Sex Differences in Temporal Sleep Patterns, Social Jetlag, and Attention in High School Adolescents.

Insufficient sleep and irregular sleep hours are common in adolescents, who experience a delayed sleep phase due to biopsychosocial changes associated with puberty, resulting in later sleep times. However, early morning class hours shorten sleep duration on weekdays. This condition is harmful to cognitive performance, which may be accentuated in girls due to a greater sleep need and less resistance to sleep deprivation. In this study, we evaluated sex differences concerning temporal sleep patterns, social jetlag, and attention in high school adolescents attending morning classes. Students ( n = 146 - F: 73-16.1 ± 0.8 years; M: 73-16.2 ± 0.9 years) completed a Health and Sleep questionnaire, kept a sleep diary for 10 days, which incorporated a Maldonado Sleepiness Scale, and performed a Continuous Performance Task. Girls went to bed earlier and woke up on weekends, and spent more time in bed at night and in 24 h on weekdays and weekends, while they also had a greater irregularity in wake-up times ( p < 0.05). There were no differences between sexes in terms of social jetlag, sleep debt, and sleepiness upon awakening ( p > 0.05). Regarding attention, the girls had a longer reaction time in phasic alertness ( p < 0.01) and a tendency to have fewer errors in selective attention ( p = 0.06). These results persisted when controlled for sleep parameters. Therefore, we suggest that girls have a greater sleep need and less resistance to sleep deprivation, while the differences in attention performance could be due to different strategies, the girls could be making a trade, increasing reaction time in favor of better accuracy, while the boys could be prioritizing a faster response time.

C57BL/6J offspring mice reared by a single-mother exhibit, compared to mice reared in a biparental parenting structure, distinct neural activation patterns and heightened ethanol-induced anxiolysis.

RATIONALE: Parenting experiences with caregivers play a key role in neurodevelopment. We recently reported that adolescents reared by a single-mother (SM) display an anxiety-prone phenotype and drink more alcohol, compared to peers derived from a biparental (BP) rearing condition. OBJECTIVES: To investigate if SM and BP offspring infant mice exhibit differential sensitivity to ethanol-induced locomotor activity and differential activity patterns in brain areas related to anxiety response. We also analyzed anxiety response and ethanol-induced anxiolysis in SM and BP adolescents. METHODS: Mice reared in SM or BP conditions were assessed for (a) ethanol-induced locomotor activity at infancy, (b) central expression of Fos-like proteins (likely represented mostly by FosB, a transcription factor that accumulates after chronic stimuli exposure and serves as a molecular marker of neural plasticity) and cathecolaminergic activity, and (c) anxiety-like behavior and ethanol-induced anxiolysis in adolescence. RESULTS: Infant mice were sensitive to the stimulating effects of 2.0 g/kg alcohol, regardless parenting structure. SM mice exhibited, relative to BP mice, a significantly greater number of Fos-like positive cells in the central amygdala and basolateral amygdala nuclei. Ethanol treatment, but not parenting condition, induced greater activation of dopaminergic neurons in ventral tegmental area. SM, but not BP, adolescent mice were sensitive to ethanol-induced anxiolysis. CONCLUSIONS: These results highlight the complex relationship between parenting experiences and neurodevelopment. The SM parenting may result in greater neural activation patterns in brain areas associated with anxiety response, potentially contributing to increased basal anxiety and alcohol sensitivity.

Alteraciones afectivo-comportamentales, acoso escolar y rendimiento académico en una población pediátrica: Salud mental y experiencia escolar / Affective-behavioral disorders, bullying and academic performance in a pediatric population: Mental health and school experience

Resumen Los niños con problemas de salud mental en la etapa escolar son más propensos a presentar menor rendimiento escolar. A su vez, las diferentes formas de acoso impacta la experiencia escolar y el bienestar general. El objetivo del presente trabajo fue determinar la asociación entre las alteraciones afectivas y comportamentales, y la experiencia escolar en población estudiantil de colegios públicos en Caldas-Colombia. Se realizó un estudio observacional analítico transversal, en individuos entre cuatro y 17 años, en el segundo semestre del año 2019 y el primer trimestre del 2020, en 17 colegios públicos de Manizales y Aranzazu (Caldas). Se deteminaron alteraciones afectivo-comportamentales mediante el Child Behavior Checklist 4-18 (CBCL/4-18), y la experiencia escolar se evaluó de acuerdo al rendimiento académico y el acoso escolar. La muestra estuvo constituida por 1533 niños. El 18.2% de los niños tenía problemas académicos, un 15.3% asistía a clases especiales y un 28.9% repitieron cursos. Las asignaturas que mostraron peor rendimiento fueron matemáticas y lenguaje, además se encontró una relación estadísticamente significativa entre el rendimiento académico y las alteraciones en los dominios de CBCL. Los percentiles para los síndromes del CBCL fueron mayores en los niños con acoso escolar. Se concluye que la experiencia escolar tiene una relación con síntomas internalizantes y externalizantes en la población estudiantil. Se requieren estrategias de detección e intevención temprana de alteraciones afectivo comportamentales en niños en el entorno escolar.

Abstract Children with mental health problems at school are more likely to present lower school performance and, in turn, different forms of bullying are an important risk factor for advancing academically. The objective was to determine the association between affective and behavioral alterations and the school experience in the student population of public schools in Caldas-Colombia. A cross-sectional analytical observational study was carried out in individuals between the ages of four and 17, carried out in the second semester of 2019 in 17 public schools in Manizales and Aranzazu (Caldas). Affective-behavioral alterations were determined using the Child Behavior Checklist 4-18 (CBCL/4-18), and the school experience was evaluated according to academic performance, bullying and play time. The sample consisted of 1533 children. 18.2% of the children had academic problems, 15.3% attended special classes and 28.9% repeated courses. The subjects that showed the worst performance were mathematics and language, in addition a statistically significant relationship was found between academic performance and alterations in CBCL domains. The percentiles for CBCL syndromes were higher in bullied children. It is concluded that the school experience has a relationship with internalizing and externalizing symptoms in the student population, it is necessary to apply strategies to carry out early detection and intervention of affective-behavioral alterations in children.

Internalizing and externalizing behaviors in high school adolescents in a northern border city of Mexico and their type of family.

