Inclusion Complexes of Litsea cubeba (Lour.) Pers Essential Oil into ß-Cyclodextrin: Preparation, Physicochemical Characterization, Cytotoxicity and Antifungal Activity.

The uses of natural compounds, such as essential oils (EOs), are limited due to their instability to light, oxygen and temperature, factors that affect their application. Therefore, improving stability becomes necessary. The objective of this study was to prepare inclusion complexes of Litsea cubeba essential oil (LCEO) with ß-cyclodextrin (ß-CD) using physical mixing (PM), kneading (KN) and co-precipitation (CP) methods and to evaluate the efficiency of the complexes and their physicochemical properties using ATR-FTIR, FT-Raman, DSC and TG. The study also assessed cytotoxicity against human colorectal and cervical cancer cells and antifungal activity against Aspergillus flavus and Fusarium verticillioides. The complexation efficiency results presented significant evidence of LCEO:ß-CD inclusion complex formation, with KN (83%) and CP (73%) being the best methods used in this study. All tested LCEO:ß-CD inclusion complexes exhibited toxicity to HT-29 cells. Although the cytotoxic effect was less pronounced in HeLa tumor cells, LCEO-KN was more active against Hela than non-tumor cells. LCEO-KN and LCEO-CP inclusion complexes were efficient against both toxigenic fungi, A. flavus and F. verticillioides. Therefore, the molecular inclusion of LCEO into ß-CD was successful, as well as the preliminary biological results, evidencing that the ß-CD inclusion process may be a viable alternative to facilitate and increase future applications of this EO as therapeutic medication, food additive and natural antifungal agent.

Attachment, suicidal behavior, and self-harm in childhood and adolescence: a study of a cohort of Brazilian schoolchildren.

BACKGROUND: Attachment influences the development and the formation of the self and subjectivity and, just as early adverse events, may be related to the occurrence of mental disorders, suicidal behavior, and self-harm throughout life. This study aimed to analyze the effect of mental representation of attachment in children on suicidal behavior and self-harm throughout childhood and adolescence, considering the mediating role of internalizing problems. METHODS: Based on a cohort of 500 students (mean age 8 years, SD 1.2) sampled from public schools in a Brazilian southeastern metropolis, 316 children were followed for eight years in three waves (2006, 2008, 2012). The following data from the research baseline (2005) were used: family drawing, maternal and family variables, and sociodemographic data. The mental representation of attachment (independent variable) was measured by the Family Drawing Global Scale, discriminating between secure attachment and non-secure attachment. Suicidal behavior/self-harm (dependent variable) and internalizing problems were evaluated in three research waves through CBCL and YSR (ASEBA). Descriptive analysis, calculation of frequencies and p-values of the variables of interest, as well as modeling of structural equations, were performed. RESULTS: The prevalence throughout the study was: 17.1% [CI 13.3-20.8] for suicidal ideation and 8.9% [CI 5.6 - 12.2] for self-harm; there was a recurrence at one time in 16.5% [IC 12.6 - 20.3] and in two or more moments in 4.1% [CI 2.0 - 6.3] of the sample. Female gender (p = 0.035), internalizing disorders (p < 0.01), and non-secure attachment (p = 0.035) were associated with the occurrence of suicidal behavior/self-harm. The modeling indicated that 92,2% of the total effect of attachment (p = 0.069) on suicidal behavior/self-harm was due to direct effect, the other 7,8% of the effect being mediated by internalizing problems, adjusted for the confounding variables sex, skin color/race, and social stratum. The total effect showed a positive value, which indicates an increase in suicidal behavior/self-harm when the non-secure attachment is present. The approximate OR of non-secure attachment on the total effect (direct + indirect) was 1.15, indicating that, when adjusting for confounding variables, there was a 15% increase in suicidal behavior/self-injury from non-secure attachment. CONCLUSIONS: The study supports the hypothesis that there is a relationship between disruptive attachment patterns (non-secure attachment) developed during infancy and suicidal and self-harm behavior during childhood and adolescence. These findings validate the concern about the first thousand days of childhood as a critical period for child growth and development, but also for the mental health of children and adolescents.

