ABSTRACT:Objective: To estimate the prevalence of bullying from the victim's perspective in Brazilian school children and to analyze its association with individual and family context variables. Methods: An analysis of the data on 109,104 adolescents, obtained by the National Adolescent School-based Health Survey, held in schools in 2012, was carried out. An association model between bullying and explanatory variables was tested in different contexts: sociodemographic, risk behaviors, mental health and family context. Univariate and multivariate analyzes were performed, calculating the Odds Ratio and confidence intervals. Results: The prevalence of bullying found in this study was of 7.2% (95%CI 6.6 -7.8). A higher chance of bullying was found among male students (OR = 1.58; 95%CI 1.51 -1.66), with an inverse relation between age and bullying, with the magnitude of risk among adolescents younger than 13 years of age being higher when compared to those with 16 years of age or more. Of individual risk behaviors, only being a smoker remained in the final model (OR = 1.11; 95%CI 1.01 -1.23). Mental health variables associated with bullying were: feeling lonely (OR = 2.66; 95%CI 2.52 -2.81), insomnia (OR = 1.92; 95%CI 1.80 -2.05), not having friends (OR = 1.71; 95%CI 1.54 -1.89), and, in the family context, those who skip class without telling their parents (OR = 1.13; 95%CI 1,07 -1,19) and those who suffer physical abuse by family members (OR = 2.03; 95%CI 1.91 -2.146). Conclusion: Bullying was associated to male students, younger, of black color, smokers, with mental health vulnerabilities and victims of domestic violence. This suggests the need for a holistic approach from education and health professionals, parents and the community in seeking measures for the prevention of bullying.

OBJECTIVE:To analyze the prevalence of bullying and its associated factors in Brazilian adolescents. METHODS:Data were used from a population-based household survey conducted by the Urban Health Observatory (OSUBH) utilizing probability sampling in three stages: census tracts, residences, and individuals. The survey included 598 adolescents (14-17 years old) who responded questions on bullying, sociodemographic characteristics, health-risk behaviors, educational well-being, family structure, physical activity, markers of nutritional habits, and subjective well-being (body image, personal satisfaction, and satisfaction with their present and future life). Univariate and multivariate analysis was done using robust Poisson regression. RESULTS:The prevalence of bullying was 26.2% (28.0% among males, 24.0% among females). The location of most bullying cases was at or on route to school (70.5%), followed by on the streets (28.5%), at home (9.8%), while practicing sports (7.3%), at parties (4.6%), at work (1.7%), and at other locations (1.6%). Reports of bullying were associated with life dissatisfaction, difficulty relating to parents, involvement in fights with peers and insecurity in the neighborhood. CONCLUSIONS:A high prevalence of bullying among participating adolescents was found, and the school serves as the main bullying location, although other sites such as home, parties and workplace were also reported. Characteristics regarding self-perception and adolescent perceptions of their environment were also associated with bullying, thus advancing the knowledge of this type of violence, especially in urban centers of developing countries.

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HIV-positive people who use drugs (PWUDs) are particularly vulnerable for suboptimal access to highly active antiretroviral therapy (HAART). We conducted a systematic review to identify factors associated with suboptimal HAART access among this population. Studies evaluating HAART access among active PWUDs as a primary outcome, presenting multivariate analysis and conducted after January 1997 were included. Of 122 studies matching the search criteria, only 14 (11.4 %) met the inclusion criteria. All selected studies were prospective cohorts and included young adults, 13 were conducted in North America or western Europe and one in Ukraine. Selected studies measured HAART access using different strategies, however, all identified PWUDs as less likely to receive HAART, when compared to those who never used drugs or former PWUDs. Additional factors associated with suboptimal HAART access include: recent incarceration, lack of health insurance, unstable housing, depression, non-white ethnicity, female PWUDs, and health professionals stigma/prejudice. Factors associated with higher rates of HIV-treatment access included: alcohol and/or drug addiction treatment (especially methadone maintenance therapy), regular source of primary care, treatment and care from the same provider (most of the time) and larger physician experience in HIV-management. PWUDs face a synergy of social and structural factors that influence their suboptimal access to HAART, struggling with poor living conditions, inadequate access to specialized care and stigma/discrimination from health professionals. Renewed strategies and effective interventions should be developed and scaled-up, in order to assure equitable HAART access, decrease morbidity and mortality among PWUDs.

Background The modified Rodnan skin score (mRSS) analyzes the extent and severity of skin thickening of Systemic Sclerosis (SSc) by palpation in 17 anatomical sites. It is graded by a scale 0-3, where 0 = normal skin, 1 = mild skin thickening, 2 = moderate 3 = skin thickening and skin thickening with intense inability to pucker the skin.1 Studies have shown that diffuse SSc have higher mRSS and this may compromise the rates of morbidity and mortality in these patients.2 However, there is no consensus on a cutoff point that confirms mRSS as an independent marker of activity and severity disease; furthermore, the subjectivity in the evaluation and disease staging and therapeutic response-related variability impair its accuracy and reprodutibility.3 Objectives To evaluate the correlation between skin thickening and disorders mood, quality of life and disability aspects in a group with diffuse and limited SSc patients. Methods Cross-sectional study with 59 SSc patients, followed-up at the Walter Cantidio University Hospital. The skin thickening was analyzed by mRSS; the disorders mood and quality of life by SRQ-20 and SF-36 questionnaires; and disability by HAQ. Mann-Whitney test was carried out to compare the scales of the diffuse and limited groups, and the Spearman test to correlate mRSS with the other scales. The significance level was stipulated in 5%. Results In that sample, 47 patients had the diffuse form (79%). The mean and standard deviation of mRSS was 20 (±8.7); of positives responses SRQ-20 8,9 (±4.9); of functional capacity, physical aspect and health general status, respectively, were 42.5 (±21.5), 26.5 (±35.9) and 38.3 (±20.1); of HAQ was 1.10 (±0.7). The mRSS correlated negatively with SRQ-20 (-0.2) and positively with HAQ (-0.2). When compared the diffuse and limited forms, the worse mRSS was the first one (21.9±8.5), P=0.00; in this group, mRSS correlated stronger negatively with SRQ-20 (-0.32; P=0.027) and positively with HAQ (-0.31; P=0.033). Conclusions It was confirmed that exist SSs related-disorders mood tendency, quality of life decrease and disability. The diffuse form showed the highest degree of skin thickening and that seemed to determine worsening of emotional and functional aspects. References Sampaio-Barros PD, Bortoluzzo AB, Marangoni RGJ, Rheumatol. Merkel PA, Silliman NP, Clements PJ, Arthritis Rheum Hasegawa M, Asano Y, Endo H, Rheumatology (Oxford) Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5829