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1.
Adv Mind Body Med ; 33(1): 4-21, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31370036

RESUMO

Objective: This paper reviews the literature linking physical violence, directed towards self or others, to serotonergic and dopaminergic psychiatric drugs and general medications. Design/methodology/approach: Data about side effects, pharmacogenetics and homeostasis are obtained from articles, electronic Medicines Compendium, DSM-IV-TR, British National Formulary (BNF) and academic books. Statistics have been obtained from articles, The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Risk, Manchester, Mental Health Equalities, National Mental Health Development Unit and the NHS Health and Social Care Information Centre. Classification for neurotoxic conditions and mental illness are obtained from the DSM-IV-TR, DSM-V and ICD-10. Findings: Psychiatric drugs and some general medications have effects that are not always the ones intended. Reactions to different drugs and drug-drug combinations are governed by individual metabolising rates. Phase 1 metabolism takes place via the cytochrome P450 enzymes with 57 human genes identified that are genetically variable i.e. polymorphic. The population are coded as poor, extensive (known as normal), intermediate or ultra rapid metabolisers. Variations in the serotonin transporter gene (5-HTTLPR) and serotonin receptors (5-HT) influence the outcome of serotonergic medications. It is established genetic polymorphisms in the CYP450 and serotoninergic metabolising system cause higher drug blood levels which are associated with neuropsychiatric adverse drug reactions (ADRs), such as akathisia. If not recognised, akathisia, which often precedes violence, suicidality, homicide, mania and psychosis, may be mistaken for new or emergent mental illness and treated with further ineffective, counter-productive psychiatric drugs. Research limitations/implications: The absence of pharmaceutical data for CYP450 diminishing, null/non- functioning or multiple polymorphisms and variations in the 5-HTTLPR and 5-HT, linking general medications and psychiatric drugs with neuropsychiatric behavioural reactions is notable. There is limited information linking psychiatric drug disruption of homeostasis and neurotransmitters with violence. These issues indicate a need for greater pharmaceutical transparency and further research into the role of CYP450, 5-HTTLPR and 5-HT polymorphism associated neuropsychiatric ADRs for all psychiatric drugs and serotonergic general medications. Practical implications: Safer prescribing is important and could be achieved by individual genotype testing, which would identify persons with genetic polymorphisms, who are unable to metabolise drugs. Prevention of violence would enhance peoples' well being, ground floor practitioner and public safety. Conclusion: This paper is the first review that implicates certain drugs as a cause of violence due to pharmacogentic polymorphisms and neurotransmitter disruption.


Assuntos
Antidepressivos , Antipsicóticos , Suicídio , Violência , Antidepressivos/efeitos adversos , Antipsicóticos/efeitos adversos , Homicídio , Humanos
3.
RECIIS (Online) ; 13(2): 261-272, abr.-jun. 2019. ilus
Artigo em Português | LILACS | ID: biblio-1005595

RESUMO

Nos textos jornalísticos, chama a atenção a diferença entre as imagens de casos de violência contra a mulher cisgênero e heterossexual e as contra pessoas LGBTQ+. Tratando-se das pessoas LGBTQ+, as imagens costumam ser brutais, com exposição de sangue e de corpos feridos por armas diversas. Já a cobertura de casos de violência contra a mulher cis e heterossexual é diametralmente oposta: as imagens tendem a ser pouco contundentes, muitas vezes mostrando paisagens de lugares onde ocorreram os crimes, em alguns casos mostrando os rostos de agressores e vítimas, nunca cenas de sangue ou corpos com marcas de agressão. Neste artigo, tomamos a instabilidade textual como ponto de partida para refletirmos sobre o contraste entre os modos de tratamento jornalístico conferidos no Brasil a essas duas violências e o que impacta no entendimento acerca das relações que conformam a visualidade e a cultura visual.


