Cancer-Associated Fibroblasts in Pancreatic Ductal Adenocarcinoma or a Metaphor for Heterogeneity: From Single-Cell Analysis to Whole-Body Imaging.

Pancreatic ductal adenocarcinoma (PDAC) represents a formidable challenge due to its aggressive nature and poor prognosis. The tumor microenvironment (TME) in PDAC, characterized by intense stromal desmoplastic reactions and a dominant presence of cancer-associated fibroblasts (CAFs), significantly contributes to therapeutic resistance. However, within the heterogeneous CAF population, fibroblast activation protein (FAP) emerges as a promising target for Gallium-68 FAP inhibitor positron emission tomography (Ga68FAPI-PET) imaging. Notably, 68Ga-FAPI-PET demonstrates promising diagnostic sensitivity and specificity, especially in conjunction with low tracer uptake in non-tumoral tissues. Moreover, it provides valuable insights into tumor-stroma interactions, a critical aspect of PDAC tumorigenesis not adequately visualized through conventional methods. The clinical implications of this innovative imaging modality extend to its potential to reshape treatment strategies by offering a deeper understanding of the dynamic TME. However, while the potential of 68Ga-FAPI-PET is evident, ongoing correlative studies are essential to elucidate the full spectrum of CAF heterogeneity and to validate its impact on PDAC management. This article provides a comprehensive review of CAF heterogeneity in PDAC and explores the potential impact of 68Ga-FAPI-PET on disease management.

Prognostic Value of Circulating Cytokines in Chemorefractory Colorectal Cancer.

Circulating cytokines could be optimal biomarkers for prognostication and management decisions in colorectal cancer (CRC). Chemorefractory CRC patients with available plasma samples were included in this study. In the discovery cohort (n = 85), 182 circulating cytokines were tested with a semi-quantitative multiplex assay, and prognostic cytokines were analyzed in the validation cohort (n = 111) by ELISA. Overall survival (OS) was the primary outcome measure, with the false discovery rate (FDR) method (significance level of <0.01) being used to correct for multiple comparisons. Four cytokines were associated with OS in the discovery cohort: insulin-like growth factor-binding protein 1 (IGFBP-1) (HR 2.1 [95%CI: 1.58-2.79], FDR < 0.001), insulin-like growth factor-binding protein 2 (IGFBP-2) (HR 1.65 [95%CI: 1.28-2.13], FDR = 0.006), serum amyloid A (SAA) (HR 1.84 [95%CI: 1.39-2.43], FDR < 0.001), and angiotensin II (HR 1.65 [95%CI: 1.29-2.1], FDR = 0.006). Of these, IGFBP-1 (HR 2.70 [95%CI: 1.56-4.76], FDR = 0.007) and IGFBP-2 (HR 3.33 [95%CI: 1.64-6.67], FDR = 0.008) were confirmed to be independently associated with OS in the validation cohort. Patients with high concentrations of IGFBP-1 and/or IGFBP-2 had a median OS of 3.0 months as compared with 6.9 months for those with low concentrations of both cytokines (HR 2.44 [95%CI: 1.52-4.0], FDR = 0.002) Validation of circulating IGFBP-1 and IGFBP-2 as independent prognostic biomarkers for chemorefractory CRC in larger, independent series is warranted.

Immunotherapies in non-metastatic gastrointestinal cancers.

PURPOSE: Over the last decade, immune checkpoint inhibitors (ICI) have emerged as cornerstone in the treatment of many metastatic tumour types, including gastrointestinal cancers. In many solid tumours, the effective therapies in the metastatic field are progressively brought into the curative setting. Consequently, earlier tumoural settings have become a field of experiment for immunotherapies. In melanoma, lung, and bladder cancers, excellent results were recorded, possibly explained by differences in the tumour microenvironment between metastatic and non-metastatic settings. In gastrointestinal (GI) Oncology, nivolumab is the first immune checkpoint inhibitor to become a standard-of-care adjuvant treatment after curative surgery for oesophagal or gastroesophageal junction cancer. RECENT FINDINGS: We herein discuss the results of a selection of the most relevant studies presented/published over the last 18 months testing immunotherapies in non-metastatic GI cancers. Among immunotherapies, ICI have been investigated in pre-, peri- and postoperative setting across tumour types, alone or in combination with chemo- and/or radiotherapy. Vaccines are also a new field of investigation. SUMMARY: Promising results from two studies (NCT04165772 and NICHE-2 study) demonstrating never-seen-before responses to neoadjuvant immunotherapy in MMR deficient (dMMR) colorectal cancers raise hope for improving the patients' outcome and developing organ-sparing strategies in this situation.

