Time until tuberculosis recurrence and associated factors in Brazil: a population-based retrospective cohort study using a linked database / Tempo até a recorrência da tuberculose e fatores associados no Brasil: um estudo de coorte retrospectiva de base populacional usando dados de linkage

ABSTRACT Objective: To calculate the rate of tuberculosis recurrence, estimate its average time until recurrence, and identify factors associated with recurrence in Brazil. Methods: Retrospective cohort study with a linked database from the Notifiable Diseases Information System. The study included individuals diagnosed with tuberculosis in 2015, focusing on those who experienced their first recurrence within 6.5 years. We estimated the relative risk (RR) and its 95% confidence interval (95%CI), as well as the population attributable fraction (PAF) or the population preventable fraction (PPF) of associated factors. Results: Within a 6.5-year period, 3,253 individuals (6.5%) experienced tuberculosis recurrence, with a median time of 2.2 years. Positively associated factors included: male sex (RR: 1.4; 95%CI 1.3-1.5; PAF: 22.9%), age 30 to 59 years (RR: 3.0; 95%CI 1.6-5.7; PAF: 36.0%), black race (RR: 1.3; 95%CI 1.2-1.5; PAF: 3.5%), mixed race (RR: 1.3; 95%CI 1.2-1.4; PAF: 10.6%), deprivation of liberty (RR: 1.9; 95%CI 1.7-2.1; PAF: 9.1%), pulmonary/mixed clinical form (RR: 1.7; 95%CI 1.4-1.9; PAF: 37.1%), acquired immunodeficiency syndrome diagnosis (RR: 1.8; 95%CI 1.5-1.9; PAF: 4.3%), and alcohol use (RR: 1.2; 95%CI 1.1-1.3; PAF: 2.9%). Negatively associated factors were: 12 or more years of schooling (RR: 0.5; 95%CI 0.4-0.6; PPF: 3.3%) and supervised treatment (RR: 0.9; 95%CI 0.8-0.9; PPF: 4.4%). Conclusion: This study revealed high tuberculosis recurrence rates in Brazil, influenced by sociodemographic, compartmental, and social factors, both positively and negatively impacting disease recurrence.

RESUMO Objetivo: Calcular a taxa de recorrência de tuberculose, estimar seu tempo médio e identificar seus fatores associados no Brasil. Métodos: Estudo de coorte retrospectiva com dados de linkage do Sistema de Informação de Agravos de Notificação. Incluímos pessoas diagnosticadas com tuberculose em 2015, com foco naquelas que tiveram sua primeira recorrência em 6,5 anos. Estimamos o risco relativo (RR) e seus intervalos de confiança de 95% (IC95%), assim como a fração atribuível populacional (FAP) ou a fração prevenível populacional (FPP) dos fatores associados. Resultados: No período de 6,5 anos, 3.253 indivíduos (6,5%) tiveram recorrência de tuberculose, com tempo médio de 2,2 anos. Fatores positivamente associados incluíram: sexo masculino (RR: 1,4; IC95% 1,3-1,5; FAP: 22,9%), idade de 30 a 59 anos (RR: 3,0; IC95% 1,6-5,7; FAP: 36,0%), raça/cor preta (RR: 1,3; IC95% 1,2-1,5; FAP: 3,5%) ou raça/cor parda (RR: 1,3; IC95% 1,2-1,4; FAP: 10,6%), privação de liberdade (RR: 1,9; IC95% 1,7-2,1; FAP: 9,1%), forma clínica pulmonar/mista (RR: 1,7; IC95% 1,4-1,9; FAP: 37,1%), diagnóstico de síndrome da imunodeficiência adquirida (RR: 1,8; IC95% 1,5-1,9; FAP: 4,3%) e uso de álcool (RR: 1,2; IC95% 1,1-1,3; FAP: 2,9%). Fatores negativamente associados foram: 12 ou mais anos de estudo (RR: 0,5; IC95% 0,4-0,6; FPP: 3,3%) e tratamento supervisionado (RR: 0,9; IC95% 0,8-0,9; FPP: 4,4%). Conclusão: Revelamos taxas elevadas de recorrência de tuberculose no Brasil, com fatores sociodemográficos, comportamentais e sociais influenciando na recorrência da doença.

Mental health of Brazilian students during the COVID-19 pandemic: the role of gratitude, optimism, and hope in reducing anxiety

Abstract Objective To investigate the role of optimism, hope, and gratitude as psychosocial factors for healthy development, especially with regard to anxiety in college students in the context of coronavirus disease 2019 (COVID-19). Methods This is a quantitative, descriptive cross-sectional study. A sociodemographic questionnaire, the Brazilian Gratitude Scale (Escala Brasileira de Gratidão [B-GRAT]), and the Brazilian versions of an anxiety subscale, the Revised Life Orientation Test (LOT-R), Hope Index Scale, and BIG-FIVE were administered. Data were analyzed using the Mann-Whitney U test, the Kruskal-Wallis test, Spearman correlations, and hierarchical linear regression. Results A total of 297 students were assessed. The relationship between gratitude and anxiety became positive in the hierarchical linear analysis, contradicting the initial negative association between these variables according to the Spearman coefficients. This contradiction may be a result of the suppression effect. When gratitude was added to the model, these three variables together accounted for 38% of the variance in anxiety. This indicates that optimism, hope, and gratitude together are significant predictors, although optimism alone accounts for the greater part of the variance in decreased anxiety. Conclusion The data confirm that family and religiosity are protective factors against mental illness, specifically non-adaptive anxiety. Furthermore, developing optimism as a protective factor makes it possible to experience less anxiety while hope has the potential to provide the individual with multiple pathways to healthy development. This study highlights that gratitude plays a dual role in these relationships as it has the potential to be associated with anxious feelings with likely negative outcomes while at the same time it can drive positive psychosocial factors of optimism and hope, decreasing anxiety.

Prevalência e fatores pessoais associados à violência autoprovocada em adolescentes / Prevalence and personal factors associated with self-harm in adolescents / Prevalencia y factores personales asociados a la violencia autoinflingida en adolescentes

RESUMO Objetivo: identificar a prevalência e os fatores pessoais associados à violência autoprovocada em adolescentes. Método: estudo observacional analítico, do tipo transversal. A população foi composta pelas notificações de violência interpessoal ou autoprovocada em adolescentes no Brasil, oriundas do Sistema de Informação de Agravos de Notificação. Foram incluídas as notificações ocorridas entre 2009 e 2021 no Brasil, em adolescentes de 10 a 19 anos. Os dados foram analisados com estatística descritiva e inferencial. Resultados: a prevalência de violência autoprovocada foi de 27,39% no Brasil. Adolescentes pretos aumentam a prevalência de violência autoprovocada em 3%, e os pardos e indígenas em 2%; mais de 8 anos de escolaridade constitui fator de proteção em relação à violência autoprovocada, reduzindo em 12% a prevalência de violência autoinfligida. Conclusão: os resultados indicam a necessidade de que sejam traçadas políticas e estratégias eficazes que auxiliem no cuidado a esse público.

