AbstractObjectivesThe involvement of adolescents in violent behaviors is becoming an important public health problem that is concerning physicians as it is associated with a decrease in adult life quality. In this context, bullying is a type of aggressive behavior that occurs repeatedly in interpersonal relationship where power imbalance exists increasing the risk of physical and psychosocial problems in all its intervenient. Prevalence of bullying in Portuguese adolescents is estimated to be ranging from 16.2 to 27.5%. Sleep disorders are a well-known problem related to bullying situations, either as a consequence or a risk factor; estimated prevalence in adolescence is 25% worldwide. In the present study we aimed to investigate the association between sleep quality and the involvement in school bullying in Portuguese adolescents in two high schools.MethodsData collected from a cross-sectional survey addressing questions on bullying behaviors and sleep quality was analyzed using SPSS 22.0. A two-tailed p-value of less than 0.05 was considered significant for all tests.ResultsWe have included 171 adolescents, mean age of 14.39 ± 1.149 years, 59.6% were boys; prevalence of bullying behaviors was 28.1%. Among the students 15.2% were identified as “pure victims”, 8.8% as “pure bullies”, 4.1% as “bully-victims” and 71.9% as “neutrals”. “Pure bullies” and “bully-victims” present higher Athens Insomina Scale (AIS) scores (p = 0.004) and higher prevalence of insomnia (p = 0.004). The prevalence of insomnia was significantly higher in the group involved in bullying behaviors comparing with the neutrals (58.3% vs 30%, p = 0.001). We verified that 65.4% of the reported bullying situations took place inside the school and 8.8% of those teachers did nothing to help the victim and in 17.5% school staff took the same attitude.ConclusionsWe found a prevalence of bullying behaviors higher than the one reported in previous studies and a prevalence of insomnia of 38.0%, proving that bullying and sleep disturbances are two major problems in adolescence which may increase future risk for psychiatric symptoms, involvement in criminal activities, hyperactive, and inattentive behaviors. We verified a strong relation between insomnia and involvement in bullying situations with those who are involved reporting difficulties in sleep induction. The group of “bully-victims” was identified as potentially being the one with the most troubled adolescents since they combine characteristics of both bullies and victims. The authors conclude that there should be an investment in school-based interventions that help recognize and reduce school bullying and change lifestyle behaviors that may negatively influence adolescents' development.

UNA-SUS System was established to enforce the National Policy of Continuing Education in Health, and it is composed of a Network of 34 public institutions (mostly Universities), responsible for online educational offerings, in response to the demands generated by the Ministry of Health. The system produces courses that are committed to the 2030 Agenda for Sustainable Development (specially Goals 3, 4, 5, 10, and 16). Objectives to verify the profile of users and the penetrance of UNA-SUS online courses and their contribution to the democratization of Continuing Education of health workers. Methods Data were collected from Arouca Platform and statistical analysis was performed by the Open Free Software R 3.6. Results There were more than 2.8 million enrollments, counting more than 1 million students, from every SUS health regions, Brazilian municipalities and states. Courses with the greatest demands were related to important clinical situations faced by the Primary Care professionals in Brazil. There was a predominance of women (80%), whites (36%), followed by browns (33%), singles (57%) and in the age group of 21 to 40 years (70%). Nurses, doctors and dentists were the professionals who most sought courses at UNA-SUS. No relationship was found between enrollment in population-weighted self-instructional courses and the Brazilian State HDI, but a negative relationship was established between the Gini coefficient and enrollment in courses, showing that the more unequal the region, the fewer enrolled students it had. Conclusions The UNA-SUS is effective in providing continuing education through free, online course offerings, reaching users from different Brazilian geographic regions, including those leaving in areas with few presential or free educational opportunities, contributing to improve the service offered by the Brazilian Public Health System. Key messages Continuing education for Health Professionals in Brazil using online education courses is democratic. UNA-SUS is an effective system to consolidate the National Policy of Continuing Education.

AAT deficiency (AATD) is an autosomal recessive disorder characterized by decreased or dysfunctional AAT production

Obstructive shock is the least common type of pediatric shock. It results from obstruction of cardiac output, with intra-abdominal masses being a rare cause

No abstract