Preexisting evidence and outcome of phase III trials in gastrointestinal oncology: a systematic review.

BACKGROUND: A minority of phase III trials in gastrointestinal oncology are positive. We assessed the association between their outcome and the level and characteristics of preexisting evidence. METHODS: EMBASE, PubMed, and proceedings from international meetings were searched for phase III gastrointestinal cancer trials (gastroesophageal, hepatocellular, biliary tract, pancreatic, small bowel, colorectal, anal, stromal, and neuroendocrine) between January 2000 and June 2020. Trials investigating anticancer drugs for advanced disease, with superiority design and standard treatments as control were eligible. The highest level of preexisting evidence was retrieved from the main study report. RESULTS: A total of 193 phase III trials were included, and 69 (35.8%) met their primary endpoint. Positivity rates were as follows: gastroesophageal 37%, colorectal 48%, pancreatic 17.1%, hepatocellular 20%, neuroendocrine 75%, and both biliary tract and GIST 60%. No information about preexisting evidence was found for 44 trials (22.8%). For the remaining 149, preexisting evidence consisted of phase II studies in 123 cases (82.6%) and phase I studies in 26 cases (17.4%). The probability of success was 34.1%, 35.8%, and 35.7%, respectively (P = .934). No parameter from prior studies predicted the outcome of phase III trials except ß < .2 (P = .048). A numerically increased success rate was observed for phase III trials preceded by positive phase II studies (41.9% vs 18.5%, P = .2). CONCLUSIONS: There does not appear to be an association between level of prior evidence and success of phase III gastrointestinal cancer trials. These data, along with the high phase III failure rate, highlight the need to improve the drug development process in this setting.

Análise narrativa e investigação qualitativa em Psicologia: porquê e como fazer / Narrative analysis and qualitative research in Psychology: why and how to do it / Análisis narrativo e investigación cualitativa en Psicología: por qué y cómo hacerlo

OBJETIVO: As metodologias qualitativas têm assumido maior relevância na investigação em Psicologia, identificando-se uma grande diversidade de métodos de análise. No entanto, na sua maioria, os estudos recorrem a métodos que têm as suas raízes noutras áreas. A análise narrativa, sendo um método de investigação qualitativa que emergiu e mais diretamente se relaciona com a área da Psicologia, tende a ser menos utilizada. Verifica-se uma grande variabilidade na forma como é conceptualizada e nos procedimentos adotados. OBJETIVO: Procura-se clarificar o background teórico subjacente à análise narrativa na investigação em Psicologia e apresentar uma proposta fundamentada de como fazer análise narrativa. MÉTODO: O trabalho decorre da revisão e análise crítica da investigação e bibliográfica. RESULTADOS: A análise narrativa assenta nos princípios da Psicologia narrativa, implicando que a análise narrativa na investigação em Psicologia se situa no paradigma construcionista social. Descreve-se detalhadamente as etapas e os procedimentos a adotar para se efetuar a análise narrativa na investigação em Psicologia, bem como as estratégias de validação. CONCLUSÃO: Há que começar a privilegiar a análise narrativa como método de investigação qualitativa em Psicologia, sendo necessário que os investigadores adotem procedimentos comuns assentes nos princípios da Psicologia narrativa.

