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Stocco CS, Zubiolo TFM, Beltrame MHA, Dell'Agnolo CM. Sexual violence against children and adolescents in Paraná State: geospatial analysis and main socioeconomic indicators. J Pediatr (Rio J) 2024:S0021-7557(24)00056-1. [PMID: 38703786 DOI: 10.1016/j.jped.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 03/10/2024] [Accepted: 03/12/2024] [Indexed: 05/06/2024] Open
Abstract
OBJECTIVE Child sexual violence is a multidimensional problem of many contemporary societies, affecting people of all sexes, social stratum and age groups. Offenses involving children and adolescents are more serious, given their total or partial dependence on parents and caregivers. Information on child sexual violence in Brazil is found in raw form and without detail. The objective was to compare the information with social and economic data in the state of Paraná. METHODS The authors conducted a retrospective study of secondary data from the Notifiable Diseases Information System (SINAN) on cases of sexual violence involving victims aged 0 to 19 years. Results are presented according to notification characteristics. The authors applied exploratory spatial data analysis to assess spatial autocorrelations and investigated relationships by the ordinary least squares regression model. RESULTS Between 2017 and 2021, there were 13,403 reports of child sexual violence in Paraná State, Brazil. Most victims (82.8%) were female and aged between 10 and 14 years. The majority of sexual violence cases (67.8%) occurred in the home environment. The highest rates on a population basis were observed in the North Central and Greater Curitiba regions, mainly in cities with higher population density and with higher rates of other types of violence. CONCLUSION The results provide data that can promote a broader understanding of the distribution of sexual violence and the state and associated variations. It is expected to improve the provision of care for victims of child sexual violence and assist in strategic planning to prevent future offenses.
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Affiliation(s)
| | | | - Matheus Henrique Arruda Beltrame
- Universidade Estadual de Maringá, Departamento de Medicina, Maringá, PR, Brazil; Universidade Estadual de Maringá, Grupo de Estudos em Tecnologias Digitais e Geoprocessamento em Saúde (GETS), Maringá, PR, Brazil
| | - Cátia Millene Dell'Agnolo
- Universidade Estadual de Maringá, Departamento de Medicina, Programa de Pós-Graduação em Gestão, Tecnologia e Inovação em Urgência e Emergência, Maringá, PR, Brazil
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Andrade JRD, Platt VB, Honicky M. Reports of Maltreatment in a Children's Hospital: Evaluation of the Epidemiological Profile and Its Relationship with the Outcome in Fractures. Rev Bras Ortop 2024; 59:e269-e277. [PMID: 38606138 PMCID: PMC11006522 DOI: 10.1055/s-0044-1785466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/19/2023] [Indexed: 04/13/2024] Open
Abstract
Objective To describe suspected/confirmed cases of child maltreatment related to fractures in a pediatric hospital in southern Brazil. Method Study of the Information System of Notifiable Diseases notifications and the victims' medical records between January/2016 and December/2020. Variables related to the victim, the perpetrator, the type of abuse, the presence of fractures, and their anatomical location and death were evaluated. Logistic regression was performed to identify fracture-related variables, adjusted for sex and age. The results were expressed in odds ratios and their respective 95% confidence intervals. It was considered significant p < 0.05. Results There were 276 cases, 73 infants (26.4%), male predominance (151, 54.7%), with authorship of the mistreatment by relatives (245, 96,0%), 85 (31,5%), they presented fractures, with five deaths (1.9%). Factors related to the presence of fracture: age of the victim (less than two years old; n = 82; or 2.48; 95% CI: 1.45 - 4.25), having more than two aggressors involved ( n = 144; or 2.09; 95% CI: 1.16-3.75), the medium being traffic/automobile accident, ( n = 52; or 2.65; 95% CI: 1.04-6.75), consult an orthopedist ( n = 91; or 6.77 / 95% CI: 3.66-12.51), and the need for surgical intervention ( n = 15; OR 36.72; 95% CI: 8.22-164.03). Conclusions The importance of suspicion, early identification of aggression, and the correct completion of notifications for activating the system of guaranteeing rights and removal of the aggressor was emphasized.
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Silva BPD, Camargo DD. Professional practices in situations of child abuse: an integrative review. CIENCIA & SAUDE COLETIVA 2023; 28:1703-1715. [PMID: 37255147 DOI: 10.1590/1413-81232023286.14022022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/08/2022] [Indexed: 06/01/2023] Open
Abstract
Child abuse is a problem that affects children all over the world. The present study therefore aimed to identify and analyze the main findings relating to professional practices for dealing with situations of child maltreatment in articles published in Brazil. To this end, we conducted an integrative literature review of articles published between 2017 and 2022 based on searches of the following databases: Google Scholar, SciELO Brasil, the periodicals database of the Agency for the Improvement of Higher Education Personnel (CAPES), MEDLINE, the Virtual Health Library, and Electronic Journals in Psychology (PePSIC). A total of 24 publications were selected for the review after screening the titles and abstracts. The findings reveal several challenges to ensuring the protection of children caused by shortcomings in professional training, which have a negative influence on the identification and reporting of child maltreatment. The present study reveals the lack of priority given to the issue of child maltreatment in professional training and provides important inputs to inform future research on professional practices for dealing with child violence.
