The Brazilian Journal of Health Research (RBPS), is a publication of the Health Sciences Center of the Federal University of Espírito Santo, has the mission of publishing manuscripts of high technical-scientific level that contribute, directly or indirectly, to the promotion of the knowledge in the areas of Health Sciences. The RBPS is intended for the quarterly publication of scientific manuscripts, including editorials, original articles, review articles, case reports and experience reports, referring to subjects and studies of technical-scientific interest in the areas of Health Sciences. You can access the "Guidelines for Authors" at https://periodicos.ufes.br/rbps/about/submissions Access the template to submit your manuscript to RBPS. Follow it strictly. Also insert the other declarations and cover sheets. For contact, send an email to rbps.ccs@ufes.br.
The Revista Brasileira de Pesquisa em Saúde (RBPS) adopts the CC BY 4.0 license, which means that authors retain the copyright of the works they submit to the journal. Authors are responsible for declaring that their contribution is an original manuscript, that it has not been previously published, and that it is not under simultaneous review by another scientific journal. Upon submitting the manuscript, authors grant RBPS the exclusive right of first publication, subject to peer review. Authors are permitted to enter into additional contracts for the non-exclusive distribution of the version published by RBPS (for example, in institutional repositories or as a book chapter), provided that due acknowledgment of authorship and of initial publication by RBPS is given. Authors are also encouraged to make their work available online (for example, in institutional repositories or on their personal pages) after its initial publication in the journal, with due acknowledgment of authorship and of the original publication by RBPS. Accordingly, under the CC BY 4.0 license, readers have the right to: Share — copy and redistribute the material in any medium or format for any purpose, even commercially; Adapt — remix, transform, and build upon the material for any purpose, even commercially. The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Laparoscopic versus Open Gastric Bypass in Brazilian Public Health System
Introduction: Roux-en-Y gastric bypass (RYGB) by laparoscopy (LRYGB) has better results than open surgery, but they have not been compared in Brazilian Public Health System and is not funded by governmental entities. Objectives: to assess safety and efficacy of laparoscopic RYGB (LRYGB) in Brazilian Public Health System (SUS) and to compare with open RYGB (ORYGB). Methods: single-center retrospective cohort study, with 106 consecutive patients who underwent primary RYGB: 34 laparoscopic RYGB and 72 open RYGB. Antropometric data, incidence of complications and readmissions were analyzed. Results: There were 82,1% female, mean age of 43,01 years old, mean body mass index (BMI)=45,05kg/m² and mean follow-up of 17,57 months. BMI was lower in LRYGB group (42,31 x 46,35kg/m²; p=0,003), that also had higher preoperative weight loss (6,94 x 4,12%; p=0,016), lower mean age (36,53 x 46,07 anos; p=0,000) and shorter anesthesia time (217,93 x 274,15min, p<0,00). Postoperatively, LRYGB group’s mean BMI=29,46 vs. 32,22kg/m² of ORYGB (p=0,014), and excess BMI loss (EBMIL) is 81,01% vs. 68,20% of ORYGB (p=0,023). ORYGB group had more complications than LRYGB group (54,2% x 38,2%, p>0,05). There were more Clavien-Dindo ≥ III complications in ORYGB group (48,7% x 15,4%, p>0,0,34). Readmissions were more frequent in ORYGB group (9,7% x 2,9%), that also had higher incidences of incisional hernia (9,7%), internal hernia (2,8%) and wound complications (12,5%), all of these parameters were null in LRYGB group (p>0,05). Conclusion: LRYGB in SUS is safe and effective. LRYGB patients present lower severe complications, mortality, readmissions and reoperations rates.
Copyright (c) 2024 Brazilian Journal of Health Research https://creativecommons.org/licenses/by-nc-nd/4.0
Prevalence of chronic diseases in the indigenous populations of Aracruz, Espírito Santo State, Brazil
Introduction: Indigenous villages located near urban centers are undergoing an accelerated process of epidemiological transition, with an increase in the incidence of non-communicable chronic diseases (NCCD). Objectives: To determine the prevalence of NCCD in the indigenous population settled in Aracruz (north coast of Espírito Santo State, Brazil), and to compare the current data with those obtained in the same population in 2003-2004. Methods: The study included 1,084 adults (≥20 years old, 111 non-indigenous and 973 indigenous individuals, including 90 Guarani and 883 Tupiniquim ethnicity) from an eligible population of 2,982 residents (36.4% attending) in the villages. All data were collected at the University Hospital (HUCAM) of Ufes, including blood and urine samples (fasting), as well as anthropometric measurements, bioimpedance, blood pressure, electrocardiogram. Data are presented as mean ± standard deviation or numbers and percentages. Proportions were compared by the Chi-square test, with statistical significance set at p<0.05. Results: The mean age was 41.6 ± 14.8 years, with predominance of women (57.6%) and young adults (20-39 years, 49.9%). The prevalence of obesity was 38.6% (higher in women 47.8% vs. 25.7%; p<0.05), arterial hypertension (39.5%, with 38% with controlled blood pressure with medicines), and diabetes mellitus (13.7%, with half being new diagnosis). Compared to the survey from 2003-4, the prevalence of obesity increased 2.5 times, and diabetes 3 times. Conclusion: The prevalence of major NCCD is high in the studied population, indicating the need for prevention and earlier diagnosis interventions.
