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Background: The COVID-19 pandemic overwhelmed health facilities and presented healthcare workers (HCWs) with a new infectious disease threat. In addition to a sanitary crisis, Brazil still had to face major political, economic, and social challenges. This study aimed to investigate mental health outcomes in frontline HCWs in different regions of the country and at different epidemic times. We also sought to identify the main risk factors associated with these outcomes., Methods: A cross-sectional online survey using respondent-driven sampling was conducted to recruit physicians (n = 584), nurses (n = 997), and nurse technicians (n = 524) in 4 regions of Brazil (North, Northeast, Southeast, and South) from August 2020 to July 2021. We used standardized instruments to screen for common mental disorders (CMD)(SRQ-20), alcohol misuse (AUDIT-C), depression (PHQ-9), anxiety (GAD-7), and post-traumatic stress disorder (PTSD)(PCL-5). Gile's successive sampling estimator was used to produce weighted estimates. We created a three-cluster data set for each HCW category and developed a hierarchical regression model with three levels: individual characteristics; workplace-related aspects; COVID-19 personal experience. The impact of the epidemic moment on the outcomes was also studied., Results: The prevalence of probable CMD was 26.8-36.9%, alcohol misuse 8.7-13.6%, depression 16.4-21.2%, anxiety 10.8-14.2%, and PTSD 5.9-8.0%. We found a stronger association between mental health outcomes and the following factors: history of psychiatric disorders, female gender, and clinical comorbidities (level 1); work overload and family isolation (level 2); sick leave (level 3). Epidemic variables, such as the number of deaths and trend of deaths by COVID-19, had almost no impact on the outcomes., Conclusion: An alarmingly high prevalence of depression and anxiety was found in Brazilian frontline HCWs. Individual factors were the most strongly associated with mental health outcomes. These findings indicate the need to develop programs that provide emotional support, identify professionals at risk and refer them to specialized treatment when necessary., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Substance use disorder (SUD) assessment and measurement in Brazil, as well as in many other countries, face significant shortcomings. The Measurement in the Addictions for Triage and Evaluation (MATE) was developed as a public domain tool, drawing from validated scales and incorporating World Health Organization International Classification of Functioning, Disability, and Health (ICF) framework. The Brazilian version of the MATE (MATE-pt-BR) was evaluated for its reliability and validity, with a total of 239 subjects participating in the study, and data collected between 11/01/2021 and 09/01/2022. The majority were male (79.2%), with diverse racial backgrounds. The substances most prevalently used in the last 30 days were. Alcohol (73.2%), nicotine (63.6%), and cocaine (44.2%). The mean scores for MATE modules showed variations, with Module Q2 assessing psychological well-being having high internal consistency (Cronbach's alpha = 0.92). MATE-pt-BR demonstrated robust internal consistency, with Module 6 (personality) and Module 2 (medical and psychiatric consultation indicators) being exceptions. MATE-pt-BR exhibited significant correlations among its sections and strong discriminant validity. Moreover, the paper compares MATE-pt-BR with the Addiction Severity Index (ASI-6), which is considered the gold-standard measure for SUD assessments. MATE-pt-BR offers a valuable tool for assessing substance use and related functional impairments in the Brazilian context. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Given a scenario of intense discussion about the legal situation of cannabis users worldwide, this paper aims to investigate the role of cannabis within a drug use sequencing pattern., Design and Methods: Data came from a representative sample of college students from 27 Brazilian capitals (n = 12 711). We analysed the patterns of transition from/to the first use of cannabis to/from the first use of alcohol, tobacco and seven other illegal drugs. Survival analysis methods were used to analyse age of onset data on all potential drug pairs. Drugs that were not specified as the target drug pair tested in each survival model were included as time-varying covariates in all models., Results: We found significant transitions from alcohol [adjusted hazard ratio (aHR) = 1.41, 95% confidence interval (CI) 1.15-1.73, P < 0.001] and inhalants (aHR = 1.56, 95% CI 1.26-1.93, P < 0.001) to cannabis. Moreover, we found significant transitions from cannabis to alcohol (aHR = 2.40, 95% CI 1.47-3.91, P < 0.001), cocaine (aHR = 7.47, 95% CI = 4.26-13.09, P < 0.001), prescription opioids (aHR = 2.16, 95% CI 1.29-3.63, P < 0.01) and tranquilisers (aHR = 1.51, 95% CI 1.11-2.06, P < 0.01)., Discussion and Conclusions: Overall, our findings point to a strategic role of cannabis within drug first use sequence pattern. We had an important and unexpected finding-the bi-directional relationship between alcohol and cannabis. In addition, the first use of cannabis still precedes the first use of cocaine and non-medical use of tranquilisers and prescription opioids. [Castaldelli-Maia JM, Nicastri S, Cerdá M, Kim JH, Oliveira LG, Andrade AG, Martins, SS. In-transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern. Drug Alcohol Rev 2017;00:000-000]., (© 2017 Australasian Professional Society on Alcohol and other Drugs.)

