Marta Maria Alves da Silva

Bullying nas escolas brasileiras: resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE), 2009

The aim of this study is to identify and describe the occurrence of bullying among students in the 9th year (8th grade) from public and private schools from 26 Brazilian state capitals and the Federal District. It is a cross-sectional study involving 60,973 students and 1,453 public and private schools. Data analysis indicates that 5.4% (IC95%: 5.1%-5.7%) of students reported having suffered bullying almost always or always in the last 30 days, 25.4% (IC95%: 24.8%-26.0%) were rarely or sometimes the victim of bullying and 69.2% (IC95%: 68.5%-69.8%) of students felt no humiliation or provocation at school. The capital with higher frequency of bullying was Belo Horizonte (6.9%; IC95%: 5,9%-7,9%), Minas Gerais, and the lowest was Palmas (3.5%; IC95%: 2.6%-4.5%), Tocantins. Boys reported more bullying (6,0%; IC95%: 5.5%-6.5%) compared with girls (4,8%; IC95%: 4.4%-5.3%). There was no difference between public schools 5.5% (IC95%: 5.1%-5.8%) and private (5.2%) (IC95%: 4.6%-5.8%), except in Aracaju, Sergipe, that show more bullying in private schools. The findings indicate an urgent need for intersectoral action from educational policies and practices that enforce the reduction and prevention of the occurrence of bullying in schools in Brazil.

Alcohol-related injuries in emergency departments in Brazil, 2006 and 2007

Alcohol-related injuries are an important public health issue worldwide. The objective of this study was to describe the epidemiology of alcohol intake perceived by interviewers among injury victims seen at emergency departments in selected Brazilian cities. Cross-sectional data were collected from the injury surveillance system based on sentinel health services recently implemented in the country through intentional sampling in 2006 and 2007 and analyzed in Epi Info 3.5.1. Alcohol intake perception was higher in violence-related injuries than in unintentional injuries (37.9% versus 8%). For violence-related injuries, highest proportions of alcohol intake perception were observed among males (43.7%), 20 to 39 years old (45.3%), blacks (40.5%), and low schooling level victims (40.3%). Settings where these injuries occurred with the highest concerned proportions were taverns (78.2%) and public places (39.5%). Higher alcohol intake perception was observed in assaults (39.1%), suicide attempts (25.4%), transport-related injuries (16.8%), and falls victims (5.9%).

Vivência de violência entre escolares brasileiros: resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE)

This article presents the main results of the National Adolescent School-based Health Survey (PeNSE). A questionnaire was applied to a sample of 60,973 students of the 9th year of Junior high school in public and private schools of the Brazilian state capitals and the Federal District, between March and June 2009. The prevalence and confidence interval of 95% (CI 95%) of the violence situations involving adolescents were analyzed. The following situations were identified: lack of safety on the way home-school (6.4%; CI95%: 6.1%-6.8%) and at school (5.5%; CI95%: 5.2%-5.8%); involving fights with physical aggression (12.9%; CI95%: 12.4%-13.4%), with knife (6.1%; CI95%: 5.7%-6.4%) or fire arm (4.0%; CI95%: 3.7%-4.3%); physical aggression by family member (9.5%; CI95%: 9.1%-9.9%). Violence situations were more prevalent among male students. There were great variations among the cities studied. Adolescents are exposed to different violence manifestations in the institutions that supposedly must assure their protection and healthy development: school and the home. These results aim to support health promotion measures and prevention of these risk factors.

A proposta da rede de serviços sentinela como estratégia da vigilância de violências e acidentes

No Brasil, as bases de dados oficiais permitem o monitoramento da mortalidade e internacoes no SUS, decorrentes dos acidentes e violencias. E preciso conhecer a magnitude e o perfil dessas causas que demandam os servicos de emergencia, bem como identificar alguns problemas ocultos tais como as violencias domestica e sexual. O proposito deste artigo e apresentar a proposta do Ministerio da Saude de implantacao da Rede de Servicos Sentinela de Vigilância de Violencias e Acidentes - Rede VIVA, iniciada em 2006, que visa complementar o sistema de informacoes existente para a vigilância dessas causas. Para obter um quadro mais completo do problema e atender a legislacao vigente no Pais, foram estabelecidos dois componentes: 1) Vigilância de acidentes e violencias em emergencias hospitalares selecionadas: coleta em um mes a cada ano, atraves de uma amostra; 2) Vigilância das violencias sexual, domestica e/ou outras violencias interpessoais em servicos de referencia: coleta universal e continua. O estabelecimento da Rede VIVA foi realizado pelo Ministerio da Saude em parceria com as Secretarias Estaduais e Municipais de Saude a partir de criterios previamente estabelecidos. A adesao ao projeto foi acima das expectativas, todas as regioes do Brasil foram representadas.

