Inter-sectoral network to face violence against children and adolescents in a rural context

OBJECTIVE

To analyze the Primary Health Care inter-sectoral network in a rural context to face domestic violence against children and adolescents.

METHOD

A qualitative research study, with the Paradigm of Complexity as theoretical and methodological framework. Eighteen health professionals from two rural Family Health Units in a municipality in the state of São Paulo were the participants. Data was collected through minimum maps of the institutional network and focus groups in May and June 2019. Data was analyzed through thematic analysis.

RESULTS

Two categories emerged, entitled "It's not nonexistent, but it's complicated" and "We're always on the firing line". The existence of a weakened network; assistance based on biomedical bias; and care fragmentation were characteristics present in the care provided to the families.

FINAL CONSIDERATIONS

The absence of network care was evident, with isolation and overload of the Primary Health Care unit that is enhanced by the characteristics of rurality.

Protection network in the assistance to children, adolescents and their families in situation of violence

OBJECTIVE

To understand the performance of the protection network for children, adolescents, and their families in situations of intrafamily violence, from the perspective of professionals of the Specialized Reference Center for Social Assistance.

METHOD

A qualitative study conducted with five Specialized Reference Center for Social Assistance professionals in a Pernambucan municipality. Data collection was conducted from October 2017 to January 2018 by means of a semi-structured interview, with data analyzed by the thematic content technique.

RESULTS

The professionals know how the protection network works, but they see the deductive logic of the team; the lack of material resources; the difficulty of articulation; and the logistics of care flow as limiting factors for maintaining effective care.

CONCLUSION

The performance of the protection network must be able to ensure the rights of children, adolescents, and their families in situations of violence, through articulated and integrated care, aiming at changing attitudes and breaking the cycle of violence.

"I don´t have it, I didn´t have it": experiences of families involved in violence against children and adolescents

OBJECTIVES

to characterize and analyze the experiences of families involved in domestic violence against children and adolescents, based on the Paradigm of Complexity.

METHODS

qualitative research, in which data of 15 families was collected through documentary research, open interviews and field diary. The data were analyzed through thematic analysis.

RESULTS

two categories "I don't have it" and "I didn't have it" emerged, revealing the historicity that marks the violence experienced in the present. They include social vulnerability, maternal burden, associated with urban violence to which families are exposed. At the same time, stories of violence by the intimate partner, as well as intergenerational violence and drug abuse have impacted the current moment. Final Considerations: nursing can contribute to attribute new meaning to violent stories woven by families, as well as to the interdisciplinary construction of perspectives and interventions that consider the multiple violence and adversities to which such a population is exposed.

Violence in intimate relationships from the point of view of adolescents: perspectives of the Complexity Paradigm

OBJECTIVE

To analyze adolescents' perceptions about intimate violence from the perspective of the Complexity Paradigm.

METHOD

A qualitative approach configured as strategic social study. The study participants were adolescents between 15 and 18 years old, attending high school in two public schools in a city in the interior of São Paulo State, Brazil. Data collection was performed through a focus group and a semi-structured interview as a complement. Data analysis was based on the dialogical, organizational and holographic principles of the Complex Paradigm.

RESULTS

The study included 39 adolescents (14 males and 25 females). Through the emerging categories, it was noticed that intimate violence occurs through dialogical affection-jealousy/control by a naturalization of violent acts which permeates gender, cultural and social issues, and by technology as preponderant for intimate violence among adolescents, denoting new forms of control and coercion.

CONCLUSION

The study introduces aspects present in intimate violence among adolescents, presenting them in an articulate and interdependent way. These aspects constitute a relevant contribution to the actions of health professionals.

DIGITAL SOCIAL NETWORKS: EXPOSURE TO VIOLENCE IN INTIMITY AMONG ADOLESCENTS IN THE LIGHT OF COMPLEXITY

ABSTRACT Objective: this study aims to learn the perception of adolescents, who are immersed in the digital age, about intimate partner violence, from the perspective of the Paradigm of Complexity. Method: a qualitative and strategic social research; 39 adolescents, males and females, attending high school in two state schools in a city in the state of São Paulo, Brazil, participated in the study. Data was collected through interviews and focus groups between October 2016 and April 2017 and analyzed in the light of the referred Paradigm. Results: the results showed the following: acceptance of violence in intimate relationships among adolescents; persistence of taboos, myths and beliefs in society that were reproduced in the participants’ reports; new forms of violence, relationships and notions engendered and updated by the digital age; prevalence of psychological violence among adolescents. Conclusion: the study shows the association between love and violence out of jealousy and the control and power over the partner’s social networks as a legitimate form of love in the daily life of intimate relationships, which are expressed in different ways. Failure to accept certain conditions is perceived as a form of cheating. The Paradigm of Complexity contributed in an indispensable way by offering an integral look on the theme and by providing greater clarity about the elements that make up the phenomenon in an articulated and contextualized way.

[Systematic review on bullying and family: an analysis based on bioecological systems]

OBJECTIVE

Analyze the relationships between family context and involvement in school bullying.

METHODS

The following databases were searched: Web of Science, PsycoInfo, Pub-Med, Lilacs and SciELO virtual library, using the terms bullying, family and parents. A total of 61 papers met the eligibility criteria. The corpus was analyzed through the Bioecological Development Framework.