ABSTRACT Objective: To identify the prevalence and personal factors associated with self-harm in adolescents. Method: A cross-sectional analytical observational study. The population consisted of notifications of interpersonal or self-harm violence in adolescents in Brazil from the Notifiable Diseases Information System. Notifications between 2009 and 2021 in Brazil were included in adolescents aged 10 to 19. The data was analyzed using descriptive and inferential statistics. Results: The prevalence of self-harm was 27.39% in Brazil. Black adolescents increase the prevalence of self-harm violence by 3% and brown and indigenous adolescents by 2%; more than eight years of schooling is a protective factor in relation to self-harm violence, reducing the prevalence of self-inflicted violence by 12%. Conclusion: The results indicate the need for effective policies and strategies to help care for this public.

RESUMEN Objetivo: identificar la prevalencia y los factores personales asociados a la violencia autoinfligida en adolescentes. Método: estudio observacional, analítico, transversal. La población estuvo constituida por notificaciones de violencia interpersonal o autoinfligida entre adolescentes de Brasil, provenientes del Sistema de Información de Enfermedades De Declaración Obligatoria. Se incluyeron las notificaciones ocurridas entre 2009 y 2021 en Brasil, en adolescentes de 10 a 19 años. Los datos fueron analizados con estadística descriptiva e inferencial. Resultados: la prevalencia de violencia autoinfligida fue del 27,39% en Brasil. Los adolescentes negros aumentan la prevalencia de la violencia autoinfligida en un 3%, y los pardos e indígenas en un 2%; más de 8 años de escolaridad constituye un factor protector en relación a la violencia autoinfligida, reduciendo en un 12% la prevalencia de la violencia autoinfligida. Conclusión: los resultados indican la necesidad de diseñar políticas y estrategias efectivas para ayudar a la atención de esta población.

Evolución del riesgo y protección en la infancia y la adolescencia / Evolution of risk and vulnerability in childhood and adolescence

(analítico) Los factores de riesgo y protección pueden ser utilizados para evaluar, prevenir e intervenir en el maltrato infantil. El objetivo de este estudio es analizar longitudinalmente el riesgo en la infancia y la adolescencia, para determinar qué factores pueden ser empleados como indicadores de evolución. Se empleó una muestra de 102 niños, niñas y adolescentes que participaban en el sistema de bienestar infantil español, en tres momentos temporales. Los resultados indicaron que existe una evolución del riesgo, con una tendencia general de disminución de riesgos e incremento de elementos protectores. Nuestros hallazgos identificaron la existencia de factores dinámicos y estáticos. Este estudio pone de manifiesto la relevancia de la atención e intervención continuada y a largo plazo para fortalecer los factores de protección y disminuir los de riesgo en niños, niñas y adolescentes.

(analytical) Risk and protective factors can be used for risk and needs assessments, prevention, and intervention in cases involving mistreatment of children. The aim of this study is to provide a longitudinal analysis of risks and vulnerabilities in childhood and adolescence, with the goal of determining which factors can be used as indicators for progress with cases. A sample of 102 children and adolescents supported by the child welfare system in Spain was used along with measurements based on three different points in time. The study's results indicated that there is a change in risk levels, with a general trend of decreasing risk and increasing protective elements. The study's findings identified the existence of a group of dynamic factors and another group of static factors. This study highlighted the relevance of continuous and long-term care and intervention in order to strengthen protection and decrease risks for children.

(analítico) Os factores de risco e protecção podem ser utilizados para avaliar, prevenir e intervir em casos de maustratos a crianças. O objectivo deste estudo é analisar o risco na infância e adolescência longitudinalmente, a fim de determinar que factores podem ser utilizados como indicadores de evolução. Uma amostra de 102 crianças e adolescentes participantes no sistema espanhol de bem-estar infantil foi utilizada em três pontos no tempo. Os resultados indicaram que existe uma evolução do risco, com uma tendência geral de diminuição do risco e aumento dos elementos protectores. Os nossos resultados identificaram a existência de factores dinâmicos e estáticos. Este estudo destaca a relevância dos cuidados e intervenções contínuos e a longo prazo para reforçar os factores de protecção e diminuir os factores de risco nas crianças.

Intervenção viabilizada por WhatsApp® para promoção da adesão às medidas preventivas na pandemia da COVID-19: um estudo piloto / Intervention made possible by WhatsApp® to promote adherence to preventive measures in the COVID-19 pandemic: a pilot study

Analisar o potencial de eficácia do envio de mensagens validadas (texto e imagens), via WhatsApp®, na promoção da adesão ao uso de máscaras, distanciamento social e associar às variáveis sociodemográficas. Trata-se de um estudo com desenho quase-experimental, do tipo pré e pós-teste com 132 participantes, acompanhados por 60 dias. As mensagens foram enviadas semanalmente junto com os formulários de adesão. Ao final da intervenção os participantes responderam ao questionário de satisfação da pesquisa. Foram realizados testes de comparação e análises descritivas. Os achados deste estudo demonstraram impacto positivo da intervenção no envio de mensagens validadas, via WhatsApp®, na adesão ao uso de máscaras e distanciamento social durante a pandemia da COVID-19. A intervenção proposta neste estudo apresenta potencial de eficácia para adesão às medidas preventivas contra o vírus do SARS-CoV-2 e constitui uma ferramenta valiosa para profissionais de saúde atuarem no combate à pandemia.

To analyze the potential efficacy of sending validated messages (text and images) via WhatsApp® in promoting adherence to the use of masks and social distancing and to evaluate its association with the sociodemographic variables. This is a study with a quasi-experimental design, of the pre and post test type. 132 participants were enrolled and followed up for 60 days. Validated messages were sent weekly along with the forms referring to adherence. At the end of the intervention, they answered the survey satisfaction questionnaire. Descriptive analyzes and tests were carried out to compare measures of adherence to mask use and social distancing. The findings of this study demonstrated the positive impact of the intervention in sending validated messages via WhatsApp® on adherence to the use of masks and social distancing during the COVID-19 pandemic. The intervention proposed in this study has potential efficacy for adherence to preventive measures against the SARS-CoV-2 virus and constitutes a valuable tool for health professionals to act in the fight against the COVID-19 pandemic.