OBJECTIVE: Identify externalizing and internalizing behaviors in high school adolescents in three schools in a northern border city in Mexico and their type of family. DESIGN: Cross-sectional survey. LOCATION: Three schools in the city of Tijuana, Mexico: two public and one private. PARTICIPANTS: 454 baccalaureate students 14-19 years old. MAIN MEASUREMENTS: We utilized Youth Self Report Scale, adapted and validated in Spanish, that measure internalization behaviors (anxiety, depression, isolation or somatic complaints), and externalization behaviors (verbal aggressiveness, delinquent behavior and attention-seeking). For dichotomous discrimination between deviant and nondeviant scores, we use the borderline clinical range by classifying YSR scale's T scores≥60, and to analyze the relationship between behavior problems or competencies and living or not in a nuclear family we utilized multiple logistic regression. RESULTS: 55% were female, mean age 16.4 years±0.98, and 62.3% came from a nuclear family. Prevalence of internalizing behaviors was 15.6%, and externalizing behaviors 14.8%. Women had statistically higher mean scores in depressive, anxious and verbally aggressive behavior, somatic complaints, and thought problems. The prevalence of internalizing behaviors in adolescents with nuclear family was 11.7% (n=33), and for adolescents with another type of family was 22.2% (n=38), OR 2.17 (CI 95% 1.30-3.61, p=0.003), but no differences was observed for externalizing behaviors and family type. When adjusted for sex, age, and public or private school, internalizing behaviors and specifically depressive behavior remained significant. CONCLUSIONS: We detected a moderate prevalence of internalizing behaviors in Mexican adolescents, predominantly among women, and also observed that not living with a nuclear family increases the odds of presenting internalizing behaviors. It is important that parents, teachers, and healthcare workers remain vigilant to detect these problems in a timely manner and develop interventions to improve the mental health and well-being of adolescents.

Health-promoting domains and lifestyle of a sample of Brazilian adolescents.

BACKGROUND: Reports indicate that the health habits of adults are strongly linked to the behaviors incorporated in adolescence. Therefore, it is essential to monitor the lifestyle of adolescents to promote their present and future health. This study aimed to identify differences in health-promoting domains according to demographic data and lifestyle behaviors, including physical activity, sedentary behavior, sleep duration, and food intake, in a sample of Brazilian adolescents. MATERIALS AND METHODS: Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect demographic data and lifestyle behaviors. To examine the health-promoting domains the Adolescent Health Promotion Scale (AHPS) was used. Data were analyzed using multivariate analysis. RESULTS: Scores attributed to each of the health-promoting domains showed substantial variations according to sex, age, year of study, parents' schooling, and family economic class. After adjustment for covariables, the adolescent who presented significantly higher scores equivalent to the overall index of health promotion reported being more physically active (F = 4.848; P = 0.009), sleeping 6-8 hours/night (F = 2.328; P = 0.046), consuming fruit/vegetable more frequently (F = 3.168; P = 0.024), while sedentary behavior and intake of sweetened products/soft drinks have not shown any significant effect. CONCLUSION: The findings confirmed the consistent positive influence of health-promoting domains assessed by AHPS on healthy lifestyle behaviors, suggesting in the intervention programs aimed at adopting healthy lifestyle approaches it is important enough to contemplate actions aimed at all the areas of health promotion with characteristics aimed at nutrition behavior, social support, health responsibility, life appreciation, exercise behavior, and stress management.

Association of health predictors with quality of life in children and adolescents.

OBJECTIVES: To evaluate the association of health-related quality of life (HRQOL) with physical activity, food consumption, sleep duration and screen time in children and adolescents. METHODS: Cross-sectional study with 268 students aged 10-17 years from a public school in Brazil. The outcome variable was HRQOL score, evaluated by the Pediatric Quality of Life Inventory™ (PedsQL™). Exposure variables were habitual physical activity, food consumption, sleep duration, and screen time. A general linear model was used to estimate age-adjusted means and 95 % confidence interval (95 % CI) of HRQOL scores, and a multivariable analysis of variance to identify factors associated with lower/higher HRQOL scores. The study was approved by the Human Research Ethics Committee of the Pontifical Catholic University of Campinas. RESULTS: Overall HRQOL score was 70.3 (95 % CI: 68.0-72.6). Multivariable analyses showed lower HRQOL scores for those adolescents who: 1-were physically inactive (67.3; p=0.014); 2-sleep less than 6 h per night (66.8; p=0.003); 3-eat fruits and vegetables less than five days/week (68.9; p=0.027); and 4-eat fast food twice/week or more (68.6; p=0.036) when compared to their opposite groups. Screen time was not statistically significantly associated with total HRQOL. CONCLUSIONS: The joint association found in our study suggests that at least three habits must change to improve the HRQOL of children and adolescents (physical activity, food consumption, and sleep duration). Therefore, interventions in schools to promote a healthy lifestyle to achieve a better HRQOL should include a multidisciplinary team to properly guide children and adolescents about these habits simultaneously.

Motivations of overweight adolescents participating in a multidisciplinary health promotion program / Motivações de adolescentes acima do peso participantes de um programa multidisciplinar de promoção da saúde

Introduction: the perception of individuals about their own health is a strong indicator of their real state, as well as their behaviors related to the prognosis in case of presence of pathologies, besides being proportional to their motivations to acquire healthy habits. Objective: to describe the motivations of overweight adolescents when participating in a multidisciplinary health promotion program and their perceptions about habits related to physical and emotional well-being. Methods: this is a qualitative study, using the Bardin content analysis technique. The tool used for data collection was the semi-structured interview, analyzed with the help of the software QSR NVivo 11 through grouping of the speech into clusters. These in turn were evaluated in three categories: (1) motivation; (2) food; and (3) physical exercise. Results: the average age of the participants was 13.8 ± 2.4, with an average body mass index of 31.8 ± 8.5 kg/m². Regarding family income, 41.66% had monthly income of 3 to 6 minimum wages. Regarding the educational level of parents, 70.83% of mothers had completed higher education, while 29.16% had completed high school. According to the respondents' answers, the greatest motivation to participate in a multidisciplinary obesity treatment program was weight loss. In category 2, it was observed that adolescents associated the act of eating with feelings such as anxiety and nervousness. In category 3, the impact of the pandemic was found under the modalities of physical exercise practiced. Conclusion: the results prove the importance of understanding the perception of adolescents about their own health and related habits, in order to elaborate effective strategies for health promotion and consequent improvement of the quality of life of these individuals.