In Brazilian journalistic texts, the difference between the images of cases of violence against cis and heterosexual women and those against LGBTQ+ people are astonishing. In the case of LGBTQ+ people, the images are usually brutal, with exposure of blood and bodies injured by various weapons. The coverage of cases of violence against cis and heterosexual women is the opposite: the images tend to be inconclusive, often showing landscapes of places where crimes occurred, sometimes showing the faces of perpetrators and victims and never scenes of blood or bodies with marks of aggression. In this article, we take the textual instability as a starting point to reflect on the contrast between the ways of journalistic treatment in Brazil conferred to these two violences and what impacts on the understanding about the relations that conform the visuality and the visual culture.


En los textos periodísticos, llama la atención la diferencia entre las imágenes de casos de violencia contra la mujer cis heterosexual y las contra personas LGBTQ+. Tratándose de las personas LGBTQ+, las imágenes suelen ser brutales, con exposición de sangre y de cuerpos heridos por armas diversas. La cobertura de casos de violencia contra la mujer cis heterosexual es diametralmente opuesta: las imágenes tienden a ser poco contundentes, muchas veces mostrando paisajes de lugares donde ocurrieron los crímenes, en algunos momentos mostrando los rostros de agresores y víctimas y nunca escenas de sangre o cuerpos con marcas de agresión. En este artículo tomamos la inestabilidad textual como punto de partida para reflexionar sobre el contraste entre los modos de tratamiento periodístico en Brasil conferidos a esas dos violencias y lo que impacta en el entendimiento acerca de las relaciones que conforman la visualidad y la cultura visual.


Assuntos
Humanos , Mulheres , Jornalismo , Cultura , Violência contra a Mulher , Minorias Sexuais e de Gênero , Identidade de Gênero , Violência , Brasil , Heterossexualidade , Ódio
5.
MMWR Morb Mortal Wkly Rep ; 68(29): 642-646, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31344023

RESUMO

The number of wild poliovirus (WPV) cases in Nigeria decreased from 1,122 in 2006 to six WPV type 1 (WPV1) in 2014 (1). During August 2014-July 2016, no WPV cases were detected; during August-September 2016, four cases were reported in Borno State. An insurgency in northeastern Nigeria had resulted in 468,800 children aged <5 years deprived of health services in Borno by 2016. Military activities in mid-2016 freed isolated families to travel to camps, where the four WPV1 cases were detected. Oral poliovirus vaccine (OPV) campaigns were intensified during August 2016-December 2017; since October 2016, no WPV has been detected (2). Vaccination activities in insurgent-held areas are conducted by security forces; however, 60,000 unvaccinated children remain in unreached settlements. Since 2018, circulating vaccine-derived poliovirus type 2 (cVDPV2) has emerged and spread from Nigeria to Niger and Cameroon; outbreak responses to date have not interrupted transmission. This report describes progress in Nigeria polio eradication activities during January 2018-May 2019 and updates the previous report (2). Interruption of cVDPV2 transmission in Nigeria will need increased efforts to improve campaign quality and include insurgent-held areas. Progress in surveillance and immunization activities will continue to be reviewed, potentially allowing certification of interruption of WPV transmission in Africa in 2020.


Assuntos
Erradicação de Doenças , Surtos de Doenças/prevenção & controle , Poliomielite/prevenção & controle , Vigilância da População , Adolescente , Criança , Pré-Escolar , Surtos de Doenças/estatística & dados numéricos , Humanos , Programas de Imunização , Lactente , Nigéria/epidemiologia , Poliomielite/epidemiologia , Poliovirus/genética , Poliovirus/isolamento & purificação , Vacinas contra Poliovirus/administração & dosagem , Avaliação de Programas e Projetos de Saúde , Sorogrupo , Violência
6.
Rev Med Suisse ; 15(657): 1329-1332, 2019 Jul 10.
Artigo em Francês | MEDLINE | ID: mdl-31290628

RESUMO

Youth sports participation is often perceived as a positive contributor to physical and psychological development. However, we must acknowledge that sometimes the sports environment can be plagued by events of abuse and non-accidental violence of different types. A global and systemic approach will allow the limitation of these catastrophic events in young athletes' lives. Healthcare professionals must be able and knowledgeable to identify abuse correctly and in a timely fashion, to report it and to manage applying interdisciplinary principles. Their role is paramount in the education of all stakeholders, helping to raise awareness around abuse in adolescent athletes. Sporting organizations must apply existing recommendations from health and sporting authorities to guarantee the welfare of the adolescents they welcome in their world.