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Affiliation(s)
- Beyle Pereira da Silva
- Universidade Tuiuti do Paraná. R. Wilsom Gomes Ramos 120, 401, bloco 3, Abranches. 82.220-510. Curitiba PR Brasil.
| | - Denise de Camargo
- Universidade Tuiuti do Paraná. R. Wilsom Gomes Ramos 120, 401, bloco 3, Abranches. 82.220-510. Curitiba PR Brasil.
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Associação entre a violência intrafamiliar experienciada e transtorno mental comum em adolescentes. ACTA PAUL ENFERM 2023. [DOI: 10.37689/acta-ape/2023ao02391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Platt VB, Coelho ESB, Bolsoni C, Honicky M, Bordin GP, Camargo MAVD. Sexual violence against children in the state of Santa Catarina, Brazil: characteristics and factors related to repetitive violence. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2022069. [PMID: 37042944 PMCID: PMC10088467 DOI: 10.1590/1984-0462/2023/41/2022069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 12/07/2022] [Indexed: 04/13/2023]
Abstract
OBJECTIVE The aim of this study was to characterize child sexual abuse and investigate the factors related to its repetition in the state of Santa Catarina, Brazil. METHODS This is a descriptive and analytical study, with data from 2009-2019 SINAN. Sociodemographic variables related to the circumstances of violence were analyzed. Multivariate logistic regression was used to test factors related to repetitive violence. RESULTS A total of 3489 cases of child sexual abuse were reported: 73.3% were girls, the most prevalent age ranged from 6 to 10 years, and 51% reported repetitive violence. The majority was perpetrated by one (85.6%) person, and in cases in which two or more perpetrators were involved, the proportion of occurrence was higher for boys (17%) versus girls (13%). Among the risk factors for the repetition of sexual violence are the place of occurrence being the residence, the perpetrator (the stepfather, the brother, and the father) being under the influence of alcohol, and the age of the child between 6 and 10 years. CONCLUSION The profile and factors that help in the identification of repetitive child sexual abuse were presented, such as the authorship being related to stepfathers, parents, and siblings, the perpetrator being under the influence of alcohol, and the victim's age between 6 and 10 years.
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Ferreira DG, Veras MA, Saggese GSR, Guimarães MDC, Magno L, Dourado I, Maia Macena RH, Leal AF, Kendall C, Mércham-Hamann E, Bermúdez XPD, Knauth D, Sansigolo Kerr LR. Prevalence, Characteristics, and Factors Associated With Sexual Violence in Adulthood Among Brazilian MSM. Am J Mens Health 2022; 16:15579883221142173. [PMID: 36527370 PMCID: PMC9768831 DOI: 10.1177/15579883221142173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Most studies of sexual violence are with women, and although men who have sex with men (MSM) is the group of the men that has been most investigated for sexual violence, there are still several questions to be answered about sexual violence and sexual revictimization among MSM. This study aimed to estimate the prevalence of sexual violence in different stages of life and identify factors associated with sexual violence in adulthood among Brazilian MSM. We conducted an analysis with data from the study conducted in 2016 with 4,176 MSM from 12 Brazilian cities recruited through respondent-driven sampling (RDS), who answered a survey to a set of questions, among which some specific about sexual violence. Most participants were under 25 years old (56.5%), with more than 12 years of schooling (71.2%), mixed race (40.8%), single (86.2%), and belonging to some religion (50.9%). The lifetime prevalence of sexual violence was 20.3%. In our analyses, having experienced sexual violence in childhood and adolescence increased the odds of experiencing sexual violence in adulthood (prevalence ratio ratios [PRR] 4.93 (95% CI [1.99, 12.21]), as did experiencing physical violence (PRR 1.99; 95% CI [1.07, 3.71]) and receiving money for sex (PRR 2.26; 95% CI [1.17, 4.36]). In addition to violence in childhood and adolescence being risk factors for sexual violence in adulthood, we also observed that half of the sample experienced sexual violence repeatedly, characterizing sexual revictimization. It is important that health services are prepared to receive boys and men victims in order to reduce the chances of revictimization and other outcomes.