Mortalidade por acidentes de transporte terrestre no Brasil na última década: tendência e aglomerados de risco

OBJECTIVE To analyze the temporal trends of mortality due to Road Traffic Accidents (RTA) as well as identify the existence and location of high risk death clusters for RTA using spatial analysis. METHODOLOGY Descriptive study of temporal trends by RTA, pedestrians, motorcyclists, motorists and passengers and spatial analysis for 2000 and 2010. The data was obtained from the Mortality Information System, and standardized rates were calculated by age in Brazilian states and municipalities grouped by population size. RESULTS The mortality rates due to RTA between 2000 and 2010 varied from 18 to 22.5 deaths/100,000 inhabitants. The risk of death for pedestrians decreased in recent years, though motorists, motorcyclists and passengers saw a rising trend. A higher risk of death by RTA occurred in municipalities with populations up to 20,000 inhabitants and in those from 20,000 to 100,000 inhabitants. Spatial analysis revealed risk clusters for RTA and motorcyclists and pillion riders with an increase between 2000 and 2010 and enlargement of the areas most at risk in the Northeast. CONCLUSION Increase in the rates of mortality by RTA mostly in the Northeast. Coordinated action between government, civil society and the citizens themselves is required to tackle this problem.

Unintentional injuries at the Emergency Department Injury Surveillance System: Brazil, 2006

In 2006, the Brazilian Ministry of Health established the Injury Surveillance System Network in Sentinel Services (Rede VIVA) to describe data on injuries victims treated at emergency departments (ED), especially minor injuries which do not cause deaths and hospitalization. This study describes the characteristics of unintentional injuries victims treated in these EDs by means of a transversal descriptive study with data coming from EDs located in 35 municipalities with the highest injury rates. The data were collected during 30 consecutive days in an alternated 12-hour shift. There were a total of 41,677 patients with unintentional injuries, mainly among males (64.8%), people aged 20 to 29 years (23.0%) and low level of education (45.8%). Falls were the main cause (40.1% overall), followed by transport related injuries (26.6% overall). The more frequent place of occurrence were public streets (36.3% overall) and residences (33.6% overall). The body parts most affected were upper members (42.7%), lower members (42.0%) and head/face (29.2%). The injury surveillance in sentinel services allows collecting timeless data about minor cases which is essential for planning and implementing preventive measures.

Violence against children: revealing the characteristics of emergency treatment, Brazil, 2006 and 2007

The aim of this article was to describe the profile of emergency care for injuries resulting from violence against children (< 10 years of age) treated Surveillance System for Violence and Accidents (VIVA) of the Ministry of Health, for 30 consecutive days in 2006 and 2007 in selected cities of Brazil. The 518 children in the sample were predominantly male (60.6%), aged 5-9 years (52.1%), and black (71.2%). The majority (55%) of the cases occurred in the home, 34.2% involved sharp objects, and 68.7% evolved to discharge. The most frequent form of violence was physical aggression (67.4%), involving beating, sharp objects, and firearms. The other types of violence included neglect (32%), psychological abuse (9.5%), and sexual assault (3.5%). The aggressors were largely male (48.1%) and family members of the victim (36.3%). The study shows childrens vulnerability to situations of violence. It is necessary to develop specific strategies for inter-sector care and social mobilization to intervene in this problem.

Análise descritiva e de tendência de acidentes de transporte terrestre para políticas sociais no Brasil

Este artigo analisou a mortalidade por acidentes de transporte terrestre no Brasil em 2003 e sua tendencia de 1980 a 2003. Utilizaram-se os obitos por acidente de transporte terrestre captados pelo Sistema de Informacoes sobre Mortalidade (SIM). Para a analise de tendencia, adotaram-se taxas padronizadas, tendo, como referencia, a populacao brasileira no ano 2000. Houve 33.182 obitos em 2003 – 19 obitos por 100 mil habitantes. Atropelamentos e acidentes com motocicleta cresceram no periodo estudado, com declinio dos primeiros a partir de 1998 e crescimento dos ultimos, principalmente, a partir de 1995. Houve diferencial no risco de mortalidade segundo raca/cor e condicao social – escolaridade. Individuos pretos associaram-se a pior condicao social e mortes por atropelamento, enquanto brancos, a melhor condicao social e mortes como ocupantes de veiculo. Os resultados reforcam a importância da vigilância de acidentes de transporte no apoio a politicas de promocao da saude e prevencao desses eventos...

