[The influence of family and peer violence in the practice of bullying among school adolescents]. / A influência da violência familiar e entre pares na prática do bullying por adolescentes escolares.

The objective of this study was to estimate the prevalence of bullies and identify factors related to bullying among high school students in Recife. This is an analytical cross-sectional epidemiological study, composed of a probabilistic sample by clusters of 1,402 students aged 15 to 19 years old, enrolled in the second year of high school in both public and private schools in Recife. In this work the bullying will be approached according to the Bioecological Theory of Human Development of Bronfenbrenner. Data were collected by means of a self-administered questionnaire about bullying and associated factors. Data analysis was conducted by the Pearson chi-square test with statistical significance of 0.05 and 95% Confidence Interval. To analyze associations, a multilevel modeling was employed and STATA version 12.0 software was used. The results showed a prevalence of 21.26% of bullying aggressors and the factors associated with the practice of bullying were violence suffered at school, violence between peers, as well as violence practiced by the mother and siblings. Hence, the results indicate that the violence suffered in the family and school context can have repercussions on the practice of bullying among adolescents.

O objetivo deste estudo foi estimar a prevalência de agressores de bullying e identificar os fatores relacionados a este comportamento em adolescentes escolares do Recife. Trata-se de um estudo epidemiológico de corte transversal analítico, composto por uma amostra probabilística por conglomerados de 1.402 estudantes de 15 a 19 anos matriculados no segundo ano do ensino médio de escolas públicas e privadas do Recife. Neste trabalho, o bullying será abordado segundo a teoria bioecológica do desenvolvimento humano de Bronfenbrenner. A coleta de dados ocorreu por meio de um questionário autoaplicável com questões sobre bullying e fatores associados. A análise dos dados foi constituída pela aplicação do teste qui-quadrado de Pearson, considerando significância estatística de 0,05 e intervalo de confiança de 95%. Para a análise das associações foi empregada a modelagem multinível e o software utilizado foi o STATA, versão 12.0. Os resultados mostraram prevalência de 21,26% de agressores de bullying e os fatores associados à essa prática foram as violências sofridas na escola e entre pares, bem como a violência praticada pela mãe e irmãos. Dessa forma, os resultados indicam que as violências sofridas no contexto familiar e escolar podem repercutir na prática do bullying entre adolescentes.

Prevalence and factors associated with bullying: differences between the roles of bullies and victims of bullying.

OBJECTIVE: To identify the differences between the prevalence and factors associated with involvement in bullying among schoolchildren from Recife, in the role of victim and perpetrator. METHOD: This is an epidemiological, cross-sectional, analytical study, with a probabilistic cluster sample of 1,402 students enrolled in high schools in Recife. Data analysis consisted of a descriptive analysis, followed by the application of Pearson's chi-squared test with statistical significance of 0.05 and 95% confidence interval. For the association analysis, multilevel modeling was used to control the cluster effect. RESULTS: It was observed that adolescents who feel different from other peers were associated with bullying, regardless of the role played. Being a victim was associated with being female, having low self-esteem, and using tranquilizers; being a transgressor was a protective factor. As for the role of perpetrator, being male, excessive alcohol consumption, having poor school performance, being a transgressor, and accepting peer violence were the associated variables; in turn, not defending their ideas when among friends showed to be a protective factor for bullying. CONCLUSION: The differences between the adolescents, whether in the role of victim or perpetrator, indicate that the advocacy and prevention actions should focus on these aspects, mainly in the school environment.

Foster care time and characteristics of adolescents under foster care by type of institutional services. Recife, Brazil, 2009-2013. / Tempo de acolhimento e características dos adolescentes acolhidos por tipo de serviços institucionais. Recife, Brasil, 2009-2013.

This study aimed to analyze foster care time and characteristics of adolescents in the institutional foster care services in the city of Recife. This is a descriptive study with a quantitative approach. The study population consisted of all adolescents under foster care in the city of Recife-PE, in the period 2009-2013. The information was retrieved by consulting the Individual Assistance Plans (IAP), with 1,300 analyzed plans. Variables were categorized and described from absolute and relative frequency. Pearson's chi-square test was used to verify the association between variables, with a significance level of 0.05. Three types of services were observed: for adolescents who are victims of violence and neglect; at-risk with/without drug use; and with special needs. A predominance of older male adolescents, with lower school attendance, greater use of psychotropic substances, involved with socio-educational measures, suffering death threats and with a higher number of service entries-exits was observed. We can conclude that the different profiles of foster care services should be addressed and investigated in a particular way because they show different difficulties related to the establishment of efficient public policies.