OBJECTIVE: Qualitative methodologies have assumed greater relevance in the research in Psychology, identifying a great diversity of analysis methods. However, most studies use methods that have their roots in other areas. Narrative analysis, as a qualitative research method that emerged and is directly related to the area of Psychology, tends to be less used. There is great variability in the way it is conceptualized and, in the procedures, adopted. OBJECTIVE: To clarify the theoretical background underlying narrative analysis in Psychology research and to present a reasoned proposal on how to carry out a narrative analysis. METHOD: The work stems from the review and critical analysis of research and literature. RESULTS: Narrative analysis is based on the principles of narrative Psychology, implying that narrative analysis in psychological research is rooted in the social constructionist paradigm. The steps and procedures to be adopted to carry out narrative analysis in research in Psychology are described in detail, as well as the validation strategies. CONCLUSION: The need to start privileging narrative analysis as a method of qualitative research in Psychology is growing, requiring researchers to adopt common procedures based on the principles of narrative Psychology.

OBJETIVO: Las metodologías cualitativas han tomado mayor relevancia en la investigación en Psicología, identificándose una gran diversidad de métodos de análisis. Sin embargo, la mayoría de los estudios utilizan métodos que tienen sus raíces en otras áreas. El análisis narrativo, al ser un método de investigación cualitativo que surgió y se relaciona más directamente con el área de la Psicología, tiende a ser menos utilizado. Existe una gran variabilidad en la forma en que se conceptualiza y en los procedimientos adoptados. OBJETIVO: Busca esclarecer los antecedentes teóricos que subyacen al análisis narrativo en la investigación en Psicología y presentar una propuesta razonada sobre cómo llevar a cabo el análisis narrativo. MÉTODO: El trabajo surge de la revisión y análisis crítico de investigaciones y literatura. RESULTADOS: El análisis narrativo se basa en los principios de la Psicología narrativa, lo que implica que el análisis narrativo en la investigación psicológica se sitúa en el paradigma construccionista social. Se describen en detalle los pasos y procedimientos a adoptar para realizar el análisis narrativo en la investigación en Psicología, así como las estrategias de validación. CONCLUSIÓN: Es necesario comenzar a privilegiar el análisis narrativo como método de investigación cualitativa en Psicología, exigiendo a los investigadores adoptar procedimientos comunes basados en los principios de la Psicología narrativa.

The emerging role of immunotherapy in the treatment of anal cancer.

For decades, chemoradiotherapy for early-stage disease and systemic chemotherapy for advanced disease have represented the mainstay of treatment for anal cancer. Over the last few years, however, the advent of immunotherapy has opened interesting therapeutic perspectives, with the establishment of new standards of care, and the development of clinical trials that may further shape the treatment algorithm for this tumour. In this review article, we discuss the rationale behind the use of immunotherapy for anal cancer and provide an overview of the available clinical data and ongoing efforts to build on these.

Regorafenib in combination with immune checkpoint inhibitors for mismatch repair proficient (pMMR)/microsatellite stable (MSS) colorectal cancer.

Immune checkpoint inhibitors (ICIs) have marked a new era of cancer treatment, showing remarkable efficacy in a wide range of solid malignancies. In colorectal cancer (CRC), however, the therapeutic potential of ICIs is limited to the small group (≈5%) of patients with mismatch repair deficient (dMMR)/high microsatellite instable (MSI-H) tumours, which are characterised by high mutational/neo-antigen burden, and an inflammatory tumour microenvironment with abundant tumour-infiltrating lymphocytes. Over the last few years, research has focused on immuno-modulatory strategies that could overcome the inherent resistance to ICIs that is observed in the vast group (≈95%) of patients with mismatch repair proficient (pMMR)/microsatellite stable (MSS) tumours. Among these, the combination of ICIs with multi-kinase inhibitors has gained traction in preclinical studies and clinical trials. Thanks to their multiple targets and mechanisms of action, generally involving key cancer pathways such as oncogenesis, angiogenesis, metastasis, and tumour immunity, these agents can exert synergistic effects with ICIs, eventually turning inherently cold cancers into hot tumours, that can be efficiently recognised and targeted by an activated immune system. Regorafenib is routinely used for chemorefractory CRC with limited efficacy. Preliminary evidence, however, suggests that this multi-kinase inhibitor could be an optimal combination partner for ICIs. In this review article, we explain the biological rationale underlying the synergism between regorafenib and ICIs, discuss the available clinical data in CRC, and take a glance into future perspectives by presenting ongoing trials and possible research developments in this setting.

