To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Given the high disease burden associated with the low intake of whole grains, modelling studies that estimate the impact of dietary strategies to increase more healthful grain foods consumption are essential to inform evidence-based and culturally specific policies. The current study investigated the potential nutritional impact of replacing staple grain foods with more healthful options.
Based on the 2015 Health Survey of São Paulo, a cross-sectional, population-based study, we modelled the substitution of white rice and white bread with brown rice and whole-wheat bread. Outcomes included changes in more healthful grain foods, energy and nutrient intakes.
Urban area of São Paulo, Brazil.
Participants aged over 12 years who completed a semi-structured questionnaire and one 24-h recall (n 1741).
The substitution of all white rice and white bread with brown rice and whole-wheat bread, respectively, would result in more than 5 % increases in Zn (+9·1 %), Ca (+9·3 %), vitamin E (+18·8 %), dietary fibre (+27·0 %) and Mg (+52·9 %) intake, while more than a 5 % decrease would be seen for total carbohydrate (–6·1 %), folate (–6·6 %), available carbohydrate (–8·5 %), Fe (–8·6 %), vitamin B6 (–12·5 %), vitamin B2 (–17·4 %), and vitamin B1 (–20·7 %). A substantial increase in the amount of more healthful grain foods consumed would be seen (10 g/d to 220 g/d, or from 4 % to 69 % of total grain intake).
Replacing white rice and white bread with their whole-grain versions has the potential to improve diet quality, suggesting they are prime targets for policy actions aiming at increasing intake of more healthful grain foods.
Catheter ablation is a safe and effective therapy for the treatment of supraventricular tachycardia in children. Current improvements in technology have allowed progressive reduction in radiation exposure associated with the procedure. To assess the impact of three-dimensional mapping, we compared acute procedural results collected from the Catheter Ablation with Reduction or Elimination of Fluoroscopy registry to published results from the Prospective Assessment after Pediatric Cardiac Ablation study.
Inclusion and exclusion criteria from the Prospective Assessment after Pediatric Cardiac Ablation study were used as guidelines to select patient data from the Catheter Ablation with Reduction or Elimination of Fluoroscopy registry to compare acute procedural outcomes between cohorts. Outcomes assessed include procedural and fluoroscopy exposure times, success rates of procedure, and complications.
In 786 ablation procedures, targeting 498 accessory pathways and 288 atrioventricular nodal reentrant tachycardia substrates, average procedural time (156.5 versus 206.7 minutes, p < 0.01), and fluoroscopy time (1.2 versus 38.3 minutes, p < 0.01) were significantly shorter in the study group. Success rates for the various substrates were similar except for manifest accessory pathways which had a significantly higher success rate in the study group (96.4% versus 93.0%, p < 0.01). Major complication rates were significantly lower in the study group (0.3% versus 1.6%, p < 0.01).
In a large, multicentre study, three-dimensional systems show favourable improvements in clinical outcomes in children undergoing catheter ablation of supraventricular tachycardia compared to the traditional fluoroscopic approach. Further improvements are anticipated as technology advances.
To examine whether the educational level moderates the relationship between baseline depressive symptoms and cognitive functioning at 5- and 10-year follow-ups in older adults, considering the association between cognitive functioning and difficulty with activities of daily living (ADL).
Using a prospective design, a path analysis was performed.
In-home, face-to-face interviews and self-administered questionnaires, within the National Social Life, Health, and Aging Project.
In total, 1,461 participants (mean age = 66.62) were followed up from Wave 1 (baseline) to Wave 2 (at 5 years) and Wave 3 (at 10 years).
Depressive symptoms were assessed at baseline. Cognitive functioning and difficulty with ADL were assessed at baseline and at 5 and 10 years.
Educational level moderates the relationship between depressive symptoms and cognitive functioning at 5 years (β = 0.07, SE = 0.03, p = 0.04, Cohen’s f2 = 0.02), being depressive symptoms related to poor cognitive functioning only at low educational levels. Cognitive functioning predicts difficulty with ADL at 5 and 10 years (β = −0.08, SE = 0.03, p = 0.008, Cohen’s f2 = 0.01; β = −0.09, SE = 0.03, p = 0.006, Cohen’s f2 = 0.02). The proposed model yielded excellent fit (CFI = 1.00, RMSEA = 0.0001, 90% CI 0.0001–0.03, SRMR = 0.004, and χ2(8) = 7.16, p = 0.52).