O objetivo deste estudo foi analisar o tempo de acolhimento e as características dos adolescentes em serviços de acolhimento institucionais na cidade do Recife. Trata-se de um estudo descritivo, com abordagem quantitativa. A população de estudo consistiu de todos os adolescentes acolhidos na cidade do Recife-PE, no período de 2009-2013. As informações foram obtidas a partir da consulta aos Planos de Atendimento Individualizado, sendo analisados ao todo 1.300. As variáveis foram categorizadas e descritas a partir de frequência absoluta e relativa. Para verificar a associação entre variáveis foi aplicado o teste do qui-quadrado de Pearson, com grau de significância de 0,05. Foram observados três tipos de serviços: para adolescentes, vítimas de violência e abandono; em situação de risco com e sem uso de drogas; e com necessidades especiais. Foi constatada uma predominância de adolescentes do sexo masculino, mais velhos, com menor frequência escolar, maior uso de substância psicotrópica, envolvimento com medidas socioeducativas, ameaça de morte e maior número de entradas e saídas nos serviços. Conclui-se que os diferentes perfis de serviços de acolhimento devem ser tratados e investigados de forma particular por apresentarem distintas dificuldades para criação de políticas públicas eficientes.

Evaluation of institutional foster care services for children and adolescents in Recife. / Avaliação dos serviços de acolhimento institucional de crianças e adolescentes no Recife.

This study aimed to evaluate the structure and process of institutional foster care services for the protection of children and adolescents who are victims of neglect and/or violence in Recife. A semi-structured questionnaire was applied to those responsible for the services. Variables frequency were calculated and the following implementation level classification system adopted: critical, when compliance was less than 40% of the recommended standards; inadequate, 40-59%; acceptable, 60%-89%; adequate and excellent, 90-100%. The qualitative analysis consisted in interviews with one manager from the Judiciary and three managers from the Executive. Of the five philanthropic institutions investigated, two had an excellent standard structure; two were acceptable and one inadequate. Among public institutions, one was considered inadequate and the others acceptable. Regarding the process, one institution was found to be excellent and the others acceptable. The content analysis identified that the greatest challenges to introduction of the measures envisaged in the Child and Adolescent Statute are drug use, family geographical remoteness, lack of integration with other institutions and staff turnover.

O objetivo do estudo foi avaliar a estrutura e o processo dos acolhimentos institucionais para proteção de crianças e adolescentes vítimas de abandono e/ou violência no Recife. Foi aplicado um questionário estruturado aos responsáveis pelos serviços, e então calculadas as frequências das variáveis e estabelecida a seguinte classificação do grau de implantação: crítico, quando a adequação à norma preconizada for inferior a 40%; inadequado, de 40-59%; aceitável, de 60%- 89%; adequado e ótimo, de 90-100%. Para análise qualitativa foram realizadas entrevistas com um gestor do poder judiciário e três do executivo. Das cinco instituições filantrópicas, duas apresentaram estrutura padrão ótimo, duas, aceitáveis, e uma, inadequada. Dentre as instituições públicas, uma municipal foi considerada inadequada e as demais, aceitáveis. Com relação ao processo, uma instituição apresentou padrão ótimo e as outras, aceitáveis. A análise de conteúdo permitiu observar que os maiores entraves para a realização das medidas previstas pelo Estatuto da Criança e de Adolescente decorrem do uso de drogas, distanciamento geográfico da família, falta de integração com outras instituições e rotatividade dos profissionais.

A influência da violência familiar e entre pares na prática do bullying por adolescentes escolares / The influence of family and peer violence in the practice of bullying among school adolescents

Resumo O objetivo deste estudo foi estimar a prevalência de agressores de bullying e identificar os fatores relacionados a este comportamento em adolescentes escolares do Recife. Trata-se de um estudo epidemiológico de corte transversal analítico, composto por uma amostra probabilística por conglomerados de 1.402 estudantes de 15 a 19 anos matriculados no segundo ano do ensino médio de escolas públicas e privadas do Recife. Neste trabalho, o bullying será abordado segundo a teoria bioecológica do desenvolvimento humano de Bronfenbrenner. A coleta de dados ocorreu por meio de um questionário autoaplicável com questões sobre bullying e fatores associados. A análise dos dados foi constituída pela aplicação do teste qui-quadrado de Pearson, considerando significância estatística de 0,05 e intervalo de confiança de 95%. Para a análise das associações foi empregada a modelagem multinível e o software utilizado foi o STATA, versão 12.0. Os resultados mostraram prevalência de 21,26% de agressores de bullying e os fatores associados à essa prática foram as violências sofridas na escola e entre pares, bem como a violência praticada pela mãe e irmãos. Dessa forma, os resultados indicam que as violências sofridas no contexto familiar e escolar podem repercutir na prática do bullying entre adolescentes.