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Affiliation(s)
- Denis Gonçalves Ferreira
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil,Denis Gonçalves Ferreira, Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Jr., 61—São Paulo 01221-020, Brazil.
| | - Maria Amelia Veras
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
| | | | - Mark Drew Crosland Guimarães
- Department of Preventive and Social Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Laio Magno
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Brasil
| | - Ines Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | | | - Andréa Fachel Leal
- Instituto de Filosofia e Ciências Humanas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Carl Kendall
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Edgar Mércham-Hamann
- Programa de Pós Graduação em Saúde Coletiva, Universidade de Brasília, Brasilia, Brasil
| | | | - Daniela Knauth
- Department of Social Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Mussabekova S, Mkhitaryan X. Sexual Inviolability of Minors in Central Kazakhstan: A Forensic Medical Analysis. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Child sexual abuse is a social phenomenon that requires special attention from society, as it leads to the suffering of the most vulnerable part of the world's population. Child sexual abuse around the world not only persists, but also continues to grow, despite the active measures of the world community against it. Taking into account the high latency of crimes against sexual inviolability and sexual freedom of the person, measures for their detection and prevention are of particular relevance. All this requires constant monitoring of the current situation not only in the world or in the country, but also in each region of the country separately. Forensic medical examination of victims of sexual violence plays an important role in the analysis of the situation on this problem, not only in the legal, but also in the medical aspect.
Research aim: Analysis of quantitative and qualitative indicators of crimes against the sexual inviolability of minors on the territory of Central Kazakhstan for the formation of indicators for assessing the current situation in the region and recommendations for the prevention of these types of crimes.
Methods A retrospective analysis of the situation on the number and structure of sexual crimes committed against children from 2018 to 2021 was carried out, and their dynamics was studied. There were investigated 1252 forensic medical examinations on cases of sexual crimes against the sexual inviolability of the person on the territory of Central Kazakhstan. Methods of applied statistical analysis were used to analyz obtained results.
Results
A detailed analysis made it possible to assess the structure and peculiarities of sexual crimes committed against children on the territory of Central Kazakhstan over the specified period of time. The number of sexual crimes against minors in the region is increasing every year. Statistically significant age characteristics of victims and specific indicators characterizing the socio-psychological aspects of sexual crimes in the region were revealed. It has been established that in most cases the aggressor is part of the victim's family or is very close to it. The analysis of the age structure of children showed that boys from 6 to 14 years old and girls over 14 are more likely to become victims. In the studied territory, the number of sexual harassment of children is more often committed by one person, often known to them, and in most cases occurs in enclosed spaces than on the street.
Conclusion
The progressive growth of crimes against the sexual inviolability of children in the region requires strengthening measures to improve legal means of countering sexual crimes against minors. A detailed study of the issue made it possible to identify lacks (organizational, tactical, diagnostic) and give the forensic medical examination of sexual conditions a qualitatively new level. The strategy of combating sexual crimes against minors should be based on active preventive work.
Key words: forensic medical examination, sexual violence, Central Kazakhstan, children, minors.
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Pedroso MRDO, Leite FMC. Prevalence and Factors Associated with Sexual Violence against Children in a Brazilian State. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9838. [PMID: 36011472 PMCID: PMC9408234 DOI: 10.3390/ijerph19169838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
Sexual violence is one of the forms of violence against children worldwide. Understanding its magnitude and its associated factors is essential to promote effective protection policies to childhood. The objective was to verify the prevalence and analyze the factors associated with sexual violence against children in a Brazilian state. This is a cross-sectional study analyzing data from reported cases of violence against children in the state of Espírito Santo, Brazil, between 2011 and 2018. The characteristics of the victim, perpetrator and aggression were studied, and the associations were analyzed using Poisson regression. The frequency of sexual violence was 41.8% and was more prevalent in girls, in the age groups 3 to 5 and 6 to 9 years old, in white ethnicity/color and in the urban area. The offenders were mainly men, known to the victim and occurred mainly in the residence. Sexual violence was the most reported violence among children in Espírito Santo, occurring within their circle of trust, demonstrating the need to provide support for families and to advance public policies to guarantee children's rights.
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Affiliation(s)
| | - Franciéle Marabotti Costa Leite
- Pos-Graduation Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitoria 29043-900, Brazil
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A Meta-Analytic Framework for Developing Protocols to Attend Child and Adolescent Victims of Sexual Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095233. [PMID: 35564628 PMCID: PMC9103342 DOI: 10.3390/ijerph19095233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 01/25/2023]
Abstract
Violence against children and adolescents is a global public health problem. In Brazil, there are challenging boundaries for professionals in the protection network in general and for health professionals in particular. Moreover, among other factors, there is the challenge of referral, due to weaknesses in decision making, given the nature of sexual violence and how it is managed by healthcare services. This study aims to propose a Meta-Analytic framework to support the referral of young victims of sexual violence, considering levels of severity, independent of factors such as how protection systems are structured and managed and the local laws in force. We propose a Meta-Analytic approach, developed using the fundamentals of Delphi and DPSIR (Drivers, Pressures, State, Impact, and Response Model of Intervention), from the perspective of Value-Focused Thinking. The Delphi method was structured in two stages: the first stage aimed to identify and classify typical cases of sexual violence; the second stage used the DPSIR model, with the aim of identifying the decision criteria for typical cases that occur in a given municipality. The main outcomes are: (i) the application of the modified Delphi participatory method within the context of local social policies; (ii) the construction of a value tree based on Value-Focused Thinking; and (iii) the identification and systematization of criteria that most interfere with the evaluation of cases of sexual violence, which can be used for multi-criteria decision making.