Assuntos
Atletas , Esportes , Violência , Adolescente , Humanos , Exame Físico
7.
Rev. Univ. Ind. Santander, Salud ; 51(2): 135-146, abr.-jun. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1003164

RESUMO

Resumen Introducción: La violencia obstétrica ha sido tipificada como una modalidad de violencia de género, que hace referencia a las conductas de acción u omisión; puede ser institucional, psicológica, simbólica o sexual. Objetivo: Caracterizar las diferentes modalidades de violencia obstétrica. Metodología: Estudio cualitativo con enfoque fenomenológico; conformado por 16 mujeres con experiencias obstétricas menores de dos años que asistieron a los hogares de Familia, Mujer e Infancia (FAMI) del Instituto Colombiano de bienestar familiar en la ciudad de Popayán (Colombia) durante el 2016. Se realizaron entrevistas estructuradas y a profundidad sobre sus experiencias en la atención institucional del parto, en términos de toma de decisiones e información sobre procedimientos, posición para el parto, presencia de acompañante, derecho a la intimidad, percepciones sobre maltrato físico y psicológico. Resultados: El 69% de las entrevistadas reportaron alguna forma de violencia obstétrica. La violencia institucional se registró en la mayoría de los relatos y estuvo asociada a políticas institucionales que no satisfacen las expectativas de las gestantes en el proceso de parto e inconformidad con la atención en salud recibida durante el trabajo de parto; la violencia psicológica, fue percibida como falta de información y de autonomía en la toma de decisiones en el proceso de atención, malos tratos e impedimento a las gestantes para expresar sus sentimientos y emociones. Conclusiones: La mayoría de mujeres desconocen sus derechos y/o naturalizan los actos de violencia obstétrica. Los profesionales de salud deben reconocer en su formación y en los campos de práctica, los distintos tipos de violencia obstétrica con el fin de diseñar mecanismos para su prevención y abolición. Se hace necesario explorar la ocurrencia de eventos asociados a violencia sexual en el marco de la atención obstétrica.


Abstract Introduction: Obstetric violence has been typified as a form of gender violence, which refers to the behaviors of action or omission; It can be institutional, psychological, symbolic or sexual. Objective: To characterize the different modalities of obstetric violence. Methodology: Qualitative study with a phenomenological approach; conformed by 16 women with obstetric experiences under two years who attended the homes of Family, Women and Children (FAMI) of the Colombian Institute of Family Welfare in the city from Popayán (Colombia) during the 2016. Structured interviews were conducted and in depth about their experiences in the institutional care of childbirth, in terms of decision making and information about procedures, position for childbirth, presence of companion, right to privacy, perceptions about physical and psychological abuse. Results: 69% of the interviewed women reported some form of obstetric violence. Institutional violence was recorded in most of the reports and was associated with institutional policies that do not meet the expectations of pregnant women in the birth process and nonconformity with health care received during labor; Psychological violence was perceived as a lack of information and autonomy in decision-making in the process of care, mistreatment and impediment to pregnant women to express their feelings and emotions. Conclusions: The majority of women are unaware of their rights and / or naturalize acts of obstetric violence. Health professionals must recognize in their training and in the fields of practice, the different types of obstetric violence in order to design mechanisms for their prevention and abolition. It is necessary to explore the occurrence of events associated with sexual violence within the framework of obstetric care.