Abstract The objective of this study was to estimate the prevalence of bullies and identify factors related to bullying among high school students in Recife. This is an analytical cross-sectional epidemiological study, composed of a probabilistic sample by clusters of 1,402 students aged 15 to 19 years old, enrolled in the second year of high school in both public and private schools in Recife. In this work the bullying will be approached according to the Bioecological Theory of Human Development of Bronfenbrenner. Data were collected by means of a self-administered questionnaire about bullying and associated factors. Data analysis was conducted by the Pearson chi-square test with statistical significance of 0.05 and 95% Confidence Interval. To analyze associations, a multilevel modeling was employed and STATA version 12.0 software was used. The results showed a prevalence of 21.26% of bullying aggressors and the factors associated with the practice of bullying were violence suffered at school, violence between peers, as well as violence practiced by the mother and siblings. Hence, the results indicate that the violence suffered in the family and school context can have repercussions on the practice of bullying among adolescents.

Prevalence and factors associated with bullying: differences between the roles of bullies and victims of bullying / Prevalência e fatores associados ao bullying: diferenças entre os papéis de vítimas eagressores

Abstract Objective: To identify the differences between the prevalence and factors associated with involvement in bullying among schoolchildren from Recife, in the role of victim and perpetrator. Method: This is an epidemiological, cross-sectional, analytical study, with a probabilistic cluster sample of 1,402 students enrolled in high schools in Recife. Data analysis consisted of a descriptive analysis, followed by the application of Pearson's chi-squared test with statistical significance of 0.05 and 95% confidence interval. For the association analysis, multilevel modeling was used to control the cluster effect. Results: It was observed that adolescents who feel different from other peers were associated with bullying, regardless of the role played. Being a victim was associated with being female, having low self-esteem, and using tranquilizers; being a transgressor was a protective factor. As for the role of perpetrator, being male, excessive alcohol consumption, having poor school performance, being a transgressor, and accepting peer violence were the associated variables; in turn, not defending their ideas when among friends showed to be a protective factor for bullying. Conclusion: The differences between the adolescents, whether in the role of victim or perpetrator, indicate that the advocacy and prevention actions should focus on these aspects, mainly in the school environment.

Resumo Objetivo: Identificar as diferenças entre prevalências e os fatores associados ao envolvimento em bullying entre adolescentes escolares do Recife no papel de vítima e agressor. Método: Estudo epidemiológico de corte transversal analítico, com amostra probabilística por conglomerados de 1.402 estudantes matriculados no ensino médio de escolas do Recife. A análise dos dados foi constituída de uma análise descritiva, seguida da aplicação do teste de Qui-Quadrado de Pearson com significância estatística de 0,05 e Intervalo de Confiança de 95%. Para a análise de associações foi empregada a modelagem multinível para controle do efeito do conglomerado. Resultados: Observou-se que o adolescente que se sente diferente dos outros colegas apresentou associação com o bullying independente do papel desempenhado. A condição de ser vítima mostrou associação com ser do sexo feminino, ter baixa autoestima e utilizar tranquilizantes, além disso, ser transgressor mostrou ser fator de proteção. No papel de agressor de bullying ser do sexo masculino, fazer uso de álcool em excesso, ter um ruim desempenho escolar, ser transgressor e aceitar violência entre pares foram as variáveis associadas; por sua vez, não defender suas ideias com amigos revelou ser fator de proteção para prática do bullying. Conclusão: As diferenças apresentadas entre os adolescentes, seja no papel de vítima ou de agressor, apontam que condutas de promoção e prevenção tenham enfoque que considerem tais aspectos principalmente no ambiente escolar.

Tempo de acolhimento e características dos adolescentes acolhidos por tipo de serviços institucionais. Recife, Brasil, 2009-2013 / Foster care time and characteristics of adolescents under foster care by type of institutional services. Recife, Brazil, 2009-2013

Resumo O objetivo deste estudo foi analisar o tempo de acolhimento e as características dos adolescentes em serviços de acolhimento institucionais na cidade do Recife. Trata-se de um estudo descritivo, com abordagem quantitativa. A população de estudo consistiu de todos os adolescentes acolhidos na cidade do Recife-PE, no período de 2009-2013. As informações foram obtidas a partir da consulta aos Planos de Atendimento Individualizado, sendo analisados ao todo 1.300. As variáveis foram categorizadas e descritas a partir de frequência absoluta e relativa. Para verificar a associação entre variáveis foi aplicado o teste do qui-quadrado de Pearson, com grau de significância de 0,05. Foram observados três tipos de serviços: para adolescentes, vítimas de violência e abandono; em situação de risco com e sem uso de drogas; e com necessidades especiais. Foi constatada uma predominância de adolescentes do sexo masculino, mais velhos, com menor frequência escolar, maior uso de substância psicotrópica, envolvimento com medidas socioeducativas, ameaça de morte e maior número de entradas e saídas nos serviços. Conclui-se que os diferentes perfis de serviços de acolhimento devem ser tratados e investigados de forma particular por apresentarem distintas dificuldades para criação de políticas públicas eficientes.

