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Pernambuco, a northeastern Brazilian state, suffered significantly during the COVID-19 pandemic. The incidence, mortality, and fatality rates were incredibly high; these outcomes were a direct failure of the public health system to manage the COVID-19 pandemic. We developed an efficient method to analyze the trends in incidence, mortality, and lethality indicators of COVID-19 and the dynamics of their main determinants in the state of Pernambuco from March 2020 to March 2022. This was a time series ecological study. We calculated the lethality, mortality, and incidence rates with official and public data from the Health Department of this state. The effective reproduction number (Rt) was estimated, and then the periods were delimited, thus creating the efficiency model. Differences were considered significant when p < 0.05. We found 585,551 cases and 18,233 deaths from COVID-19. January 2022 was the month with the highest number of cases (6312) and, in May 2020, we recorded the highest number of deaths (149). Our method was efficient in analyzing periods of COVID-19, noting a contrast between the early and most recent periods, with the latter showing a stable number of new cases and patient deaths.

The north region of Brazil is characterized by significant vulnerabilities, notably surpassing national poverty indicators. These disparities exacerbated the impact of respiratory illnesses on the healthcare system during the COVID-19 pandemic, particularly in areas with limited healthcare resources, inadequate infrastructure, and barriers to healthcare access. The crisis was further influenced by multiple lineages that emerged as significant virus variants associated with increased transmissibility. Within this context, our ecological study focused on analyzing the epidemiological evolution of COVID-19 in the state of Acre. We constructed time-series trends in incidence, lethality, and mortality from March 2020 to December 2022 using the Prais–Winsten regression model. Our findings revealed that in 2020, there was an increasing trend in incidence, while mortality and lethality continued to decrease (p < 0.05). In the following year, both incidence and mortality decreased, while lethality increased at a rate of 1.02% per day. By the end of 2022, trends remained stationary across all rates. These results underscore the importance of ongoing surveillance and adaptive public health measures to bolster the resilience of healthcare systems in remote and vulnerable regions. Indeed, continuous monitoring of the most predominant SARS-CoV-2 lineages and their dynamics is imperative. Such proactive actions are essential for addressing emerging challenges and ensuring effective responses to adverse situations.

IntroductionAutism spectrum disorder (ASD) has characteristics that have been observed to develop over time, such as the difficulty of affective, sensory, and emotional processing, which trigger some problems during childhood, limiting children's development. Applied behavior analysis (ABA) is among the therapeutic approaches for ASD, in which treatment can be tailored according to the patient's objectives.ObjectiveBased on ABA, we aimed to analyze the therapeutic strategy for independence in different skill performance tasks of patients diagnosed with ASD.MethodThis is a retrospective observational case series study including 16 children diagnosed with ASD who received ABA-based treatment at a therapeutic clinic in Santo Andre city, São Paulo State, Brazil. Individual task performance of different skill domains was registered in the ABA+ affective intelligence® software throughout the 12 months (from January 2021 to January 2022) of routine treatment.ResultsThe evolution of skills was observed between the T0 and T1 intervals, with improved skills over the observed period.ConclusionThe strategy based on the ABA methodology improved children's skill performance over the observed period.

Northeast Brazil is a region with great international tourist potential. Among the states that make up this region, Paraíba stands out due to the presence of vulnerable groups and factors that contribute to adverse outcomes of COVID-19. Therefore, the aim of this study was to analyze the epidemiological data on the incidence, mortality, and case fatality of COVID-19 in Paraíba. An ecological, population-based study was performed, with data extracted from the Brazilian Ministry of Health database. All cases and deaths from COVID-19 from March 2020 to December 2022 were included. The time series was built by applying the Prais–Winsten regression model, and the daily percent change was calculated to analyze the trends. The highest case fatality of the entire period was in April 2020 (7.8%), but in March 2021, the state broke the dismal record of 1248 deaths and the highest mortality rate (30.5 deaths per 100,000 inhabitants). Stationary mortality and case fatality were better in 2022; however, in February 2022, the mortality rate was at levels similar to the same month of the previous year. These results illustrate that COVID-19 is evolving and needs to be constantly monitored.