Indigenous people's health in Brazil is organized by the indigenous health subsystem, structured according to that of SUS, and described in the National Policy for Health Care of Indigenous Peoples. Alcohol consumption has been regarded as a health issue among indigenous peoples. In this paper, we describe the representations attributed by health professionals concerning alcohol use among indigenous peoples, and how these influence care practices. This is a descriptive ethnographic study based on interviews and participant observation. Analysis and interpretation were made with the support of Software Atlas TI 8.0. Excessive consumption occurs in specific contexts, and professionals view alcohol use as a problem. Drinking patterns vary with ethnicity, religion, and location, thus resulting in the need to develop cultural competencies that support implementation of effective actions and that also allow for collective construction, as stipulated in the policies. A network of supporters is described, among which are indigenous leaders, traditional healers, and the Evangelical Church. The study shows the difficulties of both carrying out policies and implementing actions which correspond to the indigenous peoples' expectations, recognizing the cultural and social rationale related to alcohol use. [ABSTRACT FROM AUTHOR]

As part of the GENACIS project, this paper sought to assess the prevalence of depression in an urban sample in the city of São Paulo, Brazil, as well as the association between depression and alcohol abuse according to gender. To achieve this, an epidemiological survey was conducted using a stratified probability sample, including 2,083 adults. CIDI SF was used to identify depression. The Rao Scott test and multivariate logistic regression were used for statistical analysis. The response rate was 74.9%. Females (58.3%) under 40 years of age (52%) were predominant. The prevalence of depression was 28.3% for women and 12.7% for men. Most men declared being drinkers (61.1%) in the last year. Depression was associated with an alcohol drinking pattern, mostly binge drinking, in addition to the occurrence of problems derived from alcohol use. Most women declared being abstainers (69.5%). Depression was associated with cohabiting with spouses with alcohol-related problems. Results reveal that the association between depression and alcohol consumption is distinct between genders.

In March 2020, physical distancing and quarantine measures were implemented in Brazil, which may have affected the physical and mental health of the population. This cross-sectional study used a convenience sample and telephone-based interviews to identify anxiety symptoms and alcohol use patterns among 1,264 Brazilian primary health care (PHC) patients during the COVID-19 pandemic. The State-Trait Anxiety Inventory-State 6 and Alcohol Use Disorders Identification Test (AUDIT-C) questionnaires were used to assess anxiety symptoms and alcohol use patterns, respectively. According to the AUDIT-C results, the prevalence of harmful drinking was 38.5%. Those who reported that their alcohol consumption decreased during the pandemic had high scores on the AUDIT-C, indicating a moderate/severe risk of drinking. Moderate or severe anxiety was observed in 60.1% of participants. These results highlight the needs to assess the pandemic's consequences on the mental health of the population and to encourage the implementation of preventive approaches in PHC settings to address anxiety and harmful alcohol consumption. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to supply a narrative review of the concepts, history, functions, methods, development and theoretical bases for the use of halfway houses for patients with mental disorders, and their correlations, for the net construction of chemical dependence model. This theme, in spite of its relevance, is still infrequently explored in the national literature. The authors report international and national uses of this model and discuss its applicability for the continuity of services for alcohol dependents. The results suggest that this area is in need of more attention and interest for future research.

