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Ciprofloxacin is a critically important antibiotic for human health. The increase of Escherichia coli resistance to ciprofloxacin is a global public health problem due to its importance in the treatment of complicated urinary tract infections and other serious infections; however, its prescription is high in the Colombian Caribbean. The objective was to determine the resistance trend of E. coli to ciprofloxacin in a Colombian hospital of high complexity. From antibiogram reports, isolates were categorized according to Clinical and Laboratory Standards Institute criteria for each year studied; proportions were calculated and differences in sensitivity were explored using the χ2 test. The Cochran-Armitage test was used to evaluate the resistance trend. Significance was considered when p-value ≤ 0.05. In total, 6,848 isolates were analyzed, and 49.31% resistance was found. According to origin, the highest resistance was in community samples (51.96% - 95%CI: 50.51; 53.41), and by type of sample, in skin and tissues (61.76% - 95%CI: 56.96; 66.35) and urine (48.97% - 95%CI: 47.71; 50.23). Increasing trends were observed for resistance per year (p < 0.0001), community samples (p = 0.0002) and urine (p < 0.0001). Resistance to ciprofloxacin is high and tends to increase in the community and in urine, exceeding the limit established for its use at the ambulatory level, which is of concern due to the high prescription of fluoroquinolones in the locality.

Antidepressants are the third most prescribed drug class, and most prescriptions are not performed by specialists. This study aimed to evaluate primary health care (PHC) physicians' self-perceived confidence in prescribing antidepressants. This is a cross-sectional study with PHC physicians in the municipality of Salvador, Bahia State, Brazil. Psychiatrists or psychiatry residents were excluded. The self-assessment of confidence and the collection of participants' characteristics was carried out by an online questionnaire. Categorical variables were presented in absolute and relative frequencies. Continuous variables were described as means or medians according to their normality distribution. Of 447 physicians, the sample consisted of 55 participants. Their mean age was 37.2 ± 12.8 years. Most physicians (75%) claimed confidence in prescribing antidepressants. Self-perceived confidence remained predominant in scenarios with older adults (69.2%) and patients with general comorbidities (65.4%). A minority showed confidence to prescribe antidepressants to children/adolescents (19.2%) and pregnant women (26.9%). For 80.4% of participants, selective serotonin reuptake inhibitors were the most trusted pharmacological class. Referral to the Psychosocial Care Center was the most reported strategy in cases of insecure prescription (32%). To the best of our knowledge, this is the first study to address such an issue. Thus, it can contribute to more assertive health education actions for PHC physicians.

This study aimed to analyze the trends and disparities in preventable or treatable mortality rates among different age groups, sexes, and states in Mexico from 2000 to 2019. Using national data from 2000 to 2019, we examined potentially avoidable premature mortality (PAPM) rates, disaggregated into preventable and treatable deaths. Trends over time were visualized using the average annual percent change (AAPC) derived from joinpoint analysis. Subnational analysis was conducted to identify state-specific trends for each sex and age group. The national PAPM rate decreased from 297 deaths per 100,000 in 2000 to 281 per 100,000 in 2019. Potentially preventable premature mortality (PPPM) rates were more pronounced than potentially treatable premature mortality (PTPM) rates, with 170 deaths per 100,000 and 111 per 100,000, respectively. Sex-based disparities were observed particularly in the working-age population. Our analysis at the state level revealed significant differences in trends, as certain regions experienced reductions while others rises. These disparities became more evident when examining the different aspects of PAPM, especially in terms of PTPM. Our study highlights the differences in PAPM rates across age groups, sexes, and states in Mexico. Despite a general downward trend, upward trends were observed in the male working-age group. There was also wide variation among states, highlighting the need to use PAPM in conjunction with other health metrics for a holistic health analysis.