Cannabis, legal-illegal drug: interrelationships in the border area from the experiences of users
Introduction: Cannabis is a psychoactive substance (PAS) used worldwide on a large scale. Objective: To understand the interrelationships of Brazilian and Uruguayan drug policy on Cannabis use in border areas. Methods: Study with a qualitative, exploratory and descriptive approach. Fourteen people who use Cannabis residing in a Brazil/Uruguay border city were interviewed. Data were collected through semi-structured interviews, through thematic analysis. Results: The interrelationships of Brazilian law with Cannabis consumption originate from the norms of the prohibitionist policy, which generated drug trafficking; space of violence, offer of adulterated Cannabis, work by children and adolescents in the illegal trade; misuse and perpetuation of social stigma. The interrelationships with the Uruguayan drug policy, on the other hand, allow the use of Cannabis with different characteristics and qualities; the existence of illegal Cannabis trade in Uruguay exposes Brazilian consumers to the risk of legal sanctions. Conclusion: Considering the ineffectiveness of the prohibitionist model and the implementation of new public policies on drugs in several countries, it is relevant to monitor territories that intersect different perspectives, in order to envision social and health changes.
Copyright (c) 2022 Brazilian Journal of Health Research https://creativecommons.org/licenses/by-nc-nd/4.0
Frequency of Antigen Dia in academics of a university in the state of Santa Catarina, Brazil
Introduction: The Diª Antigen is part of the Diego blood group system. It has a low frequency in the general population (1 to 6%), but with higher frequency in Asian (10%) and indigenous (36%) populations. The Brazilian ethnic composition is influenced by the indigenous ethnicity. Objectives: Identify carriers and establish the phenotypic frequency of the Diª antigen in university students from a university in Santa Catarina state - Brazil. Detect carriers of rare DI phenotype (a+ b-). Contribute with information to the hemodiagnostic reagents industry about manufacture of reagents for the identification of these irregular antibodies. Methods: Sixty-five blood samples were collected and submitted to the erythrocyte phenotyping method to identify the Diª antigen through tube hemagglutination tests with anti-Diª serum. Data on birthplace, ethnic descent and information about blood transfusion, blood donation and diseases history were collected from those enrolled for research. Results: Diª antigen phenotype was positive in 1.5% of the sample. The positive sample was an individual of indigenous descent, born in a region whose indigenous population was part of the ethnic composition. Of the sample studied, 25.8% declared themselves to be of indigenous descent. Conclusion: Although infrequent, it is possible to identify the Diª antigen in the population studied, since the indigenous ethnicity is part of the ethnic composition.
Anna Paula de Borba Batschauer de Borba Batschauer
Mortality from external causes in children and adolescents aged 5 to 14 years
Introduction: Since the 1980s, external causes have stood out as a cause of morbidity and mortality in Brazil, with high rates of homicides and traffic accidents, mainly involving the male population. The state of Espírito Santo stands out for having the highest rates of deaths of children and adolescents from traffic accidents and homicides in the Southeastern region. Objective: To analyze the deaths from external causes from 5 to 14 years of age in Espírito Santo, from 2010 to 2019. Methods: Ecological time-series study, with data from the national Mortality Information System. The trend of mortality rates was estimated by multivariable negative binomial regression models. Results: One third of deaths from external causes in this age group were due to assault, and the mortality of boys aged 10 to 14 years due to assault was twice that observed in the Southeast and Brazil. The time trends in Espírito Santo were similar to those observed in the Southeast and Brazil, with the exception of mortality from drowning. Conclusion: Although the trend in mortality from external causes is downward, the high mortality rates from aggression indicate the need to prioritize the prevention of these events.
