MSc (Med), Epidemiology and Biostatistics, Faculty of Health Sciences, University of the Witwatersrand / Objectives: To evaluate differences in virologic outcomes between adolescents and pre-adolescents initiated on HAART and to determine the patient baseline variables associated with virologic suppression. Design: Retrospective cohort study using routinely collected clinic and outcome data. Setting: Public sector HIV paediatric facility at Harriet Shezi Children’s Clinic (Chris Hani Baragwanath Hospital) Soweto, South Africa. Patients: HIV infected pre-adolescents (5 to < 11 years) and adolescents (11 to <18 years) initiating HAART between 1 April 2004 and 31 December 2008. Main outcomes and measures: Primary: virologic suppression (HIV viral load ≤ 400 copies/ml) and viral rebound (single HIV viral load ≥ 400 copies/ml after initial suppression) at 24, 48, 72 and 96 week follow up intervals. Secondary: determination of baseline variables associated with virologic suppression. Survival analysis was performed using the Kaplan Meier method and modelling was based on Cox proportional hazards. Results: Both groups exhibited similar incidence rates of virologic suppression by the 24th week from HAART initiation. Adolescents had a slightly lower incidence rate of early virologic suppression in comparison to pre-adolescents (197/100 person years vs. 203/100 person years). However, the observed difference was not statistically significant at 5% significance level (IRR: 0.97, 95%CI: 0.81 - 1.15). In a sub-group of children who had not virologically suppressed by the 24th week (168 days) of follow up, adolescents were 42% less likely to achieve virologic suppression after this time point than pre-adolescents ([IRR: 0.58, 95%CI: 0.35, 0.93). In the sub-group of all female participants, lower hazards of virologic suppression by the 24th week (aHR 0.76, 95%CI 0.59-0.99) and 96th week (aHR 0.70, 0.55-0.90) of follow up were observed among female adolescents when compared with female pre-adolescents. Additionally, clinically advanced disease was observed as a risk factor for non-virologic suppression by the 96th week of follow up among participants of all ages (aHR 0.75, 95%CI 0.64 -0.87). After 60 weeks from the initial virologic suppression, adolescents were twice more likely to experience rebound after this point than pre-adolescents (IRR: 2.33, 95%CI: 1.00 - 5.13). Conclusion: Given the potential for resistant strains of the HIV virus and the public health threat this presents, health care teams face complicated dilemmas regarding initiation of HAART to adolescents, particularly female adolescent patients who are likely to be non-adherent. Findings from the study advocate for intensified adherence and treatment support for all adolescents initiated on HAART to achieve virologic suppression within the first 6 months of treatment, a time after which they have been shown to exhibit inferior virologic suppression rates. Once virologic suppression has been attained, adolescents require prolonged treatment support to maintain long term virologic suppression at levels observed among pre-adolescents. We recommend further research into the comparison of virologic outcomes between pre-adolescents and adolescents on HAART, through prospective study designs. Qualitative study designs are also important to bridge the knowledge gaps on the barriers to HAART encountered by female adolescents.

A Research Report submitted in partial fulfilment of the requirements for the Degree of Masters in Community Based-Counselling Psychology in the Faculty of Humanities at the University of the Witwatersrand / Train surfing or staff riding has been a part of the South African working-class economic fabric since the initiation of segregation under apartheid. Now within contemporary society the activity has gained great media attention due to the fatalities that are so commonly associated with it. Despite it being a globally and locally longstanding activity it is still an area that is under-researched. The current study was aimed at exploring the growing phenomenon and how it is constructed by youth in Soweto. A total of 32 adolescent boys and girls between the ages of 18 and 21 were recruited from a public secondary school in Orlando West, Soweto, to take part in one of four focus groups. The participants’ responses from the focus group discussions were recorded then analysed using thematic content analysis. Emerging themes, including what it means to be an adolescent living in Soweto postapartheid, what adolescents now consider having fun, and what they consider to be risky behaviour, were explored in the data analysis. In addition, alternative growing phenomena within Soweto were identified, namely biking and drag-racing. Evident from the analysis was the pressure felt and experienced by adolescents, especially by male adolescents within society and the school environment to fit in to popular constructions of a growing adult and the constructions of hegemonic masculinity in contemporary South Africa. It was also found that the train surfing participants used the practice as a means to define their identity as young, black males living in South Africa. However, as much as some of the accounts of the reasons behind risky behaviours were in line with hegemonic constructions of masculinity, also revealed were the alternative and opposing voices which appeared to be tense with emotional, personal and social sacrifices. This fluidity of identity was explored through the various components of identity such as race, class and gender that all interact within the context of Soweto and results in differing adolescent identity constructions, such as, the ambitious and inspired, as well as the risk-taking train surfers who are described as being ‘in limbo’. The research concludes by shifting contemporary understanding of the phenomenon from one of thrill seeking to a performance of identity and masculinity that is influenced by race, class, and gender.