Aims and design The historical and economic involvement of Brazil with tobacco, as a major producer and exporter, was considered an insurmountable obstacle to controlling the consumption of this product. Nevertheless, the country was able to achieve significant progress in implementing public policies and to take an international leadership position, meeting its constitutional commitment to protect public health. In this paper we provide a brief historical overview of tobacco control ( TC) in Brazil, and analyse the factors that contributed to the major decline in tobacco consumption in the country over the last 20 years, as well as identify the challenges that had to be overcome and those still at play. Findings The Brazilian case demonstrates how cross-sectorial collaborations among health-related groups that capitalize on their respective strengths and capacities can help to influence public policy and overcome industry and population resistance to change. Although Brazil still lags behind some leading TC nations, the country has an extensive collaborative TC network that was built over time and continues to focus upon this issue. Conclusions The tobacco experience can serve as an example for other fields, such as alcoholic beverages, of how networks can be formed to influence the legislative process and the development of public policies. Brazilian statistics show that problems related to non-communicable diseases are a pressing public health issue, and advocacy groups, policy-makers and government departments can benefit from tobacco control history to fashion their own strategies. [ABSTRACT FROM AUTHOR]

ABSTRACT While individual studies from several South American countries have shown driving while intoxicated to be a problem, there are no objective systematically collected alcohol-associated driving data obtained in most South American countries. This limits their ability to implement and enforce targeted prevention strategies, evaluate whether proven prevention efforts from North America (particularly the United States and Canada) can be transferred to the South, and to sustain momentum for the improvement of road safety by demonstrating that previously implemented legal and policy changes are effective. The aim of this paper is to discuss the abysmal differences that exist between northern and southern American countries regarding the current status of driving while intoxicated prevention strategies-their implementation, impacts and effects-using Brazil as a case example. We propose a three-pronged approach to close this northern-southern American gap in driving while intoxicated prevention and intervention: (a) systematic collection on road traffic crash/injury/death as well as risk factor data, (b) passage of laws without loopholes requiring compliance with blood alcohol concentration testing and (c) provision of appropriate training and equipment to the police in concomitance with vigilant enforcement. Resources and energies must be put towards data collection, implementation of prevention strategies and enforcement in order to decrease the unacceptably high rates of these preventable driving while intoxicated deaths. [ABSTRACT FROM AUTHOR]

Background: This paper reports findings on Alcohol Consumption-Abuse (ACAb) in Bahia, Brazil, a research setting characterized by racial/ethnic and socioeconomic diversity.Methods: A household survey was conducted with a sample of 2,302 adults. ACAb was defined as daily intake of more than two units of beverage, with drunkenness, or weekly binge drinking plus episodes of drunkenness, or any use of alcoholic beverages with frequent drunkenness, with failed attempts to stop drinking.Results: The rate of 12-month prevalence was 7%, with an overall male: female ratio of 6:1. A positive association of ACAb prevalence with education and social class was found. Male gender and higher socio-economic status were associated with increased odds of ACAb. No relationship was found between ethnicity and ACAb. Stratified analysis yielded consistent gender effects, throughout all strata of independent variables. A strong interaction of gender (male) and social class (upper class) was found for Mulattos and Morenos (maximum Prevalence rate=9.04).Conclusion: Interaction patterns found defy simple generalizations based on class, ethnicity, and gender considered alone. [ABSTRACT FROM AUTHOR]

