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Objective: Intimate partner violence (IPV) is a major public health problem in Latin America. The present study investigates the protective factors that contribute to minimizing the risk of exposure to IPV analyzing different variables in a sample of Chilean women victims of IPV. Methods: We used data from the Cicatrices Foundation, a nonprofit Chilean organization providing psychological support to IPV victims. Relevant variables for IPV prevention were identified analyzing a database containing all the information reported by victims during a structured interview. A final sample of 444 women suffering IPV was used in the present study. Results: Logistic regression analysis was calculated in order to make predictions related to IPV protective factors, showing that having a support network (OR = 2.85), treatment compliance (OR = 2.05) and being younger (OR = 0.95) increased the probability of not living with the aggressor. Another logistic regression analysis was calculated in order to predict IPV victims´ health taking medication intake as an indicator. A significant association was observed between this variable and working outside (p = 0.002) and between mediation intake and age (p < 0.001), with an OR of 1.987 and 0.93, respectively. Working outside and being younger were identified as protective factors against consuming medication. Conclusion: To the best of our knowledge, this is one of the first studies conducted in Chile on the prevention of IPV in a sample of victims seeking for help. Our results will contribute to guide policy makers, researchers and other women in the prevention of potential risks for IPV.

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Mother-infant bonding is influenced by several risk and protective factors, and the literature has investigated the relationships between these factors independently. This study aimed to verify the interrelationships of some of these factors and how they influence mother-infant bonding in Brazil. In this study, 361 mothers participated, and the outcome variable of mother-infant bonding was assessed using the Postpartum Bonding Questionnaire (PBQ). Multivariate regression analysis was performed using a hierarchical model with three blocks structured according to the influence exerted on mother-infant bonding. The PBQ's factor scores were estimated and used in the subsequent analyses to decrease measurement error. The variable "violence experienced by mothers" was statistically significant for explaining the second block model but not significant for the third block. Network analysis was performed after multiple regression, showing that the violence experienced by mothers does not directly influence mother-infant bonding but rather is mediated by postpartum depression. This explains why violence is not significant in the hierarchical multiple regression when maternal depression is added to the model. This study's strengths lie in its utilization of PBQ factor scores and network analysis, enabling the estimation of conditional relationships among variables. This approach provides deeper insights into factors affecting mother-infant bonding.

Varios factores de riesgo y de protección ejercen influencia sobre la unión afectiva madre­infante; la literatura disponible ha investigado las relaciones entre estos factores de una manera independiente. Este estudio se propuso verificar las interrelaciones de algunos de estos factores y cómo ellos influyen en la unión afectiva madre­infante. Se consultó un total de 361 madres y el variable resultado de afectividad madre­infante se evaluó por medio del Cuestionario de Afectividad de Postparto (PBQ). Se llevaron a cabo análisis de regresión multivariados usando un modelo jerárquico con tres estructuras de bloques de acuerdo con la influencia ejercida sobre la unión afectiva madre­infante. Se estimaron y usaron los puntajes de factores del PBQ en los análisis subsecuentes para disminuir el error en la medida. La variable "violencia experimentada por las madres" fue estadísticamente significativa para explicar el segundo modelo de bloque, pero no significativa para el tercer bloque. Se llevó a cabo un análisis de interrelaciones después de la regresión múltiple, demostrando que la violencia experimentada por las madres no influye directamente la afectividad madre­infante, sino que la misma es mediada por la depresión posterior al parto. Esto explica por qué la violencia no es significativa en la jerárquica regresión múltiple cuando la depresión materna se le agrega al modelo. Entre los puntos fuertes de este estudio se incluye el uso de los puntajes de factores del PBQ y el análisis de interrelaciones, lo cual permitió que se estimaran las relaciones condicionales existente dentro del grupo de variables, aportando una mayor comprensión de algunos factores que interfieren en la unión afectiva madre­infante.