Abstract This study aimed to analyze foster care time and characteristics of adolescents in the institutional foster care services in the city of Recife. This is a descriptive study with a quantitative approach. The study population consisted of all adolescents under foster care in the city of Recife-PE, in the period 2009-2013. The information was retrieved by consulting the Individual Assistance Plans (IAP), with 1,300 analyzed plans. Variables were categorized and described from absolute and relative frequency. Pearson's chi-square test was used to verify the association between variables, with a significance level of 0.05. Three types of services were observed: for adolescents who are victims of violence and neglect; at-risk with/without drug use; and with special needs. A predominance of older male adolescents, with lower school attendance, greater use of psychotropic substances, involved with socio-educational measures, suffering death threats and with a higher number of service entries-exits was observed. We can conclude that the different profiles of foster care services should be addressed and investigated in a particular way because they show different difficulties related to the establishment of efficient public policies.

[Co-occurrence of physical and psychological violence among dating adolescents in Recife, Brazil: prevalence and associated factors]. / Coocorrência de violência física e psicológica entre adolescentes namorados do recife, Brasil: prevalência e fatores associados.

The scope of this study was to assess the prevalence of physical and psychological violence among dating adolescents from Recife, Brazil, to identify associated factors and the co-occurrence of both types of violence. 302 adolescents aged between 15 and 19 years in public and private schools who were in a relationship in the last year filled out the questionnaire. Univariate and multivariate logistic regression statistical analysis were performed and the sample weight and the complex sample design were entered. The prevalence was 19.9% of physical violence 82.8% of psychological violence and 18.9% for the co-occurrence of both. Adolescents who have experienced violence in the community and who were in dating relationships of more than one year duration were more likely to perpetrate psychological violence. For the co-occurrence of physical and psychological violence, the variables that increased the chance of perpetration were suffering physical violence from the father, violence among siblings, physical violence and the perpetration of verbal violence in previous relationships. The conclusion reached is that psychological violence and the co-occurrence of physical and psychological violence have a distinct dynamics from physical violence in dating relationships.

Avaliação dos serviços de acolhimento institucional de crianças e adolescentes no Recife / Evaluation of institutional foster care services for children and adolescents in Recife

Resumo O objetivo do estudo foi avaliar a estrutura e o processo dos acolhimentos institucionais para proteção de crianças e adolescentes vítimas de abandono e/ou violência no Recife. Foi aplicado um questionário estruturado aos responsáveis pelos serviços, e então calculadas as frequências das variáveis e estabelecida a seguinte classificação do grau de implantação: crítico, quando a adequação à norma preconizada for inferior a 40%; inadequado, de 40-59%; aceitável, de 60%- 89%; adequado e ótimo, de 90-100%. Para análise qualitativa foram realizadas entrevistas com um gestor do poder judiciário e três do executivo. Das cinco instituições filantrópicas, duas apresentaram estrutura padrão ótimo, duas, aceitáveis, e uma, inadequada. Dentre as instituições públicas, uma municipal foi considerada inadequada e as demais, aceitáveis. Com relação ao processo, uma instituição apresentou padrão ótimo e as outras, aceitáveis. A análise de conteúdo permitiu observar que os maiores entraves para a realização das medidas previstas pelo Estatuto da Criança e de Adolescente decorrem do uso de drogas, distanciamento geográfico da família, falta de integração com outras instituições e rotatividade dos profissionais.

Abstract This study aimed to evaluate the structure and process of institutional foster care services for the protection of children and adolescents who are victims of neglect and/or violence in Recife. A semi-structured questionnaire was applied to those responsible for the services. Variables frequency were calculated and the following implementation level classification system adopted: critical, when compliance was less than 40% of the recommended standards; inadequate, 40-59%; acceptable, 60%-89%; adequate and excellent, 90-100%. The qualitative analysis consisted in interviews with one manager from the Judiciary and three managers from the Executive. Of the five philanthropic institutions investigated, two had an excellent standard structure; two were acceptable and one inadequate. Among public institutions, one was considered inadequate and the others acceptable. Regarding the process, one institution was found to be excellent and the others acceptable. The content analysis identified that the greatest challenges to introduction of the measures envisaged in the Child and Adolescent Statute are drug use, family geographical remoteness, lack of integration with other institutions and staff turnover.

[Factors associated with dental caries in preschoolers in Recife, Pernambuco State, Brazil]. / Fatores associados à cárie dentária em pré-escolares do Recife, Pernambuco, Brasil.

To investigate factors associated with dental caries in deciduous dentition, a nested case-control study was conducted in a prevalence survey of preschool children (n = 1,690) aged 18 to 36 months and 5 years of age, treated under the Family Health Program in Recife, Pernambuco State, Brazil, in 2006. Cases were children with dmft > 1 and controls with dmft = 0. The independent variables were analyzed in blocks: demographic, environmental, family structure, health care, and dental services use. OR and 95%CI were estimated. Variables associated with the outcome at p < 0.20 in the univariate analysis were included in a multivariate logistic regression model. The cutoff for remaining in the final model was p < 0.10. Larger households (more members), lack of running supply, time of residence, maternal (or caregiver's) schooling, attendance in public preschool, demand for dental services, and sugar intake patterns were associated factors. Variables related to social context were the main predictors of caries, thus highlighting the need for comprehensive measures to address other common childhood health problems.

