Revisión narrativa del modelo de desarrollo positivo para adultos emergentes chilenos / A narrative review of the positive development model for Chilean emerging adults / Revisão narrativa do modelo de desenvolvimento positivo para adultos emergentes chilenos

Introducción: El desarrollo positivo es un estadio de ajuste psicosocial que acentúa las potencialidades y los recursos entre jóvenes y sus contextos próximos. En Australia, se desarrolló el primer modelo de desarrollo positivo para adultos emergentes, el cual consta de cinco componentes (competencia social, satisfacción con la vida, confianza y tolerancia con los otros, confianza hacia autoridades e instituciones, acción y compromiso cívico), pero no ha sido investigado en Chile. Objetivo: Analizar la evidencia disponible en la literatura científica sobre los cinco componentes del modelo de desarrollo positivo en adultos emergentes universitarios de Chile. Materiales y métodos: Revisión narrativa de la literatura publicada entre 2013 y 2023, en bases de datos Web of Science, Scopus, SciELO, Redalyc y Dialnet. Resultados: Se obtuvieron 83 artículos, de los cuales 53 cumplieron los requisitos de inclusión; en su mayor parte fueron estudios cuantitativos (81,13%) y en español (75,47%). Se evidenció una disparidad en la cantidad de estudios por temática; se encuentra mayor investigación en satisfacción con la vida y acción y compromiso cívico. Conclusiones: Existen brechas en la literatura científica chilena en el estudio del desarrollo positivo; además de que se discuten particularidades idiosincrásicas y desafíos asociados a la etapa de adultez emergente.

Introduction: Positive development is a stage of psychosocial adjustment that accentuates the potentials and resources of young people and their close contexts. The first positive development model for emerging adulthood was developed in Australia, which includes five components: social; life satisfaction; trust and tolerance of others; trust in the authorities and institutions; and action and civic engagement. However, this model has not been investigated in Chile. Objective: To analyze the evidence available in the scientific literature on the five components of the positive development model in emerging adults universities. Materials and methods: A narrative review of the literature published between 2013 and 2023 in the Web of Science, Scopus, SciELO, Redalyc, and Dialnet databases was conducted. Results: 83 articles were selected, of which 53 met the inclusion criteria; most of them were qualitative studies (81.13%) and in Spanish (75.47%). There is an evident disparity in terms of the number of studies and topics, e.g., there is more research on life satisfaction and civic action and commitment. Conclusions: There are gaps in the Chilean scientific literature in the study of positive development. In addition, idiosyncratic particularities and challenges associated with the stages of emerging adulthood are discussed.

Introdução: O desenvolvimento positivo é uma fase de ajustamento psicossocial que acentua o potencial e os recursos dos jovens e dos seus contextos imediatos. Na Austrália, foi desenvolvido o primeiro modelo de desenvolvimento positivo para adultos emergentes, que consiste em cinco componentes (social, satisfação com a vida, confiança e tolerância com os outros, confiança nas autoridades e instituições, ação e envolvimento cívico), mas ainda não foi investigado no Chile. Objetivo: Analisar as evidências disponíveis na literatura científica sobre os cinco componentes do modelo de desenvolvimento positivo em adultos universitários emergentes no Chile. Materiais e métodos: Revisão narrativa da literatura publicada entre 2013 e 2023, nas bases de dados Web of Science, Scopus, SciELO, Redalyc e Dialnet. Resultados: foram obtidos 83 artigos, dos quais 53 atenderam aos requisitos de inclusão; A maioria deles eram estudos quantitativos (81,13%) e em espanhol (75,47%). Ficou evidente uma disparidade no número de estudos por tema; Há mais pesquisas sobre satisfação com a vida e ação e compromisso cívico. Conclusões: Existem lacunas na literatura científica chilena no estudo do desenvolvimento positivo; Além disso, são discutidas particularidades e desafios idiossincráticos associados à fase da idade adulta emergente.

Conductas sexuales protectoras en estudiantes universitarios de primer año de una universidad de Chillán, Chile / Protective Sexual Behaviors in First-Year University Students at a University in Chillán, Chile

Objetivo: Determinar las conductas sexuales protectoras en estudiantes de una universidad de Chillán, Chile. Métodos: Estudio cuantitativo, descriptivo con un muestreo probabilístico por conveniencia de 234 estudiantes universitarios, para los criterios de inclusión destaca haber iniciado actividad sexual. La recolección de datos fue a través de Google forms. El instrumento utilizado fue "Cuestionario de conducta sexual segura". Resultados: Del total de los alumnos encuestados el 64,1 % son mujeres. En cuanto al estado civil, el 93,5 % se identifica soltero. Solo el 47,4 % detiene la actividad sexual para utilizar condón. El 80,8 % evita relaciones sexuales en la primera cita, un 81,6 % nunca tienen relaciones anales sin condón, y el 99,6 % nunca ha tenido sexo con personas que utilizan drogas. Se encontró que la media para conducta sexual protectora es de 70,2 %. Conclusión: Los encuestados presentan conductas sexuales protectoras(AU)

Objective: To determine protective sexual behaviors in students at a university in Chillán, Chile. Methods: Quantitative, descriptive study with a probability sampling by convenience of 234 university students, for the inclusion criteria it stands out to have initiated sexual activity. Data collection was through Google form. The instrument used was the "Safe sexual behavior questionnaire". Results: Of the total students surveyed, 64.1% are women. Regarding marital status, 93.5% identify themselves as single. Only 47.4% stop sexual activity to use a condom. 80.8% avoid sexual relations on the first date, 81.6% never have anal relations without a condom, and 99.6% have never had sex with people who use drugs. It was found that the mean for protective sexual behavior is 70.2 %. Conclusion: The respondents present protective sexual behaviors(AU)

Stroke associated with primary membranous nephropathy in a young adult: Case report / Evento cerebral isquémico asociado con nefropatía membranosa primaria en un adulto joven: reporte de caso

INTRODUCTION: Stroke in young individuals is becoming increasingly prevalent worldwide. Its causes can vary widely, so a thorough investigation by a multidisciplinary team is needed. Pinpointing the precise underlying pathology responsible for the stroke yields benefits for patients, particularly in recurrent events. CASE PRESENTATION: A 38-year-old man presented to the emergency department with symptoms suggestive of stroke, including right hemiparesis, dysarthria, ataxic gait, and right central facial palsy. The brain magnetic resonance image revealed an ischemic lesion located in the left basal ganglia and near the corona radiata. Following an extensive workup, a diagnosis of nephrotic was reached. Histopathology and the exclusion of secondary causes confirmed primary membranous nephropathy as the underlying condition. The patient underwent treatment tailored to address the specific glomerulopathy, along with anticoagulation therapy and immunosuppression as per current guidelines. Subsequent assessments showed stabilization of renal function, resolution of the edema, and the absence of new thromboembolic events during follow-up. CONCLUSION: The nephrotic syndrome should be recognized as a potential underlying cause of stroke in young patients and, therefore, it should be included in the differential diagnosis during the evaluation of patients with coagulopathies. Nephrotic syndrome screening may be done by conducting a simple urinalysis readily available in most healthcare facilities. This underlines the importance of considering renal pathology in the assessment of stroke etiologies, especially when coagulation abnormalities are present.