Assuntos
Humanos , Violência , Parto , Direitos Sexuais e Reprodutivos
8.
J Forensic Leg Med ; 66: 8-24, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31176280

RESUMO

The present paper aims to describe a case of a schizophrenia spectrum disorder relapse leading to attempted murder, review literature, and investigate the epidemiological data and expression of violent behavior among Capgras-related incidents. 109 case reports deriving from various scientific areas dating from 1971 to 2017 were evaluated and juxtaposed with an equivalent comparison group of random psychiatry inpatients, who were examined for the same variables. Quantitative and qualitative differences were observed between samples. High level of interpersonal violence was disclosed among Capgras-related incidents, especially towards the main care-givers, with higher propensity among male patients. Homicidal behavior was also expressed in higher levels among male patients experiencing the Capgras delusion. A multidisciplinary approach is vital for the optimal management of these incidents. Further research on the pathophysiology of Capgras delusion with the utilization of functional imaging techniques is of exceptional significance for the understanding of issues of neuroscience.


Assuntos
Síndrome de Capgras/psicologia , Homicídio , Psicologia do Esquizofrênico , Adulto , Distribuição por Idade , Cuidadores , Psiquiatria Legal , Humanos , Masculino , Doenças Neurodegenerativas/complicações , Doenças Neurodegenerativas/psicologia , Neuroimagem , Distribuição por Sexo , Violência
9.
Nervenarzt ; 90(7): 695-699, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31175380

RESUMO

In connection with the UN Convention on the Rights of Persons with Disabilities, mental healthcare concepts increasingly focus on the prevention of violence and coercion. Hospital care with an open-door policy is linked with a reduction in violence and coercive measures. The authors describe a specific therapeutic milieu aiming to promote social resources and to reduce institutional exclusion. Open-door policies can be extended to and tied in with outreach community mental health work. Model projects according to § 64b of the German Social Code (SGB V) on interdisciplinary care enable flexible needs-based care including home treatment for severe mental illness.


Assuntos
Serviços de Saúde Comunitária , Transtornos Mentais , Serviços de Saúde Mental , Psiquiatria , Coerção , Serviços de Saúde Comunitária/ética , Serviços de Saúde Comunitária/legislação & jurisprudência , Serviços de Saúde Comunitária/normas , Pessoas com Deficiência/legislação & jurisprudência , Pessoas com Deficiência/psicologia , Alemanha , Humanos , Transtornos Mentais/terapia , Serviços de Saúde Mental/ética , Serviços de Saúde Mental/legislação & jurisprudência , Serviços de Saúde Mental/normas , Psiquiatria/ética , Psiquiatria/legislação & jurisprudência , Psiquiatria/normas , Violência/prevenção & controle
10.
BMC Public Health ; 19(1): 830, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31242881

RESUMO

BACKGROUND: Aim of this study is to determine if peer group risk behaviors and neighbourhood socioeconomic status (SES) would ecologically affect injury incidence according to place and gender among adolescents (aged 13-15) in South Korea. METHODS: Three variables from the Korea Youth Risk Behavior Survey (2014) were used to represent peer group risk behaviours; current alcohol consumption (cAlc), the experience of violence or bullying (VicVB), and having undergone education for injury prevention (Edu-IP). The Korea Census Data (2010) was used for neighborhood SES; the degree of urbanization, the proportion of high educational attainment, and the proportion of low residential environment. The nationwide and regional Incidence-Rates of Injury assessed by EMS (IRI-EMS) were calculated according to age and gender based on the number of injuries from EMS record (2014). A linear regression model was used to examine associations. RESULTS: The nationwide total and inside-school IRI-EMS were 623.8 and 139.3 per 100,000 population, respectively. The range of the regional IRI-EMS showed a maximum of about 4 times the difference from 345 to 1281 per 100,000 population depending on the region. The low residential environment had a significant effect on the increase of total IRI-EMS (ß = 7.5, 95% CI 0.78-14.21). In the case of boys, the IRI-EMS inside-school was increased as the percentage of VicVB was higher (ß = 17.0, 95% CI 1.09-32.91). In the case of girls, the IRI-EMS outside-school was increased in rural compared to urban location (ß = 211.3, 95% CI 19.12-403.57). CONCLUSION: The incidence rate of outside-school was higher than that of inside-school, and incidence rate of boys was higher than that of girls. Peer group risk behaviors were significant only in the injury of boys. Among the SES factors, rural area was a significant factor in girls, especially outside-school injury. Moreover, the rate of households not in an apartment was significant in all outside-school injury and outside-school injury of boys. Our study suggests that among native South Korean adolescents, neighbourhood SES and peer group risk behavior have different effects depending on the injury context such as place of occurrence or gender.