Cognitive reserve may act as a protective factor against the effect of depressive symptoms on cognition in older adults, which, in turn, is relevant to their functional independence.
As an evolutionary lineage cycads are rare, and the extinction risk is high for many species. The genus Ceratozamia, one of the most diverse in Mexico, is experiencing drastic reductions of its habitat. Ceratozamia is widely distributed along the Sierra Madre Oriental, a complex mountain range, in a region characterized by high ecological and cultural diversity. Since 1990, various conservation and management strategies have been applied to this taxon in Mexico but evidence for the effectiveness of these measures is lacking. Ceratozamia in the Mexican Sierra Madre Oriental is highly diverse and endemic, offering a model for analysing geographical distribution patterns with ecological niche modelling. It also presents an opportunity for assessing the success of conservation and management strategies that have been implemented in this area. Here, we examined three aspects that are considered fundamental for the development and evaluation of conservation strategies: (1) taxonomy, (2) ecology and (3) sociocultural anthropology. Our findings suggest a pessimistic outlook for the long-term survival of Ceratozamia species in their natural environment, indicating the need to review the current IUCN Cycad Action Plan for the genus. To improve the protection of Ceratozamia and other taxonomic and/or ecological assemblages, we encourage a multidisciplinary approach, with increased collaboration between natural and social scientists.
This study looks at human capital in Spain during the early stages of modern economic growth. We have assembled a new dataset for age-heaping and literacy in Spain with information about men and women from six population censuses and forty-nine provinces between 1877 and 1930. Our results show that, although age-heaping was less prevalent during the second half of the 19th century than previously thought, it did not decline until the early 20th century. Given that literacy increased throughout the whole period, our study thus unveils stark differences between age-heaping and literacy, which raises further questions regarding sources, methods and interpretation.
This study has two main objectives: to describe the prevalence of undetected chronic obstructive pulmonary disease (COPD) in a clinical sample of smokers with severe mental illness (SMI), and to assess the value of the Tobacco Intensive Motivational Estimated Risk tool, which informs smokers of their respiratory risk and uses brief text messages to reinforce intervention.
A multicenter, randomized, open-label, and active-controlled clinical trial, with a 12-month follow-up. Outpatients with schizophrenia (SZ) and bipolar disorder were randomized either to the experimental group—studied by spirometry and informed of their calculated lung age and degree of obstruction (if any)—or to the active control group, who followed the 5 A’s intervention.
The study sample consisted of 160 patients (71.9% SZ), 78.1% of whom completed the 12-month follow-up. Of the patients who completed the spirometry test, 23.9% showed evidence of COPD (77.8% in moderate or severe stages). TIMER was associated with a significant reduction in tobacco use at week 12 and in the long term, 21.9% of patients reduced consumption and 14.6% at least halved it. At week 48, six patients (7.3%) allocated to the experimental group achieved the seven-day smoking abstinence confirmed by CO (primary outcome in terms of efficacy), compared to three (3.8%) in the control group.
In this clinical pilot trial, one in four outpatients with an SMI who smoked had undiagnosed COPD. An intensive intervention tool favors the early detection of COPD and maintains its efficacy to quit smoking, compared with the standard 5 A’s intervention.
Cyclospora cayetanensis is a parasite causing cyclosporiasis (an illness in humans). Produce (fruits, vegetables, herbs), water and soil contaminated with C. cayetanensis have been implicated in human infection. The objective was to conduct a scoping review of primary research in English on the detection, epidemiology and control of C. cayetanensis with an emphasis on produce, water and soil. MEDLINE® (Web of ScienceTM), Agricola (ProQuest), CABI Global Health, and Food Science and Technology Abstracts (EBSCOhost) were searched from 1979 to February 2020. Of the 349 relevant primary research studies identified, there were 75 detection-method studies, 40 molecular characterisation studies, 38 studies of Cyclospora in the environment (33 prevalence studies, 10 studies of factors associated with environmental contamination), 246 human infection studies (212 prevalence/incidence studies, 32 outbreak studies, 60 studies of environmental factors associated with non-outbreak human infection) and eight control studies. There appears to be sufficient literature for a systematic review of prevalence and factors associated with human infection with C. cayetanensis. There is a dearth of publicly available detection-method studies in soil (n = 0) and water (n = 2), prevalence studies on soil (n = 1) and studies of the control of Cyclospora (particularly on produce prior to retail (n = 0)).