Introdução - A obesidade é uma doença crônica de origem multifatorial, considerada como um dos principais problemas de saúde pública nos países desenvolvidos, que constitui fator de risco para outras doenças graves. Sua prevalência vem aumentando mundialmente e em especial, em crianças e adolescentes. Acredita-se que as principais causas estão ligadas tanto a fatores genéticos como ambientais. Objetivo - Identificar por meio do relato de pais e de equipe interdisciplinar as facilidades e as dificuldades à adesão de adolescentes obesos com deficiência intelectual e de suas famílias para cumprir programa de orientação e prevenção das complicações da obesidade. Métodos - Trata-se de estudo de coorte histórica, descritiva e quali-quantitativa com um número de 47 adolescentes obesos com deficiência intelectual, seus responsáveis e equipe interdisciplinar, que no período de 2006 a 2008, participaram de um programa de orientação e prevenção de complicações da obesidade (POPO), oferecido pela Sociedade Pestalozzi de São Paulo. Os dados foram coletados dos prontuários, das fichas de acompanhamento do programa, dos questionários de estudo sócio-econômico e por meio de entrevistas utilizando um roteiro de questões específicas dirigidas às famílias e profissionais envolvidos no processo. Resultados - A caracterização dos adolescentes envolvidos no estudo mostrou uma prevalência da Síndrome de Down representada em 19 (40,4%) deles. Observou-se também, concentração de maior grau de obesidade com aumento da idade sendo, 63,2% estão na faixa etária de 17 a 20 anos e foram conceituados ao Grupo 3 (IMC>35). As famílias estudadas foram caracterizadas em sua grande maioria moradoras da Zona Norte SP, condições sócio-econômicas precárias com renda familiar de 1 a 2 salários mínimos e grau de escolaridade da mãe apresentando na sua grande maioria o ensino fundamental incompleto. Os profissionais que compõem a equipe interdisciplinar são na maioria absoluta do sexo feminino, atuam as áreas da medicina, psicologia e fisioterapia e apresentam experiência na área da deficiência intelectual que varia de um a 21 anos. Os resultados foram apresentados e descritos segundo dois eixos norteadores: Conclusão - A falta de locais especializados para pratica de atividades físicas, preço elevado dos alimentos sugeridos, não colaboração dos demais familiares, falta de autonomia e independência dos deficientes intelectuais e pouca freqüência às reuniões de orientações realizadas pela equipe, foram apontados como sendo os principais fatores que dificultam uma maior adesão ao programa. E quanto aos aspectos facilitadores destacou-se a comodidade do programa ser na própria instituição, a persistência da equipe e preocupação com a saúde dos filhos. / Introduction - There are many factors that contribute to the chronic disease of obesity. It is regarded as a major public health problem in developed countries. It is also a risk factor for other serious diseases. It\'s prevalence is increasing worldwide and especially in children and adolescents. It is believed that the main causes are linked to genetic and environmental factors. Objective - To identify through the report of parents and interdisciplinary teams, the facilities and the difficulties that obese adolescents with intellectual disabilities and their families have in accessing the ***Obesity Education and Prevention Program (POPO). Méthodos - It refers to a historical cohort study, that was descriptive, qualitative and quantitative. It included 47 obese adolescents with intellectual disabilities, their caregivers and the multidisciplinary team that from 2006 to 2008, participated in an ***Obesity Education and Prevention Program (POPO), offered by the Pestalozzi Society of Sao Paulo. Data was collected from medical records, the monitoring reports of the program, questionnaires from a socio-economic study and through interviews using a script of questions targeted at families and professionals involved in the process. Results - The results were presented and described according to five guiding principles: The characterization of adolescents involved in the study showed a prevalence of Down syndrome represented in 19 (40.4%) of them. The results was also indicated a greater degree of obesity with increasing age and 63.2% are between the ages of 17 and 20 years, which was representede in the Group 3 (BMI> 