Introdução: a percepção dos indivíduos a respeito da própria saúde é um forte indicador do seu real estado, bem como dos seus comportamentos relativos ao prognóstico em caso de presença de patologias, além de ser proporcional às suas motivações para adquirir hábitos saudáveis. Objetivo: descrever as motivações de adolescentes acima do peso ao participarem de um programa multidisciplinar de promoção da saúde e suas percepções a respeito de hábitos relacionados ao bem estar físico e emocional. Métodos: trata-se de estudo de abordagem qualitativa, com emprego da técnica de análise de conteúdo de Bardin. A ferramenta utilizada para coleta de dados foi a entrevista semiestruturada, analisada com auxílio do software QSR NVivo 11 através de agrupamento das falas em clusters. Esses por sua vez foram avaliados em três categorias: (1) motivação; (2) alimentação; e (3) exercício físico. Resultados: a idade média dos participantes foi de 13,8 ± 2,4, com índice de massa corporal médio de 31,8 kg/m² ± 8,5. Em relação à renda familiar, 41,66% apresentaram renda mensal de 3 a 6 salários mínimos. No que tange à escolaridade dos responsáveis, 70,83% das mães possuíam o ensino superior completo, enquanto 29,16% possuíam ensino médio completo. De acordo com as respostas dos entrevistados a maior motivação para participarem de um programa multidisciplinar de tratamento da obesidade foi o emagrecimento. Já na categoria 2 observou-se que os adolescentes associaram o ato de comer com sentimentos como a ansiedade e o nervosismo. Na categoria 3, constatou-se o impacto da pandemia sob as modalidades de exercício físico praticados. Conclusão: os resultados comprovam a importância de entender a percepção dos adolescentes a respeito da própria saúde e hábitos relacionados, a fim de elaborar de estratégias efetivas para promoção da saúde e consequente, melhoria da qualidade de vida desses indivíduos.

Change in the motivation pattern of adolescents before and after participation in a multidisciplinary health promotion program

Introduction: there is evidence that multidisciplinary interventions are an efficient approach to achieving weight loss and other health-related goals. However, dropout rates of these programs are high among adolescents. The suggestion is that understanding the motivation of individuals to participate in these projects is fundamental to developing strategies for permanence and, consequently, promoting better results.Objective: the main aim of this study was to describe the motivations of overweight adolescents participating in a multidisciplinary health promotion project.Methods: this qualitative study was conducted from March to July 2021 using the Bardin content analysis technique. The tool used for data collection was the semi-structured interview, analyzed means by the software QSR NVivo 11 by grouping the speech into clusters. These, in turn, were evaluated in three categories: (1) motivation, (2) food, and (3) physical exercise.Results: the age of the participants was 13.8 ± 2.4 years old, with body mass index of 31.8 ± 8.5 kg/m². Regarding family income, 41.66% had a monthly payment of 3 to 6 minimum wages. Regarding parents' educational level, 70.83% of mothers had completed higher education, while 29.16% had completed high school. According to the respondent's answers, weight loss was the greatest motivation to participate in a multidisciplinary obesity treatment program. In category 2, it was observed that adolescents associated the act of eating with feelings such as anxiety and nervousness. In category 3, the impact of the pandemic was found under the modalities of physical exercise practiced.Conclusion: the results describe the motivation of overweight adolescents to participate in a multidisciplinary program, in addition to elucidating participants' perception of their health and related habits, strategies for health promotion, and consequent improvement of the quality of life of these individuals.

Risk-Taking Behavior of Adolescents and Young Adults Born Preterm.

OBJECTIVES: To study sexually transmitted Chlamydia trachomatis infections (STCTs), teenage pregnancies, and payment defaults in individuals born preterm as proxies for engaging in risk-taking behavior. STUDY DESIGN: Our population-based register-linkage study included all 191 705 children alive at 10 years (8492 preterm [4.4%]) born without malformations in Finland between January 1987 and September 1990 as each mother's first child within the cohort. They were followed until young adulthood. We used Cox regression to assess the hazards of STCTs, teenage pregnancies, payment defaults, criminal offending, and substance abuse by gestational age. Gestational age was considered both as a continuous and categorical (extremely, very, moderately, late preterm, early term, post term, and full term as reference) exposure. RESULTS: A linear dose-response relationship existed between gestational age and STCT and teenage pregnancy; adjusted hazard for STCT decreased by 1.6% (95% CI, 0.7%-2.6%), and for teenage pregnancy by 3.3% (95% CI, 1.9%-4.8%) per each week decrease in gestational age. Those born extremely preterm (23-27 completed weeks) had a 51% (95% CI, 31%-83%) lower risk for criminal offending than their full-term born counterparts, and those born very preterm (range, 28-31 weeks) had a 28% (95% CI, 7%-53%) higher hazard for payment defaults than those born at full term. Gestational age was not associated with substance abuse. CONCLUSIONS: The lower risk-taking that characterizes people born preterm seems to generalize to sexual and to some extent criminal behavior. Those born very preterm are, however, more likely to experience payment defaults.

Independent and combined effects of lifestyle behaviors on adolescent health-related quality of life / Efectos individuales y combinados de conductas del estilo de vida en la calidad de vida relacionada a la salud de adolescentes / Efeitos individual e combinado de condutas do estilo de vida na qualidade de vida relacionada à saúde de adolescentes

ABSTRACT Objective: To investigate the independent and combined effects of lifestyle behaviors, including physical activity, sedentary behavior, sleep duration and food intake, in the health-related quality of life (HRQoL) of Brazilian adolescents. Methods: Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect lifestyle behaviors data. Perception of the HRQoL was identified using the Kidscreen-27. The study used covariance analysis and linear regression models for statistical analysis. Results: Adolescents who reported ≤ 2 hours/day of screen-based sedentary behavior and sleep duration equivalent to 8-10 hours/night presented significantly higher HRQoL. Adolescents who reported joint adherence ≥ 3 healthy lifestyle behaviors demonstrated approximately two [OR=2.12] to three times [OR=3.04] more chance of presenting higher perceptions of HRQoL. Conclusion: Although healthy lifestyle behaviors had a positive independent effect on HRQoL, joint adherence to healthy behaviors enhances the cumulative effect.

RESUMEN Objetivo: Investigar los efectos individuales y combinados de conductas del estilo de vida, incluyendo actividad física, conducta sedentaria, sueño y ingestión de alimentos, en la calidad de vida relacionada a la salud (CVRS) de adolescentes brasileños. Métodos: Estudio observacional de base escolar, con participación de 306 adolescentes de 14 a 18 años. Fue aplicada encuesta con cuestiones estructuradas para recoger datos de conductas del estilo de vida. Percepción de la CVRS fue identificada por medio del Kidscreen-27. Análisis de covarianza y modelos de regresión linear fueron usados para análisis estadístico. Resultados: Adolescentes que apuntaron ≤ 2 horas/día de conducta sedentaria basado en pantalla y duración de sueño entre 8-10 horas/noche tuvieron CVRS significativamente más elevada. Adolescentes que relataron adherencia conjunta ≥ 3 conductas saludables del estilo de vida demostraron aproximadamente de dos [OR=2,12] a tres veces [OR=3,04] más chance de presentar percepciones más elevadas de CVRS. Conclusión: Aunque conductas saludables del estilo de vida resulten en efecto individual positivo sobre la CVRS, adherencia conjunta de conductas saludables potencializa el efecto acumulativo.