To analyze the temporal trend of the late maternal mortality ratio (LMMR) in Brazil and its geographic regions in the period from 2010 to 2019, an ecological time series study was conducted. Data related to late maternal mortality from information systems of the Brazilian Ministry of Health were used. Statistical analysis used Prais-Winsten autoregressive models. A total of 1,470 late maternal deaths were reported in Brazil, resulting in an LMMR of 5 deaths per 100,000 live births. The late maternal mortality records revealed regional disparities, with the lowest index in the North (3.5/100,000 live births) and the highest in the South (8.3/100,000 live births). The LMMR showed an increasing trend in the country, with a general increase in the LMMR in the period and a mean annual percentage variation of 9.79% (95%CI: 4.32; 15.54). The Central-West region led this increase, with a mean annual percentage change of 26.06% (95%CI: 16.36; 36.56), followed by the North and Northeast regions, with 23.5% (95%CI: 13.93; 33.88). About 83% of the reported late maternal deaths were investigated, and 65.6% were corrected by the Maternal Mortality Committees. These findings highlight the relevance of late maternal mortality as an important indicator for maternal health, which is often invisible. The increase in the LMMR result from the improvement in the quality of the registration of these deaths in recent years in Brazil, and especially from the work of investigating deaths. The fragility of reporting with regional disparities points to the need for a more comprehensive approach that promotes equity and prevention of avoidable late maternal mortality.

Since May 2020, we have been conducting a comprehensive study to understand the natural history of SARS-CoV-2 infection in Rio de Janeiro, Brazil. Our focus has been on following families, systematically collecting respiratory tract swabs and blood samples, monitoring symptoms, and gathering data on vaccine status. This paper aims to describe the household cohort across five epidemic waves of SARS-CoV-2, providing an overview of the collected data and a description of the epidemiological, clinical, and immunological characteristics and incidence of SARS-CoV-2 infection. Our cohort includes 691 participants from 189 households. During the five epidemic waves, we detected 606 infections. The incidence density of SARS-CoV-2 infection ranged from 4 (Delta) to 56 (B.1.1.33) per 1,000 person-week, with a peak in wave B.1.1.33 in all age groups. The seroprevalence of SARS-CoV-2 antibodies (IgG anti spike protein) varied from 37%, in the pre-VoC period, to 99%, in the Omicron period, progressively increasing after each wave in a similar manner regardless of age. As we have monitored the cohort continuously since the beginning of the pandemic, we were able to collect data across different scenarios according to the predominant lineage in circulation. Via active monitoring of families, we were able to carry out an epidemiological surveillance on SARS-CoV-2, including its variants, persistence of symptoms, and changes in immunity over time in the population, contributing to knowledge of the natural history of SARS-CoV-2 infection.

The Kankuamo people are one of the 102 native peoples of Colombia, who are developing strategies for individual and collective health self-management. This article aims to investigate, identify and analyze, collaboratively and interculturally, the factors that influence the well-being of the Kankuamo people, using the Capabilities Approach proposed by Amartya Sen. To this end, three focus groups were conducted with the participation of 37 people from the 15 communities of the Kankuamo reservation. The transcripts were analyzed by means of a thematic analysis. Three central themes for the well-being of the Kankuamo emerged from the focus groups: (i) harmony between nature and human beings, (ii) social coexistence and (iii) self-determination. These themes reflect the fundamental principles and values that guide the community towards a good life, expansion of their capabilities, harmony and holistic development. The results suggest that material aspects play a secondary role in the Kankuamo community's concept of good life, and confirm that it is fundamental to consider a collective vision of capabilities, not only individual ones, in indigenous contexts. Studies such as this one can contribute to the development of more contextually appropriate approaches to assess and measure the quality of life and well-being of Indigenous communities, including the Kankuamo people.