Rapid response team in the intensive care and inpatient units of a large hospital in Belo Horizonte, MG, Brazil: an observational study
Introduction: The rapid response team (RRT) is a system intended for the care of patients in aggravating circumstances outside a more complex and specialized environment to meet urgent situations. Objectives: To analyze the attendance data of a rapid response team of a large philanthropic hospital in Belo Horizonte-MG. Methods: This is a retrospective, observational and descriptive study that was carried out through the analysis of care data and monitoring of a Quick Response Team of a large philanthropic hospital, with more than a thousand beds 100% Unified Health System, in Belo Horizonte-MG, between January 2017 and June 2018. Results: The results of this work showed that during the study period there were 1,942 code yellow calls. The activities developed by RRT professionals were: guidelines, being more frequent in relation to diagnostic investigation, respiratory support, hemodynamic monitoring; the performance of procedures, mainly orotracheal intubation and therapies such as volume replacement with crystalloid solutions, use of vasoactive drugs, antimicrobials, analgesics, oxygen and sedatives. Conclusion: This work demonstrates the activities of a rapid response team within a hospital, its importance in numbers, as well as the epidemiological criteria of patients treated by this team. In addition, it allows for a discussion on better communication/standardization and implementation of protocols in order to benefit greater professional autonomy for nurses, as well as to act quickly in an adversity.
Prevalence of excess weight and associated factors in 7-10 year old children from Vitória - ES, Brazil
Introdução: As prevalências de sobrepeso e obesidade vêm crescendo em todo o mundo e em todas as faixas etárias, incluindo crianças e adolescentes. Objetivo: Este estudo buscou determinar a prevalência de excesso de peso e fatores associados em crianças de sete a dez anos. Metodologia: Trata-se de estudo transversal de base escolar com 1.282 crianças (7-10 anos) residentes em Vitória/ES, Brasil. Foram coletados dados antropométricos e analisados de acordo com a recomendação da International Obesity Task Force. Pais e/ou responsáveis forneceram informações sobre hábitos alimentares, atividade física, peso ao nascer e sobre alimentação de seus filhos, dados socioeconômicos e parentais. Resultados: 23,3% da amostra apresentaram excesso de peso (15,3% sobrepeso + 8% obesidade). Após análise multivariada, constatou-se que ser filho único (RC 1,73, IC95% 1,09-2,75), macrossômico (RC 3,45 IC95% 1,34-8,84) e ter pai com sobrepeso (RC 1,87, IC95% 1,21-2,89) aumentaram o risco para o excesso de peso, enquanto nível de escolaridade superior materno o diminuiu (RC 0,38, IC95% 0,19-0,78). Conclusão: A prevalência de excesso de peso encontrada é alta e similar às observadas em países desenvolvidos, mostrando-se fortemente associada à estrutura familiar, portanto medidas adotadas em fases precoces da vida e focadas na família são determinantes para a redução do excesso de peso.
Copyright (c) 2014 Revista Brasileira de Pesquisa em Saúde https://creativecommons.org/licenses/by-nc-nd/4.0
Violence and the importance of networking in service provision
Individuals experiencing violence must be seen in their individuality and subjectivity. Professionals working with this group must recognize both victims — direct or indirect — and perpetrators of violence as subjects of rights. This understanding requires humanized care and demands a networked approach, given the complexity of the harm and its impacts on health and the social sphere. Assistance to victims of violence still faces challenges due to the invisibility of the phenomenon, lack of knowledge about established care flows, and the fragility of structured care networks. Integrated action among health, education, justice, public security, social assistance, and community sectors is essential to promote safe and healthy environments, prevent violence, and ensure the protection of human rights. Building effective, articulated, and cooperative intersectoral networks is fundamental for addressing violence. Investing in the continuous training of professionals, the establishment of care flows, and the strengthening of public policies is indispensable for ensuring comprehensive and humanized care for individuals experiencing violence.
Copyright (c) 2025 Brazilian Journal of Health Research https://creativecommons.org/licenses/by-nc-nd/4.0
Incidence and characterization of physical violence against women aged 20 to 59 in Brazil and its regions in 2022
Introduction: Understanding the updated epidemiological situation of reported cases and the profile of violence against women—particularly physical violence, one of the most frequent forms, often indicative of other types of violence—is essential for surveillance and for the development of intersectoral public policies focused on prevention and health promotion. Objective: To describe the reported cases of physical violence against women aged 20 to 59 years in Brazil in 2022. Methodology: Ecological study using data from the Information System for Notifiable Diseases, referring to reports of interpersonal violence against adult women in Brazil. Results: In 2022, 179,594 episodes of interpersonal violence against individuals aged 20 to 59 years were reported in Brazil, 75.76% (95% CI: 75.66–75.86) of which involved women. Of these, 75.07% (95% CI: 74.84–75.30) were cases of physical violence. The incidence of physical violence was 16.32 reported cases per 10,000 women in this age group. Most victims were young, Black or Brown, experienced recurrent episodes in the domestic environment, had or had had an affective relationship with the aggressor, and frequently suffered concurrent psychological violence. Conclusion: Despite underreporting, domestic violence against women in Brazil remains alarming. Addressing this issue requires more representative and comprehensive research, as well as more effective measures to protect and provide integral support to victims.