Design, synthesis and cytotoxicity of the antitumor agent 1-azabicycles for chemoresistant glioblastoma cells.

Twelve multi-functional pyrrolizidinones, indolizidinones and pyrroliazepinones were prepared from formal aza-[3 + 2] and aza-[3 + 3] cycloadditions of five- to seven-membered heterocyclic enaminones as diverse ambident electrophiles. The antitumor activity of these alkaloid-like compounds was investigated through an initial screening performed on human glioblastoma multiform (GBM) cell lines (GL-15, U251), on murine glioma cells line (C6) and on normal glial cells. Of the compounds tested, the new pyrrolo[1,2a]azepinone, [ethyl (3-oxo-1,2-diphenyl-6,7,8,9-tetrahydro-3H-pyrrolo[1,2a]azepin-9a(5H)-yl)acetate] or (Compound-13) exhibited selective cytotoxic effects on GBM-temozolomide resistant cells. Compound-13 exerted dose-dependent cytotoxic activity by promoting arrest of cells in the G0/G1 phase of the cell cycle in the first 24 h. The apoptotic effect observed was in a time-dependent manner. Anti-migratory effect promoted by the treatment with compound-13 was also observed. Moreover, healthy mixed glial cell cultures from rat brain exhibited no cytotoxicity effect upon exposure to compound-13. Thus, the present study paves the way for the use of compound-13 as novel antitumor scaffold candidate for glioma cell therapy.

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.

Shorter telomere length and suicidal ideation in familial bipolar disorder.

Bipolar Disorder (BD) has recently been related to a process of accelerated aging, with shortened leukocyte telomere length (LTL) in this population. It has also been observed that the suicide rate in BD patients is higher than in the general population, and more recently the telomere length variation has been described as shorter in suicide completers compared with control subjects. Objectives The aim of the present study was to investigate if there is an association between LTL and BD in families where two or more members have BD including clinical symptomatology variables, along with suicide behavior. Methods Telomere length and single copy gene ratio (T/S ratio) was measured using quantitative polymerase chain reaction in a sample of 143 relatives from 22 families, of which 60 had BD. The statistical analysis was performed with a polygenic mixed model. Results LTL was associated with suicidal ideation (p = 0.02) as that there is an interaction between suicidal ideation and course of the disorder (p = 0.02). The estimated heritability for LTL in these families was 0.68. In addition, covariates that relate to severity of disease, i.e. suicidal ideation and course of the disorder, showed an association with shorter LTL in BD patients. No difference in LTL between BD patients and healthy relatives was observed. Conclusion LTL are shorter in subjects with familial BD suggesting that stress related sub-phenotypes possibly accelerate the process of cellular aging and correlate with disease severity and suicidal ideation.

Inhibition of growth and ochratoxin A production in Aspergillus species by fungi isolated from coffee beans.

Ochratoxin A (OTA) is a mycotoxin found in several agricultural commodities. Produced by Aspergillus spp., it is nephrotoxic and hepatotoxic and can be carcinogenic. Preventive measures are preventing fungal growth and OTA production. In this study, fungal strains (Rhizopus oryzae, Lichtheimia ramosa, Aspergillus westerdijkiae, Aspergillus niger, Aspergillus tamarii, Aspergillus sp., and Aspergillus fumigatus) isolated from coffee beans were identified for their abilities to inhibit the growth of Aspergillus ochraceus, Aspergillus westerdijkiae, Aspergillus carbonarius, and Aspergillus niger, and OTA production. All fungi strains tested were able to inhibit growth of the four Aspergillus species and OTA production, where A. niger showed the best results in both tests. L. ramosa showed the lowest growth-reducing potential, while the other fungal strains had a growth-reducing potential higher than 70% against all Aspergillus species tested. Regarding OTA production, L. ramosa and Aspergillus sp. completely inhibited the mycotoxin production by A. ochraceus and non-toxigenic strain A. niger completely inhibited OTA production by A. niger. Our findings indicate that the strains tested can be used as an alternative means to control growth of OTA-producing fungi and production of the mycotoxin in coffee beans.

The complex roles of space and environment in structuring functional, taxonomic and phylogenetic beta diversity of frogs in the Atlantic Forest.

