Blood alcohol content and death from fatal injury: a study in the metropolitan area of São Paulo, Brazil.

This study analyzed 5,690 toxicological screenings carried out on blood and viscera of fatally injured victims at the Institute of Forensic Medicine in the Metropolitan area of São Paulo during 1994. The screenings analyzed correspond to 39.5% of all deaths due to injury in this metropolitan area during the same period. Almost half of the victims (48.3%) presented a positive blood alcohol content (BAC). The exact proportion however, varied according to the cause of death with 64.1% of victims of drowning testing positive for alcohol, 52.3% of homicides, 32.2% of suicides and 50.6% of motor vehicle accidents. Blood alcohol concentration was also found to vary, with suicide victims presenting low concentrations and 70% of pedestrians hit by cars presenting high concentrations (0.2% or greater). Few cases tested positive for drugs other than alcohol, and of those who did, the majority were positive for cocaine. However, it should be emphasized that the methods used for the detection of substances other than alcohol were only accurate enough to detect cases of overdose. These findings highlight the need to improve surveillance of alcohol-related fatalities in Brazil and suggest an important link between alcohol intoxication and fatal injury.

[Health behavior among students of public and private schools in the metropolitan area of São Paulo, Brazil]. / Comportamentos de saúde entre jovens estudantes das redes pública e privada da área metropolitana do Estado de São Paulo.

OBJECTIVE: To investigate the prevalence of several health behaviors among students of public and private schools in S. Paulo, Brazil. METHODS: An epidemiological survey about health behaviors among high school students was carried out in S. Paulo in 1998. Seventh to eleventh graders from ten public and seven private schools were interviewed. All students were asked to fill out a Portuguese version of the questionnaire used by the Centers for Disease Control and Prevention in their annual "Youth Health Risk Behavior Survey". This questionnaire includes questions on driving-related behavior, violence, substance abuse, sexual practices, dietary habits and body weight control. RESULTS: A significant proportion of the students, mainly in the range of 15--18 years old, reported engaging in health-risk behaviors. In public schools, the most prominent risk behaviors were: riding a motorcycle without helmets (reported by 70.4% of the students who were either passengers or the driver); not using condoms in the last sexual intercourse (34% among those sexually active); carrying guns (4.8% in the last year), and suicide attempts (8.6% in the last year). In private schools, substance abuse was the most prominent risk-behavior: 25% reported at least one episode of binge-drinking in the last 30 days, 20.2% sniffed solvents at least once in the last year and 22.2% smoked marijuana in the same period; 13.8% reported using tobacco on a regular basis. Not wearing helmets while riding a motorcycle was also very high, reported by 66.3%. Female students reported less risk-behaviors, except for suicide attempts and unhealthy weight control methods. CONCLUSIONS: The information gathered could contribute to the development of preventive programs at school level, which takes into consideration the students' risk behaviors.

[Potential application of the qualitative technique focus group in substance abuse research]. / Potencialidades da técnica qualitative grupo focal em investigações sobre abuso de substâncias.

The focus group, a qualitative research method useful for Public Health investigation, is described and discussed. The potential application of the focus group method in drug abuse research in Brazil is emphasized.

Drug and alcohol use and family characteristics: a study among Brazilian high-school students.

The present work employs a multivariate analysis technique to study, simultaneously, family relations and alcohol/drug consumption among 16,378 Brazilian high-school students. The analysis is centered on the relation between subjective or objective family situations and consumption. Subjective situations are measured by adolescents' perception of their families, that is, the family's environmental "climate"--whether violent situations occur at home, whether there is frequent dialogue about the youngsters' problems, and whether they perceive interest on the part of parents. Objective situations refer to the conjugal status of parents. Results pointed to family violence as the factor most frequently associated with alcohol/drug use behavior. It was also found that the family's environmental climate constitutes a more important factor than the conjugal status of parents, when it comes to the development of drug use behavior. Therefore, the impact of this last variable (whether parents are living together) is determined by environmental conditions: when those conditions are favorable (no violence, problems habitually talked about, parents concerned with their offspring) the fact that parents were effectively living together meant a smaller probability of alcohol/drug use; when these conditions were unfavorable, the same fact was associated with a greater probability of consumption.

Identifying risk factors for drug abuse among portuguese speaking youth in the Boston area: a preliminary assessment using key informant networks.