Introducción. Los eventos cerebrovasculares en los jóvenes son un problema creciente en todo el mundo. Su etiología puede ser variada y requieren un trabajo riguroso de un equipo multidisciplinario. La identificación de la enfermedad específica que conduce al ictus tiene un impacto beneficioso en los pacientes, especialmente en aquellos con eventos recurrentes. Presentación del caso. Se presenta el caso de un hombre de 38 años que acudió al servicio de urgencias con hemiparesia derecha, disartria, ataxia y parálisis facial central derecha. La resonancia magnética cerebral reveló una lesión isquémica localizada en los ganglios basales izquierdos, cerca de la corona radiada. Después de un estudio exhaustivo, se estableció el diagnóstico de síndrome nefrótico. No obstante, al analizar las características histopatológicas y descartar otras causas secundarias, el diagnóstico final fue una nefropatía membranosa primaria. El paciente recibió tratamiento específico para su glomerulopatía, anticoagulación e inmunosupresión según las guías vigentes. Durante el seguimiento, se encontró estabilización de la función renal, el edema se resolvió y no se identificó ningún nuevo evento tromboembólico. Conclusión. El síndrome nefrótico debe considerarse entre las posibles causas del ictus en pacientes jóvenes y debería tenerse en cuenta en los estudios de coagulopatías. El tamizaje de esta enfermedad requiere únicamente un uroanálisis, el cual está disponible en la mayoría de los centros de atención de salud.

Looking beyond Body Structure and Function: ICF Foci and Who Is Being Assessed in Research about Adolescents and Young Adults with Cerebral Palsy-A Scoping Review.

PURPOSE: The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood. METHOD: Medline, EMBASE, PsycINFO, and CINAHL databases were searched using terms related to cerebral palsy, adolescents/young adults, health development, participation, and independence. Studies including youth with CP (13-30 years old) published in English from 2014 to 2021 were considered. The methods of assessment reported in the included studies were used to identify the ICF foci and who was assessed. RESULTS: In this study, 86 studies were reviewed. The main ICF foci are activity and participation (51% of the studies), personal factors (23%), ICF not covered (14%), ICF not defined (9%), with environmental factors being the least focused ICF component (3%). Most studies assessed AYAs directly (49% of studies). CONCLUSIONS: Activity- and participation-related constructs are the leading research focus of studies, and more attention is needed concerning environmental factors. AYAs are the main source of information, and the perspectives of other key figures are also being valued. To bridge the gap between child and adult health care, a broader view of health development and approaches to explore AYA developmental issues must be taken.

[Temporal pattern, spatial distribution, and factors associated with the incidence of HIV/AIDS among young people in BrazilPatrón temporal, distribución espacial y factores asociados a la incidencia de la infección por el VIH/sida en jóvenes en Brasil]. / Padrão temporal, distribuição espacial e fatores associados a incidência de HIV/AIDS entre jovens no Brasil.

Objective: To describe temporal and spatial patterns and identify the factors associated with the incidence of HIV/AIDS among young people in Brazil. Method: Ecological study of young Brazilians aged 15-24 years with reported HIV/AIDS, from 2001 to 2021. The Joinpoint method was used for the temporal analysis. Spatial clusters were detected using Bayesian methods, spatial autocorrelation, Getis-Ord Gi*, and scan techniques. Four non-spatial and spatial regression models were used to identify factors associated with the result. All statistical analyses considered p < 0.05. Results: In Brazil, the average incidence was 12.29 per 100 000 inhabitants, with an annual increase of 7.3% in the period 2007-2014 and a subsequent 3.4% decrease in 2014-2021. A high-high pattern and hotspots were observed, mainly in municipalities in the South, Southeast, Central-West, and North regions. The primary cluster was located in 572 municipalities in Rio Grande do Sul and Santa Catarina, with the highest relative risks in Manaus (Amazonas) and Rondonópolis (Mato Grosso). The illiteracy rate (ß = -0.08), GINI Index (ß = -3.74) and Family Health Strategy coverage (ß = -0.70) were negatively associated with the result. In contrast, the Firjan Municipal Development Index (ß = 2.37), Social Vulnerability Index (ß = 6.30), percentage of Bolsa Família recipients (ß = 0.04), and per capita income (ß = 0.008) showed a positive association. Conclusion: There was an upward trend in the incidence of HIV/AIDS until 2014, followed by a decline until 2021. High-rate clusters were concentrated in municipalities in the North, South, Southeast and Central-West regions in particular. Indicators of socioeconomic vulnerability had positive or negative effects on the result, depending on the territory investigated.

Objetivo: Describir el patrón temporal y espacial, y determinar los factores asociados a la incidencia de infección por el VIH/sida en jóvenes en Brasil. Método: Estudio ecológico en jóvenes brasileños de 15 a 24 años con diagnóstico de infección por el VIH/sida en el período 2001-2021. Para el análisis temporal se utilizó el método de regresión de puntos de inflexión (joinpoint). Los conglomerados espaciales se detectaron con métodos Bayesianos y de autocorrelación espacial, Gi* de Getis-Ord y escaneo. Se utilizaron cuatro modelos de regresión espacial y no espacial para detectar los factores asociados al resultado. En todos los análisis estadísticos se estableció un valor de p < 0,05 como umbral de significación. Resultados: En Brasil, la incidencia media fue de 12,29 por 100 000 habitantes, con un aumento del 7,3% anual en el período 2007-2014 y una reducción posterior del 3,4% en el período 2014-2021. Se observó un patrón alto/alto y la presencia de puntos calientes, principalmente en municipios del Sur, Sudeste, Centro-Oeste y Norte. El principal conglomerado se localizó en 572 municipios de Rio Grande do Sul y Santa Catarina, y los riesgos relativos más altos se observaron en Manaus (Amazonas) y Rondonópolis (Mato Grosso). La tasa de analfabetismo (ß = -0,08), el índice de Gini (ß = -3,74) y la cobertura de la estrategia de salud familiar (ß = -0,70) mostraron una asociación negativa con el resultado. En cambio, el índice de Firjan de desarrollo municipal (ß = 2,37), el índice de vulnerabilidad social (ß = 6,30), el porcentaje de personas que reciben ayuda del programa de bienestar social Bolsa Família (ß = 0,04) y los ingresos per cápita (ß = 0,008) mostraron una asociación positiva. Conclusión: Hubo una tendencia al aumento de la incidencia de infección por el VIH/sida hasta el 2014, con una reducción posterior hasta el 2021. Los conglomerados de tasas elevadas se concentraron especialmente en los municipios de las regiones Norte, Sur, Sudeste y Centro-Oeste. Los indicadores de vulnerabilidad socioeconómica tienen una influencia positiva o negativa en el resultado, según el territorio investigado.