Ecological communities are complex entities that can be maintained and structured by niche-based processes such as environmental conditions, and spatial processes such as dispersal. Thus, diversity patterns may be shaped simultaneously at different spatial scales by very distinct processes. Herein we assess whether and how functional, taxonomic, and phylogenetic beta diversities of frog tadpoles are explained by environmental and/or spatial predictors. We implemented a distance-based redundancy analysis to explore variation in components of beta diversity explained by pure environmental and pure spatial predictors, as well as their interactions, at both fine and broad spatial scales. Our results indicated important but complex roles of spatial and environmental predictors in structuring phylogenetic, taxonomic and functional beta diversities. The pure fine-scales spatial fraction was more important in structuring all beta diversity components, especially to functional and taxonomical spatial turnover. Environmental variables such as canopy cover and vegetation structure were important predictors of all components, but especially to functional and taxonomic beta diversity. We emphasize that distinct factors related to environment and space are affecting distinct components of beta diversity in different ways. Although weaker, phylogenetic beta diversity, which is structured more on biogeographical scales, and thus can be represented by spatially structured processes, was more related to broad spatial processes than other components. However, selected fine-scale spatial predictors denoted negative autocorrelation, which may be revealing the existence of differences in unmeasured habitat variables among samples. Although overall important, local environmental-based processes explained better functional and taxonomic beta diversity, as these diversity components carry an important ecological value. We highlight the importance of assessing different components of diversity patterns at different scales by spatially explicit models in order to improve our understanding of community structure and help to unravel the complex nature of biodiversity.

Cross-Cultural adaptation of the General Functioning Scale of the Family.

OBJECTIVE: To describe the process of cross-cultural adaptation of the General Functioning Scale of the Family, a subscale of the McMaster Family Assessment Device, for the Brazilian population. METHODS: The General Functioning Scale of the Family was translated into Portuguese and administered to 500 guardians of children in the second grade of elementary school in public schools of Sao Gonçalo, Rio de Janeiro, Southeastern Brazil. The types of equivalences investigated were: conceptual and of items, semantic, operational, and measurement. The study involved discussions with experts, translations and back-translations of the instrument, and psychometric assessment. Reliability and validity studies were carried out by internal consistency testing (Cronbach's alpha), Guttman split-half correlation model, Pearson correlation coefficient, and confirmatory factor analysis. Associations between General Functioning of the Family and variables theoretically associated with the theme (father's or mother's drunkenness and violence between parents) were estimated by odds ratio. RESULTS: Semantic equivalence was between 90.0% and 100%. Cronbach's alpha ranged from 0.79 to 0.81, indicating good internal consistency of the instrument. Pearson correlation coefficient ranged between 0.303 and 0.549. Statistical association was found between the general functioning of the family score and the theoretically related variables, as well as good fit quality of the confirmatory analysis model. CONCLUSIONS: The results indicate the feasibility of administering the instrument to the Brazilian population, as it is easy to understand and a good measurement of the construct of interest. OBJETIVO: Descrever o processo de adaptação transcultural da escala de Funcionamento Geral da Família, subescala da McMaster Family Assessment Device, para a população brasileira. MÉTODOS: A escala de Funcionamento Geral da Família, original no idioma inglês, foi traduzida para o português e aplicada a 500 responsáveis de crianças do segundo ano do ensino fundamental de escolas públicas do município de São Gonçalo, Rio de Janeiro. Os tipos de equivalências investigados foram: conceitual e de itens, semântica, operacional, e mensuração. O estudo envolveu discussão com especialistas, traduções e retraduções do instrumento e avaliação psicométrica. Foi realizado estudo de confiabilidade e validade, por testagem da consistência interna (alpha de Cronbach), da correlação pelo método de split-half de Guttman e do coeficiente de correlação de Pearson, e por análise fatorial confirmatória. Associações entre Funcionamento Geral da Família e variáveis teoricamente associadas ao tema (embriaguez do pai ou da mãe e violência entre os pais) foram analisadas por estimação de razão de chance. RESULTADOS: A equivalência semântica encontrada foi entre 90,0% e 100%. O alfa de Cronbach variou de 0,79 a 0,81, indicando boa consistência interna do instrumento. O coeficiente de correlação de Pearson oscilou entre 0,303 e 0,549. Encontrou-se associação estatística entre o escore de funcionamento geral da família e as variáveis teoricamente relacionadas e constatou-se boa qualidade dos ajustes do modelo de análise confirmatória. CONCLUSÕES: Os resultados obtidos indicam a aplicabilidade do instrumento na população brasileira, que se mostra de fácil compreensão e boa aferição do constructo de interesse.

