Search

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the countries of Latin America and the Caribbean. This study aims to summarise key findings from the Global Burden of Disease (GBD) 2021 in the region. We also explore disparities in burden rates and the relationship with the Socio-demographic Index (SDI). A cross-sectional analysis of GBD 2021 results was conducted. We obtained the disability-adjusted life years (DALYs) due to COVID-19 for 20 countries, analysing number- and age-adjusted rates. Spearman's correlation (r h o) and 95% confidence intervals (CIs) assessed the SDI–DALY rates relationship. COVID-19 was the leading cause disease burden in the region, with 20,437,321 DALYs in 2020 and 31,525,824 in 2021. Premature mortality (years of life lost) accounted for over 95%. Disparities existed across sexes, age groups, and countries, with Bolivia and Peru having the highest rates. A significant 2021 correlation was found (r h o = −0.55, 95% CI: -0.90 to 0.19; P = 0.013) but not in 2020 (r h o = −0.40, 95% CI: -0.75 to 0.05; P = 0.078). COVID-19 posed a significant burden in Latin America and the Caribbean, emphasising the need for targeted interventions, especially in socioeconomically disadvantaged regions. [ABSTRACT FROM AUTHOR]

To describe the experiences and current situation of AO Spine Fellows in Latin America, as well as the concerns of junior spine surgeons in their first 3 years of practice. A multiple-choice questionnaire was sent to AO Spine Associate Fellows who completed their studies within the past 5 years. This survey aimed to gather information on their professional activities during the initial 3 years of practice following their fellowship. By comparing the responses and activities undertaken by surgeons on a country-by-country basis, it will be possible to describe and analyze the local and regional outcomes in Latin America. The countries with the highest participation in the AO Spine Fellowship program are currently Argentina (30.7%), Brazil, and Colombia (28.21%). Participants aged 36 to 45 are the age group with the highest engagement (30.7%). Among program participants, 75% are orthopedists. Other notable findings include that 95% of respondents have greater experience and feel more comfortable working in degenerative spine pathology. Currently, junior fellows in the AO Spine program report a high level of comfort with the initiative. However, our study reveals valuable insights that can contribute to its improvement. It is worth noting that there is a clear preference for the standard posterior approach persists. Nevertheless, there is a growing interest among junior surgeons in endoscopic and minimally invasive techniques. This study serves as a gateway to essential data for future studies and the enhancement of the Fellowship education program in Latin America. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs) are the leading causes of global mortality. Modifiable behavioural and metabolic risk factors significantly contribute to the burden of CVD. Given the vast socio-demographic and health outcome heterogeneity in Latin America, similar southern Latin American countries (Argentina, Chile, and Uruguay) were analysed as a distinct group to describe the CVD death rates related to metabolic and behavioural risk factors. An ecological study was performed using data from the Global Burden of Disease Study 2019. Metabolic and behavioural risk factors-related CVD death were examined by analysing age-standardised rates per 100,000 individuals in the three countries between 1990 and 2019. While exposure to behavioural risk is decreasing, an upwards trend was observed in metabolic risks. Among the assessed risk factors, metabolic factors emerged as the primary contributors to deaths. High fasting plasma glucose exhibited a remarkable increase in relative importance across most studied contexts. Dietary risks stood out among behavioural factors due to their complexity and substantial changes observed. Although mortality rates have declined for overall CVD, peripheral artery disease mortality is rising. Modifiable behavioural and metabolic risk factors significantly influence CVD mortality in Southern Latin America. Despite the increasing exposure to metabolic risks, advancements in prevention and treatment are evidenced in the decline of mortality rates for most CVD. These findings emphasise the need for targeted interventions and comprehensive strategies to address their impact on cardiovascular health, advocating for healthy lifestyle behaviours to mitigate the progression and CVD development. • What is the cardiovascular disease burden from modifiable behavioural and metabolic risk factors in Southern Latin America? • Metabolic risks drove cardiovascular deaths: blood pressure was most significant and fasting glucose increased the most. • Focused prevention and treatment strategies targeting these factors can enhance life quality and expectancy. [ABSTRACT FROM AUTHOR]

• This systematic review represents a significant contribution to the field as it is the first comprehensive review in Latin America that addresses the influence of masculinity stigma on the diagnosis and treatment of metastatic prostate cancer. • One of the unique strengths of this review is its ability to gather and synthesize dozens of studies that were previously published only in Portuguese or Spanish, effectively summarizing and connecting these findings with the international literature. • It highlights the impact of cultural beliefs, gender norms, and social expectations on the stigmatization of prostate cancer, particularly related to notions of masculinity such as strength and invulnerability. • The review addresses the influence of machismo culture and religious/spiritual beliefs, which further complicate the challenges faced by individuals with prostate cancer and hinder open communication about the disease. • By identifying these sociocultural factors, the review contributes to a better understanding of the experiences and obstacles encountered by prostate cancer patients in Latin America. This review examines the impact of masculinity stigma on the diagnosis and treatment of metastatic prostate cancer, particularly in Latin America. It aims to provide insights into the influence of masculinity stigma on patient outcomes and inform strategies to address this issue. A comprehensive search was conducted in electronic databases (PubMed, PsycINFO, CINAHL and LILACS) using relevant keywords and controlled vocabulary related to metastatic prostate cancer, masculinity, stigma, diagnosis, and treatment up to April 2023. The search strategy was developed in consultation with a medical librarian to ensure its comprehensiveness. Thirty-three studies that investigate the role of masculinity stigma in the diagnosis and treatment of metastatic prostate cancer were included. Our findings highlight the unique sociocultural influences in Latin America that shape prostate cancer stigma. It emphasizes the impact of cultural beliefs, gender norms, and social expectations on stigma. Notions of masculinity, such as strength and invulnerability, contribute to the stigmatization of prostate cancer. Machismo culture and religious/spiritual beliefs further compound the challenges and hinder open communication about the disease. Cultural taboos, limited awareness, and misconceptions perpetuate the stigma. These sociocultural factors shape the experiences and challenges faced by individuals with and at risk of prostate cancer in Latin America. [ABSTRACT FROM AUTHOR]

Dr. Ney Bienvenido Arias Lora emerged not only as a pioneer in neurosurgery but a community leader in the Dominican Republic (DR), contributing significantly to a region where both fundamental and neurosurgical resources were scarce. This account aims to shed light on the remarkable life and career of Dr. Arias Lora, emphasizing the critical role he played in establishing and advancing neurosurgery in the DR. This paper relies on original bibliographic materials, providing an in-depth analysis of Dr. Arias Lora's life. Through a thorough examination of his career, we aim to highlight his pioneering efforts in the Caribbeans where neurosurgical expertise was nearly nonexistent during his time. Dr. Arias Lora, born in 1926, and became the first neurosurgeon in the DR in 1959. He played a pivotal role in establishing the Neurosurgery Residency Program at the Hospital Salvador B. Gautier and was instrumental in the development of neurosurgery training in his home country and the Caribbeans. Beyond his medical contributions, Dr. Arias Lora served as an educator, authoring significant works, and holding prestigious academic positions. His legacy is reflected in the " Dr. Ney Arias Lora Traumatology Hospital " in Santo Domingo, a testament to his dedication to neurosurgery and public service. Dr. Ney Bienvenido Arias Lora's life and achievements stand as a testament to the transformative impact dedicated individuals can have on the advancement of neurosurgery. Despite the intricacies inherent in the field of neurosurgery and broader societal challenges, his story serves as an inspiration. [ABSTRACT FROM AUTHOR]

