Community and domestic violence are associated with DNA methylation GrimAge acceleration and heart rate variability in adolescents.

Background: Cumulative exposure to violence can change the regulation of epigenetic and physiological markers. Although violence has been associated with accelerated cellular aging, little is known about associations with cardiac autonomic activity.Objective: The current study aimed to investigate the relationship of exposure to community and domestic violence (CDV) with vagal activity and epigenetic aging acceleration.Methods: A total of 86 adolescents (57% female) were evaluated and interviewed at two time-points in São Gonçalo (2014-2019), a Brazilian city with high levels of violence. Exposure to CDV was assessed in both time-points. GrimAge acceleration was calculated from saliva DNA methylation using Infinium HumanMethylation450K (Illumina) collected in the first assessment. Heart rate variability (HRV) was collected during two stress tasks at the second assessment.Results: The exposure to violence witnessed or directly experienced at home and in the community increased significantly (t = 4.87, p < .01) across two-time points, and males had reported higher violence exposure (t = 2.06, p = .043). Violence at 1st assessment was significantly associated with GrimAge acceleration (B = .039, p value = .043). Violence at both assessments were associated with HRV measured during the narration of the worst trauma (traumaHRV) (B = .009, p value = .039, and B = .007, p value = .024, 1st and 2nd assessment respectively). GrimAge acceleration was significantly associated with traumaHRV (B = .043, p value = .049), and HRV measured during a 3D roller coaster video (B = .061, p value = .024).Conclusions: We found relevant evidence that experiencing violence during adolescence is associated with epigenetic aging and stress-related vagal activity. Understanding these factors during this period could contribute to the development of early interventions for health promotion.HIGHLIGHTS Higher exposure to Community and domestic violence is associated with increased GrimAge acceleration.Higher GrimAge acceleration is associated with increased stress-related vagal activity.Exposure to community and domestic violence increased significantly over time.

Assessment of Attentional Functioning in Health Professionals of a Brazilian Tertiary Referral Hospital for COVID-19.

This study is aimed at assessing differences in basic attentional functioning between substantial and minimal work-related exposure to COVID-19 patients in professionals working in a tertiary referral hospital in Rio de Janeiro, Brazil. Therefore, hospital employees performed a Continuous Visual Attention Test. This test consisted of a 90-second Go/No-Go task with 72 (80%) targets and 18 (20%) nontargets. For each participant, reaction time and intraindividual variability of reaction times of all correct target responses, as well as the number of omission and commission errors, were evaluated. Participants were divided into 2 groups based on their exposure to COVID-19 patients (substantial versus minimal exposure). The substantial exposure group consisted of participants with 24 hours/week or more direct contact with COVID-19 patients. This cut-off was based on the clear division between professionals working and not working with COVID-19 patients and considered that 12-hour and 24-hour daily shifts are common for hospital employees in Brazil. A MANCOVA was performed to examine between-group differences, using age, sleep quality, sex, education level, previous COVID-19 infection, and profession as covariates. Of 124 participants, 80 had substantial exposure and 44 had minimal exposure to COVID-19. The overall MANCOVA reached statistical significance (P = 0.048). Post hoc ANCOVA analysis showed that the substantial exposure group had a statistically significantly higher intraindividual variability of reaction time of all correct target responses (P = 0.017, Cohen's δ = -0.55). This result remained after removing those with a previous COVID-19 infection (P = 0.010, Cohen's δ = -0.64) and after matching groups for sample size (P = 0.004, Cohen's δ = -0.81). No other variables reached statistical significance. Concluding, hospital professionals with a substantial level of exposure to patients with COVID-19 show a significant attention decrement and, thus, may be at a higher risk of accidental SARS-CoV-2 infection.

Posttraumatic stress disorder among adolescents in Brazil: a cross-sectional study.

