Inter-American Institute

Abstract Intestinal perforation is a surgical emergency associated with a significant morbidity and mortality. Current repair techniques such as primary suturing may be inefficient. The aim of this study was to evaluate the efficacy of autologous parietal peritoneal patch for the repair of small intestinal perforations. Twelve dogs were randomly assigned to two groups: Group A (n = 6) underwent repair using a parietal peritoneal patch, while Group B (n = 6) received conventional primary suturing. Animals were monitored clinically for 8 weeks. At endpoint, macroscopic and histological outcomes were assessed. All 12 dogs survived without major complications. The peritoneal patch group showed organized healing with neomucosal regeneration, minimal adhesions, and no stricture formation. In contrast, the control group showed more extensive adhesions, fibrosis, and stricture formation. Histological examination confirmed mature granulation tissue and epithelial coverage in Group A. Autologous parietal peritoneal patch offers a promising, biologically compatible technique for intestinal perforation repair. Compared to primary suturing, this approach reduced adhesions and enhanced tissue healing. Further studies are needed to validate its potential in gastrointestinal surgery.

Dengue is endemic throughout the tropical areas of the Americas, but little is known about its regional dynamics. We examined seasonal and multiannual dengue trends across the Americas and possible underlying mechanisms using monthly dengue surveillance data from 14 countries. We collected monthly dengue case data from 241 subnational locations in 14 countries, ranging from 1985 to 2018 (6 to 22 years), and used wavelet analysis to isolate seasonal (8 to 16 months) and multiannual (17+ months) patterns. For each location, we assessed seasonal and multiannual dynamics as well as coherence and differences in timing of dengue cycles between 22,578 location pairs. We assessed patterns in coherence over time and space and compared these patterns to variations in temperature, rainfall, and El Niño Southern Oscillation patterns. Strong synchrony in dengue dynamics was identified across the region at the seasonal and multiannual scales. Seasonal dengue dynamics were associated with local climate patterns and dengue dynamics in nearby locations. High synchrony at multiannual scales indicated that large dengue epidemics were shared across the region, with an average temporal lag of only 6 months at distances of up to 10,000 kilometers. Synchrony of these epidemics likely reflects both regional climate variability and human movement. Observed dengue dynamics were not unique to individual countries in the Americas but rather extended across the region reflecting climatic and nonclimatic drivers. These findings can support the development of better early warning tools to support epidemic preparedness and response and underscore the importance of working collaboratively across borders.

Este trabajo relata un encuentro entre mujeres científicas en el marco de la Sociedad de Toxicología y Química Ambiental Latinoamericana (SETAC-LA de las siglas en inglés) titulado +Mujeres +Ciencia. Tuvo como objetivo intercambiar sobre las diferentes dimensiones de hacer y pensar ciencia generada por y para las mujeres en forma flexible, crítica e interactiva. Nos interesaba intercambiar sobre los aspectos que tienen nuestras formas de trabajo y estudio, investigación, comunicación y aplicación de los resultados. El encuentro inició con una breve introducción por parte de las organizadoras, planteando el objetivo y la dinámica de trabajo. Fue seguida de cuatro presentaciones de las invitadas, científicas y hacedoras de la ciencia en la región, que trabajan con aspectos de género desde distintas perspectivas. Utilizando las presentaciones como punto de partida, para luego intercambiar con las y los asistentes, sobre las observaciones, desafíos y dificultades compartidas por las mujeres disertantes respecto de la ciencia por y para mujeres. El encuentro fue muy emotivo y movilizador. Emotivo y movilizador porque consideramos que todas nos encontramos en los relatos y sentires de las demás compañeras. Nos hizo pensar en lo importante que es generar nuestros encuentros, para escucharnos. Este texto pretende plasmar lo sucedido, compartirlo en el lenguaje que sabemos hablar las científicas, como trabajadoras de la palabra, nuestra tarea es crear retóricas de valor que dejen señales, hagan historia, así como lo hicieron otra por nosotras, un camino sembrado de sororidad, con la certeza de que no estamos ni estaremos solas en nunca más.