The representation of suffering among adolescents and young people:
Introduction: Suicidal behavior is recognized as being associated with distinct causes that interact with each other. Objective: To describe journalistic reports addressing two cases of suicide among adolescent and young students, thus bringing to light the representation of the phenomenon of suicide in the youth population. Methods: This is a descriptive qualitative study, using Thematic Content Analysis methodology applied to two journalistic articles. Results: The study developed two meaning units: risk factors for suicide in adolescence and protective factors against suicide in adolescence. The analysis of the reports, in connection with the literature on the subject, allowed the identification of the complexity of the issue, recognizing suicide among adolescents and young people as a serious public health problem. Conclusion: Family, school, and the fragility of bonds, relationships, and institutions can sometimes function as factors producing suffering, and at other times as factors protecting against suffering.
Introduction: Lethal violence against women in Brazil presents significant racial disparities, disproportionately affecting Black women. This inequality has its roots in a patriarchal and slave-holding historical context, the effects of which continue to structure society and impact the lives of these women. Objective: To analyze the historical and social circumstances influencing the disparity in lethal violence between Black and white women in Brazil, focusing on structural racism and the development of public policies to address violence against women. Methods: A theoretical analysis was conducted based on a literature review and epidemiological data, considering the intersectionality of gender, race, and social context, to understand how structural racism contributes to the vulnerability of Black women. Results: The findings indicate that, despite legislative advances, violence against women persists and disproportionately affects Black women, both in domestic settings and within State institutions. Structural racism and racial stigmatization perpetuate the exclusion of these women, hindering their access to protection policies and justice. Conclusion: It is urgent to formulate intersectional public policies that address racism and gender inequalities, along with the training of professionals for humanized care. Only by recognizing these structural inequalities will it be possible to advance in preventing violence and promoting racial and gender equity.
Literature review on parental alienation
Introduction: This article focuses on the Parental Alienation Law – PAL (Law No. 12,318/2010), based on the theory of American psychiatrist Richard Gardner, evaluating its scientific weaknesses and the criticisms regarding the reinforcement of gender inequalities. Objectives: The study aims to assess the limitations of the Parental Alienation Law, question its punitive application, and discuss the impacts of this legislation on the protection of women and children, especially in the context of domestic violence reports. Methods: This is a descriptive qualitative research based on a literature review. Academic publications indexed in databases from 2014 to 2024 were analyzed, allowing an understanding of contemporary discussions on the topic. Results: The findings indicate that, despite the protective character of the legislation, it can be used as an instrument of institutional violence within the Justice System, perpetuating gender stereotypes and neglecting the complexities of family dynamics. Furthermore, the application of the law has delegitimized reports of domestic violence, compromising the comprehensive protection of victims. The role of social workers is highlighted as essential for critical analyses that incorporate power and gender relations in family disputes. Conclusion: It is concluded that the revocation of the Parental Alienation Law (Law No. 12,318/2010) is necessary, considering its impacts on the perpetuation of violence and inequalities. It is recommended to adopt public policies that promote the comprehensive protection of families, prioritize the prevention and confrontation of domestic violence, and ensure the fundamental rights of women and children.
School as a place for speaking out against ableism
Introduction: Given the advancement of scientific discussions and the growing incorporation of the concept of ableism in academic productions, the following question arose: in what contexts is the term "ableism" used in school settings? Objective: To identify how the concept of ableism is described and applied in the scientific literature. Methods: A systematic search was conducted in four databases — Periódicos CAPES, PePsic, BVS-Psi, and SciELO — using the descriptor "ableism." The inclusion criteria were: national authorship scientific articles, available online, and published between 2021 and 2024. Based on the selected materials, a literature review was carried out focusing on the identification of approaches and interpretations of ableism within the school environment. Results: The analysis reveals significant reflections on the multiple forms of ableism manifestation within educational institutions, both subtly and explicitly. It is observed that, beyond openly discriminatory attitudes, ableism also manifests through gestures and practices that, although seemingly benevolent, perpetuate stigmas and prejudices against people with disabilities. Conclusion: This study may serve as both a warning and a source of information and awareness for society. Observing the school environment reveals various facets of a culture of ableism that values individuals solely based on their physical or mental abilities, overlooking the diversity and complexity of human experience. Thus, it is hoped to contribute to the construction of more inclusive, equitable, and respectful educational spaces.
Contributions of legislation to the prevention and confrontation of violence against women
Introduction: Since the formation of rights-based societies, women have been marginalized, portrayed as submissive to men, had their rights neglected, and have struggled to survive within a patriarchal system, where they are often victims of violence. Objective: To analyze Brazilian legislation and its role in combating violence against women, seeking to understand how the legal system has contributed to the creation of mechanisms for protection and the promotion of women's dignity. Methods: A narrative literature review was conducted, analyzing scientific content, legislative documents, and institutional materials produced between 2006 and 2023. The search for materials was carried out in the SciELO and Google databases. Results: Significant progress was observed in Brazilian legislation, with highlights including the Maria da Penha Law (2006), the Femicide Law (2015), and the Sexual Harassment Law (2018), among others. These laws marked a new era in the struggle for women's rights, promoting greater visibility and protection mechanisms. Conclusion: Despite advances, challenges remain, particularly regarding the realization of rights among Black, peripheral, and transgender women, who continue to face barriers in accessing services and legal support.