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BACKGROUND: Depression is a significant global disability, and early adverse experiences (EAE) represent consistent risk factors in children. However, protective factors play a vital role in promoting healthy development and mitigating these risks. METHODS: We conducted a thorough literature search on Pubmed, APA, Emcare, and EMBASE from 1946 to August 25, 2023. We included longitudinal studies analyzing protective factors for depressive symptoms in high-risk children or adolescents, excluding cross-sectional studies, reviews, and pre-clinical studies. OUTCOMES: Our analysis comprised 29 studies with 62,405 participants, identifying 38 protective factors. Positive individual characteristics, family factors, peer relationships, school-related aspects, neighborhood characteristics and intrinsic religiosity were associated with reduced depressive outcomes. INTERPRETATION: These findings have important implications for developing preventive strategies in this population. Addressing protective factors can contribute to preventing depression and enhancing mental well-being across the lifespan.

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BACKGROUND: Major depressive disorder (MDD) is a global concern due to its widespread prevalence and morbidity. Identifying protective factors in high-risk individuals, including those with a familial predisposition, maltreatment history, and socio-economic vulnerabilities, is crucial. METHODS: We assessed a high-risk subsample within a young adult population cohort (n = 791; mean age = 31.94 [SD = 2.18]) across three waves. Using multiple regression models to analyse higher education, feeling supported, spirituality, psychotherapy access, higher socioeconomic status, involvement in activities, cohabitation, and family unity in Waves 1 and 2, and their association with MDD resilience at Wave 3. RESULTS: In the high-risk group, MDD incidence was 13.7% (n=24). Paternal support had a protective effect on MDD incidence (OR = 0.366; 95% CI [0.137 to 0.955], p = 0.040) and suicidal attempt risk (OR = 0.380; 95% CI [0.150 to 0.956], p = 0.038). Higher resilience scores were also protective (OR = 0.975; 95% CI [0.953 to 0.997], p = 0.030), correlating with reduced BDI (r = 0.0484; B = -0.2202; 95% CI [-0.3572 to -0.0738]; p = 0.003) and MADRS scores (r = 0.0485; B = -0.2204; 95% CI [-0.3574 to -0.0741]; p = 0.003). CONCLUSIONS: Our paper emphasizes reorienting the MDD approach, focusing on positive prevention strategies. It highlights fathers' crucial role in family-based interventions and promoting resilience in high-risk populations.

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Background: Most people recover from COVID-19, however, between 5 to 20% have experienced new, recurring, or continuous health problems four or more weeks after being infected, a phenomenon called Long COVID, and whose reasons for its manifestation are incipient. Our objective was to analyse the risk and protective factors for Long COVID in Brazilian adults participating in the CUME Study. Methods: The CUME Study is a prospective cohort conducted with graduates from federal universities in the State of Minas Gerais, Brazil. In this study, 390 participants who answered the baseline questionnaire in 2016 and the third follow-up questionnaire in 2022 (which contained a block of questions about occurrence of COVID-19 and Long COVID) were included. The diagnosis of Long COVID was based on self-reporting of persistence of signs and symptoms of COVID-19 between 30 days and 6 months after remission of the disease. To estimate the risk and protective factors for Long COVID, a hierarchical multivariate statistical analysis was conducted using the Poisson regression technique. Results: Long COVID was observed in 48.9% of the participants. The following characteristics were identified as risk factors for the outcome: female sex (RR = 1.56; 95% CI = 1.22-1.99); prior diagnosis of hypertension (RR = 1.46; 95% CI = 1.19-1.80); having contracted COVID-19 in the first (RR =1.38; 95% CI = 1.07-1.79) or in the second waves (RR = 1.33; 95% CI = 1.07-1.65) of the pandemic period; and having presented three or more signs and symptoms during the acute phase of COVID-19 (RR = 2.99; 95% CI = 1.08-8.24). On the other hand, having a doctoral/postdoctoral educational level (RR = 0.69; 95% CI = 0.50-0.94) was identified as a protective factor for the outcome. Conclusion: Health system managers and healthcare professionals should be aware of the socioeconomic profile and disease history of patients who have had COVID-19 because women, people with a prior diagnosis of hypertension, and those who manifested multiple signs and symptoms of COVID-19 during the acute phase of the disease were at greater risk of developing Long COVID.

