Development and implementation of a brief chat-based intervention to support mental health during the COVID-19 pandemic / Desenvolvimento e implementação de uma intervenção breve via chat para suporte em saúde mental durante a pandemia da COVID-19 / Desarrollo e implementación de una intervención breve vía chat para dar apoyo en salud mental durante la pandemia de COVID-19

This paper presents the development and implementation of a brief chat-based intervention for mental health support toward people suffering from the context of the COVID-19 pandemic in Brazil and Argentina. During the development phase, we proposed a protocol that comprised: 1) screening and needs assessment; 2) health education based on active listening techniques; and 3) referral to available materials and crisis services available (e.g., crisis intervention hotlines). In the implementation phase, we recruited and trained 77 volunteers who provide healthcare chat support for users under the supervision of 20 psychologists. In less than two months, we performed 1.107 sessions. We expect that the healthcare chat support might be a valuable resource during the COVID-19 pandemic, although further studies to assess its feasibility and effectiveness are needed.

Este artigo apresenta o desenvolvimento e a implementação de uma intervenção breve via chat para suporte em saúde mental voltada para pessoas em sofrimento decorrente do contexto da pandemia de COVID-19, no Brasil e na Argentina. Durante a fase de desenvolvimento, foi proposto um protocolo que inclui: 1) triagem e avaliação de necessidades; 2) educação em saúde com base em técnicas de escuta ativa e 3) encaminhamento de materiais e contatos de serviços especializados ou de urgência disponíveis (ex. linhas diretas de intervenção em crise). Na fase de implementação, foram recrutados e treinados 77 voluntários que oferecem acolhimento em saúde via chat aos usuários sob a supervisão de 20 psicólogos. Em menos de 2 meses, 1.107 intervenções foram realizadas. Espera-se que a intervenção via chat possa ser um recurso valioso durante a pandemia de COVID-19, embora estudos adicionais sejam necessários para avaliar sua viabilidade e sua efetividade.

Este artículo presenta el desarrollo e implementación de una intervención breve vía chat para dar apoyo en salud mental destinado a personas que presentan sufrimientos debido al contexto de la pandemia de COVID-19, en Brasil y Argentina. Durante la fase del desarrollo fue propuesto un protocolo que incluye: 1) detección y evaluación de necesidades; 2) educación para la salud basada en técnicas de escucha activa y 3) derivación de materiales y contactos de servicios especializados o de emergencia disponibles (ej. líneas directas de intervención en crisis). En la fase de implementación, fueron reclutados y capacitados 77 voluntarios que ofrecen contención en salud vía chat a los usuarios bajo la supervisión de 20 psicólogos. En menos de 2 meses se realizaron 1.107 intervenciones. Se espera que la intervención vía chat pueda ser un recurso valioso durante la pandemia de COVID-19, aunque se necesitan estudios adicionales para evaluar su viabilidad y efectividad.

Drug use among street children and adolescents: what helps? / Uso de drogas entre crianças e adolescentes em situação de rua: o que ajuda?

The aim of this study was to investigate factors associated to frequent and heavy drug use among street children and adolescents aged 10 to 18 years. A sample of 2,807 street children and adolescents from the 27 Brazilian state capital cities was analyzed. A World Health Organization questionnaire for non-students was adapted for use in Brazil. Data analysis was performed using logistic regression and decision tree models. Factors inversely associated with frequent and heavy drug use were: being age nine to 11 years (OR = 0.1); school attendance (OR = 0.3); daily time (one to five hours) spent on the streets (OR = 0.3 and 0.4); not sleeping on the streets (OR = 0.4); being on the streets for less than one year (OR = 0.4); maintenance of some family bonds (OR = 0.5); presence on the streets of a family member (OR = 0.6); not suffering domestic violence (OR = 0.6); being female (OR = 0.8). All of these variables were significant at the p < 0.05 level. The findings suggest that being younger, having family bonds and engagement in school are important protective factors that affect drug use among this population and should be considered in the formulation of public policies.