'Uma parte de mim sabia que isso aconteceria um dia': vivências de jovens com HIV/aids / 'A part of me knew this would happen one day': experiences of young people with HIV/ AIDS

RESUMO O objetivo deste estudo foi compreender as representações sociais de jovens que vivem com o HIV. Estudo qualitativo, ancorado na Teoria das Representações Sociais, realizado com 16 jovens em acompanhamento ambulatorial. Os dados foram coletados entre maio e outubro de 2022, por meio de entrevista semiestruturada. Para o tratamento dos dados, empregou-se a técnica de análise lexical, operacionalizada com o auxílio do software Iramuteq. A representação fortemente associada ao diagnóstico de HIV está relacionada ao desconhecimento, preconceito e aceitação, apresentando, também, elementos positivos como recomeço. Classes: Diagnóstico positivo para o HIV: o 'eu' de agora; HIV em face do desconhecimento e do estigma; e Relações interpessoais: diálogo, acolhimento e respeito necessários aos jovens. Compreendeu-se que as representações sociais dos jovens com HIV refletem a sua condição na sociedade. Os dados deste estudo mostram que existem formas distintas de vivenciar o HIV, muitas vezes representadas pela fragilidade, pela resignação, e outras, pelo fortalecimento. A fim de minimizar a vulnerabilidade do jovem à exposição ao HIV e aos riscos de conviver com o estigma e preconceito social, fazem-se necessárias a adoção de estratégias de conscientização da sociedade sobre a doença e a ampliação da divulgação de políticas públicas que abarcam essa temática.

ABSTRACT This study was aimed at understanding the social representations of young people living with HIV. This is a qualitative study, based on the Social Representations Theory, carried out with 16 young people in outpatient follow-up. Data were collected between May and October 2022, through semi-structured interviews. For data processing, the lexical analysis technique was used, operationalized with the aid of the IRAMUTEQ software. The representation strongly associated with the diagnosis of HIV is related to lack of knowledge, prejudice and acceptance, also presenting positive elements such as a new beginning. Classes: Positive diagnosis for HIV: the new 'me'; HIV in the face of ignorance and stigma; and Interpersonal relationships: dialogue, acceptance and respect necessary for young people. It was understood that the social representations of young people with HIV reflect their condition in society. The data show that there are different ways of experiencing HIV, often represented by fragility, resignation, and other times by strengthening. In order to minimize the vulnerability of young people to exposure to HIV and the risks of living with stigma and social prejudice, it is necessary to adopt strategies to raise awareness about the disease and to expand the dissemination of public policies that cover this topic.

Surrogate indices of insulin resistance using the Matsuda index as reference in adult men-a computational approach.

Background: Overweight and obesity, high blood pressure, hyperglycemia, hyperlipidemia, and insulin resistance (IR) are strongly associated with non-communicable diseases (NCDs), including type 2 diabetes, cardiovascular disease, stroke, and cancer. Different surrogate indices of IR are derived and validated with the euglycemic-hyperinsulinemic clamp (EHC) test. Thus, using a computational approach to predict IR with Matsuda index as reference, this study aimed to determine the optimal cutoff value and diagnosis accuracy for surrogate indices in non-diabetic young adult men. Methods: A cross-sectional descriptive study was carried out with 93 young men (ages 18-31). Serum levels of glucose and insulin were analyzed in the fasting state and during an oral glucose tolerance test (OGTT). Additionally, clinical, biochemical, hormonal, and anthropometric characteristics and body composition (DEXA) were determined. The computational approach to evaluate the IR diagnostic accuracy and cutoff value using difference parameters was examined, as well as other statistical tools to make the output robust. Results: The highest sensitivity and specificity at the optimal cutoff value, respectively, were established for the Homeostasis model assessment of insulin resistance index (HOMA-IR) (0.91; 0.98; 3.40), the Quantitative insulin sensitivity check index (QUICKI) (0.98; 0.96; 0.33), the triglyceride-glucose (TyG)-waist circumference index (TyG-WC) (1.00; 1.00; 427.77), the TyG-body mass index (TyG-BMI) (1.00; 1.00; 132.44), TyG-waist-to-height ratio (TyG-WHtR) (0.98; 1.00; 2.48), waist-to-height ratio (WHtR) (1.00; 1.00; 0.53), waist circumference (WC) (1.00; 1.00; 92.63), body mass index (BMI) (1.00; 1.00; 28.69), total body fat percentage (TFM) (%) (1.00; 1.00; 31.07), android fat (AF) (%) (1.00; 0.98; 40.33), lipid accumulation product (LAP) (0.84; 1.00; 45.49), leptin (0.91; 1.00; 16.08), leptin/adiponectin ratio (LAR) (0.84; 1.00; 1.17), and fasting insulin (0.91; 0.98; 16.01). Conclusions: The computational approach was used to determine the diagnosis accuracy and the optimal cutoff value for IR to be used in preventive healthcare.

Representaciones sociales acerca de Instagram: Estudio cualitativo con adultos emergentes con diferente bienestar psicológico y autoestima corporal

Antecedentes existe una relación entre el uso de Instagram y diferentes influencias e interacciones con el bienestar y salud mental de este grupo etario. Objetivo Reconstruir las representaciones sociales acerca de la red social Instagram de adultos emergentes con diferentes niveles de bienestar psicológico y autoestima corporal. Método redes semánticas naturales y entrevistas semiestructuradas fueron aplicadas a N=12 adultos emergentes (19 - 27 años) divididos en dos grupos según sus niveles de autoestima corporal y bienestar psicológico. El análisis de datos estuvo basado en análisis de redes semánticas naturales y algunos procedimientos de codificación teórica. Resultados se muestra la presencia del concepto de "acoso" como núcleo central de la representación social de Instagram en el grupo con baja autoestima corporal y bajo bienestar psicológico, a diferencia del grupo con alta autoestima corporal y alto bienestar psicológico en donde el núcleo central fue "red social". Conclusiones en los grupos estudiados, se encontraron dos representaciones sociales diferentes respecto de Instagram. Estos resultados pueden ser relevantes para aportar a llenar el vacío de conocimiento sobre los significados subjetivos colectivos de los adultos emergentes, teniendo implicancias en la mejor comprensión de las diversas formas de relación que establecen con esta y otras redes sociales.

Background There is a relationship between the use of Instagram and various influences and interactions with the well-being and mental health of this age group. Objective To reconstruct the social representations of the Instagram social network among emerging adults with different levels of psychological well-being and body esteem. Method Natural semantic networks and semi-structured interviews were conducted with N=12 emerging adults (19 - 27 years old) divided into two groups based on their body self-esteem and psychological well-being levels. Data analysis relied on natural semantic network analysis and theoretical coding. Results The concept of "harassment" is revealed as the central core of the social representation of Instagram in the group with low body self-esteem and low psychological well-being, unlike the group with high body esteem and high psychological well-being where the central core was the "social network" itself. Conclusions Two different social representations of Instagram were found in the studied groups. These results could contribute to filling the knowledge gap about the collective subjective meanings of emerging adults, impacting the better understanding of the diverse relationships they establish with this and other social networks.