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Miziara ID, Miziara CSMG, Salguero Aguiar L, Alvez B. Physical evidence of rape against children and adolescents in Brazil: Analysis of 13,870 reports of sexual assault in 2017. SAGE Open Med 2022; 10:20503121221088682. [PMID: 35342626 PMCID: PMC8943547 DOI: 10.1177/20503121221088682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/21/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction: The medical literature reports child and adolescent maltreatment since the
8th century. Unfortunately, even today, the incomplete knowledge of this
event persists. Several forms of violence are applied to children and
adolescents, mainly sexual violence including rape and sexual assault.
Forensic medical examinations routinely include the genital area, anus, and
the body of the victims for signs of a recent or old injury. The main goal
of this study is to show the results of physical and sexual examinations
regarding confirmation of rape in children and adolescents, based on the
medicolegal reports. Methods: We made a descriptive cross-sectional study conducted by collecting data from
Medicolegal Institute (IML-São Paulo, Brazil) in 2017. We examined 13,870
reports of sexological examinations of victims of the alleged rape. The
variables analyzed were age; sex; physical examination; sexological
examination; and direct search for sperm in the vaginal, anal, or oral
cavity. We selected 11,725 reports from victims under 18 years. Results: As for the medical-legal findings, only 1735 reports (14.8%) confirmed sexual
abuse. The most affected ages were between 3 and 5 years in the male group
and 11 to 14 years in the female group. The most frequent injuries were
bruises and abrasions, fissures in the anal region. In 96.2% of the examined
males and 85.8% of the females under 14 years old, the examination was
inconclusive, and somebody cannot prove the alleged rape. Only 1735 reports
(113 from men and 1622 from women) concluded beyond any doubt the alleged
rape (14.8%). The search for sperm was positive in only 1582 cases
(13.5%). Conclusion: This study shows that the results of the medicolegal examinations were quite
limited in recording evidence. Sexual violence against children and
adolescents reaches mostly females under 13 years of age. Besides, it is a
complicated crime to prove, as 85.8% of female examinations and 96.2% of
male exams revealed: “no supporting elements” or “undetermined” to
characterize the felony. Therefore, to prevent it, the communication of the
alleged rape must be made as quickly as possible.
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Affiliation(s)
- Ivan Dieb Miziara
- Department of Legal Medicine, Ethics and Occupational Health, São Paulo University School of Medicine, São Paulo, Brazil
| | | | - Luan Salguero Aguiar
- Discipline of Legal Medicine and Bioethics, ABC School of Medicine, Santo André, Brazil
| | - Beatriz Alvez
- Discipline of Legal Medicine and Bioethics, ABC School of Medicine, Santo André, Brazil
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Torres ASB, Teixeira AL, Côrtes MTF, Alves ÂC, Alabarse O, Azevedo RCSD, Fernandes A. Sexual Violence Suffered by Women in Early and Late Adolescence: Care Provided and Follow-Up. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:667-677. [PMID: 35276748 PMCID: PMC10032055 DOI: 10.1055/s-0042-1743094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare the sexual violence suffered by women in early and late adolescence, the reactions triggered after the aggression, and the care provided. METHODS A retrospective study in which we reviewed the medical records of 521 female adolescents treated by a multidisciplinary team at a reference hospital in the city of Campinas, state of São Paulo, Brazil. We analyzed sociodemographic variables, and those pertainin to the characteristics of the episodes of violence, the emergency care, and the physical and psychological reactions observed during the follow-up. For the analysis, the sample was divided into groups of early (10 to 14 years) and late (15 to 18 years) adolescence. We used the Chi-squared/Fisher Exact, Mann-Whitney, and Kruskal-Wallis tests to compare the groups; the level of significance adopted was 5%. RESULTS The early group (n = 242) contained more adolescents who were enrolled in school (p < 0.001), suffered more daytime aggressions (p = 0.031), in their residences (p < 0.001), by an aggressor with whom they were acquainted (p < 0.001), had greater need of legal protection (p = 0.001), and took longer to seek care (p = 0.048). Feelings of guilt, shame, and the perception of violence were similar between the groups. In the late group (n = 279), there was greater consumption of alcohol during the aggression (p = 0,005); they received significantly more prophylaxis treatments; reported more physical symptoms (p = 0.033), sleep disorders (p = 0.003), symptoms of anxiety (p = 0.045), and feelings of anguish (p = 0.011); and had more prescriptions of psychotropics (p = 0.005). Only 52% completed the 6-month follow-up, with no differences between the groups. CONCLUSION The age groups showed differences in the characteristics of the episodes of violence; early adolescents took longer to seek help, and the late group presented more intense symptoms and psychological worsening during the follow-up. Measures of prevention and specific care aimed at this population are needed.
