Violência Sexual Infanto-Juvenil em Natal: uma avaliação do Programa Sentinela

Analyze the problem of sexual violence suffered by children and adolescents in the city of Natal / Rio Grande do Norte (RN), attended by the Programa Sentinela, a service aimed at combating sexual violence children and teenagers who serves on the council of Natal. Thus aims to review the implementation of the Programa Sentinela in Natal / RN, in the period 2001 to 2006, verifying that the program has contributed to the access of children and adolescents who are victims of abuse and sexual exploitation to fundamental rights under the Statute Children and adolescents (ECA) and the Local Plan and the National gainst Infanto-Youth Sexual Violence. It has a theoretical and methodological approach quantitative and qualitative, covering the issue of sexual violence against children and adolescents, as one of the expressions of economic relationships, gender, race and culture that make up the material and symbolic structure of society. It methodological procedure: review of literature on the subject and conducting interviews with professionals and families of children and adolescent victims of sexual violence. Investigate as the unit of analysis the Sentinel Program. The analysis on the governmental actions of this period on this social problem points to the continuity and little change in the care of victims of sexual violence: despite maintain features and palliative assistencialistas, favoring the "Network of Sexual Tourism", go through some innovations in terms of securing rights from the ECA, which is the need for transparency and democratization in the management of government policies. In research undertaken, Brazil will only be combating this type of crime when each of the social actors are actually doing their share, down taboos, facing corruption and strengthening a system of guarantee of rights, which target children and adolescents are unprotected, and often ignored by Brazilian society

Sexo não é brincadeira: o sentido de infância para adolescentes inseridas na exploração sexual comercial

The childhood has being highlighted by the great concern about the several contexts in which children are inserted, amongst them, commercial sexual exploitation (CSE). The experience of this violence process brings implications to the person constitution. Thus, this research aimed to understand how commercial sexual exploited adolescents to signify the childhood. Participated of this research four female adolescents that had been assisted by Programa de enfrentamento ao Abuso e Exploração Sexual de Crianças e Adolescentes (Sentinela) , with ages between 12 and 17 years. The corpus was composed by the combination of the semi-structured interview and other procedures, like childish stories, draws and photography. Moreover, we used another instruments to constitute the corpus, like the documental research and we proposed the construction of a life story book of each participant. The corpus was analyzed through the Thematic Content Analysis. Five thematic axes emerged from the participants discourse and theoretical perspective: dynamical of family, scholar process, ludic behavior, conception of childhood and insertion on CSE process. The participants presented a conception about childhood as been a preparation and education phase to ingress in adult life. In other words, while children do not grown up, they go to the school, plays, lives with family, are happy and do not have any responsibilities. Nevertheless, the life experience of these girls was implicated by negligence, sexual abuse, child labor, institutionalization and, evidently, the commercial sexual exploitation. Understanding that the childhood experienced by adolescent, as well as, her insertion on CSECA, constitutes her, while person, we investigated how the interrelation expresses it on participants future perspectives. Their goals are defined based on family constitution and professional improvement, although feelings of disillusion and pessimism had been showed up in some moments. According these results, we pointed to the necessity of the effective proposals that promote real improvement of adolescents life quality, through, in which they could to create alternatives to get over the several risks in which they are exposed, mainly, the CSECA condition

Segurança do paciente em terapia intensiva neonatal: identificação e análise de eventos adversos

