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[Rape and the "minute-after" law in Minas Gerais, Brazil: socio-demographic factors associated with emergency prophylaxis]. [巴西米纳斯吉拉斯州的强奸与 "事后一分钟 "法:与紧急预防相关的社会人口因素]。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-04-12 DOI: 10.1590/1413-81232024299.19832023
Ane Caroline Alves Vieira, Gustavo Carvalho Moreira, Aline Cristina da Cruz

This research project investigated the relationship between sociodemographic characteristics of girls and women who were the victims of rape of in Minas Gerais between 2013 and 2021, and the likelihood of receiving emergency treatment as stipulated in Law No. 12,845/2013, known as the "Minute-After" (Minuto Seguinte) Law. Data from the Notifiable Diseases Information System (SINAN) for rape cases were used to estimate binary choice models. The results indicate that the sociodemographic factors of the victims, aligned with the theory and practice of intersectionality (race, age, place of residence within health regions, relationship with the perpetrator, and year of crime registration), negatively influence the probability of receiving emergency treatment. Specifically, indigenous victims, minors, those raped by acquaintances, and residents in certain health regions, were found to have a lower probability of receiving immediate medical care after rape. Furthermore, it was found that the implementation of public policy did not result in an improvement, as there has been a decrease in the number of medical appointments since the enactment of the law in 2013 through to the year 2021.

本研究项目调查了 2013 年至 2021 年期间米纳斯吉拉斯州强奸受害女童和妇女的社会人口特征与接受第 12845/2013 号法律(即 "事后一分钟 "法)规定的紧急治疗的可能性之间的关系。来自应呈报疾病信息系统(SINAN)的强奸案件数据被用于估计二元选择模型。结果表明,与交叉性理论和实践相一致的受害者社会人口因素(种族、年龄、卫生区内的居住地、与施暴者的关系以及犯罪登记年份)对接受紧急治疗的概率产生了负面影响。具体而言,研究发现,原住民受害者、未成年人、被熟人强奸者以及某些卫生区的居民在被强奸后接受紧急治疗的概率较低。此外,研究还发现,公共政策的实施并没有带来改善,因为自 2013 年颁布法律至 2021 年,就诊人数一直在减少。
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引用次数: 0
Educational processes to combat violence against women in the health sector: an integrative review. 卫生部门打击暴力侵害妇女行为的教育进程:综合审查。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-02-16 DOI: 10.1590/1413-81232024299.14782023
Julia Costa de Oliveira, Kênia Araújo Pires, Janete Gonçalves Evangelista, Ana Pereira Dos Santos, Paula Dias Bevilacqua

The health sector can contribute to the combat of violence against women, if its services offer qualified care, but there are challenges such as the lack of health professional qualification, even though it is provided in the National Policy to Combat Violence Against Women. This study aims to analyze how health workers have been qualified to act in the prevention and confrontation of violence against women in Brazil. An integrative literature review was made and sixteen articles were analyzed, addressing training trajectories and experience reports, both in the academic and the health service context. The training on this theme proved to be insufficient, which could lead to missed opportunities for detection, care and referral of these cases to the health sector or others related to the care network. Reports on educational experiences were identified in degree courses and in Primary Health Care services, which could boost future educational processes, a need reaffirmed in all the articles. The university, in collaboration with the Unified Health System (SUS), can contribute with reflective, participatory educational processes that consider the social complexity of violence against women.