RESUMO Objetivo: Investigar os efeitos individual e combinado de condutas do estilo de vida, incluindo atividade física, comportamento sedentário, sono e consumo alimentar, na qualidade de vida relacionada à saúde (QVRS) de adolescentes brasileiros. Métodos: Estudo observacional de base escolar, com participação de 306 adolescentes de 14 a 18 anos. Foi aplicado questionário com questões estruturadas para levantar dados de condutas do estilo de vida. Percepção da QVRS foi identificada por meio do Kidscreen-27. Análise de covariância e modelos de regressão linear foram usados para análise estatística. Resultados: Adolescentes que apontaram ≤ 2 horas/dia de comportamento sedentário baseado em tela e duração de sono entre 8-10 horas/noite apresentaram QVRS significativamente mais elevada. Adolescentes que relataram adesão conjunta ≥ 3 condutas saudáveis do estilo de vida demonstraram aproximadamente de duas [OR=2,12] a três vezes [OR=3,04] mais chance de apresentarem percepções mais elevadas de QVRS. Conclusão: Embora condutas saudáveis do estilo de vida apresentaram efeito individual positivo sobre a QVRS, adesão conjunta de condutas saudáveis potencializaram o efeito cumulativo.

Social skills training as a strategy to combat prejudice against sexual and gender diversity / Treinamento de habilidades sociais como estratégia de combate ao preconceito contra a diversidade sexual e de gênero

The aim of this study was to verify the effectiveness of a social skills training program to reduce prejudice against sexual diversity. Method A total of 22 adolescents aged between 14 and 17 years who were 9th grade public school students, participated. The assessment instruments were the Social Skills Inventory for adolescents and the Scale of Prejudice Against Sexual and Gender Diversity. Both instruments were applied before and after training. Results The results indicated a significant reduction in the levels of prejudice against sexual and gender diversity, an increase in the frequency of the issuance of skills related to assertiveness, an affective approach and social resourcefulness and a decrease in the difficulties related to civility. Conclusion The social skills training program proved to be effective, indicating that this is a viable tool for greater acceptance of sexual and gender diversity.

Verificar a efetividade de um programa de treinamento de habilidades sociais na redução do preconceito contra a diversidade sexual. Método: Participaram 22 adolescentes com idades entre 14 e 17 anos, estudantes do 9º ano de escola pública. Os instrumentos de avaliação foram o Inventário de Habilidades Sociais para adolescentes e a Escala de Preconceito contra a Diversidade Sexual e de Gênero. Ambas aplicadas antes e após o treinamento. Resultados: Os resultados indicaram a redução significativa nos níveis de preconceito contra a diversidade sexual e de gênero, aumento da frequência da emissão de habilidades relacionadas à assertividade, abordagem afetiva e desenvoltura social e diminuição das dificuldades alusivas à civilidade. Conclusão: O programa de treinamento de habilidades sociais se mostrou eficaz indicando que esta é uma ferramenta viável para uma maior aceitação da diversidade sexual e de gênero.

Multidimensionalidade de significados da automutilação na adolescência: perspectiva de adolescentes, responsáveis e profissionais de saúde / Multidimensionality of meanings of self-harm in adolescence: perspective of adolescents, caregivers and health professionals / Multidimensionalidad de los significados de las autolesiones en la adolescencia: perspectiva de adolescentes, cuidadores y profesionales de la salud

Objetivo: analisar os significados da prática da automutilação na adolescência na perspectiva de adolescentes, seus responsáveis e profissionais de saúde. Métodos: pesquisa descritiva, exploratória, de abordagem qualitativa. Participaram 7 adolescentes, 20 responsáveis e 6 profissionais de um Centro de Atenção Psicossocial Infantojuvenil da região central do Brasil. Os dados foram coletados por meio de entrevistas individuais, com os responsáveis e profissionais, e grupo focal com os adolescentes. Para análise dos dados, utilizou-se análise temática de conteúdo. Resultados: emergiu a categoria temática "Significados da automutilação", contemplando sete subcategorias: "Psicopatologia"; "Comunicação social"; "Identificação de pares"; "Regular emoções"; "Sentimentos gerados"; "Intencionalidade da ação" e "Dependência". Conclusão: há uma desconexão dos significados atribuídos à automutilação pelos adolescentes, responsáveis legais e profissionais. Os diferentes significados na compreensão da automutilação podem interferir na assertividade do cuidado ofertado pelos profissionais aos adolescentes, e na percepção dos responsáveis legais de que é necessário buscar ajuda, assim como na motivação dos adolescentes em aderir ao atendimento.

Objective: to analyze the meanings of the practice of self-harm in adolescence from the perspective of adolescents, their legal guardians and health professionals. Methods:descriptive, exploratory, qualitative study. Participants were 7 adolescents, 20 legal guardians and 6 professionals from a Psychosocial Care Center for Children and Adolescents in the central region of Brazil. Data were collected through individual interviews with guardians and professionals, and focus groups with adolescents. Thematic content analysis was used in data analysis. Results: the thematic category "Meanings of self-harm" emerged, covering seven subcategories: "Psychopathology"; "Social communication"; "Peer identification"; "Regulating emotions"; "Generated feelings"; "Intentionality of action" and "Dependency". Conclusion: there is a disconnection of the meanings attributed to self-harm by adolescents, legal guardians and professionals. The different meanings in the understanding of self-harm can interfere with the assertiveness of the care offered by professionals to adolescents, in the perception of legal guardians regarding the need to seek help, and in adolescents' motivation to adherence to care.