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BACKGROUND: High cannabis use rates among American Indian (AI) adolescents necessitate the identification of factors that protect against early cannabis initiation. METHODS: Data collected from 279 AI middle school students attending reservation-based schools in 2018 and 2019 were analyzed. Three waves of data, with approximately 6 months between each, were used. A repeated measures latent class analysis examined a school-related protective factor index over three waves. The predictive power of lifetime cannabis use on school protection class membership was estimated, along with differences in past month cannabis use at follow-up 2 across school protection classes while holding baseline use constant. RESULTS: Four school protection classes were identified: high, moderate, low, and declining protection. Abstinence at baseline was associated with an increased odds of membership in the high protection class compared to the moderate and low protection classes. Students with consistent and high school protection throughout middle school were significantly less likely to report past month cannabis use at follow-up 2 compared to other classes. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Maintaining a high level of school protection throughout middle school substantially lowers the odds of cannabis use among AI adolescents. CONCLUSIONS: Interventions to promote school-related protective factors in this population are essential and should be designed and tested.

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OBJECTIVE: Assess the prevalence of self-reported burnout and identify risk and protective factors based on demographic and life quality aspects, among Latin American orthopaedic surgeons. METHODS: This study employed a cross-sectional analytical design. An original design survey was developed using multiple-choice and Likert-scale questions to gather self-reported burnout, demographic, work-related, social, personal, and mood-related data. The survey was electronically distributed to the Chilean Orthopaedic Surgery Society and the Latin American Society of Arthroscopy, Knee Surgery, and Sports Medicine members. Statistical analysis included Chi-square and Fisher's exact tests to determine associations between self-reported burnout and other variables. Subsequently, a multivariate logistic regression was carried out to identify key risk and protective factors (p â€‹< â€‹0.05). RESULTS: The survey's response rate was 20 â€‹% (n â€‹= â€‹358) out of the 1779 invitations that were sent. The most representative age range was 41-60 years (50 â€‹%) and 94 â€‹% were men. Of those surveyed, 50 â€‹% reported a burnout episode more than once per year, 60 â€‹% depersonalization when treating patients at least yearly, 13 â€‹% anhedonia, 11 â€‹% a depressive mood more than half of the month or almost every day, and 61 â€‹% weariness at the end of a working day. Burnout was statistically associated with age under 40 years old (p â€‹= â€‹0.012), fewer years as a specialist (p â€‹= â€‹0.037), fear of lawsuits (p â€‹< â€‹0.001), a non-healthy diet (p â€‹= â€‹0.003), non-doing recreational activities (p â€‹= â€‹0.004), depersonalization when treating their patients (p â€‹< â€‹0.001), weariness (p â€‹< â€‹0.001), anhedonia (p â€‹< â€‹0.001), depressive mood (p â€‹< â€‹0.001), and career dissatisfaction (p â€‹< â€‹0.001). The logistic regression demonstrated that fear of lawsuits (p â€‹< â€‹0.001), weariness at the end of a workday (p â€‹= â€‹0.016), and anhedonia (p â€‹= â€‹0.019) were those variables with stronger direct associations with self-reported burnout. A healthy diet was the strongest protective variable (p â€‹< â€‹0.001). CONCLUSION: Over 50 â€‹% of the Latin American orthopaedic surgeons who participated in the survey reported experiencing burnout episodes more than once a year, along with depersonalization when treating their patients at least once a year. Additionally, nearly 10 â€‹% of respondents experienced weekly depressive symptoms. Among the noteworthy risk factors for self-reported burnout were fear of lawsuits, weariness at the end of the workday, and anhedonia. Conversely, maintaining a healthy diet emerged as the most potent protective factor. LEVEL OF EVIDENCE: Level III.

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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.

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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.

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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.

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(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.

