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

Examining Associations Between Race, Gender, Alcohol Use, School Performance, and Patterns of Bullying in the School Context: A Latent Class Analysis

Although many studies addressed bullying occurrence and its associations, they often use individual variables constructed from few items that probably are inadequate to evaluate bullying severity and type. We aimed to identify involvement patterns in bullying victimization and perpetration, and its association with alcohol use, school performance, and sociodemographic variables. Baseline assessment of a randomized controlled trial were used and a latent class analysis was conducted to identify bullying patterns among 1,742 fifth-grade and 2,316 seventh-grade students from 30 public schools in São Paulo, Brazil. Data were collected using an anonymous self-reported, audio-guided questionnaire completed by the participants on smartphones. Multinomial logistic regressions were performed to verify how covariant variables affected bullying latent classes. Both grades presented the same four latent classes: low bullying, moderate bullying victimization, high bullying victimization, and high bullying victimization and perpetration. Alcohol use was associated with all bullying classes in both grades, with odds ratio up to 5.36 (95% CI 3.05; 10.38) among fifth graders from the high bullying victimization and perpetration class. Poor school performance was also strongly associated with this class (aOR = 10.12, 95%CI = 4.19; 24.41). Black/brown 5th graders were 3.35 times more likely to fit into the high bullying victimization class (95% CI 1.34; 8.37). Lack of evidence for association of sociodemographic variables and bullying latent class among seventh-grade students was found. Bullying and alcohol use are highly harmful behaviors that must be prevented. However, prevention programs should consider how racial and gender issues are influencing the way students experience violence.

[Alcohol use, family conflicts and parental supervision among high school students]

The association between alcohol consumption by students with family conflicts, parental supervision and quality of relationships was investigated. A cross-sectional study was conducted with 1,265 adolescents from 21 schools. The Brazilian version of the Drug Use Screening Inventory/DUSI was used, and absolute and relative prevalence for categorical variables was estimated, while bivariate analyses and Pearson's Chi Square test were conducted. For the magnitude of the association between the dependent and independent variables, prevalence ratios were estimated using Poisson multivariate regression. There was an association between alcohol consumption and drug use by family members, frequent discussions and parental lack of awareness about adolescents' activities. Family supervision, a good relationship with parents/guardians, establishing an affective family bond and parents' knowledge about teenagers' whereabouts, were protective factors for alcohol use. The conclusion was that the high rate of schoolchildren who consume alcohol is worrying, liable to health complications in general, and a harmonized family relationship is fundamental. The implementation of measures of intervention between school and the Family Health Strategy, can contribute to the establishment of a protective bond.

Co-occurrence of Health Risk Behaviors Among Brazilian Adolescent Victims of Family Violence

Although recent studies have related the occurrence of violence in childhood and adolescence with the adoption of health risk behaviors, there are no studies that quantify this co-occurrence among adolescent victims of family violence. Our objective was, therefore, to investigate the co-occurrence of health risk behaviors in these adolescent victims. Data from the National School Health Survey, collected in 2015, were used. Co-occurrence of risk behaviors-involvement in fights, substance use (alcohol, drugs, and tobacco), not wearing seat belts and helmets, inadequate food consumption-was analyzed using Venn diagrams, according to the victim's status and sex. The association between the four risk behaviors and victimization was investigated using multiple logistic regression. All the analyses were performed using Stata®13. We found an excess of risk behaviors among victims of family violence in both sexes. The co-occurrence of the four risk behaviors analyzed was higher among male and female adolescents, who were victims of family violence than in nonvictims. Family violence was associated with the adoption of risk behaviors, regardless of sex. This association was stronger as the number of risk behaviors adopted increased. The chance of engaging in one risk behavior was 1.32 (95% confidence interval (CI) = [0.88, 1.98]) and 1.24 (95% CI = [0.90, 1.72]) higher for boys and girls, respectively, who had suffered family violence. This increased to 7.76 (95% CI = [5.33, 11.29]) and 7.28 (95% CI = [5.20, 10.20]) when considering engagement in four risk behaviors. Identifying the prevalence of co-occurrence of health risk behaviors in vulnerable subgroups (such as victims of domestic violence) could help target broader interventions focusing on multiple risk behaviors.