35). The families studied were characterized mostly living in the North Zone - SP, the socio-economic situations indicated family income between 1 to 2 minimum wages, the majority of the mothers had elementary school education and the majority of the professionals who comprise the interdisciplinary team are female. They include medical professionals, psychologists and physical therapists who have between 1-21 years of experience in the area of intellectual disabilities.Conclusion - It was determined that the main factors that render lower adherence to the program are: the lack of places to practice physical activities, the high price of food, the lack of cooperation from other family members, lack of autonomy and independence of the intellectually disabled and the infrequently meetings for feedback from the team. However, it was indicated as a facilitie, that the program was convieniently located within the institution and the team was persistent and concerned about the health of the children.

Objetivos: Investigar as diferenças entre os fatores associados ao consumo de frutas e de hortaliças entre os adolescentes brasileiros. Método: Os dados do consumo de frutas e de hortaliças foram obtidos do banco de microdados sobre consumo alimentar da Pesquisa de Orçamentos Familiares 2008/2009 do IBGE. Foram utilizados os fatores de expansão para a obtenção de representatividade nacional e estimar um modelo, por meio da regressão Tobit ajustada por sexo, idade, raça/cor, IMC, escolaridade do chefe da família, zona residencial, região, renda per capita, preço de frutas e de hortaliças para identificar os fatores associados ao consumo de frutas e de hortaliças. Para a construção do modelo, adotou-se o método de stepwise forward p<0,20 e nível de significância de 5% para a significância conjunta e das variáveis independentes. Foi utilizado o Programa STATA versão 14. Não foi incluído o consumo de frutas e de hortaliças presentes nos alimentos preparados. Resultados: Foram analisados o consumo de frutas e de hortaliças de 7.613 adolescentes. Mais de 47,61% dos adolescentes não consumiram frutas e hortaliças nos dias avaliados; 3,20% consumiram a quantidade de frutas e hortaliças dentro do recomendado de 440g/dia. Os fatores associados do consumo de frutas foram sexo, IMC, a zona residencial e a renda per capita e; os fatores associados ao consumo de hortaliças foram região, renda per capita e preço implícito de hortaliças. A renda per capita foi o único fator associado comum ao consumo de frutas e de hortaliças, porém com diferentes efeitos marginais. Conclusões: A maioria dos adolescentes brasileiros não consome a quantidade de frutas e hortaliças recomendada. Os fatores associados ao consumo de frutas são diferentes dos fatores associados ao consumo de hortaliças. / Objective: To investigate the differences between the factors associated to the consumption of fruits and of vegetables among Brazilian adolescents. Methods: Data were obtained from the IBGE 2008/2009 Household Budget Survey. To identify the factors associated with fruit and vegetable consumption it was used Tobit regression adjusted for sex, age, race/color, BMI, household educational level, residential area, region, per capita income, implicit fruit price and implicit vegetable price. For the construction of the model, we adopted the stepwise forward method p<0.20 and significance level of 5% for the joint significance and the independent variables. The STATA version 14 program was used. The consumption of fruits and vegetables present in prepared foods was not included. Results: The fruit and vegetable consumption of 7,613 adolescents were analyzed. More than 47,6% of the adolescents did not consume any fruit and vegetable; 3.20% consumed the amount of fruits and vegetables within the recommended. The associated factors of fruit consumption were BMI, residential area and per capita income; The factors associated with the consumption of vegetables were region, per capita income and implicit vegetable price. Per capita income was the only common factor associated with the consumption of fruits and vegetables, but with different marginal effects. Conclusion: Most Brazilian adolescents do not consume the recommended amount of fruits and vegetables. The factors associated with fruit consumption are different from the factors associated with the consumption of vegetables.