With the legalization of marijuana (Cannabis sativa) and increasing use during pregnancy, it is important to understand its impact on exposed offspring. Specifically, the effects of Δ-9-tetrahydrocannabinol (Δ9-THC), the major psychoactive component of cannabis, on fetal ovarian development and long-term reproductive health are not fully understood. The aim of this study was to assess the effect of prenatal exposure to Δ9-THC on ovarian health in adult rat offspring. At 6 months of age, Δ9-THC-exposed offspring had accelerated folliculogenesis with apparent follicular development arrest, but no persistent effects on circulating steroid levels. Ovaries from Δ9-THC-exposed offspring had reduced blood vessel density in association with decreased expression of the pro-angiogenic factor VEGF and its receptor VEGFR-2, as well as an increase in the anti-angiogenic factor thrombospondin 1 (TSP-1). Collectively, these data suggest that exposure to Δ9-THC during pregnancy alters follicular dynamics during postnatal life, which may have long-lasting detrimental effects on female reproductive health.
Fibromyalgia (FM) is a chronic syndrome characterized by heterogeneous clinical manifestations, and knowing this variability can help to develop tailored treatments. To understand better the heterogeneity of FM the present cross-sectional study analyzed the role of several physical symptoms (pain, fatigue and poor sleep quality) and cognitive-affective variables related to pain (pain catastrophizing, pain vigilance, self-efficacy in pain management, and pain acceptance) in the configuration of clinical profiles. A sample of 161 women with FM fulfilled an interview and several self-report measures to explore physical symptoms, cognitive-affective variables, disability and psychopathology. To establish FM groups a hierarchical cluster analysis was performed. The findings revealed three clusters that differed in the grouping variables, Wilks’ λ = .17, F(14, 304) = 31.50, p < .001, ηp2 = .59. Group 1 (n = 72) was characterized by high physical and psychological affectation, Group 2 (n = 19) by low physical affectation and high pain self-efficacy, and Group 3 (n = 70) by moderate physical affectation and low pain catastrophizing. The external validation of the clusters was confirmed, Wilks’ λ = .72, F(4, 314) = 14.09, p < .001, ηp2 = .15, showing Group 1 the highest levels of FM impact and psychopathological distress. Considering the distinctive clinical characteristics of each subgroup therapeutic strategies addressed to the specific needs of each group were suggested. Assessing FM profiles may be key for a better understanding and approach of this syndrome.
To investigate potential age, period and birth cohort effects in the prevalence of suicide ideation in European ageing population.
A total of 50 782 community-dwelling adults (aged + 50) from 20 different European countries were collected in the Survey Health Ageing and Retirement study. A multilevel logistic regression model of repeated measures was modelled to assess the effects of age and other variables, including the variability of observations over three levels: birth cohort groups, time period assessment and individual differences.
The larger effect of variability was attributed to individual-level factors (57.8%). Youngest-old people (65–79 years) showed lower suicide ideation than middle-aged people (50–64 years). No significative differences were found for suicide ideation between middle-aged people and oldest-old (80 + years). Only 0.85% and 0.13% of the total variability of suicide ideation accounted for birth cohort and period effects, respectively. Cohorts born between 1941 and 1944 possessed the lowest estimates of suicide ideation. Conversely, suicide ideation started to rise with post-War generations and reached a significant level for people born from 1953–1957 to 1961–1964. Regarding the time period, participants assessed in 2006–2007 showed a lower likelihood of suicide ideation. The rest of the cohorts and period groups did not show any significant effect on the prevalence of suicide ideation.
Our results suggest that age and suicide ideation relationship is not linear in middle and older age. The European Baby boomers born from 50s to mid-60s might report higher suicide ideation than their ancestors. This scenario would imply a greater need for mental healthcare services for older people in the future.
