RESUMEN

The aim of this study was to explore maternity care providers' knowledge, attitudes, and perceptions about the use of calcium supplements during pregnancy for the prevention of preeclampsia in three hospitals from Metropolitan Buenos Aires, Argentina. We conducted semi-structured interviews and followed a thematic analysis framework. Maternity care providers' knowledge, attitudes, and practices regarding calcium supplementation during pregnancy are linked to barriers to the potential implementation of calcium supplementation. Free provision of calcium supplements by the government, coupled with training that reinforces the scientific evidence supporting their use to prevent preeclampsia, along with documented recommendations from credible sources, would be crucial to ensure that health providers adopt the use of calcium supplements in antenatal care. Future studies should assess pregnant women and policymakers' perceptions about calcium supplementation during pregnancy, as well as local infrastructure to provide access to free-of-charge calcium supplements in antenatal care settings. Economic evaluation with local information could inform policymakers and advocate for the implementation of strategies to reduce preeclampsia.

Asunto(s)

RESUMEN

Over the past two decades, femicide-the gender-based killing of women or girls-has become an issue of international concern. Yet relatively little data on perpetrators exist. Current research primarily focuses on individual risk factors with less attention on community and societal factors. We use a social capital approach to examine femicide by analyzing the extent to which crime perpetrators experience and perceive social punishment (exclusion) from their social networks. Using a quota sampling strategy, we administered a cross-sectional questionnaire to perpetrators of femicide (N = 71), male-male homicide (N = 73), and other serious crimes (N = 64) across four prisons in Buenos Aires, Argentina. Other crime perpetrators served as a control to the two lethal crime groups. Perceived social capital scores were assigned based on responses to two scales adapted from the World Bank's "Integrated Questionnaire for the Measurement of Social Capital." Before committing murder, femicide and homicide perpetrators' scores were not statistically different. Yet after the crime, femicide perpetrators retained significantly greater scores than homicide perpetrators. The perceived social capital scores of other crime perpetrators did not change after the commission of their crimes. As a secondary objective, we examined the individual and social contexts of femicide perpetrators. Most (85%) of the femicide perpetrators could name at least one other person in their social network whom they knew to be physically violent during disagreements with their partner, while 11% stated that "everyone" they knew used violence during disagreements. Although the penalty for committing femicide and homicide is ostensibly equivalent-a life sentence of 50 years-we found that the informal social punishment femicide perpetrators perceived is less severe than that experienced by homicide perpetrators. These data indicate a lack of social punishment for femicide, compared to other crimes, showing social legitimization of the crime. These findings support the development of community-level interventions to prevent femicide.

RESUMEN

This paper identifies the explanatory narratives used by perpetrators of male-male homicide in Buenos Aires (Argentina) to make sense of this crime. Drawing upon narrative criminology and masculinities theories, this study enquires into the rationalisations of perpetrators, considering their emic terms, rationalities and stories. Fieldwork was conducted between 2016 and 2020, and a convenience sample strategy was employed for participant recruitment. The analysis is based upon seventy-three narrative-biographical interviews with offenders, and field observations in prisons and homes of former convicts. The corpus was analysed following an inductive thematic coding strategy using Atlas.Ti. Eight narratives were typified, considering how men talked about agency and change, and the explanatory locus of the stories: 'rebel', 'affected', 'idiot', 'either him or me', 'repeating the story', 'gang', 'betrayed' and 'victim'. These accounts revealed two paradoxes about violence perpetration storytelling and its discursive management: men can commit a homicide and present themselves as not responsible for it and, simultaneously, they use, reconfigure and negotiate expert theories and scientific labels to explain away, excuse and justify lethal violence. This study argues that accounts are not merely neutralisation strategies, but the rationalisations of the perpetrators' experiences, and the foundation for how they relate to and inhabit penal institutions. This paper contributes to the understanding of how those explanations shape past and future actions, and how masculinities, biographical processes and violence performance are interconnected.

