Mother-infant bonding is influenced by several risk and protective factors, and the literature has investigated the relationships between these factors independently. This study aimed to verify the interrelationships of some of these factors and how they influence mother-infant bonding in Brazil. In this study, 361 mothers participated, and the outcome variable of mother-infant bonding was assessed using the Postpartum Bonding Questionnaire (PBQ). Multivariate regression analysis was performed using a hierarchical model with three blocks structured according to the influence exerted on mother-infant bonding. The PBQ\'s factor scores were estimated and used in the subsequent analyses to decrease measurement error. The variable \"violence experienced by mothers\" was statistically significant for explaining the second block model but not significant for the third block. Network analysis was performed after multiple regression, showing that the violence experienced by mothers does not directly influence mother-infant bonding but rather is mediated by postpartum depression. This explains why violence is not significant in the hierarchical multiple regression when maternal depression is added to the model. This study\'s strengths lie in its utilization of PBQ factor scores and network analysis, enabling the estimation of conditional relationships among variables. This approach provides deeper insights into factors affecting mother-infant bonding.
Varios factores de riesgo y de protección ejercen influencia sobre la unión afectiva madre‐infante; la literatura disponible ha investigado las relaciones entre estos factores de una manera independiente. Este estudio se propuso verificar las interrelaciones de algunos de estos factores y cómo ellos influyen en la unión afectiva madre‐infante. Se consultó un total de 361 madres y el variable resultado de afectividad madre‐infante se evaluó por medio del Cuestionario de Afectividad de Postparto (PBQ). Se llevaron a cabo análisis de regresión multivariados usando un modelo jerárquico con tres estructuras de bloques de acuerdo con la influencia ejercida sobre la unión afectiva madre‐infante. Se estimaron y usaron los puntajes de factores del PBQ en los análisis subsecuentes para disminuir el error en la medida. La variable “violencia experimentada por las madres” fue estadísticamente significativa para explicar el segundo modelo de bloque, pero no significativa para el tercer bloque. Se llevó a cabo un análisis de interrelaciones después de la regresión múltiple, demostrando que la violencia experimentada por las madres no influye directamente la afectividad madre‐infante, sino que la misma es mediada por la depresión posterior al parto. Esto explica por qué la violencia no es significativa en la jerárquica regresión múltiple cuando la depresión materna se le agrega al modelo. Entre los puntos fuertes de este estudio se incluye el uso de los puntajes de factores del PBQ y el análisis de interrelaciones, lo cual permitió que se estimaran las relaciones condicionales existente dentro del grupo de variables, aportando una mayor comprensión de algunos factores que interfieren en la unión afectiva madre‐infante.
Die Mutter‐Kind‐Bindung wird von mehreren Risiko‐ und Schutzfaktoren beeinflusst und die Literatur hat die Zusammenhänge zwischen diesen Faktoren unabhängig voneinander untersucht. Ziel dieser Studie war es, die Zusammenhänge zwischen einigen dieser Faktoren und deren Einfluss auf die Mutter‐Kind‐Bindung zu verifizieren. Insgesamt wurden 361 Mütter angefragt. Die Outcome‐Variable der Mutter‐Kind‐Bindung wurde durch den Fragebogen zur postpartalen Bindung (PBQ) beurteilt. Die multivariate Regressionsanalyse wurde anhand eines hierarchischen Modells mit drei Blöcken durchgeführt, die nach dem Einfluss auf die Mutter‐Kind‐Bindung gegliedert waren. Die Faktorwerte des PBQ wurden geschätzt und in den nachfolgenden Analysen verwendet, um den Messfehler zu verringern. Die Variable “Gewalterfahrung der Mütter” war statistisch signifikant für die Erklärung des zweiten Blockmodells, aber nicht signifikant für den dritten Block. Nach der multiplen Regression wurde eine Netzwerkanalyse durchgeführt, die zeigte, dass die von den Müttern erlebte Gewalt keinen direkten Einfluss auf die Mutter‐Kind‐Bindung hat, sondern vielmehr durch die postpartale Depression mediiert wird. Dies erklärt, warum Gewalt in der hierarchischen Mehrfachregression nicht signifikant ist, wen mütterliche Depression dem Modell hinzugefügt wird. Zu den Stärken dieser Studie gehören die Verwendung der PBQ‐Faktorwerte und die Netzwerkanalyse, die es ermöglichten, die in der Variablengruppe bestehenden bedingten Zusammenhänge zu schätzen, was zu einem besseren Verständnis einiger Faktoren führte, die die Mutter‐Kind‐Bindung beeinträchtigen.