The complex geographical scenario of Mexico allowed the cultural diversification and development of multiple cultures such as Tolteca, Teotihuacan, Mexica, and Maya, among others. Despite this rich cultural heritage, radiometric dating of Mexican cultural samples with radiocarbon (14C) began only in the 1980s and with accelerator mass spectrometry (AMS) in 2013. Analysis of 14C with AMS is the most widely used technique to date archaeological objects and cultural heritage. Since 2013, the Accelerator Mass Spectrometry Laboratory (LEMA) facility of the Institute of Physics at UNAM (IF-UNAM) has supported archaeological research in Mexico, but also investigation in other areas such as geology, physics, chemistry, and environmental sciences through the analysis of 14C, 10Be, 26Al, 129I, and Pu. The absolute dating with 14C continues to be the core of LEMA’s work, where different geographical scenarios of the country and climatic conditions present very diverse analytical challenges. This work presents a basic description of the AMS system of the LEMA laboratory and describes some applications that are currently being developed.
The aim was to analyse invasive pneumococcal disease (IPD) serotypes in children aged ⩽17 years according to clinical presentation and antimicrobial susceptibility. We conducted a prospective study (January 2012–June 2016). IPD cases were diagnosed by culture and/or real-time polymerase chain reaction (PCR). Demographic, microbiological and clinical data were analysed. Associations were assessed using the odds ratio (OR) and 95% confidence intervals (CI). Of the 253 cases, 34.4% were aged <2 years, 38.7% 2–4 years and 26.9% 5–17 years. Over 64% were 13-valent pneumococcal conjugate vaccine (PCV13) serotypes. 48% of the cases were diagnosed only by real-time PCR. Serotypes 3 and 1 were associated with complicated pneumonia (P < 0.05) and non-PCV13 serotypes with meningitis (OR 7.32, 95% CI 2.33–22.99) and occult bacteraemia (OR 3.6, 95% CI 1.56–8.76). Serotype 19A was more frequent in children aged <2 years and serotypes 3 and 1 in children aged 2–4 years and 5–17 years, respectively. 36.1% of cases were not susceptible to penicillin and 16.4% were also non-susceptible to cefotaxime. Serotypes 14, 24F and 23B were associated with non-susceptibility to penicillin (P < 0.05) and serotypes 11, 14 and 19A to cefotaxime (P < 0.05). Serotype 19A showed resistance to penicillin (P = 0.002). In conclusion, PCV13 serotypes were most frequent in children aged ⩽17 years, mainly serotypes 3, 1 and 19A. Non-PCV13 serotypes were associated with meningitis and occult bacteraemia and PCV13 serotypes with pneumonia. Non-susceptibility to antibiotics of non-PCV13 serotypes should be monitored.
We investigate the late-time Richtmyer–Meshkov instability (RMI) growth of sinuous perturbations on an air/sulphur hexafluoride interface (Atwood number,
$A \sim 0.67$
) subjected to a Mach 1.2 planar shock wave at Los Alamos National Laboratory's vertical shock tube facility. Interface perturbations are established using a novel membraneless technique where cross-flowing air and SF
separated by an oscillating splitter plate create a perturbed density interface. The interface formed has multi-modal features and residual small perturbations, however, a dominant mode is still noticeable. The late-time perturbation growths scale with
initial conditions (where
is the wavenumber and
is the initial amplitude of the dominant mode) as measured at the pre-shock interface. Past nonlinear models based on potential-flow theory, heuristic/interpolation approaches, Padé approximants and numerical simulations are evaluated against present experimental results. Accounting for an explicit
dependence in Sadot et al.'s (Phys. Rev. Lett., vol. 80, issue 8, 1998, pp. 1654–1657) model, we propose an empirical rational function that captures the asymptotic behaviour of perturbation growth for a broad range of initial conditions (
$0.30 \leq ka_0 \leq 0.86$
). The onset of mixing transition and its initial condition dependence are investigated with respect to the minimum state criterion (
$Re = 1.6 \times 10^5$
) for unsteady flows by Zhou (Phys. Plasmas, vol. 14, 2007, 082701). Earlier mixing transitions for higher
initial conditions are noted from local and global Reynolds number estimates which are corroborated by the existence of an inertial sub-range and formation of mixing regions indicating the physical significance of the minimum state criterion in RMI flows. The transition is accompanied by the increasing teapot-like appearance of joint probability density functions of
(invariants of the reduced velocity gradient tensor), establishing the technique as a useful tool for turbulence detection in two-dimensional diagnostics.