Infarto com Supra-ST em Adulto Jovem: Rara Apresentação de Mixoma Atrial Gigante / Acute ST-Elevation Myocardial Infarction in a Young Adult: Rare Presentation of Giant Atrial Myxoma

Resumo Neoplasias cardíacas são raras, tendo como principal representante o mixoma atrial (MA), que corresponde a cerca de metade de todos os casos. O MA tem incidência estimada entre 0.001% e 0.3% na população em geral, no entanto apenas aproximadamente 0,06% desses cursam com eventos embólicos coronarianos. Homem de 33 anos, tabagista, admitido com quadro de precordialgia intensa e irradiação para membro superior esquerdo com duração de uma hora. O eletrocardiograma evidenciou elevação de segmento ST nas derivações D2, D3 e aVF troponina sérica elevada, confirmando infarto com supra desnivelamento do segmento ST (IAMCSST). Foi realizada cineangiocoronariografia, a qual revelou oclusão em terço proximal de artéria coronária direita por trombo. Realizada tentativa de aspiração do trombo, sem sucesso, seguido por angioplastia primária com balão sem colocação de stent. Durante a investigação do quadro, paciente realizou ecocardiograma transtorácico o qual demonstrou massa homogênea de superfície regular, de 5.2 cm x 2.3 cm, aderida ao septo interatrial, com lobulações de características emboligênicas prolapsando para valva mitral e ventrículo esquerdo na diástole, compatível com MA. Foi realizada ressecção cirúrgica com paciente evoluindo assintomático, recebendo alta para seguimento ambulatorial. O caso relatado difere em idade e sexo do perfil epidemiológico típico sendo um dos poucos descritos com acometimento da parede inferior apresentando a artéria coronária direita como culpada. Este relato ratifica a importância do diagnóstico diferencial frente às apresentações de IAMCSST em jovens.

Abstract Cardiac tumors are rare entities, among which atrial myxoma (AM) stands as the most frequent, accounting for approximately half of all reported cases. The incidence of AM is estimated to range from 0.001% to 0.3% within the general population, yet only about 0.06% of these cases present with coronary embolic events. We report on a 33-year-old male smoker who experienced acute, severe precordial pain radiating to the left upper limb, lasting for one hour. The electrocardiographic evaluation demonstrated ST-segment elevation in leads D2, D3, and aVF, alongside significantly elevated serum troponin levels, confirming a diagnosis of ST-segment elevation myocardial infarction (STEMI). Subsequent coronary angiography revealed proximal occlusion of the right coronary artery due to thrombus. An initial attempt of thrombus aspiration was unsuccessful, followed by primary angioplasty with balloon inflation without stent placement. Further diagnostic exploration through transthoracic echocardiography identified a homogenous, smooth-surfaced mass measuring 5.2 cm x 2.3 cm attached to the interatrial septum. This mass, characterized by lobulations, prolapsed into the mitral valve and left ventricle during diastole, consistent with AM. Surgical resection of the mass was successfully performed, with the patient being discharged asymptomatic. In the reported case, the patient's profile, notably his age, and gender, diverges from the typical epidemiological characteristics associated with AM. This case adds to the limited number of reports where the inferior wall is affected by the right coronary artery being occluded. This report emphasizes the significance of differential diagnoses in younger patients presenting with STEMI.

Variaciones de alfa-amilasa salival relacionadas con edad, sexo e índice de masa corporal en estudiantes universitarios / Variations of salivary alpha-amylase related to age, sex and body mass index in university students

Objetivo. Determinar la presencia y dirección de la relación entre alfa-amilasa salival (AAs), edad, sexo e índice de masa corporal (IMC) en adultos jóvenes. Métodos. Este estudio transversal se desarrolló con una muestra de 50 estudiantes de odontología de 19 a 34 años de edad, 58% mujeres y 42% hombres. Se recogieron muestras de saliva entera sin estimular en la mañana (6:30-7:30 a.m.) y en la tarde (4:00-6:00 p.m.). Los valores de AAs se determinaron mediante método cinético y se expresaron como media ± desviación estándar. Se realizaron análisis descriptivo de datos, prueba de chi-cuadrado, prueba de correlación de Pearson y prueba t de muestras pareadas. Resultados. El IMC promedio fue de 23,85 ± 3,30 kg/m2, 66% de los participantes presentó peso normal (IMC ≤ 25 kg/m2). Los niveles de AAs por la tarde (282,74 ± 59,60 U/ml) fueron mayores a los de la mañana (190,84 ± 61,80 U/ml), (t = 16,51, p < 0,0001). Los hombres mostraron niveles de AAs más altos que las mujeres (p < 0,0001). La edad no mostró asociación con los niveles de AAs. Los valores de IMC y AAs presentaron una correlación positiva (AM: r = 0,35, p = 0,0121; PM: r = 0,40, p = 0,0036). Conclusión. El nivel de actividad de AAs se puede utilizar como posible biomarcador para evaluar el IMC en relación con el sexo, especialmente en los adultos jóvenes.

Objective. To determine the presence and direction of the relationship between salivary alpha-amylase (sAA), age, sex, and body mass index (BMI) in young adults. Methods. This cross-sectional study was developed with a sample of 50 dental students from 19 to 34 years of age, 58% women and 42% men. Unstimulated whole saliva samples were collected in the morning (6:30-7:30 a.m.) and in the afternoon (4:00-6:00 p.m.). sAA values were determined by the kinetic method and expressed as mean ± standard deviation. Descriptive data analysis, chi-square test, Pearson correlation test, and paired samples t-test were made. Results. Mean BMI was 23.85 ± 3.30 kg/m2, 66% of the participants presented normal weight (BMI ≤ 25 kg/m2). Levels of sAA in the afternoon (282.74 ± 59.60 U/ml) were higher than those in the morning (190.84 ± 61.80 U/ml), (t = 16.51, p < 0, 0001). Men showed higher levels of sAA than women (p < 0.0001). Age did not show an association with sAA levels. BMI and AAs values presented a positive correlation (AM: r = 0,35, p = 0,0121; PM: r = 0,40, p = 0,0036). Conclusions. AAs activity level can be used as a potential biomarker to assess BMI in relation to sex, especially in young adults.

Effects of stretching in a pilates program on musculoskeletal fitness: a randomized clinical trial.