母‐子のボンディングは多様な危険因子と保護因子の影響を受けており、これまで文献ではこれらの因子間の関係について個別に検証が行われてきた。本研究は、これらの因子の複数についての相互関係とそれらが母‐子ボンディングに与える影響を検証することを目的とした。計361名の母親を対象とし、産後ボンディング質問票 (PBQ) によって評価された母‐子ボンディングを結果変数とした。多変量回帰分析は、母‐子ボンディングに及ぼす影響に従って構造化された3つのブロックからなる階層モデルを用いて行った。PBQの因子得点は、測定誤差を減らすために推定の後、解析に用いた。変数「母親が経験した暴力」は、2番目のブロックモデルの説明には統計的に有意であったが、3番目のブロックでは有意ではなかった。重回帰の後にネットワーク解析を行ったところ、母親が経験した暴力は母‐子ボンディングに直接影響せず、むしろ産後うつによって媒介されることが示された。このことは、母親のうつをモデルに加えた場合、暴力が階層的重回帰で有意でない理由を説明している。本研究の長所としては、PBQの因子得点とネットワーク解析を用いることで、変数の集合に存在する条件付き関係を推定することができ、母‐子ボンディングを阻害するいくつかの要因についてより深い理解を提供することができた。.
摘 要:母婴关系受到多种危险因素和保护因素的影响, 相关文献已经独立研究了这些因素之间的关系。本研究旨在验证其中一些因素之间的相互关系, 以及它们对母婴关系的影响。共有361位母亲参与了本研究, 母婴关系的结果变量由“产后情感关系问卷” (PBQ) 评估。采用分层模型进行了多元回归分析, 按照对母婴关系产生影响的程度, 将其分为三个模块。估算并使用PBQ的因子得分进行后续分析, 以减少测量误差。变量”母亲经历的暴力“在解释第二模块模型时具有统计学显著性, 但对于第三模块则不显著。在多元回归之后进行了网络分析, 显示”母亲经历的暴力“并不直接影响母婴关系, 而是由产后抑郁症介导。这解释了为什么在模型中添加了母亲抑郁症时, 暴力在分层多元回归中并不显著。本研究的优势包括使用PBQ的因子得分和网络分析, 这使得能够估计变量集中存在的条件关系, 从而更好地理解一些干扰母婴关系的因素。.