RESULTS

The experiences of students experiencing situations of bullying are multifaceted and are related to the family context. Elements from the microsystem, such as violence in the family, parental practices, environment and type of family arrangements, were the elements more frequently explored and related to bullying, though the relationships of parents with the children's friends, the parents' education and socioeconomic conditions, along with the exo, meso and macro systems were also related to bullying.

CONCLUSION

The review contributes to the literature by broadening the approach to this phenomenon that affects the health and development of children and adolescents.

Prevalence of school violence and use of alcohol and other drugs in adolescents

OBJECTIVE

to analyze the school violence suffered and practiced and its association with the use of alcohol and other drugs in adolescents between 12 and 18 years old.

METHOD

the study sample consisted of 643 adolescents enrolled in six schools, who answered two self-administered questionnaires: "Global School-based Student Health Survey" and "Violence in School". Statistical analysis was performed using the chi-square test and the degree of association between the variables was analyzed using the prevalence ratio.

RESULTS

the prevalence of school violence suffered and practiced was 62.2% and 51.9%, respectively. About 44.6% of the aggressors said they did not want to change their behavior. There was an expressive prevalence of alcohol use (16.5%), tobacco (15.7%) and illicit drugs (6.8%), and drunkenness (12.6%). There was a significant association between the violence suffered and the age group of 12 to 14 years old (p=0.001); (p=0.011) and education level in elementary school (p<0.001). In mothers with less than eight years of studies, the association was significant for the violence practiced (p=0.002).

CONCLUSION

the study contributes to the aspects involved in school violence, which can subsidize actions and policies in this area.

Understanding and contextualizing teen dating violence

Abstract Objective: To describe and analyze teen dating violence with adolescents of a public school in a city in the state of São Paulo. Method: Qualitative research, anchored by the Paradigm of Complexity. Data collection was carried out with 16 students of the 11st year of high school, through focus groups and semi-structured interviews. Data analysis was based on the thematic modality. Results: There emerged three themes, which made it possible to understand that the myth of romantic love has still present in intimate relationships; as an aspect of these myths, jealousy is revealed as inherent in relationships, while time triggering teen dating violence at the same. Digital social networks have been throughout this process; the family and the school emerge as contexts that expose adolescents to vulnerability, including the experience of other violence manifestations. Conclusion and implications for practice: Multidimensional, retroactive and interdependent nature of the aspects related to teen dating violence were identified. Promotion of healthy dating relationships from the deconstruction of romantic love myths; safe use of virtual social networks by adolescents; actions to promote healthy parenting and articulation of health-school-family, with the empowerment of these spaces as factors to protect violence involving adolescents are necessary.

Social support network of family members of abused children and adolescents: Perspectives and possibilities

AIMS AND OBJECTIVES

To analyse the network of care and social support from the perspectives of family members of children and adolescents who have been abused.

BACKGROUND

The theoretical-methodological background of the ecological model for understanding violence and the Paradigm of Complexity provide a broad perspective of violence. The paradigm considers all aspects that constitute a phenomenon as well as particular features.

DESIGN

Qualitative research based on the Paradigm of Complexity, developed by Edgar Morin, the primary philosopher. We have adhered to the COREQ Checklist guidelines for qualitative research.

METHODS

Data were collected through Minimal Maps of Personal Social Networks, and semi-structured interviews were held with 15 families who were assisted by a nongovernmental organisation in a Brazilian city. The notions of comprehension and contextualisation guided the data analysis.

RESULTS

Two categories emerged from the data analyses: "Social isolation" and "Affective relationships needs." The maps revealed a weakened and limited network with low-density, homogeneous bonds and few significant bonds. Therefore, the network provided predominantly instrumental and material social support with few important effective relationships. The participants disclosed some strategies to empower their lives.

CONCLUSIONS

We conclude that it is urgent to develop strategies in a broad manner to promote family empowerment, especially on education and employment dimension, and to construct supportive and respectful relationships between services and families as well.

RELEVANCE TO CLINICAL PRACTICE

The present study contributes to international clinical nursing, especially in low- and middle-income countries, by discussing (a) looking at and caring for family members of children and adolescents who have been abused in a contextualised manner; (b) family empowerment, which enables them to have access to healthier environments and to educational/employment opportunities; and (c) broad comprehension of health care among the family members, which provides perspectives not only for looking at violence but also for strengthening supportive social relationships.

Critical path of women in situations of intimate partner violence

Objective:

To know and analyze the critical path followed by women subjected to intimate partner violence until reaching a Reference Center of a Brazilian city, from the perspective of these women.

Method:

Qualitative research, based on the concept of critical path. Participant observations of the support group of the Reference Center and interviews with ten women in situations of violence who were followed up in this service.

Results:

the motivating factors for women to seek help were the increase in the severity of the aggressions, the impact of the violence on their children and support from their family. They go to several sectors and services before reaching the Reference Center, such as the police and legal counsel, health and social services. They find little effective responses from the services, and care is indicated as the most relevant response factor to face the situation.

Conclusion:

the assistance is fragmented and dependent on the posture of the professional. The Reference Center is recognized as an important place of support for women. In addition to governmental efforts to maintain the network structured, the permanent education of the working professionals is also fundamental.