Objetivo: analizar los significados de la práctica de autolesiones en la adolescencia en la perspectiva de los adolescentes, sus tutores legales y profesionales de la salud. Métodos: estudio descriptivo, exploratorio, cualitativo. Participaron 7 adolescentes, 20 tutores legales y 6 profesionales de un Centro de Atención Psicosocial a Niños y Adolescentes de la región central de Brasil. Los datos fueron recolectados a través de entrevistas individuales con tutores y profesionales, y grupos focales con adolescentes. En el análisis de datos se utilizó el análisis de contenido temático. Resultados: surgió la categoría temática "Significados de la autolesión", que abarca siete subcategorías: "Psicopatología"; "Comunicación social"; "Identificación de pares"; "Regular las emociones"; "Sentimientos generados"; "Intencionalidad de la acción" y "Dependencia". Conclusión: hay una desconexión de los significados atribuidos a la autolesión por los adolescentes, tutores legales y profesionales. Los diferentes significados en la comprensión de la autolesión pueden interferir en la asertividad del cuidado ofrecido por los profesionales a los adolescentes, en la percepción de los tutores legales sobre la necesidad de buscar ayuda y en la motivación de los adolescentes para la adhesión al cuidado

Lei, para que te quero? Dados comparativos da Pesquisa Nacional de Saúde do Escolar (PeNSE) sobre acesso a cigarros por adolescentes / Ley ¿para qué te necesito? Datos comparativos del Encuesta Nacional de Salud del Escolar (PeNSE) sobre el acceso a cigarrillos por los adolescentes / Law compliance, why do we need it? Comparative data from the Brazilian National Survey of School Health (PeNSE) on adolescents' access to cigarettes

Nas últimas décadas, o Brasil obteve importantes avanços no combate à epidemia de tabaco. No entanto, dados recentes nacionais apontam para uma provável estagnação na queda da iniciação ao tabagismo entre jovens e adolescentes. O objetivo deste estudo foi avaliar a evolução no tempo do cumprimento da lei que proíbe a venda de cigarros para menores de idade no Brasil. Para tal, utilizaram-se os dados da Pesquisa Nacional de Saúde do Escolar das edições de 2015 e 2019. Foram estimadas proporções para indicadores "sequenciais" criados da combinação das respostas às perguntas "alguém se recusou a lhe vender cigarros?" e "como conseguiu seus próprios cigarros?". Houve uma queda, entre 2015 e 2019, na proporção de fumantes entre 13 e 17 anos que tentaram comprar cigarros nos 30 dias anteriores à pesquisa (72,3% vs. 66,4%; valor de p ≤ 0,05). Contudo, independentemente do ano da pesquisa, cerca de 9 em cada 10 adolescentes fumantes tiveram sucesso em alguma tentativa de compra de cigarros. Desses, aproximadamente 7 em cada 10 utilizaram a compra ativa como a principal modalidade de acesso ao cigarro, sendo que a respectiva compra em estabelecimentos comerciais autorizados (vs. com ambulantes) aumentou entre 2015 e 2019 (81,1% vs. 89,6%; valor de p ≤ 0,05). Em 2019, 70% dos adolescentes que compraram cigarros em estabelecimentos comerciais autorizados realizaram a compra avulsa. O descumprimento de leis voltadas à prevenção da iniciação ao fumo é um enorme obstáculo para a redução da proporção de fumantes. O fortalecimento das ações legislativas e de fiscalização, aliado a ações educativas e de sensibilização junto aos varejistas, é fundamental para proteger as novas gerações quanto aos efeitos nocivos do uso do tabaco.

En las últimas décadas, Brasil ha logrado importantes avances en el combate a la epidemia del tabaquismo. Pero, recientes datos nacionales apuntan a un probable estancamiento en la recucción de la iniciación tabáquia entre jóvenes y adolescentes. El objetivo de este estudio fue evaluar la evolución en el tiempo de cumplimiento de la ley que prohíbe la venta de cigarrillos a menores en Brasil. Para ello, se utilizaron datos de la Encuesta Nacional de Salud del Escolar de 2015 y 2019. Se estimaron proporciones para los indicadores "secuenciales" creados desde una combinación de las respuestas a las preguntas "alguien se negó a venderte cigarrillos" y "cómo conseguiste cigarrillos". Hubo una disminución entre 2015 y 2019 en la proporción de fumadores de entre 13 y 17 años que intentaron comprar cigarrillos en los treinta días antes de la encuesta (72,3% vs. 66,4%; valor de p ≤ 0,05). Sin embargo, independientemente del año de la encuesta, alrededor de 9 de cada 10 adolescentes fumadores tuvieron éxito en algún intento de comprar cigarrillos. De estos, aproximadamente 7 de cada 10 utilizaron la compra activa como el principal método de acceso a cigarrillos, y la respectiva compra en establecimientos comerciales autorizados (vs. con vendedores ambulantes) aumentó entre 2015 y 2019 (81,1% vs. 89,6%; valor de p ≤ 0,05). En 2019, el 70% de los adolescentes que compraron cigarrillos en establecimientos comerciales autorizados los compraron sueltos. El incumplimiento de la ley destinada a prevenir la iniciación al tabaquismo es un gran obstáculo para reducir la proporción de fumadores. El fortalecimiento de las acciones legislativas y de fiscalización, sumado a acciones educativas y de sensibilización con los comerciantes, es fundamental para proteger a las nuevas generaciones de los efectos nocivos del consumo de tabaco.

In recent decades, Brazil has made significant progress in fighting the tobacco epidemic. However, recent national data suggest a probable stagnation in the reduction of smoking initiation among youth and adolescents. The objective of this study was to evaluate the evolution over time of compliance with the law that prohibits the sale of cigarettes to minors in Brazil. To this end, data from the Brazilian National Survey of School Health conducted in 2015 and 2019 were used. Percentages were estimated for "sequential" indicators created by combining answers to the questions "Did anyone refuse to sell you cigarettes?" and "How did you obtain your cigarettes?" There was a decrease between 2015 and 2019 in the percentage of smokers aged 13 to 17 who tried to buy cigarettes in the 30 days prior to the survey (72.3% vs. 66.4%; p-value ≤ 0.05). However, regardless of the survey year, approximately 9 out of 10 adolescent smokers were successful in an attempt to buy cigarettes. Of those, approximately 7 out of 10 used direct purchase as the main method of obtaining cigarettes, with purchases at licensed commercial establishments (vs. street vendors) increasing between 2015 and 2019 (81.1% vs. 89.6%; p-value ≤ 0.05). In 2019, 70% of teenagers who bought cigarettes at licensed commercial establishments purchased single cigarettes. Non-compliance with laws aimed at preventing smoking initiation is a huge obstacle to reducing the proportion of smokers. Increased implementation of legislative measures and oversight of cigarettes sales, combined with educational and awareness actions with retailers, is key to protecting new generations from the harmful effects of tobacco use.