Assuntos
Bullying , Serviços Médicos de Emergência , Assunção de Riscos , Classe Social , Meio Social , Violência , Ferimentos e Lesões/etiologia , Adolescente , Comportamento do Adolescente , Consumo de Bebidas Alcoólicas , Feminino , Humanos , Incidência , Masculino , Grupo Associado , República da Coreia/epidemiologia , Características de Residência , Fatores de Risco , População Rural , Instituições Acadêmicas , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana , Ferimentos e Lesões/epidemiologia
11.
J Craniofac Surg ; 30(4): e312-e315, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31166276

RESUMO

Interpersonal violence is a major cause of maxillofacial fractures. The aim of this study was to analyze the characteristics of these fractures associated in an effort to develop more effective management. The clinical records and radiographs of 272 patients with maxillofacial fractures associated with interpersonal violence collected during a 36-year period were retrospectively analyzed. Two hundred and nineteen patients were male (80.5%) and 53 (19.5%) were female. The patients ranged in age from 1 to 77 years. Two hundred and two patients (74.3%) were aged 10 to 29 years. The injury was the result of impact by a fist/hand/elbow in 224 patients (82.3%). The fracture site was the mandible in 191 patients (70.2%), the midface in 78 (28.7%), and both sites in 3 (1.1%). One hundred and eight (39.6%) of 273 mandibular fractures were in the angle, 75 (27.5%) were in the symphysis, and 90 (33.0%) were at other sites. Forty-three (53.1%) of 81 fractures in the midface were in the zygoma, 19 (23.5%) were in the maxilla, and 19 (23.5%) were at other sites. Fractures were more common on the left side. Nine patients (3.3%) also had injuries at other body sites. Ninety-five patients (34.9%) were treated by maxillomandibular fixation, 84 (30.9%) by open reduction and internal fixation, 59 (21.7%) by observation, 14 (5.1%) by intramaxillary splinting, 14 (5.1%) by transcutaneous reduction, and 6 (2.2%) by other procedures. Interpersonal violence-related maxillofacial fractures have characteristic features, especially with regard to site and laterality.


Assuntos
Traumatismos Faciais/cirurgia , Fraturas Cranianas/cirurgia , Violência , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Fixação Interna de Fraturas/métodos , Humanos , Lactente , Técnicas de Fixação da Arcada Osseodentária , Masculino , Mandíbula/cirurgia , Fraturas Mandibulares/cirurgia , Fraturas Maxilares/cirurgia , Pessoa de Meia-Idade , Redução Aberta/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Estudos Retrospectivos , Adulto Jovem
12.
Am J Forensic Med Pathol ; 40(3): 227-231, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31166200

RESUMO

The abundance of actionable information available in a medicolegal suicide investigation is often inaccessible and underutilized in public health to the detriment of prevention efforts. Epidemiologists obtained the Washington County subset of the Oregon Violent Death Reporting System (OR-VDRS). To determine if additional information beyond the OR-VDRS was available through a standard death investigation, an epidemiologist shadowed medicolegal death investigators (MDIs) for nearly 2 years. The MDIs and epidemiologist developed a novel, real-time, MDI-entered surveillance system, the Suicide Risk Factor Surveillance System (SRFSS), to capture suicide risk factor data with greater timeliness and accuracy than available through the OR-VDRS. To evaluate the performance of each surveillance system, differences in the prevalence of suicide risk factor data from SRFSS were compared with the county OR-VDRS subset for the same 133 suicides occurring in 2014-2015. Across 27 suicide risk factors and circumstances, the median difference in prevalence was 10.5 percentage points between the OR-VDRS and the SRFSS, with the higher prevalence in SRFSS. The prevalence was significantly different between the 2 surveillance systems for 21 (78%) of 27 variables. This study demonstrates the truly exceptional data quality and timeliness of MDI information over traditional sources.


