Adolescent substance use and its association with risk and protective factors. An exploratory analysis of the large-scale school survey of Comunidades Que se Cuidan, Colombia. / Uso de sustancias en adolescentes y su asociación con factores de riesgo y protección. Un análisis exploratorio de la encuesta escolar a gran escala de Comunidades Que se Cuidan, Colombia.

Communities That Care (CTC) is a prevention system aimed at reducing antisocial behaviors in adolescents. In Colombia, this system has been developed and adapted under the name of Comunidades Que se Cuidan (CQC). Successful implementation of CQC depends on valid associations between measured risk and protective factors (RPFs) for substance use and substance use outcomes. This study assessed these associations using large-scale, school-based surveys of Colombian youth. A cross-sectional analysis was performed. Data from 23 communities in Colombia were collected between 2012 and 2016 from young people (N = 50,946) aged 10 to 19 years. Dichotomous alcohol, cigarette, cannabis, and other illegal drug use outcomes were assessed for past 30-day, past-year, and lifetime use. Logistic regression analyses, adjusting for age, gender, and age by RPF, and gender by RPF interactions, were performed for each RPF. All the associations of the 14 RPF evaluated were statistically significant (p<,001). Regarding observed effect sizes, 3.0% were considered very small (0.70 ≥ OR ≤ 1.43), 51.7% small (0.70 ≥ OR ≥ 1.43), 42.6% medium (0.40 ≥ OR ≥ 2.48) and 7.1% large (0.23 ≥ OR ≥ 4.27). Significant main effects for age and gender, and their interactions with RPFs were found for most RPFs. Findings from this study demonstrate the viability of RPFs for adolescent substance use as focal points for intervention planning, development, and evaluation of community-based prevention systems like CQC that rely on epidemiologic data for local decision making.

Communities That Care (CTC) es un sistema preventivo que busca disminuir comportamientos problemáticos en adolescentes. En Colombia, este sistema ha sido adaptado bajo el nombre de Comunidades Que se Cuidan (CQC). Este estudio validó las asociaciones entre los factores de riesgo y protección (FRP) para el uso de sustancias psicoactivas (SPA) medidos por CQC y las prevalencias de consumo de estas en adolescentes colombianos. Entre 2012 y 2016, se aplicó una encuesta a gran escala en jóvenes de 10 a 19 años (N = 50,946) pertenecientes a 23 comunidades de Colombia. Se analizó de forma transversal la asociación entre los FRP con el consumo de alcohol, cigarrillo, marihuana y otras drogas ilegales en los últimos 30 días, año y alguna vez en la vida. Se realizaron regresiones logísticas, ajustando por edad, sexo y sus interacciones con cada FRP. Todas las asociaciones de los 14 FRP evaluados fueron significativas (p<,001). De los efectos observados, 3,0% se consideraron efectos muy pequeños (0,70 ≤ OR ≤ 1,43), 51,7% pequeños (0,70 ≥ OR ≥ 1,43), 42,6% medianos (0,40 ≥ OR ≥ 2,48) y 7,1% grandes (0,23 ≥ OR ≥ 4,27). Se encontraron asociaciones significativas para edad, sexo y sus interacciones con los FRP para la mayoría de FRP. Los hallazgos demuestran la validez de los FRP estudiados para la planificación, el desarrollo y la evaluación futura de sistemas preventivos comunitarios como CQC, los cuales se basan en datos epidemiológicos para la toma de decisiones locales.

Outcome of Decolonization Therapy in a Hospital in Southern Puerto Rico.

OBJECTIVE: Methicillin resistant Staphylococcus aureus (MRSA) is a resistant bacteria responsible for hard-to-treat infections. To understand the primary impact of this infection in healthcare settings, a retrospective study was performed at a hospital in southern Puerto Rico. Our objectives were to classify the types of MRSA infection, identify factors associated with the infection, and evaluate the outcome of decolonization therapy after its having been implemented at the hospital. METHODS: Medical records of cases encompassing October 2009 through October 2011 were reviewed. A total of 761 MRSA-positive patients were identified and their infections classified as community-acquired MRSA (CA-MRSA), hospital-acquired MRSA (HA-MRSA), or healthcare-associated community-onset MRSA (HACO-MRSA). Basic demographics, reason for hospitalization, medical history, and culture sites, along with other information, were obtained for each case. SPSS v17 was used for statistical analysis. Fisher's exact test was used to measure the statistical significance of the crude OR, using the patients with CA-MRSA as the comparison group. HA-MRSA cases were compared before and after the intervention, using Epidat v4.0 to calculate the cumulative incidence of HA-MRSA before and after the implementation of decolonization therapy at the hospital. RESULTS: In our study, 5.0% of the patients were found to be infected with HA-MRSA, 72.8%, with CA-MRSA, and 22.2%, with HACO-MRSA. After the intervention, we found a decrease of 10.35% (p = 0.704) in HA-MRSA, of 2.6% (p = 0.791) in CA-MRSA, and of 7.0% in HACO-MRSA (p = 0.650). CONCLUSION: Our findings suggest that CA-MRSA could be responsible for the majority of the infections caused by MRSA within the hospital at which the study took place. Decolonization of MRSA is a useful tool in helping to control the spread of infection, although future studies are needed to confirm our study's findings.