[Telephone counseling for young users of crack cocaine]. / Aconselhamento telefônico para jovens usuários de crack.

This study seeks to evaluate the use of Brief Motivational Intervention in a telephone counseling service offered to young people in the process of cessation of crack cocaine use. A descriptive study was conducted based on a survey of the records of callsfrom users during the period January 2006 to December 2007. The researchers included 40 recordsfrom calls of young people aged between 16 and 24 years who consumed crack cocaine, associated or not with other substances. At the end of the six-month follow up, 65% of youths had stopped the consumption of crack cocaine. Of the total, 57.5% were in stage of preparation and action on the first call. The chances of relapse to crack cocaine use were higher in follow-ups to 30 days. The conclusion suggests that the association of IBM with telephone counseling is an important treatment option in cessation of crack cocaine use.

Role of Parenting Styles in Adolescent Substance Use Cessation: Results from a Brazilian Prospective Study.

BACKGROUND: This study aims to identify the association between parenting styles and behavioral changes among adolescents regarding the consumption of alcohol, tobacco, cannabis, cocaine/crack. METHODS: A group of ninety-nine adolescents (39 girls and 60 boys), aged 14 to 19 years (17.05 ± 1.51), who called in to a call center that provides counseling to substance users, was followed-up for 30 days. Data collection occurred between March 2009 and October 2015. The adolescents answered questions regarding parental responsiveness and demanding nature on a scale to assess parental styles and provided sociodemographic data, substance abuse consumption characteristics, and the Contemplation Ladder scale score. RESULTS: The parental styles most reported by the adolescents were authoritative (30%) and indulgent (28%). Children who perceived their mothers as having an indulgent style and who had absent fathers presented more difficulties in making behavioral changes to avoid alcohol and cocaine/crack consumption. CONCLUSION: The study found that parent-child relationships were associated with a lack of change in the adolescent regarding substance use behavior, particularly the consumption of alcohol and cocaine/crack.

CBI-20: Psychometric Properties for the Coping Behaviors Inventory for Alcohol Abuse in Brazil.

For any professional, it is of crucial importance to know not only how coping styles and strategies are present in an individual, but to know about its role to the treatment of alcohol abuse. Moreover, new approaches have emerged in this area in terms of relapse prevention and the counseling by phone can be an alternative. The aim of this study is to examine the factor structure of the Coping Behaviors Inventory (CBI) and to test its invariance across groups face-to-face and phone counseling in Brazil. For this purpose, two studies were carried out: study I, the factor structure was revisited in terms of exploratory factor analysis. Study II, face-to-face and phone counseling were examined through confirmatory factor analysis and multigroup analysis. The results confirmed the 4-factor solution with a revised model for the removal of 16 items. Thus presented, a reduced version with better indexes than the previous versions developed over the last 30 years that was ones reformulated from 60 items. The Internal consistency for study I presented α = 0.90 and homogeneity was between 0.17 and 0.5). In addition the KMO = 0.9 = 0.932, X ( df = 630 ) 2 = 6091.94, p < 0.0 < 0.001. In study II, cronbach's alpha = 0.91 and homogeneity 0.23-0.61 (telemedicine treatment) and α = 0.90 0.17 to 0.63 (face-to-face treatment). In the CFA, the examination of the current version has better fit than the that the traditional model. Moreover, the new version showed convergent validity with the IDHEA questionnaire. In the multigroup analysis no significant changes between groups to a metric level. Finally, the Brazilian version of inventory showed no differences between the phone counseling and face-to-face participants in a metric level after a multigroup analysis.

Dropout Prevalence and Associated Factors in Randomized Clinical Trials of Adolescents Treated for Depression: Systematic Review and Meta-analysis.

