Purposes Mental disorders are responsible for 16% of the global burden of disease in adolescents. This review focuses on one contextual factor called community violence that can contribute to the development of mental disorders Objective To evaluate the impact of community violence on internalizing mental health symptoms in adolescents, to investigate whether different proximity to community violence (witness or victim) is associated with different risks and to identify whether gender, age, and race moderate this association. Methods systematic review of observational studies. The population includes adolescents (10-24 years), exposition involves individuals exposed to community violence and outcomes consist of internalizing mental health symptoms. Selection, extraction and quality assessment were performed independently by two researchers. Results A total of 2987 works were identified; after selection and extraction, 42 works remained. Higher exposure to community violence was positively associated with internalizing mental health symptoms. Being a witnessing is less harmful for mental health than being a victim. Age and race did not appear in the results as modifiers, but male gender and family support appear to be protective factors in some studies. Conclusion This review confirms the positive relationship between community violence and internalizing mental health symptoms in adolescents and provides relevant information that can direct public efforts to build policies in the prevention of both problems.

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Objectives: We aimed to investigate the effect of insulin sensitivity and insulin resistance status at baseline on longitudinal body mass index, and the possible effect modification by sex.Methods: This is a secondary analysis of a randomized intervention community trial, in which a subgroup of 84 adolescents, aged between 10 and 12 years, were analyzed. Body weight, height, and body mass index (BMI) were determined before and after 8 months of follow-up. Glucose and serum insulin were examined at baseline and IR was defined based on the homeostasis model assessment-insulin resistance (HOMA-IR), with a cutoff >2.5 for both genders. Linear mixed-effects models were performed to evaluate the influence of HOMA-IR at baseline on BMI changes over time. Models were adjusted for age, pubertal stage, and stratified by sex. Results: The sample comprised 65.4% of girls and the prevalence of overweight/obesity was 54.7% among girls and 50.0% among boys. The overall prevalence of IR was 75.3%, of which 60.7% for boys and 83.0% for girls. We found an interaction effect by sex (p = .004) for HOMA-IR as a continuous variable, with a decreased BMI rate of change among boys (β = À0.13; p = .03) but not for girls (β = +0.03; p = .36). Longitudinal BMI changes considering IR status at baseline (IR vs. non-IR) did not demonstrate any statistically significant difference for both boys (À0.1 vs. +0.4; p = .28) and girls (+0.7 vs. +1.0; p = .44). Conclusion: Increased HOMA-IR values at baseline were associated with greater BMI reduction over time among boys but not girls, with no influence of IR status.

Background: Mental health diseases are responsible for 16% of the global burden of disease in adolescents. Identifying the main determinants of these disorders in this age group can direct public and political efforts aimed at their prevention. Two previous meta-analyses showed a moderate and positive effect between exposure to community violence and mental health symptoms; however, there are still significant gaps to be addressed. Objectives: To evaluate whether adolescents’ exposure to a higher degree of community violence is associated with a higher risk of internalizing mental health symptoms and to investigate whether degrees of community violence events (victimization, witnesses and heard about) is associated with a higher risk of internalizing mental health outcomes (depression, anxiety and postraumatic stress disorder). Methods: A systematic review, research question and inclusion and exclusion criteria were developed according to the PEO format. The population consists of adolescents aged 10 to 24 years, the exposition involves individuals who were exposed to community violence, the comparison is adolescents who were not exposed or who were exposed to community violence to a smaller degree, and the outcome consists of internalizing mental health symptoms. Selection, extraction and quality assessment are being performed independently by two researchers. Results: A narrative synthesis will be presented. If possible, a meta-analysis will be performed with subgroup analyses of age, sex, degree of community violence and race. Publication bias will be assessed using funnel plots. This protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) - CRD 42019124740.

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