Geomorphology Drives Amphibian Beta Diversity in Atlantic Forest Lowlands of Southeastern Brazil.

Beta diversity patterns are the outcome of multiple processes operating at different scales. Amphibian assemblages seem to be affected by contemporary climate and dispersal-based processes. However, historical processes involved in present patterns of beta diversity remain poorly understood. We assess and disentangle geomorphological, climatic and spatial drivers of amphibian beta diversity in coastal lowlands of the Atlantic Forest, southeastern Brazil. We tested the hypothesis that geomorphological factors are more important in structuring anuran beta diversity than climatic and spatial factors. We obtained species composition via field survey (N = 766 individuals), museum specimens (N = 9,730) and literature records (N = 4,763). Sampling area was divided in four spatially explicit geomorphological units, representing historical predictors. Climatic descriptors were represented by the first two axis of a Principal Component Analysis. Spatial predictors in different spatial scales were described by Moran Eigenvector Maps. Redundancy Analysis was implemented to partition the explained variation of species composition by geomorphological, climatic and spatial predictors. Moreover, spatial autocorrelation analyses were used to test neutral theory predictions. Beta diversity was spatially structured in broader scales. Shared fraction between climatic and geomorphological variables was an important predictor of species composition (13%), as well as broad scale spatial predictors (13%). However, geomorphological variables alone were the most important predictor of beta diversity (42%). Historical factors related to geomorphology must have played a crucial role in structuring amphibian beta diversity. The complex relationships between geomorphological history and climatic gradients generated by the Serra do Mar Precambrian basements were also important. We highlight the importance of combining spatially explicit historical and contemporary predictors for understanding and disentangling major drivers of beta diversity patterns.

Mobility decline in patients hospitalized in an intensive care unit. / Declínio da mobilidade dos pacientes internados em unidade de terapia intensiva.

OBJECTIVE: To evaluate the variation in mobility during hospitalization in an intensive care unit and its association with hospital mortality. METHODS: This prospective study was conducted in an intensive care unit. The inclusion criteria included patients admitted with an independence score of ≥ 4 for both bed-chair transfer and locomotion, with the score based on the Functional Independence Measure. Patients with cardiac arrest and/or those who died during hospitalization were excluded. To measure the loss of mobility, the value obtained at discharge was calculated and subtracted from the value obtained on admission, which was then divided by the admission score and recorded as a percentage. RESULTS: The comparison of these two variables indicated that the loss of mobility during hospitalization was 14.3% (p < 0.001). Loss of mobility was greater in patients hospitalized for more than 48 hours in the intensive care unit (p < 0.02) and in patients who used vasopressor drugs (p = 0.041). However, the comparison between subjects aged 60 years or older and those younger than 60 years indicated no significant differences in the loss of mobility (p = 0.332), reason for hospitalization (p = 0.265), SAPS 3 score (p = 0.224), use of mechanical ventilation (p = 0.117), or hospital mortality (p = 0.063). CONCLUSION: There was loss of mobility during hospitalization in the intensive care unit. This loss was greater in patients who were hospitalized for more than 48 hours and in those who used vasopressors; however, the causal and prognostic factors associated with this decline need to be elucidated.

A population-based study of the stratum corneum moisture.