PURPOSE: Depression currently affects 350 million people, and its prevalence among adolescents is 4% to 8%. Adolescents who abandon antidepressant treatment or drop out of clinical trials are less likely to recover or experience a remission of symptoms because they are not being followed up by a medical team. The objective of this study was to analyze the dropout rates of randomized clinical trials of depressed adolescents receiving treatment with antidepressant drugs and the factors associated with nonadherence by summarizing this information in a systematic review and meta-analysis. METHODS: Articles were retrieved from MEDLINE, EMBASE, Cochrane, Clinical Trial, PsycINFO, and Web of Science using the MeSH terms "depressive disorder," "randomized trials," and "adolescents." The evaluation of study quality was performed by using the Cochrane Handbook for Systematic Reviews of Interventions and the Jadad scale. FINDINGS: The final sample included 50 articles, of which 44 presented dropout rates. The overall dropout prevalence was 23% (95% CI, 20-27; P < 0.0001). Participants aged ≥16 years, those treated with serotonin norepinephrine reuptake inhibitors, and those receiving medication only exhibited the highest dropout prevalence, respectively (33% [95% CI, 27-39], 45% [95% CI, 31-64], and 15% [95% CI, 13-17]). The adverse effects most associated with dropout were attempted suicide followed by mania, skin rash, and headache. Problems relating to clinical trials and family arbitration were also related with dropout. IMPLICATIONS: Serotonin/norepinephrine reuptake inhibitor treatment, adolescent age >16 years, and receiving medication were the only factors demonstrating a higher association with dropout rates. Selective serotonin reuptake inhibitors were linked to the lowest prevalence, probably due to fewer perceived problems with related adverse effects and higher efficacy in adolescents. Cognitive-behavioral therapy combined with pharmacotherapy produced a lower nonadherence prevalence; this approach can be an alternative to avoid dropouts and relapse. Prospero identifier: CRD42014013475.

Sexualidade infantil: a percepção de professores de uma escola do município de Osório/RS / Child sexuality: the perception of teachers of a school in the municipality of Osório/RS

RESUMO Este estudo teve por objetivo analisar a percepção de professores da educação infantil acerca da sexualidade na infância. Delineou-se uma pesquisa descritiva, exploratória, de cunho qualitativo. Utilizou-se do Grupo Focal (GF) como método de coleta de dados. Dentre os instrumentos utilizados na coleta, fizeram-se presentes a observação-participante, o questionário sociodemográfico e o roteiro de entrevista semiestruturado, elaborado pelos autores. Para a análise dos resultados, recorremos à Análise de Conteúdo (AC) de Bardin. Os resultados apontaram para a presença da sexualidade no dia a dia da educação infantil, deficiências na formação e não contemplação do tema nas formações continuadas ofertadas pelo município.

ABSTRACT This study aimed to analyze the perception of teachers of early childhood education about sexuality in childhood. A descriptive, exploratory, qualitative research was delineated. The Focus Group (FG) was the method used for data collection. Among the instruments used in the gathering were the participant observation, the sociodemographic questionnaire and semi-structured interview script, all elaborated by the authors. For the analysis of the results, we used Bardin's Content Analysis (CA). The results pointed to the presence of sexuality in the daily education of children, deficiency in formation and the non-contemplation of the theme in the continuing education offered by the town.

Family functioning and health issues associated with codependency in families of drug users.

UNLABELLED: Substance abuse affects both the user and the family system as a whole, yet substance abuse treatment is centered on the user, leaving the family in the background. OBJECTIVE: To identify the symptoms of codependency and health issues in the codependent family members of drug users who called a toll-free telephone counseling service. In total, 505 family members participated in this cross-sectional study. Drug users' mothers and wives who had less than 8 years of education and those who were unemployed had a greater chance of high codependency. It was also determined that a high level of codependency imposed a significant burden on the physical and emotional well-being of those affected, resulting in poor health, reactivity, self-neglect and additional responsibilities. It was concluded that codependency has a negative impact on the family system and on the health of the family members of drug users.

Non-adherence to telemedicine interventions for drug users: systematic review.

OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence.

Assessment of changes in nicotine dependence, motivation, and symptoms of anxiety and depression among smokers in the initial process of smoking reduction or cessation: a short-term follow-up study.