This academic article discusses the historical underrepresentation of female in science, with a focus on Latin America. It highlights the importance of both technical and non-technical skills in the medical-surgical field, particularly the role of research skills. The study aims to quantify and characterize the scientific output of Latin American female researchers over the past decade, providing insights into the challenges and opportunities in low and middle-income countries. A retrospective cross-sectional bibliometric study was conducted in 2023, focusing on pediatric surgical science journals in Scopus and PubMed. It assessed Latin American female participation, journal details, and interaction networks, using SPSS and Gephi software. The period analyzed was from January 2012 to December 2022. Between 2012 and 2022, 727 articles with Latin authorship in pediatric surgery were analyzed across 304 journals. Of these, 63.69% had female co-authors. The majority were original articles (53.13%), with contributions from Brazil, Mexico, and Chile. Notable journals included the Journal of Pediatric Surgery and Child's Nervous System. Keywords like Laparoscopy and Cardiac surgery were common. A growth trend in female Latin American publications was observed, despite temporary declines. This study highlights a growing trend in Latin American females' scientific contributions to pediatric surgery from 2012 to 2022, although a gender gap persists. The research mainly consists of primary data studies, with a focus on Brazil and Mexico from public institutions. The Journal of Pediatric Surgery featured prominently, and common topics included Laparoscopy, Cardiac surgery, Liver transplant, Congenital heart defects, and COVID-19. IV. • Latin American Women's Contribution to Pediatric Surgical Research: female co-authorship accounted for 63.69% of the identified articles. • Latin America contributes with less than 10% to the global scientific production in this area. • There has been a growth trend in the past 11 years with interruptions in 2017 and 2018, likely influenced by economic conditions in some Latin American countries. • The study highlights the centralization of scientific development in Latin American countries, with Brazil and Mexico leading in terms of publication volume. • The study shows that Latin American women's research in pediatric surgery aligns with the most relevant topics in the field, such as gastrointestinal and cardiovascular specialties, minimally invasive laparoscopic surgery, and the impact of the COVID-19 pandemic on pediatric surgical research. [ABSTRACT FROM AUTHOR]

This study aimed to assess the burden of type 2 diabetes mellitus (T2DM) in Latin America. An ecological study design was applied. The data on T2DM (i.e. incidence, mortality, disability-adjusted life years [DALYs], years lived with disability [YLDs] and years of life lost [YLLs]) were extracted from the Global Burden Disease 2019 study. To assess the trends, the average annual percentage change was computed using the joinpoint regression analysis. Approximately 2.3 million new cases of T2DM were diagnosed in Latin America in 2019, with about 214,000 deaths. The age-standardised rates of T2DM burden in 2019 were highest in Central Latin America. Incidence of T2DM has increased in both males and females in Latin America over the last three decades, while mortality has increased only in males. Of particular concern are the significant increasing trends in the incidence of T2DM among individuals in the young age and middle age groups (15–64 years) in both men and in women. Increasing trends in the burden of T2DM were observed in almost all countries of Andean Latin America, the Caribbean and Central Latin America (in particular, in Guatemala, where T2DM incidence increased by 2.4% per year, mortality by 3.7%, DALYs by 3.4%, YLDs by 2.7% and YLLs by 3.8%). T2DM is an important health issue in Latin America due to the high mortality and disability burdens and the impact on life expectancy and quality of life of the population. Unfavourable trends in T2DM burden highlight the need to introduce effective public health disease management strategies. [ABSTRACT FROM AUTHOR]

Primary oral and sinonasal mucosal melanomas (POSNMMs) are aggressive neoplasms with limited therapeutic alternatives. The aim of this review was to characterize the demographic, clinical, immunohistochemical, and molecular information regarding these tumors in the Latin American population. Articles published in English, Spanish, or Portuguese (1990–2022) retrieved from the PubMed/MEDLINE, Scopus, CAS, Web of Science, EBSCO, and Google Academic databases were included. Thirty-three studies, with a total of 1212 cases, were identified. Clinicopathological data were available for 870 cases and immunohistochemical and/or molecular information for 342. Nineteen studies (57.6%) reported cases of oral melanoma, three (9.1%) sinonasal melanoma, and 11 (33.3%) oral and sinonasal melanoma. Fifteen studies (45.5%) provided only clinicopathological data, 12 (36.4%) reported only immunohistochemical data, two (6.1%) shared clinicopathological and immunohistochemical data, one (3.0%) offered clinicopathological, immunohistochemical, and molecular data, one (3.0%) provided immunohistochemical and molecular data, one (3.0%) clinicopathological and molecular data, and one (3.0%) only molecular data. The mean age of individuals with POSNMMs was 58 years, and slightly more were male (male 51.3%, female 48.7%). In Latin America, POSNMMs are a rare but aggressive malignancy with a poor prognosis and limited treatment options. Although molecular data and targeted therapy are still being researched, data from Latin America indicate the need for multicenter collaborative clinical trials to unite individual and isolated efforts. [ABSTRACT FROM AUTHOR]

Neurosurgery is a specialty that has been dominated by males. Although there has been an increase in the number of women in the field, it is not yet close to being equal. Some noteworthy women who have carved the path for other women to follow in their footsteps include Drs. Sofía Ionescu and Diana Beck, the first and second female neurosurgeons worldwide, respectively. However, there are limited publications on Dr. María Cristina García-Sancho, the first Latina neurosurgeon. The purpose of this review was to illuminate the neurosurgical community on the life of Dr. García-Sancho. A thorough literature was performed on medical and non-medical publications that were either authored by Dr. García-Sancho or mentioned her directly. Dr. García-Sancho earned her medical degree at the School of Medicine of the National Autonomous University of Mexico under the guidance of Dr. Clemente Robles, who founded Mexico's first neurosurgical department. Her training took her worldwide. Her expertise allowed her to pioneer a revolutionary advancement known as the one-step bilateral cordotomy. Her perseverance led her to becoming the head of the Department of Neurosurgery at the National Cancer Institute of Mexico and co-found the Mexican Society of Neurological Surgery, where she served on the board of directors. This review aims to advocate for an equitable environment in the field of neurosurgery with Dr. García-Sancho's story. [ABSTRACT FROM AUTHOR]

Opsoclonus-myoclonus syndrome (OMS) is a rare neuroinflammatory disorder characterized by ataxia, opsoclonus, and myoclonus. Clinical diagnosis of OMS has been challenging; therefore, we sought to determine the clinical and treatment profiles of patients with OMS at the largest pediatric hospital in Latin America. We analyzed the data of patients diagnosed with OMS between 2010 and 2020 at Pequeno Principe Hospital (Brazil) to determine the corresponding clinical profile more accurately. Of the approximately 50,000 visitors to our pediatric neurology department from 2010 to 2020, 10 patients with OMS were observed. Five nontumor cases included three parainfectious and two idiopathic cases. The median time from symptom onset to diagnosis was 34 days. All patients with diagnostic OMS criteria in the idiopathic, nontumor group underwent whole-exome sequencing, with potentially pathogenic mutations identified in two cases. Nine patients were treated with methylprednisolone pulse, followed by oral steroids; eight received one or more intravenous immunoglobulin treatments; and six received azathioprine and cyclophosphamide. Complete symptomatic recovery was observed in only one patient. OMS diagnosis remains challenging. Diagnostic suspicion is necessary to improve the management of these patients and allow early immunosuppressive treatment. Paraneoplastic etiology is the most prevalent. In idiopathic patients who do not respond to immunosuppressive treatment, tests, such as whole-exome sequencing, may reveal a differential diagnosis. Genetic alterations that increase the risk of tumors may be an important clue to the pathophysiology of OMS. [ABSTRACT FROM AUTHOR]