BACKGROUND: The scientific literature questions the impact of stretching exercises performed immediately before muscle strengthening exercises on different components of musculoskeletal physical fitness. Pilates is a physical exercise modality that typically uses stretching exercises preceding muscle-strengthening exercises. However, no studies have investigated the effects of stretching in a Pilates program on components of musculoskeletal fitness. The aim of the present study was to verify the effects of stretching in a Pilates exercise program on flexibility, strength, vertical jump height and muscular endurance. METHODS: Thirty-two sedentary young women were randomized into two groups: traditional Pilates (TP), who performed flexibility and muscle strengthening exercises (n = 16), and nontraditional Pilates (NTP), who only performed muscle-strengthening exercises (n = 16). Sessions took place 3 times a week for 8 weeks. The following tests were performed pre- and postintervention: 10-RM knee extensors, vertical jump, handgrip, 1-min sit-ups, Sorensen and sit-and-reach. The occurrence of adverse events was recorded throughout the intervention and compared between groups using odds ratio (OR). To compare the results of motor tests between groups, ANCOVA or Mann‒Whitney U test was used for parametric and nonparametric data, respectively. The data were analyzed by intention-to-treat. RESULTS: After intervention, the TP was superior to NTP for the sit-and-reach test, with a large effect size (d = 0.87; p = 0.035), with no differences between groups for the other tests. Intragroup comparisons showed significant differences (p < 0.05) for TP and NTP for improvement in 10-RM knee extensors and vertical jump measurements, while only TP showed significant intragroup improvement (p < 0.05) for the sit-and-reach test. A greater chance of experiencing pain or other discomfort as a result of exercise was shown by NTP (OR = 4.20, CI95% 0.69 to 25.26). CONCLUSION: Our findings demonstrated that stretching exercises performed at the beginning of sessions in a Pilates program did not impair or enhance the development of strength, vertical jump height and muscular endurance in young women. However, only the Pilates program with stretching improved flexibility and reduced the chances of adverse events such as musculoskeletal pain and other discomfort resulting from the exercise protocol. CLINICALTRIALS: GOV: NCT05538520, prospectively registered on September 16, 2022.

Impact of Telemedicine on Access to Care for Rural Transgender and Gender-Diverse Youth.

OBJECTIVE: To explore the impact of telemedicine on access to gender-affirming care for rural transgender and gender diverse youth. STUDY DESIGN: A retrospective analysis of data drawn from the electronic medical records of a clinic that provides approximately 10 000 adolescent and young adult visits per year and serves patients seeking gender health care. The no-show rate was examined as a proxy for access to care due to anticipated challenges with recruiting a representative sample of a historically marginalized population. Logistic regression with generalized estimating equations was conducted to model the association between the odds of a no-show visit and covariates of interest. RESULTS: Telemedicine visits, rural home address, gender health visits, longer travel time, and being younger than 18 years old were associated with lower odds of a no-show in univariate models (n = 17 928 visits). In the adjusted model, the OR of no-shows for gender health visits was 0.56 (95% CI 0.42-0.74), adjusting for rurality, telemedicine, age (< or >18 years), and travel time to the clinic. CONCLUSIONS: In this study, telemedicine was associated with reduced no-shows overall, and especially for rural, transgender and gender diverse youth, and patients who hold both identities. Although the no-show rate does not fully capture barriers to access, these findings provide insight into how this vulnerable population may benefit from expanded access to telemedicine for rural individuals whose communities may lack providers with the skills to serve this population.

Efetividade de recursos audiovisuais educativos sobre infecções sexualmente transmissíveis: protocolo de revisão sistemática / Effectiveness of educational audiovisual aid on sexually transmitted infections: a systematic review protocol

OBJETIVO: analisar o efeito das intervenções fornecidas por meio de recursos audiovisuais em comparação com a orientação tradicional para melhorar o conhecimento sobre infecções sexualmente transmissíveis entre jovens, adultos e idosos. MÉTODO: trata-se de uma revisão sistemática de efetividade, serão incluídas pessoas jovens, adultos e idosos, cuja intervenção foi apoiada em recursos audiovisuais. A estratégia de busca inicial foi construída na MEDLINE e será adaptada para as bases Scopus, Web of Science, CINAHL, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS via BVS), Cochrane e Embase. Não haverá delimitação de tempo ou idioma. A seleção e triagem acontecerá por dois revisores independentes. Para a análise crítica dos estudos elegíveis será utilizado instrumentos padronizados. Os estudos, independente da qualidade metodológica, passarão pelo processo de síntese e extração de dados. Se possível, os estudos serão agrupados em uma meta-análise estatística. Número de registro na PROSPERO: CRD42022374619.

OBJECTIVE: to analyze the effect of interventions provided by audiovisual aid compared to traditional guidance to increase knowledge on sexually transmitted infections among young, adult, and older persons. METHOD: this is an effectiveness systematic review. Young, adult, and older persons are to be included. The intervention was supported by audiovisual aid. The initial search strategy was built on MEDLINE and will be adapted to the following databases: Scopus, Web of Science, CINAHL, the Latin American and Caribbean Health Sciences Literature (LILACS via BVS), Cochrane, and Embase. There will not be a time or language delimitation. Two independent reviewers will carry out the selection and screening. Standardized instruments will be used to carry out the critical analysis of the eligible studies. These studies will go through a synthesis and data extraction process regardless of methodological quality. If possible, these studies will be grouped into a statistical meta-analysis. PROSPERO registration number: CRD42022374619.

Moderating effects of impulsivity and morning cortisol on the genotype-phenotype relationship of attention deficit hyperactivity disorder in young adults.

Dysregulation of the morning cortisol response in young adults with attention deficit hyperactivity disorder (ADHD) has been shown to underlie several of the alterations present in their lives. Thus, the interaction of this mechanism with genetic and behavioural characteristics could explain a large proportion of the aetiology of ADHD in this population. For these reasons, the present study explores the associations of 30 single nucleotide polymorphisms (SNPs) previously identified as significant (after correction for multiple comparisons) in the aetiology of ADHD with an assessment of morning cortisol and impulsivity traits in a group of 120 adults aged 18-24 years. Participants were recruited through private centres of neuropsychology and psychiatry, as well as through events in local universities. Morning cortisol within 30 min of awakening and motor impulsivity traits were shown to moderate the effect of SNP rs10129500 on the severity of the symptoms of ADHD measured by the Adult Self-Report Scale. This variant associated with cortisol-binding globulin would explain the low concentrations of this hormone found in young adults with high symptoms of ADHD, which is accentuated when there are high levels of impulsivity. The proposed model allows for transferring the theoretical relationships between the dimensions that explain the aetiology of ADHD to an applied exploratory model with good performance.