O objetivo do estudo foi verificar fatores associados ao uso frequente e pesado de drogas entre adolescentes em situação de rua no Brasil. Estudo transversal com amostra representativa nacional de 2.807 crianças e adolescentes (10-18 anos). Foi usado um questionário da Organização Mundial da Saúde adaptado para o Brasil e análise dos dados, modelo de regressão logística. Fatores inversamente associados ao uso frequente e pesado de drogas: faixa etária entre 9-11 anos (OR = 0,1); frequentar escola (OR = 0,3); permanecer entre 1 e 5 horas na rua (OR = 0,3 e 0,4); não dormir na rua (OR = 0,4); estar na rua há menos de um ano (OR = 0,4); manter algum vínculo familiar (OR = 0,5); permanecer na rua com algum membro da família (OR = 0,6); não ter sofrido violência doméstica (OR = 0,6); gênero feminino (OR = 0,8). Todas essas variáveis apresentaram p < 0,05. Os achados sugerem que ser mais jovem, ficar menos tempo na rua e manter vínculos com escola e família são importantes fatores de proteção para essa população quanto ao uso frequente e pesado de drogas. Esses são fatores importantes na formulação de políticas públicas para essa população.

Drug use among street children and adolescents: what helps?

The aim of this study was to investigate factors associated to frequent and heavy drug use among street children and adolescents aged 10 to 18 years. A sample of 2,807 street children and adolescents from the 27 Brazilian state capital cities was analyzed. A World Health Organization questionnaire for non-students was adapted for use in Brazil. Data analysis was performed using logistic regression and decision tree models. Factors inversely associated with frequent and heavy drug use were: being age nine to 11 years (OR = 0.1); school attendance (OR = 0.3); daily time (one to five hours) spent on the streets (OR = 0.3 and 0.4); not sleeping on the streets (OR = 0.4); being on the streets for less than one year (OR = 0.4); maintenance of some family bonds (OR = 0.5); presence on the streets of a family member (OR = 0.6); not suffering domestic violence (OR = 0.6); being female (OR = 0.8). All of these variables were significant at the p < 0.05 level. The findings suggest that being younger, having family bonds and engagement in school are important protective factors that affect drug use among this population and should be considered in the formulation of public policies.

The Brazilian smoker: a survey in the largest cities of Brazil.

OBJECTIVE: To understand the sociodemographic factors associated with daily consumption of cigarettes and pattern of cigarette use among Brazilian smokers. METHOD: A cross-sectional study was performed in 2005 involving the 108 largest Brazilian cities. Data were collected through interviews with subjects aged 12 to 65 years in randomly selected households. Based on a questionnaire adapted to the Brazilian context, a logistic regression model was used to investigate the association between the sociodemographic characteristics of the sample and smoking. RESULTS: Of the 7,921 subjects interviewed, 16.4% reported daily use of cigarettes. The smoking prevalence was similar between genders, although women reported to start smoking at a later age and smoke fewer cigarettes per day. Almost 65% of the smokers were interested in quitting or reducing their smoking habit. The main sociodemographic characteristics associated with smoking were as follows: adult age (30-59 years old), unemployment, low education level, and low socioeconomic level. Alcohol abuse was also shown to be associated with smoking. CONCLUSIONS: Our findings suggest that adverse socioeconomic characteristics are implicated in increased susceptibility to smoking in Brazil. In our sample, a high proportion of smokers reported interest to quit or reduce smoking. These data suggest that sociodemographic factors should be considered in the elaboration of smoking prevention and treatment policies.

The Brazilian smoker: a survey in the largest cities of Brazil / Fatores associados ao hábito de fumar do brasileiro: um estudo nas maiores cidades do país

OBJECTIVE: To understand the sociodemographic factors associated with daily consumption of cigarettes and pattern of cigarette use among Brazilian smokers. METHOD: A cross-sectional study was performed in 2005 involving the 108 largest Brazilian cities. Data were collected through interviews with subjects aged 12 to 65 years in randomly selected households. Based on a questionnaire adapted to the Brazilian context, a logistic regression model was used to investigate the association between the sociodemographic characteristics of the sample and smoking. RESULTS: Of the 7,921 subjects interviewed, 16.4 percent reported daily use of cigarettes. The smoking prevalence was similar between genders, although women reported to start smoking at a later age and smoke fewer cigarettes per day. Almost 65 percent of the smokers were interested in quitting or reducing their smoking habit. The main sociodemographic characteristics associated with smoking were as follows: adult age (30-59 years old), unemployment, low education level, and low socioeconomic level. Alcohol abuse was also shown to be associated with smoking. CONCLUSIONS: Our findings suggest that adverse socioeconomic characteristics are implicated in increased susceptibility to smoking in Brazil. In our sample, a high proportion of smokers reported interest to quit or reduce smoking. These data suggest that sociodemographic factors should be considered in the elaboration of smoking prevention and treatment policies.

