This study aimed to analyze how the Brazilian Ministry of Health (MS) is implementing the Sex Reassignment Process (SRP) in the

Violência doméstica contra mulheres e a atuação profi ssional na atenção primária à saúde: um estudo etnográfi co em Matinhos, Paraná, Brasil Domestic violence against women and professional intervention in primary healthcare: an etnographic study in Matinhos, Paraná State, Brazil Violencia doméstica contra mujeres y la actuación profesional en la atención primaria a la salud: un estudio etnográfi co en Matinhos, Paraná, Brasil

No ano de 2012, realizamos pesquisa etnográfica com travestis de Santa Maria, Rio Grande do Sul, Brasil, por meio de observação participante, entrevistas e acompanhamento de suas vidas cotidianas. Durante esse período, percebemos que as violências física e simbólica e o sofrimento delas decorrentes eram invariantes, condição com a qual tinham que lidar em seus itinerários, em suas práticas e afazeres diários. Este artigo discute as violências vivenciadas nas trajetórias percorridas pelas travestis (família, escola, delegacias, serviços de saúde), procurando, sobretudo, compreender como tais violências estão relacionadas às experiências nos serviços de saúde e como os serviços de saúde por elas acessados reagiram às violências.

Itinerários terapêuticos de travestis da região central do Rio Grande do Sul, Brasil

Background: Massive Open Online Courses (MOOCs) are a teaching format with universal access and the potential and viability to be implemented by health professionals. Despite their proven success in providing high-quality continuing education, usage and offerings of this technology are still scarce in Brazil. Materials and Methods: This article describes the development of an online-based education strategy (MOOC) on the topic of health policies aimed at the Lesbian, Gay, Bisexual, Transgender, and Intersex (LGBTI+) population and analyzes its performance and reach after 6 months. Results: This introductory MOOC course on LGBTI+ health included an assortment of multimedia material and consisted of 30 h of autonomous learning activities divided into two modules, with problem-based evaluation strategies. During its 6-month promotion period, the course had a total of 3,000 people enrolled with a completion rate of *20%. Conclusions: Results point to a high interest in LGBTI+ health and high demand for training on this topic among health professionals. This was the first course of its kind administered in Brazil. The MOOC format was successful and reliable in enabling the teaching-learning process.

Brazil currently has the highest absolute number of homicides in the world, which results from a complex range of factors. This study aimed at understanding the associations between socio-environmental determinants of health (SDH) and homicides in Brazil through a systematic literature review. The review followed PRISMA guidelines, selecting quantitative and qualitative studies published in Portuguese, English, and Spanish carried out between 2002 and 2017, available in the PubMed, MEDLINE, LILACS, SciELO and BVS-BIREME databases. Two trilingual reviewers tracked studies independently by basing on the eligibility criteria. We critically assessed the selected studies with the Critical Appraisal Skills Programme (CASP) or the Checklist for Analytical Cross-Sectional Studies, depending on the study design. We considered 60 studies and grouped their SDH into categories to develop a narrative synthesis about each SDH. These categories were: territory; race/ethnicity; gender; age; social inequalities and economic factors; development; education; work and employment; drugs and trafficking; other SDH. We found some SDH were more associated with homicides, such as being young, black, male, of low education level, and also people who lived in places of high social inequality, such as urban suburbs and agricultural frontiers. Unemployment and drug trafficking, as well as intersections between various SDH were also prominent. Education seems to be a protective factor for homicide. Despite the limited capacity of interpretation due to the high range of methodological approaches, this review shows the importance of considering SDH and their intersections when developing homicide prevention policies.

Domestic violence against women, public policies and community health workers in Brazilian Primary Health CareViolência doméstica contra mulheres, políticas públicas e agentes comunitários de saúde na Atenção Primária Brasileira

IntroductionIntimate partner violence (IPV) considerably harms the health, safety and well-being of women. In response, public health systems around the globe have been gradually implementing strategies. In particular, low-income and middle-income countries (LMIC) have been developing innovative interventions in primary healthcare (PHC) addressing the problem. This paper describes a protocol for a systematic review of studies addressing the impacts and outcomes of PHC centre interventions addressing IPV against women from LMIC.Methods and analysisA systematic search for studies will be conducted in African Index Medicus, Africa Portal Digital Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Index Medicus for the Southeast Asia Region, IndMed, Latin American and Caribbean Health Science Literature Database (LILACS), Medecins Sans Frontieres, MEDLINE, Minority Health and Health Equity Archive, ProQuest, PsycINFO, Scientific Electronic Library Online, (SciELO) and Social Policy and Practice. Studies will be in English, Spanish and Portuguese, published between 2007 and 2017, addressing IPV against women from LMIC, whose data quantitatively report on the impacts and outcomes for survivors and/or workers and/or public health systems preintervention and postintervention. Two trilingual reviewers will independently screen for study eligibility and data extraction, and a librarian will cross-check for compliance. Risk of bias and quality assessment of studies will be measured according to: (1) the Cochrane Collaboration’s tool for assessing risk of bias for randomised controlled trials and (2) the Methodological Index for Non-Randomised Studies (MINORS). Data will be analysed and summarised using meta-analysis and narrative description of the evidence across studies. This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols(PRISMA P) guidelines.Ethics and disseminationThis systematic review will be based on published studies, thus not requiring ethical approval. Findings will be presented in conferences and published in a peer-reviewed journal.PROSPERO registration number CRD42017069261.