Assuntos
Vigilância da População , Suicídio/estatística & dados numéricos , Violência/estatística & dados numéricos , Ferimentos e Lesões/mortalidade , Coleta de Dados , Bases de Dados Factuais , Humanos , Armazenamento e Recuperação da Informação , Fatores de Risco , Estados Unidos/epidemiologia
13.
Artigo em Alemão | MEDLINE | ID: mdl-31201448

RESUMO

BACKGROUND: In Germany, there is widespread use of smartphones that can be operated via voice assistants (VAs). Due to their increasing distribution, they hold the potential to influence health behavior at a population level. OBJECTIVES: This study examines the response behavior of German-speaking VAs to questions on mental and physical health as well as interpersonal violence. METHODS: Common VAs received nine standardized health questions. Responses were evaluated in terms of the categories "Recognizing the question," "Respectful responsiveness," and "Referring to support services." RESULTS: Fifty-one VAs were tested on 44 devices. Mental health issues were mostly recognized and answered with respect. Regarding expressed suicidal thoughts, only one VA did not refer to a specific crisis line. With respect to "interpersonal violence," only one VA recognized the expressed problems. In terms of physical health, only one VA showed respectful responses in all three tested healthcare areas, leading help seekers to additional healthcare services (e.g., hospitals, pharmacies). For some complaints, the VAs gave behavioral advice. CONCLUSION: VAs are able to recognize health issues, to respond respectably, and to guide those in need of care to specific healthcare and counselling services. However, responsiveness is insufficient and inconsistent. Future research should investigate how the responsiveness of VAs can be improved to provide the best possible support to people in crisis.


Assuntos
Internet , Interface para o Reconhecimento da Fala , Telemedicina , Voz , Alemanha , Hospitais , Humanos , Interface Usuário-Computador , Violência
14.
BMJ ; 365: l2147, 2019 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-31189556

RESUMO

OBJECTIVE: To examine associations between gabapentinoids and adverse outcomes related to coordination disturbances (head or body injuries, or both and road traffic incidents or offences), mental health (suicidal behaviour, unintentional overdoses), and criminality. DESIGN: Population based cohort study. SETTING: High quality prescription, patient, death, and crime registers, Sweden. PARTICIPANTS: 191 973 people from the Swedish Prescribed Drug Register who collected prescriptions for gabapentinoids (pregabalin or gabapentin) during 2006 to 2013. MAIN OUTCOME MEASURES: Primary outcomes were suicidal behaviour, unintentional overdoses, head/body injuries, road traffic incidents and offences, and arrests for violent crime. Stratified Cox proportional hazards regression was conducted comparing treatment periods with non-treatment periods within an individual. Participants served as their own control, thus accounting for time invariant factors (eg, genetic and historical factors), and reducing confounding by indication. Additional adjustments were made by age, sex, comorbidities, substance use, and use of other antiepileptics. RESULTS: During the study period, 10 026 (5.2%) participants were treated for suicidal behaviour or died from suicide, 17 144 (8.9%) experienced an unintentional overdose, 12 070 (6.3%) had a road traffic incident or offence, 70 522 (36.7%) presented with head/body injuries, and 7984 (4.1%) were arrested for a violent crime. In within-individual analyses, gabapentinoid treatment was associated with increased hazards of suicidal behaviour and deaths from suicide (age adjusted hazard ratio 1.26, 95% confidence interval 1.20 to 1.32), unintentional overdoses (1.24, 1.19 to 1.28), head/body injuries (1.22, 1.19 to 1.25), and road traffic incidents and offences (1.13, 1.06 to 1.20). Associations with arrests for violent crime were less clear (1.04, 0.98 to 1.11). When the drugs were examined separately, pregabalin was associated with increased hazards of all outcomes, whereas gabapentin was associated with decreased or no statistically significant hazards. When stratifying on age, increased hazards of all outcomes were associated with participants aged 15 to 24 years. CONCLUSIONS: This study suggests that gabapentinoids are associated with an increased risk of suicidal behaviour, unintentional overdoses, head/body injuries, and road traffic incidents and offences. Pregabalin was associated with higher hazards of these outcomes than gabapentin.