Relação entre violência física, consumo de álcool e outras drogas e bullying entre adolescentes escolares brasileiros

O objetivo deste estudo foi identificar a associacao entre o consumo de alcool e outras drogas e o bullying com o envolvimento em situacoes de violencia fisica entre adolescentes de 13 a 15 anos, em escolas publicas e privadas das capitais brasileiras e do Distrito Federal. Foram analisados os dados da Pesquisa Nacional de Saude do Escolar (PeNSE) de 2009. Para analise dos dados foi utilizada a regressao logistica. A prevalencia de envolvimento em situacoes de violencia fisica foi 12,9% maior no sexo masculino. Em ambos os sexos, foram observadas associacoes entre violencia fisica e ser vitima de bullying com o uso de drogas ilicitas e efeito potencializado do consumo de alcool e drogas. Para o sexo masculino, o uso de alcool mostrou associacao significante com violencia fisica. Morar o pai ou ambos os genitores na residencia apresentou associacao inversa para violencia fisica no sexo feminino. O conhecimento de fatores associados a violencia fisica entre adolescentes e importante para auxiliar estrategias de promocao da saude e da cultura de paz, rompendo com a ideia de que a violencia entre adolescentes e algo banal e esperado.This study aimed to identify the association between alcohol and drug consumption and bullying on the one hand and involvement in situations of physical violence among adolescents 13 to 15 years in public and private schools in State capitals and the Federal District of Brazil. The study analyzed data from the National School Health Survey (PeNSE) for the year 2009. Data analysis used logistic regression. Prevalence of involvement in physical violence was 12.9% more common in boys than girls. Both genders showed associations between physical violence or being a victim of bullying and use of illegal drugs, plus the heightened effect of the combined consumption of alcohol and other drugs. In boys, alcohol consumption showed a significant association with physical violence. Having the father or both parents living at home was inversely associated with physical violence in girls. Knowledge of factors associated with physical violence among adolescents is important for supporting health promotion strategies and a culture of peace, thereby counteracting the idea of taking teenage violence for granted.

A implementação das prioridades da Política Nacional de Promoção da Saúde, um balanço, 2006 a 2014

The scope of this article is to analyze the National Health Promotion Policy with respect to the implementation of core management priorities. Information contained in institutional documents, websites, books and published articles was consulted in order to analyze the actions implemented. There were advances in management, such as the creation of a specific budget line, insertion of the promotion in the Multi-Year Plan, monitoring of indicators of health promotion in the federal pacts, financing of health promotion projects in municipalities and the creation of health promotion programs. Evaluation of physical activity programs was conducted that revealed the effectiveness of the programs. Intersectorial actions taken were relevant, in particular coordination with the Education, Justice, Cities, Human Rights, Social Development, Sports and Leisure sectors, among others. Regulatory actions have been implemented such as the Drink and Drive ban and no smoking environments. Advances were observed, especially greater emphasis on health promotion in the health sector agenda as well as partnerships as intersectorial actions, identifying inequities in the area seeking reduction thereof, in addition to the sustainability of health promotion actions.The scope of this article is to analyze the National Health Promotion Policy with respect to the implementation of core management priorities. Information contained in institutional documents, websites, books and published articles was consulted in order to analyze the actions implemented. There were advances in management, such as the creation of a specific budget line, insertion of the promotion in the Multi-Year Plan, monitoring of indicators of health promotion in the federal pacts, financing of health promotion projects in municipalities and the creation of health promotion programs. Evaluation of physical activity programs was conducted that revealed the effectiveness of the programs. Intersectorial actions taken were relevant, in particular coordination with the Education, Justice, Cities, Human Rights, Social Development, Sports and Leisure sectors, among others. Regulatory actions have been implemented such as the Drink and Drive ban and no smoking environments. Advances were observed, especially greater emphasis on health promotion in the health sector agenda as well as partnerships as intersectorial actions, identifying inequities in the area seeking reduction thereof, in addition to the sustainability of health promotion actions.