INTRODUCTION: The first days of a quit attempt represent an important challenge to long-term abstinence, especially because of the changes that take place over this period. OBJECTIVE: To examine whether smokers who have recently changed their smoking behavior show changes in the intensity of nicotine dependence, motivational stage, or symptoms of anxiety and depression relative to smokers without recent changes in smoking behavior. METHODS: Smokers attending a support group for smoking cessation in Porto Alegre, southern Brazil, were invited to participate. The program consisted of four weekly sessions. Smokers answered questionnaires covering intensity of nicotine dependence, stage of motivation, and symptoms of anxiety and depression at baseline and in the fourth week. Urine was collected at both time points, tested for cotinine concentration, and used to determine the final status of smokers. RESULTS: Of the 54 smokers included in the study, 20 (37%) stopped smoking or decreased tobacco use. Both smokers who stopped or reduced tobacco use and those who did not change their behavior presented a decrease in nicotine dependence scores (p = 0.001). Conversely, only the smokers who changed behavior presented an increase in scores in the maintenance stage (p < 0.001). CONCLUSION: When modifying tobacco use, smokers face a difficult process, marked by several changes. A better understanding of these changes and their implications for treatment are discussed.

Family functioning and health issues associated with codependency in families of drug users / Funcionamento familiar e questões de saúde associados com codependência em familiares de usuários de drogas

Abstract Substance abuse affects both the user and the family system as a whole, yet substance abuse treatment is centered on the user, leaving the family in the background. Objective: To identify the symptoms of codependency and health issues in the codependent family members of drug users who called a toll-free telephone counseling service. In total, 505 family members participated in this cross-sectional study. Drug users’ mothers and wives who had less than 8 years of education and those who were unemployed had a greater chance of high codependency. It was also determined that a high level of codependency imposed a significant burden on the physical and emotional well-being of those affected, resulting in poor health, reactivity, self-neglect and additional responsibilities. It was concluded that codependency has a negative impact on the family system and on the health of the family members of drug users.

Resumo A dependência química atinge o usuário e o sistema familiar como um todo, todavia o tratamento dessa condição é centrado no usuário, o que deixa a família em segundo plano. Objetivo: identificar os sintomas de codependência e questões de saúde em familiares codependentes de usuários de drogas que ligaram para um serviço telefônico de aconselhamento. No total, 505 familiares participaram de um estudo transversal. Mães e esposas de usuários de drogas que tinham menos de 8 anos de estudo e que estavam desempregadas apresentaram maior chance de alta codependência. Além disso, foi identificado que o nível alto de codependência interfere significativamente no bem-estar físico e emocional dos familiares, o que resultou em problemas de saúde, reatividade, autonegligência e sobrecarga de tarefas. Foi concluído que a codependência tem um impacto negativo no sistema familiar e na saúde dos familiares de usuários de drogas.

Brief Motivational Intervention and telemedicine: a new perspective of treatment to marijuana users.

The main purpose of this study was to evaluate the telephone Brief Motivational Intervention (BMI) efficacy in marijuana consumption cessation. A clinical trial was performed on Brazilian citizens, who were randomly divided into experimental (BMI) and minimal intervention (reference material) treatment groups; the study involved 524 participants who were monitored for 6 months. In addition, the data was collected by a free-service call center; both marijuana consumption and level of motivation for behavior change were evaluated, based on the telephone service offered. The proportion of abstainers in the BMI group was significantly greater than in the control group: 73% of the individuals in the BMI group were abstainers. In the control group, 59% of them ceased on using marijuana. The ratio of probability for marijuana cessation was 1.6 times higher in the BMI group. There was no significant difference on the motivation for behavior change in both groups. The collected data demonstrated the telephone BMI's positive efficacy in marijuana consumption cessation.

Non-adherence to telemedicine interventions for drug users: systematic review / Não adesão em intervenções por telemedicina para usuários de drogas: revisão sistemática

OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence. .