De la bioética de protección a la medicina basada en la evidencia desde una perspectiva transdisciplinar

En el contexto de la bioética se debate con frecuencia el hecho de que, con el desarrollo de la ciencia y la técnica, de las tecnologías de la información y las comunicaciones, y los cambios relacionados con el ecosistema, se hace necesario garantizar el respeto de la vulnerabilidad humana y la integridad personal al aplicar y fomentar el conocimiento científico, la práctica médica y las tecnologías vinculadas (artículo 8 de la Declaración Universal sobre Bioética y Derechos Humanos). Esta vulnerabilidad se protege a través del respeto con equidad y justicia, de los derechos básicos de cada ser humano y al garantizar la integridad personal; esta es la esencia de la bioética de protección y constituye, también, la base principal de la medicina basada en la evidencia, caracterizada por el uso consciente, explícito y juicioso de la evidencia clínica en la práctica diaria para el cuidado del paciente, en aras de ofrecer la mejor atención. Existe una necesidad inmediata de proporcionar beneficios sostenibles a las personas vulnerables en situaciones de enfermedad, por ello es vital mantener un enfoque en la salud pública cubana desde la perspectiva de la bioética de protección y la transdisciplinariedad, sustentada en una medicina basada en la evidencia, en las 3 esferas, en el proceso asistencial, en el proceso pedagógico y en el investigativo; como máximo exponente de la salud global, que tiene como esencia una visión transdisciplinaria, ya que aborda la salud desde la perspectiva del derecho universal a esta y al bienestar social.

In the context of bioethics, the fact that with the development of science and technology, of information and communication technologies, and the changes related to the ecosystem, it is necessary to guarantee respect for vulnerability and personal integrity when applying and promoting scientific knowledge, medical practice and related technologies (article 8 of the Universal Declaration on Bioethics and Human Rights). This vulnerability is protected through respect, with equity and justice, for the basic rights of every human being and by guaranteeing personal integrity; this is the essence of protection bioethics and also constitutes the main basis of evidence-based medicine, characterized by the conscious, explicit and judicious use of clinical evidence in daily practice for patient care, for the sake of to offer the best care. There is an immediate need to provide sustainable benefits to vulnerable people in disease situations, for this reason it is vital to maintain a focus on Cuban public health from the perspective of protective bioethics and transdisciplinarity, supported by evident-based medicine, in the 3 spheres, in the care process, in the pedagogical process and in the investigative process; as the greatest exponent of Global Health, whose essence is a transdisciplinary vision, since it addresses health from the perspective of the universal right to it and to social well-being.

Factores de Protección en el Trastorno Afectivo Bipolar: Una Revisión Narrativa de la Literatura

El Trastorno Afectivo Bipolar es una patología mental grave, de curso cíclico, caracterizada por episodios anímicos recurrentes que habitualmente transcurren entre dos polos opuestos: la manía o hipomanía y la depresión. Cuenta con una elevada morbimortalidad (enfermedad cardiovascular, deterioro cognitivo, alteración de la funcionalidad y ausentismo laboral) y costo socioeconómico asociado, siendo su desenlace más dramático la muerte por suicidio (el cual sucede en 5% a 15% de los pacientes). La detección precoz juega un rol importante en modificar el curso natural de la enfermedad; un elemento fundamental, junto con determinar los factores de riesgo para TAB, consiste en la identificación de factores protectores específicos, de modo que la enfermedad no se presente, y de serlo así, sea más tarde y con menor deterioro. Características tales como el perfil genético, la reserva cognitiva (explicada en parte por el nivel educacional y la inteligencia premórbida), el cronotipo (en particular el cronotipo matutino), aspectos de personalidad (que incluyen la resiliencia y el temperamento hipertímico), la ausencia de consumo de sustancias y maltrato infantil, además de una adecuada red de apoyo, se han asociado con un menor impacto en relación al inicio y curso de la enfermedad. Una vez presente, intervenciones tanto en la etapa temprana como tardía (farmacoterapia y psicoterapias específicas, factores dietéticos, actividad física y uso juicioso de antipsicóticos), pueden jugar un rol protector en relación a la aparición y/o gravedad de los episodios anímicos.

Bipolar Affective Disorder (BD) is a severe mental pathology characterized by recurrent mood episodes that usually cycle between two opposite poles: mania or hypomania and depression. It has a high level of morbidity/mortality (i.e., cardiovascular disease, cognitive impairment, altered functionality, and absenteeism from work) and associated substantial socioeconomic costs. The most dramatic outcome is death by suicide, which occurs in 5% to 15% of patients. Early detection plays a vital role in modifying the natural course of the disease. It is essential to determine the disease's risk and specific protective factors to prevent its occurrence, delay its appearance, and reduce its deterioration effects. Characteristics such as genetic profile, cognitive reserve (partially explained by educational level and premorbid intelligence), chronotype (particularly morning chronotype), personality aspects (including resilience and hyperthymic temperament), the absence of substance use and childhood maltreatment, in addition to an adequate support network, have been associated with a lower impact in the onset and course of the disease. Once present, interventions -both in the early and late stages (i.e., specific pharmacotherapy and psychotherapy, dietary factors, physical activity, and judicious use of antipsychotics)-can play a protective role against the appearance of the disease and the severity of its mood episodes.

Cirugía bariátrica y evolución de COVID-19 / Bariatric surgery and evolution of COVID-19

INTRODUCTION. Obesity is recognized as a risk factor for developing severe new coronavirus disease. Bariatric surgery prior to infection could behave as a protective factor against serious infections and death. OBJECTIVE. To describe the impact of bariatric surgery on the severity and mortality of patients with obesity and new coronavirus disease; through a systematic review and meta-analysis of the specialized literature from 2020-2022. METHODOLOGY. Publications indexed in databases such as Pubmed, Tripdatabase, and Google scholar, on the impact of previous bariatric surgery on the evolution and prognosis of patients with new coronavirus disease were taken. The Newcastle-Ottawa scale was used to assess quality and risk of bias. RevMan 5.0 software was used for statistical analysis. RESULTS. Eight cohort studies were included, with a population of 137 620 adult subjects with obesity and new coronavirus disease; of these, 5638 (4.09%) had a history of bariatric surgery. In the meta-analysis, it was determined that, in subjects with obesity and new coronavirus disease, the history of bariatric surgery had a protective effect against the use of mechanical ventilation [OR: 0.68; 95% CI: 0.62-0.75] (p<0.001) and mortality [OR: 0.57; 95% CI: 0.50-0.65] (p<0.01). CONCLUSIONS. The history of bariatric surgery in subjects with obesity seems to have a protective effect against the severity defined by the use of mechanical ventilation in patients with obesity and mortality due to the new coronvirus disease; therefore, the resumption of bariatric surgical activity, at pre-pandemic levels, could represent an additional benefit for candidate subjects.

INTRODUCTION. Obesity is recognized as a risk factor for developing severe new coronavirus disease. Bariatric surgery prior to infection could behave as a protective factor against serious infections and death. OBJECTIVE. To describe the impact of bariatric surgery on the severity and mortality of patients with obesity and new coronavirus disease; through a systematic review and meta-analysis of the specialized literature from 2020-2022. METHODOLOGY. Publications indexed in databases such as Pubmed, Tripdatabase, and Google scholar, on the impact of previous bariatric surgery on the evolution and prognosis of patients with new coronavirus disease were taken. The Newcastle-Ottawa scale was used to assess quality and risk of bias. RevMan 5.0 software was used for statistical analysis. RESULTS. Eight cohort studies were included, with a population of 137 620 adult subjects with obesity and new coronavirus disease; of these, 5638 (4.09%) had a history of bariatric surgery. In the meta-analysis, it was determined that, in subjects with obesity and new coronavirus disease, the history of bariatric surgery had a protective effect against the use of mechanical ventilation [OR: 0.68; 95% CI: 0.62-0.75] (p<0.001) and mortality [OR: 0.57; 95% CI: 0.50-0.65] (p<0.01). CONCLUSIONS. The history of bariatric surgery in subjects with obesity seems to have a protective effect against the severity defined by the use of mechanical ventilation in patients with obesity and mortality due to the new coronvirus disease; therefore, the resumption of bariatric surgical activity, at pre-pandemic levels, could represent an additional benefit for candidate subjects.