Asunto(s)

RESUMEN

BACKGROUND: Growing evidence indicates that the residential neighbourhood contributes to the complex aetiology of mental disorders. Although local crime and violence, key neighbourhood stressors, may be linked to mental health through direct and indirect pathways, studies are inconclusive. This systematic review and meta-analysis aimed to synthetize the evidence on the association between neighbourhood crime and individual-level mental health problems. METHOD: We searched 11 electronic databases, grey literature and reference lists to identify relevant studies published before September 14, 2020. Studies were included if they reported confounder-adjusted associations between objective or perceived area-level crime and anxiety, depression, psychosis or psychological distress/internalising symptoms in non-clinical samples. Effect measures were first converted into Fisher's z-s, pooled with three-level random-effects meta-analyses, and then transformed into Pearson's correlation coefficients. Univariate and multivariate mixed-effects models were used to explore between-study heterogeneity. RESULTS: We identified 63 studies reporting associations between neighbourhood crime and residents' mental health. Pooled associations were significant for depression (r = 0.04, 95% CI 0.03-0.06), psychological distress (r = 0.04, 95% CI 0.02-0.06), anxiety (r = 0.05, 95% CI 0.01-0.10), and psychosis (r = 0.04, 95% CI 0.01-0.07). Moderator analysis for depression and psychological distress identified stronger associations with perceived crime measurement and weaker in studies adjusted for area-level deprivation. Importantly, even after accounting for study characteristics, neighbourhood crime remained significantly linked to depression and psychological distress. Findings on anxiety and psychosis were limited due to low number of included studies. CONCLUSIONS: Neighbourhood crime is an important contextual predictor of mental health with implications for prevention and policy. Area-based crime interventions targeting the determinants of crime, prevention and service allocation to high crime neighbourhoods may have public mental health benefits. Future research should investigate the causal pathways between crime exposure and mental health, identify vulnerably groups and explore policy opportunities for buffering against the detrimental effect of neighbourhood stressors.

Asunto(s)

RESUMEN

Resumen Introducción: el artículo presenta una revisión bibliográfica de los artículos científicos sobre muertes violentas en Argentina, publicados entre 2001 y 2016, con el objetivo de describir temas, áreas de conocimiento, disciplinas y metodologías; además, se indaga en qué medida la producción académica capta, interpreta y/o instala las violencias como problema sanitario. Materiales y métodos: se relevaron artículos en soporte digital publicados en revistas indizadas en BVS, PubMed, Redalyc, SciELO y Scopus. El corpus final incluyó 72 artículos. Se desarrolló un análisis cuanticualitativo siguiendo la síntesis interpretativa crítica. Resultados: se encontró que la bibliografía: a) aborda predominantemente la violencia física; b) se enmarca principalmente dentro de las ciencias médicas; c) tiene objetivos descriptivos; d) se caracteriza por tener alcances geográficos nacionales e institucionales; e) parte de datos primarios para el abordaje empírico, y f) emplea mayoritariamente metodologías de análisis cuantitativas. La mayoría de los artículos aborda el suicidio, y en los estudios sobre homicidio aparece un área de vacancia desde la perspectiva de los homicidas. Si bien estos aspectos describen estructuralmente esta bibliografía, se encontraron núcleos temáticos con características diferentes. Es escaso el uso de estadísticas nacionales para dar cuenta de la relevancia epidemiológica de "las violencias". Conclusión: la recurrencia de definiciones y taxonomías de organismos internacionales (principalmente, la Organización Mundial de la Salud) sobre salud y violencia da cuenta de su posición discursiva dominante. Se plantea la necesidad de realizar otros estudios de este tipo, en diferentes países de la región, a fin de tematizar y problematizar la producción académica sobre muertes violentas.

Abstract Introduction: This literature review collected scientific papers about violent deaths in Argentina, published between 2001 and 2016. The objectives are to describe the topics, fields of knowledge, disciplines, and methodologies of the papers and analyze the extent in which the academic production captures, interprets, and/or establishes violence as a public health problem. Materials and Methods: A total of 72 digital-format papers from scientific journal indexed in BVS, PubMed, Redalyc, SciELO, and Scopus were collected. A quantitative and qualitative strategy was developed, following the Critical Interpretive Synthesis framework. Results: The review indicated that the literature (a) is predominantly focused on physical violence, (b) is mainly produced by the Medical Sciences, (c) has descriptive objectives, (d) is characterized by having national and institutional geographical scopes, (e) uses primary data to study empirically the phenomena, and (f) mainly employs quantitative analysis methodologies. Most of the papers studied suicide, and the ones that analyzed homicide usually neglected to study the perpetrators' perspective. These aspects structurally describe the literature, yet distinctive thematic subfields were found, with heterogeneous features. The use of national statistics is scarce to indicate the epidemiological relevance of violence. Conclusion: The frequent recurrence of definitions and taxonomies of international organizations (mainly, World Health Organization) in the definition of health and violence indicates the dominant discursive position of these organizations in certain fields of knowledge.