Social network of adolescents under probation from the perspective of public health

RESUMO Objetivo: analisar o sentido da rede social de adolescentes que cumprem Liberdade Assistida e identificar os componentes essenciais dessa rede. Método: estudo exploratório, de abordagem qualitativa. Participaram do estudo 26 adolescentes com idade de 13 a 18 anos. Para a coleta dos dados, optou-se por entrevista semiestruturada e construção de mapas de rede. Resultados: evidenciou-se a essencialidade da rede social para os adolescentes, destacando-se a importância da família - especialmente a mãe -, e do Centro de Referência Especializado de Assistência Social, para promoção social e construção de um novo projeto de vida, sem envolvimento com atos infracionais. Todavia, os adolescentes não revelaram vínculos com profissionais de saúde. Conclusão: observou-se a necessidade do enfermeiro, enquanto profissional da atenção primária à saúde, atuar de forma intersetorial e interdisciplinar, no sentido de fortalecer a rede social de adolescentes em conflito com a lei.

Institutional links to cope with school violence: an exploratory study

Abstract Objective: Identify and analyze the institutional links of secondary schools to cope with school violence. Methods: Qualitative, descriptive and exploratory study, based on the concept of social network. Twelve secondary school administrators and coordinators were interviewed. The links established between the schools and other institutions were mapped using minimum maps of social institutional external network and semi-structured interviews. Data were analyzed through thematic content analysis. Results: The category "Mapping institutional links" showed important deficiencies in the institutional links between the studied schools and other sectors to cope with school violence. Conclusion: In methodological terms, the study considers social and institutional networks to cope with contemporaneous phenomena and presents important contributions to nursing, warning to current health needs of adolescents.

Domestic violence against children and adolescents: social support network perspectives

Objective

To identify and analyze the social support network of families involved in violence against children and adolescents, from the perspective of health professionals and families in a municipality of the state of São Paulo, Brazil.

Methods

This was a qualitative strategic social study, anchored in the paradigm of complexity. Data were collected from 41 health professionals and 15 families using institutional or personal network maps, and semi-structured interviews. Analysis was conducted by organizing the data, constructing theoretical frameworks, and categorizing resulting information.

Results

The category "weaving the network" was unveiled, with family experiences and professionals focused on a logic of fragmentation of care.

Final considerations

The creation and implementation of public policy are urgently needed to address the needs of this population, by empowering families and communities and developing research that respects the multidimensional nature of the phenomenon.

Violence against children and adolescents: the perspective of Primary Health Care

ABSTRACT Objective: To analyze the care provided by Basic Health Units (BHU) to families involved in domestic intrafamily violence against children and adolescents. Method: Qualitative research, based on the Paradigm of Complexity. Data collection was performed with 41 professionals through focus groups and semi-structured interviews. Results: The following categories emerged from data analysis: 'Everything comes here', which reflects the legitimate place of BHUs for the population and the actions taken to build care for families; and 'We only do what is really necessary', which brings the look to violence still based on the positivist and biomedical paradigm. Final considerations: The model of understanding and construction of work processes in the BHU is structured in the aforementioned paradigm. Nurses have the possibility to become agents of change, both in professionals' training and in the care thought and provided to communities.

The care network of the families involved in violence against children and adolescents: the Primary Health Care perspective

AIMS AND OBJECTIVES

To contribute the understanding of the network care provided to families involved in family violence against children and adolescents (FVACA), from the Primary Health Care (PHC) perspective.

BACKGROUND

Children and adolescents figure among the main victims of violence around the world, which occurs predominantly in the family context. PHC-guided network care has emerged as a new process that contrasts with traditional approaches, which rely on fragmented, punctual and compensatory actions and produce simplified and segmented interventions in response to complex phenomena like violence. The Paradigm of Complexity interacts with the network care approach and, by articulating the multiple dimensions of the research phenomenon, contributes to its understanding.

DESIGN

Qualitative research, based on the Paradigm of Complexity.

METHODS

Data were collected through minimal maps of the external institutional social network, focus groups and semi-structured interviews held with 41 PHC professionals in Brazil. The notions of comprehension and contextualisation as well as dialogical, recursive and holographic principles from complexity theory guided the data analysis.

RESULTS

The two thematic categories that emerged revealed reduced institutional networks, with low-density and homogeneous bonds, which resulted in fragmented care in all stages of the care process.

CONCLUSIONS

Although the network organisation of care for the families involved in FVACA is fundamental, the construction of these networks still represents a great challenge, as it requires the joint work of a multiprofessional team.

RELEVANCE TO CLINICAL PRACTICE

For nursing to respond to the contemporary care demands in a contemplative and pertinent manner, a perspective and a reference framework need to be developed, leading to broader and more contextualised actions, with a multidimensional approach to the families and communities of which child and adolescent victims of violence are a part.

Family violence against children and adolescents in context: How the territories of care are imbricated in the picture

Objective:

to understand the context of care addressed to the families involved in family violence against children and adolescents (IVCA), as produced in the context of the Primary Health Care (PHC), from the vantage point of the practitioners of a municipality in the State of Sao Paulo.

Methods:

qualitative research of the social-strategic type, based on the Complexity Paradigm. The participants were 41 health practitioners in five health units of the municipality under study, pertaining to the five districts of the municipality. Data collection was done through 5 focus groups and 10 semi-structured interviews from April 24th 2013 to December 12th 2013. Data analysis was oriented by the comprehension and contextualization mindset and based on the dialogic, recursive and hologramatic principles.

Results:

two main issues regarding the care provided by the Health of the Family team were identified: the context of this violence (the domestic space) and the power relations that prevail in the territory where this violence surfaces. The community health workers are the targets of specific attention because they experience the live/work dialogic in this same area.