The Brazilian Unified National Health System (SUS) has incorporated newborn screening for cystic fibrosis since 2001. The protocol involves two samples of immunoreactive trypsinogen (IRT1/IRT2). This study aims to analyze fixed and floating values at the first and second IRT (IRT1/IRT2) cutoff points and assess the accuracy of the IRT/IRT methodology in a population from Northeastern Brazil. Descriptive, individual-level data from the newborn screening reference service data system (2013-2017) were used in this observational population study. The sensitivity, specificity, and positive predictive values (PPV) for the protocol were calculated. The best cutoff point was determined using the Youden's index. The previous year's cut-off values for the IRT1 and IRT2 99.4-, 99.5-, 99.6-, and 99.7-percentiles were utilized for the floating cutoff. During the studied period, 840,832 newborns underwent screening for cystic fibrosis, obtaining 49 cystic fibrosis diagnoses: 39 by newborn screening (79.6%) and 10 (20.4%) by clinical suspicion (false negative). The sensitivity, specificity, and PPV of the protocol totaled 79.6%, 99.9%, and 6.1%, respectively. No proposed cutoff for IRT1 performed better than the current one. IRT2 performed similarly to the current protocol at a cutoff point of 90ng/mL, showing the appropriate sensitivity and specificity while reducing the frequency of false positives. The protocol to screen newborns for cystic fibrosis had low sensitivity, a predictive positive value, and a high number of false positives and negatives. A floating cut point for IRT1 or IRT2 seems to constitute no viable option. However, changing the IRT2 cut point from 70ng/mL to 90ng/mL seems to have advantages and should undergo consideration.

Leisure activities are necessary to improve the quality of life and good health of the population. Some studies in developed countries have described that people with disabilities participate less in leisure activities. The aim of this study was to estimate the association between disability and participation in active leisure activities in the population aged 18 years or older in Chile, during 2015. An analytical cross-sectional study was conducted using data from the Chilean II National Survey on Disability (ENDISC II) 2015. The independent variable was disability, and the dependent variable was participation in active leisure activities in the last six months. Poisson regression models were developed and prevalence ratios (PR) and the 95% confidence intervals (95%CI) were estimated. In total, 12,236 participants were included. Chileans with moderate and severe disability were less likely to participate in active leisure activities (PR = 0.96; 95%CI: 0.93-0.99 and PR = 0.78; 95%CI: 0.72-0.84, respectively), compared to Chileans without disability. When stratified by age group, this association remained significant only in those older than 45 years. In conclusion, people with disabilities in Chile participate less in active leisure activities compared to people without disabilities, although only if they are older than 45 years. Social recreation programs should prioritize the incorporation of older people with disabilities.

Promoting socioemotional skills has been highlighted among the evidence to prevent suicidal behavior in childhood and adolescence. This review aimed to map and analyze national and international scientific papers on initiatives and programs for the prevention of suicidal behavior in adolescence based on the theoretical framework of socioemotional skills. It is a scoping review using the methodology proposed by the Joanna Briggs Institute. Eleven academic bibliographic databases were analyzed, and searches were conducted on institutional websites related to suicide prevention and Google. Papers in Portuguese, Spanish, French, and English from 2010 to July 2022 were included in the review, which consisted of 97 studies, analyzed through data matrix and thematic grouping. The results show that most are international and focused on suicide, not on self-harm alone. In general, they have an informational and instructional bias for professionals, institutions, and governments, proposed laws, programs and action plans, studies on the role of socioemotional skills and intervention research. Few strategies have been clearly tested and validated. The key elements are the ability to perceive, recognize, understand, express, and regulate one's own emotions, get motivated, and build empathy in relationships. Schools are key players in this process and the health system should act as a collaborative network. National and local prevention plans are required, emphasizing the role of schools, the health sector, and intersectoral coordination to promote health and quality of life.

This study aimed to investigate the association between child maltreatment and human capital, measured by intelligence quotient (IQ) at age 18 years and schooling at age 22 years in 3,736 members from a population-based birth cohort in Southern Brazil. A multiple linear regression was used to assess the association between child maltreatment and human capital measurements. Physical and emotional abuse and physical neglect occurring up to 15 years of age were considered child maltreatment. Physical neglect was associated with lower IQ scores in women (β = -4.40; 95%CI: -6.82; -1.99) and men (β = -2.58; 95%CI: -5.17; -0.01) and lower schooling for all sexes: women (β = -1.19; 95%CI: -1.64; -0.74) and men (β = -0.82; 95%CI: -1.34; -0.30). Moreover, men who had experienced one type of child maltreatment and women who had experienced two or more types had lower years of schooling at 22 years (β = -0.41; 95%CI: -0.73; -0.89 and β = -0.57; 95%CI: -0.91; -0.22, respectively) than those who suffered no kind of maltreatment. Efforts to improve future educational and cognitive outcomes must include early prevention and intervention strategies for child maltreatment.