Mind the target: human epidermal growth factor receptor 2 in colorectal cancer.

PURPOSE OF REVIEW: In this article, we briefly summarise the current knowledge about human epidermal growth factor receptor 2 (HER2) alterations in colorectal cancer (CRC) and provide an overview of the latest published evidence especially regarding standardisation of detection methods/diagnostic criteria, prognostication, prediction and targeted treatments. RECENT FINDINGS: Over the last 18 months, the results of many studies have been presented confirming the therapeutic potential of established anti-HER2 agents either as a monotherapy or in combination, as well as new anti-HER2 agents like antibody-drug-conjugates and tyrosine kinase inhibitors. Also, we have seen confirmation of the utility of liquid biopsy and ctDNA analyses as tool for HER2 detection and patient selection. SUMMARY: Despite concerning only 5% of metastatic CRC, HER2 represents a valuable target for emerging anti-HER2 therapies that might significantly improve the outcome of these patients. Standardising HER2 detection methods/diagnostic criteria, and producing high-quality, randomised evidence are the next challenges to meet the standards of regulatory authorities and ultimately have anti-HER2 agents available for use in routine practice.

Targeted agents in older patients with gastrointestinal cancers - An overview.

Targeted agents have been increasingly used in different malignancies and are associated with improved survival outcomes, including gastrointestinal cancers. Their use in the treatment of older patients is appealing given their favorable toxicity profile. In the last years, this subgroup of patients has been attracting increased interest given their representativeness and specific clinical needs. Nonetheless, the lack of data on efficacy and safety of standard treatments in older patients hinders proper evidence-based decision-making, leaving most therapeutic recommendations to be extrapolated from registration trials with low representation of older and frail patients. However, even if most decisions regarding the use of targeted agents in older patients with gastrointestinal cancer remain guided by subanalyses of large trials, data from recent older adult-specific trials are beginning to emerge, particularly in colorectal cancer. This review aims to summarize the existing evidence on treatment of older patients with gastrointestinal carcinomas (colon and rectum, stomach, esophagus, liver, and pancreas) with targeted agents (cetuximab, panitumumab, bevacizumab, ramucirumab, aflibercept, regorafenib, encorafenib, trastuzumab, sorafenib, lenvatinib, cabozantinib, erlotinib, olaparib), and place the evidence in a geriatric oncology perspective.

Virtual Reality-Based Cognitive Stimulation on People with Mild to Moderate Dementia due to Alzheimer's Disease: A Pilot Randomized Controlled Trial.

The use of ecologically oriented approaches with virtual reality (VR) depicting instrumental activities of daily living (IADL) is a promising approach for interventions on acquired brain injuries. However, the results of such an approach on dementia caused by Alzheimer's disease (AD) are still lacking. This research reports on a pilot randomized controlled trial that aimed to explore the effect of a cognitive stimulation reproducing several IADL in VR on people with mild-to-moderate dementia caused by AD. Patients were recruited from residential care homes of Santa Casa da Misericórdia da Amadora (SCMA), which is a relevant nonprofit social and healthcare provider in Portugal. This intervention lasted two months, with a total of 10 sessions (two sessions/week). A neuropsychological assessment was carried out at the baseline and follow-up using established neuropsychological instruments for assessing memory, attention, and executive functions. The sample consisted of 17 patients of both genders randomly assigned to the experimental and control groups. The preliminary results suggested an improvement in overall cognitive function in the experimental group, with an effect size corresponding to a large effect in global cognition, which suggests that this approach is effective for neurocognitive stimulation in older adults with dementia, contributing to maintaining cognitive function in AD.

The Exciting New Field of HER2-Low Breast Cancer Treatment.