يتأثر الارتباط بين الأم والرضيع بعدة عوامل خطر وعوامل وقائية، وقد بحثت الأدبيات في العلاقات بين هذه العوامل بطريقة مستقلة. هدفت هذه الدراسة إلى التحقق من العلاقات المتبادلة بين بعض هذه العوامل وكيفية تأثيرها على الترابط بين الأم والرضيع. اشترك عدد 361 من الأمهات في الدراسة ، وتم تقييم نتائج الترابط بين الأم والرضيع بواسطة استبيان الترابط بعد الولادة(PBQ) وإجراء تحليل الانحدار متعدد المتغيرات باستخدام نموذج هرمي مكون من ثلاث كتل منظمة وفقاً للتأثير الذي يمارس على الترابط بين الأم والرضيع. كما تم تقدير درجات عاملPBQ واستخدامها في التحليلات اللاحقة لتقليل خطأ القياس. أظهر متغير “العنف الذي تتعرض له الأمهات” دلالة إحصائية في تفسير نموذج الكتلة الثانية ولكنه لم يكن ذا دلالة إحصائية في الكتلة الثالثة. تم إجراء تحليل الشبكة بعد الانحدار المتعدد، مما أسفر عن نتيجة أن العنف الذي تعاني منه الأمهات لا يؤثر بشكل مباشر على الترابط بين الأم والرضيع بل يتوسطه اكتئاب ما بعد الولادة. وهذا ما يفسر سبب عدم أهمية العنف في الانحدار الهرمي المتعدد عند إضافة اكتئاب الأم إلى النموذج. تشمل نقاط القوة في هذه الدراسة استخدام درجات عاملPBQ وتحليل الشبكة، مما مكن من تقدير العلاقات الشرطية الموجودة في مجموعة المتغيرات، مما يوفر فهماً أكبر لبعض العوامل التي تتداخل في الترابط بين الأم والرضيع.

Based on ethnographic work conducted between 2015 and 2022 at the periphery of Fortaleza, in Northeast Brazil, this article analyzes the work of community activists as a form of subversive care. Women activists, many of whom work for the local public clinics, as social workers with local NGOs, or as schoolteachers, challenge dominant narratives presented in the media and political discourses about their neighborhood as being poor and therefore violent. By establishing relationships of mutual trust with gang members and humanizing them, women activists \"challenge the logic of fear\" and maintain presence in areas controlled by the gangs to direct the economically vulnerable toward existing public resources. Activists\' understanding of urban violence is informed by participation in collective action and living together with gang members and their families. These experiences lead activists to see urban violence as the symptom of systemic inequalities that require systemic changes.
A partir de uma pesquisa etnográfica realizada entre 2015 e 2022 na periferia de Fortaleza, no Nordeste do Brasil, este artigo analisa o trabalho dos ativistas comunitários como cuidado subversivo. Mulheres ativistas, muitas das quais trabalham como agentes de saude, assistentes sociais em ONGs locais ou professoras, desafiam as narrativas dominantes apresentadas na mídia e os discursos políticos sobre seu bairro como sendo pobre e, portanto, violento. Ao estabelecer relações de confiança mútua com os membros das gangues e humanizá‐los, as mulheres ativistas “desafiam a lógica do medo” e mantêm presença em áreas controladas pelas gangues para direcionar moradores economicamente vulneráveis aos recursos públicos existentes. O entendimendo dos ativistas da violência urbana é resultado da participação em ações coletivas e da convivência com membros de gangues e suas famílias. Essas experiências levam os ativistas a ver a violência urbana como sintoma de desigualdades sistêmicas que exigem mudanças sistêmicas.

Violence is a public health problem, and when it affects childhood, it can cause illness throughout the individual\'s life. Apart from being able to cause damage in the physical, mental and social spheres, it represents a violation of the rights of the affected children, and a high consumption of resources, both economic and social. A multitude of investigations have improved attention to this violence. However, these advances are not consistent with the practical management of victims, both in Primary and Hospital Care. There is a significant area of improvement for paediatric care. Through this article, different professionals from all established paediatric health care facilities develop general lines of knowledge and action regarding violence against children. An overview is taken of the legislation related to childhood, the different types of abuse that exist, their effects, management and prevention. It concludes with an epilogue, through which we aim to move sensibilities. In summary, this work aims to promote the training and awareness of all professionals specialized in children\'s health, so that they pursue the goal of achieving their patients\' greatest potential in life, and in this way, to help create a healthier society, with less disease, and more justice.

BACKGROUND: Previous analyses on the burden of disease in Mexico identified that injuries differentially affect young people, males and working-age people.
OBJECTIVE: To analyze the burden of disease due to intentional and unintentional injuries in Mexico during 1990 and 2021, at the national and state levels.