Spatial study of mortality in motorcycle accidents in the State of Pernambuco, Northeastern Brazil.

OBJECTIVE: To analyze the spatial distribution of mortality due to motorcycle accidents in the state of Pernambuco, Northeastern Brazil. METHODS: A population-based ecological study using data on mortality in motorcycle accidents from 01/01/2000 to 31/12/2005. The analysis units were the municipalities. For the spatial distribution analysis, an average mortality rate was calculated, using deaths from motorcycle accidents recorded in the Mortality Information System as the numerator, and as the denominator the population of the mid-period. Spatial analysis techniques, mortality smoothing coefficient estimate by the local empirical Bayesian method and Moran scatterplot, applied to the digital cartographic base of Pernambuco were used. RESULTS: The average mortality rate for motorcycle accidents in Pernambuco was 3.47 per 100 thousand inhabitants. Of the 185 municipalities, 16 were part of five clusters identified with average mortality rates ranging from 5.66 to 11.66 per 100 thousand inhabitants, and were considered critical areas. Three clusters are located in the area known as sertão and two in the agreste of the state. CONCLUSIONS: The risk of dying from a motorcycle accident is greater in conglomerate areas outside the metropolitan axis, and intervention measures should consider the economic, social and cultural contexts.

Mortalidade por causas externas em Pernambuco, 2001-2003 e 2011-2013 / Mortalidad por las Causas Externas en Pernambuco, 2001-2003 y 2011-2013 / Mortality from external causes in Pernambuco, 2001-2003 and 2011-2013

RESUMOObjetivo:descrever a distribuição dos óbitos por causas externas, por Região de Saúde de Pernambuco, nos períodos 2001-2003 e 2011-2013.Método:estudo descritivo, cuja fonte de dados foi o Sistema de Informação sobre Mortalidade. Para análise foram utilizados percentuais, variações percentuais e razões de proporção.Resultados:os óbitos por causas externas reduziram em Pernambuco, entretanto aumentaram em algumas Regiões de Saúde do interior. Registrou-se aumento dos óbitos por acidentes e intenção indeterminada. Houve aumento dos óbitos classificados como “outros/não especificados” de intenção indeterminada.Conclusão:observou-se alteração da distribuição espacial dos óbitos por causas externas, deslocando-se para o interior de Pernambuco. Verificou-se ainda a necessidade da qualificação dos dados dos óbitos por causas externas e o fortalecimento do monitoramento.

RESUMENObjetivo:describir la distribución de óbitos por causas externas, por Región de Salud de Pernambuco, en los períodos de 2001-2003 y 2011-2013.Método:estudio descriptivo, cuya fuente de datos fue el Sistema de Información sobre Mortalidad. Para análisis fueron utilizados porcentajes, variaciones porcentuales y razón de proporción.Resultados:los óbitos por causas externas se redujeron en Pernambuco, pero aumentaron en algunas Regiones de Salud del interior. Se registró un aumento de los óbitos por accidentes e intención indeterminada. Hubo aumento de los óbitos clasificados como "otros/no especificados" de intención indeterminada.Conclusión:fue posible observar la alteración de la distribución espacial de los óbitos por causas externas para el interior de Pernambuco. Se verificó también necesidad de la cualificación de los datos de los óbitos por causas externas y el fortalecimiento del seguimiento.

ABSTRACTObjective:to describe the mortality from external causes, by Health Regions in Pernambuco, during the periods of2001-2003 and 2011-2013.Method:descriptive study with data from the Mortality Information System. For data analysis we used percentage, percentage variation and proportion ratio.Results:mortality from external causes reduced in Pernambuco, however, mortality increased in some health regions of the countryside. Increased numbers of deaths from accidents and event of undetermined intent were registered. There was an increase of deaths classified as "other/unspecified" event of undetermined intent.Conclusion:there was a change in the spatial distribution of mortality from external causes moving to Pernambuco countryside regions. We found necessity for data classification regarding deaths from external causes and strengthening of the monitoring.

An analysis of prehospital care for victims of accidents and violence in Recife, Brazil.