Criminal recidivism in Colombian juvenile offenders: Related risk and protective factors / Reincidencia delictiva en adolescentes colombianos: factores de riesgo y protectores relacionados

Abstract Research with adolescent offenders is concerned with identifying risk and protective factors that influence recidivism and desistance from crime. A quantitative and cross-sectional investigation designed to examine the influence of risk and protective factors on recidivism in Colombian adolescents is presented. In seven regions of Colombia, a convenience sample was obtained, and 646 adolescents aged 14 to 19 years (M = 17.08; SD: 1.23; 15 % girls) belonging to the Sistema de Responsabilidad Penal para Adolescentes (SRPA) participated. The Communities That Care Youth Survey (CTC-YS) was used for the evaluation. It evaluated a broad set of risk and protective factors identified through the community, school, family, peer group, individual conditions, and behavioral outcomes, including drug use, antisocial behavior, and delinquency. Descriptive analyses were conducted, and all CTC-YS factors were correlated with antisocial behavior. The results show varying degrees of relationship between the factors assessed and antisocial behavior. Binary logistic regression was used to determine which risk and protective factors influence recidivism. It was noted that favorable parental attitudes towards drug use and antisocial behavior, early onset of drug use, low school engagement, and interaction with antisocial peers increases the probability of recidivism. Recidivism was identified as being affected by, among other factors, favorable parental attitudes toward drug use and antisocial behavior, early onset of drug use, and low school engagement. It was also observed that beliefs in a moral order, opportunities for prosocial school participation and lower drug use frequency reduce the probability of recidivism. According to the results, the factors that influence criminal recidivism are multiple, and social, family, school, and individual factors need to be addressed. The need to intervene in attitudes favorable to antisocial behavior on the part of parents, strengthen school services, and carry out treatment for drug use to favor the reduction of recidivism in Colombian adolescents is discussed.

Resumen La investigación con adolescentes ofensores busca identificar los factores de riesgo y de protección que afectan a la reincidencia y al desistimiento. Esta información es útil para desarrollar programas de prevención de la conducta antisocial y facilita los procesos de intervención que favorecen la reinserción social. Desde el punto de vista legal, la reincidencia es la participación de un individuo en nuevos actos delictivos, que conduce a una nueva condena, después de haber sido judicializado por un delito anterior. El desistimiento, en cambio, es la interrupción de la conducta antisocial y se caracteriza por la reinserción social exitosa y el ajuste a las normas de la comunidad. Se han identificado factores sociales, familiares, escolares, relacionales e individuales que afectan a la reincidencia y al desistimiento. Se presenta una investigación cuantitativa que utilizó una medición de corte transversal, diseñada para examinar la influencia de los factores de riesgo y protección en la reincidencia de los adolescentes colombianos. Se realizó un muestreo por disponibilidad y conveniencia en instituciones de siete departamentos o regiones geográficas de Colombia. Los participantes fueron 646 adolescentes de entre 14 y 19 años (M = 17.08; DT: 1.23; 15 % chicas). Todos ellos estaban judicializados y cumpliendo sus sanciones legales en el Sistema de Responsabilidad Penal para Adolescentes (SRPA). Para la evaluación se utilizó la encuesta Communities That Care Youth Survey (CTC-YS). Se trata de un instrumento de 135 ítems diseñado para medir un amplio conjunto de factores de riesgo y de protección identificados a través de las condiciones de la comunidad, la escuela, la familia, el grupo de pares y el individuo, así como los resultados conductuales, que incluyen el uso de drogas, la violencia, el comportamiento antisocial y la delincuencia. El instrumento mostró buena fiabilidad en este estudio. La reincidencia se evaluó con criterios legales, es decir, se tuvieron en cuenta el número de condenas oficiales. Para ello se revisaron los expedientes de los participantes y se los cruzó con la información reportada por los profesionales que atendían los centros y el autoinforme de los participantes. Se obtuvo la aprobación del comité de ética y permiso del gobierno a través del Instituto Colombiano de Bienestar Familiar -ICBF- (Autorización E-2016-660327-0111). Los consentimientos informados fueron firmados por los defensores, los directores de los centros de atención, los padres de los adolescentes y por cada uno de los participantes. Una vez finalizada la investigación, se socializaron los resultados a través de grupos focales con los interesados, incluidos los adolescentes. Se realizaron análisis descriptivos con los datos y se correlacionaron todos los factores del CTC-YS con la variable conducta antisocial y delictiva provista por el mismo instrumento. Luego se realizó una regresión logística binaria para determinar qué factores de riesgo y protección influyen en la reincidencia. Se observaron diferentes grados de relación entre los factores evaluados y la conducta antisocial-delictiva. Los resultados indican que la reincidencia se ve afectada, entre otros factores, por las actitudes favorables de los padres hacia el uso de drogas y la conducta antisocial, el inicio temprano del consumo de drogas y el bajo compromiso escolar. Las creencias en un orden moral y las oportunidades por la participación escolar prosocial y la menor frecuencia de uso de drogas muestran disminución en la probabilidad de reincidencia. Según los resultados, los factores que influyen en la reincidencia delictiva son múltiples y requieren la intervención de las condiciones sociales, familiares, escolares e individuales. Se discute la necesidad de intervenir en las actitudes favorables a la conducta delictiva por parte de los padres, fortalecer los servicios escolares, realizar tratamiento para abandonar el uso de drogas y desarrollar modelos de intervención que cuenten con evidencias de eficacia para ayudar a reducir la reincidencia en los adolescentes colombianos.

Assessment of Suicide Risk and Potential Protective Factors among Patients Admitted at a Tertiary Mental Health Care Institute in Assam

Suicide is a major public health concern having a number of risk factors. Psychopathology is found to be one of the many protective factors of suicide. The current study intended to appraise the risks of attempting suicide and the presence of preventive factors among the patients admitted to tertiary mental health care setting. A total of 53 patients with mental illness care hospital in- cluded in the study. The risk of suicide was assessed with modified SAD PERSONS and Nurses'#39; Global Assessment of Suicide Risk tools and protective factors were assessed with the Reasons for Living inventory. The result showed that 13.3 percent of the admitted patients with mental illness had high risk of suicide and 3.8 percent very high risk of suicide requiring hospitalisation for the same. The participants had scored considerably higher in protective factors as described by the reasons for living inventory.