Conclusion:

paying attention to the territory, and considering the complexity of contexts and dimensions is inherently linked to the design of care to families involved in IVCA in the PHC environment.

Minimum Map of Social Institutional Network: a multidimensional strategy for research in Nursing

OBJECTIVE

To analyze the use of methodological strategies in qualitative research - Minimum Maps of Social Institutional Network, as proposed to understand the phenomena in the multidimensional perspective.

METHOD

Methodological theoretical essay in which we aimed to reflect on the use of innovative methodological strategies in nursing research, supported in Complex Paradigm fundamentals.

RESULTS

The minimum map of Social Institutional External Network aims to identify institutional linkages and gaps for the intervention work of the surveyed institutions. The use of these maps provided important advances in know-how qualitative research in Health and Nursing.

CONCLUSIONS

In this perspective, the use of minimum Social Intitutional Network maps can be stimulated and enhanced to meet the current demands of the contemporary world, particularly for its flexibility in adapting to various research subjects; breadth and depth of discussion; and possibilities with health services.

OBJETIVO

Analisar o uso de estratégias metodológicas em pesquisas qualitativas - Mapa mínimo da Rede Social Institucional, como proposta para compreender os fenômenos na perspectiva multidimensional.

MÉTODO

Ensaio teórico metodológico em que buscou-se refletir sobre o uso de estratégias metodológicas inovadoras de pesquisa na enfermagem, sustentada nos fundamentos do Pensamento Complexo.

RESULTADOS

O mapa mínimo da Rede Social Institucional Externa tem o objetivo de identificar os vínculos institucionais e lacunas para o trabalho de intervenção das instituições pesquisadas. O uso destes mapas proporcionou avanços importantes no saber-fazer pesquisa qualitativa em Saúde e Enfermagem.

CONCLUSÃO

Nessa perspectiva, o uso de mapas mínimos da Rede Social Institucional pode ser estimulado e potencializado para responder às atuais demandas da contemporaneidade, em especial pela sua flexibilidade na adequação a diversos objetos de pesquisa; amplitude e profundidade de discussão; e possibilidades de articulação com a prática dos serviços.

Enfrentamento da violência doméstica contra crianças e adolescentes na perspectiva de enfermeiros da atenção básica

RESUMO Objetivo Analisar as ações relatadas por enfermeiros da atenção básica no enfrentamento da violência doméstica contra crianças e adolescentes. Métodos Pesquisa qualitativa, realizada em cinco Unidades de Estratégia de Saúde da Família do Estado de São Paulo, Brasil. Dados coletados no segundo semestre de 2013 através de entrevistas semiestruturadas com cinco enfermeiras e analisados através de análise de conteúdo, modalidade temática. Resultados Emergiram dois núcleos temáticos: “Políticas públicas identificadas pelas enfermeiras” e “Ações das enfermeiras diante da violência permeadas por medos e conflitos”. As enfermeiras conheciam as políticas públicas, mas não conseguiam colocá-las em prática; estavam despreparadas para identificar e enfrentar a violência; não participavam de cursos de capacitação; temiam notificar os casos detectados de violência. Conclusão As principais limitações ao trabalho prático dos enfermeiros são a sobrecarga de trabalho, a falta de segurança e a dinâmica de trabalho desarticulada com a rede de proteção as quais levam à subnotificação dos casos de violência.

Interaction during feeding times between mothers and malnourished children under two years of age

This study sought to understand the relations between mothers and malnourished children at feeding times. It is an exploratory study with qualitative data analysis. Data collection was performed at home by means of participant observation with eight mother-child dyads and three grandmothers. Based on the thematic analysis, the following themes emerged: food and interaction; day-to-day care of the child. The families' life situation was unfavorable. Mothers and grandmothers were responsible for preparing family meals, feeding and child care. The mother-child relationships were permeated by gestures of affection, slaps, scolding, and threats during feeding and there were cases of negligence, physical and psychological violence in daily care. Some mothers and grandmothers spoke quietly and cared for the child to be fed and cleaned while others mothers showed little patience for dealing with the child and they became easily irritated. Mothers' life stories were marked by adverse events and most of them faced emotional problems that could have repercussions in relationships with children at feeding times and in daily care. The mother-child interactions at home do not always favor feeding and responsive care, which may further worsen the nutritional status of these children.

Sistemas de justiça e a vitimização secundária de crianças e ou adolescentes acometidas de violência sexual intrafamiliar

Este artigo aponta resultados de pesquisa realizada junto aos juízes de direito, sobre a inquirição de crianças e/ou adolescentes, vítimas de violência sexual, no sistema de justiça. Referencial teórico centrado na visão do contexto ecológico do desenvolvimento humano. O método foi de natureza qualitativa, com entrevista semiestruturada e observação livre, em Comarcas do Judiciário Brasileiro. O tratamento dos dados deu-se a partir da técnica de análise de conteúdo temática, que aponta “Impotências e Limites” e “Violência Secundária”. Na primeira, o juiz, desprovido de preparo, socorre-se à hora da inquirição da vítima, de modelo cujas bases estão na prática, experiência de vida, sem apropriar-se das estruturas necessárias ao procedimento. A didática utilizada é de senso comum. “Violência Secundária” evidencia que os modos de intervenção do lugar do judiciário podem ser vistos como aspectos de revitimização de crianças e adolescentes, quando apenas ouve tais pessoas em sucessivos momentos para obtenção de materialidade da prova para incriminação do agressor, em discordância entre a prioridade imediata e a absoluta assegurada legalmente pela Constituição Federal Brasileira. O Sistema Judicial não demonstra estar organizado para priorizar questões envolvendo crianças e adolescentes. Seja como suporte para lidar com as possíveis implicações da inquirição, seja na discussão para se formular abordagens que evitem a violência secundária de vítimas de violência sexual. O campo da saúde poderá trazer contribuições para a área judiciária desde que o problema seja visto a partir de uma dimensão interdisciplinar, ainda que caiba ao judiciário a palavra final para a sua solução.