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Affiliation(s)
- Alejandra Suyapa Becerra Torres
- Department of Gynecology and Obstetrics, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Ana Luiza Teixeira
- Department of Gynecology and Obstetrics, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Maria Teresa Ferreira Côrtes
- Department of Gynecology and Obstetrics, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Ândria Cléia Alves
- Department of Gynecology and Obstetrics, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Otávio Alabarse
- Department of Gynecology and Obstetrics, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Renata Cruz Soares de Azevedo
- Department of Gynecology and Obstetrics, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Arlete Fernandes
- Department of Gynecology and Obstetrics, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Taquette SR, Monteiro DLM, Rodrigues NCP, Ramos JAS. The invisible magnitude of the rape of girls in Brazil. Rev Saude Publica 2021; 55:103. [PMID: 34932694 PMCID: PMC8664051 DOI: 10.11606/s1518-8787.2021055003439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Compare official data on notifications of sexual violence against girls aged 10 to 13 years with data on pregnancy for the same age group between 2012 and 2018. METHODS This is an epidemiological, descriptive, cross-sectional study with data from the Department of Informatics of the Unified Health System (DATASUS) on violence against and pregnancy of girls aged 10 to 13 years from 2012 to 2018. Data on sexual violence were accessed in the Health Information System (SINAN); on pregnancy, in the Live Births Information System (SINASC), on fetal deaths, in the Mortality Information System (SIM), and on abortions, in the Hospital Admission System (SIH). RESULTS Between 2012 and 2018, out of 136,387 pregnancies, there were 120,185 live births and 15,402 interrupted pregnancies by abortions or fetal deaths of mothers who became pregnant aged 13 years or younger. In the same period, SINAN received 46,548 notifications of sexual abuse against girls aged 10 to 13 years. The number of girls who became pregnant before the age of 14, victims of statutory rape, was 2.9 times higher than the number of cases notified to SINAN. CONCLUSION The lack of adequate notification of statutory rapes in Brazilian official statistics leads to the underestimation of its magnitude.
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Affiliation(s)
- Stella Regina Taquette
- Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Departamento de Pediatria. Rio de Janeiro, RJ, Brasil
| | - Denise Leite Maia Monteiro
- Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Departamento de Ginecologia e Obstetrícia. Rio de Janeiro, RJ, Brasil.,Centro Universitário Serra dos Órgãos (UNIFESO). Departamento de Ginecologia e Obstetrícia. Teresópolis, RJ, Brasil
| | - Nádia Cristina Pinheiro Rodrigues
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil.,Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Rio de Janeiro, RJ, Brasil
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Ferreira DG, Saggese GSR, Veras MA. Sexual Violence Communication Between Men and Women. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2793-2794. [PMID: 34258695 DOI: 10.1007/s10508-021-01923-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 01/11/2021] [Accepted: 01/15/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Denis Gonçalves Ferreira
- Faculdade de Medicina, Centro Universitário de Várzea Grande Cristo Rei, Várzea Grande, MT, 78118900, Brazil.
| | - Gustavo Santa Roza Saggese
- Department of Medicine, Division of Prevention Science, University of San Francisco, San Francisco, CA, USA
| | - Maria Amélia Veras
- Departamento de Medicina Social, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
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Ferragut M, Ortiz-Tallo M, Blanca MJ. Victims and Perpetrators of Child Sexual Abuse: Abusive Contact and Penetration Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189593. [PMID: 34574520 PMCID: PMC8472568 DOI: 10.3390/ijerph18189593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/10/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
Child sexual abuse (CSA) includes abusive contact experiences, which habitually impact the victim's whole life. This study aims to analyze the characteristics of six CSA experiences with physical contact, including penetration, in a representative sample of the Spanish population. Participants were 1071 Spanish adults (53% males; Mage: 45.37) who completed the Child Sexual Abuse Experiences Questionnaire. The victim's age at the first episode, the perpetrator's characteristics, and the number of times that each experience occurred were analyzed, taking into account gender differences. Results were reported for every experience independently. The most prevalent age at the first experience was from 6 years old onwards, but with differences in some experiences. The abuses usually happened more than once, committed by the same person. The most prevalent perpetrator is a male, although a female perpetrator is more prevalent in male victims. Most of the abuses were committed by an adult acquaintance, a strange adult, and other minors, with some gender differences. The implications of the results concerning every CSA experience are discussed, highlighting their value for future research and practice, the design of preventive programs, and early detection of CSA.