Assuntos
Prescrições de Medicamentos/estatística & dados numéricos , Gabapentina/efeitos adversos , Pregabalina/efeitos adversos , Medicamentos sob Prescrição/efeitos adversos , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Idoso , Overdose de Drogas/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Suicídio/estatística & dados numéricos , Suécia/epidemiologia , Violência/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adulto Jovem
15.
Niger J Clin Pract ; 22(6): 777-781, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31187761

RESUMO

Background: Sharp and penetrating object injuries (SPOIs) are seen frequently in forensic medicine practice. In this study, we aimed to retrospectively investigate cases with SPOIs. Materials and Methods: This study investigated the charts of patients treated at Adiyaman University Education and Research Hospital between January 1, 2013, and December 31, 2017. A total of 934 inpatients with sharp object injuries were included in the study. Data were assessed using a suitable computer-aided package program. Cases were examined in terms of age, gender, injury body site, suicide or homicide, radiologic findings, presence of vital danger, and severity of injury. Results: In this study, we examined the charts for 934 inpatients with stab wounds. It was stated that 124 (13.27%) of those injured were female and 810 (86.63%) male; the average age of the injured persons was 29.8 ± 18.2 years. It was found that 214 (22.91%) people were exposed to vital danger and that 720 (77.09%) suffered from soft tissue injuries (penetrating skin and muscle injuries). Also, 69.27% of the cases (n = 647) involved people less than 35 years of age. Conclusion: Considering that stab injuries are more frequent in the lower age groups, we believe that such injuries could be reduced by increasing training programs for young people.


Assuntos
Lesões dos Tecidos Moles/etiologia , Tentativa de Suicídio , Violência , Ferimentos Perfurantes/etiologia , Adolescente , Adulto , Fatores Etários , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/lesões , Estudos Retrospectivos , Pele/lesões , Turquia/epidemiologia , Adulto Jovem
16.
Rev Infirm ; 68(249): 33-35, 2019 Mar.
Artigo em Francês | MEDLINE | ID: mdl-31056176

RESUMO

Violence against health professionals is a global public health problem. A study carried out of hospital emergency departments in Tunis sought to analyse assaults on nurses. It reveals high levels of violence, particularly at weekends and during night shifts. Under-reporting of such incidents is observed, revealing a sort of 'culture of silence' which, over time, can lead to suffering in the workplace and a deterioration in the quality of care.


Assuntos
Vítimas de Crime , Recursos Humanos de Enfermagem no Hospital , Violência , Violência no Trabalho , Local de Trabalho , Serviço Hospitalar de Emergência , Pessoal de Saúde , Humanos , Inquéritos e Questionários
17.
FP Essent ; 480: 11-15, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31063340

RESUMO

Adverse childhood experiences include direct abuse, such as emotional, physical, or sexual abuse; neglect, which can be emotional or physical; and family or household problems. Exposure to violence is one of several types of adverse childhood experiences that can affect individuals for the rest of their lives. The effects of exposure to violence during childhood include associated physical and mental health conditions, as well as concerns about involvement in intimate partner violence in adulthood. Family physicians can aid in the prevention of and response to adverse childhood experiences in several ways. On an individual level, they can assess patients for such experiences and provide trauma-informed care. They also can educate children and their parents and caregivers about exposure to violence and adverse childhood experiences. On a societal level, they can advocate for safer media, communities, schools, and home environments for children and adolescents. Early results of studies of physician education in this area have yielded promising results.