A nationwide school-based study of violence in Brazil (PeNSE, 2015)

The study aims to describe victimization for domestic violence (DV), knife-related violence (KV), firearm-related violence (FV) and sexual violence (SV). This was a nationwide Brazilian survey with school-based interviews. All 9th grade students from public and private schools in Brazil were invited to participate. The sampling process was at random and cluster-based and performed in three stages: municipalities, schools, and classrooms. Univariate, bivariate and multivariate analyses were carried out considering the sample weights. A total of 100,540 individuals were assessed and the prevalence of victimization for DV, KV, FV and SV was 14.5%, 7.9%, 5.7% and 4.0%, respectively. The DV was more frequent in the South-eastern region, FV was more frequent in the Central-Western region and the KV and SV were more frequent in the Northern region. The victimization for DV and SV was higher among the girls, while the FV and KV were greater among the boys. All forms of victimization were more frequent among public school students, among those at age 16 or older, for those whose mothers have a lower educational level and those who have used alcohol or illegal drugs.

Consumo de álcool e drogas ilícitas e envolvimento de adolescentes em violência física em Pernambuco, Brasil

O objetivo foi estimar a prevalência e analisar a associação do consumo de álcool e drogas ilícitas com indicadores de violência física em adolescentes. Estudo transversal repetido com estudantes do Ensino Médio em escolas da rede pública em Pernambuco, Brasil (2006, n = 4.207; 2011, n = 6.264). Os dados foram obtidos por questionário. Os indicadores de violência física foram: vitimização por violência física; envolvimento em brigas. As variáveis independentes foram: consumo de álcool e uso de drogas ilícitas. A regressão logística binária foi utilizada para verificar a associação entre o consumo de álcool e drogas e ter sofrido violência física. A prevalência do consumo de álcool por adolescentes que sofreram violência física reduziu em cinco anos, porém, nenhuma alteração foi constatada no uso de drogas ilícitas. As variáveis comportamentais estiveram associadas aos diferentes indicadores de violência, apresentando em geral uma tendência de aumento. Em 2006, adolescentes que usavam drogas ilícitas apresentaram uma chance 2,12 maior de sofrer violência física, e em 2011 este valor foi de 2,41 (IC95%: 1,80; 3,22). A chance de adolescentes que consumiam bebida alcoólica ter envolvimento em brigas aumentou de 1,96 (IC95%: 1,64; 2,34) em 2006, para 2,11 (IC95%: 1,78; 2,51) em 2011. O consumo de álcool pelos adolescentes que sofreram violência física diminuiu em cinco anos, entretanto, o risco de os adolescentes que consumiram bebida alcoólica ou usaram drogas ilícitas sofrerem violência física aumentou ao longo de cinco anos.

[Enforcement of the Menino Bernardo Law on Networks for the Protection and Care of Children and Adolescents in Brazil]

Although many countries have passed laws to ban the use of physical violence for purported educational purposes, the World Health Organization has stated that the enforcement of such laws is still a challenge. The study thus aimed to verify whether networks in Brazil for the protection and care of children and adolescents at risk are organized to enforce the Menino Bernardo Law (Law n. 13,010/2014). Using a qualitative and exploratory approach, the study interviewed 16 professional staff members from different services in these networks in a city in the state of Rio Grande do Sul, Brazil. The data collected in the interviews were analyzed with inductive thematic analysis, resulting in four themes: (1) culturally accepted practice; (2) ignorance versus awareness of the law; (3) shortage of networks; and (4) enforcement strategies. Taken as a whole, the four themes point to non-enforcement of the Menino Bernardo Law by the networks for protection and care of children and adolescents at risk in the municipality where the study was carried out. This revealed social acceptance of resort to violence in raising children and adolescents; ignorance of the Menino Bernardo Law by the staff; and fragmentation between professional staff and the networks' services. It is thus necessary to strengthen institutional resources and staff training to improve professional development and the networks' services.

Violence against adolescents: analysis of health sector notifications, Brazil, 2011-2017

INTRODUCTION

Violence experienced in adolescence results in serious damage and suffering to society. This study aims to characterize the profile of violence victims and likely perpetrators of violence against adolescents, as well as to describe the percentage of notifying municipalities according to the federation unit.

METHODS

Cross-sectional study conducted with data on notification of violence against adolescents from the Information System for Notifiable Diseases, from 2011 to 2017. The chi-square test was used to assess the statistical significance of the differences between the proportions in the comparison between genders. Proportion ratios for the most frequent types of violence were estimated according to selected variables.

