Emotional and Behavioral Problems in Children Living With Addicted Family Members: Prevention Challenges in an Underprivileged Suburban Community

Abstract Children living with substance abusers are more likely to experience negative outcomes. Our goal was to compare caregivers' reports on the Child Behavior Checklist (CBCL) and a socioeconomic and risk form of psychological aspects of children exposed to substance abuse assisted versus not assisted by a preventive intervention program in an underprivileged community. This observational intervention study was conducted with 66 caregivers of children who attended the program and 35 caregivers of children from the same community who did not attend. Ages ranged between six and 11 years old. Chi-square and logistic regression tests indicate that children exposed to substance abusers have more mental health problems than the general population and those who did not participate in the preventive intervention program presented worse outcomes, with higher rates of behavioral/emotional problems and exposure to risk situations. Results suggest that preventive actions might be helpful to promote the mental health of children at risk, validating the need for public policies and services

Exposure to violence in incarcerated youth from the city of São Paulo Exposição à violência entre jovens da cidade de São Paulo em privação de liberdade

OBJECTIVE: This study aimed to determine the extent of exposure to community violence among delinquent Brazilian youth in the 12-month period prior to their incarceration and to identify factors associated with this exposure. METHOD: With an oversampling of girls, a cross-section of youth under 18 years of age from juvenile detention units in the city of São Paulo, Brazil completed a structured interview. Key items related to exposure to violence (witnessed and experienced) were drawn from the Social and Health Assessment questionnaire to cover the 12-month period prior to incarceration. RESULTS: Participants (n = 325, 89% boys) reported high rates of exposure to violence with largely similar levels for boys and girls. Being threatened with physical harm, being beaten or mugged and/ or shot at were the most common forms of violence experienced. After controlling for demographic and family variables, the fact of having peers involved in risk behavior, easy access to guns and previous involvement with the justice system were associated with witnessed violence; whereas having slept on the street was the only variable associated with experienced violence. CONCLUSION: This group of youth was exposed to high levels of violence and other adverse experiences. Future research should examine the effectiveness of strategies aimed at reducing the exposure to violence of high-risk youth.<br>OBJETIVO: Esse estudo procurou determinar a extensão da exposição à violência na comunidade entre jovens brasileiros delinquentes nos 12 meses que antecederam sua privação de liberdade e identificar fatores associados a essa exposição. MÉTODO: Um corte transversal de menores de 18 anos internados em unidades da Fundação Casa/ex-FEBEM na cidade de São Paulo, Brasil (com meninas superamostradas) participou de entrevista estruturada. Itens-chave sobre exposição à violência (testemunhada e vivenciada) foram retirados do questionário Social and Health Assessment para cobrir o período de 12 meses anterior à internação. RESULTADOS: Os participantes (n = 325, 89% meninos) referiram altas taxas de exposição à violência, taxas estas muito similares entre meninos e meninas. Ter sofrido ameaças de lesão física, ter sido espancado ou assaltado e/ou baleado foram as formas mais comuns de violência vivenciada. Após controlar por fatores sociodemográficos e familiares, o relacionamento com jovens envolvidos em comportamentos de risco, o fácil acesso a armas de fogo e a passagem prévia pela Justiça estiveram associados à violência testemunhada, enquanto ter dormido na rua foi o único fator associado à violência vivenciada. CONCLUSÃO: Esse grupo de jovens foi exposto a altos níveis de violência e a outras experiências adversas. Pesquisas futuras devem examinar a efetividade de estratégias que visem reduzir a exposição à violência entre jovens de alto risco

Biallelic mutation in MYH7 and MYBPC3 leads to severe cardiomyopathy with left ventricular noncompaction phenotype

Dominant mutations in the MYH7 and MYBPC3 genes are common causes of inherited cardiomyopathies, which often demonstrate variable phenotypic expression and incomplete penetrance across family members. Biallelic inheritance is rare but allows gaining insights into the genetic mode of action of single variants. Here, we present three cases carrying a loss‐of‐function (LoF) variant in a compound heterozygous state with a missense variant in either MYH7 or MYBPC3 leading to severe cardiomyopathy with left ventricular noncompaction. Most likely, MYH7 haploinsufficiency due to one LoF allele results in a clinical phenotype only in compound heterozygous form with a missense variant. In contrast, haploinsufficiency in MYBPC3 results in a severe early‐onset ventricular noncompaction phenotype requiring heart transplantation when combined with a de novo missense variant on the second allele. In addition, the missense variant may lead to an unstable protein, as overall only 20% of the MYBPC3 protein remain detectable in affected cardiac tissue compared to control tissue. In conclusion, in patients with early disease onset and atypical clinical course, biallelic inheritance or more complex variants including copy number variations and de novo mutations should be considered. In addition, the pathogenic consequence of variants may differ in heterozygous versus compound heterozygous state