BACKGROUND: The frequency of trauma and different types of violence exposure in urban areas and their effects on the mental health of adolescents in developing countries are poorly investigated. Most information about traumatized young people comes from war scenarios or disasters. This study aimed to determine the prevalence of PTSD in trauma-exposed students in a low-resource city of the state of Rio de Janeiro, Brazil. The effects of sociodemographic and individual and family factors in the development of PTSD were also investigated. METHODS: Through multi-stage cluster sampling, 862 adolescents (Mage = 15 years old, 65% female) from public and private schools in the city of São Gonçalo were selected for the study. Self-rating structured questionnaires were applied to assess sociodemographic profile, exposure to physical and psychological violence (family, school, community), sexual abuse, social support, social functional impairment, resilience, and posttraumatic stress disorder. The data were grouped in blocks regarding sociodemographic, individual, family, and community variables. For statistical analysis, chi-square, Fisher's exact test, and logistic regression were performed. RESULTS: The PTSD prevalence was 7.8% among adolescents. Boys were exposed to significantly higher number of events of community violence, while girls to family violence. The adjusted odds ratio (OR) for PTSD were statistically significant for age (OR, 1.45, [95% CI, 1.043-2.007]), social functional impairment (OR, 4.82, [95% CI, 1.77-13.10]), severe maternal physical violence (OR, 2.79, [95% CI, 0.79-9.93]), psychological violence by significant people (OR, 3.96, [95% CI, 1.89-8.31]) and a high number of episodes of community violence (OR, 3.52, [95% CI, 1.47-8.40). CONCLUSIONS: There was a high prevalence of PTSD within this population associated with exposure to violence. Not only physical, but also psychological violence contributed to PTSD. The results also raise awareness to the differences in life trajectories between boys and girls regarding violence. These differences need to be better understood in order to enable the development of effective preventative interventions. Treating and preventing mental health disorders presents a challenge for countries, especially those with a lower degree of social and economic development and high community violence.

[Adolescent dating in Brazil: the circularity of psychological violence in different relationship contexts]. / Namoro na adolescência no Brasil: circularidade da violência psicológica nos diferentes contextos relacionais.

The scope of this paper is to evaluate the perpetration of psychological violence in current male and female dating relationships and their link to psychological violence experienced in other contexts of their lives, namely family, relationships with friends and dating partners. 3,205 students in the 2nd year of high school (15 to 19 years old) in public and private schools in ten Brazilian cities filled out a closed and self-administered questionnaire. The results highlight the fact that the increase in the number of psychologically violent events perpetrated by adolescents in their intimate relationships is related to greater verbal aggression of the mother and father, and the more frequent experiences of psychological violence between parents, siblings, friends and that existing in earlier dating relationships. This reinforces the notion of circularity of psychological violence in various contexts of socialization of adolescents and highlights the continuity of aggressive behavior in other dating relationships, and those between siblings, family and friends.

[Sexual violence and co-occurrences suffered by children and adolescents: study of incidents over a decade]. / Violência sexual e coocorrências em crianças e adolescentes: estudo das incidências ao logo de uma década.

The study analyzes the evolution of the incidence of sexual violence (SV) and co-occurrences between 2001 and 2010. The records of the Guardianship Councils in Feira de Santana, State of Bahia, Brazil were used and the incidence rates and graphs of the events during the period were calculated. Of the total of the different types of violence, 21.8 % involved co-occurrences, the majority being female, most frequently during adolescence. There was a high proportion of abuse in male children, with most offenders bring family members or acquaintances. The incidence of SV revealed an increasing trend in both sexes during the decade, more significantly in females in 2002 and 2009. The age groups indicated the same trend, with a higher proportion of cases in adolescence. The record of co-occurrences with SV was more pronounced in the second half of the decade, namely psychological violence in 2008, neglect in 2008 and physical violence in 2009. The conclusion is that the increase in the coefficients of sexual violence and co-occurrences may indicate an improvement of the reporting system of instances in reference, as well as greater citizen participation through the Dial 100 complaint hotline. The indicators help to prevent and control violence against children.

[Surveillance System for Violence and Accidents (VIVA) and notification of infant-juvenile violence in the Brazilian Unified Health System (SUS) in Feira de Santana in the state of Bahia]. / Sistema de Vigilância de Violências e Acidentes/VIVA e a notificação da violência infanto-juvenil, no Sistema Único de Saúde/SUS de Feira de Santana-Bahia, Brasil.

The scope of the study is to analyze data of children and adolescents who are the victims of different forms of violence, registered in the Surveillance System for Violence and Accidents (VIVA/MS) in Feira de Santana in the state of Bahia, Brazil. The total number of records, since the implementation of VIVA in the city (01/2009 to 01/2011) was used and the analyses sought associations between characteristics of violence and profiles of victims and perpetrators. The results showed that children and adolescents were molested using different types of violence, including the use of physical force, verbal threats and weapons and sundry cases of personal injury. Approximately 35% were hospitalized and 15% died. Physical violence was more common among males during adolescence in the home environment and perpetrated by a family member. Sexual violence occurred with greater frequency among females during childhood and 55.5% of the cases occurred in the home environment and more frequently perpetrated by a family member or acquaintances. The results highlight the importance of investments in policies and programs for harm prevention and reduction, seeking to broaden coverage in the care and the enhancement of the information system and surveys of these indicators.

[Psychological violence and the family context of adolescent users of outpatient services in a public tertiary pediatric hospital]. / Violência psicológica e contexto familiar de adolescentes usuários de serviços ambulatoriais em um hospital pediátrico público terciário.