RESULTS

The notifications came from 75.4% of all the Brazilian municipalities. Physical violence predominated among males, aged 15-19 years. Psychological violence was predominant among females, between 10 and 14 years old, when perpetrated repeatedly at home by family aggressors. Sexual violence prevailed among females, aged 10 to 14 years old, in the indigenous, black and yellow races/colors, when perpetrated repeatedly at home. Negligence was more common among males, between 10 and 14 years old, when perpetrated repeatedly by family aggressors.

CONCLUSIONS

Sexual violence occurred predominantly against females and generated significant negative impacts on mental, physical, sexual and reproductive health. Community violence, perpetrated with sharp objects and firearms, were prominent among males and are important risk factors for male over-mortality. Because the problems are complex, addressing them requires intersectoral actions.

Factors associated with family violence against adolescents based on the results of the National School Health Survey (PeNSE)

The study analyzes factors associated with family aggression against adolescents. Data from the National School Health Survey for 2015 were analyzed, and the prevalence of physical aggression per family was calculated according to four blocks. The bivariate analysis was performed, calculating the unadjusted Odds Ratio (OR) within each block and the multivariate regression. Familial aggression was reported by 14.5%. The variables associated with the model were: female, black, yellow, brown, mothers with no higher educational level, adolescent workers (OR 2.10 CI 95% 1.78-2.47). In the family context, they remained associated with aggression, lack of parents "understanding" (OR 1.71 CI95% 1.63 -1.80) and their intrusion into adolescent's privacy (OR 1.80 CI95% 1.70 -1, 91). Report of missing school (OR1.43 CI95% 1.36-1.50). Among the behaviors: smoking (OR 1.23 CI95% 1.12-1.34), alcohol (OR 1.49 CI95% 1.41-1.57), drug experience (OR 1.24 CI95% 1, 15-1,33), early sexual intercourse (OR 1.40 CI95% 1.33 -1.48), reports of loneliness, insomnia and bullying (ORa 2.14 CI95% 2.00-2.30). It is concluded by the association between violence and gender, greater victimization of girls, living in unfavorable social and family contexts.

Prevalence of bullying and associated factors among Brazilian schoolchildren in 2015

This study analyzed the prevalence of bullying and associated factors among Brazilian schoolchildren using data produced by the 2015 National School Health Survey (PeNSE, acronym in Portuguese) consisting of a national sample of 102,301 eighth grade students. The prevalence of bullying was calculated and bivariate analysis was performed using a 95% confidence level to determine the association between victimization and socio-demographic variables and other variables relating to family background, mental health, and risk behaviors. Multivariate analysis was then conducted using the biologically plausible variables of interest. For the final model, variables that obtained p-values of < 0.05 were maintained. The prevalence of bullying was found to be 7.4%. The results of the multivariate analysis showed that boys aged 13 years studying in public schools who worked and whose mother did not have any schooling were more likely to be bullied, as were schoolchildren who felt lonely, had no friends, suffered from insomnia, skipped lessons without parental permission, and who smoked. Victims of bullying were predominantly 13-year-olds from an unfavorable social and family background, painting a picture of vulnerability that calls for support from social protection networks, schools and families alike .

[Peer violence, school environment and developmental contexts: its effects on well-being]

The scope of this study is to analyze the implications of peer violence in the school context, the school environment and the perceived developmental contexts on the subjective well-being of children and adolescents. The sample is comprised of 910 students in Years 6 and 7 of primary school in 27 urban and rural public and private schools in Ceará. It is a quantitative cross-sectional study and the following tools were used: scales measuring victimization and aggression among peers and the school environment; three indices on perceptions of developmental contexts (home, school, neighborhood); and three well-being scales (Students' Life Satisfaction Scale, Personal Well-being Index and Single item on Overall Life Satisfaction). Data were analyzed using multivariate variance analysis, with a significance level below 0, 01. Results indicate that bullying, alone or in interaction with the variables analyzed, is the variable that has the greatest impact on the well-being of the population studied, whereby those involved in bullying have the lowest well-being averages. Low levels of perception regarding the contexts of home, school and neighborhood and the school environment, as well as attending a public school and/or living in rural areas, are all also associated with low subjective well-being.