This paper aims to analyze alcohol abuse and unprotected sex and the association between them in students in a city in the southern region of Brazil. This is a cross-sectional study using a quantitative approach with 590 secondary school students from two public schools. Regarding alcohol use, 14% scored from eight to 40 in The Alcohol Use Disorders Identification Test (AUDIT), which means, at least, a risky drinking behavior, with higher rate among boys. Moreover, 31.1% indulged themselves in binge drinking, which means drinking six or more doses according to AUDIT; and even among those who are lowrisk drinkers, 21.1% had this drinking pattern. Regarding sexual behavior, young boys started sexual life earlier and the kind of relationship more referred to by them is one with no commitment; boys have uncommitted relationships, while girls have more relationships with commitment. In relation to the results of the association between alcohol use and sexual intercourse, 47.3% stated alcohol use before having sex, and those who started sexual activity got more drunk and had higher scores in the AUDIT. New studies are recommended regarding the association between both behaviors in Brazil, considering that the causal relationship is not clear and shows several explanation models. [ABSTRACT FROM AUTHOR]

Alcohol screening and brief intervention in primary care reduce harmful alcohol use but are rarely conducted in Brazil. This study describes health professionals' perceptions of patients' harmful alcohol use. A modified grounded theory approach drawing on purposive sampling was used to secure interviews from thirty-three primary care professionals between September and November 2018. Data analysis was iterative; initial coding was developed by the full research team and refined using formative and axial coding. Alcohol symptomology varied and professionals associated harmful alcohol use with patients' economic hardship. Although health professionals rarely identified alcohol-related problems among their patients, when alcohol problems were identified, it was often through consultations about other symptoms. Compared to drug use, low to moderate alcohol use was not considered harmful, supported in part by a widespread acceptance of alcohol use. Brazil's universal primary care system uses a collaborative care model to support integrated treatment of medical and mental health conditions, but alcohol screenings often occur only after problems manifest. Given limited early identification of harmful alcohol use in primary care, it is necessary to improve professionals' training related to alcohol screening and brief intervention to reduce alcohol-related disability-adjusted life years. [ABSTRACT FROM AUTHOR]

Copyright of Revista Enfermagem Digital Cuidado e Promoção da Saúde is the property of Revista Enfermagem Digital Cuidado e Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Health professionals are in a strategic position to help people with substance use disorders (SUDs) who seek health services for support or treatment. However, it is known that professionals' attitudes towards people who use alcohol and other drugs are marked by stigmatizing attitudes that create barriers to access quality treatment and make it difficult for the user to adhere to it. From this, the present study aimed to investigate the attitudes of 264 health professionals from specialised services and primary health care (PHC) in the Southeast region of Brazil, through Opening Minds Scale for Healthcare Providers (OMS‐HC), taking into account the hypothesis of contact with the subject as a predictor of more positive attitudes. For this, a Multiple Hierarchical Regression was carried out to ascertain the contribution of the variables used in the explanatory model of attitudes. In addition, the measure of social desirability (SD), assessed by Brazilian Portuguese adaptation of Marlowe–Crowne Social Desirability Scale, was used as a control variable in the regression model to obtain a more robust and accurate model regarding the presence of biased responses, pervasive in studies on attitudes. In general, our findings showed that contact/familiarity with substance use, either through direct contact with users or through the respondent's own use, predicted more positive attitudes, with specialised service professionals expressing more positive attitudes than those working in PHC. Blaming the user for his/her condition presented itself as a predictor of more negative attitudes. Studies like this are of paramount importance for understanding the relationship established between professionals and service users and, therefore, for tailoring interventions and programs that aim to reduce stigmatizing attitudes and provide better access to health for people with SUDs. The importance of using the SD measure as a control variable in Regression is also emphasised, as an effective way to overcome to a common limitation in studies of attitudes. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of SMAD Revista Electronica Salud Mental, Alcohol y Drogas is the property of Universidade de Sao Paulo, Escola de Enfermagem de Ribeirao Preto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The author comments on the paper "Why don't northern American solutions to drinking and driving work in southern America?" by F. Pechansky and A. Chandran, which addresses the lack of policies regarding drinking and driving. According to her, lack of data or laws is not a problem in Brazil but lapses in the enforcement of existing laws is. She refers to several studies on drunk driving and suggests acquiring a better understanding of the problem through research and monitoring.