Introdução: A atividade física desempenha função importante na prevenção de doenças crônicas não transmissíveis. Objetivo: Estudar a importância da atividade física sobre parâmetros bioquímicos, pressão arterial sistêmica e elasticidade arterial na adolescência. Métodos: Na primeira fase da pesquisa foram envolvidos 3.000 adolescentes de 15 a 17 anos de idade, estudantes da rede estadual de ensino de Joinville-SC. A amostra foi obtida mediante procedimento de sorteio por conglomerado sob critério de partilha proporcional ao tamanho em único estágio, cuja unidade de sorteio foi a sala de aula. Na segunda fase, 300 alunos foram sorteados para a determinação dos parâmetros bioquímicos (glicose, insulina, colesterol total, HDL-c, LDL-c, triglicerídeos, homocisteína, ácido fólico, vitamina B12, Proteína C-reativa (PCR) e fibrinogênio), aferição dos índices de elasticidade arterial e medidas antropométricas, hábitos relacionados ao estilo de vida e nível de atividade física. Resultados: Retornaram o termo de consentimento, 1.104 adolescentes, sendo que 16,9 por cento relataram que algum membro da família sofreu infarto agudo do miocárdio e 31,4 por cento acidente vascular cerebral. Quanto à prática de atividade física, 80,6 por cento foram classificados como ativos e 20,7 por cento considerados com excesso de peso. Em relação aos dados bioquímicos, foram encontradas concentrações acima do recomendado para glicose (63,0 por cento), colesterol total (58,3 por cento), triglicerídeos (14,7 por cento), LDL-c (14,7 por cento), PCR (5,2 por cento), homocisteína (5,1 por cento) e fibrinogênio (5,5 por cento) e abaixo do recomendado para HDL-c (5,5 por cento). Foram encontrados baixos valores para elasticidade das grandes (LAEI) (67,8 por cento) e das pequenas (SAEI) (8,8 por cento) artérias. A atividade física apresentou correlação positiva com os LAEI e SAEI e negativa com o batimento cardíaco/minuto. Entretanto, não apresentou correlação com nenhum parâmetro bioquímico. Os adolescentes ativos e não ativos apresentaram médias diferentes (p<0,05) para as seguintes variáveis: circunferências da cintura e pescoço, dobra cutânea triciptal, batimento cardíaco/minuto, LAEI e SAEI. A atividade física não mostrou influência sobre os parâmetros bioquímicos, apenas sobre os índices de elasticidade (LAEI e SAEI) de forma independente. Após ajustes nos modelos de regressão linear a atividade física passou a influenciar a pressão arterial sistêmica e manteve sua influência sobre os índices de elasticidade. Conclusão: Apesar da maioria dos adolescentes serem classificados como ativos, o perfil nutricional do grupo estudado revelou elevada prevalência de excesso de peso e de alterações dos parâmetros bioquímicos. A atividade física influenciou a medida da pressão arterial sistêmica e o aumento da elasticidade arterial dos adolescentes. Entretanto, o mesmo comportamento não foi evidenciado para os parâmetros bioquímicos avaliados. / Introduction: The physical activity performs important function in the prevention of non-transmissible chronic diseases. Objective: To study the importance of physical activity over biochemical parameters, systemic arterial blood pressure and arterial elasticity in adolescence. Methods: In the first phase of research involved 3,000 adolescents who were 15 to 17 years old, students from statewide network of teaching in Joinville-SC. The sample was obtained through the draw procedure under cluster criterion of a size proportional share in a single stage, and the classroom was the draw unit. In the second phase, 300 students were drawn to determine the biochemical parameters (glucose, insulin, cholesterol, HDL-c, LDL-c, triglycerides, homocysteine, folic acid, vitamin B12, C-reactive protein (CRP) and fibrinogen), measurement of arterial elasticity index and anthropometric measures, habits related to lifestyle and level of physical activity. One thousand one hundred and four adolescents returned the consent terms, 16.9 per cent reported that a family member suffered acute myocardial infarction and 31.4 per cent stroke. Regarding physical activity, 80.6 per cent were classified as active and 20.7 per cent were considered overweight. For the biochemical data, concentrations