Uso de drogas e Bullying entre adolescentes brasileiros

RESUMO Este estudo teve como objetivo avaliar possíveis relações entre uso de drogas e envolvimento em bullying entre adolescentes. Participaram 1.192 adolescentes escolares, que preencheram um formulário de informações sociodemográficas, DUSI R e Escala de Violência Escolar. Enquanto o consumo de álcool, cocaína e algum tipo de droga (exceto álcool e tabaco) foi associado a ser autor de bullying, o uso de algum tipo de droga (exceto álcool e tabaco) esteve associado a ser alvo (vítima); o caso de ser alvo/autor mostrou-se associado ao uso de maconha. Idade, localização da escola e religião foram fatores relevantes para a ocorrência de bullying. Ter 12 anos, ser ateu e morar na zona urbana aumentaram as chances de ser vítima, enquanto ter 15 anos e habitar a zona urbana elevaram as possibilidades de ser alvo/autor de bullying, assim como ter 13 anos, as de ser autor. Estar envolvido em situações de bullying em qualquer posição se mostrou associado ao uso de drogas.

Evidences of the association between individual attributes and bullying: a cross-sectional study with adolescents from Florianópolis, Santa Catarina State, Brazil

This study aimed to estimate the prevalence of bullying and to verify the association between nutritional status, demographic and socioeconomic factors, and individual attributes among schoolchildren aged from 11 to 14 years. This is cross-sectional study with a probabilistic sample of 975 adolescents attending public and private schools in Florianópolis, Santa Catarina State, Brazil. Bullying was investigated with a self-administered questionnaire by applying Item Response Theory and dichotomized according to victimization or not. Body mass index (BMI) was classified according to the World Health Organization criteria. Data such as age, school type and location, household income, as well as the education background of the parents were collected by a questionnaire given to the parents. Crude and adjusted analyses were performed using logistic regression. The prevalence of victims of bullying and of overweight/obese adolescents was 13.2% and 29%, respectively. No association was found between bullying and age, sex, school type, mother's education, household income, and overweight/obesity. The crude analysis model indicated that overweight/obese adolescents and those with individual attributes (fat, thin, tall, short, good-looking, ugly, from a different ethnic background, rich, poor, with a disability and/or other) had a greater chance of being bullied. In the analysis model adjusted by household income and stratified by sex, boys were discriminated for being fat, good-looking, ugly, or for having a disability, while girls were discriminated for being fat, tall, short, ugly, rich, poor, among other individual attributes.

Trends in violent situations experienced by Brazilian adolescents: National Adolescent Student Health Survey 2009, 2012, and 2015

OBJECTIVE

To present trends found in the last three editions of the National Adolescent Student Health Survey (Pesquisa Nacional de Saúde do Escolar - PeNSE) on violent situations experienced by Brazilian students.

METHODS

Time-series study with a focus on the Brazilian state capitals, using PeNSE databases of 2009, 2012, and 2015. The indicators evaluated were: missing classes due to insecurity in the home-school route or at school; involvement in a fight with firearm or melee weapon; and physical assault by an adult of the family. We estimated the prevalence of indicators according to the total number of adolescents, gender, school type, and capital. Trends in prevalence were estimated by linear regression, adjusted for age.

RESULTS

We identified a trend in increasing prevalence, with statistical significance, for all selected violence indicators in the period from 2009 to 2015, in Brazilian state capitals.

DISCUSSION

The most vulnerable groups were public schools students; male adolescents for involvement in fights with melee weapons or firearms; and female adolescents for physical assault by family members.

CONCLUSION

PeNSE contributed to identifying the increase in the prevalence of violence experienced by adolescents, which alerts to the need of planning and implementing policies that help to prevent violence, and promote health and a culture of peace.

Risk and protective factors for noncommunicable chronic diseases in adolescents by race/skin color: National Adolescent School-Based Health Survey

Introduction:

The race/skin color is an important predictor of health status of the population, as well as a marker of social inequalities.

Objective:

The aim of this paper was to describe the prevalence of the main risks and the protective factors for chronic diseases in schoolchildren, according to race/skin color differences.

Methods:

Data from the National Adolescent School-Based Health Survey (2012) were used. This is a cross-sectional study carried out in public and private schools. Prevalences were calculated according to the distribution by race/skin color. Prevalence ratios adjusted for age and maternal schooling were analyzed.

Results:

White adolescents were younger, studied more frequently in private schools and had mothers with higher levels of education in comparison to the other students. Consumption of beans and fruits was higher among black, brown, and indigenous participants. Physical activity was more frequent among indigenous people. Experimentation with alcohol was higher among white adolescents. Indigenous students reported greater physical violence. Asian and black adolescents reported experiencing greater bullying.