Neglect is a type of child abuse that leads to a variety of consequences on child development. Although neglect is present in any social class, a lot of parents that live in poverty are not negligent; but poverty has many characteristics that contribute to the presence of neglect. Considering the importance of preventing and better understanding neglect, the present paper aims to describe and discuss similarities and differences among negligent families, comparing them to other families in terms of socioeconomic aspects and risk factors related to neglect. A total of 90 parents of children aged 6–8 years participated in the data collection. They were divided into three groups: (1) 30 caregivers of substantiated cases of child neglect from Child Protection Services; (2) 30 caregivers of suspected cases of child neglect based on teachers' observations, but that were not notified to Child Protection Services; and (3) 30 caregivers of children who were not suspected of child neglect. All participants were interviewed. Results showed that poverty is not a determining factor for neglect, but it presents a highly favorable context for neglect to be expressed. Considering participant's working status, group 1 showed a significant difference (p-value = 0,003) when compared with groups 2 and 3. In groups 2 and 3, most participants worked (53% and 67%), but in group 1 the majority were unemployed. When comparing the groups in relation to educational years, it was noted that groups 1 and 2 were equivalent (average of 4,5 and 5,1 respectively), and significant different (p = 0,001) from group 3 (average of 9,4 years). Considering the social support provided for mothers after their first child was born, 70% of mothers from group 3, 26,7% of mothers from group 2 and 30% from group 1 had support. When comparing the three groups, there were statistical differences (p-valor = 0,001) between group 3 and groups 1 and 2. As for alcohol abuse, groups 1 and 2 had similar results (30% group 1 and 20% group 2) and the groups were statistically different (p-valor = 0,003) from group 3 (0%), indicating that, although they were a minority, there were participants from groups 1 and 2 consuming alcohol. No participant declared to use drugs. Although they live in the same neighborhoods and study in the same schools as do the reference group, groups of children suspected of being neglected had less favorable economic conditions, and their caregivers had fewer years of education and less specialized employment. Presence of risk factors and lack of social support favor the occurrence of child neglect. According to the results obtained by the present study, we must also point out that the condition of poverty is not a determining factor for neglect, but it is presented as a highly favorable context for the expression of neglect. [ABSTRACT FROM AUTHOR]

Purpose: There is a virtual absence of previous research about the experiences of people affected by the presence of a substance misuser in the family in Brazil. Materials and methods: A diverse sample of 3158 (80.6% female) affected family members (AFMs) was recruited in the largest cities in all five Brazilian regions. A Brazilian Portuguese translation of a set of standard measures for the assessment of AFM stress, strain, coping, hopefulness and total family burden, based on the stress-strain-coping-support (SSCS) model, was employed. Results: Mothers and wives reported the greatest burden. Burden was also related to a number of other demographic and background variables, notably being higher for AFMs of lower socio-economic status and for those whose substance misusing relatives were currently receiving hospital treatment. Results offer some support for additive and moderation coping hypotheses, suggesting that greater engaged and tolerant-inactive coping add to stressful impact in the prediction of symptoms, and that lower engaged and tolerant-inactive coping in the face of relatively high stressful impact may be particularly useful in reducing symptom levels. Conclusions: This is the first national sample of AFMs to be studied in Brazil and the largest to have been reported from any country. The results should help build an emerging picture of how AFMs are affected and assist in planning services for AFMs. [ABSTRACT FROM AUTHOR]

Copyright of SMAD Revista Electronica Salud Mental, Alcohol y Drogas is the property of Universidade de Sao Paulo, Escola de Enfermagem de Ribeirao Preto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nucleus (16786602) is the property of Fundacao Educacional de Ituverava and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The author comments on the article "Why don't northern American solutions to drinking and driving work in southern America?" by F. Pechansky and A. Chandran. She highlights the points addressed by the authors of the study regarding aspects lacking in Brazil and notes that the issue of advocacy and active popular support is not taken into consideration by the study. She opines that active participation as a critical factor to tackle the state of affairs of drinking and driving rates.