Estudio de sobrevida a largo plazo en pacientes adultos con enfermedades respiratorias crónicas atendidos por infección respiratoria aguda por coronavirus SARS-CoV-2 / Study of long-term survival in adult patients with chronic respiratory diseases treated for acute respiratory infection by coronavirus SARS-CoV-2

La enfermedad respiratoria aguda por coronavirus SARS-CoV-2 (COVID-19) se ha convertido en un grave problema de salud pública a nivel mundial. Objetivos: Examinar el uso de recursos sanitarios, riesgo de complicaciones y muerte en pacientes adultos con enfermedades respiratorias crónicas atendidos por COVID-19. Métodos: Estudio clínico descriptivo prospectivo realizado en pacientes adultos atendidos por COVID-19 en la Red de Salud UC Christus entre el 1 de abril y 31 de diciembre de 2020. Resultados: Se evaluaron 2.160 pacientes adultos, edad: 47 ± 17 años (rango: 18-100), 51,3% sexo masculino, 43,8% tenía comorbilidades, especialmente hipertensión (23,2%), diabetes (11,7%) y enfermedades respiratorias crónicas: asma (5%), EPOC (1,4%) y enfermedad pulmonar difusa (EPD: 0,8%). Los pacientes adultos con enfermedades respiratorias crónicas tuvieron mayor riesgo de hospitalización y uso de oxígeno suplementario; sin embargo, la evolución de los pacientes asmáticos y la sobrevida a los doce meses fue similar a los pacientes sin comorbilidades atendidos por COVID-19, mientras que en los pacientes con EPOC y EPD la admisión a la unidad de paciente crítico y riesgo de muerte fueron más elevados. En el análisis multivariado, los principales predictores clínicos asociados al riesgo de muerte en el seguimiento a doce meses en pacientes adultos con COVID-19 fueron la edad y admisión al hospital, mientras que el asma fue un factor protector. Conclusión: Los pacientes asmáticos tuvieron bajo riesgo de complicaciones y muerte asociados a COVID-19; mientras que los pacientes con EPOC y EPD tuvieron mayor riesgo de complicaciones y muerte en el seguimiento a largo plazo.

The acute respiratory disease associated to coronavirus SARS-CoV-2 (COVID-19) has become a serious public health problem worldwide. Objectives: To examine the use of healthcare resources, risk of complications and death in adult patients with chronic respiratory diseases treated for COVID-19. Methods: Prospective descriptive clinical study conducted in adult patients treated for COVID-19 in the UC Christus Healthcare Network between April 1 and December 31, 2020. Results: 2,160 adult patients were evaluated, age: 47 ± 17 years-old (range: 18-100), 51.3% male, 43.8% had comorbidities, especially hypertension (23.2%), diabetes (11.7%), and chronic respiratory diseases: asthma (5%), COPD (1,4%) and interstitial lung disease (ILD: 0.8%). Adult patients with chronic respiratory diseases were at higher risk for hospitalization and use of supplemental oxygen; however, the evolution of asthmatic patients and survival at twelve months was similar to that of adult patients without comorbidities treated for COVID-19, while in patients with COPD and ILD admission to the critical care unit and risk of death were higher. In the multivariate analysis, the main clinical predictors associated to 12-month mortality risk in adult patients with COVID-19 were age and hospital admission, while asthma was a protective factor. Conclusion: Asthmatic patients had minor risk of complications and mortality associated with COVID-19; while patients with COPD and ILD had a significant higher risk of complications and 12-month mortality.

Risk and protective factors for suicide: a populational case-control study, Brazil, 2019

ABSTRACT OBJETIVE To estimate risk and protection factors associated with suicide in Campinas, Brazil, in 2019. METHODS This is a populational case-control study analyzing 83 cases of suicide that occurred in 2019 in Campinas, a Brazilian city with about 1.2 million inhabitants. Controls were composed of 716 inhabitants. An adjusted multiple logistic regression was used. Cases and controls were the dichotomous response variables. Sociodemographic and behavioral variables were the predictor variables. RESULTS The categories which presented higher risk of suicide were: males [OR = 5.26 (p < 0.001)]; people aged 10-29 years [OR = 5.88 (p = 0.002)]; individuals without paid work [OR = 3.06 (p = 0.013)]; individuals presenting problematic use of alcohol [OR = 33.12 (p < 0.001)] and cocaine [14.59 (p < 0.007)]; and people with disabilities [OR = 3.72 (p < 0.001)]. Moreover, the perception of fear was associated with reduced suicide risk [OR = 0.19 (p = 0.015)]. Higher district HDI levels also showed a 4% decrease in risk for each 0.01 increase in district HDI levels [OR = 0.02 (p = 0.008)]. CONCLUSIONS This study evidenced the association between sociodemographic and behavioral variables and suicide. It also emphasized the complexity in the dynamics between personal, social, and economic factors to this external cause of death.

Programa educativo para modificar la percepción de riesgo del VIH/sida en estudiantes de Medicina / Educational program to modify the risk perception of HIV/AIDS in medical students

Fundamento: actualmente son elevadas las cifras de jóvenes con virus de inmunodeficiencia humana y síndrome de inmunodeficiencia adquirida, lo cual impone la necesidad de disponer de amplia información, percibir la vulnerabilidad propia y la gravedad del riesgo de infección. Objetivo: diseñar una propuesta de programa educativo con orientación popular para la modificación de percepción de riesgo del VIH/sida en estudiantes becarios de primer año de Medicina, 2021-2022. Métodos: se realizó una investigación de desarrollo, entre enero-diciembre de 2021. Se aplicaron métodos teóricos, empíricos y matemáticos. Se utilizó la variable percepción de riesgo, referida a la valoración del VIH/sida como amenaza para la salud de los seres humanos. Como instrumentos se manejó un cuestionario previamente validado. Resultados: el diagnóstico realizado teniendo en cuenta el nivel de información sobre el VIH/sida, vulnerabilidad y severidad percibidas, demostró insuficiencias en ambos sexos, con mayor frecuencia en el femenino; por lo que se diseñó un programa educativo basado en educación popular, estructurado en: título, introducción, justificación, objetivo general, metodología, evaluación y orientaciones de actividades, con el fin de modificar la percepción de riesgo del VIH/sida en la muestra. Conclusiones: fue valorado por un grupo de especialistas, quienes ofrecieron sugerencias para su optimización, aplicadas en su conformación definitiva, lo cual resultó de suma utilidad para el resultado de la investigación y su aplicación en contextos similares.