The purpose of our study was to assess the multiscalar changes in leprosy burden and its associated risk factors over the last three decades. We conducted an in-depth examination of leprosy's spatial–temporal trends at multiple geographical scale (global, regional, and national), utilizing information from Global Burden of Disease, Injuries, and Risk Factors Study (GBD 2019). Incidence and the estimated annual percentage change (EAPC) in age-standardized incidence rate (ASIR) of leprosy were determined, with countries categorized based on leprosy incidence changes. We examined socioeconomic and physical geography influences on leprosy incidence via Spearman correlation analysis, using ternary phase diagrams to reveal the synergetic effects on leprosy occurrence. Globally, incident cases of leprosy decreased by 27.86% from 1990 to 2019, with a reduction in ASIR (EAPC = −2.53), yet trends were not homogeneous across regions. ASIR and EAPC correlated positively with sociodemographic index (SDI), and an ASIR growth appeared in high SDI region (EAPC = 3.07). Leprosy burden was chiefly distributed in Tropical Latin America, Oceania, Central Sub-Saharan Africa, and South Asia. Negative correlations were detected between the incidence of leprosy and factors of SDI, GDP per capita, urban population to total population, and precipitation, whereas the number of refugee population, temperature, and elevation showed opposite positive results. Despite a global decline in leprosy over the past three decades, the disparities of disease occurrence at regional and national scales still persisted. Socioeconomic and physical geographic factors posed an obvious influence on the transmission risk of leprosy. The persistence and regional fluctuations of leprosy incidence necessitate the ongoing dynamic and multilayered control strategies worldwide in combating this ancient disease. [ABSTRACT FROM AUTHOR]

Virtual reality's (VR) applications in education have been a topic of interest to the academia in recent years. Although literature expands significantly worldwide, the focus on education still presents a high number of opportunities to explore. In Latin America, the literature regarding the use of virtual reality is limited and not yet systematized. Therefore, the present study aims to provide an overview of Latin America's research publications regarding the use of VR in higher education. Using bibliometric measures and coding in Scopus and Web of Science (WoS) databases' outputs, we analyzed 126 papers, the majority of them from social sciences, followed by engineering, business, and medicine. Content tree analysis resulted in 5 dimensions: 'Functional aspects of using VR as a learning tool', 'Teaching strategies and methodologies using VR', 'Behavioral aspects of using VR as a learning tool', 'Outputs of VR use as an educational tool' and 'Competencies and readiness to use VR as a learning tool'. Most publications (74,6%) focus or present as one of the discussions the functional aspects of VR, such as access, viability, usefulness, virtual environment, the association with artificial intelligence, among others. [ABSTRACT FROM AUTHOR]

We aimed to analyse the trends of interpersonal violence (IV) in Latin America (LA) between 1990 and 2019 for females and males at a national level. Cross-sectional descriptive study. Following the 2019 Global Burden of Disease study we report IV mortality, premature mortality, years lived with disability and disability-adjusted life-years (DALYs) in LA by sex. To estimate the DALYs trends, we conducted a Joinpoint regression analysis. Across all LA countries, IV burden was higher among males. Most of the IV burden was attributable to premature death, with a higher percentage in men than women. The burden of IV was most pronounced within the 15 to 39 age-groups in the majority of countries. Physical violence (PV) by firearm was the main cause of IV in LA, followed by PV by other means. Women in LA experienced at least twice as many sexual violence DALYs as men. IV in LA exhibited heterogeneous trends, with certain countries witnessing a significant decline in the IV DALYs rate, while others displayed a significant increase. Our results show the great heterogeneity of IV burden present in the region as the trends varied from one country to another. Policing and criminal justice institutions in LA have failed to reduce crime and violence. Thus, tailored preventive measures and public policies that account for the specific context and geographical areas where this phenomenon is prevalent are urgently needed. [ABSTRACT FROM AUTHOR]

This study aimed to synthesize and compare the prioritization strategies outlined in the national vaccination plans (NVPs) against Coronavirus Disease 2019 (COVID-19) developed by countries in the Latin America and Caribbean (LAC) region. We conducted a comparative policy analysis based on COVID-19 NVPs. We conducted a search strategy in three stages to identify NVPs for COVID-19 across 41 countries/territories in the LAC region. Sources included official governmental repositories, complementary Google searches, and less formal documentation. We extracted key variables and conducted a comparative policy analysis based on the prioritization criteria and specific prioritization groups. The study identified 52 NVPs for COVID-19, corresponding to 27 (65.8 %) out of 41 countries/territories in the LAC region. Official national websites yielded documents for 12 countries. All NVPs included frontline healthcare personnel in the first prioritization phase/stage, whilst some included residents of long-term healthcare facilities, adults aged 60 years or more, and people with disabilities. The decision criteria for prioritization were declared in 14 countries/territories. Ethical considerations declared in five NVPs included human welfare, equality, solidarity, equity, and social justice as values. The early stages of vaccination rollout in LAC countries prioritized protection of the healthcare system and epidemiological risk for severe disease. Few countries included ethical considerations in their NVPs, and global inequities in vaccine access and distribution led to varied protections for vulnerable populations across LAC. This analysis highlights the need for improved emergency-response capacity, planning, and enhanced multilateral cooperation in the LAC region for future public health emergencies. [ABSTRACT FROM AUTHOR]

This study aimed to compare the prevalence and socio-economic determinants of frailty in older adults in Brazil and Chile using nationally representative survey data. Analytical research using data from the Brazilian Longitudinal Study of Aging (ELSI) and the Chilean National Health Survey (ENS) conducted in Brazil and Chile between 2015 and 2017. The study included 5484 older adults aged 60 years or older in Brazil and 2031 in Chile. Frailty was measured using the FRAIL index, and logistic regression models were used to identify the determinants of frailty. The prevalence of frailty is 15.6% and 12.6% in Brazil and Chile, respectively. Frailty is associated with several factors, including age, sex, living alone, residing in urban areas, and decreased life satisfaction. However, the analysis revealed notable differences between countries. A greater number of significant variables were associated with frailty in Brazil, whereas Chile displayed fewer categories with significant odds. Health insurance had no significant effect in either of the two countries. The limitations in data sources and methodologies make it challenging to compare frailty determinants in Latin America. This study overcomes these barriers and shows that, even within the same region, significant differences exist. Levels and characteristics that are important in one country may not be so in another. The results emphasize the need to consider contextual factors in the implementation of emerging social and healthcare policies, such as home-based long-term care. [ABSTRACT FROM AUTHOR]

The growing threat from pre-extensively drug-resistant tuberculosis (pre-XDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) poses a major public health concern in Latin America and the Caribbean (LAC). Therefore, this study aimed to summarize the available evidence on the prevalence of pre-XDR-TB and XDR-TB among patients with multidrug-resistant tuberculosis in LAC. A systematic review was conducted in the following databases on June 3, 2023: PubMed, Scopus, Ovid Medline, Web of Science, Scielo and LILACS. We estimated pooled proportions using a random effects model (Dersimonian and Laird). The 95% confidence intervals (95% CI) were calculated using the binomial exact method (Clopper-Pearson Method). Subgroup (by time period and country) and sensitivity analyses were performed. Twenty-nine studies were eligible for qualitative synthesis and 27 for meta-analysis (n = 15,565). The pooled prevalence of XDR-TB in the study participants was 5% (95% CI: 3%-6%), while that of pre-XDR-TB was 10% (95% CI 7%-14%). Cuba (6%, 95% CI 0%-17%) and Peru (6%, 95% CI 5%-7%) had the highest pooled prevalence of XDR-TB. Regarding pre-XDR-TB, Brazil (16%, 95% CI 11%-22%) and Peru (13%, 95% CI: 9%-16%) showed the highest prevalence. The pooled prevalence of pre-XDR-TB and XDR-TB in LAC was 10% and 5%, respectively. Governments should strengthen drug-resistance surveillance and TB programs. • The pooled prevalence of XDR-TB in LAC was 5%, being higher in Cuba and Peru. • The pooled prevalence of pre-XDR-TB in LAC was 10%, being higher in Brazil and Peru. • The highest prevalence of pre-XDR-TB was 12% between 2014 and 2020. • There was significant heterogeneity and high risk of bias in most of included studies. [ABSTRACT FROM AUTHOR]