OBJECTIVES: This study was aimed at carrying out a situational diagnosis of the prehospital healthcare network for victims of accidents and violence in Recife, Brazil. METHODS: National policy for reducing accident- and violence-related morbidity and mortality was used as reference. Questionnaires were applied and half-structured interviews conducted with managers and healthworkers from thirteen prehospital fixed units and one mobile unit. RESULTS: Children, adolescents and females predominantly sought attention; there were few preventative actions, little social coverage and deficient referral, counterreferral and communication with other sectors. A lack of equipment and basic materials, insufficient multidisciplinary teams and the need for ongoing training were also observed. Notifying and recording accidents and violence also lacked precision; ensuring that these were done properly would allow track to be kept of them as well as developing a proper assessment and action plan. However, important state, city and academic initiatives towards preventing and reducing morbidity and mortality caused by accidents and violence in particular municipalities were identified. CONCLUSIONS: Taking national policy for reducing accident- and violence-related morbidity and mortality as a point of reference, then it can be seen that some advances have been made in the city of Recife; however, many shortcomings can still be seen in terms of introducing such policy.

Methodology of a nationwide cross-sectional survey of prevalence and epidemiological patterns of hepatitis A, B and C infection in Brazil.

A population-based survey to provide information on the prevalence of hepatitis viral infection and the pattern of risk factors was carried out in the urban population of all Brazilian state capitals and the Federal District, between 2005 and 2009. This paper describes the design and methodology of the study which involved a population aged 5 to 19 for hepatitis A and 10 to 69 for hepatitis B and C. Interviews and blood samples were obtained through household visits. The sample was selected using stratified multi-stage cluster sampling and was drawn with equal probability from each domain of study (region and age-group). Nationwide, 19,280 households and ~31,000 residents were selected. The study is large enough to detect prevalence of viral infection around 0.1% and risk factor assessments within each region. The methodology seems to be a viable way of differentiating between distinct epidemiological patterns of hepatitis A, B and C. These data will be of value for the evaluation of vaccination policies and for the design of control program strategies.

Directionality of physical and psychological dating violence among adolescents in Recife, Brazil / Direcionalidade da violência física e psicológica no namoro entre adolescentes do Recife, Brasil

OBJECTIVE: The aim was to investigate the physical and psychological dating violence among adolescents with respect to the profiles of directionality - only man perpetrates, only woman perpetrates, and bidirectional, ie, both perpetrate violence. METHODS: Sample was performed by two-stage cluster selection in public and private school in the city of Recife (PE), Brazil, presenting data on 355 adolescents of both sexes between 15 and 19 years old. Psychological violence was measured in dimensions threat, verbal/emotional, and relational. Statistical analyzes incorporated the sampling weight and the complex sample design. RESULTS: Violence is bidirectional in most forms studied (83.9%) and girls reported higher levels of perpetration of physical violence, and boys reported more perpetration of relational violence. CONCLUSION: It was concluded that adolescent dating violence shows a pattern where partners attack each other, both physically and psychologically. Future research should study the patterns of these acts of violence, keeping the adolescent couple as the unit of analysis and exploring the context in which such violence occurs. .

OBJETIVO: O objetivo desta pesquisa foi estudar a violência física e psicológica entre namorados adolescentes com relação aos perfis de direcionalidade - apenas o homem perpetra, apenas a mulher perpetra, e bidirecional, ou seja, ambos perpetram violência. MÉTODO: Realizou-se amostra por conglomerados em dois estágios de seleção nas redes pública e particular de ensino médio da cidade de Recife (PE), apresentando-se dados referentes a 355 adolescentes de ambos os sexos entre 15 e 19 anos de idade. A violência psicológica foi mensurada nas dimensões ameaça, verbal/emocional e relacional. As análises estatísticas incorporaram o peso amostral e o desenho da amostra complexa. RESULTADOS: A violência é bidirecional na maioria das formas estudadas (83,9%). As meninas relataram mais alto nível de perpetração de violência física, e os meninos apresentaram maior perpetração de violência relacional. CONCLUSÃO: Concluiu-se que a violência praticada nas relações afetivas/amorosas dos adolescentes apresenta um padrão onde os parceiros se agridem mutuamente, tanto física como psicologicamente. Futuras pesquisas devem aprofundar os estudos sobre esses padrões e contextos de violência, tendo como unidade de análise o casal de adolescentes. .

Avaliação da completitude, da consistência e da duplicidade de registros de violências do Sinan em Recife, Pernambuco, 2009-2012* / Evaluation of the completeness, consistency and duplicity of cases of violence registered on the National Disease Notification Information System in Recife, Pernambuco State, Brazil, 2009-2012

Objetivo: avaliar a completitude, consistência e duplicidade de registros de violências no Sistema de Informação de Agravos de Notificação (Sinan) em Recife, estado de Pernambuco, Brasil, de 2009 a 2012. Métodos: foi realizado estudo descritivo; a qualidade da base de dados do Sinan foi avaliada quanto à completitude e consistência de 35 variáveis e não duplicidade de registros; aplicou-se o teste do qui-quadrado para tendência linear (p<0,05) para avaliação da completitude e consistência. Resultados: no período 2009-2012, houve aumento de 283,9 por cento no número de notificações, as médias percentuais de completitude, de consistência e de duplicidade foram, respectivamente, de 70,3 por cento, 98,5 por cento e 0,2 por cento; houve redução de 53,9 por cento na completitude e aumento de 66,7 por cento na consistência das variáveis; o percentual de duplicidade foi de 0,5 por cento em 2012, e inexistente em 2009. Conclusão: as médias percentuais de completitude, consistência e duplicidade foram consideradas, respectivamente, regular, excelente e aceitável.