Resumo Introdução: se apresenta uma revisão bibliográfica dos artigos científicos sobre mortes violentas na Argentina, publicados entre 2001 e 2016, com o objetivo de descrever temas, áreas de conhecimento, disciplinas e metodologias de tais artigos; para além, indaga-se em que medida a produção acadêmica capta, interpreta e/ou instala as violências como problema sanitário. Materiais e métodos: se revelaram artigos em formato digital publicados em revistas indexadas em BVS, PubMed, Redalyc, SciELO e Scopus. O corpus final incluiu 72 artigos. Se desenvolve uma análise quanti-qualitativa seguindo a síntese interpretativa crítica. Resultados: Se encontrou que a bibliografia: a) aborda predominantemente a violência física; b) se enquadra principalmente dentro das ciências médicas; c) tem objetivos descritivos; d) se caracteriza por ter alcances geográficos nacionais e, em segundo lugar, institucionais; e) parte de dados primários para a abordagem empírica, e f) emprega maioritariamente metodologias de análise quantitativas. A maioria dos artigos abordam o suicídio e, nos estudos sobre homicídio aparece uma área de vacância a perspectiva dos homicidas. Embora estes aspetos descrevem estruturalmente esta bibliografia, se encontraram núcleos temáticos com características diferentes. É escasso o uso de estatísticas nacionais para dar conta da relevância epidemiológica "das violências". Conclusão: a recorrência de definições e taxonomías de organismos internacionais (principalmente, Organização Mundial da Saúde) sobre saúde e violência dá conta de sua posição discursiva dominante. Se apresenta a necessidade de realizar outros estudos deste tipo, em diferentes países da região, com o objetivo de tematizar e proble-matizar a produção acadêmica sobre mortes violentas.

Asunto(s)

RESUMEN

Resumen En este artículo se analiza el uso del consentimiento informado en torno a partos y nacimientos, mediante el análisis de las estrategias que efectúan las mujeres gestantes de la Ciudad de Buenos Aires en pos del reconocimiento de sus cuerpos, sus bebés, la fisiología de sus partos y el respeto por sus decisiones informadas. A partir de una investigación etnográfica, se analizan las tensiones que experimentan en sus intentos por hacer respetar sus necesidades, derechos y elecciones. Diferentes estrategias (directivas anticipadas, plan de parto, etc.) son desplegadas por las mujeres para efectivizar su protagonismo en las decisiones médicas respecto de sus partos. Este trabajo sugiere que el consentimiento informado no solo es un procedimiento médico formal que utilizan los/as médicos/as para avalar sus decisiones y dejar por sentado la aceptación del paciente, sino que se trata de una herramienta por la cual las mujeres se apropian y movilizan en sus interacciones con el sistema de salud.

Resumo Este artigo analisa o uso do consentimento informado em torno de partos e nascimentos, analisando as estratégias adotadas por gestantes na cidade de Buenos Aires, a fim de reconhecer seus corpos, seus bebês, a fisiologia de seus nascimentos e respeito por suas decisões informadas. A partir de uma investigação etnográfica, são analisadas as tensões que elas experimentam em suas tentativas de reforçar suas necessidades, direitos e escolhas. Estratégias diferentes (diretrizes antecipadas, plano de parto, etc.) são adotadas pelas mulheres para desempenhar seu papel nas decisões médicas sobre seus partos. Este artigo sugere que o consentimento informado não é apenas um procedimento médico formal que os/as médicos/as usam para apoiar suas decisões e dar como certa a aceitação da paciente, mas que é uma ferramenta pela qual as mulheres se apropriam e mobilizam suas interações com o sistema de saúde.

Abstract This paper inquires about the use of informed consent in childbirths and labours, analysing the strategies employed by pregnant women in Buenos Aires Capital City in pursuit of the recognition of their bodies, their babies, the physiology of their labours and the respect of their informed choices. In the context of an ethnographic study, the tensions that women experience in their attempts to make their needs, rights and decisions respected are analyzed. Different strategies (advance healthcare directive, birth plans, etc.) are devised by women to secure their central position in the decision-making related to their labours. This study suggests that informed consent is not only a formal medical procedure that physicians use to support their decision and have a written document of the patient's agreement, but also a tool used by women to seize control of their interactions in the health-care system.

Asunto(s)