Vanessa Andina Teixeira

Influência da família no consumo de crack

Objective This paper aims to study the contributions of families of crack users on promoting both consumption and cessation of consumption of this substance. Methods A cross-sectional, mixed study with a quantitative design (descriptive and analytical statistics, by robust Poisson regression) and a qualitative design (thematic content analysis). Results Among 519 crack users interviewed 48.3% reported having shared crack cocaine with some family member. The more expressive occurrence of sharing was for marital relations indicated by 30.6% of respondents. The estimated prevalence rates of the outcome crack usage stopped for more than 12 weeks, by robust Poisson regression controlling for confounding factors, for crack users who reported shared with brothers use was 0.940 (95% CI: 0.885-0.999; p = 0.045). For qualitative dimension, 20 respondents freely exposed the involvement they realize that their families have with their drug use, some indicating opposition to consumption, other stimulus, or offering, besides the interplay between crack usage and family conflicts and a negative environment. In addition, respondents who reported having family members in mental health treatment were 9% more likely to be stopped for 12 weeks or more (PR = 1.09 95% CI: 1.03-1.15; p = 0.005). Conclusion Family groups appear not only as a protective factor, but also as an important risk factor for crack cocaine use and their inclusion treatments is justified on these evidences.

Condições associadas a prejuízo de desempenho em habilidades sociais em uma amostra de conveniência de usuários de crack

O artigo apresenta condicoes associadas a escores deficitarios no Inventario de Habilidades Sociais (IHS) entre usuarios de crack da Regiao Metropolitana de Porto Alegre, Rio Grande do Sul, Brasil. Estudo transversal, com amostragem de conveniencia de 519 individuos, entrevistados em 2011. Escore deficitario no IHS ocorreu para 52,8% da amostra e nao houve diferencas quanto a estar ou nao em uso ativo de crack, ou quanto a estar ou nao em atendimento. Apresentaram probabilidade aumentada de deficit no IHS os usuarios de crack em pre-contemplacao ou contemplacao no University of Rhode Island Change Assessment - URICA (p = 0,031), com escores elevados no Inventario de Depressao de Beck - BDI (p = 0,037) os que viveram luto de filho (p = 0,001) e os que ja assaltaram para obter o crack (p = 0,020). Com probabilidade diminuida estavam os que tinham escolaridade de 9 anos ou mais (p = 0,001), apoio social elevado (p < 0,001), resiliencia elevada (p < 0,001), com historico de ter perdido o contato com seus pais (p = 0,032), ja tendo sido hospitalizado em funcao da droga (p = 0,009) e que relataram ja ter mantido atividade sexual para obter a pedra (p = 0,009). Os achados tem utilidade clinica e mostram a importância do tema.The article analyzes conditions associated with low scores on the Social Skills Inventory (SSI) among crack users in Greater Metropolitan Porto Alegre, Rio Grande do Sul State, Brazil, based on a cross-sectional study in a convenience sample of 519 individuals interviewed in 2011. Low SSI scores occurred in 52.8% of the sample, and there were no differences according to currently active use of crack (yes/no) or current addiction treatment. Higher likelihood of low SSI was associated with crack users in pre-contemplation or contemplation in University of Rhode Island Change Assessment - URICA (p = 0.031), high Beck Depression Inventory - BDI scores (p = 0.037), mourning a deceased child (p = 0.001), and having committed armed robbery to obtain crack (p = 0/020). Lower likelihood of low SSI was associated with 9 or more years of schooling (p = 0.001), high social support (p < 0.001), high resilience (p < 0.001), having lost contact with parents (p = 0.032), history of hospitalization due to crack (p = 0.009), and history of sex to obtain crack (p = 0.009). The findings are clinically useful and highlight the issues importance.