It's been proved that cognitive stimulation has direct effects over the improvement of general cognitive functions in people with cognitive impairment. People older than 50 are progressively familiar with computers and mobile devices, opening an opportunity for computer based online cognitive stimulation programmes.
To compare the efficacy of face to face cognitive stimulation (FFCS) with online home delivered cognitive stimulation (OCS) regarding adherence, number of sessions, cognitive function and mood.
Patients and Methods
Participants were enrolled in a public memory clinic; 51 patients with cognitive decline were assigned to two groups: 27 received FFCS in a group format and 24 received OCS with the assistance of a carer. Both face to face and online interventions where designed and supervised by a trained Occupational Therapist. Pre and post assessments were carried out by a Clinical Psychologist with the Mini Mental State Exam (MMSE), the clock test, and the brief Geriatric Depression Scale. No differences were found between groups in age (69.65±9.74 years), cognitive function (MMSE=24.63±3.67), gender (55% women) and education. The treatment consisted of 32 sessions of CS held twice a week during 4 months.
Data was analysed with nonparametric statistics and between group effect sizes were calculated. The FFCS participants completed 29.19 ± 1.73 sessions while the OCS group completed 26.00 ± 10.64 sessions (p < .000). All the participants in the FFCS group (100%) and 14 of the OCS group (58%) finished the treatment (p < .000).
Between group effect size favoured the FFCS intervention for MMSE (dc = 0.36). No between group differences were found for mood (dc = −0.5) or the clock test (dc = 0.13).
FFCS is better accepted by patients than OCS, with higher rates of adherence and less dropouts. FFCS leads to better results in the preservation of cognitive capacity.
Background: Annual flu vaccination is the most effective way to prevent the disease and its complications. Vaccine effectiveness (EV) varies from season to season, requiring annual re-evaluation. The objective of this study was to estimate the preliminary effectiveness of the influenza vaccine until epidemiological week 4 of the 2019–2020 season, in patients admitted to a tertiary-level hospital. Method: We conducted a case-control study at University General Hospital, Alicante, Spain, during the 2019–2020 season. We included all patients hospitalized with influenza confirmed by laboratory test (ie, PCR positive for influenza) during the period between epidemiological week 40 of 2019 and epidemiological week 4 of 2020. These were considered cases, and those with clinical suspicion of influenza and negative RT-PCR were considered controls. Vaccination coverage was calculated in cases and in controls, determining the odds ratio. We calculated the vaccine effectiveness (VE) and its 95% confidence interval using the following formula: VE = (1 − odds ratio) ×100. Result: We included 545 patients: 61 cases and 484 controls. The overall EV for influenza cases prevention was 40.7% (95% CI, −17.1 to 70.1), and for those >1 year of age, the overall EV was 56.9% (95% CI, 13.9–78.5). Conclusion: The 2019–2020 Influenza vaccine was effective in preventing influenza cases in patients admitted up to week 4 of the 2019–2020 season. These results are preliminary and may vary; they should be re-evaluated at the end of the season.