This study aimed to characterize the burden of asthma-related issues in Latin American and Caribbean countries from 1990 to 2019 and to assess their relationship with the sociodemographic index (SDI). A cross-sectional analysis with an ecological approach was conducted. The disability-adjusted life years (DALYs) and the SDI data were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Linear regression models were used to evaluate the relationship of interest. During the study period, a total of 41.7 million DALYs were accounted, with the highest rates observed in children aged under 5 years (651, uncertainty interval [UI]: 369 to 1037 per 100,000) and females (342, UI: 241 to 471 per 100,000). In the multiple regression model based on data from 2019, a significant negative association was observed between the log-transformed DALY rates and the SDI. Specifically, for each unit increase in the SDI, asthma-related DALY rates decreased by an average of 0.97 % (95 % confidence interval: 0.48–1.00 %). This study highlights heterogeneous age, gender, and country-related variations in asthma rates across Latin American and Caribbean countries and emphasizes the influence of sociodemographic factors on its burden. [ABSTRACT FROM AUTHOR]

Infant mortality is a crucial indicator of socio-economic development, reflecting the conditions in which children are born and raised. Despite notable reductions in Latin America, infant mortality rates remain relatively high compared to other regions worldwide. By understanding the socio-economic factors that influence infant mortality, we not only uncover immediate causes of infant deaths but also shed light on broader socio-economic and healthcare disparities contributing to the burden of disease. This study analyzes the impact of socio-economic factors on infant mortality rates in Latin America from 2000 to 2019, estimating the speed and magnitude of the response of infant mortality rates to changes in specific socio-economic factors. Longitudinal panel study. Panel data regression models were used to examine the influence of specific socio-economic factors on infant mortality rates in Latin America. Additionally, impulse response functions estimated by local projections were used to estimate the speed and magnitude of the impact of socio-economic factors on infant mortality rates. The results highlight the importance of factors such as healthcare expenditure, female literacy, public expenditures on education, maternal mortality, physician density, total fertility rate, and tuberculosis incidence as significant determinants of infant mortality rates in the region. This study adds to the existing literature by offering empirical evidence on the association between these socio-economic factors and infant mortality in Latin America. It also provides a foundation for future research that investigates specific cases within Latin America and examines the variations of these socio-economic factors within those countries. [ABSTRACT FROM AUTHOR]

To estimate the current gap and the necessary supply of human resources for care (HRC) for older people experiencing severe care dependence in Latin America and the Caribbean (LAC). Simulation study using previous estimations of severe care dependence for LAC countries. Older people (aged 65+) experiencing severe care dependence in 26 countries of LAC. We calculated the current gap and the necessary supply of HRC in 2020, 2035, and 2050 assuming a mix of complementary human resources, in line with regional standards for long-term care (LTC) schemes, and differing levels of care coverage. Considering 100% coverage of LTC services for the population aged 65+ experiencing severe care dependence, the region will need almost 5 million people working full-time in the sector. This figure is expected to increase to more than 14 million by 2050. Nurse assistants and nurses will be the professional profiles in highest demand. In addition, the region requires 2 million rehabilitation professionals in 2020, and this figure will increase to more than 6 million in 2050. The rapid aging process in LAC will bring several challenges and opportunities to the region. Countries should start designing strategies to reduce the current gaps of HRC to meet older people's care needs in the coming years, in terms of both quantity and competencies, to help ensure that their human rights are met. [ABSTRACT FROM AUTHOR]

To evaluate gender differences in workplace violence (WPV) against physicians and nurses in Latin America. Cross-sectional study. A cross-sectional electronic survey was conducted between January 11 and February 28, 2022. A prespecified gender analysis was performed. Among the 3056 responses to the electronic survey, 57% were women, 81.6% were physicians, and 18.4% were nurses. At least one act of violence was experienced by 59.2% of respondents, with verbal violence being the most common (97.5%). Women experienced more WPV than men (65.8% vs 50.4%; P < 0.001; odds ratio [OR]: 1.89; 95% confidence interval [CI]: 1.63–2.19). Women were more likely to report at least one episode of WPV per week (19.2% vs 11.9%, P < 0.001), to request for psychological help (14.5% vs 9%, P = 0.001) and to experience more psychosomatic symptoms. In addition, women were more likely to report having considered changing their job after an aggression (57.6% vs 51.3%, P = 0.011) and even leaving their job (33% vs 25.7%, P = 0.001). In a multivariate analysis, being a woman (OR: 1.76), working in emergency departments (OR: 1.99), and with COVID-19 patients (OR: 3.3) were independently associated with more aggressive interactions, while older age (OR: 0.95) and working in a private setting (OR: 0.62) implied lower risk. Women are more likely to experience WPV and to report more psychosomatic symptoms after the event. Preventive measures are urgently needed, with a special focus on high-risk groups such as women. [Display omitted] [ABSTRACT FROM AUTHOR]

In this paper, we examine the factors influencing labor productivity and sales growth among micro, small, and medium-sized enterprises (MSMEs) within a middle-income economy. Although MSMEs play a pivotal role in employment within middle-income countries, they often display a lower economic value-added, pointing to underlying challenges in labor productivity. Using a longitudinal dataset of firms and employing both quantile regressions and machine learning techniques, we find that SMEs led by older, male, and more seasoned managers tend to exhibit higher productivity. Similarly, companies with a larger proportion of highly educated employees, affiliation to business groups, and engagement in R&D activities demonstrate superior performance. Finally, to improve the performance of MSMEs in developing economies, our results suggest that implementing targeted, well-defined vertical public support programs would be an effective public policy approach. [ABSTRACT FROM AUTHOR]

Copyright of Value in Health Regional Issues is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Contemporary ethnobiologists employ the biocultural approach to different contexts and countries, and they seek to describe the relationship between biological and cultural diversity. For Latin American researchers, this approach is particularly interesting from a critical standpoint. We offer a review of the concept of "biocultural", departing from Mexican ethnobiologist contributions. Later, we analyze different uses of this concept in several regional meetings, including the SOLAE Congress of 2015 in Colombia, the SOLAE Congress of 2017 in Ecuador, and the SOLAE Congress of 2019 in Bolivia. Likewise, we reflect on the 2018 congress at Belém do Pará, Brazil, which commemorated the creation of the ISE there thirty years earlier. We argue that the importance of the biocultural approach becomes influential insofar as non-academic and academic people meet and promote Latin American discussion in terms of local realities. [ABSTRACT FROM AUTHOR]

• Latin American central line-associated bloodstream infections (CLABSI) rates are higher than those of high income countries. • Our objective is to identify CLABSI rates and risk factors in Latin American intensive care units (ICUs). • Length of stay, duration of central line, femoral, arterial and jugular increase CLABSI risk. • Public hospital, and Medical-surgical ICU increase CLABSI risk. • PICC was not associated with risk for CLABSI. Our objective was to identify central line (CL)-associated bloodstream infections (CLABSI) rates and risk factors in Latin-America. From January 1, 2014 to February 10, 2022, we conducted a multinational multicenter prospective cohort study in 58 ICUs of 34 hospitals in 21 cities in 8 Latin American countries (Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama). We applied multiple-logistic regression. Outcomes are shown as adjusted-odds ratios (aOR). About 29,385 patients were hospitalized during 92,956 days, acquired 400 CLABSIs, and pooled CLABSI rate was 4.30 CLABSIs per 1,000 CL-days. We analyzed following 10 variables: Gender, age, length of stay (LOS) before CLABSI acquisition, CL-days before CLABSI acquisition, CL-device utilization (DU) ratio, CL-type, tracheostomy use, hospitalization type, intensive care unit (ICU) type, and facility ownership, Following variables were independently associated with CLABSI: LOS before CLABSI acquisition, rising risk 3% daily (aOR=1.03;95%CI=1.02-1.04; P <.0001); number of CL-days before CLABSI acquisition, rising risk 4% per CL-day (aOR=1.04;95%CI=1.03-1.05; P <.0001); publicly-owned facility (aOR=2.33;95%CI=1.79-3.02; P <.0001). ICU with highest risk was medical-surgical (aOR=2.61;95%CI=1.41-4.81; P <.0001). CL with the highest risk were femoral (aOR=2.71;95%CI=1.61-4.55; P <.0001), and internal-jugular (aOR=2.62;95%CI=1.82-3.79; P <.0001). PICC (aOR=1.25;95%CI=0.63-2.51; P =.52) was not associated with CLABSI risk. Based on these findings it is suggested to focus on reducing LOS, CL-days, using PICC instead of femoral or internal-jugular; and implementing evidence-based CLABSI prevention recommendations. [ABSTRACT FROM AUTHOR]

