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Ciencias Psicológicas

versión impresa ISSN 1688-4094versión On-line ISSN 1688-4221

Cienc. Psicol. vol.14 no.2 Montevideo  2020  Epub 15-Ago-2020

https://doi.org/10.22235/cp.v14i2.2309 

Original articles

Gender conceptions and violence against women

Júnnia Maria Moreira1 
http://orcid.org/0000-0003-1167-111X

Hellen Luane Silva Peixinho1 
http://orcid.org/0000-0002-9210-6675

Gleice de Oliveira Cordeiro2 
http://orcid.org/0000-0003-0273-5126

Jackeline Maria de Souza3 
http://orcid.org/0000-0003-3402-3481

1 Universidade Federal do Vale do São Francisco - UNIVASF - Brasil

2 Universidade Estadual de Feira de Santana. Brasil

3 Universidade de São Paulo - USP - Brasil


Abstract:

Violent behaviors against women can be learned, among other forms, through rules. The present study evaluated the level of agreement with descriptive rules related to gender conceptions and violence against women in a sample of 49 social work and public safety professionals divided in two groups: with and without training on domestic violence. Questionnaires were applied, in which the participant evaluated their level of agreement regarding 35 statements. The "training" variable showed significant differences only in category 12, regarding the relationship between the professional and the victim, in which the group with training presented less agreement and greater disagreement. Training can change gender conceptions, but further investigations are necessary since this change occurred only in the category related to professional performance. One limitation of the study was not to evaluate other variables such as training type and instruction level.

Keywords: violence against women; gender conceptions; descriptive rules; professional training; behavior analysis

Resumo:

Comportamentos violentos contra a mulher podem ser aprendidos por meio de regras. A presente pesquisa avaliou o nível de concordância com regras descritivas relativas a concepções de gênero e violência contra a mulher em uma amostra de 49 profissionais da assistência social e segurança pública alocados em dois grupos: com e sem treinamento sobre violência doméstica. Foram aplicados questionários em que o participante avaliava o seu nível de concordância em relação a 35 itens. A variável “treinamento” apontou diferenças significativas apenas na categoria 12, referente à relação do profissional com a vítima, em que o grupo com treinamento apresentou menor concordância e maior discordância. O treinamento pode alterar concepções de gênero, porém maiores investigações são necessárias visto que essa alteração ocorreu apenas na categoria referente à atuação profissional. Uma limitação do estudo consistiu em não avaliar outras variáveis como o tipo de treinamento e a escolaridade.

Palavras-chave: violência contra a mulher; concepções de gênero; regras descritivas; treinamento de profissionais; análise do comportamento

Resumen:

Las conductas violentas contra la mujer pueden ser aprendidas por medio de reglas. La presente investigación evaluó la concordancia con reglas descriptivas relativas a concepciones de género y a violencia contra la mujer en una muestra de 49 profesionales de la asistencia social y seguridad pública asignados en dos grupos: con y sin entrenamiento en violencia doméstica. Se aplicaron cuestionarios en los que el participante evaluaba su nivel de concordancia con 35 afirmaciones. La variable "entrenamiento" apuntó diferencias significativas sólo en la categoría 12, referente a la relación del profesional con la víctima, en que el grupo con entrenamiento presentó menor concordancia y mayor discordancia. El entrenamiento puede cambiar las concepciones de género, pero son necesarias más investigaciones, ya que este cambio se produjo solo en la categoría relacionada con el desempeño profesional. Una limitación del estudio consistió en no evaluar otras variables como el tipo de entrenamiento y la escolaridad.

Palabras clave: violencia contra la mujer; concepciones de género; reglas descriptivas; entrenamiento de profesionales; análisis de la conducta

World Health Organization data (Organização Mundial da Saúde, 2014) shows that 30% of women that had a relationship in the world suffered physical or sexual violence somehow from an intimate partner sometime in their lives. Despite of the possibility of violence mutuality on marital violence (Rosa & Falcke, 2014), women are on higher vulnerability position even in these mutual violence situations (Barros & Schraiber, 2017; Lindner, Coelho, Bolsoni, Rojas & Boing, 2015). Besides, violence against women specifically has been the subject of research and interventions due to alarming data. In addition, this kind of violence is not restricted to marital context, encompassing every education level, social status and ethnic type (Santos, Antunes & Penna, 2014). In Brazil, according to 2015 Violence Map (Waiselfisz, 2015), from 2003 to 2013 homicides against women increase in 21%. This scenario led to Maria da Penha (Law 11.340/2006) and Feminicide (Law 13.104/2015) laws sanctioning. The last one classifies feminicide as heinous crime and with aggravating in specific vulnerability situations (pregnancy, in children presence, against underage girl, among others; see Taquette, 2015 for a violence against teenager women review).