The recent Intergovernmental Panel on Climate Change Sixth Assessment Report (IPCC-AR6) brought into sharp relief the potential health impacts of a changing climate across large geographic regions. It also highlighted the gaps in available evidence to support detailed quantitative assessments of health impacts for many regions. In an increasingly urbanizing world, there is a need for additional information about the risk of mosquito-borne diseases from vectors adapted to human water storage behavior. Specifically, a better understanding of the geographic distribution of disease risk under different climate warming scenarios and human population shifts. We present novel geospatial descriptions of risk for transmission for five mosquito-borne disease systems under future projected climate and demographic scenarios, including the potential risk for malaria in the event of the introduction and establishment of a vector of high global concern, Anopheles stephensi. We then present country-level and IPCC geospatial sub-regional risk descriptions under baseline and future projected scenarios. By including demographic projections using the shared socioeconomic pathway (SSP) scenarios, we capture potential future risk in a way that is transparent and straightforward to compare and replicate. The goal of this paper is to report on these model output data and their availability. From a sub-regional perspective, the largest proportional gains in risk will be seen in the Southwestern South America (SWS) sub-region, comprising much of the southwestern coastline, for which the suitability for Aedes aegypti-transmitted dengue and Zika will see massive increases with warming, putting a large number of people at risk under future scenarios. In contrast, at the country level, the largest projected population impacts will be seen in Brazil for both arboviral and potential introduced malaria risk, despite some risks projected to decrease as parts of the country are too hot to sustain transmission. This paper provides modeled outputs for future use, in addition to broad summary descriptions at regional and country levels.

The present research aimed to analyze the main effects of the COVID-19 pandemic on the quality of life at work of health professionals in Primary Health Care (PHC). The research consisted of an integrative literature review, using Google Scholar and Scielo to search for scientific articles on quality of life at work of PHC health professionals during the COVID-19 pandemic. Strict inclusion criteria were applied, resulting in the selection of a sample of three articles for detailed analysis. The studies present a comprehensive analysis of the effects of the COVID-19 pandemic on the quality of work life and mental health of health workers, especially those on frontline and primary care. In addition to highlighting the social and labor dimension of the crisis triggered by the pandemic, the studies highlight the neglect of the care and respect needs of these professionals, who are often perceived only as caregivers. The lack of adequate social protection and exposure to the risk of contamination contributed to feelings of anguish and insecurity, aggravated by the intensification of occupational stress. Integrative and Complementary Health Practices (ICPs) have emerged as a relevant alternative for professionals' self-care and health promotion, highlighting the need for holistic approaches that consider both physical and mental health. The implementation of policies and strategies to prevent mental illness and promote the well-being of professionals is crucial, requiring a sensitive look at their experiences during the pandemic. In summary, the studies underline the importance of an integrated approach to address the impacts of the pandemic on the health of health workers and ensure that they are supported to face future challenges.

Abstract Globally, urban settlements face increases in the frequency, magnitude, and duration of extreme climate events and shifts in their timing and spatial extent. Variation in temperature and rainfall conditions affect the temporal onset of dengue transmission. However, there is a need to understand how climate-related patterns and disease transmission mechanisms vary by location, particularly for topographically complex landscapes. In this investigation, we used dengue cases from 1,120 municipalities and five regions across Colombia during 2008–2019, and analyzed associations with extreme climate covariates generated from fine-scale, daily-level meteorological data, accounting for varying landscape and socio-economic properties. Using Bayesian spatio-temporal hierarchical models, we determined that high-intensity warm spells (with positive temperature anomalies of 8–12°C above mean monthly conditions) resulted in an earlier onset of dengue transmission risk in high-elevation settlements compared to low- elevation settlements. Furthermore, the risk of dengue transmission after extremely dry conditions was greater and extended for a longer duration in highly urbanized municipalities compared to those with a low urban population. Our findings highlight that meteorological hazards affect disease transmission in urban settlements differently based on elevation and socio-economic conditions. Additionally, our analysis adds to increasing evidence of the vulnerability of mountainous urban communities to extreme weather and vector-borne diseases. Overall, we emphasize the need for monitoring and forecasting the occurrence and intensity of meteorological hazards and associations with emerging climate-sensitive disease threats.