如果卫生部门能提供合格的护理服务,就能为打击对妇女的暴力行为做出贡献,但目前还存在着一些挑战,如缺乏卫生专业人员的资格,尽管《国家打击对妇女的暴力行为政策》对此做出了规定。本研究旨在分析在巴西,卫生工作者是如何获得预防和应对暴力侵害妇女行为的资格的。对文献进行了综合审查,分析了 16 篇文章,涉及学术和保健服务方面的培训轨迹和经验报告。事实证明,有关这一主题的培训是不够的,这可能会导致错失发现、护理和将这些病例转介给卫生部门或与护理网络有关的其他部门的机会。在学位课程和初级保健服务中发现了关于教育经验的报告,这可以促进未来的教育进程,所有文章都重申了这一需求。大学可以与统一卫生系统(SUS)合作,通过反思性、参与性的教育过程,考虑到暴力侵害妇女行为的社 会复杂性,从而做出贡献。
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引用次数: 0
Evaluation of an intervention to improve Primary Health Care's response to cases of domestic violence against women - São Paulo, Brazil. 对一项干预措施的评估,以改善初级保健对妇女家庭暴力案件的反应--巴西圣保罗。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-05-10 DOI: 10.1590/1413-81232024299.02982024
Stephanie Pereira, Yuri Nishijima Azeredo, Lilia Blima Schraiber, Janaína Marques de Aguiar, Beatriz Diniz Kalichman, Cecilia Guida Vieira Gralia, Marina Silva Dos Reis, Nayara Portilho Lima, Loraine J Bacchus, Manuela Colombini, Gene Feder, Ana Flávia Pires Lucas d'Oliveira

The aim was to analyse and improve the Primary Health Care (PHC) response to domestic violence against women (DVAW) by developing, implementing and evaluating an intervention. A pilot study evaluating the before and after of intervention implementation, using mixed methods and carried out in three phases - formative, intervention and evaluation - between August 2017 and March 2019 in two Basic Health Units (UBS) in the city of São Paulo. In this paper, we present the details and evaluation of the intervention, carried out six to twelve months after its implementation. The intervention was developed based on the findings of the formative phase and in line with the health policy that establishes the Violence Prevention Nucleus (NPV) and consisted of stablishing a care pathway; general training for all workers and specific training for the NPV; drawing up educational material and monthly case discussions over 6 months. The evaluation showed acceptability among the workers, increased identification and repertoire for caring for cases of DVAW, strengthening internal referral and the intersectoral network. We identified obstacles to the full implementation and sustainability of the intervention.

目的是通过制定、实施和评估一项干预措施,分析和改进初级卫生保健(PHC)应对针对妇女的家庭暴力(DVAW)的措施。2017年8月至2019年3月期间,我们在圣保罗市的两个基本医疗单位(UBS)开展了一项试点研究,采用混合方法,分三个阶段(形成、干预和评估)对干预措施实施前后的情况进行了评估。在本文中,我们将介绍干预措施的详细情况,并在实施六至十二个月后对其进行评估。干预措施是根据形成阶段的研究结果制定的,与建立暴力预防核心(NPV)的卫生政策相一致,包括制定护理路径;对所有工作人员进行一般培训,并对 NPV 进行专门培训;编写教育材料,并在 6 个月内每月进行案例讨论。评估结果表明,该计划得到了工作人员的认可,提高了对暴力侵害妇女案件的识别能力和处理能力,加强了内部转介和跨部门网络。我们发现了全面实施和持续开展干预措施的障碍。
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引用次数: 0
ERRATUM. 错误。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 DOI: 10.1590/1413-81232024298.06722024

[This corrects the article doi: 10.1590/1413-81232022278.00632022] [This corrects the article doi: 10.1590/1413-81232022278.00632022EN].

[This corrects the article doi: 10.1590/1413-81232022278.00632022] [This corrects the article doi: 10.1590/1413-81232022278.00632022EN].
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引用次数: 0
[Are there differences between men and women with respect to the factors associated with calcium intake?] [在与钙摄入相关的因素方面,男女之间是否存在差异?]
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 Epub Date: 2023-08-24 DOI: 10.1590/1413-81232024298.03032023
Renata Luz, Marilisa Berti de Azevedo Barros, Lhaís de Paula Barbosa Medina, Daniela de Assumpção, Antonio de Azevedo Barros Filho

The scope of this article is to verify if there are differences in factors associated with calcium intake between men and women. It is based on a study conducted with data from a health survey in a sample of 1641 individuals aged 20 years or more living in the urban area of the city of Campinas, in the State of São Paulo. Calcium intake was obtained from a 24-hour recall (24hr recall method) and analyzed according to sociodemographic variables, health behavior, frequency of meals and body mass index (BMI). The existence of associations was verified by multiple linear regression tests, and it was detected that the profile of associated factors differed between genders. Physical exercise in the leisure context was only associated with calcium intake in males, while skin color, smoking, income, overweight/obesity, and frequency of having breakfast only revealed an association in females. Schooling and having snacks were associated with calcium intake in both sexes. The analysis of the associated factors indicates segments of the female and male population in which the importance of calcium intake needs to be more closely examined. Furthermore, it highlights the importance of conducting health analyses stratified by sex due to the different behavioral patterns that prevail between the sexes.