Social support from the perspective of adolescent victims of domestic violence

Objective: Assess the understanding of adolescents regarding the social support received in situations of domestic violence. Method: A qualitative study with data collection carried out through focus groups with 17 adolescent victims of domestic violence, institutionally welcomed in Campinas-SP, and through semi-structured interviews with seven of these adolescents. Information was analyzed by content analysis, thematic modality. Results: Observing the thematic categories it was found that social support for the subjects came from the extended family, the community, the Guardianship Council, the interpersonal relationships established at the user embracement institution and from the religiosity/spirituality. Conclusion: The mentioned sources of support deserve to be enhanced and expanded. With the current complexity of the morbidity and mortality profiles, especially in children and adolescents, the (re)signification and the (re)construction of health actions is imperative.



Vulnerabilidade na saúde do adolescente: questões contemporâneas

Este estudo exploratório de natureza qualitativa objetivou analisar como adolescentes percebem a realidade em termos da vulnerabilidade na saúde. Foram realizadas 17 entrevistas semiestruturadas com adolescentes de duas escolas de educação fundamental de um município do interior do estado de São Paulo. A interpretação dos dados, orientada pela análise de conteúdo, fez emergir três núcleos temáticos. Os resultados indicaram que os adolescentes compreendem a complexa interação entre a predisposição individual à vulnerabilidade para a saúde, bem como as questões relacionadas à estrutura social, o que contribui para o fortalecendo da concepção de vulnerabilidade a partir das lógicas individual, social e programática. Identificou-se que as políticas públicas, a prevenção e a assistência na adolescência não devem ser orientadas por um único referencial, mas sim pelo reconhecimento da pluralidade do ser adolescente quanto à vulnerabilidade em suas dimensões, rompendo, dessa forma, com a ideia de universalidade do processo de adolescer.

Institutional shelter to protect adolescent victims of domestic violence: theory or practice?

OBJECTIVE

To understand and analyze, from the perspective of adolescent victims of domestic violence who were cared for in an institution in Campinas-SP, the protective factors to which they are submitted and / or have access.

METHOD

This was qualitative research, with data collection occurring through focus groups with 17 adolescents, and semistructured interviews with seven of them; the data analysis was based on content analysis, using a thematic modality.

RESULTS

Two themes emerged, entitled Four Walls and Trust. We discuss the context of institutional care, that despite the efforts made contemporaneously, still maintains an authoritarian environment; the importance of the bond and trust established with some employees, acting as protective factors for the adolescents and the protective aspect of religiosity.

CONCLUSIONS

It is understood that these considerations should be valued and reinforced through the healthcare services provided to children and adolescents, as they contribute to the promotion of the physical and mental health of this population.

Primary care nurses' approach to cases of violence against children

In Primary Care, the field of nursing comes face-to-face with the complexity of violence, leading these professionals to constantly re-evaluate their habitus. OBJECTIVE: to analyze how cases of violence against children and adolescents are approached by primary care nurses, identifying limits and possibilities for dealing with these cases. METHOD: a qualitative study, undertaken in 2011, through semi-structured interviews with 8 out of 48 nurses in the Family Health teams in the city of Uberaba in the state of Minas Gerais, the analysis of which followed the interpretation of meanings, based in dialectical hermeneutics. RESULTS: the following stand out: non-identification of violence as a problem for the nurses; denunciations and notifications as a role of the nurses; and the limits found in the face of violence. CONCLUSION: it is determined that the habitus of nursing directed at health promotion and prevention of violence must be restructured, overcoming the biomedical paradigm and involving intersectorial and multidisciplinary actions.

Violência sexual intrafamiliar contra crianças e adolescentes: entre a prevenção do crime e do dano

OBJETIVOS: compreender as representações sociais de membros do Poder Judiciário acerca da prevenção da violência sexual intrafamiliar contra crianças e adolescentes. MÉTODOS: pesquisa de abordagem qualitativa que teve como campo de estudo as 1ª e 2ª Varas dos Crimes contra a Criança e o Adolescente, no Tribunal de Justiça de Pernambuco, com participação de 17 sujeitos (juiz, assessor, técnicos e analistas judiciários). Observação participante, entrevistas semiestruturadas e grupo focal compreenderam as técnicas para coleta de dados, que foram analisados por meio da interpretação dos sentidos. RESULTADOS: a categoria "cultura penal" emergiu dos discursos, bem como suas subcategorias: "prevenção do crime" e "prevenção do dano". CONCLUSÕES: as representações dos sujeitos revelam uma dicotomia, caracterizando o conflito entre a tradição do Poder Judiciário e o direito novo, que abrange os princípios da proteção integral e da prioridade absoluta às crianças e dos adolescentes. O conceito de prevenção da violência sexual intrafamiliar contra crianças e adolescentes deve ser ampliado para além da mera prevenção do crime. A abordagem do problema por meio da prevenção requer que se incorpore ao Poder Judiciário uma cultura penal que abarque os princípios da proteção integral e da prioridade absoluta.

