Violence and post-traumatic stress disorder in Sao Paulo and Rio de Janeiro, Brazil: the protocol for an epidemiological and genetic survey

Background: violence is a public health major concern, and it is associated with post-traumatic stress disorder and other psychiatric outcomes. Brazil is one of the most violent countries in the world, and has an extreme social inequality. Research on the association between violence and mental health may support public health policy and thus reduce the burden of disease attributable to violence. the main objectives of this project were: to study the association between violence and mental disorders in the Brazilian population; to estimate the prevalence rates of exposure to violence, post-traumatic stress disorder, common metal disorder, and alcohol hazardous use and dependence: and to identify contextual and individual factors, including genetic factors, associated with the outcomes.Methods/design: one phase cross-sectional survey carried out in São Paulo and Rio de Janeiro, Brazil. A multistage probability to size sampling scheme was performed in order to select the participants (3000 and 1500 respectively). the cities were stratified according to homicide rates, and in São Paulo the three most violent strata were oversampled. the measurements included exposure to traumatic events, psychiatric diagnoses (CIDI 2.1), contextual (homicide rates and social indicators), and individual factors, such as demographics, social capital, resilience, help seeking behaviours. the interviews were carried between June/2007 February/2008, by a team of lay interviewers. the statistical analyses will be weight-adjusted in order to take account of the design effects. Standardization will be used in order to compare the results between the two centres. Whole genome association analysis will be performed on the 1 million SNP (single nucleotide polymorphism) arrays, and additional association analysis will be performed on additional phenotypes. the Ethical Committee of the Federal University of São Paulo approved the study, and participants who matched diagnostic criteria have been offered a referral to outpatient clinics at the Federal University of São Paulo and Federal University of Rio de Janeiro

Vitimização por homicídios segundo características de raça no Brasil

OBJETIVO: Descrever a tendência temporal da mortalidade por homicídio no Brasil. MÉTODOS: Estudo de série temporal dos homicídios no Brasil de 2000 a 2009. As variáveis explicativas foram raça/cor, sexo e escolaridade. Os óbitos foram provenientes do Sistema de Informações de Mortalidade. A análise de tendência foi realizada por meio de regressão polinomial para séries históricas (p < 0,05; intervalo de 95% de confiança). RESULTADOS: A população negra representou 69% das vítimas de homicídios em 2009. O número de homicídios aumentou entre a população negra e diminuiu entre a branca, com tendência de crescimento da taxa nos negros e de redução nos brancos no período. As taxas aumentaram nos grupos de maior e menor escolaridade entre negros, enquanto, entre brancos, reduziram para os de menor nível escolar e mantiveram-se estáveis no grupo com maior nível de escolaridade. Em 2009 negros tiveram maior risco de morte por homicídios do que a população branca, independentemente do nível de escolaridade. Entre 2004 e 2009, as taxas de homicídios na população branca diminuíram e aumentaram na negra. CONCLUSÕES: O risco relativo de homicídios cresce na população negra, sugerindo o aumento das desigualdades. A repercussão das medidas antiarmas no Brasil, implantada em 2004, foi positiva na população branca e discreta na população negra. Raça/cor pode predizer a ocorrência de homicídio.OBJETIVO: Describir la tendencia temporal de la mortalidad por homicidio en Brasil. MÉTODOS: Estudio de serie temporal de los homicidios en Brasil de 2000 a 2009. Las variables explicativas fueron raza/color, sexo y escolaridad. Los óbitos fueron provenientes del Sistema de Informaciones de Mortalidad. El análisis de tendencia fue realizada por medio de regresión polinomial para series históricas (pOBJECTIVE: To describe the temporal patterns of mortality by homicide in Brazil. METHODS: A series of homicides in Brazil from 2000 to 2009 were studied. The explanatory variables were race/skin color, gender and education. The death statistics were obtained from the Mortality Information System. A trend analysis was performed by means of a polynomial regression for a historic time series (p < 0.05, 95% confidence interval). RESULTS: The black population represented 69% of the homicide victims in 2009. The homicide rate increased in the black population, while it decreased in the white population in the period studied. The homicide rate increased in groups with both higher and lower education among blacks; among whites, the rate decreased for those with the lowest level of schooling and remained stable in the group with higher educational levels. In 2009, blacks had a higher risk of death than whites from homicide, regardless of education level. Between 2004 and 2009, the homicide rate decreased in the white population, while it increased in the black population. CONCLUSIONS: The relative risk of falling victim to homicide increased in the black population, suggesting an increase in inequality. The effect of the anti-gun measures implemented in Brazil in 2004 was positive in the white population and less pronounced in the black population. Overall, race/skin color predicted the occurrence of homicide

Youth violence in Latin America: A framework for action

No Abstract. African Safety Promotion: A Journal of Injury and Violence Prevention Vol. 4 (2) 2006: 120-13

The establishment of injury surveillance systems in Colombia, El Salvador, and Nicaragua (2000-2006) Establecimiento de sistemas de vigilancia de lesiones en Colombia, El Salvador y Nicaragua (2000-2006)

<abstract language="spa">La Organización Panamericana de la Salud (OPS), en colaboración con los Centros para el Control y la Prevención de Enfermedades (CDC) de los Estados Unidos de América, estableció en 2000 sistemas para la vigilancia de lesiones en Colombia, El Salvador y Nicaragua. Estos sistemas, basados en los servicios hospitalarios de emergencia, formaron parte de un proyecto piloto fundamentado en las guías para la vigilancia de lesiones, desarrolladas por la Organización Mundial de la Salud (OMS) y los CDC. Los objetivos de este proyecto eran evaluar la utilidad de las guías de la OMS/CDC, crear mecanismos apropiados para la vigilancia de lesiones en los tres países, promover intervenciones preventivas adecuadas e integrar la prevención y el control de lesiones en proyectos nacionales de salud pública. En este artículo se describe el proyecto piloto de la OPS/CDC y se resaltan los principios más importantes y las lecciones aprendidas durante sus seis años de funcionamiento (2000-2006). Entre las principales recomendaciones se encuentran la integración de la vigilancia de las lesiones en las unidades de epidemiología e información existentes en los ministerios de salud, la recogida de los datos importantes exclusivamente, la garantía de monitoreos y evaluaciones adecuados y la adopción de las prácticas que han demostrado ser más efectivas para el entrenamiento de personal y la diseminación de información