The prevention and protection of victims of domestic violence in the Brazilian justice system
Introduction: Domestic and family violence has been present since ancient times in human history, and in Brazilian history, since the period of discovery, it was common to treat women differently. This situation only began to be reconsidered from another perspective in the mid-twentieth century, when women started gaining rights previously exclusive to men and greater political protagonism. In the justice system, until a few years ago, victims were treated with indifference, a situation that began to change with the enactment of Law No. 11,340/2006, which granted greater protection, although further progress in protection and policy development is still needed. Objective: To present relevant information regarding the treatment of victims and to understand how the Brazilian justice system acts in the prevention and protection of victims of domestic violence. Methods: This is a theoretical and reflective study based on the author's experience in the Brazilian justice system, aiming to understand the needs of victims and the best application of the law. Results: The analysis showed that, despite the advances achieved in recent years, further improvements are needed to make protection and prevention truly effective. Conclusion: It is concluded that Brazil has been striving to comply with international treaties and internal legislation; however, greater effectiveness in public policies is essential, especially in inland regions, to ensure adequate protection for victims.
Introduction: The relationship between media and violence reflects the power dynamics that permeate society. Media narratives often adopt a sensationalist approach to violence, highlighting extreme cases and perpetuating stigmas against certain social groups. Objective: To investigate how media narratives about violence impact the development of public policies in Brazil. Methods: An integrative literature review was conducted, with data collection between October and December 2024, using the SciELO and Virtual Health Library (BVS) databases. Articles published between 2014 and 2024 were selected. The search terms used were: "Media discourse," "Violence," "Public policies," combined with the Boolean operator "AND." Results: Twelve articles were included as the final sample, and their content was categorized into three thematic approaches: “Media narratives on violence,” “Impact on public policy development,” and “Responsible and ethical media coverage.” Conclusion: Media narratives about violence do not merely reflect reality but also shape public discourse and influence the formulation of public policies in Brazil. By emphasizing solutions aimed at social inclusion and the reduction of inequalities, the media can contribute to the adoption of more effective and humanized policies, promoting a fairer, safer, and less violent society.
Occurrence of traffic violence according to psychological factors and mental disorders
Introduction: Traffic violence is analyzed as a complex phenomenon, involving risky behaviors and the violation of traffic rules. Objective: To survey the main findings regarding the relationship between traffic violence and psychological factors and mental disorders. Methods: This is a narrative literature review, with an electronic search conducted by the researcher between 2019 and 2023 in the Virtual Health Library (BVS). The guiding question of the study was: “Which psychosocial factors are involved in traffic violence?”. The search expression used was: (violence) AND ((drivers) OR (traffic)). A semantic analysis of the data was performed. Results: The results indicate the influence of conditions such as anxiety, depression, irritability, and emotional dysregulation on impulsive and aggressive driver behavior, as well as the importance of emotional self-regulation and the impact of sleep deprivation on decision-making and traffic violations. Conclusion: The reviewed studies reveal the complexity of psychological factors influencing behavior in traffic, with emphasis on anxiety and depression among drivers.
Obstetric violence from an intersectional perspective
Introduction: Obstetric violence is a public health issue, and deepening the study of this phenomenon is one of the paths to addressing it. It consists of a dehumanized appropriation of women's bodies and reproductive processes by health professionals. However, the experience and consequences of this type of violence do not affect all women equally. Objective: To understand obstetric violence against Black women through an intersectional approach, considering that intersectionality involves the interaction of two or more axes of subordination/discrimination, such as racism, patriarchy, and social inequality. Methods: A narrative literature review was conducted by analyzing articles published in scientific databases over the last 10 years that addressed this topic. Results: The research found that Black women are the primary victims of obstetric violence, and the intersectional analysis was essential to understand the extent of this victimization. Obstetric violence against Black women goes beyond gender issues, also involving race and social class. Conclusion: It is concluded that being Black and poor in Brazil increases vulnerability to obstetric violence, exposing the institutional racism present in various health services.