The Brazilian Applied Economic Research Institute (IPEA from the Portuguese Instituto de Pesquisa Econômica Aplicada) points that from 2009 to 2011 in states of Bahia and Pernambuco, the present study locus, feminicide rates were 9.08 and 7.81 per 100 thousand women, respectively (IPEA revela dados, 2013). It led recently the city of Juazeiro in Bahia to implement the Maria da Penha Patrol, a specialized service for domestic violence victims (Operação Ronda Maria da Penha, 2015; see also Brigadão, Santos & Spink, 2016; Cavalcanti, Moreira, Vieira, & Silva, 2015; Sousa, 2014; Tavares, 2016 for examples of similar measure accomplishment evaluation), one more achievement in battle against women violence. Although, in spite of these measures, little was observed in what concerns to real changes in the violence against women big picture in Brazil (Gomes, 2015). Studies and protective measures on violence against women cases become even more relevant in light of impairments including that ones on victims’ physical health (Coronel & Silva, 2018).

Violence against women is defined as any violence act, based on gender, that cause sexual, physical, psychological, patrimonial, among other damages, performed by people or institutions (Brasil, 2011; Organização Mundial da Saúde, 2014; Silva, Sousa, & Borges, 2015). On the other hand, the gender notion regards to a set of behavior patterns considered typical for women and typical for men in a specific human history time and culture (Sant’Ana, 2003; Silva & Laurenti, 2016). Therefore, on mentioning violence against women, we are talking about a violence derivative from a social framework with social practices that support men despite of women, a patriarchal social structure (Saffioti, 2001; Scott, 1986; Silva & Laurenti, 2016). In behavior analysis, when it comes to gender cultural practices, it is also a matter of social control, power and dominance. This social control affects a person, or a group of people access to sources of reinforcement in a cultural context (Ruiz, 2003).

Among all sorts of violence against women, the structural or institutional violence is performed on emplacement of service provision. This type of violence is defined as a violence performed for a professional who uses the power of his or her position in the institution as a way to delegitimize the savvy of service users (Aguiar & D’Oliveira, 2010). It ended up taking apart the professional and the public to be served, what in turn preclude the professional to have a better understanding of the service user social and cultural reality (Pedrosa & Spink, 2011).

The violence against women phenomena in behavior analysis is synonym of coercion; someone uses punishment and threat of punishment to get other person behaving the way he or she wants and to reinforce this behavior with the aversive stimulus withdrawal (Sidman, 1989/2003). A type of control based on aversive stimulus, for example in institutional framework, happen when a professional daunt a service user by morally judging her clothes or appearance (e.g., lipstick or makeup) by saying: “The woman in seductive clothes cannot complain about being raped”. In this case, an aversive stimulus, the censure related to “seductive clothes”, is used to control the service user behavior through an implicit instruction - “Do not use these clothes”.

The example above illustrates, besides a gender conception of the speaker, the instructional control, a way of learning with others through verbal behavior (Skinner, 1957/1978). In the example, the professional’s (emitter’s) instruction has some probability of changing the service user’s (listener’s) behavior of using specific clothes. Or even avoid her persistence on reporting or seeking for the protection service in the future, which can be correlated to violence against women underreporting data (Invisível aos olhos, 2015).

When we affirm that a behavior was “controlled” by an instruction or rule it means that this behavior is being controlled mainly by a discriminative verbal stimulus (Baum, 2005/2006). Accordingly, the main rule function is changing the listener verbal or non-verbal behavior. So, the rule can replace natural contingencies by verbal antecedents. Another instruction function is altering others evoking stimuli function (Schlinger & Blakely, 1987). The example of a service user and a professional interaction mentioned earlier suggests that an instruction can alter a contingency stimuli function in a way to control a non-verbal behavior, altering the future probability to use “seductive clothes”.