were above the recommended for glucose (63.0 per cent), cholesterol (58.3 per cent), triglycerides (14.7 per cent), LDL-c (14.7 per cent), CRP (5.2 per cent), homocysteine (5.1 per cent) and fibrinogen (5.5 per cent), and below the recommended level for HDL-c (5.5 per cent). Low values were found to large (LAEI) (67.8 per cent) and small artery elasticity index (SAEI) (8.8 per cent). The physical activity showed positive correlation with LAEI and SAEI and negative correlation with the heartbeat per minute. However, the values showed no correlation with any biochemical parameter. The active and not active adolescents had different means (p<0.05) for the following variables: waist circumference, neck circumference, triceps skinfold, heartbeat per minute, LAEI and SAEI. The physical activity showed no influence on the biochemical parameters, only on the indices of elasticity (LAEI and SAEI) independently. After adjustments in the linear regression models, the physical activity began to influence systemic arterial blood pressure and remained its influence on the indices of elasticity (LAEI and SAEI). Conclusion: Although most adolescents are classified as active, the nutritional profile of the group studied revealed high prevalence of overweight and changes in biochemical parameters. The physical activity influenced the measure of the systemic blood pressure and the increase of the arterial elasticity of the adolescents. However, the same behavior was not evidenced for the biochemical parameters.

Introdução: Nas últimas décadas os óbitos por DCNT aumentaram três vezes nos estados brasileiros. Assim, o objetivo do estudo foi identificar a prevalência da obesidade e da hipertensão arterial na população de crianças e adolescentes estudantes da rede estadual de ensino de Ribeirão Preto/SP. Métodos: Foi conduzido um estudo transversal com 505 crianças/adolescentes, da faixa etária de 10 a 16 anos, que frequentavam as escolas estaduais de Ribeirão Preto. A coleta de dados, foi realizada através de pesquisa de campo com visitas às escolas e entrevista dos alunos selecionados ao longo dos anos de 2013 e 2014. Medidas antropométricas (peso, altura, cintura, quadril), e os níveis de pressão arterial foram aferidos em todos os participantes. Resultados: Aproximadamente 53% (n=265) dos estudantes eram do gênero masculino e 47% (n=240) do gênero feminino, com média de idade de 12,74 anos. Verificou-se alteração do peso corporal em 30,9% da população estudada, sendo 18,22% com sobrepeso e 12,67% com obesidade, sem diferença estatística entre os gêneros. Quanto aos níveis de pressão arterial, verificou-se alteração em 8,71% da população total, sendo mais frequente no grupo feminino (4,95%). As crianças com níveis de PA normal admitem passar menos tempo livre sem gasto energético quando comparadas com as de PA alterada [RP 0,92 (IC95% 0,88 0,97)]. Encontrou-se associação significativa [RP 2,02 (IC95% 1,28;3,2)] para o IMC alterado e menarca antes dos 10 anos de idade. A análise de regressão linear simples mostrou associação positiva entre IMC e níveis de PA tanto sistólica (R² = 0,2244; y= 61,1770 + 1,8228x; p<0,001) quanto diastólica (R² = 0,3450; y = 35,2008 + 1,0726 x; p <0,0001). Para as demais variáveis comportamentais e de hábitos alimentares, não foram encontradas associações entre obesidade ou níveis de PA. Conclusão: Observou-se alta prevalência de obesidade e hipertensão arterial na população estudada. Foi encontrada associação positiva entre IMC e HAS. Para as variáveis comportamentais e alimentares poucas foram as associações. Houve associação para a ocorrência da menarca antes dos 10 anos e o IMC alterado. Houve associação também para o aumento dos níveis pressóricos e o tempo livre sem gasto energético. Não foram encontradas associações significativas entre consumo elevado de doces, refrigerantes e a prática de atividade física foi menor que a recomendação feita pela OMS. Ressalta-se a importância do desenvolvimento de estratégias de intervenção com a participação de equipe multiprofissional e familiares para prevenção e controle da obesidade e da hipertensão arterial nas crianças e adolescentes. / Introduction: In recent decades, deaths from CDNT increased three times in