BACKGROUND: The stratum corneum (SC) has important functions as a bound-water modulator and a primary barrier of the human skin from the external environment. However, no large epidemiological study has quantified the relative importance of different exposures with regard to these functional properties. In this study, we have studied a large sample of individuals from the Brazilian population in order to understand the different relationships between the properties of SC and a number of demographic and self-perceived variables. METHODS: One thousand three hundred and thirty-nine individuals from a rural Brazilian population, who were participants of a family-based study, were submitted to a cross-sectional examination of the SC moisture by capacitance using the Corneometer® CM820 and investigated regarding environmental exposures, cosmetic use, and other physiological and epidemiological measurements. Self-perception-scaled questions about skin conditions were also applied. RESULTS: We found significant associations between SC moisture and sex, age, high sun exposure, and sunscreen use frequency (P<0.025). In specific studied sites, self-reported race and obesity were also found to show significant effects. Dry skin self-perception was also found to be highly correlated with the objective measurement of the skin. Other environmental effects on SC moisture are also reported.

Posição prona em pacientes em ventilação espontânea com insuficiência respiratória por COVID-19: relato de caso / Prone position in patients in spontaneous ventilation with respiratory failure by COVID-19: case report

A Posição Prona (PP) geralmente é utilizada em casos de Insuficiência Respiratória Aguda (IRpA) grave, em pacientes com Síndrome da Angústia Respiratória Aguda (SARA) e em ventilação mecânica invasiva, com o objetivo de melhorar a oxigenação. Entretanto, pode ser útil em casos de IRpA leve secundária ao COVID -19 reduzindo a necessidade de ventilação mecânica invasiva e as complicações associadas ao ventilador. OBJETIVO: Descrever o relato de caso do uso da posição prona (PP) em pacientes em ventilação espontânea com Insuficiência Respiratória Leve secundária ao COVID-19. MÉTODO: Trata-se de um relato de caso de um paciente com diagnóstico de COVID-19, com IRpA leve, com dispneia, tosse, hipoxemia e dessaturação, que dentre as técnicas de tratamento utilizou um protocolo de posição prona por períodos de duas horas, duas vezes ao dia, durante todo o período de internação. RESULTADOS: O paciente apresentou hipoxemia (SPO2 -94% e PO2- 62,9), associada a dispneia (Borg 6) na admissão, tendo apresentado melhora na dispneia (Borg 4) e saturação na oximetria de pulso de 96% após 24 horas de início do protocolo. Após 48 horas apresentou melhora gasométrica com valores e SPO2 e PO2 de 96,5% e 80,6 mmHg respectivamente. CONCLUSÃO: A posição prona em pacientes em ventilação espontânea, com insuficiência respiratória leve secundária ao COVID-19 é segura e pode ser utilizada como terapia adjuvante ao tratamento desse perfil de pacientes.

The Prone Position (PP) is generally used in cases of Acute Respiratory Insufficiency (IRPA), in patients with Acute Respiratory Distress Syndrome (ARDS) and in invasive mechanical ventilation, in order to improve oxygenation, but it can be used useful in cases of mild IRPA, using the need for invasive mechanical ventilation and complications associated with the ventilator. OBJECTIVES: To describe or report the case of using the prone position (PP) in patients with spontaneous ventilation with mild respiratory failure secondary to COVID-19. METHODS: this is a case of a patient diagnosed with COVID-19, with an IRPA level, with dyspnea, cough, hypoxemia and desaturation, which includes treatment techniques that use a prone position protocol for two hours, twice a day for the entire hospital stay. RESULTS: The patient presented hypoxemia (SpO2 -94% and PO2- 62.9), associated with a food (Borg 6) on admission, having received improvements in food (Borg 4) and 96% saturation in pulse oximetry after 24 hours from the beginning of the protocol and after 48 hours it improves the gasometric and SpO2 and PaO2 values of 96.5% and 80.6 mmHg, respectively. CONCLUSION: The prone position in patients on spontaneous ventilation, with respiratory failure secondary to COVID-19 is safe and can be used as adjunctive therapy to treatment in this patient profile.

[Resilience, gender and family during adolescence]. / Resiliência, gênero e família na adolescência.