Objective: to evaluate the completeness, consistency and duplicity of cases of violence registered on the National Disease Notification Information System in Recife-PE, Brazil, 2009-2012. Methods: descriptive study. The quality of this database was evaluated regarding the completeness and consistency of 35 variables and non-duplicity of records each year. Chi square for trend (p<0.05) was calculated. Results: A 283.9 per cent increase was observed in the number of notifications. The average percentage of completeness, consistency and duplicity was 70.3 per cent, 98.5 per cent and 0.2 per cent, respectively. Comparing the number of notifications recorded in the 2009 and 2012, there was a 53.9 per cent decrease in the degree of completeness and an increase of 66.7 per cent in consistency. The percentage of duplicated cases was zero in 2009 and 0.5 per cent in 2012. Conclusion: the average percentage of completeness, consistency and duplicity was considered regular, excellent e acceptable, respectively.

Avaliação da implantação de uma Rede Estadual de Reabilitação Física em Pernambuco na perspectiva da Política Nacional de Redução da Morbimortalidade por Acidentes e Violência, 2009 / Evaluation of the implementation of a Public Physical Rehabilitation service based on the National Policy for Reduction of Morbidity and Mortality from Accidents and Violence, 2009

Objetivo: avaliar a implantação da Rede Estadual de Reabilitação Física de Pernambuco, Brasil, na perspectiva da Política Nacional de Redução da Morbimortalidade por Acidentes e Violência. Métodos: foram estudados oito municípios com mais de 100 mil habitantes e 27 serviços de reabilitação física, no ano de 2009; o desenho da investigação foi de um estudo de caso, com foco avaliativo do tipo de análise de implantação. Foram analisados 37 indicadores em três dimensões: gestão, atenção à saúde e controle social. Resultados: a implantação da Rede em Pernambuco foi classificada como intermediária, considerando-se critérios estabelecidos; tanto o contexto político como o estrutural foram favoráveis à implantação no nível estadual, diferentemente dos municípios, que apresentaram contextos de implantação não favoráveis. Conclusão: observou-se considerável empenho por parte da gestão estadual no sentido de avançar com a implantação da Rede Estadual de Reabilitação Física em Pernambuco, embora tenha-se detectado baixo engajamento dos municípios.

Objective: to evaluate the implementation of the Public Physical Rehabilitation service in Pernambuco State-Brazil, from the perspective of the National Policy for Reducing Morbidity and Mortality from Accidents and Violence. Methods: eight municipalities with more than 100,000 inhabitants and 27 physical rehabilitation services were studied. Investigation design was a case study with implementation type analysis. We analyzed 37 indicators from three dimensions: management, health care and social policy watch. Results: implementation in Pernambuco was classified as intermediate, considering the established criteria. Both the political and the structural context were favorable for implementation at state level, differently to the municipal level which presented no favorable contexts. Conclusion: there were considerable efforts on the part of the state administration to move forward with the implementation of the Public Physical Rehabilitation System, although low commitment on the part of the municipal administrations was detected.

Coocorrência de violência física e psicológica entre adolescentes namorados do recife, Brasil: prevalência e fatores associados / Co-occurrence of physical and psychological violence among dating adolescents in Recife, Brazil: prevalence and associated factors

Os objetivos foram estimar a prevalência de perpetração de violência física e psicológica entre adolescentes namorados de Recife, identificar fatores associados e a coocorrência de ambos os tipos de violência. Participaram do estudo 302 adolescentes de escolas públicas e particulares, com idade entre 15 e 19 anos, que tiveram algum relacionamento amoroso no último ano e esses preencheram o questionário. Foram realizadas análise univariada e regressão logística e todas as análises estatísticas incorporaram o peso amostral e o desenho da amostra complexa. A prevalência de violência física foi de 19,9%, de 82,8% para violência psicológica e de 18,9% para a coocorrência de violência física e psicológica. Os adolescentes que vivenciaram violência na comunidade e em relacionamentos de mais de um ano de duração apresentaram maiores chances de perpetrar violência psicológica. Enquanto, sofrer violência física do pai, entre irmãos e em namoros anteriores, além de ter perpetrado violência verbal em relacionamentos anteriores, foram variáveis que aumentaram a chance de perpetração de violência física e psicológica no namoro. Conclui-se que a violência psicológica e a coocorrência de violência física e psicológica possuem uma dinâmica distinta da violência física no namoro.