Therefore, the behavior determined by a rule, as for example, an instruction of a public security agent provided in a talking: “It is not decent (or safe) for a woman to walk alone in the street at night especially in lascivious clothes and with untied hair because men could harass, rob or even rape her”. It can control the listener behavior of avoiding going outside at night, even though she would never suffer violence, narrowing women’s liberty (Albuquerque, Mescouto, & Paracampo, 2010).

In addition, rules can be classified as prescriptive and descriptive (Paracampo, Albuquerque, Carvalló, & Torres, 2009). Prescriptive or explicit rules define the behavior to be emitted and also the listener who must behave, for example, when a judge say, “close your legs firmly and also all your female organs when facing a threat of being raped” (Juíza pergunta a vítima, 2016). In turn, descriptive or implicit rules, aimed in the present study, do not specify a particular listener and can be exemplified in: “The woman that was beaten by a partner and keep the relationship enjoy being beaten”.

Rules can predict behaviors, so they are interesting to be analyzed. In Gomes and Costa (2014) research, the authors used a survey with 25 items, written as descriptive rules concerning gender conceptions and violence against women. Items were allocated in seven categories: traditional female and male role, relationship privacy, unbroken family model is the pattern, victim’s responsibility, jealousy related to love, jealousy related to violence, violence justifications, among others. The sample comprised 252 students including undergraduates and non-undergraduates’ males and females. Their findings pointed to education level as a statistically significant variable concerning to items agreement, overpassing even the gender variable and suggesting that increases in the education level is a relevant factor regarding the violence against women reversal.

Similar results were found in a Gomes and Costa (2014) replication study conducted by Callou, Bastos, Moreira e Souza (2016). In a sample of 223 participants, also including undergraduates and non-undergraduate’s male and female, these authors used an adapted Gomes and Costa survey consisting of 32 items allocated in 11 categories. Seven categories were the same as in the former study and another four new were constructed by the authors: violence attribution to men’s character/nature - internalism, violence attribution to education - learning, female sexuality depending on male sexuality, violence attribution to alcohol consumption, and higher allowance to violence when it is verbal. Items construction aimed to turn it harder to recognize the respectively category and to mask agreement or disagreement socially expected and reinforced. Data indicated that education level and agreement to some items were weak and moderated correlated besides there was more agreement by non-undergraduates than undergraduates. In addition, as in Gomes and Costa (2014) study, education level surpass gender concerning agreement.

Since the 80’s, studies like these have been carried out in an attempt to shed light on gender violence (Bandeira, 2014). In Brazil, feminist movements have been conducting actions and setting partnerships with the government in order to eradicate violence against women (Mapeamento das Delegacias da Mulher no Brasil, 2008; Mota, 2004; Saffioti, 2001).

The Brazilian protection system includes since the women rights national council, special police stations to women protection (Pereira, 2006) until others services like CRAM (reference center to women attendance) and CREAS (specialized social work reference center), spots for psychological and social attendance, besides legal instruction and support (Secretaria Especial de Políticas para as Mulheres, 2006).

Trainings can be a fundamental way to approach behavior and context aspects, in order to facilitate professional skills acquisition and professional’s comprehension of the complex problems like gender conceptions and gender relationships. As the contingency shaped behavior is more sensitive to context changes than the rule governed behavior (Matos, 2001), trainings should not be only instructional. They must include experiential strategies and also technical and interpersonal skills teaching, showing stronger social efficacy and efficiency (Del Prette & Del Prette, 2011). Besides being part of the institutional policy, trainings must also be evaluated.

This service complexity and in this area professions challenges are being related with lack of training, understanding of gender violence as natural and afraid of notification, what in turn could led to difficulties in violence identification and consequently in properly attending and directing the cases (Mattos, Ribeiro & Camargo, 2012). This scenario poses questions about conceptions of gender and violence against women concerning the professional’s performance on attention to women services. So, the present study replicates Callou et al. (2016) work aiming to verify differences in agreement with gender conceptions and violence against women descriptive rules in two groups of professionals: the first one has been received specific violence against women training and the second one have not.

Method

Study Type

The present study is descriptive, correlational and transversal.

Participants

A total of 49 public security and social workers who worked with violence against women participated in this study. This non-probabilistic convenience sampling consisted of 24 men and 25 women, average age of 36.7 years (SD= 8.59), ranging from 20 to 63 years. From those who informed marital status, the majority was married (59.6%) followed by single (34%). With regards to religion, most declared themselves as Catholics (44.2%). In what concerns to sexual orientation, all participants reported being heterosexual. Education level ranged from complete middle school (4.3%), complete high school (19.2%), incomplete college (27.7%), complete college (38.3%) and graduate (10.6%).