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Research conducted in high-income countries has investigated influences of socioeconomic inequalities on drinking outcomes such as alcohol use disorders (AUD), however, associations between area-level neighborhood social deprivation (NSD) and individual socioeconomic status with these outcomes have not been explored in Brazil. Thus, we investigated the role of these factors on drink-related outcomes in a Brazilian population, attending to male-female variations. Methods: A multi-stage area probability sample of adult household residents in the São Paulo Metropolitan Area was assessed using the WHO Composite International Diagnostic Interview (WMH-CIDI) (n = 5,037). Estimation focused on prevalence and correlates of past-year alcohol disturbances [heavy drinking of lower frequency (HDLF), heavy drinking of higher frequency (HDHF), abuse, dependence, and DMS-5 AUD] among regular users (RU); odds ratio (OR) were obtained. Results: Higher NSD, measured as an area-level variable with individual level variables held constant, showed an excess odds for most alcohol disturbances analyzed. Prevalence estimates for HDLF and HDHF among RU were 9% and 20%, respectively, with excess odds in higher NSD areas; schooling (inverse association) and low income were associated with male HDLF. The only individual-level association with female HDLF involved employment status. Prevalence estimates for abuse, dependence, and DSM-5 AUD among RU were 8%, 4%, and 8%, respectively, with excess odds of: dependence in higher NSD areas for males; abuse and AUD for females. Among RU, AUD was associated with unemployment, and low education with dependence and AUD. Conclusions: Regular alcohol users with alcohol-related disturbances are more likely to be found where area-level neighborhood characteristics reflect social disadvantage. Although we cannot draw inferences about causal influence, the associations are strong enough to warrant future longitudinal alcohol studies to explore causal mechanisms related to the heterogeneous patterns of association and male-female variations observed herein. Hopefully, these findings may help guide future directions for public health. [ABSTRACT FROM AUTHOR]

Comments on the editorial of Raul Caetano in the March 1989 issue of the 'British Journal of Addiction' about alcohol research in Latin America, particularly Brazil. Trends in alcohol production in Brazil in 1987; Information on the focus of alcohol research conducted by research institutes and groups in Brazil; Organization of the Brazilian Association for Studies on Alcohol and Alcoholism.

The study aimed to analyze the clinical aspects of the treatment of crack cocaine and excessive alcohol users who were seen in a Psychosocial Care Center of Alcohol and Other Drugs (CAPS AD) in Sobral, Ceará, during the years 2010 and 2011. This is an exploratory descriptive and documentary study, with a retrospective quantitative approach. The sample was composed of 567 medical records of drug users, from which 291 were crack cocaine users, and 276 were alcohol users. For data collection, a form was developed based on the Care Script Service, the data from which was then used to populate a database in an EPI INFO 7, a statistics software system. In both groups of users, males were predominant (85%, n = 482), and were between the ages of 20 and 29 years for crack users (50.9%, n = 148), and between 30 and 39 years for alcohol users (31.9%, n = 88). There were significant differences between crack cocaine users and alcohol users in liver disorders ( p < 0.01) and withdrawal syndrome ( p < 0.05), however, there were similar signs and symptoms between users. Crack users hospitalized less frequently (OR 0.33 [95% CI 0.23 to 0.47 p < 0.01]). Suicidal ideation and suicide attempts were similar in both crack cocaine and alcohol users. Thus, this research will lead to new proposals for health care professionals in order to enhance and improve the care provided to service customers in CAPS AD. [ABSTRACT FROM AUTHOR]