The scope of this research was to investigate the association of psychological violence (PV) during adolescence with social and demographic factors, family structure/relationships and with other forms of maltreatment. A questionnaire was applied to 229 adolescents (11-18 years) in outpatient services in a state-run tertiary pediatric hospital. It was found that 26.4% of respondents suffered severe PV in the family context, and only 5 of the respondents reported they did not suffer any PV in the family context, illustrating how this kind of violence is seen as commonplace in the family relationship. The most common forms of PV behavior were: being criticized for what one does or says; not being encouraged when trying to act autonomously; being called nasty names, and having an adult saying one is wrong when one tries to act. Dissatisfaction of parents with the adolescent, the nuclear family structure, the position of the child among siblings sharing the same parents were associated with PV occurring within the family context. In order to enable it to detect signs of PV, the health sector can promote the right to comprehensive health of adolescents, confirming itself as one of the main social sectors capable of acting preventively on the forms of violence suffered and practiced by the family group.

Association between family environment and attention deficit hyperactivity disorder in children--mothers' and teachers' views.

BACKGROUND: To ascertain whether factors of the family environment and gestational period are associated with the appearance of ADHD in children, as reported by various different informants (mothers and teachers). METHODS: This paper presents results from the dataset of a longitudinal study to evaluate behavioral problems among schoolchildren in São Gonçalo, Rio de Janeiro State, in 2005 and 2006. The cross-section considered for this paper comprises records of exposure factors and ADHD. In all, 370 schoolchildren of the public school system were assessed by 3-stage cluster sampling. The Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF) were used to measure outcomes. The exposure factors examined were: profile of child and mother, variables relating to the family environment, and perinatal considerations. The questions were answered by mothers and teachers. A hierarchical logistic regression model was used. RESULTS: Precariously functioning families, lack of social support for mothers, adverse life events and discord during pregnancy were the factors associated with mother-reported ADHD. When ADHD was reported by teachers, the variables selected were: Intelligence quotient (IQ) and sex, with children with low IQ scores and boys more likely to display the disorder. CONCLUSIONS: Assessment of ADHD by teachers or mothers reveals specific characteristics that reflect how each of these informants understands the children. This highlights the importance of using informants from different environments in diagnosing the disorder.

[Reports of domestic, sexual and other forms of violence against children in Brazil]. / Notificações de violência doméstica, sexual e outras violências contra crianças no Brasil.

The scope of this article is to outline the scenario of domestic, sexual and other forms of violence against children (0-9 years old) in Brazil for the year 2010. It is based on data from reports of domestic, sexual and other forms of violence registered with SINAN - Information System for Notifiable Diseases (Continuous VIVA). Absolute and relative numbers are presented, derived from reported violence, discriminating between children under 1 year of age and those between 1-9 years old, due to the specificities that exist in these age groups. Throughout the country, the number of reports among those under 10 years of age is low (17.1%). Differences were found for the distribution of reports in the different Brazilian States. Few municipalities and few services reported violence to SINAN-Net in 2010 in the country. Some differences were found between children under 1 year of age and those between 1 and 9 years of age, as for instance the relationship between the profile of the violence, the victim and the perpetrator, and the handling of the case. The quality of the reported information is discussed showing the high level of unreported data in some spaces of the reporting form. Lack of information may prejudice comprehension of the phenomenon, interfering with the planning, organization and operation actions of the health services in the country.

[The impact of professional activities on the physical and mental health of the civil and military police of Rio de Janeiro (RJ, Brazil)]. / Impacto das atividades profissionais na saúde física e mental dos policiais civis e militares do Rio de Janeiro (RJ, Brasil).

In this article, we analyze the physical and mental stress and illness of military and civil police force officers in the State of Rio de Janeiro (Brazil) due to their working conditions and professional activities. The same methodology was used for the study of two categories, namely a quantitative approach (simple random sampling by conglomerates, involving a total of 1,458 civil police officers and 1,108 military police officers, who answered questionnaires anonymously) and a qualitative approach (focal groups involving 143 professionals and 18 interviews with managers of both police forces). The data presented here are all original. Disorders identified were: overweight and obesity in both forces but mainly in the Military Police; low frequency of physical exercise and high levels of cholesterol, especially in the Civil Police. The main health complaints are neck, back or spinal cord pain, eyesight complaints and headaches/ migraines. Sixteen point two per cent of officers of both forces reported physical lesions that were more prevalent in the Military Police, among whom psychic suffering was also more frequent (SRQ20). The need for changes in the individual and professional dimensions and in institutional aspects regarding the conditions and organization of work and of health services is emphasized.

[The situation of Brazilian children and adolescents with regard to mental health and violence]. / Situação de crianças e adolescentes brasileiros em relação à saúde mental e à violência.