Judiciary as the last resort to protect children and adolescents: intersectoral actions, investment in human resources, and structuring of services

This study aimed to identify the work developed by the Judiciary to prevent sexual violence against children and adolescents within the family. The approach to social representations in a cultural perspective was used. The field study consisted in the 1st and 2nd Court of Crimes against Children and Adolescents, at the State Supreme Court of Pernambuco, Brazil. Participant observation, semi-structured interviews, and focus group with 17 subjects were the techniques for data collection, analyzed through the interpretation of meanings, allowing the identification of the category "The Judiciary as the ultimate level" and the following subcategories: "The public policies to prevent violence" and "The structure and dynamics of Courts". This study allows the visualization of the Judiciary's limitations with regard to the full protection and absolute priority, and that the work along with the victims demands investments in structure and human resources.

Influências das relações intrafamiliares no comportamento de crianças que frequentam creches públicas de alfenas

Nos últimos anos, as organizações sociais e familiares se modificaram, tornando as creches mais requisitadas pela população. Nosso objetivo foi compreender as influências das relações intrafamiliares no comportamento das crianças de 0 a 3 anos, que frequentam creches, por meio das experiências vivenciadas por seus monitores. Pesquisa qualitativa, utilizando a Trajetória Fenomenológica, com entrevista de 12 monitores de seis creches públicas municipais. Como categorias: reprodução de comportamentos apreendidos no ambiente familiar; integração família-creche como facilitadora do trabalho desempenhado pelos monitores; déficit de cuidados higiênicos oferecidos pela família. Estudos futuros poderão promover melhorias nas ações dos cuidadores frente às necessidades infantis, apontando para uma melhor qualidade de vida das crianças, contribuindo para o desenvolvimento de todo o seu potencial.

[Spatial analysis of the social vulnerability of adolescent pregnancy]

The purpose of this study was to present a spatial analysis of the social vulnerability of teenage pregnancy by geoprocessing data on births and deaths present on the Brazilian Ministry of Health databases in order to support intersectoral management actions and strategies based on spatial analysis in neighborhood areas. The thematic maps of the educational, occupational, birth and marital status of mothers, from all births and deaths in the city, presented a spatial correlation with teenage pregnancy. These maps were superimposed to produce social vulnerability map of adolescent pregnancy and women in general. This process presents itself as a powerful tool for the study of social vulnerability.

[Protective and family risk factors related to drugs in families of adolescents from Valparaíso, Chile]

This quantitative, cross-sectional, descriptive and exploratory research aimed to identify and describe protective and family risk factors related to the phenomenon of drugs in adolescents' families in the community of Valparaiso, Chile. The sample consisted of 61 students enrolled in 2008 and selected through simple random sampling. The data collection instrument was a questionnaire, developed and validated by experts from five countries in the Americas. Of the adolescents, 86.9% perceived the family relations, in general, as a protective factor, highlighting great communication with parents. Tensions, health and behavior problems were found as protective factors by a small number of students who act as neutral actors, in both cases associated with alcohol and drugs consumption by some family member. As risk factors, education and parents' kind of work were appointed.

[The representation of alcoholic beverages consumption for adolescents in a Family Health Unit]

Alcoholic beverages consumption by adolescents is a global problem with repercussion on different social sectors. However, the reasons that cause this behavior are still little studied. This qualitative research aimed to understand the socially constructed representations of adolescents about the consumption of alcoholic beverages, in a Family Health Unit in the city of Feira de Santana, state of Bahia, Brazil. Subjects were twenty-one adolescents of both genders. Observation, focus groups and semi-structured interviews were used for data collection, followed by interpretation of meanings as data analysis. Results showed that this practice represents "to drink much", which is close to the concept of binge drinking and "to be in the group", evidencing the socializing character of drinking. It also means a rite of passage. Among the factors that influence this representation, adults' attitudes to alcohol, especially the father and media, are highlighted. It is concluded that this substance represents a symbolic capital, with contradictions regarding the issue, precariousness of protective factors and existence of vulnerability factors. Rethinking adolescent-targeted and alcohol-related public policies is needed.

Factores protectores de las familias para prevenir el consumo de drogas en un municipio de Colombia

El objetivo de este estudio fue analizar los factores protectores de prevención del consumo de drogas, presentes en familias con niños que asisten a Hogares Comunitarios de Bienestar Familiar en un municipio colombiano. El estudio es de tipo descriptivo y cuantitativo transversal; la muestra estuvo constituida por 256 familias, seleccionadas por muestreo aleatorio simple. El instrumento para la recolección de datos fue un cuestionario aplicado durante los meses de marzo y abril de 2007, de forma autoaplicada. Se encontraron factores protectores como demostraciones de afecto con los hijos, jugar y hablar con ellos sobre lo que les gusta, comunicación fácil, toma de decisiones en pareja, adecuada flexibilidad durante la educación familiar, y existencia de normas. Por otro lado existen factores de riesgo como el consumo de drogas lícitas (cigarrillo y alcohol) y bajo porcentaje de drogas ilícitas. Un alto porcentaje de familias considera que los padres, principalmente, deben tomar medidas de prevención en los primeros años de vida del niño. Los factores protectores encontrados deben ser reforzados, debido a que no son muy fuertes; también, se deben controlar los factores de riesgo encontrados para convertirlos en factores protectores.