Validation of an instrument to evaluate health promotion at schools

ABSTRACT OBJECTIVE To validate an instrument designed to assess health promotion in the school environment. METHODS A questionnaire, based on guidelines from the World Health Organization and in line with the Brazilian school health context, was developed to validate the research instrument. There were 60 items in the instrument that included 40 questions for the school manager and 20 items with direct observations made by the interviewer. The items’ content validation was performed using the Delphi technique, with the instrument being applied in 53 schools from two medium-sized cities in the South region of Brazil. Reliability (Cronbach’s alpha and split-half) and validity (principal component analysis) analyses were performed. RESULTS The final instrument remained composed of 28 items, distributed into three dimensions: pedagogical, structural and relational. The resulting components showed good factorial loads (> 0.4) and acceptable reliability (> 0.6) for most items. The pedagogical dimension identifies educational activities regarding drugs and sexuality, violence and prejudice, auto care and peace and quality of life. The structural dimension is comprised of access, sanitary structure, and conservation and equipment. The relational dimension includes relationships within the school and with the community. CONCLUSIONS The proposed instrument presents satisfactory validity and reliability values, which include aspects relevant to promote health in schools. Its use allows the description of the health promotion conditions to which students from each educational institution are exposed. Because this instrument includes items directly observed by the investigator, it should only be used during periods when there are full and regular activities at the school in question.

Exposure to physical and sexual violence and suicidal ideation among schoolchildren

Objective: The purpose of this study was to estimate the association between exposure to physical and sexual violence, and suicidal ideation in Brazilian Schoolchildren, accounting for confounding variables of religious practice, and problems with alcohol and other drugs. Methods: This study consists of a cross-sectional analytical approach of a larger school-based study conducted in 2012 in two medium-sized municipalities in south of Brazil. Participants were 3,547 students aging 12 to 17 years old who answered an assembled questionnaire. Descriptive and Logistic Regression analyses were conducted with suicide ideation outcome testing prediction models stratified by sex. Results: Suicide ideation prevalence in the sample was of 21.7%, and regression analysis indicated that girls and boys exposed to physical or sexual violence had 3.42 and 3.14 times more probability of referring suicidal ideation in the past 30 days. Adjusted analyses showed little interference of religious practice, while problems with alcohol and other drugs seemed to also explain suicidal ideation in the sample. Conclusion: We highlight the importance of future longitudinal studies to investigate the mechanisms through which exposure to physical or sexual abuse influence suicidal ideation among boys and girls, as well as mediation studies that could enlighten the role of drug and alcohol use in this relationship.

Relacionamento entre pai e mãe e consumo de álcool segundo relato de escolares de 12 a 14 anos do sul do Brasil

Objective To examine the relationship between parents’ relationship and their alcohol consumption as reported by students from 12 to 14 years old. Methods A cross-sectional school-based study was performed, visiting all schools of two towns in the state of Rio Grande do Sul, southern Brazil (2012), involving a sample stratified by gender, age, municipality and type of school (public or private). Data were submitted to descriptive and Poisson regression analysis with design effect control for the variable school. Results The sample consisted of 2,189 students who were 1,351 (61.7%) from the city of Lajeado and 838 (38.3%) from Sapiranga. No statistically significant association between mother’s alcohol consumption and relationship between father and mother perceived as negative was found. Father’s alcohol consumption reduced the likelihood of the relationship between him and the mother being reported as negative in the crude analysis [PR = 0.857 (95%CI: 0.744-0.988)]. This association also disappears when the analysis was adjusted by sex, age and education level of the main responsible in the family house. Conclusion There is a risk of strong dissonance between the perception the students have about the influence of adults’ alcohol beverage on the relationships in their homes and speeches aiming to show to schoolchildren that alcohol consumption is harmful to loving relationships and care.

Padrão de uso e possibilidade de cessação do consumo do crack: estudo transversal

O objetivo desta pesquisa foi analisar a relacao entre o padrao de consumo de crack nos ultimos seis meses de uso ativo e a condicao de abstinencia ou nao no momento das entrevistas. Trata-se de um estudo transversal com amostragem de conveniencia, sendo que foram entrevistadas 495 pessoas entre os 14 e os 54 anos de idade. Foram estimadas razoes de prevalencia por Regressao de Poisson robusta para a condicao abstinente por 12 semanas ou mais, segundo os padroes de consumo referidos, ajustando para sexo, idade, escolaridade, tempo desde o primeiro contato com a droga, uso de medicacao e hospitalizacao em funcao do crack. Identificou-se associacao entre o uso frequente e pesado e a cessacao do consumo (RP 1,06 [IC95%: 1,01 - 1,12] p = 0,019). Esse achado amplia o leque de particularidades em relacao ao crack e reforca os investimentos terapeuticos para todos os padroes de consumo.

