de Paraguay, una de varones y otra de mujeres, mediante un muestreo probabilístico bietápico. Las muestras sanguíneas se tomaron por punción dactilar para la determinación de anticuerpos anti SARS-CoV-2 por una prueba rápida IgG/IgM (Orient Gene Biotech COVID-19 casete). Para el análisis de datos se utilizó estadística descriptiva (media, desviación estándaryporcentajes) y analítica (prueba de chi cuadrado). Resultados. Se incluyeron 602 PPL, 67% varones y 33% mujeres, la media de edad fue de 34 años (DE 10,71), 21% (n=124) con comorbilidad, 31% (n=186) con vacunación completa. De los 66 PPL (11%) que informaron infección previa de Covid-19, 79% (n=52) desarrolló síntomas y 6% (n=4) requirió hospitalización. El 95% (IC95%: 92,18-96,58) presentó serología positiva (IgG y/o IgM) para SARS-CoV-2en hombres y 94% (IC95%: 89,65-96,83) en mujeres. En el grupo de vacunados la seropositividad fue 98,5% (IC95%: 97,11-99,25) y entre los no vacunados 57% (IC95%: 53,22-70,29). Conclusión. La seroprevalencia de SARS-CoV-2 fue similar a lo reportado en otros estudios. La insalubridad estructural y hacinamiento son factores que potencian la dispersión del virus y enfatiza la importancia de incentivar la vacunación en estas poblaciones. Palabras clave: estudios seroepidemiológicos; anticuerpos;SARS-CoV-2; prisiones; Paraguay

Introduction. The COVID-19 pandemic has exposed many of the inequalities in society and one of the most neglected vulnerable populations are those deprived of their liberty. Objective. Determine the seroprevalence of SARS-CoV-2 in the population deprived of liberty (PDL) in two penitentiary institutions in ParaguaybetweenApril-May 2022. Materials and methods. Cross-sectional descriptivestudy in two penitentiary institutions in Paraguay, one for men and the otheronefor women, using two-stage probabilistic sampling. The blood samples were taken by fingerprint for the determination of anti-SARS-CoV-2 antibodies by a rapid IgG/IgM test (Orient Gene Biotech COVID-19 cassette). Descriptive statistics (mean, standard deviation (SD), percentages) and analytical statistics (chi square test) were used for data analysis. Results. A total of 602 PDLwere included, 67%menand 33% women, the average age was 34 years (SD 10.71), 21% (n=124) with comorbidity, 31% (n=186) with complete vaccination. Of the 66 PPL (11%) who reported prior Covid-19 infection, 79% (n=52) developed symptoms and 6% (n=4) required hospitalization. In men,95% presented positive serology (IgG and/or IgM) for SARS-CoV-2 (95% CI: 92.18-96.58) and 94%(95% CI:89.65-96.83) in women. In the vaccinated group, seropositivity was 98.5% (95% CI: 97.11-99.25), and among the unvaccinated, 57% (95% CI: 53.22-70.29). Conclusion. The seroprevalence of SARS-CoV-2 was similar to that reported in other studies. The structural unhealthiness and overcrowdingare factors that enhance the spread of the virus and emphasize the importance of encouraging vaccination in these populations. Key words: seroepidemiologic studies; antibodies; SARS-CoV-2; prisons; Paraguay

Direitos sexuais e direitos reprodutivos na percepção de: mulheres privadas de liberdade / Sexual rights and reproductive rights in the perception of: women deprived of freedom / Derechos sexuales y derechos reproductivos percibidos por: mujeres privadas de libertad

Objetivo: analisar a percepção de mulheres privadas de liberdade quanto aos seus direitos sexuais e direitos reprodutivos. Método: pesquisa descritiva, com abordagem qualitativa. Foram realizadas entrevistas com mulheres que estavam vivenciando a gestação (9) e o puerpério (4), em duas unidades prisionais do Rio de Janeiro. O método de análise foi o Hermenêutico dialético. Resultados: foram elencadas duas categorias: 1) Violações institucionais como infração dos direitos sexuais e dos direitos reprodutivos e 2) Contradições entre a possibilidade de exercer os direitos e as limitações impostas pelo sistema carcerário. Conclusão: as violações que essas mulheres sofrem, não estão restritas a elas. A luta pelos direitos das mulheres é um movimento constante. Os avanços são significativos, contudo, há amarras reais que impedem que as mulheres usufruam seus direitos sexuais e seus direitos reprodutivos, mesmo que eles existam no plano legal e normativo