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Affiliation(s)
- Marta Ferragut
- Faculty of Psychology, University of Málaga, 29071 Málaga, Spain; (M.O.-T.); (M.J.B.)
- Correspondence:
| | - Margarita Ortiz-Tallo
- Faculty of Psychology, University of Málaga, 29071 Málaga, Spain; (M.O.-T.); (M.J.B.)
- Con.Ciencia Association, 29016 Málaga, Spain
| | - Maria J. Blanca
- Faculty of Psychology, University of Málaga, 29071 Málaga, Spain; (M.O.-T.); (M.J.B.)
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Franco RPAV, Franco A, Turkina A, Arakelyan M, Arzukanyan A, Velenko P, Bortolami PB, Makeeva I, Silva RHAD. Third molar classification using Gleiser and Hunt system modified by Khöler in Russian adolescents – Age threshold of 14 and 16. FORENSIC IMAGING 2021. [DOI: 10.1016/j.fri.2021.200443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Bastos KRP, Eusébio AML, Pereira KNDA, Silva TOSD, Costa LF. Características dos adolescentes ofensores sexuais e de suas vítimas: um estudo de processos judiciais. SAUDE E SOCIEDADE 2021. [DOI: 10.1590/s0104-12902021181112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo A violência sexual praticada por adolescentes ainda é pouco estudada no Brasil. Conhecer esses sujeitos é fundamental para a compreensão do fenômeno e execução de ações preventivas. Este artigo apresenta características dos adolescentes ofensores sexuais, bem como de suas vítimas e do contexto da violência. Para isso, foram analisados 254 processos judiciais, entre 2013 e 2016, no Distrito Federal, envolvendo 285 ofensores e 291 vítimas. A partir das informações coletadas, elaborou-se um quadro descritivo, cuja análise foi realizada de forma contextualizada e tendo como referência outros importantes estudos na área. Os resultados apontaram a diversidade dos adolescentes ofensores sexuais, porém as informações sobre as famílias foram bastante escassas nos processos. Quanto à idade e à escolaridade, a maior parte cometeu a ofensa com 16/17 anos (41,4%) e cursava o ensino fundamental II (29,5%). Um número significativo de adolescentes tinha envolvimento anterior com a justiça (24,2%). Os abusos foram prioritariamente extrafamiliares (48,5%), com vítimas do sexo feminino (67,7%), entre 10 e 14 anos (40,5%) e conhecidas do ofensor (92,2%). Ressalta-se a complexidade dos casos, impossibilitando intervenções padronizadas e descontextualizadas, assim como a importância de conhecer o contexto social e as relações familiares desses sujeitos com vistas a intervenções mais assertivas.
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Silva FCD, Monge A, Landi CA, Zenardi GA, Suzuki DC, Vitalle MSDS. The effects of sexual violence experienced in childhood and adolescence on undergraduate students. Rev Saude Publica 2020; 54:134. [PMID: 33331528 PMCID: PMC7703533 DOI: 10.11606/s1518-8787.2020054002576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE: This study aims to investigate the prevalence of adolescents and young adults who were victims of sexual violence at some point in their lives and to compare the presence of depressive and anxious symptoms, quality of life, and use of alcohol, tobacco, and illegal drugs among this population and those who were not abused. METHODS: Validated questionnaires and instruments were applied in a group of university students to assess: sexual profile and behavior, socioeconomic status, presence or not of sexual violence (Questionnaire on Exposure to Traumatizing Events), depressive (Beck Depression Inventory) and anxious symptoms (Beck Anxiety Inventory), quality of life (World Health Organization's Quality of Life Assessment) and the use or abuse of tobacco, alcohol, and illegal drugs (Smoking, Alcohol, and Substance Involvement Screening Test). RESULTS: Out of the 858 students who participated, 71 (8.3%) were victims of sexual violence, 52 girls (73.2%). In the victims of violence group there were more students who already had the first sexual intercourse (p = 0.029), students who already had become pregnant (p = 0.001), students with higher scores for depressive (p < 0.001) and anxious symptoms (p = 0.001), students with worse quality of life (p < 0.001), and who used more tobacco (p = 0.008) and marijuana (p = 0.025) as well as abused hypnotics or sedatives (p = 0.048) than in the non-victim group. CONCLUSION: The abuses are presented in several forms and affect, even in long term, the survivors' life. The sexual violence theme should be addressed and widely discussed in all spheres of society in order to mobilize, to sensitize, and provide society with knowledge, demystifying this subject and drawing attention to this important social issue.