OBJETIVO Estimar taxas de não adesão em intervenções com estratégias de telemedicina para tratamento de dependência química. MÉTODOS Foi realizada revisão sistemática de ensaios clínicos randomizados com diferentes métodos terapêuticos de dependência química que incluíam telemedicina. Foram consultadas as bases de dados PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase e Clinical Trials e a plataforma Google Scholar no período de 18/4/2012 a 21/6/2012. Para avaliar a qualidade dos estudos, utilizou-se a escala Grading of Recommendations Assessment, Development and Evaluation . Os critérios avaliados foram: adequada sequência da geração de dados, ocultação da alocação, cegamento, descrição das perdas e exclusões e análises por intenção de tratar. Foram selecionados 274 estudos, dos quais 20 foram analisados. RESULTADOS As taxas de não adesão variaram entre 15,0% e 70,0%. As intervenções avaliadas possuíam no mínimo três meses de intervenção e, embora todos utilizassem a telemedicina como apoio, os métodos de tratamentos foram diferentes. Em relação à qualidade dos estudos, os valores também variaram entre muito baixa qualidade e alta qualidade. Os estudos com qualidade alta demonstraram maiores taxas de adesão, bem como aqueles que utilizaram mais de uma técnica de intervenção e tempo limitado de tratamento. Estudos com monousuários apontaram maiores taxas de adesão que estudos com poliusuários. CONCLUSÕES As taxas de não adesão a tratamentos para usuários de substâncias psicoativas por meio de telemedicina apresentaram consideráveis diferenças, dependendo do país, método da intervenção, tempo de seguimento ...

Estresse em adolescentes: estudo com escolares de uma cidade do sul do Brasil / Stress in adolescencents: a study with schoolars from a city in southern Brazil

Estudo analítico transversal com objetivo de avaliar a prevalência e os fatores associados ao estresse em adolescentes escolares de Canoas/RS. Participaram do estudo 475 adolescentes, de 14 a 18 anos, que responderam a Escala de Stress para Adolescentes (ESA) e a um questionário sobre dados sociodemográficos, relações familiares, sexualidade, uso de drogas e comportamento de risco. Os resultados apontaram prevalência de estresse de 10,9 %. Além do ambiente familiar, os fatores associados a níveis mais elevados de estresse foram 'achar possível contrair AIDS', 'ter sofrido acidente no último ano', 'não ter usado camisinha na primeira e na última transa' e 'já ter tido alguma DST'. Conclui-se que especialmente o ambiente familiar e as práticas sexuais são significativos ao aumento de estresse em jovens e, portanto, necessitam de intervenções que promovam comportamentos saudáveis para esta população.(AU)

Study with analytic cross sectional design that aimed to evaluate the prevalence and associated factors related to stress in school adolescents from the city of Canoas/RS. The sample consisted of 475 adolescents, aged 14-18 years, who answered the Stress Scale for Adolescents and a questionnaire about socio-demographic data, family relations, sexuality, drug use and risk behavior. The results revealed 10.9% of stress prevalence in the adolescents. Besides the family environment, factors associated with higher levels of stress were 'possibility to contract AIDS', 'having suffered an injury in the last year', 'have not used a condom in the first and in last sex intercourse' and 'have had an STD'. In conclusion, the family environment and sexual practices are especially significant to the increased stress in the studied adolescents and therefore require interventions that promote healthy behaviors for this population.(AU)

Assessment of changes in nicotine dependence, motivation, and symptoms of anxiety and depression among smokers in the initial process of smoking reduction or cessation: a short-term follow-up study / Avaliação de mudanças na dependência da nicotina, motivação e sintomas de ansiedade e depressão em fumantes no processo inicial de redução ou cessação do tabagismo: estudo de seguimento de curto prazo

Introduction: The first days of a quit attempt represent an important challenge to long-term abstinence, especially because of the changes that take place over this period. Objective: To examine whether smokers who have recently changed their smoking behavior show changes in the intensity of nicotine dependence, motivational stage, or symptoms of anxiety and depression relative to smokers without recent changes in smoking behavior. Methods: Smokers attending a support group for smoking cessation in Porto Alegre, southern Brazil, were invited to participate. The program consisted of four weekly sessions. Smokers answered questionnaires covering intensity of nicotine dependence, stage of motivation, and symptoms of anxiety and depression at baseline and in the fourth week. Urine was collected at both time points, tested for cotinine concentration, and used to determine the final status of smokers. Results: Of the 54 smokers included in the study, 20 (37%) stopped smoking or decreased tobacco use. Both smokers who stopped or reduced tobacco use and those who did not change their behavior presented a decrease in nicotine dependence scores (p = 0.001). Conversely, only the smokers who changed behavior presented an increase in scores in the maintenance stage (p < 0.001). Conclusion: When modifying tobacco use, smokers face a difficult process, marked by several changes. A better understanding of these changes and their implications for treatment are discussed.