Conclusion:

Minimizing racial and ethnic disparities in health is necessary to disease prevention and health promotion among adolescents.

Anti-bullying interventions in schools: a systematic literature review

This paper presents a systematic literature review addressing rigorously planned and assessed interventions intended to reduce school bullying. The search for papers was performed in four databases (Lilacs, Psycinfo, Scielo and Web of Science) and guided by the question: What are the interventions used to reduce bullying in schools? Only case-control studies specifically focusing on school bullying without a time frame were included. The methodological quality of investigations was assessed using the SIGN checklist. A total of 18 papers composed the corpus of analysis and all were considered to have high methodological quality. The interventions conducted in the revised studies were divided into four categories: multi-component or whole-school, social skills training, curricular, and computerized. The review synthesizes knowledge that can be used to contemplate practices and intervention programs in the education and health fields with a multidisciplinary nature.

Uso de substâncias psicoativas em adolescentes brasileiros e fatores associados: Pesquisa Nacional de Saúde dos Escolares, 2015

RESUMO: Objetivo: Analisar o uso de substâncias psicoativas (tabaco, álcool e drogas ilícitas) em escolares em relação a fatores sociodemográficos, contexto familiar e saúde mental. Métodos: Foram utilizados dados da amostra de 102.301 escolares do nono ano da Pesquisa Nacional de Saúde do Escolar de 2015. Realizou-se o cálculo da prevalência de uso de tabaco e de álcool nos últimos 30 dias e experimentação de drogas, segundo variáveis sociodemográficas, contexto familiar e saúde mental. Procedeu-se a análise univariada, por teste do χ2 de Pearson e cálculo das odds ratios (OR) não ajustadas. Por fim, realizou-se análise multivariada para cada desfecho com as variáveis que apresentaram associação com os desfechos (p < 0,20), calculando-se as OR ajustadas com intervalo de confiança de 95%. Resultados: A prevalência de uso de tabaco foi de 5,6%; do uso de álcool, 23,8%; e da experimentação de drogas, 9,0%. A análise multivariada apontou que, no contexto familiar, morar com os pais, fazer refeição com pais ou responsável e a supervisão familiar foram associados a menor uso de substâncias; enquanto faltar às aulas sem consentimento dos pais aumentou a chance de uso. Maior chance do uso de substâncias esteve ainda associada a cor branca, aumento da idade, trabalhar, sentir-se solitário e ter insônia. Não ter amigos foi associado com uso de drogas e tabaco, porém foi protetor para o uso de álcool. Conclusões: A supervisão familiar foi protetora do uso de substâncias psicoativas em escolares brasileiros, enquanto trabalhar, sentir-se solitário e ter insônia aumentaram suas chances de uso.

[Alcohol consumption and physical violence among adolescents: which is the predictor?]

The scope of this integrative review was to investigate the association between alcohol consumption and physical violence in the literature, with an emphasis on identifying the predictor between them. A search was conducted in the Lilacs, Medline and SciELO databases, adopting "violence," "alcohool drinking" and "adolescent" as descriptors. It included articles published between 2005 and 2014 that analyzed the association between alcohol consumption and physical violence using multivariate analysis. Of the total of 1667 articles located, 29 met the inclusion criteria. Alcohol consumption was investigated more as a predictor of involvement in physical violence when the teenager is the perpetrator or the victim of violence, with a significant association found in 19 studies. However, when victimization was investigated as a predictor (7 studies), most of these (6) revealed no significant association with the intake of alcoholic beverages. The consumption of alcohol has proven to be the predictor of physical violence for both the teen perpetrator and for the adolescent victim of violence. However, having been the victim of violence in childhood and adolescence may also lead adolescents to alcohol consumption.

Epidemiological profile of care for violence in public urgency and emergency services in Brazilian capital, Viva 2014

Injuries and deaths resulting from violence constitute a major public health problem in Brazil. The article aims to describe the profile of calls for violence in emergency departments and emergency Brazilian capitals. This is a descriptive study of Violence and Accident Surveillance System (VIVA), carried out in public emergencies Brazilian cities, from September to November 2014, a total of 4406 calls for aggression. We considered the following categories of analysis: 1) sociodemographic characteristics (gender, age, race / skin color, education, place of residence, vulnerability, alcohol intake); 2) Event feature (probable author, nature and means of aggression); and characteristics of care (getting to the hospital, prior service, evolution). Of the total calls for violence (n = 4406), the highest prevalence was among young people 20-39 years (50.2%), male, black and low education. As for the event characteristics it stands out that 87.8% were physical assaults; 46.3% cut/laceration and 13.7% involved a firearm. The results point to the need to strengthen intersectoral actions to expand the network of care and protection.