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Intimate partner violence (IPV) is a complex, multidimensional phenomenon and may involve different risk and protective factors, as well as people of different sexual orientations, including gay men. Despite scientific evidence of the high prevalence of victimization and perpetration of this phenomenon, IPV in gay men is still largely invisible. The aim of this study was to map the risk and protective factors related to IPV among gay cis men based on a literature review. The Scopus, PsycNET, Pubmed, BVS-Psi, and SciELO databases were searched to retrieve articles published between 2018 and 2022. Thematic analysis was used to map the risk and protective factors of the 29 articles that met the inclusion criteria. Among the results, most studies investigated the risk factors for victimization of IPV, despite showing the high prevalence of bidirectionality in IPV among gay men. In addition, multiple risk and protective factors (individual, relational, and socio-community) have been shown to be associated with IPV among gay men. Mapping risk and protective factors for IPV at different ecological levels makes it possible to identify a more accurate profile of gay men's vulnerabilities, in addition to enabling the construction of more systemic interventions, which are multisectoral with specific prevention strategies, for IPV among gay men.

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OBJECTIVE: The present study examines self-compassion (SC) as a potential protective factor in the relationship between value-behavior discrepancy guilt (VBDG) and the mental health outcomes of anxiety and suicide risk in a sample of Mexican-descent college students. METHOD: Participants consisted of 810 college students of Mexican descent. Students were recruited through a psychology participant pool and completed an online survey. Two regression analyses examined the direct effect of VBDG on anxiety symptoms and suicide risk with SC as a moderator. RESULTS: Results indicated that high levels of SC were protective in the relationship between VBDG and mental health outcomes. On the other hand, lower levels of SC put one at risk for increased anxiety symptoms and higher suicide risk when they experience VBDG. CONCLUSION: The study shows the need to develop interventions that cultivate a high sense of SC in Mexican-descent college students.

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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.

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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.

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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.

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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.

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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.

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OBJECTIVE: Suicide is an outcome arising from a combination of risk and protective factors. Examining psychological resilience traits associated with successful aging may help to better understand late-life suicide and depression. We examined self-reported protective factors including mindfulness, life satisfaction and engagement, flourishing, and subjective and objective social support in a high suicide-risk sample of depressed older adults. METHODS: Participants were 297 individuals aged 55+ (mean age: 64.2): 92 depressed suicide attempters, 138 depressed individuals who never attempted suicide, and 67 non-psychiatric comparisons. Using linear and binomial logistic regression, we examined the effects of a combined Protective Factor value on presence and severity of depression and suicidal ideation, and history of suicide attempt. RESULTS: Relative to the non-psychiatric comparison group, all depressed participants had significantly lower Protective Factor values. Higher Protective Factor value was associated with lower likelihood of depression, depression severity, and likelihood of ideation, but was not associated with ideation severity or history of suicide attempt. Participants with one standard deviation higher Protective Factor had lower odds of ideation incidence by a factor of OR=0.68 (95%CI=0.48-0.96). CONCLUSION: Resiliency characteristics relevant to psychological wellbeing and successful aging may mitigate the emergence of depression and suicidal ideation, as well as the severity of depression in late-life. The Resilience Factor used in this study can help clinicians nuance their appraisal of depression and suicide risk.

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This study investigated risk and protective factors for marijuana use and problems with use in Ecuadorian girls in an attempt to inform this growing problem. Female secondary school students (N = 16,310; M = 15.02, SD = 1.73 years) who completed the 2016 national survey of drug use participated. The likelihood of lifetime marijuana use, reported by 7.3% of the sample, was predicted by older age, greater perceived access to marijuana and affiliation with tobacco- and marijuana-using peers; aspects of parental monitoring and perceived physical safety in and around school were negatively related to the probability of use. Among girls reporting any marijuana use, age, frequency of past year use, ease of access and affiliation with marijuana-using peers was positively associated with marijuana use problems. These data support the roles of both parents and communities in reducing marijuana use among Ecuadorian girls and highlight the important role of peer influence.

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