本文旨在验证男性和女性在钙摄入相关因素方面是否存在差异。该研究基于一项健康调查数据,抽样调查了居住在圣保罗州坎皮纳斯市城区的 1641 名 20 岁或 20 岁以上的人。钙摄入量是通过 24 小时回忆(24 小时回忆法)获得的,并根据社会人口变量、健康行为、进餐频率和体重指数(BMI)进行分析。通过多元线性回归测试验证了相关性的存在,并发现不同性别的相关因素存在差异。休闲体育锻炼只与男性的钙摄入量有关,而肤色、吸烟、收入、超重/肥胖和吃早餐的频率只与女性有关。上学和吃零食与男女的钙摄入量有关。对相关因素的分析表明,需要对女性和男性人群中钙摄入量的重要性进行更深入的研究。此外,由于男女的行为模式不同,因此按性别进行健康分析也很重要。
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引用次数: 0
Are heart attacks deadlier on weekends? Evidence of weekend effect in Brazil. 心脏病发作在周末更致命吗?巴西周末效应的证据
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 Epub Date: 2023-08-30 DOI: 10.1590/1413-81232024298.03892023
Pedro Henrique Soares Leivas, Lívia Madeira Triaca, Anderson Moreira Aristides Dos Santos, Paulo de Andrade Jacinto, César Augusto Oviedo Tejada

This article aims to examine the effects of weekend admission on in-hospital mortality for patients with acute myocardial infarction (AMI) in Brazil. Information from the Hospital Information System of the Unified Health System (SIH/SUS) of urgently admitted patients diagnosed with acute myocardial infarction (AMI) between 2008 and 2018 was used, made available through the Hospital Admission Authorization (AIH). Multivariable logistic regression models, controlling for observable patient characteristics, hospital characteristics and year and hospital-fixed effects, were used. The results were consistent with the existence of the weekend effect. For the model adjusted with the inclusion of all controls, the chance of death observed for individuals hospitalized on the weekend is 14% higher. Our results indicated that there is probably an important variation in the quality of hospital care depending on the day the patient is hospitalized. Weekend admissions were associated with in-hospital AMI mortality in Brazil. Future research should analyze the possible channels behind the weekend effect to support public policies that can effectively make healthcare equitable.

本文旨在研究周末入院对巴西急性心肌梗死(AMI)患者院内死亡率的影响。研究使用了统一卫生系统医院信息系统(SIH/SUS)中通过入院授权(AIH)提供的2008年至2018年间被诊断为急性心肌梗死(AMI)的急诊入院患者的信息。研究采用了多变量逻辑回归模型,控制了可观察到的患者特征、医院特征以及年份和医院固定效应。结果与周末效应的存在一致。在包含所有控制因素的调整模型中,周末住院患者的死亡几率要高出 14%。我们的研究结果表明,住院日不同,医院护理质量也可能存在很大差异。在巴西,周末入院与急性心肌梗死的院内死亡率有关。未来的研究应分析周末效应背后的可能渠道,以支持能有效实现医疗公平的公共政策。
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引用次数: 0
Children's health care in the care network for people with disabilities in Brazil: a multicenter study. 巴西残疾人护理网络中的儿童保健:一项多中心研究。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 Epub Date: 2023-08-24 DOI: 10.1590/1413-81232024298.06802023
Ayrles Silva Gonçalves Barbosa Mendonça, Bianca Larissa Lesca de Oliveira, Tiótrefis Gomes Fernandes, Ralf Braga Barroso, Kátia Suely Queiroz Silva Ribeiro, Ana Carolina Basso Schmitt