Background: Estimating the burden of intestinal colonization with antibiotic-resistant gram-negative bacteria (AR-GNB) is critical to understanding their global epidemiology and spread. We aimed to determine the prevalence of, and risk factors for, intestinal colonization due to AR-GNB in population-based hospital and community settings in Chile. Methods: Between December 2018 and May 2019, we enrolled randomly selected hospitalized adults in 4 tertiary-care public hospitals (Antofagasta, Santiago, Curico and Puerto Montt), and adults residing in a community-based cohort in the rural town of Molina. Following informed consent, we collected rectal swabs and epidemiological information through a standardized questionnaire. Swabs were plated onto MacConkey agar with 2 µg/mL ciprofloxacin or ceftazidime. All recovered morphotypes were identified, and antibiotic susceptibility testing was performed via disk diffusion. The primary outcome was the prevalence of colonization with fluoroquinolone (FQ)- or third-generation cephalosporin (3GC)–resistant GNB. The secondary outcome was the prevalence of colonization with multidrug-resistant (MDR) GNB, defined as GNB resistant to ≥3 antibiotic classes. Categories were not mutually exclusive. Bivariate and multivariate analyses were performed to describe risk factors for colonization with these categories. Results: In total, 775 hospitalized adults and 357 community participants were enrolled, with a median age of 60 years (IQR, 42–72) and 55 years (IQR, 48–62) years, respectively. Among hospitalized participants, the prevalence of colonization with FQ- or 3GC-resistant GNB was 47% (95% CI, 43%–50%) and 41% (95% CI, 38%–45%), respectively, whereas the prevalence of MDR-GNB colonization was 27% (95% CI, 24%–31%). In the community setting, the prevalence of colonization with either FQ-, 3GC-resistant GNB, or MDR-GNB was 40% (95% CI, 34%–45%), 29% (95% CI, 24%– 34%), and 5% (95% CI, 3%–8%), respectively. Independent risk factors for hospital MDR-GNB colonization included the hospital of admission, unit of hospitalization (intensive care units carried the highest risk), in-hospital antimicrobial exposure, comorbidities (Charlson index), and length of stay. In the community setting, recent antibiotic exposure (<3 months) predicted colonization with either FQ- or 3GC-resistant GNB, and alcohol consumption was inversely associated with MDR GNB colonization. Conclusions: A high burden of colonization with AR-GNB was observed in this sample of hospitalized and community-dwelling adults in Chile. The high burden of colonization with GNB resistant to commonly used antibiotics such as FQ and 3GC found in community dwellers, suggests that the community may be a relevant source of antibiotic resistance. Efforts to understand relatedness between resistant strains circulating in the community and the hospital are needed.
The Mayan Codex of Mexico (MCM), the only Mayan codex found in the 20th century, was unveiled in 1971 during the Ancient Maya Calligraphy exhibition at Club Grolier. The codex comprises 10 pages of bark paper in accordion format, coated with a layer of plaster on both sides. It illustrates the synodic cycles of Venus, with its four phases. Since its discovery, the MCM has been subject to controversy and discussions about its authenticity. In 2016, a group of specialists led by Baltazar Brito chief of the National Library of Anthropology and History, carried out an exhaustive study of the codex with the purpose of determining its temporality and authenticity. In this work, the pre-Columbian authenticity of the codex is verified by the radiocarbon (14C) technique using AMS. Two cleaning procedures were contrasted: the standard acid-base-acid (ABA) protocol and a second one with Soxhlet plus ABA. Results obtained when samples were prepared following ABA protocol only, placed the age of the bark paper between 991 and 1147 cal AD. The second cleaning method with Soxhlet plus ABA, resulted in younger ages, between 1159 and 1261 cal AD. However, we consider that when Sohxlet is used as part of the cleaning protocol, organic contaminants are reduced to a minimum, and 14C dates are more reliable. These results indicate that the vegetal support of the MCM belongs to Postclassical Mayan period and place it as the oldest known manuscript of America found to date.
In 1990, Latin American countries committed to psychiatric reforms including psychiatric bed removals. Aim of the study was to quantify changes in psychiatric bed numbers and prison population rates after the initiation of psychiatric reforms in Latin America.
We searched primary sources to collect numbers of psychiatric beds and prison population rates across Latin America between the years 1991 and 2017. Changes of psychiatric bed numbers were compared against trends of incarceration rates and tested for associations using fixed-effects regression of panel data. Economic variables were used as covariates. Reliable data were obtained from 17 Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Honduras, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, El Salvador, Uruguay and Venezuela.
The number of psychiatric beds decreased in 15 out of 17 Latin American countries (median −35%) since 1991. Our findings indicate the total removal of 69 415 psychiatric beds. The prison population increased in all countries (median +181%). Panel data regression analyses showed a significant inverse relationship −2.70 (95% CI −4.28 to −1.11; p = 0.002) indicating that prison populations increased more when and where more psychiatric beds were removed. This relationship held up when introducing per capita income and income inequality as covariates −2.37 (95% CI −3.95 to −0.8; p = 0.006).
Important numbers of psychiatric beds have been removed in Latin America. Removals of psychiatric beds were related to increasing incarceration rates. Minimum numbers of psychiatric beds need to be defined and addressed in national policies.