Prevalência e fatores associados à iniciação sexual em adolescentes escolares do Piauí, 2015 / Prevalência y factores asociados a la iniciación sexual en adolescentes escolares de Piauí, Brasil, 2015 / Prevalence of sexual initiation and associated factors in school adolescents in Piauí, Brazil, 2015

Objective: to analyze prevalence of sexual initiation and associated factors in adolescents in Piauí. Methods: this was a cross-sectional study, with secondary data from the 2015 National Adolescent School-based Health Survey. Hierarchical analysis was performed using robust Poisson regression. Results: a total of 3.872 adolescents were interviewed. Prevalence of sexual initiation was 24.2%; risk factors for sexual initiation were being male [prevalence ratio (PR) = 2.18; 95% confidence interval (95%CI) 1.90;2.47], being 15 years old or over (PR = 2.49; 95%CI 2.18;2.76), living with mother (PR = 0.68; 95%CI 0.54;0.82), working (PR = 1.82; 95%CI 1.55;2.10), attending a public school (PR = 1.39; 95%CI 1.09;1.75), practicing bullying (PR = 1.50; 95%CI 1.31;1.72), using alcohol (PR = 2.35; 95%CI 2.09;2.64), using cigarettes (PR = 1.46; 95%CI 1.22;1.70) and using illicit drugs (PR = 1.40; 95%CI 1.15;1.66). Conclusion: prevalence of sexual initiation was high and associated with sociodemographic characteristics and vulnerable health behaviors, indicating the need for health promotion strategies.

Objetivo: analizar prevalencia y factores asociados a la iniciación sexual de adolescentes en Piauí. Métodos: estudio transversal, con datos de la Encuesta Nacional de Salud Adolescente, 2015. Se realizó análisis jerárquico mediante regresión robusta de Poisson. Resultados: han sido entrevistados 3.872 adolescentes. Hubo prevalencia de iniciación sexual del 24,2%, estando asociada con ser hombre (RP = 2,18; IC95% 1,90;2,47), tener 15 años o más (RP = 2.49; IC95% 2,18;2,76), vivir con la madre (RP = 0,68; IC95% 0,54;0,82), trabajar (RP = 1.82; IC95% 1,55;2,10), estudiar en escuela pública (RP = 1,39; IC95% 1,09;1,75), practicar bullying (RP = 1,50; IC95% 1,31;1,72), consumir alcohol (RP = 2.35; IC95% 2,09;2,64), consumir cigarrillos (RP = 1,46; IC95% 1,22;1,70) y consumir drogas ilícitas (RP = 1,40; IC95% 1,15;1,66). Conclusión: la prevalencia de iniciación sexual fue alta y se asoció con comportamientos vulnerables a la salud y características sociodemográficas, indicando estrategias para de promoción de la salud.

Objetivo: analisar prevalência e fatores associados à iniciação sexual de adolescentes do Piauí. Métodos: estudo transversal, com dados da Pesquisa Nacional de Saúde do Escolar, 2015. Realizou-se análise hierarquizada por regressão de Poisson. Resultados: foram entrevistados 3.872 adolescentes. A prevalência de iniciação sexual foi de 24,2%; sexo masculino [razão de prevalência (RP) = 2,18; intervalo de confiança de 95% (IC95%) 1,90;2,47], idade ≥ 15 anos (RP = 2,49; IC95% 2,18;2,76), morar com a mãe (RP = 0,68; IC95% 0,54;0,82), trabalhar (RP = 1,82; IC95% 1,55;2,10). estudar em escola pública (RP = 1,39; IC95% 1,09;1,75), praticar bullying (RP = 1,50; IC95% 1,31;1,72), usar álcool (RP = 2,35; IC95% 2,09;2,64), cigarro (RP = 1,46; IC95% 1,22;1,70) e drogas ilícitas (RP = 1,40; IC95% 1,15;1,66) foram fatores de risco para o evento. Conclusão: a prevalência de iniciação sexual foi alta e associada a características sociodemográficas e comportamentos vulneráveis à saúde, demandando estratégias de promoção de saúde.

Infecção pelo HIV em jovens: prevalência e fatores associados / HIV infections in youth: prevalence and associated factors

RESUMO Objetivo estimar a prevalência e fatores associados à infecção pelo Human Immunodeficiency Virus (HIV) em jovens. Métodos estudo transversal, realizado em dois Centros de Testagem e Aconselhamento, com 279 jovens entre 15 e 24 anos. Realizou-se teste anti-HIV e aplicou-se instrumento estruturado. Empregaram-se análise bivariada e regressão logística com correção de Bonferroni para investigar a associação entre as variáveis e o desfecho sorológico. Resultados a prevalência de HIV entre os jovens foi de 3,9% (Intervalo de confiança-IC95%: 1,0-10,1). A associação com o desfecho HIV mostrou-se estatisticamente significante entre jovens do sexo masculino (p=0,001), homossexuais (p<0,001), exposição sexual como motivo do teste (p=0,034), percepção de alto de risco de adquirir HIV (p=0,002) e prática de sexo anal (p=0,004). Jovens homossexuais (Odds ratio-OR=13,46; IC95%:1,14-15,84) e com percepção de alto risco de adquirir o HIV (OR=18,11; IC95%: 2,28-143,69) tiveram maiores chances de apresentarem resultado positivo para HIV. Conclusão foi possível identificar a prevalência e fatores associados ao HIV em jovens. Contribuições para a prática: as informações geradas podem disponibilizar evidências aos formuladores de políticas, gestores e profissionais de saúde, e subsidiar a elaboração de estratégias que contemplem o aperfeiçoamento das ações de prevenção, coordenadas e ajustadas aos contextos comportamentais nos cenários estudados.

ABSTRACT Objective to estimate the prevalence and associated factors with Human Immunodeficiency Virus (HIV) infection in youths. Methods cross-sectional study in two Centers for Testing and Counseling, with 279 youths from 15 to 24 years old. An anti-HIV test and a structured instrument were applied. We used bivariate analysis and logistic regression, with Bonferroni corrections, to investigate the association between the variables and the outcome. Results the prevalence of HIV in the youth analyzed was 3.9% (Confidence interval - CI95%: 1.0-10.1). The association with the outcome of HIV was statistically significant in male youth (p=0.001), homosexuals (p<0.001), those who tested due to sexual exposure (p=0.034), perception of a high risk of acquiring HIV (p=0.002), and anal sex (p=0.004). Homosexual youth (odds ratio-OR=13.46; CI95%;1.14-15.84), with a perception of high risk of acquiring HIV (OR=18.11; CI95%: 2.28-143.69) had a higher chance of being HIV positive. Conclusion the prevalence of HIV and associated factors in youth was ascertained. Contributions to practice: the information produced here shows evidence for those who aim to formulate policies, including health managers and workers. It can give support to the elaboration of strategies that involve perfecting preventive, coordinated actions, adjusted to behavioral contexts in the settings studied.