METHODS: The results of the Global Burden of Disease study for the 1990-2021 period were used to describe the burden of disease attributed to injuries in Mexico. The life years lost (YLL) due to premature mortality, years lived with disability (YLD) and disability-adjusted life years (DALY) were analyzed.
RESULTS: The burden of disease related to intentional injuries has increased, as also have YLDs and DALYs associated with unintentional injuries. Men continue to have higher mortality and DALY rates compared to women. Interpersonal violence and suicide have steadily increased. The analysis by state showed patterns with important variations.
CONCLUSIONS: Injuries generate catastrophic consequences in terms of mortality and disability in Mexico. It is necessary to promote and strengthen programs and policies in order to improve the data system and injury prevention.
BACKGROUND: Análisis previos sobre la carga de la enfermedad en México identificaron que las lesiones afectan de manera diferenciada a hombres, personas jóvenes y en edad productiva.
OBJECTIVE: Analizar la carga de la enfermedad por lesiones intencionales y no intencionales en México durante 1990 y 2021 en los ámbitos nacional y estatal.
UNASSIGNED: Se utilizaron los resultados del Global Burden of Disease respecto al período 1990-2021 para describir la carga de la enfermedad por las principales causas de lesiones en México; se analizaron los años perdidos por muerte prematura (APMP), los años vividos con discapacidad (AVD) y los años de vida saludable perdidos (AVISA).
RESULTS: La carga de la enfermedad relacionada con lesiones intencionales se ha incrementado, al igual que los AVD y AVISA por lesiones no intencionales. Los hombres continúan presentando tasas de mortalidad y AVISA más altas comparados con las mujeres. La violencia interpersonal y el suicidio se han incrementado de manera sostenida El análisis por estados mostró patrones con variaciones importantes.
CONCLUSIONS: Las lesiones generan consecuencias catastróficas en términos de mortalidad y discapacidad en México. Es indispensable impulsar y reforzar los programas y políticas para mejorar el sistema de datos y la prevención de lesiones.

Background: Government actions and participating in protracted-duration protests against it affect protesters\' mental health, leading to high distress levels, such as posttraumatic and depressive symptoms. Aside from exposure to violence and other issues, protest participation can pose unique challenges to the protesters as they may be exposed to potentially morally injurious events (PMIEs), such as the betrayal of leaders they once trusted. This study\'s primary objective was to examine the extent of psychological difficulties among civilians participating in long-duration protests in Israel. More specifically, the study aimed to understand the contribution of exposure to protest-related PMIEs to psychological difficulties such as posttraumatic and depressive symptoms.Method: Participants comprised 4036 Israelis who were actively involved in the unfolding civil protest movement against the government-led judicial overhaul between January 2023 and August 2023. The protesters completed validated self-report questionnaires that included measures of PMIE exposure, PTSD and depressive symptoms.Results: About half (44.3%) of the sample met the criteria for self-report diagnosis of major depression and 10.6% for PTSD. Most of the protesters indicated their exposure to at least one moral injury event, with 63.9% reporting exposure to PMIE-Betrayal. Protesters exposed to PMIEs reported significantly higher levels of both PTSD and depression than non-PMIE-exposed protesters. Hierarchical regression analyses revealed that, beyond demographics and protest-related characteristics such as exposure to violence, PMIE dimensions significantly contributed to both PTSD and depression levels.Conclusions: The findings highlight the mental burden of protesters during the civil protests against the judicial overhaul in Israel. More central to the present research, the findings highlight the critical contribution of PMIEs exposure to this burden. Clinicians treating protesters coping with depression and PTSD following the civil actions should attend to their exposure to PMIEs, which may relate to the deleterious psychological effects among protesters.
Participation in protests have high mental burden as about half of the sample met the criteria for self-report diagnosis of major depression and 10.6% for PTSD.Protesters exposed to protest-related PMIEs reported significantly higher levels of both PTSS and depression than non-PMIE-exposed protesters.The findings highlight the critical contribution of PMIE-betrayal exposure to both PTSS and depressive symptoms, above and beyond demographic and protest-related characteristics.