Objective: analyze the perception of women deprived of liberty regarding their sexual rights and reproductive rights. Method: descriptive research, with a qualitative approach. Interviews were conducted with women who were experiencing pregnancy (9) and the puerperium (4), in two prison units in Rio de Janeiro. The analysis method was the dialectic hermeneutic. Results: two categories were listed: 1) Institutional violations as infractions of sexual rights and reproductive rights and 2) Contradictions between the possibility of exercising rights and the limitations imposed by the prison system. Conclusion: the violations that these women suffer are not restricted to them. The fight for women's rights is a constant movement. The advances are significant, however, there are real obstacles that prevent women from enjoying their sexual rights and their reproductive rights, even though they exist in the legal and normative plan

Objetivos: respecto a sus derechos sexuales y derechos reproductivos. Método: investigación descriptiva, con un enfoque cualitativo. Las entrevistas fueron realizadas a mujeres en situación de embarazo (9) y de puerperio (4), en dos unidades penitenciarias de Río de Janeiro. El método de análisis fue la hermenéutica dialéctica. Resultados: se han dividido en dos categorías: 1) Violaciones institucionales como la infracción de los derechos sexuales y los derechos reproductivos y 2) Contradicciones entre la posibilidad de ejercer los derechos y las limitaciones impuestas por el sistema carcelario. Conclusión: las violaciones que sufren estas mujeres no se limitan a ellas. La lucha por los derechos de la mujer es un movimiento constante. Los avances son significativos, sin embargo, existen ataduras reales que impiden a las mujeres disfrutar de sus derechos sexuales y sus derechos reproductivos, aunque existan a nivel legal y normativo

"Todo homem precisa de uma mãe", mas nem todo merece uma: o cuidado em notícias sobre o sistema penitenciário mineiro / "Every man needs a mother", but not everyone deserves one: care in news about the penitentiary system of Minas Gerais / "Todo hombre necesita una madre", pero no todo la merece: el cuidado en las noticias sobre el sistema penitenciario en Minas Gerais

Resumo Enquanto a literatura sobre cuidado costuma ignorar suas possíveis imbricações com a violência e as atividades realizadas fora dos domicílios, estudos sobre prisões tendem a subestimar a sua relevância como cuidado no cotidiano destas instituições. Neste mote, analisamos o conteúdo de notícias sobre o sistema prisional mineiro publicadas online pelo jornal "O Tempo" durante o período de 2005 a 2019 para entender os significados, protagonistas, relações e trocas que são próprios ao cuidado no sistema prisional. A partir do conceito "circuitos de cuidado", buscamos demonstrar que, no contexto de privação de liberdade, cuidar e ser cuidado se realiza somente quando há "merecimento" dos dois polos desta relação.

Abstract While the literature on caregiving tends to ignore its possible imbrications with violence and activities executed out of households, studies on prisons tend to underestimate care as part of the daily life of these institutions. In this motto, we analyze the content of news about the prison system in Minas Gerais published online by the newspaper "O Tempo" during the period from 2005 to 2019 to understand the meanings, protagonists, relationships and exchanges that are proper of care into the prison system. Based on the concept "circuits of care", in this paper, we seek to demonstrate that, in the context of deprivation of liberty, caring and being cared are fulfilled only when there is some "deserving" from both sides"".

Resumen Mientras que la literatura sobre el cuidado tiende a ignorar sus posibles imbricaciones con la violencia y las actividades realizadas fuera del hogar, los estudios sobre las prisiones tienden a subestimar su importancia como cuidado en la vida cotidiana de estas instituciones. Teniendo esto en cuenta, analizamos el contenido de las noticias sobre el sistema penitenciario de Minas Gerais publicadas en línea por el periódico «O Tempo¼ entre 2005 y 2019, con el fin de comprender los significados, los protagonistas,elaciónes y los intercambios propios del cuidado en el sistema penitenciario. A partir del concepto de «circuitos de cuidado¼, en este trabajo buscamos demostrar que, en el contexto de la privación de libertad, cuidar y ser cuidado construyen el circuito y sólo realizan lo que llamamos «cuidado como mérito¼ para los dos polos de esta relación.