This article seeks to investigate the family factors that influence the resilience potential of male and female adolescent students. It is a cross-sectional study with data derived from an epidemiological survey with the participation of 889 randomly selected adolescents in the 9th year of public and private schools in a municipality in the state of Rio de Janeiro. Social and demographic variables indicate that family violence factors such as a difficult relationship with the mother or stepmother and a lack of family supervision, the presence of depression and low use of active and supportive coping strategies for distraction are associated with a low resilience potential. Tests of association between variables and resilience were made, considering a significance level of 5%. Variables like living in a confined space and having a difficult relationship with siblings only appear harmful to the resilience potential of girls. Public policies and programs need to work with families to understand the needs of adolescents, as a way of preventing mental health problems and promoting health in this population from a gender standpoint.

[Adolescence, sexual behavior and risk factors to health]. / Adolescência, comportamento sexual e fatores de risco à saúde.

OBJECTIVE: To analyze the relationships between sexual behavior and risk factors to physical and mental health in adolescents. METHODS: Study of 3,195 pupils aged 15 to 19 in secondary education, in public and private schools in 10 state capitals in Brazil between 2007 and 2008. Multi-stage (schools and pupils) cluster sampling was used in each city and public and private educational network. All of the students selected completed a questionnaire on the following items: socioeconomic and demographic data; sexual behavior; having sex with those of the same sex, the opposite sex, or both; alcohol and cannabis use; using condoms; traumatic sexual experiences as a child or adolescent; suicidal thoughts. The analysis included describing frequencies, Chi-square test, analysis of multiple and cluster correspondence. Responses to an open ended question in which the adolescent expressed general comments about themselves and their lives were qualitatively analyzed using content analysis. RESULTS: Around 3.0% of adolescents reported homosexual or bisexual behavior, with no difference according to sex, age, skin color, social status family structure or educational network. Adolescents with homosexual/bisexual sexual behavior, compared to their heterosexual peers, reported: (p < 0.05): getting drunk (18.7% and 10.5%, respectively), frequent cannabis use (6.1% and 2.1%, respectively), suicidal thoughts (42.5% and 18.7%, respectively), and having been the victim of sexual violence (11.7% and 1.5%; respectively). Adolescents with homosexual/bisexual sexual behavior reported that they used condoms less frequently (74.2%) than their heterosexual peers (48.6%, p < 0.001). In the correspondence analysis, three groups were found, one composed of adolescents with homosexual/bisexual behavior and experiencing risk factors; suffering sexual violence, never using a condom, suicidal thoughts, frequent cannabis use; another composed of occasional cannabis and condom users, who got drunk frequently, and adolescents with heterosexual behavior and none of the risk factors investigated. More of the risk factors were found in adolescents with homosexual/bisexual behavior compared with those with heterosexual behavior. Adolescents with homosexual/bisexual sexual behavior were more likely to talk about their positive personal experiences and negative relationship experiences that their heterosexual peers, but spoke less about religion. CONCLUSIONS: Not only should this issue be studied in more detail, but preventative actions aimed at adolescents with homosexual/bisexual behavior should be widened.

[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.

[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.

CHILDHOOD DEPRESSION. Exploring the association between family violence and other psychosocial factors in low-income Brazilian schoolchildren.

BACKGROUND: Childhood depression affects the morbidity, mortality and life functions of children. Individual, family and environmental factors have been documented as psychosocial risk factors for childhood depression, especially family violence, which results in inadequate support, low family cohesion and poor communication. This study investigates the association between psychosocial depression factors in low-income schoolchildren and reveals the potential trouble spots, highlighting several forms of violence that take place within the family context. METHODS: The study was based on a cross-sectional analysis of 464 schoolchildren aged between 6 and 10, selected by random sampling from a city in the state of Rio de Janeiro, Brazil. Socio-economic, family and individual variables were investigated on the strength of the caregivers' information and organized in blocks for analysis. A binary logistic regression model was applied, according to hierarchical blocks. RESULTS: The final hierarchical regression analysis showed that the following variables are potential psychosocial factors associated with depression in childhood: average/poor relationship with the father (OR 3.24, 95% CI 1.32-7.94), high frequency of victimization by psychological violence (humiliation) (OR 6.13, 95% CI 2.06-18.31), parental divorce (OR 2.89, 95% CI 1.14-7.32) and externalizing behavior problems (OR 3.53 IC 1.51-8.23). CONCLUSIONS: The results point to multiple determinants of depressive behavior in children, as well as the potential contribution of psychological family violence. The study also reveals potential key targets for early intervention, especially for children from highly vulnerable families.