the Brazilian county. The objective of the study was to identify the prevalence of obesity and high blood pressure in the population of children and adolescents students of the county school of Ribeirão Preto/SP. Methods: A cross-sectional study was conducted with 505 children / adolescents, the age group 10-16 years who attended state schools in Ribeirão Preto/SP. Data collection was conducted through field research with visits to schools and interviews of selected students over the years 2013 and 2014. Anthropometric measurements (weight, height, waist, and hip) and blood pressure levels were measured for all participants. Results: Approximately 53% (n=265) of the students were male and 47 % (n 240) were female, with a mean age of 12.74 years. There was change in body weight in 30.9 % of the study population, and 18.22 % were overweight and 12.67 % were obese, with no statistical difference between genders. As for blood pressure levels, there was change to 8.71 % of the total population, being more frequent in the female group (4.95%). Children with normal BP levels admit spend less time off without energy expenditure compared with the amended BP [RP 0.92 (95% CI from 0.88 to 0.97)]. Found a significant association [RP 2.02(95% CI 1.28, 3.2)] BMI changed and menarche before 10 years of age. Simple linear regression analysis showed a positive association between BMI and both systolic BP levels (R² = 0.2244, y = 61.1770 + 1,8228x; p < 0.001) and diastolic (R² = 0.3450, y = 35 2008 x + 1.0726; p <0.0001). For the other behavioral and eating habits variables, there were no associations between obesity and BP levels. Conclusion: There was a high prevalence of obesity and hypertension in this population. There was a positive association between BMI and SAH. For behavioral and dietary variables were few associations. There was an association for the occurrence of menarche before age 10 and the changed BMI. Was associated also to increased blood pressure and the free time without energy expenditure. Significant associations between high consumption of sweets, soft drinks and physical activity lower than recommended were found. It emphasizes the importance of developing intervention strategies with the participation of multidisciplinary team, including schools and family for the prevention and control of obesity and high blood pressure in children and adolescents.

Thesis advisor: David Smith / The terrorist attack on the World Trade Center on September 11, 2001 was witnessed first-hand by individuals of all ages in New York City, and many witnesses experienced symptoms of posttraumatic stress. This study investigated whether adolescent witnesses report being more negatively affected by the 9-11 event than adult witnesses. It is predicted that adolescents will be more negatively affected by 9-11 because they generally have had fewer life experiences in managing stress, thus they have developed fewer coping mechanisms for dealing with trauma. The study recruited adolescent participants from Stuyvesant High School (located 5 blocks away from the WTC) alumni graduating classes of 2002-05. Adult participants were recruited from employees of Cleary, Gottlieb, Steen, Hamilton, LLP (one block the street from WTC). Participants were sent an Internet survey via World Wide Web consisting of a series of questionnaires. The questionnaires asked participants to recall specific events from 9-11, put in order a series of events, report significant life changes post 9-11, rate how often they engage in various coping behaviors, and describe their current physical and mental well-being. The study found age to be significant on two factors within the life changes questionnaire: compared to adults, adolescents reported experiencing a wider range of emotions and the ability to focus on work despite outside stressors. These findings were contrary to the hypothesis. Essentially, adolescents reported faring either the same or better than adults across all measures. The study also unexpectedly found significance examining gender and hours of media consumption. / Thesis (BA) — Boston College, 2008. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Psychology. / Discipline: Psychology Honors Program.