Introdução: Os primeiros dias de uma tentativa de parar de fumar representam um desafio importante para a abstinência a longo prazo, especialmente por causa das mudanças que ocorrem nesse período. Objetivo: Examinar se fumantes que mudaram recentemente seu hábito de fumar mostram mudanças na intensidade da dependência à nicotina, no estágio motivacional ou nos sintomas de ansiedade e depressão em comparação com fumantes sem mudanças recentes em seu hábito de fumar. Métodos: Fumantes participando de um grupo de apoio para a cessação do tabagismo em Porto Alegre, sul do Brasil, foram convidados a participar do estudo. O programa consistia de quatro sessões semanais. Os fumantes responderam a questionários que avaliaram a intensidade da dependência à nicotina, o estágio motivacional e sintomas de ansiedade e depressão no início do programa e na 4ª semana. Amostras de urina foram coletadas nos dois momentos para avaliar a concentração de cotinina para determinar o status final dos fumantes. Resultados: Dos 54 fumantes incluídos no estudo, 20 (37%) pararam de fumar ou reduziram o uso de tabaco. Tanto os fumantes que pararam ou reduziram o uso de tabaco quanto aqueles que não mudaram seu hábito apresentaram diminuição nos escores de dependência à nicotina (p = 0,001). Por outro lado, apenas os fumantes que mudaram seu hábito apresentaram aumento nos escores do estágio de manutenção (p < 0,001). Conclusão: Ao modificar o uso de tabaco, os fumantes enfrentam um processo difícil, marcado por várias mudanças. Um melhor entendimento dessas mudanças e suas implicações para o tratamento são discutidas.

Abuso e dependência de maconha: comparação entre sexos e preparação para mudanças comportamentais entre usuários que iniciam a busca por tratamento / Cannabis abuse and dependency: differences between men and women and readiness to behavior change among users seeking treatment

OBJETIVOS: Descrever o perfil sociodemográfico de usuários de maconha que iniciam tratamento e comparar os sexos dos indivíduos em relação aos estágios de prontidão para mudança e uso associado de outras drogas. MÉTODO: Estudo transversal descritivo, com amostra não probabilística de indivíduos que ligaram para um teleatendimento especializado em dependência química. RESULTADOS: A amostra se constituiu de 72 por cento de indivíduos do sexo masculino na faixa etária de 12 a 25 anos. Um percentual de 85,5 por cento fazia uso associado de outras drogas. O estágio motivacional predominante foi de ação (56 por cento), sem diferenças entre sexos (p = 0,4). Os homens mais frequentemente procuraram auxílio para o tratamento do uso de maconha. CONCLUSÕES: Com base nesses dados, foi possível delinear o perfil dos usuários de maconha para auxiliar no direcionamento de informações e atendimento adequado.

OBJECTIVES: To describe the social and demographic profile of cannabis users seeking treatment and to compare differences between sex in relation to readiness to behavior change and in relation to associated use of marijuana and other drugs. METHOD: A cross-sectional, descriptive study including a nonprobability sample of individuals who called a chemical dependency hotline. RESULTS: The sample comprised 72 percent male individuals aged between 12 and 25 years. The sample was composed by 85.5 percent used other drugs in association with cannabis. The action stage was the most frequent stage of readiness to behavior change observed, in 56 percent of the callers, with no differences between sex (p = 0.4). Men more frequently sought treatment for the use of cannabis. CONCLUSIONS: Our findings allowed delineating a profile of cannabis users, so as to better guide the provision of adequate information and treatment services.