A narrative review on violence against LGBT+ adolescents
Introduction: Violence against LGBT+ adolescents is a serious public health and human rights issue, associated with cis-heteronormative social structures that marginalize dissident identities. This population faces discrimination, family rejection, bullying, and systemic exclusion, leading to significant impacts on mental and physical health, such as anxiety, depression, suicidal ideation, and vulnerability to chronic diseases. Objective: To discuss violence against LGBT+ adolescents from a conceptual perspective, public policy framework, and the roles of education and family in addressing it. Methods: Scientific articles (2015–2024) were included, selected from databases such as PubMed and BVS. After screening, 15 articles, 4 governmental documents, 1 book, and 1 report were analyzed, with synthesis into thematic categories: concepts and impacts of violence, public policies and challenges, and the roles of education and family. Results: The main risk factors identified include institutional discrimination, intrafamily violence, lack of representation in educational spaces, and weaknesses in public policies. The National LGBT Comprehensive Health Policy (2013) faces obstacles such as institutional discrimination and lack of professional training. Schools and families are central to promoting safe environments but often lack inclusive approaches and qualified support. Conclusion: Violence against LGBT+ adolescents demands intersectoral responses, integrating health, education, and social assistance. It is recommended to strengthen public policies, train professionals, promote critical sexual education, and expand family support networks. Future studies should assess the effectiveness of policies and incorporate intersectional approaches.
Introduction: Violence against women in the workplace is a multifaceted phenomenon that reflects structural gender inequalities, mainly manifesting as moral harassment, sexual harassment, and discrimination. Objectives: To analyze the national scientific production published between 2016 and 2025 on violence against women in the workplace, identifying the main manifestations, impacts, and coping strategies. Methods: A narrative review was conducted, including 14 articles selected from databases such as BVS, SciELO, Google Scholar, and CAPES Journals Portal, using the descriptors "violence against women," "workplace violence," and "moral harassment." Results: The data indicated that harassment is the most prevalent form of gender-based violence in the workplace, impacting the mental and physical health of victims and generating significant social and organizational costs. Additionally, underreporting of cases and challenges in implementing effective public policies and organizational strategies were highlighted. Conclusion: Although Brazil has made progress in legislative frameworks, there are still significant gaps in the practical application of these policies, especially within organizations. Preventive strategies such as training, awareness campaigns, and reporting mechanisms are essential to transform organizational culture and promote gender equity in the workplace.
Key points in constructing a scientific research question
The formulation of a well-structured research question is a crucial step in the development of a scientific study. It defines the direction of the investigation and influences its methodological design, data analysis, and the relevance of results. This editorial explores the essential criteria for constructing robust research questions, emphasizing the use of structured frameworks such as PICOT (Population, Intervention, Comparator, Outcome, Time) and FINER (Feasible, Interesting, Novel, Ethical, Relevant). Furthermore, it highlights ten key strategies that guide researchers in refining their questions, including literature review, stakeholder perspectives, and methodological feasibility. The text also discusses common challenges faced during this process, especially by early-career researchers, and presents best practices to overcome them. A strong research question enhances study quality, replicability, and scientific contribution. Therefore, investing in its careful formulation is a strategic step toward producing impactful and reliable scientific knowledge.
Impacts of racial violence on cognitive development
Introduction: Racial relations permeate various dimensions of social life and profoundly influence cognitive development. This study is situated within a theoretical framework that questions the production and distribution of knowledge. Objective: To analyze the impacts of racial violence on cognitive development, based on the concepts of epistemicide and inventive cognition, exploring how dynamics of racial exclusion influence memory, intelligence, and learning processes. Methods: The adopted methodology was a critical reflection, grounded in the analysis of theoretical works and a review of scientific literature, which revealed an academic omission on the topic. Results: Based on the perspectives of Sueli Carneiro, Jean Piaget, Lev Vygotsky, and Virgínia Kastrup, the article identifies gaps in the Brazilian academic literature regarding the relationship between racism and cognitive development, highlighting the lack of approaches that directly connect racial dynamics to mental processes. The research points out that violent and exclusionary environments can compromise intellectual and emotional development, limiting the construction of adaptive strategies and reinforcing dynamics of social and academic exclusion. At the same time, it emphasizes the potential for cognitive resistance, where individuals and communities create new epistemologies and narratives that challenge hegemonic power structures. Conclusion: Epistemicide and scientific racism perpetuate the devaluation of racialized populations, reinforcing intellectual hierarchies and erasing alternative knowledge. In contrast, it suggests adopting educational and epistemological practices that recognize cultural plurality and inventive forms of cognition as fundamental strategies to combat racism and promote inclusive science.
The role of the psychologist in the palliative care service of a tertiary hospital in Ceará state, Brazil
Introduction: Palliative care aims to improve the quality of life of patients and their families facing life-threatening illnesses. A palliative care service is composed of an interprofessional team, minimally including physicians, psychologists, nurses, and social workers. Objective: To report the author’s experience as a psychologist in a palliative care service. Methods: This is a descriptive, qualitative study in the form of an experience report, conducted in a tertiary hospital located in Fortaleza, Ceará, Brazil. Results: Psychological support may be offered to both patients and family members, either through active outreach or upon request from the team. Assistance often begins when the illness is already at an advanced stage. Among the various possible interventions, the psychologist may play a key role in facilitating difficult conversations and family conferences. Conclusion: Interventions that could be initiated at the time of diagnosis are often delayed until the end-of-life stage, already marked by suffering and exhaustion, which limits the work not only of the psychologist but of the entire care team.