Bullying during adolescence in Brazil: an overview

Bullying has been the subject of worldwide study for over four decades and is widely reported by social media. Despite this, the issue is a relatively new area of research in Brazil. This study analyzes academic literature addressing bullying produced in Brazil focusing on aspects that characterize this issue as a subtype of violence: gender differences, factors associated with bullying, consequences, and possible intervention and prevention approaches. The guiding question of this study was: what have Brazilian researchers produced regarding bullying among adolescents? The results show that over half of the studies used quantitative approaches, principally cross-sectional methods and questionnaires, and focused on determining the prevalence of and factors associated with bullying. The findings showed a high prevalence of bullying among Brazilian adolescents, an association between risk behavior and bullying, serious consequences for the mental health of young people, lack of awareness and understanding among adolescents about bullying and its consequences, and a lack of strategies to manage this type of aggression. There is a need for intervention studies, prevention and restorative practices that involve the community and can be applied to everyday life at school.

Substance Use among Adolescents Involved in Bullying: A Cross-Sectional Multilevel Study

Being involved in bullying as a victim or perpetrator could have deleterious health consequences. Even though there is some evidence that bullies and victims of bullying have a higher risk for drug use, less is known about bystanders. The aim of this research was to study the association between bullying experience (as victims, bullies, or bystanders) and substance use. We gathered complete information from a nationally representative sample of 36,687 students (51.4% female) attending 756 schools in Chile. We used a self-reported questionnaire which was developed based on similar instruments used elsewhere. This questionnaire was piloted and presented to an expert panel for approval. We used multilevel multivariate logistic regression analyses, controlling for several variables at the individual (e.g., school membership, parental monitoring) and school levels (e.g., school type, school denomination). This study shows that bullies and bully-victims have a high risk for cigarette, alcohol, and cannabis use than bystanders. This is one of the few studies exploring the association between witnessing bullying and substance use. These findings add new insights to the study of the co-occurrence of bullying and substance use. Other factors, such as higher academic performance, stronger school membership, and better parental monitoring reduced the risk of any substance use, while the experience of domestic violence and the perception of social disorganization in the neighborhood, increased the risk. These findings may help the design of preventive interventions.

Bullying e fatores associados em adolescentes da Região Sudeste segundo a Pesquisa Nacional de Saúde do Escolar

RESUMO: Objetivo: Estimar a prevalência de bullying, sob a perspectiva da vítima, em escolares da Região Sudeste e analisar sua associação com variáveis individuais e de contexto familiar. Métodos: Analisadas informações de 19.660 adolescentes da Pesquisa Nacional de Saúde do Escolar (PeNSE), calculando-se associação entre bullying e variáveis sociodemográficas, comportamentos de risco, saúde mental e contexto familiar. Foram realizadas análises multivariadas e efetuado cálculo odds ratio (OR), com respectivos valores de intervalo de confiança (IC95%). Resultados: A prevalência de bullying foi de 7,8% (IC95% 6,5 - 9,2). Após o ajuste, foi constatada a sua associação com: os escolares menores de 13 anos (OR = 2,40; 1,4 - 3,93) (p < 0,001); a proteção para estudantes de 14, 15 e 16 anos (p < 0,0001); o sexo masculino (OR = 1,47 IC95% 1,35 - 1,59); a cor preta (OR = 1,24 IC95% 1,11 - 1,40); a cor amarela (OR = 1,38 IC95% 1,14 - 1,6); os alunos de escola privada (OR = 1,11 IC95% 1,01 - 1,23) e os alunos que trabalham (OR = 1,30 IC95% 1,16 - 1,45). Maior escolaridade das mães mostrou-se fator protetor em todas as faixas. Foram considerados de risco: sentir-se sozinho (OR = 2,68 IC95% 2,45 - 2,94), ter insônia (OR = 1,95 IC95% 1,76 - 2,17), não ter amigos (OR = 1,47 IC95% 1,24 - 1,75), sofrer agressão física dos familiares (OR = 1,83 IC95% 1,66 - 2,03), faltar às aulas sem avisar aos pais (OR = 1,23 IC95% 1,12 - 1,34), além de supervisão familiar (OR = 1,14 IC95% 1,05 - 1,23). Como fator de proteção, ter bebido nos últimos 30 dias (OR = 0,88 IC95% 0,8 - 0,97). Conclusão: O bullying amplia as vulnerabilidades entre escolares, o que sugere necessidade de uma abordagem intersetorial na busca de medidas para sua prevenção.