The aim of this study was to identify factors associated with early identification of disabilities and developmental follow-up of children in primary health care (PHC) services under the Care Network for People with Disabilities (RCPCD). We conducted a cross-sectional study using data from a multicenter study undertaken in eight states. The data were collected using a structured questionnaire answered by PHC professionals with degree-level qualifications selected using random sampling and stratified by state and municipality. Poisson regression with robust variance was performed for the two outcomes. Of the 1,488 workers in the final sample, 63.6% performed early identification of disabilities and 49% provided developmental follow-up. Family health teams performed early identification of disabilities and follow-up more than traditional model teams, and expanded family health teams provided developmental follow-up more than both these teams. The factors that showed the strongest association with identification and developmental follow-up were profession, working in a family health team and knowledge of the RCPCD.

本研究旨在确定与早期识别残疾和在残疾人护理网络(RCPCD)下的初级卫生保健(PHC)服务中对儿童进行发育跟踪相关的因素。我们利用在八个州开展的一项多中心研究的数据进行了横断面研究。数据是通过随机抽样并按州和市进行分层,由具有学位水平的初级卫生保健专业人员回答的结构化问卷收集的。对两个结果进行了稳健方差泊松回归。在最终样本的 1488 名工作人员中,63.6% 的人进行了残疾早期识别,49% 的人提供了发育跟踪服务。与传统模式的团队相比,家庭保健团队更多地进行早期残疾鉴定和跟进,而扩大的家庭保健团队提供的发展跟进则比这两种团队都多。与残疾鉴定和发展跟进关系最密切的因素是专业、在家庭健康团队工作以及对《儿童权利公约》的了解。
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引用次数: 0
Guardians' perceptions of the benefits of dogs in family dynamics during the pandemic. 大流行病期间监护人对狗在家庭动态中的益处的看法。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 Epub Date: 2024-04-17 DOI: 10.1590/1413-81232024298.06452024
Cristiana Isabel da Cruz Furtado Firmino, Filipa Alexandra Coelho Pinto, Nídia Sofia Tavares Varela, Débora Bianca Sancho Westermann, João José Rolo Longo, Maria João Sousa Fernandes

During the pandemic, there were a lot of lockdowns that brought changes to the population's daily routine, reducing social interactions, changing work and study methods, isolating the family at their home, which brought changes to family dynamics. These changes sparked the interest of nursing students in carrying out a research study. Starting from the question: What is the role of the dog in the family dynamics in times of pandemic? and the objective: identify the guardians' perceptions about the role of the dog in the family dynamics in a period of confinement, a qualitative, exploratory, and descriptive study was carried out, collecting data through a focus group with six guardians from different families. Bardin's protocol was used to analyze and process the data. Three categories emerged in this study, highlighting the benefits in terms of mental health, physical and psychological well-being of the family with the presence of the dog, its importance in strengthening family ties and the lessons learned from adopting the dogs. We conclude that, in nursing, it is necessary to highlight the presence of the dog in the family since it brings benefits to its dynamics.

在大流行期间,许多封锁措施改变了人们的日常生活,减少了社会交往,改变了工作和学习方法,将家人隔离在家中,从而改变了家庭动态。这些变化激发了护理专业学生开展研究性学习的兴趣。从问题出发狗在大流行病时期的家庭动态中扮演什么角色? 目标:确定监护人对狗在禁闭时期的家庭动态中扮演的角色的看法,我们开展了一项定性、探索和描述性研究,通过与来自不同家庭的六位监护人进行焦点小组讨论来收集数据。在分析和处理数据时使用了 Bardin 协议。在这项研究中出现了三个类别,突出了狗的存在给家庭带来的精神健康、身体和心理健康方面的益处,狗在加强家庭联系方面的重要性,以及从收养狗中吸取的经验教训。我们的结论是,在护理工作中,有必要强调狗在家庭中的存在,因为它能为家庭带来活力。
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引用次数: 0
Trajectories of adolescents living with vertical transmission-HIV virus. 垂直传播艾滋病毒的青少年的生活轨迹。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 Epub Date: 2024-03-29 DOI: 10.1590/1413-81232024298.05172024
Imara Moreira Freire, Maria Cecília de Souza Minayo