Background: currently there are high numbers of young people with human immunodeficiency virus and acquired immunodeficiency syndrome, which imposes the need to have extensive information, perceive one's own vulnerability and the severity of the risk for infection. Objective: to design a proposal for an educational program with popular orientation to modify the risk perception of HIV/AIDS in first-year medical scholarship students, 2021-2022. Methods: a development investigation was carried out from January to December 2021. Theoretical, empirical and mathematical methods were applied. The risk perception variable was used, referring to the assessment of HIV/AIDS as a threat to the health of human beings. A previously validated questionnaire was used as instruments. Results: the diagnosis carried out taking into account the level of information about HIV/AIDS, perceived vulnerability and severity, demonstrated insufficiencies in both sexes, more frequently in the female; Therefore, an educational program was designed based on popular education, structured in: title, introduction, justification, general objective, methodology, evaluation and guidelines for activities, in order to modify the perception of risk for HIV/AIDS in the sample. Conclusions: it was evaluated by a group of specialists, who offered suggestions for its optimization, applied in its final conformation, which was extremely useful for the results of the research and its application in similar contexts.

Risk and protective factors for the development of stress in the Federal Highway Police / Fatores de risco e proteção para o desenvolvimento do estresse na Polícia Rodoviária Federal

Objective The present study aimed to identify the risk and protective factors for the development of stress in a random and stratified sample of Brazilian federal highway police officers in the state of São Paulo (N = 202). Method The instruments used were a General Questionnaire (sociodemographic and occupational variables) and Lipp's Stress Symptom Inventory for Adults. The prevalence ratio was used as a measure of association and the independent variables were organized into 8 models and inserted into a logistic regression model. Results A stress prevalence of 43.1% (95% CI = 36.2-50.0) was found, with most of the sample in the resistance phase (82.7%). The factors related to stress were leisure, educational level, degree of job satisfaction, low remuneration, suicidal ideations, insomnia, lack of training, and work-family conflict. Conclusion The results can influence actions aimed at controlling stress.

Objetivo: O presente estudo objetivou identificar os fatores de risco e proteção para o desenvolvimento de estresse numa amostra aleatória e estratificada de policiais rodoviários federais do estado de São Paulo (N = 202). Método: Utilizou-se os seguintes instrumentos: Questionário Geral (variáveis sociodemográficas e ocupacionais) e Inventário de Sintomas de Estresse para Adultos de Lipp (ISSL). A razão de prevalência foi utilizada como medida de associação, e as variáveis independentes foram organizadas em 8 modelos e inseridas em um modelo de regressão logística. Resultados: Foi encontrada a prevalência de estresse de 43,1% (95% IC = 36,2-50,0), com a maioria da amostra na fase de resistência (82,7%). Os fatores relacionados ao estresse foram lazer, formação acadêmica, grau de satisfação com o trabalho, remuneração incompatível, ideação suicida, insônia, falta de treinamento e conflito trabalho-família. Conclusão: Conclui-se que os resultados podem influenciar em ações que visem controlar o estresse.

Percepciones de riesgo respecto a la transmisión de VIH/sida en estudiantes de Universidad de Chile / Risk perception regarding HIV/AIDS transmission among students from the University of Chile

Fundamento: mantenerse informados es un mediador influyente en las conductas de riesgo, mas no determinante. Conocerlo no es suficiente para traducirlo en conductas preventivas ya que existen otros factores que podrían influir en el comportamiento sexual, como la percepción de riesgo. Objetivo: determinar la percepción sobre el riesgo de contraer y/o transmitir VIH/sida, en estudiantes de la Facultad de Medicina de la Universidad de Chile en el año 2020, desde una perspectiva de género. Métodos: se realizó una investigación cualitativa con enfoque fenomenológico, de tipo exploratorio descriptivo, a estudiantes de la Facultad de Medicina de la Universidad de Chile durante el año 2020. Se emplearon métodos teóricos: análisis-síntesis, inductivo-deductivo e histórico-lógico; y empíricos: entrevistas individuales semiestructuradas. Para obtener la información se aplicó el análisis narrativo de contenido. Resultados: los estudiantes demostraron tener conocimiento respecto a VIH/sida, sus mecanismos de transmisión, tratamiento y prevención. La mayoría dice usar métodos de barrera, aunque distinguen su uso entre relaciones casuales y estables. En las relaciones de pareja estable la percepción de riesgo parece ser menor, asociada el no uso de preservativo por confianza y placer, entre otros. Conclusiones: el manejo teórico del tema no logra ser suficiente para que la autopercepción de riesgo sea incrementada y se adopten conductas preventivas. Conocer los elementos que influyen en la percepción de riesgo es relevante para lograr programas de educación sexual efectivos, considerando factores socioculturales además de la entrega de información.

Background: being updated is an influencial mediator of risk behaviors, but it is not determinant. To know the risk is not enough to put in practice prevetive behaviors since there are others factors that could influence upon sexual behavior, as the risk perception. Objective: to determine the perception about the risk of getting and/or transmitting HIV / AIDS, among students from the University of Chile, Faculty of Medicine, 2020, and with a gender perspective. Methods: a qualitative research with a phenomenological approach of descriptive exploratory type, with students from the Faculty of Medicine of the University of Chile, was carried out in 2020. Theoretical methods were used: analysis-synthesis, inductive-deductive and historical-logical methods; and empirical ones: semi-structured individual interviews. To get the information, narrative content analysis was applied. Results: students showed their knowledge regarding HIV/AIDS, the mechanisms of transmission, treatment and prevention of it. Most of them refer using barrier methods, although they distinguish the use of it depending on what if it is a casual or stable relationship. In case of stable relationships, the perception of risk seems to be lower, associated with the non-use of condoms for trust and pleasure, among others. Conclusions: the theoretical management of the topic is not sufficient for the increase of self-perception risk and preventive behaviors be adopted. Knowing the elements that influence on risk perception is relevant to achieve effective sexual education programs, taking into account sociocultural factors in addition to the communication of information.

Factores relacionados a la depresión durante la adolescencia: una revisión integrativa / Factors related to depression during adolescence: an integrative review

INTRODUCCIÓN: La depresión es un problema de salud mental común en la etapa de la adolescencia, se manifiesta por descenso del humor, tristeza y pérdida de interés en actividades cotidianas. Esta etapa es sensible por los grandes cambios biopsicosociales. OBJETIVO: identificar factores relacionados a la depresión en adolescentes que puedan actuar como factores protectores o factores de riesgo. METODOLOGÍA: se realizó una búsqueda bibliográfica en las bases de datos WoS, PUBMED, Scopus, y BVS; se utilizaron descriptores normalizados para la expresión de búsqueda "Adolescente AND factores protectores OR factores de riesgo AND depresión", seleccionando 38 artículos. RESULTADOS: se obtuvieron 34 factores, que pueden actuar como de riesgo y protectores, y agrupados en dimensiones: a) biológica: género, edad, índice de masa corporal, problemas de salud; b) psicológica: autorregulación, autoestima, afecto positivo/negativo, pensamientos negativos, imagen corporal, estrés, alexitimia, calidad de vida, y c) social, subdividida en tres grupos: c.1) hábitos: consumo de sustancias nocivas, actividad física/sedentarismo, adicción a pantallas, rendimiento académico, participación comunitaria, estilo de vida, actividad sexual, sueño; c.2) contexto familiar: experiencias familiares, relación padres-hijos, funcionalidad familiar, composición familiar, nivel socioeconómico; y c.3) entorno: escuela urbana, implicación escolar, bullying, apoyo social, exposición a violencia, eventos vitales negativos, alfabetización en salud y áreas verdes. CONCLUSIÓN: Existen factores relacionados a la depresión en adolescentes que podrán actuar como factores protectores o de riesgo, su conocimiento por parte de los profesionales de la salud y de la enfermera en particular es fundamental para intervenirlos.