Clinical-epidemiological profile of elderly HIV patients treated at a specialized care center in Vitória, ES, Brazil, in the post-HAART era
Introduction: Human immunodeficiency virus (HIV) infection remains a relevant public health issue. While most cases are concentrated in the younger population, the age group above 50 years is on the rise. Objective: To describe the clinical and epidemiological profile of elderly patients infected with HIV/AIDS in the post-HAART era followed at a reference center. Methods: This is an epidemiological, retrospective, qualiquantitative study conducted in the HIV/AIDS outpatient clinic of the Infectious Diseases Service at Cassiano Antônio Moraes University Hospital (Hucam). Results: Of the 60 patients, 60% were male and 40% were female. Self-declared, brown-skinned individuals, with 8-12 years of schooling and heterosexual preference, predominated. The majority (60%) had comorbidities, mainly cardiovascular diseases (37.3%) and endocrinological diseases (18%), with a focus on systemic arterial hypertension, diabetes mellitus, and dyslipidemia. Regarding origin, 65% came from the inpatient ward. Regarding the diagnosis period, 78.3% had a recent diagnosis of HIV/AIDS and 43.3% had opportunistic infections at diagnosis. The median value of CD4 T lymphocytes at the beginning of follow-up was 211.5 cells/µl, being 131 for patients from the inpatient ward and 393 for those from the outpatient clinic. The current CD4 T lymphocyte count was greater than 500 in 36.6% of individuals (71.4% and 17.9% when analyzing the outpatient and inpatient subgroups, respectively). Conclusion: The aging of the HIV/AIDS population with the advent of HAART is a global trend that brings new challenges to health services, requiring comprehensive geriatric assessment and individualized interventions that consider the specificities of the elderly population.
Interobserver agreement of the visual entorhinal cortex atrophy (ERICA) score
Introduction: The ERICA score has been used as an assessment tool for entorhinal cortex atrophy in cranial MRI images of patients with suspected Alzheimer's Disease. Objectives: To evaluate the degree of interobserver agreement and reproducibility in the application of the ERICA score to verify the degree of entorhinal cortex atrophy. Methods: Analyses were performed by two evaluators based on MRI exams with 1.3 mm slices, using the T1 SPGR sequence without contrast, in the hippocampal region at the level of the mammillary bodies. The sample consisted of 51 patients treated at the radiology and imaging diagnosis service of Cassiano Antônio Moraes University Hospital. To measure interobserver agreement, the weighted Kappa test (linear weight) was used. Results: In the classification, scores 0 and 1 were the most common in the sample for both cerebral hemispheres. For the evaluation of agreement in the classification of entorhinal cortex atrophy, the weighted Kappa test indicated that there is moderate reliability between the two observers for both the right side (k= 0.4785; p=7.333e-05) and the left side (k= 0.5526; p=8.199e-07). Conclusion: The interpretation of Kappa should consider the specific context in which it is applied; therefore, the interpretation of MRI images for the ERICA score appears to be a viable instrument in relation to entorhinal cortex atrophy, supporting, as an imaging biomarker, the early diagnosis of AD.
Clinical and epidemiological profile of patients with endometriosis in a gynecological service in Espírito Santo
Introduction: Endometriosis is a chronic and inflammatory clinical pathology, characterized by the presence of functional endometrial tissue outside the uterus. Objectives: The following article seeks to identify the clinical and epidemiological profile of patients with endometriosis in a reference gynecology service in Espírito Santo, with the aim of sensitizing professionals regarding the suspicion of the presence of the disease. Methods: This is a cross-sectional study involving 130 patients with pelvic pain, aged between 18 and 55 years old, who were submitted to a form to collect epidemiological and clinical data, and then underwent a physical examination and Nuclear Magnetic Resonance Imaging (MRI) for the diagnosis of endometriosis. Results: Of the 130 patients interviewed, 63 had a positive diagnosis of endometriosis. The most frequent symptoms were dysmenorrhea (92%) and dyspareunia (77.7%). The most specific symptoms were dysuria (65.6%) and dyschesia (64.1%). In the epidemiological analysis, 42.9% were aged between 40 – 49 years old, 68.2% were married and 49.2% had completed secondary education. Conclusion: It was possible to identify that the majority of patients were aged between 40 and 49 years old (42.9%), showing a late diagnosis compared to other populations. Among the most common symptoms studied, dysmenorrhea (92%) and dyspareunia (77.7%) were the most sensitive symptoms. Dysuria (65.6%) and pain when evacuating (64.1%) were the most specific. Thus, these associated symptoms can be extremely valuable for clinical suspicion and diagnostic management of cases.