OBJETIVO: Conhecer fatores sociodemográficos associados ao consumo diário de cigarros, bem como o padrão de uso de cigarros do tabagista brasileiro. MÉTODO: Estudo transversal realizado em 2005 nas 108 maiores cidades brasileiras através de entrevistas a indivíduos de 12 a 65 anos em domicílios sorteados por amostragem representativa. Com base em questionário adaptado para o contexto brasileiro, as características sociodemográficas foram investigadas em modelo de regressão logística para verificar associação com o hábito de fumar. RESULTADOS: De 7.921 entrevistados, 16,4 por cento relataram uso diário de cigarros. A prevalência de uso entre os gêneros foi semelhante, embora as mulheres tenham relatado idade de início de uso superior e menores quantidades por dia. Quase 65 por cento dos fumantes manifestaram interesse em abandonar ou reduzir o hábito. As principais características sociodemográficas associadas ao tabagismo foram: idade adulta (30 a 59 anos), desemprego, menor escolaridade e menor poder aquisitivo. O uso abusivo de álcool também se mostrou associado ao fumo. CONCLUSÕES: Os achados sugerem características socioeconômicas desfavorecidas implicadas em maior vulnerabilidade ao tabagismo no Brasil. Houve um elevado relato de fumantes interessados em abandonar ou reduzir o hábito. Os dados apontam fatores sociodemográficos que devem ser considerados na elaboração de políticas de prevenção e tratamento.

Recreational use of benzydamine as a hallucinogen among street youth in Brazil.

OBJECTIVE: To describe the recreational use of benzydamine, an anti-inflammatory drug, among street youth in Brazil. DESIGN: a descriptive, cross sectional survey. SETTING: 93 welfare services for the street youth in 27 Brazilian capitals. PARTICIPANTS: 2807 street youth, 10 to 18 years old. MAIN OUTCOME MEASURES: demographic characteristics, drug use pattern (lifetime use, use in the past 30 days, frequency, and characteristics of use in the past month) and effects of benzydamine through the use of a questionnaire. RESULTS: 78 reported lifetime recreational benzydamine use (67 cases identified only in three capitals). Among the 30 respondents reporting drug use in the last month (the month preceding the survey), 66.7% (n = 20) used the drug on 4 or more days (in the month preceding the survey). The most frequently (50%) pleasure effects reported were hallucination and nonspecific sensory changes described as 'trips'. Unwanted effects were reported by 75% of respondents, they were especially nausea and vomiting (21.4%). In the majority of the cases, drug was obtained from drugstores without a medical prescription. CONCLUSION: This study identifies the recreational use of benzydamine among street youth, mainly in the Northeast of Brazil, and also indicates the need for special controls on the dispensation of this substance.

Recreational use of benzydamine as a hallucinogen among street youth in Brazil / Uso recreacional de benzidamina como alucinógeno entre adolescentes em situação de rua no Brasil

OBJECTIVE: To describe the recreational use of benzydamine, an anti-inflammatory drug, among street youth in Brazil. METHOD: Design: a descriptive, cross sectional survey. Setting: 93 welfare services for the street youth in 27 Brazilian capitals. Participants: 2807 street youth, 10 to 18 years old. Main outcome measures: demographic characteristics, drug use pattern (lifetime use, use in the past 30 days, frequency, and characteristics of use in the past month) and effects of benzydamine through the use of a questionnaire. RESULTS: 78 reported lifetime recreational benzydamine use (67 cases identified only in three capitals). Among the 30 respondents reporting drug use in the last month (the month preceding the survey), 66.7 percent (n = 20) used the drug on 4 or more days (in the month preceding the survey). The most frequently (50 percent) pleasure effects reported were hallucination and nonspecific sensory changes described as "trips". Unwanted effects were reported by 75 percent of respondents, they were especially nausea and vomiting (21.4 percent). In the majority of the cases, drug was obtained from drugstores without a medical prescription. CONCLUSION: This study identifies the recreational use of benzydamine among street youth, mainly in the Northeast of Brazil, and also indicates the need for special controls on the dispensation of this substance.

OBJETIVO: Descrever o uso recreacional de benzidamina, um medicamento antiinflamatório, entre adolescentes em situação de rua no Brasil. MÉTODO: Desenho: descritivo, transversal. Local: 93 instituições assistenciais para crianças e adolescentes em situação de rua nas 27 capitais do Brasil. Participantes: 2.807 crianças e adolescentes em situação de rua, com idade entre 10 e 18 anos. Principais medidas de interesse: características demográficas, padrão de uso (uso na vida, uso nos últimos 30 dias, frequência e características de uso no mês anterior à pesquisa) e efeitos da benzidamina usando um questionário. RESULTADOS: 78 relataram uso recreacional na vida de benzidamina (67 casos identificados somente em três capitais). Entre os 30 entrevistados que relataram uso recente da substância (no mês que precedia a investigação), 66,7 por cento (n = 20) tomaram o medicamento em quatro dias ou mais no mês. Os efeitos desejados mais frequentemente reportados foram alucinações e alterações sensoriais inespecíficas como "viagem" (50 por cento). Efeitos indesejados foram citados por 75 por cento dos entrevistados, principalmente náuseas e vômitos (21,4 por cento). Na maioria dos casos, o medicamento foi obtido de drogarias sem apresentação de prescrição médica. CONCLUSÃO: Os resultados observados neste estudo identificam o uso recreacional de benzidamina entre crianças e adolescentes em situação de rua, especialmente no Nordeste do Brasil, e indicam a necessidade de controle especial sobre a dispensação desta substância.