This article presents the results of a key-informant mail survey conducted with thirty-nine community leaders and local workers of the three main groups of the Boston area Portuguese speaking community, namely Brazilians, Cape Verdeans, and Portuguese. They were asked to rank on the questionnaire the frequency with which some youth problems-identified in the literature as risk factors for substance abuse-were present in the community. Six of the ten most cited problems were family-related, such as inter-generational cultural differences, poor family management skills, and social isolation of family.

Extracurricular activities: are they an effective strategy against drug consumption?

This work describes data obtained among 16,117 high-school students in fifteen Brazilian cities, involving participation in a number of extracurricular activities and consumption of drugs and alcohol. In the great majority of cases, no association was found between attendance of artistic-, community-, or sports-related activities and the use of these substances. On the other hand, a weak but constant negative association was found involving alcohol/drug consumption and attendance of religious activities. The authors discuss these findings in the light of some current preconceptions prevailing in Brazilian society: namely, that such activities constitute effective strategies for drug use prevention and the "idle" young persons tend to be potential drug users. They also discuss the implications that among students involved in religious activities drug and alcohol consumption was shown to become slightly lower.

[Extracurricular activities and drug abuse prevention: a controversial issue]. / Atividades extra-curriculares e prevenção ao abuso de drogas: uma questão polêmica.

Data obtained from 16,117 high school students in fifteen Brazilian cities, relating to participation in a number of extracurricular activities and consumption of drugs and alcohol, are described. In the great majority of cases, no association was found between participation in artistic, community or sports-related activities and the use of these substances. On the other hand, a weak but constant negative correlation was found between alcohol/drug consumption and involvement in religious activities. The authors discuss these findings in the light of some of the current preconceptions prevailing in Brazilian society: namely, that such activities constitute effective strategies for drug use prevention; and that "idle" young persons tend to be potential drug users. They also discuss the implications of the fact among students involved in religious activities drug and alcohol consumption has been shown to be slightly lower.

[Didactic books and teaching for health: the case of psychotropic drugs]. / Os livros didáticos e o ensino para a saúde: o caso das drogas psicotrópicas.

Eighteen didactic books on Sciences/Biology, Civic and Moral Education and Brazilian Political and Social Studies, for primary and secondary schools, were analyzed, with a view to assessing the way in which the issue of psychotropic drug use is dealt with. The texts analyzed are structurally centered on the discussion of the harmful effects of drugs instead of discussing others topics (such as etiology, concepts, treatment, incidence and prevalence). The texts are characterized especially by the use of non-scientific language in which emotional appeal and an exceedingly exacerbated style are the rule. The drug user is described as being necessarily a moral, physical and psychological decadent. The results were discussed in the light of recent theories on the prevention of drug abuse.

[Tobacco use by students in the 1st and 2d grades in 10 Brazilian capitals: possible contributions of multivariate statistics to the understanding of the phenomenon]. / O uso de tabaco por estudantes de primeiro e segundo graus em dez capitais brasileiras: possíveis contribuições da estatística multivariada para a compreensão do fenômeno.

The use of tobacco among school children in ten Brazilian cities, by means of statistical techniques such as bivariate and multivariate analysis (Logit Model), was analyzed. Bivariate analysis revealed a positive association between the use of tobacco and the school child's non-academic occupation, evening course attendance, poor school performance, and parents' smoking habits. Multivariate techniques and the Logit Model showed that poor school performance (on the evening course) and parents' smoking habits (on the day-time course) were most significant variables. The importance of the utilization of multivariate technics for the real understanding of the various factors involved in complex behavior patterns such as the use of tobacco, alcohol and drugs, was discussed.

The use of solvents and other drugs among children and adolescents from a low socioeconomic background: a study in São Paulo, Brazil.

This paper describes the pattern of solvent and other drug use among a sample of 1,836 students from a low socioeconomic background, aged 9-18 years. Nearly 24% of the respondents reported lifetime use of solvents and 4.9% used them within the past 30 days. The more common ones were a mixture of chloroform and ether popularly known as "lança-perfume" (35.9%), acetone (33.9%), gasoline (31.9%), fingernail polish (30.3%), and glue (25.2%). The use of solvents was associated with poor academic performance, being employed, and heavy alcohol consumption among close relatives. Marijuana was the next most often used drug, followed by tranquilizers (3.6% and 2.6%, respectively). Males, compared to females, were more likely to report the use of solvents and marijuana. The use of sedatives was more common among females.