Regarding profession, most were military police officers (53.1%), followed by others like social workers, psychologists, law course interns, lawyers, among others. The participants income ranged from up to two (6.5%) to more than four (50%) minimum wage. Concerning violence against women training performed, from a total of 49 participants, 25 (51.02%) reported “yes” and were allocated on Training Group (TR), 24 (48.97%) reported “no” and were allocated on Non-Training Group (NTR). Participants comments were signaled as “P” and the participant number, followed by the group in parenthesis (e.g., P30 (NTR)).

The TR group participants were 38 years old in average (SD= 7.86). The TR group participants were 35.5 years old in average (SD= 9.27) and consisted majority by men (62.5%). In both groups, military police officers, catholics and married participants prevailed. Although, women with higher education level prevailed in TR compared to NTR group. Detailed data for both groups is on Table 1.

Table 1: Sample description regarding NTR and TR groups  

Materials

We used the Men and Women Behavior in Intimate Relationship Survey from Callou et al. (2016). We added the “Professional and victim relationship” category to cover training influence and it consisted on three items: “The woman who reports the violence frequently and even so still goes on in the relationship, she doesn’t really want to solve the problem”; “When the woman wants to give up the reporting, she is devaluating the professional’s job”; and “If the partner attacks the woman only verbally it is not necessary her to report it”. Then, the survey final version consisted of 35 items allocated in 12 categories (Table 2). In the survey initial part, besides information like age, gender, sexual orientation, education level and income, participants also have answered about job position and if they were engaged in any kind of violence against women training. When answering to every item, participants should do it according to a Likert type scale consisting of four points: totally agree, partially agree, partially disagree and totally disagree.

Table 2: Men and Women Behavior in Intimate Relationship Survey Categories and Items 

*Categories retrieved from Gomes and Costa (2014) study **Categories retrieved from Callou et al. (2016) study ***Category created for the present study These items translation is free and was not validated to be used with English speaker participants

Procedure

After this research project approval by the institutional review board (Comitê de Ética e Deontologia em Estudos e Pesquisa CEDEP/UNIVASF), registration number CAAE 46697015.1.0000.5196, we recruited participants in their workplaces (ordinary and specialized police stations, CREAS/CRAM and police companies). We presented the research aims and relevance and we assured the participants privacy. After agreeing with and signing the research consenting term, the participants had instructions to answer the survey.

Data Analysis

The data collected were quantitatively analyzed in terms of percentage and frequency descriptive measures. We also verified correlations between ordinary variables and we compared the TR and NTR groups in terms of category agreement. For this purpose, we used Spearman and Mann-Whitney non-parametric tests.

Results

In general, our data have shown lower agreement level in both groups. Comparing the groups TR and NTR, the agreement level was statistically different only in category 12 (Professional and victim relationship), in which the TR group disagreed more than the NTR group (p= .028). It is worth to consider that there was no difference in TR group on category 12 in terms of age, education level and gender, in a way that the difference in agreement level in this sample was in fact related to performing a gender violence training.

Table 3 shows partial and total agreement level and partial and total disagreement level in all categories. The total agreement levels in each category was fairly low for both groups, lower than 13%. The TR group have shown more total agreement in category 7 (Violence attribution to men’s character/nature - internalism) (12.5%) compared to NTR group (4.2%) and both groups have shown high partial agreement in category 8 (Violence attribution to education - learning) (TR: 23.8% and NTR: 21.7%).

Table 3: Average, Standard Deviation, and Categories Agreement Percentage for TR and NTR groups (n=49). 

The NTR group totally agreed more in category 10 (Higher allowance to violence when it is verbal) (11.1%) than TR group (4.4%), even though partially agreement in this category was higher in TR group (TR: 26.7% and NTR: 15.6%).

A steeper difference between groups were found in total agreement level in category 11 (Violence attribution to alcohol consumption), TR group have shown 0% and NTR group 10.4%. In addition, partial agreement level was higher in TR group (TR: 20.8% and NTR: 12.5%). This result suggest that training had an effect on reducing total agreement in this matter, however, it would be interesting to verify if training covered substance abuse, investigation not included in present study.