INTRODUCTION: Depression is a common mental health problem in adolescence, manifested by poor mood, sadness and loss of interest in daily activities. Adolescents are especially susceptible to depression due to the great biopsychosocial changes in this stage of life. OBJECTIVE: To identify risk factors and protective factors associated with adolescent depression that are evidence-based. METHODOLOGY: a bibliographic search was carried out in the WoS, PUBMED, Scopus, and VHL databases. Standardized descriptors used to conduct the search included Adolescent AND protective factors OR risk factors AND depression. 38 articles were selected. RESULTS: 38 factors were identified, classified as risky and protective, and grouped into the following dimensions: a) biological: gender, age, BMI, health problems; b) psychological: negative or positive affection, negative thoughts, satisfaction with body image, stress, alexhythemia, quality of life, self-regulation, self-esteem; and c) social, subdivided into three groups: c.1) habits, physical activity, consumption of harmful substances, screen addiction, lifestyle that needs to be improved, sexual activity, community participation, sleep duration, academic performance; c.2) family context: experiences, parent-child relationship, composition, socioeconomic level, functionality, educational level of parents; and c.3) environmental:: social support, bullying, exposure to violence, belonging to an urban school, negative life events, school involvement, neighborhood with green areas and health literacy. CONCLUSION: Several factors that affect depression in adolescents are reported by the literature. In the biological dimension, they tend to be risk factors, and in the psychological and social dimensions, they may increase risk or be protective. Knowledge of these factors by the nurse is essential to guide interventions.

Temporal trends of morbidities, and risk and protective factors for noncommunicable diseases in elderly residents in Brazilian capitals / Tendências temporais de morbidades e fatores de risco e de proteção para doenças crônicas não transmissíveis em pessoas idosas residentes nas capitais brasileiras

ABSTRACT Objective: To analyze the temporal trends of prevalence of morbidities, risk and protection factors for noncommunicable diseases in elderly residents in Brazilian capitals between 2006 and 2021. Methods: A time series study with data from the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Inquiry. The variables analyzed were: high blood pressure, diabetes, smoking, overweight, obesity, consumption of alcoholic beverages, soft drinks, fruits and vegetables, and the practice of physical activity. Prais-Winsten regression and Interrupted Time Series from 2006 to 2014 and 2015 to 2021 were used. Results: From 2006 to 2021, for the total elderly population, there was an increase in diabetes (19.2 to 28.4%), alcohol consumption (2.5 to 3.2%), overweight (52.4 to 60.7%) and obesity (16.8 to 21.8%), and a reduction in the prevalence of smokers (9.4 to 7.4%) and in soft drink consumption (17 to 8.7%). By the interrupted series, between 2015 and 2021, there was stability in the prevalence of diabetes, female smokers, overweight among men, obesity in the total and male population, and soft drink consumption. Conclusion: Over the years, there have been changes and worsening in the indicators analyzed, such as an increase in diabetes, alcohol consumption, overweight, and obesity, which reinforces the importance of continuous monitoring and sustainability programs to promote the health, especially in the context of economic crisis, austerity, and COVID-19 pandemic.

RESUMO Objetivo: Analisar as tendências temporais das prevalências de morbidades e dos fatores de risco e de proteção para as doenças crônicas não transmissíveis em pessoas idosas residentes nas capitais brasileiras entre 2006 e 2021. Métodos: Estudo de série temporal com dados do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico. Analisaram-se as variáveis: hipertensão arterial; diabetes; tabagismo; excesso de peso; obesidade; consumo de bebidas alcoólicas, refrigerantes, frutas e hortaliças; e prática de atividade física. Empregaram-se o modelo de regressão de Prais-Winsten e a séries temporais interrompidas (de 2006 a 2014 e de 2015 a 2021). Resultados: De 2006 a 2021, para a população total de idosos, houve aumento de diabetes (19,2 para 28,4%), do consumo de álcool (2,5 para 3,2%), do dexcesso de peso (52,4 para 60,7%) e da obesidade (16,8 para 21,8%), e redução do tabagismo (9,4 para 7,4%) e consumo de refrigerantes (17,0 para 8,7%). Pelas séries interrompidas, entre 2015 e 2021, houve estabilidade da prevalência de diabetes, fumantes do sexo feminino, excesso de peso nos homens, obesidade na população total e no sexo masculino e consumo de refrigerante. Conclusão: Ao longo dos anos houve mudanças e piora dos indicadores analisados, como aumento de diabetes, do consumo de álcool, do excesso de peso e da obesidade, o que reforça a importância do monitoramento contínuo e da sustentabilidade de programas de promoção da saúde, especialmente no contexto de crise econômica, austeridade e pandemia decorrente da COVID-19.

Association of child labor with risk and protective factors for Chronic Noncommunicable Diseases in Brazilian schoolchildren: National School Health Survey 2015 / Associação do trabalho infantil com fatores de risco e proteção para doenças crônicas não transmissíveis em escolares brasileiros: Pesquisa Nacional de Saúde do Escolar 2015

ABSTRACT Objective: To analyze the sociodemographic profile of adolescents working in Brazil and the association of child labor with risk and protection factors for Chronic Noncommunicable Diseases. Methods: Cross-sectional study with data from sample 2 of the 2015 National School Health Survey (PeNSE). The variables gender, age, ethnicity/skin color, administrative dependence on school and maternal education, eating habits, physical activity and drug use were analyzed by prevalence and respective 95% confidence intervals (95%CI) and calculation of crude and adjusted Odds Ratio. Results: A total of 10,926 students participated in the survey, of which 16.9% (95%CI 15.1-18.9) were currently working/employed. Child labor was higher among male adolescents (ORa: 1.82; 95%CI 1.55-2.15); aged between 16 and 17 years (ORa: 2.96; 95%CI 2.37-3.69); enrolled in public schools (ORa: 1.69; 95%CI 1.14-2.52); whose mothers had incomplete high school (ORa: 1.54; 95%CI 1.11-2.13); living in the South region of the country (ORa: 2.17; 95%CI 1.60-2.94). Adolescents who worked were more likely to smoke (ORa: 1.94; 95%CI 1.52-2.48); use alcohol (ORa: 2.01; 95%CI 1.71-2.36) and drugs (ORa: 1.76; 95%CI 1.35-2.31); perform physical activity (ORa: 1.24; 95%CI 1.07-1.44); consume sweets (ORa: 1.30; 95%CI 1.13-1.49), fried snacks (ORa: 1.41; 95%CI 1.15-1.74), and soft drinks (ORa: 1.23; 95%CI 1.06-1.44); however, they were less likely to present sedentary behavior (ORa: 0.68; 95%CI 0.59-0.79). Conclusion: Child labor in Brazil is related to sociodemographic differences. Those who worked were more likely to show risk behaviors for NCDs, but they were more physically active.