Lesão renal aguda e COVID-19 em adultos jovens na terapia intensiva / Lesión renal aguda y COVID-19 en adultos jóvenes en cuidados intensivos / Acute kidney injury and COVID-19 in young adults in intensive care

Resumo Objetivo Descrever a prevalência de lesão renal aguda em adultos jovens com diagnóstico da COVID-19 admitidos em unidade terapia intensiva. Métodos Estudo retrospectivo, quantitativo e analítico. A amostra foi de adultos jovens (20 a 40 anos) admitidos em unidades de terapia intensiva, com diagnóstico de infecção por SARS-CoV-2 entre março e dezembro de 2020. Os dados foram obtidos por meio do prontuário eletrônico, e a lesão renal aguda foi definida pelo valor da creatinina, segundo critérios das diretrizes da Kidney Disease Improving Global Outcomes. A significância estatística foi de p≤0,05. Resultados Foram internados 58 adultos jovens, sendo 63,8% do sexo masculino. A hipertensão arterial sistêmica esteve presente em 39,6%, a obesidade em 18,9% e o diabetes mellitus em 8,6%. A lesão renal aguda foi identificada em 55,1%, sendo o estágio 3 predominante em 43,1% deles. Nesses pacientes, o uso de ventilação mecânica e de drogas vasoativas foi significativo em 92%, assim como a disfunção orgânica respiratória (80%), seguida da renal (76%). Fatores de risco, como transplante renal ou doença renal crônica e obesidade, aumentaram em 12,3 e 9,0 vezes, respectivamente, a chance de desenvolver lesão renal aguda. Conclusão Este estudo demonstrou alta prevalência de lesão renal em adultos jovens e sua associação com comorbidades prévias. Obesidade, transplante renal e doença renal crônica elevaram a chance de o adulto jovem desenvolver lesão renal aguda, resultando em desfechos a favor da morbimortalidade.

Resumen Objetivo Describir la prevalencia de lesión renal aguda en adultos jóvenes con diagnóstico de COVID-19 admitidos en unidad de cuidados intensivos. Métodos Estudio retrospectivo, cuantitativo y analítico. La muestra fue de adultos jóvenes (20 a 40 años) admitidos en unidades de cuidados intensivos, con diagnóstico de infección por SARS-CoV-2 entre marzo y diciembre de 2020. Los datos se obtuvieron por medio de historias clínicas electrónicas, y la lesión renal aguda fue definida por el valor de la creatinina, de acuerdo con criterios de las directrices de la Kidney Disease Improving Global Outcomes. La significación estadística fue de p≤0,05. Resultados Hubo 58 adultos jóvenes internados, el 63,8 % de sexo masculino. La hipertensión arterial sistémica estuvo presente en el 39,6 %, la obesidad en el 18,9 % y la diabetes mellitus en el 8,6 %. Se identificó lesión renal aguda en el 55,1 %, de nivel 3 como predominante en el 43,1 % de los casos. En esos pacientes, el uso de ventilación mecánica y de drogas vasoactivas fue significativo en el 92 %, así como también la disfunción orgánica respiratoria (80 %), seguida de la renal (76 %). Los factores de riesgo, como trasplante renal o enfermedad renal crónica y obesidad, aumentaron 12,3 y 9,0 veces respectivamente la probabilidad de presentar lesión renal aguda. Conclusión Este estudio demostró alta prevalencia de lesión renal en adultos jóvenes y su asociación con comorbilidades previas. La obesidad, el trasplante renal y la enfermedad renal crónica aumentaron la probabilidad de que los adultos jóvenes presenten lesión renal aguda, lo que da como resultado desenlaces a favor de la morbimortalidad.

Abstract Objective To describe acute kidney injury prevalence in young adults diagnosed with COVID-19 admitted to the Intensive Care Unit. Methods This is a retrospective, quantitative and analytical study. The sample consisted of young adults (20 to 40 years old) admitted to Intensive Care Units, diagnosed with SARS-CoV-2 infection between March and December 2020. Data were obtained through electronic medical records, and kidney injury acute was defined by the creatinine value, according to the Kidney Disease Improving Global Outcomes guidelines criteria. Statistical significance was p≤0.05. Results A total of 58 young adults were hospitalized, 63.8% of whom were male. Hypertension was present in 39.6%, obesity in 18.9%, and diabetes mellitus in 8.6%. Acute kidney injury was identified in 55.1%, with stage 3 predominating in 43.1% of them. In these patients, the use of mechanical ventilation and vasoactive drugs was significant in 92% as well as respiratory organ dysfunction (80%), followed by renal organ dysfunction (76%). Risk factors such as kidney transplantation or chronic kidney disease and obesity increased by 12.3 and 9.0 times, respectively, the chances of developing acute kidney injury. Conclusion This study demonstrated a high kidney injury prevalence in young adults and its association with previous comorbidities. Obesity, kidney transplantation and chronic kidney disease increased the chance of young adults to develop acute kidney injury, resulting in outcomes in favor of morbidity and mortality.

O papel mediador da dependência de mídia social e da qualidade do sono na associação entre tempo de uso de mídia social e sintomas depressivos em universitários / The mediating role of social media addiction and sleep quality in the association between social media usage and depressive symptoms in university students / El papel mediador de la adicción a las redes sociales y la calidad del sueño en la asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos en estudiantes universitarios

Resumo: O aumento do uso de mídias sociais e sua associação com sintomas depressivos, especialmente em jovens adultos, tem gerado a necessidade do entendimento de como ocorre tal associação para subsidiar políticas de redução de danos e agravos. Nesse sentido, este estudo objetivou verificar o efeito mediador da dependência de mídias sociais e da qualidade do sono na associação entre o tempo de uso de mídias sociais e sintomas depressivos em universitários brasileiros. Trata-se de um estudo transversal, realizado com 2.823 universitários, que forneceram informações referentes ao tempo de uso de mídias sociais, à dependência de mídias sociais, aos sintomas depressivos e à qualidade do sono. A análise de mediação, ajustada por fatores de confusão, foi realizada por meio do software PROCESS para SPSS, para obtenção do efeito total (c), direto (c') e indiretos (EI1, EI2 e EI3). Os resultados identificaram associação entre o tempo de uso de mídias sociais e os sintomas depressivos, mediada pela dependência de mídias sociais (EI1 = 20%) e pela qualidade do sono (EI1 = 40%). Os resultados permitem ampliar o conhecimento acerca dos mecanismos que influenciam mutuamente a relação entre o tempo de uso de mídias sociais e os sintomas depressivos, auxiliando na adoção de estratégias de redução de danos decorrentes do uso excessivo de mídias sociais.

Abstract: Increase in time spent on social media and its association with depressive symptoms, especially among young adults, has generated the need to understand how this association occurs in order to support the development of policies to reduce harm and complications. In view of this fact, this study aimed to assess the mediating effect of social media addiction and sleep quality on the association between time spent on social media and depressive symptoms in Brazilian university students. This is a cross-sectional study conducted with 2,823 university students, who provided information regarding time spent on social media, social media addiction, depressive symptoms and sleep quality. The mediation analysis, adjusted for confounding factors, was performed using the PROCESS macro for SPSS to obtain the total (c), direct (c'), and indirect effects (EI1, EI2, and EI3). The results identified an association between time spent on social media and depressive symptoms, mediated by social media addiction (EI1 = 20%) and sleep quality (EI1 = 40%). These findings help expand knowledge about the mechanisms that mutually influence the relationship between time spent on social media and depressive symptoms, supporting the adoption of strategies to reduce harm resulting from excessive social media use.