Condições associadas à cessação do uso de crack entre usuários em atendimento

This paper presents conditions associated with abstinence from crack in a cross-sectional study with a snowball sampling, in a sample of 495 crack users in treatment at different health services in a metropolitan area in southern Brazil. Data were submitted to a multivariate analysis, by robust Poisson regression in order to estimate the prevalence ratio for the outcome abstinence, defi ned as reference to a period equal or over 12 weeks since the last usage. Remained in association with crack abstinence: lack of partner, relative in mental health treatment, mourning in the last 12 months, sexual diffi culties assigned to crack cocaine and knowledge of therapeutic community as effective resource. Appeared on negative association with abstinence: having smocked crack cocaine with the father, attend the criteria for crack cocaine dependence, poor health self perception and BDI score more than minimum. Despite not establishing causation, this paper contributes to the advancement of the recognition of elements that must be integrated into treatment planning, in order to optimize results.

Violence exposure and substance use among southern Brazilian schoolchildren

espanolEste estudio transversal con muestra probabilistica de 3.547 adolescentes, 54.2% ninas, media de edad 14 anos (SD=1.66), realizado en escuelas brasilenas del sur de Brasil, analizo la asociacion entre la exposicion a la violencia y el consumo de sustancias. El genero y la edad fueron controlados y la proporcion de la muestra fue asegurada. Una medida de autoinforme ha evaluado datos sociodemograficos, la violencia, el consumo de sustancias, trastornos psiquiatricos, rendimiento escolar, practicas parentales y la relacion de los jovenes con padres y profesores. Se realizo analisis descriptivo y la razon de prevalencia para el consumo de sustancias fue estimada por regresion de Poisson, precedida por el control para efecto de la variable escuela. El analisis fue ajustada por sexo y el consumo de alcohol y tabaco por los padres, asi como por los trastornos psiquiatricos. Asociaciones entre la exposicion a la violencia y el uso en el ano de todos las sustancias investigadas fueron encontradas: tabaco [PR=2.49 (IC 95%: 1.92 - 3.25) p EnglishCross-sectional study with probabilistic sample of 3,547 adolescents aged from 12 to 17 years old, 54.2% girls, from southern Brazilian schools that analysed the association between exposure to violence and substance use. Gender and age distribution in general population were controlled and sample proportions were assured. A self report measure was used to evaluate sociodemographic conditions, violence, substance use, psychiatric disorders, school performance, parental practices and relationship with parents and teachers. Descriptive analysis were hold, prevalence ratio for substance use were estimated by Poisson Regression, preceded by control for design effect by school variable. The analysis were adjusted by gender, alcohol and tobacco use by the parents and psychiatric disorders. Association between violence exposure and use in the year of all drugs investigated was found: tobacco [PR=2.49 (CI95%: 1.92-3.25) p

Inserção no mercado de trabalho e uso de drogas entre escolares de duas cidades de médio porte do sul do Brasil

aBStraCt objective: Having a paid work appears among the factors associated with the onset of drug usage by teenagers. This paper aims to estimate the association between the insertion in the labor market and last year usage of alcohol, tobacco, marijuana or cocaine in a sample of 1,961 students aging 14 to 17 on two medium-sized cities in southern Brazil. Methods: Pre-valence ratios were estimated, first adjusted for sex and age, and then adjusted also for sex, age, and then to sex, age, and supervision of internet use at home. r esults: Prevalence rates indicated significant association among the insertion in the labor market and the consump-tion of the interest substances, but when adjusting for gender and age, only the association with tobacco use remained significant and it disappeared when parent’s supervision was in-cluded in the model of analysis. Conclusions: Data show that among adolescents yet linked 1 Universidade do Vale do Rio dos Sinos (Unisinos), Programa de Pos-Graduacao em Saude Coletiva.Endereco para correspondencia: Rogerio Lessa Horta Rua Jari, 671, ap. 703, Passo D’Areia91350-170 – Porto Alegre, RS, BrasilE-mail: rogeriohortamed@gmail.com