Involvement of school students in fights with weapons: prevalence and associated factors in Brazil

Background

Violence, as well as other behaviors, is often intensified during adolescence and early adulthood. The objective of this study is estimate the prevalence of Brazilian school students involvement in fights with weapons and to analyze the associated factors.

Methods

This is a cross-sectional study using data from the National School Student Health Survey conducted in 2012 with 9^th grade elementary school students attending 2842 schools in all 27 Brazilian Federative Units. The outcome studied was involvement in fights with firearms and/or cold weapons in the 30 days prior to the interview. Poisson regression was used to estimate the prevalence ratios and 95 % confidence intervals (95 % CI). The analyses were stratified by sex.

Results

Fifty seven thousand and eighty nine female students and 52,015 male students were included; the prevalence of their involvement in fights with weapons was 7.2 (95 % CI 6.9–7.5) and 13.8 (95 % CI 13.4–14.3), respectively. In the adjusted analysis the factors associated with male student involvement in fights with weapons were: being older, working, having smoked a cigarette, consumed alcoholic beverages and illicit drugs recently, insomnia, not having any close friends, skipping classes without parental supervision, having suffered aggression from a family member, reporting feeling unsafe on the way to or from school and/or at school. The same associated factors were found among female students in addition to not living with their father and/or mother and having suffered bullying. There was no association with type of school in either sex.

Conclusion

Involvement in fights with weapons was greater among older male students. Health-risk behaviors, mental health characteristics, parental supervision and context of violence also showed association with the outcomes.

Factors associated with injuries in adolescents, from the National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE

To estimate the prevalence of injuries among teenagers and to examine the associated risk factors, such as sociodemographic characteristics, risk behaviors, family ties and other factors.

METHOD

The prevalence of the outcome (injury) was estimated with a 95%confidence interval. In order to verify factors associated with the injury, a bivariate analysis was made with estimated odds ratio (OR) and its respective confidence intervals. Then, a multivariate analysis was carried out, only with variables whose descriptive level was equal to or lower than 5% (p < 0.05) remaining in the model.

RESULTS

The study of injury in adolescents, based on the data from the National Adolescent School-based Health Survey (PeNSE), pointed out that 10.3% of the teenagers suffered severe injuries in the past 12 months, such as cuts or perforations, broken bones or dislocated joints. The following variables remained independently associated with "suffering severe injuries": being a male teenager; black, mulatto or indigenous race/color and working. Factors related to family ties are significant when the relations are fragile amongst members: adolescents that are injured the most are the ones who suffer most aggressions at home, who skip classes without notifying their parents, those who do not live with their parents and have low family control. The most relevant aspects of mental health are insomnia and loneliness. The factors associated to the exposure to situations of violence that remained in the model were: insecurity in school and in the route home-school; getting a ride with someone inebriated; drinking and driving motorized vehicles; not wearing the seatbelt; not wearing a helmet and being bullied. Among the factors of individual behavior, the following can be emphasized: use of alcohol, cigarettes, trying illicit drugs and early sexual intercourse.

CONCLUSION

The analysis of the determinants for suffering injuries in childhood and adolescence shows the complex relationship between associated factors, which points to the need for action towards several aspects to reduce social inequalities, strengthen family ties and prevent violent contexts and individual risk factors.

Bullying and associated factors among Brazilian adolescents: analysis of the National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE

To estimate the prevalence of bullying from the victim's perspective in Brazilian school children and to analyze its association with individual and family context variables.

METHODS

An analysis of the data on 109,104 adolescents, obtained by the National Adolescent School-based Health Survey, held in schools in 2012, was carried out. An association model between bullying and explanatory variables was tested in different contexts: sociodemographic, risk behaviors, mental health and family context. Univariate and multivariate analyzes were performed, calculating the Odds Ratio and confidence intervals.