Resumen: El aumento del uso de las redes sociales y su asociación con síntomas depresivos, especialmente en adultos jóvenes, ha generado la necesidad de comprender cómo se produce esta asociación como una forma de apoyar las políticas de reducción de daños y afecciones. En ese sentido, el presente estudio tuvo como objetivo verificar el efecto mediador de la adicción a las redes sociales y de la calidad del sueño en la asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos en estudiantes universitarios brasileños. Se trata de un estudio transversal, realizado con 2.823 estudiantes universitarios, quienes brindaron información respecto al tiempo de uso de las redes sociales, adicción a las redes sociales, síntomas depresivos y calidad del sueño. El análisis de mediación, ajustado por factores de confusión, se realizó por medio del software PROCESS para SPSS, para obtener el efecto total (c), directo (c') e indirectos (EI1, EI2 y EI3). Los resultados identificaron una asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos, mediada por adicción a las redes sociales (EI1 = 20%) y la calidad del sueño (EI1 = 40%). Los resultados permiten ampliar el conocimiento acerca de los mecanismos que influyen mutuamente en la relación entre tiempo de uso de las redes sociales y los síntomas depresivos, ayudando a adoptar estrategias para reducir los daños resultantes del uso excesivo de las redes sociales.

Mid-range theory of the nursing diagnosis Overweight / Teoria de médio alcance do diagnóstico de enfermagem sobrepeso / Teoría de rango medio del diagnóstico de enfermería sobrepeso

ABSTRACT Objective: To build a mid-range theory for the nursing diagnosis Overweight in adolescents and young adults. Methods: A methodological study in the light of the theoretical frameworks of Roy and of Lopes, Silva and Herdman. A total of 3,925 articles were retrieved and assessed using the State of the Art Through Systematic Review software. The final sample consisted of 28 articles. Results: The findings converged to 3 essential attributes, 13 antecedents, and 7 consequences. A mid-range theory was built consisting of an illustrated diagram, 11 propositions, and 12 causal relationships. Final considerations: From the creation of the theory, it was possible to better understand the nursing diagnosis Overweight within the context of adolescents and young adults. Understanding nursing phenomena contributes to nursing science's advancement and strengthening.

RESUMO Objetivo: Construir uma teoria de médio alcance para o diagnóstico de enfermagem Sobrepeso em adolescentes e adultos jovens. Método: Estudo metodológico à luz dos referenciais teóricos de Roy e Lopes, Silva e Herdman. Um total de 3.925 artigos foram identificados e avaliados usando o programa State of the Art Through Systematic Review. A amostra final foi composta por 28 artigos. Resultados: Os achados convergiram para 3 atributos essenciais, 13 antecedentes e 7 consequentes. Foi construída uma teoria de médio alcance composta por um diagrama ilustrado, 11 proposições e 12 relações causais. Considerações finais: A partir da elaboração da teoria, foi possível compreender melhor o diagnóstico de enfermagem Sobrepeso no contexto de adolescentes e adultos jovens. A compreensão dos fenômenos da enfermagem contribui para o avanço e fortalecimento da ciência da enfermagem.

RESUMEN Objetivo: Construir una teoría de rango medio para el diagnóstico de enfermería Sobrepeso en adolescentes y adultos jóvenes. Métodos: Estudio metodológico a la luz de los marcos teóricos de Roy y de Lopes, Silva y Herdman. Un total de 3.925 artículos fueron recuperados y evaluados utilizando el software State of the Art Through Systematic Review. La muestra final fue de 28 artículos. Resultados: Los resultados convergieron en 3 atributos esenciales, 13 antecedentes y 7 consecuencias. Se construyó una teoría de rango medio compuesta por un diagrama ilustrado, 11 proposiciones y 12 relaciones causales. Consideraciones finales: A partir de la creación de la teoría, fue posible comprender mejor el diagnóstico de enfermería Sobrepeso en el contexto de adolescentes y adultos jóvenes. La comprensión de los fenómenos de enfermería contribuye para el avance y fortalecimiento de la ciencia de enfermería.

A randomized controlled trial of a dissonance‐based eating disorder prevention intervention for body-dissatisfied Brazilian men: results from a 1-year follow-up

Objective: To test the efficacy of a dissonance-based (DB) intervention in targeting risk factors for eating disorders (EDs) and predisposing factors for muscle dysmorphia (MD) symptoms in body-dissatisfied Brazilian men over 1 year of follow-up and evaluate whether reductions in body-ideal internalization would mediate the intervention's impact on ED and MD symptoms. Methods: Participants were randomized to a two-session DB intervention (n=89) or assessment-only control (AOC) (n=91), and completed validated measures assessing body-ideal internalization, body dissatisfaction, ED, and MD symptoms at baseline, post-intervention, 1-month, 6-month, and 1-year follow-ups. Results: The DB condition showed significantly greater reductions in MD symptoms and body dissatisfaction compared with the AOC group over a 1-year follow-up, while significant differences were not observed for body-ideal internalization and ED symptoms. Changes in body-ideal internalization from baseline to 1-month follow-up completely mediated the relationship between condition and the changes observed in both ED and MD symptoms. Conclusion: These results provide further evidence of the efficacy of the tested intervention through 1-year follow-up in reducing body dissatisfaction and MD symptoms, but no such result was observed for body-ideal internalization and EDs. Our findings provide support for theoretical models of eating pathology and MD symptoms in Brazilian men. Clinical Trial Registration: Brazilian Registry of Clinical Trials (ReBEC): RBR-27dc264.

Lexical quality measures in the assessment of reading proficiency in Brazilian university students / Medidas de qualidade lexical na avaliação da proficiência de leitura em alunos universitários brasileiros

ABSTRACT Purpose: to assess the reading ability of university students using tasks to measure Lexical Quality (LQ) and evaluate the influence of socioeconomic status (SES) on both the reading performance and the components of Lexical Quality (LQ). Methods: 44 students from two federal universities took online linguistic tests, 19 from the Federal University of the Great ABC Region (UFABC) and 25 from the Federal University of Ceará (UFC), Brazil. Two-ranked Mann-Whitney (Wilcoxon rank-sum test) and Pearson's Correlation tests at p<0,05 were applied to analyze the data. Results: high and medium correlations were obtained among the different components of LQ, such as vocabulary and spelling recognition. In addition, significant differences were found between the performances of the two universities' students and their distinct socioeconomic levels. Conclusion: shorter reading times were correlated to higher accuracy in the Test of Word Reading Efficiency for Adults. The number of correct answers in the homonym test was correlated to the higher accuracy of the Test of Word Reading Efficiency for Adults, and both were correlated to the reaction time measures of these tests. The influence of socioeconomic status on reading performance and Lexical Quality components tasks was also found.