The scope of this study was to assess the prevalence of physical and psychological violence among dating adolescents from Recife, Brazil, to identify associated factors and the co-occurrence of both types of violence. 302 adolescents aged between 15 and 19 years in public and private schools who were in a relationship in the last year filled out the questionnaire. Univariate and multivariate logistic regression statistical analysis were performed and the sample weight and the complex sample design were entered. The prevalence was 19.9% of physical violence 82.8% of psychological violence and 18.9% for the co-occurrence of both. Adolescents who have experienced violence in the community and who were in dating relationships of more than one year duration were more likely to perpetrate psychological violence. For the co-occurrence of physical and psychological violence, the variables that increased the chance of perpetration were suffering physical violence from the father, violence among siblings, physical violence and the perpetration of verbal violence in previous relationships. The conclusion reached is that psychological violence and the co-occurrence of physical and psychological violence have a distinct dynamics from physical violence in dating relationships.

Tendência de mortalidade por acidentes de motocicleta no Estado de Pernambuco, no período de 1998 a 2009* / Mortality trends in motorcycle accidents in the State of Pernambuco, 1998-2009

Objetivo: analisar a tendência da mortalidade por acidentes de motocicleta (AM) no período de 1998 a 2009, no Estado de Pernambuco, Brasil, segundo sexo e Regiões de Desenvolvimento (RD). Métodos: estudo ecológico de série temporal dos óbitos por AM de residentes em Pernambuco registrados entre 1998 e 2009; para a análise da tendência dos coeficientes de mortalidade por AM, utilizaram-se modelos de regressão polinomial. Resultados: no período, ocorreram 3.110 óbitos por AM; o coeficiente médio de mortalidade por AM foi de 2,81 (por 100 mil habitantes); observou-se sobremortalidade masculina em toda a série estudada; a tendência da mortalidade revelou um crescimento médio anual de 0,3 óbitos por 100 mil hab. (p=0,001); a média anual de crescimento foi maior no sexo masculino e nas RD de Sertão do Araripe, Sertão Meridional e Sertão do Pajeú. Conclusão: a tendência da mortalidade por AM foi crescente; recomenda-se implementar intervenções amplas e multissetoriais para o enfrentamento desse problema.

Objective: to analyse motorcycle accident (MA) mortality trends from 1998 to 2009 in Pernambuco according to gender and development areas (DA). Methods: ecological time series study of Pernambuco state resident MA deaths recorded between 1998 and 2009. Polynomial regression models were used, with statistical significance set at 5 per cent, to analyse MA mortality coefficient trends. Results: 3,110 MA deaths and average MA mortality coefficient of 2.81/100,000 inhabitants. Excess male mortality was found in the entire time series studied. Mortality showed an average annual increase trend of 0.3 deaths per 100,000 inhab. (p=0.001). Average annual increase was higher in males and in the Araripe, Meridional and Pajeú hinterland DAs . Conclusion: given the growing trend of MA mortality, wide-ranging and multi-sectoral intervention implementation is recommended to respond to this problem.

Anos potenciais de vida perdidos por acidentes de transporte no Estado de Pernambuco, Brasil, em 2007* / Potential years of life lost because of road traffic accidents in Pernambuco state, Brazil, 2007

Objetivo: estimar os anos potenciais de vida perdidos (APVP) por acidentes de transporte no Estado de Pernambuco, Brasil. Métodos: foi realizado estudo descritivo, incluindo os óbitos por acidentes de transporte terrestre (ATT) de residentes em Pernambuco, registrados no Sistema de Informações sobre Mortalidade (SIM) em 2007; foram calculados os valores do indicador APVP e a taxa de APVP por 100 mil habitantes (TAPVP) Resultados: o APVP global foi de 104,3 anos por 100 mil hab.; os motociclistas apresentaram a maior TAPVP (28,4 APVP por 100 mil hab.); para todos os ATT, o valor do indicador TAPVP foi maior entre os homens (923,9 anos), frente às mulheres (173,4 anos), e na faixa etária de 20 a 39 anos para todos os tipos de vítima. Conclusão: os ATT, principalmente ao envolver homens e motociclistas, são importante causa de morte prematura na população de Pernambuco.

Objective: to estimate potential years of life lost (PYLL) because of road traffic accidents in Pernambuco state, Brazil. Methods: descriptive study of road traffic deaths among people aged 1 to 69 years living in the city of Pernambuco, northeastern Brazil. Data was obtained from the Brazilian National Mortality Database for the year 2007. The number of PYLL and PYLL rate per 100,000 people were calculated. Results: overall number of PYLL was 104.3 years per 100,000 people. Motorcyclists accounted for the highest number of PYLL (28.4 years per 100,000). The number of PYLL was higher in males (923.9 years), when compared to females, and in those aged 20–39 years for all types of road traffic accidents. Conclusion: given the high number of PYLL from motorcycle-related injuries, actions for injury prevention especially targeting motorcyclists are needed...