Dance therapy is thought to improve mental and physical health by activating psychological and physiological processes such as motor coordination, and expression of emotions. Some currently used mind-body interventions for posttraumatic symptoms address both mental and physical health. Although some studies have evaluated the efficacy of dance therapy for posttraumatic symptoms, a systematic review of extant research has not been conducted.
To identify the effects of dance therapy in adults with psychological trauma as well as the barriers and facilitators associated with its therapeutic use.
Articles published between 2000 and March 2023 have been selected with the help of six relevant keyword combinations applied on seven databases. Two reviewers independently screened 119 titles and abstracts against inclusion and exclusion criteria. Bias evaluation has been conducted with the help of the NIH study quality assessment tools and JBI\'s critical appraisal tools. A report of the results has been organized with the help of a thematic analysis.
Of the 15 articles included, only one case study directly reports a diminution of pathognomonic symptoms of trauma. Other studies present improvements in the key aspects of trauma therapy: bodily sensations and perceptions, psychological processes, and interpersonal skills. These improvements depend on the stability of the intervention, the applied method (dance as therapy or dance/movement therapy), and likely, the skill set of the therapists. However, the reviewed studies lacked uniformity in assessments of adherence and its effect on therapeutic outcomes.
Dance therapy may be a useful technique for improving both psychological and physiological symptoms associated with trauma exposure, such as avoidance and dissociative phenomena. To complement the results of this qualitative systematic review, further quantitative and qualitative research on the impact of dance therapy interventions as a trauma treatment should be conducted.
Dance therapy may be a promising approach for the therapeutic management of psychological trauma as it can address both psychological and physical symptoms.Therapist skills and training may be important factors to consider in evaluating the impact of dance therapy on posttraumatic symptoms.Dance/movement therapy, a specific type of dance therapy, appears to be associated with improvements in sensory-motor perceptions and motor skills.To date, examination of dance therapy as a trauma treatment in an adult population has been limited primarily to women and people facing migration.

Background: Cumulative exposure to violence can change the regulation of epigenetic and physiological markers. Although violence has been associated with accelerated cellular aging, little is known about associations with cardiac autonomic activity.Objective: The current study aimed to investigate the relationship of exposure to community and domestic violence (CDV) with vagal activity and epigenetic aging acceleration.Methods: A total of 86 adolescents (57% female) were evaluated and interviewed at two time-points in São Gonçalo (2014-2019), a Brazilian city with high levels of violence. Exposure to CDV was assessed in both time-points. GrimAge acceleration was calculated from saliva DNA methylation using Infinium HumanMethylation450K (Illumina) collected in the first assessment. Heart rate variability (HRV) was collected during two stress tasks at the second assessment.Results: The exposure to violence witnessed or directly experienced at home and in the community increased significantly (t = 4.87, p < .01) across two-time points, and males had reported higher violence exposure (t = 2.06, p = .043). Violence at 1st assessment was significantly associated with GrimAge acceleration (B = .039, p value = .043). Violence at both assessments were associated with HRV measured during the narration of the worst trauma (traumaHRV) (B = .009, p value = .039, and B = .007, p value = .024, 1st and 2nd assessment respectively). GrimAge acceleration was significantly associated with traumaHRV (B = .043, p value = .049), and HRV measured during a 3D roller coaster video (B = .061, p value = .024).Conclusions: We found relevant evidence that experiencing violence during adolescence is associated with epigenetic aging and stress-related vagal activity. Understanding these factors during this period could contribute to the development of early interventions for health promotion.HIGHLIGHTS Higher exposure to Community and domestic violence is associated with increased GrimAge acceleration.Higher GrimAge acceleration is associated with increased stress-related vagal activity.Exposure to community and domestic violence increased significantly over time.

To measure the perception of obstetric violence among health sciences students.