The patient safety is a major concern in health services for its global dimension, as evidenced by the fragility of care processes that predispose an occurrence of adverse events. These events in a neonatal intensive care unit are considered serious and hazardous to lives of newborns. The present study aimed to identify and analyze adverse events in a neonatal intensive care unit based in Trigger Tool. It is an epidemiological, cross-sectional , exploratory, retrospective study with quantitative, descriptive and analytical approach, performed in 2015 at a school hospital. The sample was not probabilistic, involving 116 newborns who met the eligibility criteria. Data collection was performed by retrospective review of medical records, using a specific kind of "trigger" instrument, composed of sentinel events in neonatology, adapted from the American model used by the Vermont-Oxford Network. Data were analyzed using descriptive and inferential statistics. The chi-square test for linear trend was used to assess the associations between the variables of interest. The research received a favorable agreement from Ethics Committee of the Federal University of Rio Grande do Norte, under number 1055533, and Presentation Certificate for Ethics Assessment 43894515.6.0000.5537. The results show among investigated newborns, 110 experienced at least one adverse event during their stay, with a total of 391 medical records analyzed and rate of 3.37 events per patient. Prevailed the preterm newborns with low birth weight, from mother who had hypertensive diseases during pregnancy and urinary tract infection. The average hospitalization time was 25 days, associated with hospital-acquired infections events (p = 0.01). Among the identified adverse events stood out the events related to thermoregulation disorders (39.0%), with prevalence of hypothermia (26.0%), followed by health care-related infections (16.4%) and blood glucose disorders, hypoglycemia (9.00%) and hyperglycemia (6.64%). Most of these incidents were classified in categories E and F, which represents that there was damage small proportion. Due to these damages come from the care practice with newborn, 78% were classified as avoidable. There was statistically significant association between the variable birth weight with infections (p = 0.006) as well as peri/intraventricular bleeding (p = 0.02), hypoglycemia (p = 0.021), hyperglycemia (p = 0.001), hyperthermia (p = 0.39) and death (p=0,02). Gestational age was associated with seizures (p = 0.002), hyperglycemia (p=0.017) e hyperthermia (p=0.027). The security institution culture was reported by the health workers as intermediate, even though the number of adverse events found in only one unit of service indicates that there is much to be done. Thus the high rate of adverse events identified in the neonatal intensive care unit reinforces the necessity to elaborate specific preventive strategies for this risk environment.

Segurança do paciente em terapia intensiva neonatal: identificação e análise de eventos adversos

The patient safety is a major concern in health services for its global dimension, as evidenced by the fragility of care processes that predispose an occurrence of adverse events. These events in a neonatal intensive care unit are considered serious and hazardous to lives of newborns. The present study aimed to identify and analyze adverse events in a neonatal intensive care unit based in Trigger Tool. It is an epidemiological, cross-sectional , exploratory, retrospective study with quantitative, descriptive and analytical approach, performed in 2015 at a school hospital. The sample was not probabilistic, involving 116 newborns who met the eligibility criteria. Data collection was performed by retrospective review of medical records, using a specific kind of "trigger" instrument, composed of sentinel events in neonatology, adapted from the American model used by the Vermont-Oxford Network. Data were analyzed using descriptive and inferential statistics. The chi-square test for linear trend was used to assess the associations between the variables of interest. The research received a favorable agreement from Ethics Committee of the Federal University of Rio Grande do Norte, under number 1055533, and Presentation Certificate for Ethics Assessment 43894515.6.0000.5537. The results show among investigated newborns, 110 experienced at least one adverse event during their stay, with a total of 391 medical records analyzed and rate of 3.37 events per patient. Prevailed the preterm newborns with low birth weight, from mother who had hypertensive diseases during pregnancy and urinary tract infection. The average hospitalization time was 25 days, associated with hospital-acquired infections events (p = 0.01). Among the identified adverse events stood out the events related to thermoregulation disorders (39.0%), with prevalence of hypothermia (26.0%), followed by health care-related infections (16.4%) and blood glucose disorders, hypoglycemia (9.00%) and hyperglycemia (6.64%). Most of these incidents were classified in categories E and F, which represents that there was damage small proportion. Due to these damages come from the care practice with newborn, 78% were classified as avoidable. There was statistically significant association between the variable birth weight with infections (p = 0.006) as well as peri/intraventricular bleeding (p = 0.02), hypoglycemia (p = 0.021), hyperglycemia (p = 0.001), hyperthermia (p = 0.39) and death (p=0,02). Gestational age was associated with seizures (p = 0.002), hyperglycemia (p=0.017) e hyperthermia (p=0.027). The security institution culture was reported by the health workers as intermediate, even though the number of adverse events found in only one unit of service indicates that there is much to be done. Thus the high rate of adverse events identified in the neonatal intensive care unit reinforces the necessity to elaborate specific preventive strategies for this risk environment.