[Suicide mortality in people aged 60 and over in Brazilian municipalities between 1996 and 2007]. / Mortalidade por suicídio em pessoas com 60 anos ou mais nos municípios brasileiros no período de 1996 a 2007.

The scope of this article was to assess the nationwide scale of suicides among the elderly. An overview of suicides in Brazilian municipalities was conducted to identify municipalities with the highest incidence of suicide. Data from the Mortality Information System (SIM/MS) were used for the period from 1996 to 2007, using the events with codes X60 through X84 and Y87.0 of the 10th review of the International Classification of Diseases (CID-10). The rates were standardized according to the criteria of the WHO. It was discovered that 3,039 Brazilian municipalities have records of suicide cases of people aged 60 and more in at least one of the triennia analyzed (54.6% of all the municipalities). A total of 29.3% of those municipalities were in the Southern Region, 29.6% in the Southeast and 27.5% in the Northeast. The State of Rio Grande do Sul has the highest percentage of municipalities with suicide cases in the four triennia (27.3%), followed by the States of São Paulo (17.4%) and Santa Catarina (9.1%). Between the first and the final triennium, it was observed that there was a reduction in 32 of the 51 municipalities with higher rates. The mean ratio of male/female deaths was 2.8 male deaths for every female death. The main method used is hanging, strangulation and suffocation among both men (58.2%) and women (49.8%).

[Family environment and attention-deficit hyperactivity disorder]. / Ambiente familiar e transtorno de déficit de atenção e hiperatividade.

OBJECTIVE: To analyze factors associated with attention-deficit and hyperactivity disorder in children. METHODS: This is a longitudinal study about behavior problems in schoolchildren that was carried out in the city of São Gonçalo (Southeastern Brazil) in 2005. A total of 479 students from public schools was analyzed, selected through three-stage cluster sampling. The Child Behavior Checklist was used to measure the outcome. A questionnaire was administered to parents/guardians concerning the exposure factors, which were: child's and family's profile, family relationship variables, physical and psychological violence. The log-binomial regression model with a hierarchical approach was employed in the analysis. RESULTS: Higher intelligence quotient was inversely associated with the frequency of the disorder (PR=0.980 [95%CI 0.963;0.998]). The prevalence of the disorder in the children was higher when there was family dysfunction than among families with a better way of relating (PR=2.538 [95%CI 1.572; 4.099]). Children who suffered verbal abuse from the mother had a prevalence 3.7 times higher than the ones not exposed to this situation in the last year (PR=4.7 [95%CI 1.254;17.636]). CONCLUSIONS: Negative family relationships are associated with symptoms of Attention-Deficit and Hyperactivity Disorder. Its association with the intelligence quotient reiterates the importance of the genetic and environmental basis at the origin of the disorder.

[Suicide mortality temporal trends in people aged 60 years or more in the Brazilian states: 1980 to 2009]. / Evolução temporal da mortalidade por suicídio em pessoas com 60 anos ou mais nos estados brasileiros, 1980 a 2009.

The scope of this paper is to determine the temporal evolution of mortality by suicide in people aged 60 or more per State in Brazil between 1980 and 2009. Historical mortality by suicide data (ICD-9 codes E950 to E959 and ICD-10 codes X60 to X84 and Y87.0) were obtained from the Mortality Information System (SIM / MS). Data regarding population counts were obtained from the Brazilian Institute of Geography and Statistics. In the assessment of temporal trends the Poisson regression model was used, in which the dependent variable was the number of deaths and the centralized calendar year was the explanatory variable. Statistically significant trends were considered those whose p-value was d" 0.05. The results revealed the presence of a statistically significant increasing trend in four states and a decrease in two (general population; 60 years or more). In the male population there was an increase in five states and a reduction in two. The female rate showed an increase in one state and a decrease in three. There was an increasing trend in Piauí, Ceará and Rio Grande do Norte and a reduction in Amazonas, Roraima, and São Paulo for people aged between 60 and 69. Increasing rates were observed in the population aged 70-79 in Piauí and decreasing trends in Roraima.