RESUMO Objetivos: comparar o desempenho de alunos universitários brasileiros a partir de tarefas com habilidades de qualidade lexical e avaliar a influência do nível socioeconômico no desempenho da leitura e nos componentes que formam a qualidade lexical. Métodos: testes linguísticos on-line foram aplicados em 44 estudantes de duas universidades federais, sendo 19 da Universidade Federal do ABC e 25 da Universidade Federal do Ceará. Para análise foram utilizados os testes Mann-Whitney (Wilcoxon rank-sum test) de duas vias e a Correlação de Pearson com p<0,05. Resultados: foram obtidas correlações altas e médias entre os diferentes componentes da qualidade lexical, tais como vocabulário e reconhecimento ortográfico, além de terem sido encontradas diferenças significativas entre o desempenho dos alunos das duas universidades e de diferentes níveis socioeconômicos. Conclusão: menor tempo de leitura apresentou correlação com maior quantidade de acertos na leitura de palavras em voz alta, a quantidade de acertos no teste de homônimos correlacionou-se a quantidade de acertos no teste de leitura de palavras em voz alta e ambas correlacionaram-se com o tempo de resposta destes testes. Houve, também, influência do nível socioeconômico no desempenho da leitura e nos componentes que formam a qualidade lexical.

Padrão temporal, distribuição espacial e fatores associados a incidência de HIV/AIDS entre jovens no Brasil / Temporal pattern, spatial distribution, and factors associated with the incidence of HIV/AIDS among young people in Brazil / Patrón temporal, distribución espacial y factores asociados a la incidencia de la infección por el VIH/sida en jóvenes en Brasil

RESUMO Objetivo. Descrever o padrão temporal e espacial e identificar os fatores associados a incidência de HIV/AIDS entre jovens no Brasil. Método. Estudo ecológico que incluiu jovens brasileiros de 15 a 24 anos notificados com HIV/AIDS de 2001 a 2021. Utilizou-se o método joinpoint para a análise temporal. Aglomerados espaciais foram detectados pelos métodos Bayesiano, autocorrelação espacial, Getis-Ord Gi* e Varredura Scan. Quatro modelos de regressão não espacial e espacial foram usados para identificar fatores associados ao desfecho. Todas as análises estatísticas consideraram p < 0,05. Resultados. No Brasil, a incidência média foi de 12,29 por 100 000 habitantes, com aumento de 7,3% ao ano no período 2007-2014 e posterior decréscimo de 3,4% em 2014-2021. Observou-se padrão Alto/Alto e hotspots, principalmente em municípios do Sul, Sudeste, Centro-Oeste e Norte. O cluster primário localizou-se em 572 municípios do Rio Grande do Sul e Santa Catarina e os maiores riscos relativos em Manaus (Amazonas) e Rondonópolis (Mato Grosso). A taxa de analfabetismo (β = -0,08), Índice de GINI (β = -3,74) e Cobertura da Estratégia de Saúde da Família (β = -0,70) apresentaram relação negativa com o desfecho. Em contrapartida, o Índice Firjan de Desenvolvimento Municipal (β = 2,37), o Índice de Vulnerabilidade Social (β = 6,30), o percentual de pessoas que recebem o Bolsa Família (β = 0,04) e renda per capita (β = 0,008) apresentaram associação positiva. Conclusão. Houve tendência de aumento da incidência de HIV/AIDS até 2014 com posterior declínio até 2021. Aglomerados de altas taxas concentraram-se, especialmente, em municípios das regiões Norte, Sul, Sudeste e Centro-Oeste. Indicadores de vulnerabilidade socioeconômica influenciam o desfecho positivamente ou negativamente, dependendo do território investigado.

ABSTRACT Objective. To describe temporal and spatial patterns and identify the factors associated with the incidence of HIV/AIDS among young people in Brazil. Method. Ecological study of young Brazilians aged 15-24 years with reported HIV/AIDS, from 2001 to 2021. The Joinpoint method was used for the temporal analysis. Spatial clusters were detected using Bayesian methods, spatial autocorrelation, Getis-Ord Gi*, and scan techniques. Four non-spatial and spatial regression models were used to identify factors associated with the result. All statistical analyses considered p < 0.05. Results. In Brazil, the average incidence was 12.29 per 100 000 inhabitants, with an annual increase of 7.3% in the period 2007-2014 and a subsequent 3.4% decrease in 2014-2021. A high-high pattern and hotspots were observed, mainly in municipalities in the South, Southeast, Central-West, and North regions. The primary cluster was located in 572 municipalities in Rio Grande do Sul and Santa Catarina, with the highest relative risks in Manaus (Amazonas) and Rondonópolis (Mato Grosso). The illiteracy rate (β = -0.08), GINI Index (β = -3.74) and Family Health Strategy coverage (β = -0.70) were negatively associated with the result. In contrast, the Firjan Municipal Development Index (β = 2.37), Social Vulnerability Index (β = 6.30), percentage of Bolsa Família recipients (β = 0.04), and per capita income (β = 0.008) showed a positive association. Conclusion. There was an upward trend in the incidence of HIV/AIDS until 2014, followed by a decline until 2021. High-rate clusters were concentrated in municipalities in the North, South, Southeast and Central-West regions in particular. Indicators of socioeconomic vulnerability had positive or negative effects on the result, depending on the territory investigated.

RESUMEN Objetivo. Describir el patrón temporal y espacial, y determinar los factores asociados a la incidencia de infección por el VIH/sida en jóvenes en Brasil. Método. Estudio ecológico en jóvenes brasileños de 15 a 24 años con diagnóstico de infección por el VIH/sida en el período 2001-2021. Para el análisis temporal se utilizó el método de regresión de puntos de inflexión (joinpoint). Los conglomerados espaciales se detectaron con métodos Bayesianos y de autocorrelación espacial, Gi* de Getis-Ord y escaneo. Se utilizaron cuatro modelos de regresión espacial y no espacial para detectar los factores asociados al resultado. En todos los análisis estadísticos se estableció un valor de p < 0,05 como umbral de significación. Resultados. En Brasil, la incidencia media fue de 12,29 por 100 000 habitantes, con un aumento del 7,3% anual en el período 2007-2014 y una reducción posterior del 3,4% en el período 2014-2021. Se observó un patrón alto/alto y la presencia de puntos calientes, principalmente en municipios del Sur, Sudeste, Centro-Oeste y Norte. El principal conglomerado se localizó en 572 municipios de Rio Grande do Sul y Santa Catarina, y los riesgos relativos más altos se observaron en Manaus (Amazonas) y Rondonópolis (Mato Grosso). La tasa de analfabetismo (β = -0,08), el índice de Gini (β = -3,74) y la cobertura de la estrategia de salud familiar (β = -0,70) mostraron una asociación negativa con el resultado. En cambio, el índice de Firjan de desarrollo municipal (β = 2,37), el índice de vulnerabilidad social (β = 6,30), el porcentaje de personas que reciben ayuda del programa de bienestar social Bolsa Família (β = 0,04) y los ingresos per cápita (β = 0,008) mostraron una asociación positiva. Conclusión. Hubo una tendencia al aumento de la incidencia de infección por el VIH/sida hasta el 2014, con una reducción posterior hasta el 2021. Los conglomerados de tasas elevadas se concentraron especialmente en los municipios de las regiones Norte, Sur, Sudeste y Centro-Oeste. Los indicadores de vulnerabilidad socioeconómica tienen una influencia positiva o negativa en el resultado, según el territorio investigado.