Since human epidermal growth factor receptor-2 (HER2) characterization, going through clinical research and regulatory approval of HER2-targeted therapies, much has elapsed and is still unfolding. Hitherto, only breast cancer (BC) patients with HER2 immunohistochemistry 3+ or with HER2 gene fluorescence in-situ hybridization (FISH) amplification (a.k.a., HER2-positive BC) have benefited from anti-HER2 agents. In recent years, however, much of the research effort has been expanded, with positive outcomes being reached for formerly known HER2-negative BC that yet express HER2 to some degree (HER2 immunohistochemistry 1+ or 2+, but FISH negative) and are currently being classified as HER2-low BC for the purpose of trial enrollment. In this sense, our aim is to review the body of evidence of HER2-low BC that led to the study of first-generation anti-HER2 agents, like trastuzumab, and how they have failed to achieve any clinical applicability in this setting. In addition, we review new data that is leading to the growing success of the new generation of drugs, especially the promising HER2-directed antibody-drug conjugates. A narrative review is also performed regarding the rationale behind the consolidated and ongoing clinical trials studying anti-HER2 agents in combination with unrelated agents, such as immunotherapy, endocrine therapy, and CDK4/6 inhibitors. Hopefully, all this ongoing research effort will be able to extend the survival benefits seen with anti-HER2 agents in HER2-positive disease, at least to some degree, to the greater proportion of patients with HER2-low BC.

Clinical outcomes of platinum-based chemotherapy in patients with advanced breast cancer: An 11-year single institutional experience.

BACKGROUND/METHODS: Although the prognosis of metastatic breast cancer (BC) has improved, some patients still develop high burden metastases or visceral crisis (VC) and polychemotherapy is commonly used in these cases. Data reporting the real effectiveness of this strategy are scanty. Therefore, the outcomes of patients with metastatic BC treated with platinum-based chemotherapy (P-ChT) at the Jules Bordet Institute during the period of January 2008 and December 2018 were retrospectively reviewed. The presence of VC was defined according to ABC 4 criteria. RESULTS: 441 patients were identified: visceral metastases were observed in 430 (97.5%) while 261 (59.2%) presented VC. As for metastatic BC subtype, 255 (57.8%) had ER-positive/HER2-negative, 41 (9.3%) ER-positive/HER2-positive, 34 (7.7%) ER-negative/HER2-positive and 111 (25.1%) triple-negative BC. Median number of prior treatment lines was 3.8 (0-12). Median OS with P-ChT in the entire cohort was 6.13 months. Patients with VC had lower OS than patients without VC (8.6 vs 3.7 months; p < 0.001). On multivariate analysis, the variables correlated with worse OS were hyperbilirubinemia (HR 1.90; 95% CI 1.34-2.75), ECOG ≥2 (HR 1.77; 95% CI 1.13-2.78) and ECOG ≥3 (HR 2.52; 95% CI 1.48-4.28), and >3 previous treatment lines (HR 2.27; 95% CI 1.53-3.21). Of the 261 patients with VC, 106 (40.5%) presented a resolution of the VC which correlated with better OS (9.3 vs 2.0 months, HR 0.27; 95% CI 0.21-0.36). CONCLUSION: Patients who overcome VC benefit from P-ChT with OS similar to patients without VC. In this analysis, hyperbilirubinemia, poor ECOG and >3 previous treatment lines were significant prognostic factors in the overall study population.

Cynotherapy in Cancer Pain Management: A Pilot Study.