This article reflects about the situation of mental health and violence against Brazilian children and adolescents, proposing a discussion about the need for public health policies including these extremely relevant issues in their priority agenda. In Brazil, the debate about this problem has occurred in a fragmented and not very consistent way. This article presents a non-systematic selection of epidemiological investigations on this subject conducted in Brazilian schools and communities. The great variety and prevalence of familiar and community violence and of mental health problems is pointed out and the methodological differences between the studies and the concentration of studies in the South and Southeastern regions of the country are emphasized. The article still highlights to the scarce service network for dealing with this kind of problem and the lack of concern with the prevention of mental disorders and promotion of mental health.

[The relation between teachers with psychological distress and schoolchildren with behavior problems]. / A relação entre professores com sofrimento psíquico e crianças escolares com problemas de comportamento.

The present article aims to analyze the relation between teachers suffering from psychological distress and school children with behavioral problems. A total of 372 children were evaluated by teachers through utilizing the Teachers Report Form (TRF). The teachers also answered a questionnaire in order to evaluate some personal characteristics and the presence of psychological distress (Self Reported Questionnaire, SRQ-20). The prevalence of psychological distress found was of 21.8%. The results show that the teachers presenting psychological distress identified higher percentages of internalizing problems in the children.

[Violence and post-traumatic stress disorder in childhood]. / Violência e transtorno de estresse pós-traumático na infância.

This study presents the prevalence of symptoms of Posttraumatic Stress Disorder (PTSD) in 500 schoolchildren (6-13 years old) in São Gonçalo, Rio de Janeiro. It also investigates the association between PTSD, violence and other adverse events in the lives of these children. The multi-stage cluster sampling strategy involved three selection stages. Parents were interviewed about their children's behavior. The instrument used to screen symptoms of PTSD was the Child Behavior Checklist-Posttraumatic Stress Disorder Scale (CBCL-PTSD). Conflict Tactics Scales (CTS) were applied to evaluate family violence and other scales to investigate the socioeconomic profile, familiar relationship, characteristics and adverse events in the lives of the children. Multivariate analysis was performed using a hierarchical model with a significance level of 5%. The prevalence of clinical symptoms of PTSD was of 6.5%. The multivariate analysis suggested an explanation model of PTSD characterized by 18 variables, such as the child's characteristics; specific life events; family violence; and other family factors. The results reveal that it is necessary to work with the child in particularly difficult moments of his/her life in order to prevent or minimize the impact of adverse events on their mental and social functioning.

[Occurrence of child abuse: knowledge and possibility of action of speech-language pathologists]. / Ocorrência de maus-tratos em crianças: formação e possibilidade de ação dos fonoaudiólogos.

BACKGROUND: This work presents the results of an epidemiological survey about the professional experience of Speech-Language Pathologists and Audiologists of Rio de Janeiro (Brazil) with children and adolescents who are victims of domestic violence. AIM: To understand the occurrence of child abuse and neglect of children and adolescents treated by speech-language pathologists, characterizing the victims according to: most affected age group, gender, form of violence, aggressor, most frequent speech-language complaint, how the abuse was identified and follow-up. METHOD: 500 self-administered mail surveys were sent to a random sample of professional living in Rio de Janeiro. The survey forms were identified only by numbers to assure anonymity. RESULTS: 224 completed surveys were mailed back. 54 respondents indicated exposure to at least one incident of abuse. The majority of victims were children, the main abuser was the mother, and physical violence was the most frequent form of abuse. The main speech disorder was late language development. In most cases, the victim himself told the therapist about the abuse--through verbal expression or other means of expression such as drawings, story telling, dramatizing or playing. As the majority of the victims abandoned speech-language therapy, it was not possible to follow-up the cases. CONCLUSION: Due to the importance if this issue and the limited Brazilian literature about Speech-Language and Hearing Sciences and child abuse, it is paramount to invest in the training of speech-language pathologists. It is the duty of speech-language pathologists to expose this complex problem and to give voice to children who are victims of violence, understanding that behind a speech-language complaint there might be a cry for help.

[The nursing and the attention to the child who is victim of familiar violence]. / A enfermagem e a atenção a criança vitima de violência familiar.

Bibliographic study that aimed to reflect about the nursing care to the child who is victim of familiar violence from the analysis of scientific production concerning this subject. Thirty-seven indexed publications were analyzed (08 national and 29 international) using the following bibliographic databases: BDENF; LILACS and MEDLINE. Estalishing the period of 1993-2003 as limit time. The results were analyzed applying the technique of content analysis becoming possible the distinction of knowledge in three topical cores: diagnostic, qualification of the nurse, and nursing care to the child victim of familiar violence. An increase of significant nursing scientific production focalizing this subject was not visualized in the last years.