Upper gastrointestinal bleeding (UGIB) in COVID-19 presents challenges in patient management. Existing studies lack comprehensive review due to varied designs, samples, and demographics. A meta-analysis can provide valuable insights into the incidence, features, and outcomes of UGIB in COVID-19. A comprehensive literature search was carried out using several databases. We considered all appropriate observational studies from all over the world. Mantel-Haenszel odds ratios and associated 95% confidence intervals (CIs) were produced to report the overall effect size using random effect models. Besides, Random effects models were used to calculate the overall pooled prevalence. Funnel plots, Egger regression tests, and Begg-Mazumdar's rank correlation test were used to appraise publication bias. Data from 21 articles consisting of 26,933 COVID-19 patients were considered. The pooled estimate of UGIB prevalence in patients admitted with COVID-19 across studies was 2.10% (95% CI, 1.23-3.13). Similarly, the overall pooled estimate for severity, mortality, and rebleeding in COVID-19 patients with UGIB was 55% (95% CI, 37.01-72.68), 29% (95% CI, 19.26-40.20) and 12.7% (95% CI, 7.88-18.42) respectively. Further, UGIB in COVID-19 patients was associated with increased odds of severity (OR=3.52, 95% CI 1.80-6.88, P=0.001) and mortality (OR=2.16, 95% CI 1.33-3.51, P=0.002) compared with patients without UGIB. No significant publication bias was evident in the meta-analysis. The results of our study indicate that UGIB in individuals with COVID-19 is linked to negative outcomes such as severe illness, higher mortality rates, and an increased risk of re-bleeding. These findings highlight the significance of identifying UGIB as a significant complication in COVID-19 cases and emphasise the importance of timely clinical assessment and proper treatment.

Due to an unprecedented rise in demand, in 2020 the Peruvian Ministry of Education implemented a centralized assignment mechanism that allowed thousands of students at various levels of education to move from the private to the public sector. In this paper, we empirically explore the determinants of accepting a public school assignment and, subsequently, remaining in the public system. Specifically, we exploit the randomness in the assignment of students to new public schools to causally estimate the influence of distance on the decision to accept a public school placement, and we explore its role in the decision to remain there. We also provide insights into various determinants of parental preferences. Our findings reveal that families care about distance from home to the assigned public school as well as the relative academic and peer quality with respect to their school of origin. Parents weigh these factors differently based on their familiarity with them. Consequently, experiencing a new school environment can alter the significance of specific attributes when it comes time to decide whether to stay at the assigned school. These findings offer valuable insights into how governments can strengthen the supply of public schooling.

El presente documento define el abordaje que la Oficina de Evaluación y Supervisión (OVE) adoptará en su evaluación del trabajo del Grupo Banco Interamericano de Desarrollo (BID) en la adaptación al cambio climático. Este incluye los objetivos, alcance, y metodología de la evaluación. Esta evaluación fue incorporada en los programas de trabajo de OVE 2021-2022 (documento RE-551-1) y 2022-2023 (documento RE-563-3), por solicitud de los Directorios del BID y BID Invest. La evaluación buscará informar de manera independiente a los Directorios del BID y BID Invest sobre el rol del Grupo BID en el apoyo a la región de América Latina y el Caribe (ALC) para lograr un crecimiento sostenible e inclusivo ante los choques climáticos.

The article relates to the COVID-19 pandemic and education, aiming to reflect on its implications for school learning in the pandemic context. It has interfered with the educational reality of students at all levels of education. Furthermore, it has also had an impact on the way modern society operates and lives since 2019. The concept of the COVID-19 pandemic and current educational thinking are developed in contrast to deficient educational systems, based on studies of the pandemic's occurrence and educational practices during and after the peak of pandemic events. In this context, potential classifications, and typologies of educational systems in response to the pandemic reality are explored in a general sense. The conclusion is dedicated to evaluating the implications and challenges resulting from the COVID-19 pandemic, which has left significant marks on learning and the educational process in our educational institutions.