OBJECTIVES: This was a pilot study to evaluate the feasibility and impact of a single dog-assisted therapy (cynotherapy) session in reducing pain and emotional distress in oncological outpatients compared with typical waiting room experience (control). DESIGN: This was a quasi-experimental before-after controlled study that took place at a chronic pain outpatient clinic of a tertiary cancer center, whose participants were adult oncological patients, able to consent and without medical contraindication. SETTING: Chronic pain outpatient clinic of a tertiary cancer center. PARTICIPANTS: Adult oncological patients able to consent and without medical contraindication. METHODS: All participants completed self-reported questionnaires including a numeric rating scale for pain and distress thermometer at admission and immediately before departure from the clinic. RESULTS: Eighty-one patients were enrolled over a 10-month study period, 41 in the cynotherapy group and 40 controls. Improvement was greater in cynotherapy than control group for pain (median difference score = -1.0 vs 0.0; P = 0.037), distress levels (median = -1.0 vs 0.0; P = 0.017), and depression (median = -1.0 vs 0.0; P = 0.030). The proportion of patients with a clinically relevant improvement in pain (reduction ≥2 points) was approximately twofold in the cynotherapy group when compared with controls, although not statistically significant (39% vs 20%, odds ratio = 2.53, 95% confidence interval = 0.86-8.02; P = 0.088). The mean satisfaction rate was 9.3/10, and no negative occurrences were reported. CONCLUSION: A single session of dog-assisted therapy can provide immediate improvement in the perception of pain and distress for patients with chronic cancer pain in an outpatient setting, with high satisfaction rates and no negative occurrences. This nonrandomized pilot study points toward the clinical relevance of implementing cynotherapy at a cancer pain clinic and developing a larger scale, more directed study.

A perpetração dos comportamentos antissociais em jovens cabo-verdianos: um estudo preditivo / The perpetration of antisocial behaviours in young cape verdean: a predictive study

Resumo Em Cabo-Verde, desde finais dos anos 90 tem-se assistido a um aumento crescente dos comportamentos antissociais cometidos por jovens com idades compreendidas entre os 12 e os 21 anos. Todavia, o conhecimento acerca dos fatores que estão na génese e manutenção de tais comportamentos revela-se, ainda, incipiente. Neste estudo procurou-se identificar os fatores que predizem comportamentos antissociais auto relatados, recorrendo-se, para o efeito, aoInternational Self-Report DelinquencyStudy (ISRD-3). A amostra foi constituída por 535 alunos de ambos os sexos a frequentar o ensino público secundário em Cabo Verde, sendo 284 (53%) do sexo feminino e 247 (46.25%) do sexo masculino. A idade dos jovens varia entre os 13 e os 21 anos, tendo uma média de idade de 16.66 e um desvio padrão de 2.04. Os resultados indicam que o sexo é um forte preditor da perpetração de comportamentos antissociais, sendo que indivíduos do sexo masculino revelam maior probabilidade de envolvimento em comportamentos antissociais. Os adolescentes com menos atitudes antissociais são também aqueles com menor probabilidade de se envolverem em comportamentos antisociais. Da mesma forma, e ainda que apenas se revele marginalmente significativa, os adolescentes que relatam maior envolvimento em atividades antissociais evidenciam uma maior probabilidade de se envolverem em atividades de ocupação dos tempos livres disruptivas. Estes resultados são analisados em termos das suas implicações para a prevenção da delinquência.

Abstract In Cape Verde, since the end of the 1990s years there has been a significant increase of antisocial behaviors committed by young people (aged 12 and 21). Nevertheless, knowledge of factors that lie at the origin and maintenance of such behaviors still reveals incident or are still at an early stage. In this study, we tried to identify possible risk factors that forecast antisocial behaviour, self-reported by using, for this purpose, the International Self-Report Delinquency Study (ISRD-3).The sample consisted of 535 students from both sexes attending public secondary education in Cape Verde, of which 284 (53%) were females and 247 (46.25%) males. The age of young people varies between 13 and 21 years, having an average age of 16.66 and a standard deviation of 2.04. The results indicate that sex is a strong predictor of perpetration of antisocial behaviors, given that males show greater probability of engaging in antisocial behaviors. Teenagers with less antisocial attitudes are also those with less probability to engage in antisocial behaviors. Likewise, and even if only reveals marginally significant, adolescents who report major involvement in antisocial activities highlights a greater probability to engage in disruptive hobby activities. These results are analyzed in terms of their implications for the prevention of delinquency.