RESUMO Objetivo: Analisar o perfil sociodemográfico dos adolescentes que trabalham no Brasil e a associação do trabalho infantil com fatores de risco e proteção para doenças crônicas não transmissíveis. Métodos: Estudo transversal com dados da amostra 2 da Pesquisa Nacional de Saúde do Escolar de 2015. Analisaram-se as variáveis sexo, idade, raça/cor da pele, dependência administrativa da escola e escolaridade materna, variáveis acerca de alimentação, atividade física e uso de drogas. Realizaram-se análises por meio das prevalências e respectivos intervalos de confiança de 95% (IC95%) e cálculo da odds ratio bruta e ajustada. Resultados: Participaram da pesquisa 10.926 escolares, destes, 16,9% (IC95% 15,1-18,9) trabalhavam. O trabalho infantil foi maior nos adolescentes: do sexo masculino (ORaj: 1,82; IC95% 1,55-2,15); idade entre 16 e 17 anos (ORaj: 2,96; IC95% 2,37-3,69); que estudavam em escolas públicas (ORaj: 1,69; IC95% 1,14-2,52); com escolaridade materna igual ao ensino médio incompleto (ORaj: 1,54; IC95% 1,11-2,13); residentes da região Sul (ORaj: 2,17; IC95% 1,60-2,94). Esses adolescentes trabalhadores apresentaram maiores chances de: fumar (ORaj: 1,94; IC95% 1,52-2,48); consumir bebidas alcoólicas (ORaj: 2,01; IC95% 1,71-2,36); usar drogas ilícitas (ORaj: 1,76; IC95% 1,35-2,31); realizar atividade física (ORaj: 1,24; IC95% 1,07-1,44); consumir guloseimas (ORaj: 1,30; IC95% 1,13-1,49); consumir salgados fritos (ORaj: 1,41; IC95% 1,15-1,74), e refrigerantes (ORaj: 1,23; IC95% 1,06-1,44). Contudo apresentaram menor chance de comportamento sedentário (ORaj: 0,68; IC95% 0,59-0,79). Conclusão: Houve diferenças sociodemográficas em relação ao trabalho infantil no Brasil. Os que trabalhavam apresentaram maiores chances de manifestar comportamentos de risco para as DCNT, no entanto eram mais ativos fisicamente.

Depresión posparto: prevalencia y factores de riesgo asociados en una muestra de población mexicana / Postpartum depression: prevalence and associated risk factors in a sample of the Mexican population

Resumen OBJETIVO: Determinar la prevalencia de depresión posparto en una muestra de población mexicana por medio de la Escala de Edimburgo y los factores de riesgo asociados con su inicio MATERIALES Y MÉTODOS: Estudio observacional, transversal, relacional y analítico efectuado en una muestra de población mexicana atendida entre los meses de marzo a julio del 2022 en cuatro hospitales de segundo y tercer nivel de cuatro entidades de la República Mexicana. Se aplicó la escala de Edimburgo a pacientes en el puerperio. Los datos obtenidos se procesaron con una técnica de regresión logística binaria ajustada para identificar los factores de riesgo más importantes de depresión posparto. RESULTADOS: De una muestra de 717 pacientes a quienes se aplicó la Escala de Edimburgo, 106 resultaron positivas a depresión posparto, lo que da una prevalencia del 14.9%. La edad promedio de las pacientes fue de 26 años (límites de 12 y 46). El estado civil soltera resultó un factor protector de depresión posparto y, en su contraparte, quienes estaban casadas tuvieron cierta predisposición a la depresión posparto. A mayor grado de escolaridad menor predisposición a la depresión posparto. CONCLUSIONES: Los principales factores de riesgo de depresión posparto fueron: el antecedente de trastornos psiquiátricos en la familia, depresión previa, dificultades económicas y ser soltera. Las pacientes pueden cursar con diversos factores de riesgo simultáneos, circunstancia que potencia el riesgo de depresión. Es primordial que el obstetra identifique los factores de riesgo desde el control prenatal, a fin de prevenir que el estado depresivo se agudice durante el puerperio.

Abstract OBJECTIVE: To determine the prevalence of postpartum depression in a Mexican population sample by means of the Edinburgh Scale and the risk factors associated with its onset. MATERIALS AND METHODS: Observational, cross-sectional, relational and analytical study carried out in a sample of Mexican population attended from March to July 2022 in four second and third level hospitals in four Mexican states. The Edinburgh scale was applied to postpartum patients. The data obtained were processed with a binary logistic regression technique adjusted to identify the most important risk factors for postpartum depression. RESULTS: From a sample of 717 patients to whom the Edinburgh Scale was applied, 106 were positive for postpartum depression, giving a prevalence of 14.9%. The average age of the patients was 26 years (range 12 and 46). Unmarried marital status was a protective factor for postpartum depression and, on the other hand, those who were married had a certain predisposition to postpartum depression. The higher the level of schooling the lower the predisposition to postpartum depression. CONCLUSIONS: The main risk factors for postpartum depression were: history of psychiatric disorders in the family, previous depression, economic difficulties and being single. Patients may have several simultaneous risk factors, a circumstance that increases the risk of depression. It is essential for the obstetrician to identify the risk factors from the prenatal check-up, to prevent the depressive state from worsening during the puerperium.

Principal component analysis of dental caries related factors among 3- to 5-year-old children in Urumqi City / 口腔疾病防治

Objective @#To explore dental caries-related factors among children aged 3-5 years in Urumqi City and to provide evidence for the etiological study and primary prevention of caries among local children. @*Methods @# A multistage stratified cluster sampling method was used to randomly select children aged 3-5 years in Urumqi City for oral examination, physical examination and questionnaire survey. Data were collected and analyzed by principal component logistic regression using SPSS 23.0 software.@*Results@#Principal component analysis showed that there were seven risk factors whose characteristic root value was greater than 1: oral hygiene habits, family education level, sugar intake, bedtime eating habits, age, gestational age, feeding mode, and cumulative contribution were 66.486% of the total variance. Principal component logistic regression analysis indicated that five factors, namely, oral hygiene habits (OR = 0.795, P = 0.044), family education level (OR = 0.667, P = 0.019), sugar intake (OR = 1.260, P = 0.006), bedtime eating habits (OR = 5.432, P<0.001) and age (OR = 0.676, P = 0.015), were closely related to early childhood caries, and they were statistically significant (P<0.05). @*Conclusion@#According to the principal component analysis, oral hygiene habits factor, family education level factor, sugar intake factor, bedtime eating habits factor and age factor were dental caries related factors among 3- to 5-year-old children in Urumqi City.