Pediatric surgery is a developing specialty with increasing volume in Latin America. However, the research and scientific activity trends carried out in this region in recent years are unknown. This study aimed to analyze and visualize Latin American research in pediatric surgery from 2012 to 2021. Bibliometric cross-sectional study of scientific articles on pediatric surgery published by Latin American authors from 2012 to 2021 in Scopus was performed. Statistical and visual analysis was performed with R programming language and VOS viewer. 449 articles were found. Observational studies (44.7%; n = 201), case reports (20.4%; n = 92) and narrative reviews (11.4%; n = 51) were found to be the most common study designs. The published articles were predominantly monocentric (73.1%; n = 328), only 17% (n = 76) involved authors from 2 or more countries, and mostly there was no collaboration with high-income countries (80.6%; n = 362). The Journal of Pediatric Surgery was the journal with the highest volume of articles published (n = 37). The most used terms were Laparoscopy, Complications, and Liver Transplantation, and the countries with the highest number of articles published were Brazil and Argentina. This study found a progressive increase in the scientific activity of Latin authors in pediatric surgery from 2012 to 2021. The evidence produced was mainly from observational studies and case reports, predominantly conducted in Brazil. Multinational and international collaboration was low; the most frequent topics of interest were laparoscopy and minimally invasive surgery. IV. [ABSTRACT FROM AUTHOR]

Barriers to neurosurgery training and practice in Latin American and Caribbean countries (LACs) have been scarcely documented. The World Federation of Neurosurgical Societies Young Neurosurgeons Forum survey sought to identify young neurosurgeons' needs, roles, and challenges. We present the results focused on Latin America and the Caribbean. In this cross-sectional study, we analyzed the Young Neurosurgeons Forum survey responses from LACs, following online survey dissemination through personal contacts, social media, and neurosurgical societies' e-mailing lists between April and November 2018. Data analysis was performed using Jamovi version 2.0 and STATA version 16. There were 91 respondents from LACs. Three (3.3%) respondents practiced in high-income countries, 77 (84.6%) in upper middle-income countries, 10 (11%) in lower middle-income countries, and 1 (1.1%) in an unclassified country. The majority (77, or 84.6%) of respondents were male, and 71 (90.2%) were younger than 40. Access to basic imaging modalities was high, with access to computed tomography scan universal among the survey respondents. However, only 25 (27.5%) of respondents reported having access to imaging guidance systems (navigation), and 73 (80.2%) reported having access to high-speed drills. A high GDP per capita was associated with increased availability of high-speed drills and more time dedicated to educational endeavors in neurosurgery, such as didactic teaching and topic presentation (P < 0.05). This survey found that neurosurgery trainees and practitioners of Latin America and the Caribbean face many barriers to practice. These include inadequate state-of-the-art neurosurgical equipment, a lack of standardized training curricula, few research opportunities, and long working hours. [ABSTRACT FROM AUTHOR]

To describe the demographic and clinical features, as well as the frequency of the HLA-B*51 allele in Behçet disease (BD) patients in Latin American countries. A systematic literature review of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines was conducted without performing a meta-analysis. We included observational studies (cross-sectional or cohort) of BD patients fulfilling the International Study Group for BD classification criteria and reported the demographic, clinical, and laboratory features of the disease in adult patients. Twelve studies were included in the SLR. Information from 532 patients across 5 Latin American countries was included for the analysis. Mean age at disease diagnosis was 33 years, 58.3% were female and 41.7% male; most patients were non-Caucasian. The most common clinical manifestations were recurrent oral ulcers and genital ulcers, followed by skin, eye, joint, neurological, gastrointestinal, vascular, and cardiac involvement. The prevalence of BD was described in 2 studies, 1 conducted in Brazil that reported a prevalence of.3/100,000 inhabitants, and another in Colombia with a prevalence of 1.1/100,000 inhabitants. The frequency of HLA-B*51 allele in BD patients was 38%, 30.1%, and 9% in Argentina, Brazil, and Mexico, respectively. The prevalence of BD in the Latin American countries seems to be low, as well as the frequency of HLA-B*51 allele. However, the strength of association between HLA-B*51 and BD remains high in our population. The key clinical features of BD are like those reported in countries/regions where BD is endemic. [ABSTRACT FROM AUTHOR]

Latinx youth are a population of concern, at elevated risk for chronic diseases and with poor adherence to dietary recommendations. To examine Latinx seventh-grade students' perceptions of the factors that influence their diet and eating behaviors. This qualitative research used focus groups and an inductive content analysis approach. Five sex-stratified focus groups (three groups with females) with 35 primarily Latinx seventh-grade students were conducted at two local Title 1 public middle schools in a large metropolitan area of the Southwestern United States. The discussion protocol included questions about participants' food choices, the role of their parents in their diet, and healthy body-related concerns among their peers. Verbatim transcripts were coded in NVivo 12 on the basis of specificity, extensiveness, and frequency. Themes emerged from group dialogue, detailed conversations, and predominant topics of discussion, and aligned with ecological systems theory. Participants referred to factors influencing Latinx seventh-grade students' eating behaviors at the individual, family, household, and school levels. At the individual level, participants described their eating as unhealthy and perceived it as determined by taste, convenience, ease of preparation, and home availability. Participants expressed concerns about diabetes because of their body weight and family history, and identified those concerns as reasons for acceptance of healthy foods and the desire for parents to model healthy eating behaviors. Family-level factors perceived as influencing dietary behaviors included the role of parents as providers of food and models of unhealthy eating, budget constraints, and availability (or lack thereof) of healthy foods at home. Similarly, the identified school-level factors aligned with availability and quality of foods in that environment. Family- and household-related factors emerged as important influences on seventh-grade students' dietary behaviors. Future diet interventions should incorporate strategies targeting these multiple-level factors that influence dietary intake for Latinx youth and that address the concerns related to disease risk. [ABSTRACT FROM AUTHOR]

• There is scarce evidence about the impact of personal experiences and contextual variables on preferences for risk reduction. • We analyzed differences in the impact of personal experiences and contextual variables in three Latin American countries. • We present evidence of heterogeneous impacts of personal experiences and contextual variables in preferences for risk reduction across individuals and countries. This article explores how preferences for risk reduction during the COVID-19 pandemic are influenced by personal experiences and contextual variables such as having a close friend or relative who has been infected by the virus (closeness), the severity of the illness (severity), people's own perceptions of being in a risky group (risk group), change in employment status due to the pandemic (employment situation), and vaccination status (vaccination status and altruistic vaccination). We conducted a choice experiment (CE) in Chile, Colombia, and Costa Rica. The attributes of the experiment were risk reduction, latency, and cost. Then, we estimated a mixed logit model to capture preference heterogeneity across the countries. The attributes presented in the CE were statistically significant, with the expected sign in each country. The variables closeness and employment situation presented homogeneous behavior in each country; however, severity , risk group, and vaccination status showed mixed results. We found that preferences were more heterogeneous for the attributes of the CE than for the personal experiences and contextual variables. Understanding the impact of these variables is essential for generating more effective risk reduction policies. For instance, methodologies such as the value of statistical life base their calculations on society's valuation of risk reduction. We provide evidence that the preferences for risk reduction vary due to the everyday situations that individuals face in the context of the pandemic. The latter may cause distortions in the values used to evaluate policies aimed at mitigating the outbreak. [ABSTRACT FROM AUTHOR]