Identificación de hábitos, conductas y prácticas de niñas, niños y adolescentes de 5º y 6º año en instituciones educativas públicas y privadas / Identification of behaviours, habits and practices of 5th and 6th grade children and adolescents studying at private and public schools / Identificação de hábitos, comportamentos e práticas dos meninos, meninas e adolescêntes de 5to e 6to ano do ensino fundamental de instituçoes de ensino público e privado

Introducción: lograr la interacción entre los equipos de salud y la educación, es fundamental para generar futuras generaciones con conocimientos y destrezas que les permitan cuidar su salud, la de sus familias y comunidades. Durante la edad escolar se desarrollan gran parte de las preferencias, costumbres y estilos personales. Objetivo: conocer los hábitos, conductas y prácticas de las niñas, niños y adolescentes de quinto y sexto año de tres instituciones educativas públicas y tres privadas de Montevideo para realizar un diagnóstico de situación que permita planificar una intervención posterior. Material y método: estudio descriptivo, observacional y transversal entre octubre y diciembre 2017. Se aplicó una encuesta anónima a escolares de quinto y sexto año de tres instituciones públicas y tres privadas de los barrios Paso de la Arena, Prado y Colón. Se solicitó consentimiento informado y autorización al comité de investigación institucional. Se utilizaron frecuencias absolutas y porcentajes. Resultados: participaron 331 escolares, 73,1% del sector público y el 26,9% del privado. En la merienda escolar, 46% consume merienda casera y 75% comprada. El 53% no consume alimentos UP en el recreo. En el hogar un 50% come frutas y un 35% come verduras todos los días, un 64,3% consume carne UP hasta 3 veces por semana. Si bien un 48,3% refiere correr todos los días, casi cuatro de cada diez nunca bailan, patinan o andan en bicicleta y dos de cada diez nunca practican deportes. El 65% destina más de 2 horas a las pantallas, 2 de cada 10 duermen menos de 6 horas y más del 50% usan el celular o miran televisión antes de dormir. Se encontraron diferencias entre el sector público y privado en la merienda casera, consumo de UP, carne y agua. Conclusiones: se realizó un diagnóstico de los hábitos, conductas y prácticas de los escolares de esas 3 zonas que permitió elegir los temas prioritarios de salud para trabajar con esas escuelas. La situación es inquietante y debe trabajarse con celeridad a nivel interinstitucional generando cambios en los hábitos de vida de los escolares, sus familias y la comunidad. Se determinó un punto de partida para poder evaluar y medir el impacto de las acciones.

Introduction: promoting interaction between health and educational teams is essential to build the necessary skills and knowledge in future generations that would enable them to take care of their health, their families' and their communities'. Most preferences, habits and personal styles are developed at school age. Objective: to get to know the habits, behaviors and practices of children and adolescents of fifth and sixth grade attending three public and three private educational institutions in Montevideo and make a diagnosis of the situation to able to plan a subsequent intervention. Material and Methods: descriptive, observational and crosssectional study between October and December 2017. An anonymous survey was applied to fifth and sixth grade students from three public and three private institutions in the Paso de la Arena, Prado and Colón neighborhoods. Informed consent and authorization were obtained from the institutional research committee. Absolute frequencies and percentages were used. Results: 331 school children participated, 73.1% from the public sector and 26.9% from the private sector. Regarding school snacks, 46% of them consume homemade snacks and 75% consume processed snacks. 53% do not consume food during recess. At home 50% eat fruits and 35% eat vegetables every day, 64.3% consume UP meat up to 3 times a week. While 48.3% report running every day, almost four out of ten have never danced, skated or ridden a bike and two out of ten have never played sports. 65% spend more than 2 hours watching screens, 2 out of 10 sleep less than 6 hours and more than 50% use the cell phone or watch television before bed. We found significant differences between the public and private sectors regarding homemade snacking, meat and water consumption. Conclusions: we carried out a diagnosis of the habits, behaviors and practices of schoolchildren in these 3 areas, which enabled us to choose priority health topics to work with these schools. The situation is disturbing and it must be addressed quickly at interinstitutional level in order to generate changes in the schoolchildren habits, their families and their communities. We have set up a starting point in order be able to evaluate and measure the impact of actions taken.

Introdução: alcançar a interação entre as equipes de saúde e de educação é essencial para gerar conhecimentos e habilidades nas gerações futuras que lhes permitam cuidar de sua saúde, a de sua família e a de suas comunidades. A maior parte das preferências, costumes e estilos pessoais são desenvolvidos durante a idade escolar. Objetivo: conhecer os hábitos, comportamentos e práticas de crianças e adolescentes do quinto e sexto ano de ensino fundamental de três instituições de ensino público e três de ensino privado de Montevidéu para fazer um diagnóstico da situação que permita planejar uma intervenção posterior. Material e Métodos: estudo descritivo, observacional e transversal entre outubro e dezembro de 2017. Uma pesquisa anónima foi aplicada a alunos do quinto e sexto ano do ensino fundamental de três instituições públicas e três privadas dos bairros Paso de la Arena, Prado e Colón. Consentimento informado e autorização foram solicitados ao comitê de pesquisa da instituição. Foram utilizadas frequências absolutas e porcentagens. Resultados: participaram 331 escolares, sendo 73,1% do setor público e 26,9% do setor privado. Na merenda escolar, 46% consomem lanche caseiro e 75% compram. 53% não consomem alimentos UP no recreio. Em casa 50% comem frutas e 35% comem vegetais todos os dias, 64,3% consomem carne UP até 3 vezes por semana. Enquanto 48,3% relatam correr todos os dias, quase quatro em cada dez nunca dançam, patinam ou andam de bicicleta e dois em cada dez nunca praticam esportes. 65% passam mais de 2 horas assistindo a telas de computador ou telefones, 2 em cada 10 dormem menos de 6 horas e mais de 50% usam o celular ou assistem à televisão antes de dormir. Foram encontradas diferenças entre os setores público e privado no consumo de lanches caseiros, UP, carne e água. Conclusões: um diagnóstico dos hábitos, comportamentos e práticas dos escolares das 3 zonas que permitiram escolher os temas prioritários de saúde para trabalhar com estas escolas. A situação é preocupante e deve ser trabalhada rapidamente no nível interinstitucional, com o fim de gerar mudanças nos hábitos de vida dos escolares, de suas famílias e da comunidade. Determinouse um ponto de partida para poder avaliar e mensurar o impacto das ações realizadas.