Colorectal cancer registry in the Brazilian Public Health System, from 2015 to 2023
Introduction: Colorectal cancer is a common neoplasm in individuals over 50 years old, with rising incidence in younger populations. Objectives: Given its high prevalence, assessing epidemiological pattern changes is essential. Method: This observational, descriptive, cross-sectional study analyzed DataSus epidemiological databases on hospitalized colorectal cancer patients in Brazil. Results: Between 2015 and 2023, 683,388 hospitalizations were recorded (422,100 colon; 261,288 rectosigmoid/anal canal), with 50.7% male, 53% white, 31.54% brown, and 4.2% black. The southeast region had the most cases, and 19.7% were under 50 years old. Espírito Santo, with 1.87% of Brazil’s population, accounted for 3.54% of hospitalizations, predominantly brown (61%) and with a higher female prevalence (50.1%). From 2016 to 2023, colon cancer cases increased by 39%, and rectosigmoid/anal canal cancer by 38%. Hospitalizations among black individuals rose by 96%, and cases increased by 29.9% in those under 50 and 41.8% in those over 50. Discussion: Data from DataSus do not align with international studies regarding the early-onset colorectal cancer rise but highlight racial and regional epidemiological differences in Brazil and Espírito Santo. Conclusion: Colorectal cancer is an increasing national burden, controllable through prevention, early diagnosis, and treatment. This study’s epidemiological data indicate regional disparities requiring further investigation.
Epidemiology in one year of hospitalizations in a gastroenterology ward at a referral hospital
Introduction: Gastrointestinal diseases are prevalent in Brazil and require highly complex care. Objectives: To evaluate gastroenterology hospital admission data at a tertiary hospital of the public health system in the Southeast region of Brazil. Methods: Cross-sectional retrospective study of 335 hospitalizations of 282 patients, from 4/1/21 to 3/31/22. Results: Mean age: 55.8 years, 67% men, hospitalized for an average of 14.5±14.8 days (median: 10). The main diagnosis was decompensated liver cirrhosis (51.8%), followed by pancreatic diseases (11.9%) and inflammatory bowel diseases (8.9%). Alcoholism was present in 37.9% of the patients. Nosocomial infection: 24.8%, renal dysfunction: 27.8%. Cirrhosis was a risk factor for the development of renal dysfunction (p<0.001) and death occurred in 30 patients (9%). Conclusion: In gastroenterological diseases with hospitalization, decompensated cirrhosis was the most frequent disease and alcoholism was the main preventable risk factor. Patients had a high risk of infection and renal dysfunction. Comprehensive care with teams trained in making quick decisions can prevent and treat early infections and kidney dysfunctions, with rational use of public resources.
Aortic aneurysm diagnosed during pregnancy
Introduction: Abdominal aortic aneurysm (AAA) is characterized as a pathological focal dilation of the abdominal aorta, presenting a diameter greater than 50% of the normal vessel diameter. Symptoms usually manifest insidiously, and its discovery is often incidental, although it is associated with a reserved prognosis during pregnancy. Case report: This article presents the case report of a 42-year-old hypertensive pregnant woman, at 22 weeks and 3 days of gestation, admitted to the obstetric ward of a tertiary hospital due to a hypertensive spike. During obstetric ultrasound, a fusiform aneurysm was incidentally diagnosed, located below the emergence of the renal arteries and above the bifurcation of the iliac arteries, without thrombi, measuring 7.4 x 7.1 cm. An evaluation by a multidisciplinary team was conducted to determine the ideal timing for pregnancy interruption and the type of aneurysm treatment, aiming for the best maternal-fetal outcome, both successfully achieved. Conclusion: This report highlights the challenge of managing an AAA during pregnancy, the ideal gestational age for pregnancy interruption, and the complexity of the interventions required for aneurysm treatment.
Exophiala fungal arthritis in a patient with systemic lupus erythematosus
Introduction: Fungi of the genus Exophiala sp are found in soil and organic matter. They have low virulence and are generally symptomatic in immunosuppressed individuals. The main clinical manifestations are cutaneous or subcutaneous alterations, with joint involvement being rare. Case report: We report a case of a patient with Systemic Lupus Erythematosus (SLE), on immunosuppressive therapy, presenting with chronic monoarthritis of the left wrist, with a diagnosis of septic arthritis caused by a fungus of the genus Exophiala sp, evidenced by histopathological analysis, culture and colony micromorphology of the synovial fluid. Conclusion: This is the first case reported in the literature of a SLE patient with joint involvement caused by Exophiala sp. Histopathology and culture are the gold standard for the precise diagnosis of fungal monoarthritis. Early diagnosis is essential due to the risk of chronicity and poor joint prognosis in patients who do not receive specific treatment.