Assuntos
Experiências Adversas da Infância , Maus-Tratos Infantis , Nível de Saúde , Violência por Parceiro Íntimo , Violência , Adolescente , Cuidadores , Criança , Humanos , Fatores de Risco
18.
FP Essent ; 480: 28-31, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31063343

RESUMO

In the United States, approximately 1 in 5 women will experience a sexual assault in her lifetime. In most reported cases, men are identified as perpetrators regardless of the sex of the individual assaulted. There typically is some form of relationship between the survivor and the perpetrator-whether it be an acquaintance, friend, family member, or authority figure. As such, female patients should be asked routinely about a history of sexual assault, particularly if the patient reports relevant physical symptoms and/or substance abuse. Factors that could lead to children experiencing sexual assault (particularly via domestic minor sex trafficking) include a history of abuse, substance use, mental health issues, family dysfunction, and the involvement of Child Protective Services. Short-term goals of primary care include management of physical injuries and psychological needs, evaluation for pregnancy, and prevention of sexually transmitted infections. Long-term effects may include sexual dysfunction, mental disorders (eg, depression, posttraumatic stress disorder), and medical symptoms (eg, chronic headache, infections).


Assuntos
Vítimas de Crime , Tráfico de Pessoas , Delitos Sexuais , Doenças Sexualmente Transmissíveis , Criança , Feminino , Nível de Saúde , Humanos , Masculino , Gravidez , Saúde Pública , Estados Unidos , Violência
19.
Rev Saude Publica ; 53: 46, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31066824

RESUMO

OBJECTIVE: To evaluate the effect of the time and the sex of victims and perpetrators on the rates of family and community physical violence in a Brazilian municipality over seven years (2008-2014). METHODS: We made a census analysis from non-fatal victims attended in the Forensic Institute of the Scientific Civil Police. The monthly and annual violence rates were calculated based on the population size of the municipality. Time series was evaluated by negative binomial regression models, based on the number of cases with population offset and considering the effect of the sex of victims and perpetrators. RESULTS: A total of 3,324 cases of family and 4,634 cases of community violence were analyzed. There was a significant increase in family violence rates for female victims and male perpetrators. Family violence rates were always higher for female victims than for male and it was always lower for female perpetrators than for male (p < 0.001). There was a lower risk of community violence for male victims after 2013 and a decrease of aggression perpetrated by men over time. Men and women were similarly affected by community violence; however, the perpetrators were more frequently men. CONCLUSIONS: The results indicate a trend of increasing female victims in the family violence, mainly perpetrated by men. The reduction in community violence rates could be the result of policies to reduce crime.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Criminosos/estatística & dados numéricos , Violência Doméstica/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Violência/estatística & dados numéricos , Distribuição Binomial , Brasil , Feminino , Humanos , Masculino , Valores de Referência , Fatores Sexuais , Fatores de Tempo
20.
Am Surg ; 85(5): 449-455, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31126354

RESUMO

Firearm violence in the United States knows no age limit. This study compares the survival of children younger than five years to children and adolescents of age 5-19 years who presented to an ED for gunshot wounds (GSWs) in the United States to test the hypothesis of higher GSW mortality in very young children. A study of GSW patients aged 19 years and younger who survived to reach medical care was performed using the Nationwide ED Sample for 2010-2015. Hospital survival and incidence of fatal and nonfatal GSWs in the United States were the study outcomes. A multilevel logistic regression model estimated the strength of association among predictors of hospital mortality. The incidence of ED presentation for GSW is as high as 19 per 100,000 population per year. Children younger than five years were 2.7 times as likely to die compared with older children (15.3% vs 5.6%). Children younger than one year had the highest hospital mortality, 33.1 per cent. The mortality from GSW is highest among the youngest children compared with older children. This information may help policy makers and the public better understand the impact of gun violence on the youngest and most vulnerable Americans.


Assuntos
Violência/estatística & dados numéricos , Ferimentos por Arma de Fogo/mortalidade , Adolescente , Criança , Pré-Escolar , Feminino , Mortalidade Hospitalar , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores Socioeconômicos , Taxa de Sobrevida , Estados Unidos/epidemiologia , Adulto Jovem
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