Cross-sectional design in which the validated questionnaire PercOV-S (Perception of Student Obstetric Violence) was used. The questionnaire was offered to the students who participated in the I Congress of Feminist Medicine of the CEEM (State Councils of Medical Students) held on March 12, 2021. This questionnaire was sent online through Google Forms.
The mean score obtained on the total scale was 3.83 scores (SD=0.61). For the dimension of protocolized-visible obstetric violence, the mean score is 2.79 points (SD=0.84) and for the dimension of non-protocolized-invisible obstetric violence, a mean of 4.16 points is obtained (SD=0.61). The global score of the displayed question differs statistically significantly with the variable scope (p=0.019), course (p=0.008), treatment according to ethnicity (p=0.008), treatment according to socioeconomic level, immigrant status (p<0.001), and prior knowledge about the concept of obstetric violence (p<0.001).
The data show a marked generalised sensitivity of the sample to the issue of obstetric violence, especially with regard to the ethnic characteristics of the women. Likewise, the need to generate ethical-attitudinal training in the response to obstetric violence is observed.

Background: International research has established that children and adolescents are at risk for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as defined by the WHO ICD-11. There is a need for a Danish language version of the International Trauma Questionnaire - Child and Adolescent (ITQ-CA) to assess symptoms of PTSD and CPTSD.Objective: To test the ICD-11 formulations of PTSD and DSO (Disturbances of Self-Organization) using the ITQ-CA version in a sample of children exposed to abuse. Additionally, to study the distribution of symptoms and probable prevalence of ICD-11 PTSD and CPTSD among the population of children exposed to violence or sexual abuse.Method: Confirmatory factor analysis of competing models of the dimensionality of the ITQ-CA was tested among a sample of 119 children and adolescents that were referred to the Danish Children Centres on suspicion of physical or sexual abuse or both. Latent class analysis (LCA) was used to study the distribution of symptoms and consequences of different operationalisations of functional impairment were explored.Results: Findings supported a two-factor second-order model corresponding to the operationalisation of CPTSD in ICD-11 as the best representation of the data. Findings from the LCA suggested that symptoms were distributed in a pattern consistent with the ICD-11 proposal for CPTSD. CPTSD was more prevalent than PTSD regardless of the operationalisation of functional impairment.Conclusion: ITQ-CA is a valid tool for identifying symptoms of ICD-11 PTSD and CPTSD among Danish children exposed to physical or sexual abuse. Further research is needed to study the relationship between ICD-11 C/PTSD symptomatology and anxiety and depression in this population.
The International Trauma Questionnaire – Child and Adolescent version (ITQ-CA) is a valid measure of symptoms of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD among Danish children exposed to physical or sexual violence.The structure of the ITQ-CA in the Danish sample reflects the ICD-11 diagnostic algorithm.CPTSD is a more prevalent disorder among children recently exposed to violence than PTSD.

The educational system is one of the most powerful agents of socialization; it can contribute to perpetuate the gender system and tolerance towards violence or on the contrary, to reduce violence by promoting more equitable and healthy relationship models. The Agència de Salut Pública de Barcelona set out to design a strategy to prevent violence by promoting equitable and healthy relationships at different educational levels in schools in the city of Barcelona. The objective of this article is to present the process of developing this strategy. They characteristics are: (1) use of a participatory approach to ensure the quality and coherence of the process; (2) creation of a theoretical framework for the strategy; (3) use of the intervention mapping methodology as a strategy for the diagnosis, planning, design, development and evaluation of interventions to promote equitable and healthy relationships; and (4) adaptation or design and evaluation of different programs to incorporate different educational stages. It is argued that the strategy designed is considered adequate because it plans interventions to promote equitable and healthy relationships framed within a global educational strategy that starts in the early stages of early childhood education and is continued in all compulsory educational stages. This strategy is based on a conceptual framework that takes into account the determinants and social inequalities in health and promotes an approach based on the promotion of health assets and the use of participatory methodologies.