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Copyright of SMAD Revista Electronica Salud Mental, Alcohol y Drogas is the property of Universidade de Sao Paulo, Escola de Enfermagem de Ribeirao Preto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study was to compare three groups of Brazilian psychoactive substance (PAS) abuse patients (crack cocaine users, cocaine snorters, and non-cocaine PAS users) in terms of psychiatric comorbidities and severity of psychosocial problems. A cross-sectional, multi-center study was conducted at five Brazilian research centers. A total of 738 current PAS abusers seeking specialized treatment (outpatient and inpatient clinics) were assessed using the sixth version of the Addiction Severity Index (ASI-6): 293 patients using crack cocaine were compared with 126 using powder cocaine and 319 using non-cocaine PAS (mostly alcohol and marijuana). Psychiatric comorbidities were assessed in a smaller sample (290 cases), originating from three of the centers, using the Mini International Neuropsychiatric Interview Plus (MINI-Plus). Crack and powder cocaine users were significantly younger than non-cocaine PAS users (31.1 ± 8.1 and 32.9 ± 8.8 vs. 42.4 ± 12, respectively; p < .001). Crack users presented a higher rate of antisocial personality disorder (25%) than powder cocaine (9%) and non-cocaine PAS users (9%), even when adjusted for confounding factors (Pr = 2.6; 95% CI 1.10-6.40). According to ASI-6 summary scores, crack users presented a significantly higher rate of occupational, family, and legal problems and reported more illegal and violent activities such as burglary and theft (23%) and threatening or assaulting (32%) than non-cocaine PAS users. Our findings, combined with the recent increase observed in the prevalence of crack use in Brazil, highlight the severity of psychiatric symptoms and psychosocial problems related to this powerful drug and corroborate the already suggested association between crack/cocaine, violence, and legal problems. Treatment programs for crack users should routinely consider the possibility of associated psychiatric comorbidities, such as antisocial personality disorder, which may affect treatment outcomes. (Am J Addict 2012;00:1-11) [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the prevalence and factors associated with simultaneous health risk behaviors in freshmen college students enrolled in a Brazilian university. We interviewed 738 students (59.2% men) with average age of 20.1 years (CI 95%: 19.8-20.5). The risk behaviors assessed were smoking habit, alcohol use, unhealthy diet and physical inactivity. Independent variables were sex, age, employment, marital status, maternal education, study shift and socioeconomic level. It was found that 8.7% were smokers, 45.9% showed alcohol abuse, 59.4% had inadequate diet and 18.5% were physically inactive. Of the students, 20.2% showed no risk behavior, 39.1% one behavior, 29.0% two risk behaviors and 11.7% three and/or four risk behaviors. Males (OR: 2.04, CI 95%: 1.13-3.67) and night shift students (OR: 1.83, CI 95%: 1.01-3.33) were more likely to have three and/or four risk behaviors. Health promotion interventions focusing simultaneous behavior changes should be employed at the university. [ABSTRACT FROM AUTHOR]

An interview with alcohol epidemiologist Raul Caetano is presented. When asked about the role of Brazil in his personal and professional development, he refers to the amalgam of African and European culture. He says that people of Brazil have developed their own resources for difficulties as they do not depend on the government. He believes that alcohol-related problems arise due to availability of low-cost alcohol. He comments on high rate of alcohol dependence.

The article focuses on a research conducted in order to investigate the occurrence and epidemiological aspects of human myiasis caused by the screw-worm, Cochliomyia hominivorax, in Rio de Janeiro, Brazil. It discusses the use of vaseline to suffocate the larvae, followed by their preservation in 70 percent ethanol. The study revealed the occurrence of factors like open wounds, poor personal hygiene, alcoholism and physical or mental disability that are responsible human myiasis.