In TR group there were significant differences in agreement level as a function of age, education level and gender. Concerning to age, older participants agreed less with rules pointing to a men violent nature (category 7), since, according to Spearmen test, there was a mild negative correlation (-.470; p= .02) between these variables. Similar negative correlation, however stronger, was found between age and higher allowance to violence when it is verbal (category 10; - .632; p= .002). Even on TR group, participants with higher education level tended to agree less with the idea of female sexuality depending on male sexuality (category 9) as shown by a mild correlation (-.445; p= .043).

Regarding to gender, men have shown higher agreement levels in category 5 (Jealousy related to love) than women. This happen on TR group with averages of 2.07 and 1.41 (p< .05), as well as on NTR group with averages of 2.19 and 1.54 (p< .05) for men and women respectively.

Discussion

As well as in Callou et al. (2016) and Gomes and Costa (2014) studies, we have found lower agreement levels for both TR and NTR participants groups. This result was expected because the sample consisted of professionals who work with violence (Machado et al., 2009).

Regarding to TR group higher agreement in category 12 (Professional and victim relationship), it is worth noting, however, an important study limitation concerning the lack of information about training specificity as it was considered just the participant report about performing a violence against women training.

In addition, another limitation is related to extrapolate the findings to the actual participants behavior in their work routine, especially because the difference between groups observed here was only on the category concerning professional performance. However, disregarding to the kind of training, at least the verbal behavior has changed, evidenced here in terms of the rule’s agreement. Thus, violence against women training seems to modify agreement with items regarding to professional performance and relationship with the victim, although without changing another categories agreement.

The higher TR group total agreement in category 7 (Violence attribution to men’s character/nature - internalism) suggests that training could led to an understanding of violence as being due to intern causes (e.g., personality and character) although not without taking learning into account. The high partial agreement level in both groups in category 8 (Violence attribution to education - learning) points to a phenomena big picture suggesting individual and context interaction as the base for the violent behavior building. This interactionist vision is advocated by the Behavior Analysis, according to that the behavior is shaped since the organism interaction with the environment. Behaviors, including violent ones, do not arise from a “human nature” but they are learned from social environment interaction and they are maintained by the consequences produced in this interaction (Skinner, 1957/1978).

The TR group higher total disagreement and partial agreement in category 10 (Higher allowance to violence when it is verbal) provides evidence that, although the rise in total disagreement, there is still tolerance when the abuse is verbal even after training. This raises a worrisome question that is being pointed in literature: how hard it is to identify psychological violence (Silva, Coelho, & Caponi, 2007). The Brazillian National Policy to Violence against Women Coping (Brasil, 2011) defines psychological violence as every action or omission that causes damage to self-esteem, to identity or to person development, including threats, depreciation, humiliation, blackmail, among others.

In the TR group, the absence of total agreement in category 11 (Violence attribution to alcohol consumption) and more partial agreement than NTR group denotes that trained professionals do not assign violence only or directly to alcohol consumption despite not underestimating alcohol effects on domestic violence as suggests this P49(TR) comment free translation: “Psychoactive substances led to harmful consequences to familiar relations but it’s not a single factor”. Studies (Signori & Madureira, 2007; Vieira et al., 2009) indicate that security professionals report alcohol consumption among the main reasons to violence and in most of their cases alcohol consumption was present. This also appears in others free translated comments: P45(NTR): “Alcohol and drugs potentiate crime. The police station routine reveals that in most reports the man was under alcohol or drug effects”. P10(NTR): “In my professional experience, all aggressors were under alcohol effect”. In fact, alcohol consumption was involved in 56.6% of reports on 325 DEAM inquiries evaluated by Gama, Filho, Silva, Vieira and Parente (2014) in Fortaleza. The Oliveira et al. (2017) review also shows that jealousy and alcohol and other drugs consumption are the main violence against women root. However, Medeiros (2015) pointed that aggressor behavior pattern is stronger than drugs and alcohol consumption as risk factors.

As already mentioned, age, education level and gender similarities in TR group concerning to category 12 (Professional and victim relationship), provide initial evidence to training as responsible for the difference between groups. Notwithstanding this difference was only in category 12 not broadening to the other categories analyzed. Considering category 12 items, the workers answers seem to valuate victim report despite of she’s keeping the relationship with the aggressor or reporting it many more times and also despite of her decision to remove the report later. The TR group seems to be “less permissive” to verbal aggression advocating the report in these cases. However, the training and its effects on gender conceptions and violence against women other aspects still need to be evaluated in order to verify the training broadening on professional gender conceptions and performance.