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Affiliation(s)
- Flávia Calanca da Silva
- Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Pediatria. São Paulo, SP, Brasil.,Universidade Federal de São Paulo. Escola Paulista de Medicina. Programa de Pós-Graduação em Saúde Coletiva. São Paulo, SP, Brasil
| | - Aline Monge
- Universidade Federal de São Paulo. Escola de Filosofia, Letras e Ciências Humanas. Programa de Pós-Graduação em Educação e Saúde. Guarulhos, SP, Brasil
| | - Carlos Alberto Landi
- Faculdade de Ciências Médicas da Santa Casa de São Paulo. Departamento de Atenção Primária. São Paulo, SP, Brasil.,Universidade Nove de Julho. Faculdade de Medicina. Módulo de Pediatria. São Paulo, SP, Brasil
| | | | - Denise Chrysostomo Suzuki
- Universidade Federal de São Paulo. Escola Paulista de Medicina. Programa de Pós-Graduação em Saúde Coletiva. São Paulo, SP, Brasil
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Bourgou S, Meddouri SL, Ben Hamouda A, Ben Mustapha H, Charfi F, Hamza M, Belhadj A. [Profile of the victims of sexual violence in child psychiatry consultation]. Encephale 2020; 47:221-226. [PMID: 33190821 DOI: 10.1016/j.encep.2020.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 06/04/2020] [Accepted: 06/19/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Child sexual abuse is a major health problem that remains under-declared and under-reported worldwide. In this paper we have taken an interest in establishing the profile of the victims in a clinical population of children consulting for sexual abuse. METHOD We conducted a descriptive retrospective study in the child and teenager psychiatry department of the Mongi-Slim hospital (Tunis, Tunisia). We included all patients referred for treatment or medical expertise during the period from January 2013 to June 2019 and recorded sociodemographic data and clinical characteristics on pre-established charts from patient files. RESULTS The total number of consultants was 150 patients with 61,33 % of female subjects (n=92). The average age was 9,9 years old with extremes ranging from 2 to 18 years old. The assault was unique in 62,7 % and happened in a place known by the victim in 47,33 %. Sexual abuse with non-penetrating contact was the most frequent (48 %). The average age at which the first sexual abuse happened was 9 years old. In the vast majority of cases, the abuser was a male. Concerning the identity of the abuser, he was someone of the family in 37,3 % of the cases and in half of these cases, he was the father. In the other cases where the abuser wasn't a family member, the identity was known by the child and/or his family in 48,66 %. A psychiatric diagnosis was made in 58 % of the cases with a percentage of 52,1 % among girls and 60,3 % among boys. Main diagnoses were acute stress disorder in 10,6 %, post trauma stress disorder in 19,3 %, adjustment disorder in14,6 % and a major depressive disorder in 8 %. CONCLUSION Knowing the profile of victims of child sexual abuse and taking into consideration the social and psychiatric impact can help in adapting the means to intervene properly in order to take care of the victims and prevent such abuse.
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Affiliation(s)
- S Bourgou
- Faculté de médecine de Tunis, service de pédopsychiatrie, hôpital Mongi-Slim, université de Tunis-El-Manar, 1007, La Marsa, 2046 Tunis, Tunisie.
| | - S L Meddouri
- Faculté de médecine de Tunis, service de pédopsychiatrie, hôpital Mongi-Slim, université de Tunis-El-Manar, 1007, La Marsa, 2046 Tunis, Tunisie
| | - A Ben Hamouda
- Faculté de médecine de Tunis, service de pédopsychiatrie, hôpital Mongi-Slim, université de Tunis-El-Manar, 1007, La Marsa, 2046 Tunis, Tunisie
| | - H Ben Mustapha
- Faculté de médecine de Tunis, service de pédopsychiatrie, hôpital Mongi-Slim, université de Tunis-El-Manar, 1007, La Marsa, 2046 Tunis, Tunisie
| | - F Charfi
- Faculté de médecine de Tunis, service de pédopsychiatrie, hôpital Mongi-Slim, université de Tunis-El-Manar, 1007, La Marsa, 2046 Tunis, Tunisie
| | - M Hamza
- Faculté de médecine de Tunis, service de pédopsychiatrie, hôpital Mongi-Slim, université de Tunis-El-Manar, 1007, La Marsa, 2046 Tunis, Tunisie
| | - A Belhadj
- Faculté de médecine de Tunis, service de pédopsychiatrie, hôpital Mongi-Slim, université de Tunis-El-Manar, 1007, La Marsa, 2046 Tunis, Tunisie
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Marques NM, Belizario GO, Rocca CCDA, Saffi F, de Barros DM, Serafim ADP. Psychological evaluation of children victims of sexual abuse: development of a protocol. Heliyon 2020; 6:e03552. [PMID: 32211541 PMCID: PMC7082511 DOI: 10.1016/j.heliyon.2020.e03552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 07/25/2019] [Accepted: 03/03/2020] [Indexed: 11/15/2022] Open
Abstract
Sexual abuse (SA) is associated with significant psychological problems in childhood, making it increasingly important to develop evaluation protocols. This study examined clinical aspects and cognitive measures of 49 children (24 with SA history and 25 controls). It employed a SA assessment questionnaire, clinical evaluations of posttraumatic stress disorder, risk indicators and neuropsychological tests in order to elaborate a specific forensic psychological evaluation protocol for this population. Conflicting couples (80%), separated parents (68%) and parents' alcohol/drug abuse (76%) were revealed as major risk factors. Fathers represented the primary perpetrator (24%). The main cognitive complaint was difficulty concentrating. Regarding the association between clinical and cognitive variables, it was observed that children who were anxious or referred to having fear, difficulties with operational memory and difficulty sleeping, had more trouble performing tasks that required attention and memory (operational, immediate and late). Children with SA history demonstrated inferior performance in visual attention/task switching and memory; with an emphasis in the loss of set in the Wisconsin test. The findings suggest the possibility of a primary attention deficit in children with SA history, possibly influencing the performance of other cognitive functions.