A ultrassonografia na promoção da saúde no sistema penitenciário feminino / Ultrasonography in health promotion in the female penitentiary system

Introdução: o sistema prisional brasileiro apresenta um total de 644.305 pessoas privadas de liberdade, de ambos os sexos. São Paulo tem 195.787 presos, representando 30,10% da população carcerária do país. Deste total, 4,34% são do sexo feminino e correspondem a 8.520 mulheres privadas de liberdade, também chamadas de reeducandas. Ao exibirem certas peculiaridades no tocante à saúde, as reeducandas tornam-se mais vulneráveis às doenças físicas e mentais. Nesse sentido, a ultrassonografia de vários locais do organismo tem se revelado capaz de identificar expressivo número de afecções, tanto quando indicado na rotina, como nos casos de indicações específicas. Objetivos: identificar os achados ultrassonográficos mais frequentes nas mulheres privadas de liberdade, sintomáticas ou não, do Centro de Progressão Penitenciária Feminino "Dra. Marina Marigo Cardoso de Oliveira" do Butantan (CPP do Butantan), bem como analisar a associação entre estes achados e as características das reeducandas. Material e Métodos: o estudo do tipo retrospectivo incluiu a análise de 1254 exames solicitados no período de 2015 a 2020 em mulheres privadas de liberdade do CPP do Butantan. Os exames foram realizados no Centro Médico Assistencial Cruz de Malta, localizado no Jabaquara. Métodos estatísticos: medidas-resumo e gráficos de setor circular, barras, boxplot, diagrama de dispersão unidimensional, além de testes de Mann-Whitney, Qui-quadrado de Pearson, Exato de Fischer ou sua extensão. Utilizado nível de significância alfa igual a 5%, com análises pelos programas IBMSPSS Statistics versão 24 e R versão 3.6.3. Resultados: achados mais encontrados: Mioma, Litíase biliar, Litíase renal, Cisto simples ovariano, Alteração textural de útero, Nódulos mamários, síndrome dos ovários policísticos (SOP), hérnia de parede, Cisto simples mamário. Os miomas e as alterações texturais encontramse na faixa etária mais alta, enquanto o SOP na faixa etária menor. Os cistos mamários estão no grupo com maior grau de instrução; e os cistos ovarianos nas homossexuais. Discussão: como os trâmites de cuidados de saúde das reeducandas são complexos, os mutirões de saúde foram criados para reduzir a lista de ultrassonografias do CPP do Butantan, realizar diagnóstico das afecções e otimizar o tratamento mais adequado Conclusões: identificamos 55,6% das reeducandas com os achados ultrassonográficos mais frequentes.

Introduction: the Brazilian prison system currently detains a total of 644,305 people deprived of their liberty, comprising both sexes. São Paulo houses 195,787 prisoners, representing 30.10% of the country's incarcerated population. Among these, 4.34% are female which corresponds to 8,520 women deprived of liberty, also referred to as inmates. As they display certain health peculiarities, female inmates are more susceptible to physical and mental illnesses. In this context, ultrasound scans of various internal body organs have proven capable of identifying a significant number of conditions, both as part of routine screenings as well as in specific cases. Objectives: To identify the most frequent ultrasound findings in female inmates, whether symptomatic or not, at the "Dra. Marina Marigo Cardoso de Oliveira" Female Penitentiary Progression Center in Butantan (Butantan CPP), and to analyze the association of these findings with the characteristics of the female inmates. Material and Methods: the retrospective study included the analyses of 1254 exams conducted between 2015 and 2020 on female inmates at the Butantan CPP. The exams were carried out at the Cruz de Malta Medical Assistance Center, located in Jabaquara. Statistical methods: summary measures and pie charts, bars, boxplot, one-dimensional dispersion diagram, as well as Mann-Whitney U test, Pearson's Chisquared test, Fischer's exact tests, or their extension. An Alpha (Significance) level was set to 5%, with analysis using the IBM-SPSS Statistics version 24 and R version 3.6.3 programs. Results: Most common findings: Myoma, Gallstone disease, Kidney stones, Simple ovarian cyst, Uterine textural alteration, Breast nodules, polycystic ovary syndrome (PCOS), abdominal wall hernia, Simple breast cyst. Fibroids and textural alterations are prevalent in older age groups, while PCOS is observed in younger age groups. Breast cysts are more common in the group with the highest level of education, and ovarian cysts in homosexual women. Discussion: as the health care procedures for female inmates are complex, health campaigns were established to reduce the demand for ultrasounds at the Butantan CPP, diagnose conditions, and optimize the most appropriate treatment. Conclusions: we identified 55.6% of female inmates with the most frequent ultrasound findings.