Thesis advisor: Sandra R. Mott / The purpose of this research was to address the gap in the literature regarding the lack of first hand accounts of the factors that influence adolescent sexual decision making. Using a narrative approach, I asked a cohort of late adolescent participants to tell their stories about the events surrounding their decision to become sexually active, and how this initial decision affected subsequent decision making. The specific research questions that guided the study were: 1) What are late adolescents' perspectives of the factors that influenced their decision to become and remain sexually active? and 2) What is the effect of sexual decision making regarding coital debut on subsequent sexual activity? To accomplish my research aims I used narrative inquiry to elicit rich information, in the adolescents' own words, about what they perceive to be the most salient factors that contributed to their decisions to engage in sexual activity. I recruited a purposive sample of 11 late adolescents between the ages of 18 and 22 years from a series of family planning and sexually transmitted infection (STI) clinics in the Northeastern United States. As their stories unfolded, four main components emerged. These components included the internal and external environmental context, expected social norms, implied sexual consent, and self-reflection and evaluation. The results of this study provide evidence that adolescent sexual decision making is a complex process with multiple layers of influence. Through the stories of my participants, I have constructed a more comprehensive conceptualization of adolescent sexual decision making and related sexual behaviors. This will guide the development of possible interventions to improve health care for this population. These interventions include expanding nursing knowledge to inform the development of theories, practice innovations, research, sexual health education, and policies for addressing adolescents' needs across the continuum of the adolescents' development from childhood to adulthood. / Thesis (PhD) — Boston College, 2009. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Este estudo teve como objetivos apreender as percepções dos adolescentes em situação de exclusão social sobre a violência em seu cotidiano, identificar as experiências de violência desse grupo e analisar a realidade apreendida à luz da violência como processo histórico e socialmente determinado. Ou seja, a violência é um fenômeno social que possui caráter revelador de estruturas de dominação (de classe, etnia, geração, gênero, entre outros) e surge como expressão de contradições entre os que querem manter privilégios e os que se rebelam contra a opressão. Foram realizadas 16 entrevistas semi-estruturadas no Centro Comunitário da Criança e do Adolescente (CCCA) com adolescentes entre 12 a 17 anos de idade. Os dados foram tratados mediante análise de conteúdo. Os resultados evidenciam que as percepções que os adolescentes têm da violência estão intrinsecamente relacionadas às suas vivências dentro de um meio social hostil, caracterizado por um sistema sociopolítico gerador de profundas desigualdades sociais. O conceito de violência foi associado a algo natural, enquanto medida disciplinar; violação aos seus direitos; discriminação social e de gênero, associado a atos físicos como agressões e brigas na comunidade. O tipo de violência mais citado pelos adolescentes foi a violência interpessoal que a Organização Mundial da Saúde caracteriza como violência doméstica quando ocorre entre os membros de uma família e seus agregados e violência social quando ocorre entre pessoas sem laços de parentesco. A superação dessa situação dar-se-á na medida em que os diferentes setores se organizem para garantir aos grupos sociais envolvidos uma assistência na medida das suas necessidades sociais e de saúde / This study aimed to capture the perceptions of adolescents at risk of social exclusion on the violence in their daily lives, identify the experiences of violence of this group and examine the reality perceived in the light of violence as a historical process and socially determined. It is violence is a social phenomenon that has character reveals structures of domination (of class, ethnicity, generation, gender, etc.) and appears as an expression of conflict between those who want to maintain privileges and who rebel against oppression. Were carried out 16 semi-structured interview in the Community Center on Children and Adolescents (CCCA) with adolescents between 12 to 17 years of age. The data were treated by content analysis as method of analysis. The results show that the perceptions that adolescents have of violence are intrinsically linked to their experiences within a hostile social environment, characterized by a sociopolitical system generates deep social inequalities.The concept of violence was associated with something natural, as a disciplinary measure; violation of their rights, social and gender discrimination, coupled with acts such as physical assaults and fights in the community. The type of violence most cited by teens was the interpersonal violence that the World Health Organization characterizes as domestic violence when it occurs between members of a family and their household and social violence when it occurs between people without ties of kinship. Overcoming this situation will occur in that the different sectors to organize themselves to provide social groups involved as well as their social needs and health