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Affiliation(s)
- Natali Maia Marques
- Department and Institute of Psychiatry, Forensic Psychology Program, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Gabriel Okawa Belizario
- Department and Institute of Psychiatry, Bipolar Disorder Research Program (PROMAN), University of São Paulo Medical School, Sao Paulo, Brazil
| | | | - Fabiana Saffi
- Department and Institute of Psychiatry, Forensic Psychology Program, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Daniel Martins de Barros
- Department and Institute of Psychiatry, Forensic Psychology Program, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Antonio de Pádua Serafim
- Department and Institute of Psychiatry, Neuropsychology Unit, University of São Paulo School of Medicine, São Paulo, Brazil.,Department of Psychology, Methodist University of São Paulo, São Bernardo do Campo, Brazil
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Santos LF, Costa MMD, Javae ACRDS, Mutti CF, Pacheco LR. Fatores que interferem no enfrentamento da violência infantil por conselheiros tutelares. SAÚDE EM DEBATE 2019. [DOI: 10.1590/0103-1104201912010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO A presente pesquisa objetivou apresentar perspectivas de conselheiros tutelares sobre a atuação nos casos de violência contra a criança. Para tanto, foram entrevistados 16 profissionais atuantes no município de Palmas (TO), Brasil. Os dados foram submetidos à análise de conteúdo. Identificou-se que interferem no enfrentamento da violência infantil, por esses atores, a falta de conhecimento e habilidades para identificar crianças em risco ou situação de violência, o envolvimento das famílias nos casos, a precariedade de recursos materiais, o quantitativo insuficiente de profissionais, falhas na rede de proteção à criança, estereótipos culturais, a desvalorização profissional e a impunidade do agressor. Sendo assim, para que o Conselho Tutelar consiga exercer plenamente suas funções e contribuir para a interrupção do ciclo de violência infantil, são necessários investimentos em diversas áreas, tais como a qualificação dos conselheiros tutelares, por meio da oferta de cursos periódicos, e a implantação de ambientes de trabalho com recursos material e humano suficientes, de modo a contribuir para que se exerçam ações integradas, intersetoriais e resolutivas.
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Pereira CDA, Maciel SC, Dias CCV, Alexandre TMDO, Oliveira MXD, Pimentel CE. Validação da Escala de Crenças sobre Abuso Sexual (ECAS) no Contexto Brasileiro. PSICO-USF 2019. [DOI: 10.1590/1413-82712019240112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo O presente artigo objetiva adaptar e validar para o contexto brasileiro a Escala de Crenças sobre Abuso Sexual (ECAS) de origem portuguesa, composta por 17 itens e três fatores. Para tanto foram realizados dois estudos, no primeiro foi feita uma análise fatorial exploratória com amostra de 208 estudantes universitários, obtendo-se uma estrutura unifatorial, divergindo da escala original, com alfa de Cronbach de 0,88. Diante da discordância, foi realizado um segundo estudo, visando confirmar a estrutura fatorial da escala, com amostra de 209 estudantes universitários. Portanto, o resultado confirmou como melhor modelo a estrutura unifatorial da escala, com redução de 17 para 11 itens, obtendo-se alfa de Cronbach de 0,84. Sendo assim, a adaptação e validação da ECAS contribui para preencher uma carência existente no Brasil em relação a instrumentos voltados a mensurar as crenças sobre o abuso sexual infantojuvenil, podendo colaborar com estudos e intervenções na área.
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