This study analyzes the life stories of eight young people living with vertically transmitted HIV in order to understand their perceptions marked by secrecy and silence regarding their experiences with the virus. Conducted at a specialized outpatient clinic in Rio de Janeiro, the study adopted circle dance, a Complementary and Integrative Health Practice, as a care tool. Using a qualitative approach and Life History as a data collection method, the focus was to understand the youth's experiences related to the disease and the crucial aspects of their lives. Three girls and five boys participated in the study, all aware of their diagnosis. The principal emerging themes included family dynamics, school environment connection, challenges in treatment adherence, age at the time of diagnosis disclosure, and time elapsed since then. Analyzing these young people's narratives allowed us to explore individual and social aspects of their experiences, revealing their similarities and differences. The circle dance workshops provided a playful space for expressing emotions and feelings through body movements, expanding young people's perspectives on the future.

本研究分析了八名垂直传播艾滋病病毒感染者的生活故事,以了解他们对自己感染病毒的经历所持的保密和沉默态度。这项研究在里约热内卢的一家专科门诊进行,采用了圆圈舞(一种补充和整合保健实践)作为护理工具。采用定性方法和生活史作为数据收集方法,重点是了解青少年与疾病相关的经历以及他们生活的重要方面。三名女孩和五名男孩参与了研究,他们都知道自己的诊断结果。新出现的主要主题包括家庭动态、与学校环境的联系、坚持治疗所面临的挑战、确诊时的年龄以及确诊后的时间。通过分析这些年轻人的叙述,我们探索了他们经历的个人和社会方面,揭示了他们的异同。圆圈舞工作坊为通过肢体动作表达情绪和感受提供了一个游戏空间,拓展了年轻人对未来的视野。
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引用次数: 0
Qualitative analysis of nurses' performance and experiences in hospital management in the face of COVID-19. 定性分析护士在面对 COVID-19 时在医院管理方面的表现和经验。
IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-01 Epub Date: 2024-03-28 DOI: 10.1590/1413-81232024298.05052024
Patzy Dias Rebello, Sabrina da Costa Machado Duarte, Janieiry Lima de Araújo, Cristina Lavareda Baixinho, Andreia Costa, Marcelle Miranda da Silva

This study aimed to analyze the role of nurses in hospital management in the face of COVID-19. The study had a qualitative, descriptive, and exploratory approach. The setting was a hospital that was completely transformed to care for patients with COVID-19. At the time of data collection, ten nurses managed the services, and all participated in the semi-structured interview. After thematic analysis, the data were presented in three categories, representing the elements of Donabedian's triad: structure, process, and result. Category 1 highlighted the hospital structure reconfiguration based on material and people management; category 2 addressed the work process restructuring to achieve goals with safety and quality; and category 3 focused on nurses' experiences in describing the results achieved and expected. The analysis highlighted the importance of teamwork, involvement, and adaptation of managers in the face of the challenges of a new and life-threatening disease, scarce resources, and the complexity of human relationships in the crisis. In transformational leadership, these nurses encouraged behavior change, professional growth, and resilience.

本研究旨在分析护士在医院管理中面对 COVID-19 所扮演的角色。研究采用定性、描述性和探索性的方法。研究背景是一家为护理 COVID-19 患者而进行全面改造的医院。在收集数据时,有十名护士负责管理服务,他们都参与了半结构化访谈。经过主题分析,数据被分为三个类别,分别代表多纳贝迪恩三要素:结构、过程和结果。第一类强调了以物质和人员管理为基础的医院结构重组;第二类讨论了为实现安全和质量目标而进行的工作流程重组;第三类侧重于护士描述所取得和预期结果的经验。分析强调了团队合作、参与和管理者在面对威胁生命的新疾病、稀缺资源和危机中复杂的人际关系等挑战时进行调整的重要性。在变革型领导中,这些护士鼓励行为改变、专业成长和应变能力。
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引用次数: 0
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