To describe efficacy, safety, and patient-reported outcomes (PROs) in patients with rheumatoid arthritis (RA) with an inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) treated with tofacitinib or biological DMARDs (bDMARDs) in real-life conditions. A noninterventional study was performed between March 2017 and September 2019 at 13 sites in Colombia and Peru. Outcomes measured at baseline and at the 6-month follow-up were disease activity (RAPID3 [Routine Assessment of Patients Index Data] score), functional status (HAQ-DI [Health Assessment Questionnaire] score), and quality of life (EQ-5D-3L [EuroQol Questionnaire]). The Disease Activity Score-28 (DAS28-ESR) and frequency of adverse events (AEs) were also reported. Unadjusted and adjusted differences from baseline were estimated and expressed as the least squares mean difference (LSMD). Data from 100 patients treated with tofacitinib and 70 patients with bDMARDs were collected. At baseline, the patients' mean age was 53.53 years (SD 13.77), the mean disease duration was 6.31 years (SD 7.01). The change from baseline at month 6 was not statistically significant different in the adjusted LSMD [SD] for tofacitinib vs. bDMARDs for RAPID3 score (−2.55[.30] vs. −2.52[.26]), HAQ-DI score (−.56[.07] vs. −.50[.08]), EQ-5D-3L score (.39[.04] vs..37[.04]) and DAS28-ESR (−2.37[.22] vs. −2.77[.20]). Patients from both groups presented similar proportions of nonserious and serious AEs. No deaths were reported. Changes from baseline were not statistically significantly different between tofacitinib and bDMARDs in terms of RAPID3 scores and secondary outcomes. Patients from both groups presented similar proportions of nonserious and serious AEs. NCT03073109. [ABSTRACT FROM AUTHOR]

The successful implementation of clean cooking programs can considerably impact health, CO2 emissions, and household safety. However, this success will depend on the extent to which clean cooking programs target the right populations, and account for potential adoption barriers. To identify who these populations are, the present work relies on comparable household datasets from Guatemala, Peru, and Ecuador, and econometric analysis. Findings show that the characteristics of populations that clean coking programs should target vary considerably by country, and that households that are urban, more educated and with a female head, are most likely to adopt clean cooking. These quantitative results, however, only capture one side of the story. The other side has to do with potential barriers to adoption. To identify these barriers, we conduct a thorough review of the existing literature and complement it with findings from semi-structured interviews carried out during fieldwork. We find that barriers exist both before and after the initial adoption, and that the most important ones are informational, institutional, and cultural and traditional. To the best of our knowledge, this work is the first to rely on comparable household datasets and qualitative evidence to assess clean cooking programs in Guatemala, Peru and Ecuador. • Clean cooking improves life expectancy and reduces air pollution. • Urban and female-led households are more likely to adopt. • Income as a determining factor is inconclusive. • The strongest barriers to adoption are informational, institutional, and traditional. • Programs need to be tailored to country and local community needs. [ABSTRACT FROM AUTHOR]

This paper investigates greenhouse gas emissions convergence among nineteen Latin American countries, for the period 1970 to 2018. To that end, we use the Phillips–Sul methodology to examine whether these countries have followed an absolute convergence process, or whether there has been a club convergence process. Our results offer important insights into the greenhouse gas emissions catch-up exhibited by several countries, and do not support the hypothesis that all countries of the Latin American region, taken together, converge to a single equilibrium in greenhouse gas emissions intensity. We find strong evidence of subgroups that converge to different steady states. An iterative testing procedure reveals the existence of different patterns of behavior and shows that such emissions are not uniform across these countries. We also estimate an Ordered Logit Model to identify the forces underlying the creation of clubs and the likelihood that any given country will be a member of any convergence club. Estimates from an Ordered Logit Model reveal that income, population density, openness, natural resources rents, and – particularly – the level of corruption, play a crucial role in explaining the formation of convergence clubs. The existence of clubs means that the climate policies aimed at reducing emissions should consider the specific characteristics of the countries, according to the club convergence results. [Display omitted] • We investigate greenhouse gas emissions convergence among nineteen Latin American countries for the period 1970 to 2018. • Results do not support the hypothesis that all countries convergence to a single equilibrium state. • We find strong evidence of subgroups that converge to different steady states. • Income, population density, openness, natural resources, and the level of corruption, play a crucial role in explaining the formation of convergence clubs. [ABSTRACT FROM AUTHOR]

Background: Chile's landmark food labeling and advertising policy led to major reductions in sugar purchases. However, it is unclear whether this led to increases in the purchases of nonnutritive sweeteners (NNS). Objectives: The objective of this study was to assess the changes in NNS and caloric-sweetened (CS) products purchased after the law's first phase. Methods: Longitudinal data on food and beverage purchases from 2,381 households collected from January 1, 2015 to December 31, 2017, were linked to nutritional information and categorized into added sweetener groups (unsweetened, NNS-only, CS-only, or NNS with CS). Logistic random-effects models and fixed-effects models were used to compare the percentage of households purchasing products and the mean volume purchased by sweetener category to a counterfactual based on pre-regulation trends. Results: Compared with the counterfactual, the percentage of households purchasing any NNS beverages (NNS-only or NNS with CS) increased by 4.2 percentage points (pp) (95% CI: 2.8, 5.7; P < 0.01). This increase was driven by households purchasing NNS-only beverages (12.1 pp, 95% CI: 10.0, 14.2; P < 0.01). The purchased volume of beverages with any NNS increased by 25.4 mL/person/d (95% CI: 20.1, 30.7; P < 0.01) or 26.5%. Relative to the counterfactual, there were declines of -5.9 pp in households purchasing CS-only beverages (95% CI: -7.0, -4.7; P < 0.01). Regarding the types of sweeteners purchased, we found significant increases in the amounts of sucralose, aspartame, acesulfame K, and steviol glycosides purchased from beverages. Among foods, differences were minimal. Conclusions: The first phase of Chile's law was associated with an increase in the purchases of beverages containing NNS and decreases in beverages containing CS, but virtually no changes in foods. [ABSTRACT FROM AUTHOR]

The Latin American region has been marked by a historic process of extractivism and weak institutional structures, causing deep socio-environmental and economic crises. The resaturation of territorial justice has then become the center of the debate. Nature-based solutions, for their innovative and systemic nature, could be key in approaching these complex problems. However, the interplay between these strategies and justice is not clear enough. This article addresses this interaction centering on protected areas, the most traditional response from regional governments to nature degradation. We attempt to test the hypothesis that integrating protected areas in land use planning policies improves the exercise of justice, understanding it from a place-based point of view. To this end, we carried out quali- and quantitative analysis of social perceptions, historical background, land use policies and governance in Tandil and Tornquist, two municipal districts of the Province of Buenos Aires, Argentina. The results showed that i) protected areas were associated with justice if a conservation project reached a legal rule and if the community was involved in its formulation and management; ii) the integration of protected areas in land use planning policies helped to satisfy both conditions. We end by proposing a theoretical model which outlines how three strengths of land use planning can turn PAs into more just NbS. We also discuss the need to develop a broader and place-based approach of justice as "territorial justice". • More comprehensive and place-based senses of justice are necessary. • Territorial justice expresses a decolonizing sense of justice. • Protected areas are a special kind of nature-based solutions (NbS). • Integrating NbS in land use planning (LUP) is key to achieve territorial justice. • LUP's main strengths are being local, participative, comprehensive and justice-oriented. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had negative effects on mental health. Understanding sex and age differences in the perception of stressors, the use of coping strategies, and the prevalence of depression and anxiety can lead to detecting at-risk groups. A cross-sectional online study surveyed perceived stressors, coping strategies, and the PHQ-9 and GAD-7 rating scales for symptoms of depression and anxiety. The study was open from Spring 2020 to Spring 2021 and was aimed at children, adolescents and young adults of Latin America. The survey was completed by 3965 participants (63.8% females). The sample was divided into children (N = 621, 15.7%), adolescents (N = 1123, 28.3%) and young adults (N = 2021, 56%). Moderate to severe symptoms of depression and anxiety were found in 43.53% and 27%, respectively, being more frequent in females. Children of both sexes showed the lowest scores in rating scales. Adult females reported a higher level of stress in regards to pandemic news, having someone close diagnosed with COVID-19,the possibility of getting sick, academic delays, economic impact, and depression, while female adolescents reported a higher level of stress regarding the lockdown, losing contact with peers and anxiety. In juxtaposition, females also reported a higher frequency of positive coping strategies. A multivariate analysis confirmed the association of several variables with the presence of depression and anxiety. A high prevalence of depression and anxiety was found among young people. Specific intervention programs must be created taking into account age and sex differences. [ABSTRACT FROM AUTHOR]