Redes sociais no contexto de uso de drogas entre crianças e adolescentes em situação de rua / Social networks: the context of drug use among children and adolescents at street circumstance

O presente artigo relata que estudos demonstram que o ser humano tende a adoecer quando percebe que sua rede social foi reduzida ou rompida. Neste estudo foram utilizadas duas técnicas qualitativas: observação participante e entrevistas em profundidade, de referencial etnográfico. Dezessete adolescentes foram entrevistados. Os sistemas observados foram compostos por diferentes segmentos sociais que variaram entre a família, escola, serviços de saúde, instituições específicas para pessoas em situação de rua, polícia, comércio, tráfico e, até mesmo, os ambulantes, transeuntes, motoristas (especialmente nos faróis) e os próprios “irmãos” da rua. Para esses adolescentes as situações de vulnerabilidade no ambiente familiar, parecem contribuir para o uso precoce de drogas. A cola apareceu como a droga mais usada pelos adolescentes. Diante disso, é fundamental ressaltar a responsabilidade que as redes sociais têm de auxiliar famílias, crianças e adolescentes para a diminuição da desfiliação social e redução das desigualdades sociais no Brasil.

This article reports that studies show that humans tend to fall sick when they realize that their social network has been narrowed or broken. In this study two qualitative techniques were used: participant observation and in-depth interviews, ethnographic of reference. Seventeen adolescents were interviewed. The systems observed were composed of different social segments that ranged from family, school, health services, specific institutions for people in streets circumstances, police, trading sector, trafficking and even the itinerant, passersby, drivers (especially the headlights) and the"brothers" of the street. For these adolescents the situation of vulnerability in the family environment appears to contribute to the early use of drugs. Glue has emerged as the substance mostly used by adolescents in street circumstances. Thus, it is essential to emphasize the responsibility of social networks to help families, children and adolescents decreasing the social detachment and reducing social inequalities in Brazil.

Redes sociais no contexto de uso de drogas entre crianças e adolescentes em situação de rua / Social networks: the context of drug use among children and adolescents at street circumstance

O presente artigo relata que estudos demonstram que o ser humano tende a adoecer quando percebe que sua rede social foi reduzida ou rompida. Neste estudo foram utilizadas duas técnicas qualitativas: observação participante e entrevistas em profundidade, de referencial etnográfico. Dezessete adolescentes foram entrevistados. Os sistemas observados foram compostos por diferentes segmentos sociais que variaram entre a família, escola, serviços de saúde, instituições específicas para pessoas em situação de rua, polícia, comércio, tráfico e, até mesmo, os ambulantes, transeuntes, motoristas (especialmente nos faróis) e os próprios “irmãos” da rua. Para esses adolescentes as situações de vulnerabilidade no ambiente familiar, parecem contribuir para o uso precoce de drogas. A cola apareceu como a droga mais usada pelos adolescentes. Diante disso, é fundamental ressaltar a responsabilidade que as redes sociais têm de auxiliar famílias, crianças e adolescentes para a diminuição da desfiliação social e redução das desigualdades sociais no Brasil.(AU)

This article reports that studies show that humans tend to fall sick when they realize that their social network has been narrowed or broken. In this study two qualitative techniques were used: participant observation and in-depth interviews, ethnographic of reference. Seventeen adolescents were interviewed. The systems observed were composed of different social segments that ranged from family, school, health services, specific institutions for people in streets circumstances, police, trading sector, trafficking and even the itinerant, passersby, drivers (especially the headlights) and the"brothers" of the street. For these adolescents the situation of vulnerability in the family environment appears to contribute to the early use of drugs. Glue has emerged as the substance mostly used by adolescents in street circumstances. Thus, it is essential to emphasize the responsibility of social networks to help families, children and adolescents decreasing the social detachment and reducing social inequalities in Brazil.(AU)