RESULTS

The prevalence of bullying found in this study was of 7.2% (95%CI 6.6 - 7.8). A higher chance of bullying was found among male students (OR = 1.58; 95%CI 1.51 - 1.66), with an inverse relation between age and bullying, with the magnitude of risk among adolescents younger than 13 years of age being higher when compared to those with 16 years of age or more. Of individual risk behaviors, only being a smoker remained in the final model (OR = 1.11; 95%CI 1.01 - 1.23). Mental health variables associated with bullying were: feeling lonely (OR = 2.66; 95%CI 2.52 - 2.81), insomnia (OR = 1.92; 95%CI 1.80 - 2.05), not having friends (OR = 1.71; 95%CI 1.54 - 1.89), and, in the family context, those who skip class without telling their parents (OR = 1.13; 95%CI 1,07 - 1,19) and those who suffer physical abuse by family members (OR = 2.03; 95%CI 1.91 - 2.146).

CONCLUSION

Bullying was associated to male students, younger, of black color, smokers, with mental health vulnerabilities and victims of domestic violence. This suggests the need for a holistic approach from education and health professionals, parents and the community in seeking measures for the prevention of bullying.

FACTORS ASSOCIATED WITH VIOLENCE IN SCHOOLS: EXTENDING KNOWLEDGES AND PRACTICES FOR NURSING

ABSTRACT This study aimed to identify the factors associated with violence among students of public schools located in the central region of Rio Grande do Sul. It is an observational, transversal and analytical study. The sample was made up of 435 students aged from 10 to 19 years old. The data were collected through a structured questionnaire applied via interview. Associations between the dependent and independent variables were taken from the Poisson regression model. Once analyzed, the data evidenced greater prevalence between violence and the following variables: male sex, larger number of siblings, and a low income; while religion was associated as an indicator of protection for psychological violence. It is concluded that interdepartmental, interdisciplinary and multidimensional approaches constitute an important strategy for promoting health and reducing violence in schools, above all in communities with indicators of vulnerability. Specific strategies for the work of the nurse are indicated for preventing risks associated with violence.

Características da violência escolar no Brasil: revisão sistemática de estudos quantitativos

Objetivos: dimensionar e identificar fatores associados à violência escolar no Brasil descritos na literatura. Métodos: foram selecionados artigos com dados quantitativos sobre violência escolar no Brasil e indexados nas bases de dados SciELO, LILACS e PubMed, até maio de 2013, sem restrição temporal para o início. A seleção de artigos e a extração dos dados foram realizadas de modo independente por duas pesquisadoras e as inconsistências resolvidas por consenso. Resultados: vinte e quatro estudos cumpriram os critérios de inclusão. A maioria destes foi desenvolvida com alunos do ensino fundamental em escolas públicas localizadas no Sul e no Sudeste brasileiro e durante os anos 2000. A definição de violência escolar e as modalidades estudadas diferiram entre os artigos analisados. A violência psicológica e a física foram as mais abordadas. O bullying destacou-se como modalidade específica da violência escolar. Ser do sexo masculino e ter vivenciado situações de violência na família foram os fatores mais freqüentemente associados à violência escolar. Conclusões: a presente revisão detectou poucos estudos quantitativos sobre violência em escolas brasileiras, sobretudo entre professores. É necessário estabelecer critérios para o estudo desse fenômeno, que permitam comparação de sua ocorrência no tempo e no espaço.

Psychoactive substance use, family context and mental health among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE: To evaluate the association between the consumption of psychoactive substances (tobacco, alcohol and illicit drugs) and demographic variables, mental health and family context among school-aged children. METHODS: The National Adolescent School-based Health Survey was held with a national sample of 109,104 students. Data regarding demographic variables, family background and mental health were collected. Logistic regression was used to evaluate the associations of interest. RESULTS: Multivariate analyses showed that alcohol consumption was higher among girls, drug experimentation was more frequent among boys and that there was no difference between sexes for smoking. Being younger and mulatto were negatively associated with the use of tobacco, alcohol and illicit drugs. Also negatively associated with such risk behaviors were characteristics of the family context represented by: living with parents, having meals together and parental supervision (when parents know what the child does in their free time). Moreover, characteristics of mental health such as loneliness and insomnia were positively associated with use of tobacco, alcohol and illicit drugs. Not having friends was positively associated with use of tobacco and illicit drugs and negatively associated with alcohol use. CONCLUSIONS: The study shows the protective effect of family supervision in the use of tobacco, alcohol and drugs and, on the contrary, the increasing use of substances according to aspects of mental health, such as loneliness, insomnia and the fact of not having friends. The study's findings may support actions from health and education professionals, as well as from the government and families in order to prevent the use of these substances by adolescents.