Representations of eating and of a nutrition program among female caregivers of children under 5 years old in Tizimin, Yucatan, Mexico

This study was carried out between January and April 2008 with 14 caregivers of children younger than 5 years residing in Tizimín city, Mexico. It aimed to understand the social representations of eating and the Programa Oportunidades [Opportunity Program] held by caregivers taking into account their social and cultural context. This qualitative investigation with an ethnographic approach was based on participant observation and semi-structured interviews. Two empirical categories emerged: 1) feeding and 2) an aid. The first refers to the caregivers' representation of eating patterns of children younger than 5 years and the second reveals that the program is considered an aid, which favors and helps caregivers to meet part of their needs. The study achieved the proposed objectives since it enabled us to understand caregivers in the complex task of feeding these children and also to propose strategies in several spheres to improve infant nutrition.

[The institutional violence in day-care and pre-schools according to mothers' view]

The objective of this research is to know the institutional violence in the day-care centers and preschools by the mothers' view. It was elaborated with two approaches:quantitative and qualitative. The researcher through interview and observation made the collection of primary data, and the qualitative data werw collected by recorded interview, being made the content analysis. The results show that 23,9%of the mothers affirm that violence exists against the child; the proportion of children that didn't suffer violence in the day-care center can be considered statistically significant, when cmpared with those already suffered, independently of the time of frequency in the day-care center (p= 0,95);the mothers say they don't know the cause of the institutional violence; the physical violence appears with larger incidence; it is more frequent the mother to try to know the cause of theviolence, and the minus, to denounce to Guardian Council. It's compatible to the parents the child's protection and they need to know the ways of protecting them of the infantile violence.

Intrafamily violence and justice

This study aimed to analyze the structural, developmental and functional dimensions of families in situations of violence, under judicial intervention in the city of São Paulo, SP, Brazil. The theoretical reference utilized was centered on the perspective of the ecological context of human development. A qualitative methodology was adopted. Data collection was constituted in the analysis of the judicial lawsuits, census maps, semi-structured interviews, free observation and photographs produced by the subjects. Data analysis was inspired by dialectic hermeneutics. "I did not have" and "In the streets" were empirical categories emerging from the subjects' statements, evidencing situations of insecurity and despair, the insertion in perverted relations, established in the universe of drug dealing, exploitation, violation of rights and economic privations. Families showed changes from one historical moment to another, under distinct variables and with a specific complexity, regarding their capacity of discovering, maintaining or altering their development in the environment.

Perceptions of adolescents students on the consumption of drugs: a case study in Lima, Peru

The consumption of drugs has increased worldwide and has become a public health problem, affecting particularly adolescents. This study aimed to identify the opinions of adolescent students on the use of drugs and drug users, in a school in Lima, Peru. It is a descriptive and cross-sectional study with a questionnaire self-applied to 386 students. Data collected comprised students' personal data, their perception on the risk of drugs consumption, motivations, information on preventive interventions, drugs availability, opinion regarding drug users and their family, and social acceptance. Male gender was predominant. Most of the participants were unfavorable regarding risk perception and consumption motives, though, they were favorable towards information. We have a relevant role in explaining behaviors and also in implementing appropriate and efficient preventive and treatment programs.

Drugs use by six to seven-year-old children from an elementary school in Celaya, Guanajuato, México

This study aimed to identify the use of drugs by six to seven-year-old students from an elementary school in Celaya, Gto., Mexico. It is a cross-sectional exploratory study with non-probabilistic sample. Thirty-nine students, both genders, were interviewed, and the use of drugs was identified, not only among students, but also among people close to them. The whole sample (100%) was 7 years old, 61.5% female, 77% reported their mothers smoked, and 25% she consumed alcohol; 24.3% reported their father smoked, and 48.6% he consumed alcohol; 30.6% of the scholars had already consumed alcohol once (beer), 8.1% had tried cigarettes, but not other drugs.

School as a "protective factor" against drugs: perceptions of adolescents and teachers

This study aims to discover and describe protective factors regarding the use of drugs, according to teachers and students, aged 14 to 15 years, from a Public Secondary School in Santiago de Querétaro, Mexico. This is a descriptive and exploratory study. Data collection was carried out through semi-structure interview and non-participative observation with ten students and five teachers. Three themes resulted from data analysis: school and school's environment: the school does not provide a healthy environment; use of drugs: perceived by both the students and teachers in the institution itself; prevention programs: there are health promotion and prevention programs available at the school. According to the students' and teachers' perceptions, the school represents a risk factor.

Assistência em saúde às crianças e adolescentes abrigados em Ribeirão Preto, SP

O presente artigo tem como objetivo descrever a assistência em saúde oferecida às crianças e adolescentes abrigados no Centro de Atendimento à Criança e ao Adolescente Vitimizados (CACAV), no município de Ribeirão Preto-SP. O estudo é descritivo e exploratório. Os dados foram coletados mediante entrevista semi-estruturada, observação não estruturada e análise documental. Os pontos que investigamos foram as estruturas de recursos humanos e do espaço físico do abrigo e a assistência em saúde prestada pelo abrigo e pela unidade de saúde de referência. Observamos muitas deficiências, cujas soluções não dependem apenas do abrigo, mas sim de uma articulação com outros setores, buscando uma assistência em saúde de qualidade, que contemple as necessidades das crianças e adolescentes em sua integralidade.