The incidence of cancer in Latin America and the Caribbean (LAC) is increasing yearly and is expected to reach 2.4 million new cases by 2040, with a more pronounced effect in Central America and South America. In addition, cancer is already the most frequent cause of premature death for most countries in LAC, and the second cause of death independent of country socioeconomic status, clearly demonstrating that the cancer burden in LAC should be addressed now rather than considered as an issue to be dealt with in the future. LAC countries performed in a mid-range zone in terms of income and mortality-to-incidence ratio compared to other countries globally. The LAC continent has, in general, a median income per capita and a median availability of radiotherapy (RDT) machines per capita. Patients that have private health coverage are more likely to receive preventive care such as pap smears and mammography in many countries of the LAC. The human development index was negatively related to mortality from oral cancer in the LAC countries with medium and low Human Development Index (HDI). Cancer treatment adverse events can negatively affect survivors' workability compromising their return to work after diagnosis. In conclusion, the cancer burden can be a major public health issue with a considerable socioeconomic impact in LAC countries. It is demonstrated in several studies that unequal access to optimal care is frequent in LAC and that health insurance type may impact patients' diagnosis and outcome. [ABSTRACT FROM AUTHOR]

To assess the real-world application of legislative measures and regulations governing newborn hearing testing in Latin America. An online survey was sent to the Interamerican Association of Pediatric Otorhinolaryngology (IAPO) network to investigate neonatal hearing screening practices. Twelve questions were asked about legislation, implementation, and barriers to neonatal hearing screening. A total of 89 pediatric otolaryngologists representing 20 Latin American nations participated in this survey. The majority of respondents (64 %) indicated the existence of neonatal hearing laws within their respective countries and correctly named the specific legislation. However, it is noteworthy that over half (58 %) of pediatric ear, nose, and throat specialists reported that these laws are not consistently put into practice in their daily clinical routines. Respondents from five countries disclosed that neonatal hearing screening is not conducted within the first month of an infant's life. While the majority of Latin American nations have established legislation concerning neonatal hearing screening, its application in clinical practice is lacking due to economic obstacles. Marked disparities across Latin America persist for neonatal hearing screening. Our study provides key insights and recommendations aimed at addressing these issues, including the need for stronger legislative enforcement, increased funding, improved infrastructure, targeted professional training, and expanded public education to strengthen this vital aspect of healthcare in Latin America. [ABSTRACT FROM AUTHOR]

A large and growing literature argues that the agricultural labor market is stratified by ethnicity and legal status. However, other markers of distinction, such as indigeneity, may overlap with legal status to reveal additional health inequalities. Our study contributes to this scholarly dialogue by assessing the relation between indigeneity, legality, and health among immigrant-origin farmworkers from Latin America. To this end, we use data from the National Agricultural Worker Survey (N = 21,092) to examine health outcomes among indigenous and non-indigenous immigrants. Results indicate that indigenous farmworkers experience higher rates of pain—but not chronic conditions—than their non-indigenous counterparts. While undocumented farmworkers who are not indigenous exhibit especially favorable health, indigenous workers who are documented are significantly more likely to suffer from pain. Finally, there is limited evidence that differences in insurance coverage can fully explain the patterning between legal status, indigeneity, and health. This project sheds light on the well-being of indigenous migrant laborers in the U.S. food system, a population that experiences pervasive barriers to socioeconomic advancement at home and abroad. • We ask whether indigeneity and legality are correlated with farmworker health. • Undocumented, non-indigenous farmworkers have especially good health. • Indigenous workers—especially the documented—are most likely to report pain. • Health insurance increases the odds of farmworkers reporting chronic conditions. • Insurance does not fully explain patterning between legal status, indigeneity, and health. [ABSTRACT FROM AUTHOR]

• This paper examines the connection between exposure to drug trafficking and school truancy in Costa Rica. • We use a unique microdata set that merges information on cocaine seizures and socioeconomic characteristics of Costa Rican districts with student and school data from the Programme for International Student Assessment (PISA). • Results show that students in districts with higher exposure to drug trafficking are more prone to school truancy. Exposure to crime and violence associated with drug trafficking has been shown to have negative consequences on students' health, peer relationships, and educational outcomes. However, little attention has been devoted to analyzing the effects of exposure to drug trafficking on students' truancy behavior, a critical outcome with a high cost at an individual and societal level. This study investigates the connection between exposure to drug trafficking (an increasingly common form of chronic crime and subsequent violence in Latin America) and school truancy in Costa Rica. To do so, we use a unique and comprehensive microdata set that merges detailed information on a specific measure of exposure to drug trafficking (cocaine seizures) and socioeconomic characteristics of Costa Rican districts with student and school data from the Programme for International Student Assessment (PISA). In total, we obtain a sample of 4,584 students in secondary education attending 195 schools in 147 districts. Using logistic regression, we find that students in districts with higher exposure to drug trafficking (measured by cocaine seizure rate) are more prone to school truancy. This finding suggests that strategies to tackle school truancy should consider a neighborhood context perspective. [ABSTRACT FROM AUTHOR]

What explains prison recidivism? Relying on previously unavailable data on prison inmates in Uruguay, we study how external factors, such as employment dynamics on labor-intensive low-skilled jobs, and internal, such as prison-related factors, affect recidivism. Whereas the literature on recidivism has mostly focused on developed countries, we bring its study to the developing world and find that greater employment opportunities in labor-intensive, low-skill sectors, such as construction and domestic services, reduce recidivism. Consistent with the logic of economic opportunities, we also find heterogeneous effects by type of crime (property vs non-property). Finally, we find that prison-specific factors are also relevant, pointing to the importance of understanding prisons as part of the illegal ecosystem and the crime repression system. This analysis is novel to Latin America, a region besieged by the growing influence of criminal organizations that usually extend their influence and power to prisons. • We study how employment dynamics and prison-related factors affect recidivism. • Greater opportunities in labor-intensive, low-skill sectors, reduce recidivism. • We find heterogeneous effects by type of crime. • Findings point to researching prisons' role in illegal and crime repression systems [ABSTRACT FROM AUTHOR]