A era digital vivenciada na contemporaneidade promove transformações nos modos de circulação de informações e conhecimentos. De igual modo, incentiva o surgimento de novas formas de comportamento e de vivências. Tal processo afeta diretamente as novas gerações e a produção social dos sujeitos, nos seus tempos e espaços, constituindo os denominados Geração Z, que são adolescentes que apresentam novas demandas às instituições da vida moderna. Essa conjuntura influi diretamente no espaço escolar, principalmente quando os estudantes estão em constante interação com as Tecnologias de Informação e Comunicação (TICs) que objetivam facilitar a comunicação e troca de informações. Assim, a relação entre a escola e esses sujeitos, que buscam primeiramente espaços online para obter informações e realizam múltiplas tarefas simultaneamente, implica em se pensar espaços educacionais que favoreçam a aprendizagem desses novos estudantes, considerando também as características específicas por eles apresentadas. A vista disso, a pesquisa objetivou conhecer o sentido da escola para os estudantes imersos a tecnologia digital. Para tanto foram utilizados como metodologia um roteiro de perguntas autoaplicável visando obter o perfil sociodemográfico, Observação Participante e Grupo Focal (GF) realizados com estudantes do Ensino Médio de uma escolapública da cidade de Palmas, TO. Os resultados analisados por meio da estatística descritiva evidenciaram que dos 426 estudantes que responderam o roteiro de perguntas, 98% possuem acesso à internet e 33% permanecem online mais que oito horas diárias. Entre os locais de acesso, a casa foi citada por 80% e a escola por 37%. Ainda, 85% usam a internet para acesso às redes sociais e 41% para pesquisas escolares; 57% disseram que adquiriram conhecimento por meio de aplicativos em computadores e dispositivos móveis e 33% por meio de curso online. A somar, 57 participantes dos GFs apresentaram por meio da análise de conteúdo, modalidade temática,trêsnúcleos, a saber: Escola, espaço para aprender e preparar para o futuro; Mas não só, escola é alcançar voo e Impasses e em passos, construindo novas perspectivas sobre a escola.A Geração Zcompreende a escola como um espaço de construção da aprendizagem, porém não o únicoe, assim, consideram o ambiente virtual também como um espaço de se aprender, construir e reconstruir conhecimento. Dessa maneira, expressam o desejo de serem reconhecidos nesse espaço, bem como que a escola se redescubra no tempo atual. Apreender a percepção dos estudantes sobre a escola na era digital contribui para o repensar a educação a eles direcionada, no sentido de atribuir ao ensino novas linguagens e inovações na relação entre escola, professor e estudante, capazes de modificar a forma de ser, agir e pensar das novas gerações / The digital age experienced in the contemporary world promotes transformations on how information and knowledge circulate. It also encourages the emergence of new forms of behaviour and experiences. Such process directly affects the new generations and the social production of the subjects, in their own times and spaces, constituting the so-called Generation Z, which are adolescents who present new demands to the institutions of modern life. This situation directly affects the school space, especially when the students are in constant interaction with Information and Communication Technologies (ICTs) that aim to facilitate the communication and exchange of information. Thus, the relationship between the school and these subjects, who firstly seek online spaces to obtain information and perform multiple tasks simultaneously, implies thinking about educational spaces that favour the learning of these students, also considering the specific characteristics presented by them. In light of this, the aim of this research was to apprehendthe meaning of the school to the Generation Z students. For this purpose, a self-administered questionnaire was used as methodology to obtain the sociodemographic profile, the Participant Observation and Focal Group (FG) carried out with high school students from a public school in Palmas, TO.Analysed through descriptive statistics, the results showed that out of the 426 students who answered the questionnaire, 98% had internet access and 33% remained online more than 8 hours a day. Among the access places, the house was mentioned by 80% and the school by 37%. Also, 85% use the internet to access social networks and 41% to school searches; 57% said they acquired knowledge through applications on computers and mobile devices and 33% through online courses. To sum up, 57 participants of the FGs presented through content analysis, thematic modality, three nuclei, which are: School, space to learn and prepare for the future; Learning is taking off; Building new perspectives about the school. Generation Z understands the school as a space of construction of learning, but not the only one, and thus also consider the virtual environment as a space to acquire information, build and rebuildknowledge. In this way, they express the desire to be recognized in this space, as well as that the school gets rediscovered in the present time. To capture the student\'s perceptions about the school in the digital era contributes to the rethinking of the education directed to them, in the sense of attributing a new language and innovations in the relationship between school, teacher and student, which can be capable of changing the way of being, acting and thinking of the new generations