Vitimação múltipla feminina ao longo da vida: uma revisão sistemática da literatura / Lifetime multiple victimization among women:a systematic review of the literature

No contexto internacional assistimos a um crescente reconhecimento científico de que as mulheres, vítimas preferenciais de diferentes formas de vitimação, tendem a coo-experienciar outras formas de vitimação ao longo da vida. Neste artigo realizamos uma revisão sistemática da literatura existente sobre a vitimação múltipla de mulheres ao longo da vida. Conclui-se que predominam os estudos quantitativos de natureza transversal, retrospectivos e com designs descritivos correlacionais, centrados na vitimação múltipla interpessoal, nomeadamente, íntima. Os inventários de autorrelato e as entrevistas semiestruturadas são os instrumentos mais frequentes para avaliar o fenómeno, recorrendo, maioritariamente, a amostras por conveniência, recrutadas em contexto normativo (universitário) ou forense. A prevalência, embora elevada, oscila entre os estudos, reflexo das diferentes amostras e instrumentos utilizados. Quanto ao impacto, os estudos são consensuais na ideia de que quanto maior a vitimação cumulativa, maior o impacto (efeito dose). Finalmente, apresentamos os principais contributos e limitações que derivam desta revisão sistemática.(AU)

There is an increasing scientific recognition that women, primary victims of different forms of interpersonal victimization, tend to co-experience other forms of victimization throughout lifetime. Therefore, we conducted a systematic review of publications on lifetime multiple victimization of women. We found predominantly cross-sectional studies, retrospective and correlational designs, directed to study multiple interpersonal violence, particularly intimate abuse. Self-report inventories and semi-structured interviews were the most commonly strategies used to evaluate the problem, and the most frequent sampling option was convenience samples, recruited in normative (university) or forensic contexts. The prevalence of multiple victimization reported by women, although high, varied between studies, reflecting the different samples and evaluation tools. In terms of impact, the studies were consensual on the idea that the greater the cumulative victimization the greater impact victimization would produce. Finally, we present the main contributions and limitations that draw from this systematic review.(AU)

Vitimação múltipla feminina ao longo da vida: uma revisão sistemática da literatura / Lifetime multiple victimization among women:a systematic review of the literature

No contexto internacional assistimos a um crescente reconhecimento científico de que as mulheres, vítimas preferenciais de diferentes formas de vitimação, tendem a coo-experienciar outras formas de vitimação ao longo da vida. Neste artigo realizamos uma revisão sistemática da literatura existente sobre a vitimação múltipla de mulheres ao longo da vida. Conclui-se que predominam os estudos quantitativos de natureza transversal, retrospectivos e com designs descritivos correlacionais, centrados na vitimação múltipla interpessoal, nomeadamente, íntima. Os inventários de autorrelato e as entrevistas semiestruturadas são os instrumentos mais frequentes para avaliar o fenómeno, recorrendo, maioritariamente, a amostras por conveniência, recrutadas em contexto normativo (universitário) ou forense. A prevalência, embora elevada, oscila entre os estudos, reflexo das diferentes amostras e instrumentos utilizados. Quanto ao impacto, os estudos são consensuais na ideia de que quanto maior a vitimação cumulativa, maior o impacto (efeito dose). Finalmente, apresentamos os principais contributos e limitações que derivam desta revisão sistemática.

There is an increasing scientific recognition that women, primary victims of different forms of interpersonal victimization, tend to co-experience other forms of victimization throughout lifetime. Therefore, we conducted a systematic review of publications on lifetime multiple victimization of women. We found predominantly cross-sectional studies, retrospective and correlational designs, directed to study multiple interpersonal violence, particularly intimate abuse. Self-report inventories and semi-structured interviews were the most commonly strategies used to evaluate the problem, and the most frequent sampling option was convenience samples, recruited in normative (university) or forensic contexts. The prevalence of multiple victimization reported by women, although high, varied between studies, reflecting the different samples and evaluation tools. In terms of impact, the studies were consensual on the idea that the greater the cumulative victimization the greater impact victimization would produce. Finally, we present the main contributions and limitations that draw from this systematic review.