University rankings have become a widespread tool for assessing and comparing the performance of higher education institutions worldwide. Over time, these rankings have evolved into crucial references for both students and academic institutions when making decisions. Several well-established university rankings, such as the QS and Scimago Ranking, utilize various evaluation criteria to classify universities. However, these criteria may adversely affect universities in different regions, including Latin America. In this study, we aim to address the unique reality of Latin American universities, considering their specific characteristics and challenges. Our focus will be on a comprehensive review of the evaluation criteria used in these two renowned rankings and their impact on the region, including how they influence the performance of universities. We propose a novel ranking model using the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) to counter these potential biases and regional disparities. This multicriteria optimization approach enables us to evaluate and compare universities based on multiple criteria, considering their similarities to the ideal solution and differences from the anti-ideal solution. By adopting the TOPSIS method, we aim to create a more robust and balanced approach incorporating carefully selected criteria. It allows us to include economic and inclusion criteria often overlooked in conventional rankings. Our study seeks to establish a fairer, more relevant university ranking system tailored to Latin America's needs and aspirations. Our proposed TOPSIS-based model aims to contribute significantly to the ongoing discussions on higher education excellence in Latin America by providing a comprehensive evaluation considering the region's specific circumstances. [ABSTRACT FROM AUTHOR]

Electrification is a key pillar in energy transformation to reduce emissions. However, it may also have consequences on production. This study analyzes the effect of using electricity and non-electricity energy sources on production growth. An extended neoclassical production function, with the two uses of energy (electricity and non-electricity), is estimated for 17 Latin American countries from 1990 to 2019 and, for subsamples, based on the level of production per persons employed. The study is performed applying the cross-sectionally augmented, autoregressive distributed lag modeling approach and a non-parametric time-varying coefficients model. The parametric results indicate that the effect of both sources of energy on production are positive and significant. However, the production elasticity with respect to non-electricity consumption is higher than that with respect to electricity consumption. Only in countries with the lowest production levels could electrification be neutral. The non-parametric results show that the effect of non-electricity consumption is decreasing slightly over the period, while the effect of electricity use is increasing slightly, with a tendency towards stabilization at the end of the period. Nevertheless, these changes have been small. • The effect of electricity and non-electricity consumption on production is studied. • An extended neoclassical production function is estimated for Latin America. • The production elasticity to non-electricity consumption is higher than to electricity. • Energy conservation policies cannot be applied without impacting production. • Energy transition based on electrification should be conducted gradually. [ABSTRACT FROM AUTHOR]

We study the potential impact of the commodity price boom of 2003 to 2013 on public social spending in Latin America. We estimate structural vector autoregressions and local projections for 16 Latin American countries over the period from 1990 to 2019 and investigate if we can attribute increases in public spending on health, education, and social protection to increases in a country's net commodity terms-of-trade. By focusing on the impulse responses derived from country-specific estimations, we find a huge variety in response patterns. Our study finds that two countries experienced lasting increases in public social spending due to the commodity boom (Argentina, Ecuador). Some others observed at least temporary increases of few years (Brazil, Mexico), reacted first with declines and then rises (Chile), and yet others did not respond at all (Bolivia, Colombia, Peru). As expected, we cannot relate public social spending with commodity prices in countries without commodity price boom. Among countries with positive responses, there is no clear tendency concerning the function of spending that benefits most. We discuss potential explanations behind the heterogeneity of our country-wise results and conclude that the presence of left-wing governments, fiscal rules, natural resource funds and economic diversification provide plausible explanations for single country cases, but no general patterns emerge. We conclude that the commodity price boom was neither necessary nor sufficient for social policy expansion in Latin America, and factors explaining its effects differ from country to country. Our study highlights the importance of in-depth examinations of country-specific factors and the need of (currently lacking) high-quality time series data in development research. • Analysis of the effect of commodity price changes on different types of public social spending in commodity-dependent Latin American countries. • Social spending shows heterogeneous responses across countries, ranging from long-lasting positive effects to no reactions. • There is no clear tendency which of the main functions of public social spending benefits most from an increase in commodity prices. • General determinants of public social spending cannot explain the heterogeneity of the results. • The commodity price boom 2003–2013 was neither a necessary nor a sufficient condition for increasing public social spending in Latin America. [ABSTRACT FROM AUTHOR]

While formal institutions are considered rather stable in Western countries, the same cannot be said of those in Latin America and the Caribbean (LAC). In LAC, these institutions are superseded by nonformalized but deeply embedded practices—especially of political favoritism. Accordingly, this paper explores how members of parliament in LAC favor their birth regions by providing clientelistic goods and services to their constituents. The paper shows that the development of subnational regions is affected by their proximity to parliament leaders' birthplaces. We collect data on 366 political leaders' birth locations over 1992–2016 and construct a panel of approximately 183,000 subnational micro–regions across 45 LAC countries/autonomous territories. Our results show that incumbent parliament leaders favor regions near their birthplaces, as measured by night light emissions and World Bank aid. This favoritism is enabled by the patterns of formal institutional weakness, and de jure plus de facto influence given to the parliament by the particularly unstable constitutions of LAC countries. • In LAC, institutions are often overshadowed by non–formalized but deeply embedded corrupt practices such as favoritism. • This study shows how the development of subnational regions is affected by their proximity to parliament leaders' birthplaces. • It comprises approximately 183,000 subnational micro–regions across 45 LAC countries/autonomous territories. • Data was collected on 366 political leaders' birth locations over the years 1992–2016. • Leaders of parliament in LAC favor their birth regions by providing clientelistic goods and services to their constituents. • Not just presidents but also parliament leaders engage in regional favoritism. [ABSTRACT FROM AUTHOR]

Labor unions play a key role in the defense of workers' rights and in the construction of more egalitarian societies. Despite this, few empirical investigations have analyzed how attitudes toward labor unions are shaped by subjective manifestations of inequality. Bringing together the sociological and social-psychological research on inequality, in this article we do so by studying how attitudes towards unions are shaped by class identification and by ideal inequality, understood as the level of inequality that people consider ideal or fair. Using data from the 2020 Latinobarómetro survey for 18 Latin American countries, we find that pro-union attitudes are significantly higher among those who identify with the lower-middle class but not among those who identify with the lower class. We also find a negative relationship between ideal inequality, measured by a pseudo-Gini index of ideal inequality, and pro-union attitudes: those who want less economic inequality have more positive attitudes towards unions. Finally, we find that the effect of class identification and ideal inequality is moderated by individual political orientations. At the end of this article, we explain these findings and show how they contribute to the recent research on subjective inequality and attitudes toward labor unions. • We study how attitudes towards labor unions are shaped by subjective inequality • Subjective inequality is measured as class self-placement and ideal inequality • Data from Latin America show that subjective inequality shapes attitudes to unions • For instance, pro-union attitudes are higher among those who want less inequality • This relationship is moderated by political position [ABSTRACT FROM AUTHOR]

Adverse Childhood Experiences (ACEs) are widely recognized as significant predictors of poor mental health in adulthood. Latin America presents several unique challenges regarding ACEs, such as higher prevalence of violence and income and political inequality. However, little is known about this issue from nationally representative samples in the region, particularly in Chile. This investigation examines the association between individual and cumulative ACE scores and seven self-reported mental health conditions (substance abuse, depression, PTSD, generalized anxiety, suicide ideation, non-suicidal self-harm, and learning disorders) in a representative Chilean urban sample. A representative urban sample of 2101 adult Chileans completed the International Adverse Childhood Experiences Questionnaire (ACE-IQ) and disclosed any prior mental health diagnoses. Around 40 % of the sample had experienced four or more ACEs in their lifetime. For these individuals, the risk of reporting a mental health disorder was significantly higher. Several logistic regression analyses were conducted to address the associations between ACEs and the seven mental health conditions. Notably, sexual abuse, bullying, and exposure to collective violence were the ACEs most strongly associated with self-reported mental health issues. Additionally, a cumulative ACE score was found to be a significant predictor of having a previous mental health diagnosis. We found a significant predictive association between exposure to collective violence and six out of the seven self-reported mental health disorders. Similarly, sexual abuse demonstrated an association with all mental health conditions. Finally, individuals who experienced four or more ACEs had a notably higher chance of reporting a previous mental health diagnosis. We recommend conducting further ACE research in Latin America due to its cultural and contextual singularities. [ABSTRACT FROM AUTHOR]