Knowledge about head and neck cancer among adolescents

Introduction: The expansion of knowledge about head and neck cancer can provide greater care and the ability to identify risk factors and symptoms of the disease, as well as the incorporation of healthy habits. The younger these concepts are sedimented, the better results will be, making society healthier and more aware. Objective: To assess knowledge about head and neck cancer among adolescents from private schools, aged between 13 and 22 years. Methods: 200 questionnaires were applied among students, about the profile of adolescents and their knowledge about head and neck neoplasms, treatment, and teaching in schools on this topic. The results were analyzed both quantitatively and qualitatively. Results: Only 55 students (29.9%) identified HPV as a risk factor for the disease. 137 students (74.5%) identified the brain as an organ treated by head and neck surgery. As for the therapeutic strategies used for the treatment of neoplasms in the region, only 67 students (36.4%) are aware. On the topic of teaching in schools, 153 students (83.1%) relate to some deficiency in the approach and learning. Conclusion: Knowledge about head and neck cancer is insufficient. It is necessary to introduce in the curriculum basic cancer education in biology classes. The expansion of acquirements about cancer can provide better care and the ability to identify risk factors, initial signs, and symptoms of the disease, as well as the incorporation of healthy habits in families because these students can propagate valid information in their environment.

Adherence to Combined Healthy Movement Behavior Guidelines among Adolescents: Effects on Cardiometabolic Health Markers.

BACKGROUND: The combined movement behavior guidelines for adolescents recommend ≥60 min of moderate to vigorous physical activity, ≤2 h of screen time, and 8-10 h of sleep. Considering that the information available on this topic in the young Latin American population is rare, this study aimed to identify the proportion of a sample of Brazilian adolescents meeting individual guidelines as well as the combination of the three healthy movement behavior guidelines. In addition, another objective of the study was to examine the effects of compliance with these guidelines on cardiometabolic health markers. METHODS: This is a cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire with structured questions was applied to collect data on physical activity, screen time, and sleep duration. Cardiometabolic health was assessed by the calculation of a continuous risk score, including twelve markers related to body fat, blood pressure, plasma lipids and lipoproteins, glycemia, and insulin. RESULTS: Only 4.8% (4.3-5.4) of the adolescents met the three healthy movement behavior guidelines, while 9.3% (8.4-10.4) of the sample did not meet any of the guidelines. No significant difference between sexes was found in the simultaneous compliance of the three movement guidelines. Adolescents who did not meet any of the movement guidelines were twice as likely to have higher cardiometabolic risk (OR = 2.05 (1.41-3.17)) than their peers who met all three guidelines. CONCLUSIONS: Considering the high proportion of adolescents who did not meet the movement behavior guidelines and the negative effects on cardiometabolic health, it is suggested that future policies and interventions should consider an integrated and holistic approach aimed at simultaneous actions of maximizing physical activity, minimizing screen time, and ensuring sufficient sleep duration.

Traducción y adaptación cultural del Cuestionario sobre el Uso Problemático de Internet para la población peruana / Translation and cultural adaptation of the Questionnaire on the Problematic Use of the Internet for the Peruvian population

RESUMEN Objetivo: Adaptar el Cuestionario sobre el Uso Problemático de Internet (PIUQ) para su utilización en el Perú. Material y Métodos: La traducción al español y la adaptación cultural del PIUQ siguieron un proceso sistematizado que incluyó la traducción directa, la evaluación por juicio de expertos y la retrotraducción, y culminó con la aprobación final de los creadores de la escala. Para cada uno de los 18 ítems, un primer comité de expertos evaluó en la versión preliminar la comprensibilidad, aceptabilidad, relevancia y el conjunto de respuestas; posteriormente, un segundo comité, examinó en la versión final los rasgos de claridad, pertinencia y relevancia. Se calculó la V de Aiken para cada uno de los diferentes aspectos evaluados en los 18 ítems. Resultados: En la versión preliminar, la V de Aiken tuvo valores bajos para la comprensibilidad de los ítems 1, 3, 4, 6 y 16, y para el conjunto de respuestas del ítem 4. El análisis del primer comité de expertos produjo modificaciones en los ítems 1, 4 y 16 de la dimensión de obsesión, 5 y 8 de negligencia, y 15 de trastorno de control. La evaluación por parte del segundo comité de expertos resultó en valores adecuados de V de Aiken en todos los aspectos de los 18 ítems. Conclusiones: La versión peruana final así obtenida demostró estar alineada a los fines del cuestionario original, sin alterar el significado de los ítems.

SUMMARY Objective : To adapt the Problem Internet Use Questionnaire (PIUQ) for its utilization in Peru. Material and Methods : The translation and cultural adaptation of the PIUQ followed a systematic process that involved direct translation, evaluation and judgment by expert committees and back-translation, culminating with the final approval by the scale creators. For each of the 18 items, a first group of experts assessed comprehensibility, acceptability, relevance and quality of the response set in the preliminary version; subsequently, a second group of experts, evaluated clarity, relevance and pertinence in the final version. Aiken's V was calculated for each of the different features evaluated in the 18 items. Results : In the preliminary version, Aiken's V had low values for the comprehensibility of items 1, 3, 4, 6 and 16, and for the response set of item 4. The analysis of the first expert committee led to modifications in items 1, 4 and 16 of the obsession dimension, 5 and 8 of neglect, and 15 of control disorder. The evaluation by the second expert committee resulted in adequate Aiken V values for all aspects of the 18 items. Conclusions : The final Peruvian version thus obtained proved to be aligned to the purposes of the original questionnaire, without altering the meaning of the items.

Individual and Contextual Characteristics Associated With Alcohol Use Among Brazilian Adolescents.

Objective: To analyze the association between individual and contextual characteristics with alcohol indicators of experimentation, use in the last 30 days and drunkenness in Brazilian adolescents. Methods: Cross-sectional study based on data from 100,914 student attending 9th grade from the 2015 National School Health Survey. Multilevel logistic regression models were performed for the outcomes: alcohol experimentation; use in the last 30 days and drunkenness; and exposures, adjusted for adolescents' sociodemographic characteristics. Results: Girls were more likely to experiment alcohol (OR = 1.09; 95% CI = 1.05-1.12), use it in the last 30 days (OR = 1.09; 95% CI = 1.00-1.13) and less prone to drunkenness (OR = 0.90; 95% CI = 0.87-0.93). A higher proportion of public-school students reported drinking. There was a positive association of substance use by parents, peers and the adolescents themselves with the outcomes. Having a policy of banning alcohol consumption at school was associated with a greater chance of alcohol experimentation in public schools. Conclusion: Exposure to legal and illegal substances by friends, family members and a prohibitive school environment favored the outcomes.