Family dynamics from the perspective of parents and children involved in domestic violence against children and adolescents

We sought, in this investigation, to understand the family dynamics in the view of parents and children involved in Domestic Violence against children and adolescents institutionalized in the Center of Assistance to the Victimized Child and Adolescent (CACAV), in Ribeirão Preto-SP, Brazil. This is a qualitative study with semi-structured interviews applied to parents and children from six families involved in domestic violence. The data were analyzed through content analysis. Ecology of human development was used as theoretical reference. Domestic violence was reported, though it is understood as common practice for the families. We identified that the parents' view favors the denial of the violence perpetrated. The children, on the other hand, point that love ties and affection are more significant for their development than blood relations. We believe that the knowledge acquired as how violence is experienced, can contribute with intervention strategies capable of breaking the perverse cycle of violent family relationships.

Public care policies for child and adolescent victims of domestic violence

This is a qualitative study that aimed to know and analyze the social representations of social workers regarding the assistance to the child and adolescent, victims of domestic violence. The data collection was carried out through semi-structured interviews and participant observation. The data analysis was based on the hermeneutic-dialectic perspective. The empirical categories that emerged from the subjects' representations were: "lack of policy", "do not support because have not received support", and "social assistance" whereas the political economic aspect was highlighted as determinant of violence; the cultural aspects, perpetuating a cycle of violence in the families. An important step must be taken is the formulation of public policies directed to all children and adolescents and not policies of exception, directed only to those who are in situation of "social and personal risk".

A violência familiar no mundo da criança de creche e pré-escola

A presente pesquisa utiliza o estudo descritivo e transversal e também a análise de conteúdo para conhecer a violência familiar em crianças de creches e pré-escolas. A população e os sujeitos são constituídos de educadores infantis, professores e monitores. Verificam-se nos resultados a presença da violência doméstica, praticada principalmente pela mãe, a criança agressiva está presente no ambiente das escolas como uma forma de reprodução de comportamento e também da negligência com relação aos cuidados e a atenção à criança no cotidiano. Esses comportamentos podem gerar outras formas de violência, mantendo a criança sempre em ambientes de risco durante várias fases da vida.

[Family violence in the perspective of the child who goes to day care center and pre-school]

The present research uses the descriptive and traversal study and also the content analysis to know the family violence in children of day care center and pre-schools. The population and the subjects are constituted of infantile educators, teachers and monitors. It is verified in the results the presence of the domestic violence, practiced mainly by the mother, the aggressive child is present in the atmosphere of the schools as a form of reproduction of behavior and also, the negligence regarding the cares and the attention to the child in the daily. These behaviors can generate other violence forms, maintaining the child always in risk atmospheres during several phases of the life.

A study about families of children and teenagers who were victims of violence and faced judicial intervention

The goal of this study was to track the steps of families that committed some kind of violence against their children and faced judicial intervention, as well as to explore their perceptions about the events involving such intervention; to quantify and assess the lawsuits, during the period from 2000 to 2005, characterizing situations of family violence and re-victimization. The study was theoretically based on the ecological context of human development. The methodology employed was quantitative-qualitative. The tools used were: analysis of the proceedings, filling out census maps, elaboration of genogram and ecomap. The analysis was based on dialectic hermeneutics. The results showed that there were 1766 lawsuits at the court, 8.21% of which were linked to family violence. Three empirical categories came up: I didn't have, which portrays a kind of childhood where negation was a constructive element of interactions, perversely engendered in the economic, political and institutional universes; It doesn't help and it won't change anything showed a Judicial System that did not understand society and its conflicts, and In the street, featuring everyday routines of social exclusion.

Domestic violence: from the visible to the invisible

This study aimed to identify and analyze notifications of domestic violence against children registered at the Regional Health Services in Guarulhos, São Paulo, Brazil; the limitations imposed to health professionals' actions and the meaning of domestic violence against children in the health professionals' routine. The notifications registered between 2001 and 2002 were characterized in order to better understand this reality and also to support the collected data through the qualitative approach. There is a predominance of negligence cases 45%, while 26% of the notifications related to physical violence and 14% to suspected sexual violence. Social workers registered the highest number of notifications, 46%. Based on the social agents' discourse, we identified two empirical categories: "interfaces of the violence" and "fear".

Historical and social aspects of halitosis

Buccal odors have always been a factor of concern for society. This study aims to investigate the historical and social base of halitosis, through systematized research in the database BVS (biblioteca virtual em saúde - virtual library in health) and also in books. Lack of knowledge on how to prevent halitosis allows for its occurrence, limiting quality of life. As social relationships are one of the pillars of the quality of life concept, halitosis needs to be considered a factor of negative interference. Education in health should be accomplished with a view to a dynamic balance, involving human beings' physical and psychological aspects, as well as their social interactions, so that individuals do not become jigsaw puzzles of sick parts.

[Adolescent fatherhood: social silence and scientific emptiness]

This study aimed at discussing adolescent fatherhood both as a social issue and scientific research object. A review of the Brazilian and Latin America scientific literature published between 1994 and 2004 was carried out by searching ADOLEC (Health in Adolescence) and LILACS (Latin American and Caribbean Literature on Health Sciences data bases. Few studies were found, evidencing social silence on this subject, as it is generally expected that teenagers do not experience fatherhood. This demonstrates the need to create new policies and to develop scientific studies on adolescent fatherhood.