The negative correlations observed on NTR group between age, on the one hand, and agreement with men violent nature (category 7) and major tolerance to violence when it is verbal (category 10), on the other hand, suggest that older participants on NTR group tend to assign the violence to “non-natural” factors like learning and culture, besides being less permissive to verbal violence. These findings suggest effects of variables that ordinarily come with age, like education and relational and professional experience. Further research could investigate if professional experience reduces the violence attribution to intern factors since time on the job was not verified in the present study. In this line of thought, age was also negatively correlated with the idea of female sexuality depending on the male sexuality (category 9) in NTR group, corroborating another data regarding higher education level and agreement with these rules (Callou et al., 2016; Gomes & Costa, 2014) besides the lower education level among them who perform violence (Silva et al., 2015).

The higher agreement between men in category 5 (Jealousy related to love) points that women differs from men and considers jealous behavior as different than loving behavior (Sucre & Petrizzo, 2016). It is worth noting that Costa (2016) have found association between feeling of possession and sexual violence in victims’ narrative. Besides, the jealousy and love dissociation seem to be even more important in face of evidences of jealousy softening the violence against women pejorative perception in Americans (Puente & Cohen, 2003) and Brazilians (Costa et al., 2016), suggesting a common cultural aspect. In Behavior Analysis functional terms, jealousy happen in a reinforcing competition situation and can be maintained by social consequences (attention) or by rival removal, it is then liable to extinction (Oliveira & Paranaguá, 2017). This view on violence against women professionals is important because, besides probably reducing jealous behavior tolerance, it can provide a new possible analysis.

Taken together, these findings point to the relevance of those violence professionals training and also indicate that domestic violence institutional protocols in Brazil must be investigated and reviewed (Abdala, Silveira, & Minayo, 2011; Brandão, 2006; Hasse & Vieira, 2014; Santos, 2008) This is true especially in face of the evidence of aggressive relapse without formal reporting as a risk factor of physical violence against women (Gama et al., 2014). The victim’s responsibility and blame, for example, is a huge problem on health professional’s attendance (Souza & Cintra, 2018). Studies addressing this issue could ensure these institutions better working and could provide the professionals’ skills development to improve legal procedures and conflict mediation, also claiming victim’s fundamental rights (Nobre & Barreira, 2008).

In spite of our small sample, data were relevant to better understand professional training process in this specific area in Brazil, providing an analysis of the rules these professionals tend to agree and disagree. For future studies, we suggest a bigger sample, allowing parametric statistics tests and a joint analysis of many variables’ interaction (education level, age, gender, participants’ job position). These researches would favor findings generalizability. We also suggest future researchers to better control the training variables. It could be better characterized in terms of training duration, contents, methodological strategies and training recency.

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How to cite: Moreira, J.M., Peixinho, H.L.S., Cordeiro, G. O., & Souza, J.M. (2020). Gender conceptions and violence against women. Ciencias Psicológicas, 14(2), e-2309. doi: https://doi.org/10.22235/cp.v14i2.2309

Correspondence: Júnnia Maria Moreira. Universidade Federal do Vale do São Francisco - UNIVASF. Colegiado de Psicologia, UNIVASF Campus Petrolina Centro. Avenida José de Sá Maniçoba, S/N, Centro. Petrolina, PE; CEP 56304-91. E-Mail: junnia.moreira@gmail.com. Hellen Luane Silva Peixinho; e-mail: hellenpeixinho23@gmail.com. Gleice de Oliveira Cordeiro; e-mail: gocordeiro@uefs.br. Jackeline Maria de Souza; e-mail:jackeline.souza1@gmail.com

3Authors' participation: a) Conception and design of the work; b) Data acquisition; c) Analysis and interpretation of data; d) Writing of the manuscript; e) Critical review of the manuscript. J.M.M. has contributed in a,c,d,e; H.L.S.P. in a,b,c,d; G.O.C. in c,d,e; J.M.S. in c,d,e.

4Scientific editor in charge: Dra. Cecilia Cracco

Received: March 11, 2019; Accepted: August 15, 2020

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