Background: Drug use and abuse may hamper learning capabilities and the development of technical skills in medical students and, therefore, the quality of care offered to patients. The aim of this investigation was to estimate the prevalence of psychoactive drug use among medical students of public universities in Rio de Janeiro, Brazil, and to identify characteristics associated with substance use.Method: This was a cross-sectional investigation designed to include all medical students of four universities. The final sample included 1,054 students. Patterns of licit and illicit drug use (at least once in lifetime drug use, drug use in the last 30 days (LTD) and CAGE) before and during medical school were assessed by a multiple-choice, self-administered anonymous questionnaire.Results: Alcohol abuse was more prevalent among male students from higher income families. Alcohol LTD use was more prevalent among male students with college-educated parents. Tobacco, cannabis and inhalant lifetime use was more prevalent among males and tranquillizer use among females. Tobacco, cannabis and tranquillizer lifetime use was more prevalent among students with divorced or dead parents. Inhalant lifetime use was more prevalent among students from higher income families. Students who had college-educated, divorced or dead parents or evidenced tobacco, cocaine or inhalant lifetime use were more prevalent among cannabis users. Male students from higher income families had higher prevalence of cocaine lifetime use.Conclusion: Substance use in this group of medical students is not widespread compared to rates reported for developed countries. Preventive efforts should focus on alcohol and cannabis use by medical students. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To assess the prevalence of potential alcohol use disorders and associated factors using the Alcohol Use Disorders Identification Test (AUDIT). Design Cross-sectional study. Setting A town in southern Brazil. Participants A representative sample of 1260 people aged 15 and over. Measurements Demographic, socioeconomic, smoking habit and mental health data were collected. Logistic regression was used in the multivariate analysis, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Findings Overall prevalence of alcohol use disorder was 7.9%, with 14.5% prevalence among men and 2.4% among women. The risk of alcohol misuse increased across social class (P linear trend = 0.03) and compared with the highest classes (A and B), groups C through E had ORs of 1.48, 1.51 and 2.36, respectively. Males had an OR of 6.89 (CI 3.61–13.16) compared with women. A linear trend was found (P = 0.001) between smoking categories, and smokers (OR 3.27; CI 1.91–5.58) and ex-smokers (OR 1.30; CI 0.56–2.98) were at higher risk than non-smokers. Those with minor psychiatric disorders had a 2.48 OR (CI 1.35–4.56) of presenting a positive test. Conclusions The AUDIT detected a high prevalence of potential alcohol use disorders in the population sampled. Those identified are potential targets for preventive measures implemented through health policies. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the prevalence and risk groups of domestic violence during pregnancy among public health care users in Rio de Janeiro, Brazil. The study focuses on violence perpetrated by both women and partners. Method: 526 women giving birth at term in public maternities from March to October 2000 were randomly selected and interviewers used the Revised Conflict Tactics Scales (CTS2). Results: 33.8% [95% confidence interval (CI): 28.8–37.0%] of the respondents reported some form of physical violence and 16.5% (95% CI: 13.3–19.8%) referred to severe forms. A total of 78.3% (95% CI: 74.8–81.8%), 9.9% (95% CI: 7.5–12.7%) and 15.6% (95% CI: 12.6–18.9%) reported psychological aggression, sexual coercion and injuries, respectively. Physical violence mainly occurred among adolescent women with less schooling, who did not work outside the home, with fewer prenatal appointments, and with little social support. Families with more under-five children, alcohol and drug abuse, and low socio-economic status were also involved more frequently. Conclusion: High prevalence rates for various forms of domestic violence in Brazil suggest that the issue should be viewed as a major public health problem. [Copyright &y& Elsevier]

Presents a study which examined the challenges posed by the drug and alcohol misuse in Brazil for nurses. Extent of the social problem in the country; Attitude of nurses toward substance misusers; Key factor which influences the beliefs of nurses in nursing care.