Experiences of pregnant Venezuelan migrants/refugees in Brazil, Ecuador and Peru: a qualitative analysis

BACKGROUND

It is estimated that since 2014, approximately 7.3 million Venezuelan migrants/refugees have left the country. Although both male and female migrants/refugees are vulnerable, female migrants/refugees are more likely to face discrimination, emotional, physical, and sexual violence. Currently there is a lack of literature that explores the experiences of pregnant Venezuelan migrants/refugees. Our aim is to better understand the experience of this vulnerable population to inform programming.

METHODS

In the parent study, Spryng.io's sensemaking tool was used to gain insight into the gendered migration experiences of Venezuelan women/girls. A total of 9339 micronarratives were collected from 9116 unique participants in Peru, Ecuador and Brazil from January to April 2022. For the purpose of this analysis, two independent reviewers screened 817 micronarratives which were identified by the participant as being about someone who was pregnant, ultimately including 231 as part of the thematic analysis. This was an exploratory study and an open thematic analysis of the narratives was performed.

RESULTS

The mean age and standard deviation of our population was 25.77 ± 6.73. The majority of women in the sample already had at least 1 child (62%), were married at the time of migration (53%) and identified as low socio-economic status (59%). The qualitative analysis revealed the following main themes among pregnant Venezuelan migrants/refugees: xenophobia in the forms of racial slurs and hostile treatment from health-care workers while accessing pregnancy care; sexual, physical, and verbal violence experienced during migration; lack of shelter, resources and financial support; and travelling with the hopes of a better future.

CONCLUSION

Pregnant Venezuelan migrants/refugees are a vulnerable population that encounter complex gender-based and societal issues that are rarely sufficiently reported. The findings of this study can inform governments, non-governmental organizations, and international organizations to improve support systems for pregnant migrants/refugees. Based on the results of our study we recommend addressing xenophobia in health-care centres and the lack of shelter and food in host countries at various levels, creating support spaces for pregnant women who experience trauma or violence, and connecting women with reliable employment opportunities and maternal healthcare.

Testimonios in the mouth of the dragon: A call for Black liberation in psychology

U.S. society has witnessed and experienced the impact and suffering caused by the racial pandemic within the COVID-19 viral pandemic. In response to anti-Blackness, a multigenerational and multiracial movement of people is rising and demanding justice for Black lives. Using testimonio research and Liberation Psychology as a theoretical framework, the authors describe their current understanding of what it means to practice a more responsible resistance to racist power structures as non-Black Latinas in the field of psychology. Braun and Clarke's (2016) thematic analysis (TA) was used to search for patterns of meaning within the authors' testimonios. Results revealed four themes: (a) to "hold the line" means to struggle for Black liberation, (b) confront anti-Blackness and colonial mentality in the self and community, (c) challenge anti-Blackness within the field of psychology, and (d) collective struggle. The third theme was divided into two subthemes: (a) tear down and (b) center Black lives. The testimonios emphasize that practicing allyship involves being a dissenter who questions and challenges colonial mentality and anti-Blackness, who fights for the abolition of racist policies and power systems, and who moves beyond the hegemonic values that exist in the field of psychology. This study presents the use of testimonio research and Liberation Psychology as suitable tools for psychologists to increase their racial consciousness. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Respiratory rate estimation from multilead directions, based on ECG delineation

Estimating the instantaneous respiratory rate (Rr) from the electrocardiogram (ECG) is of interest as respiration direct measurement in clinical situations is often cumbersome. In this study, the Rr was estimated from the same Final Directions of maximum projection (FD) used for multi lead ECG automatic delineation. Power spectral analysis over the directions based on QRS complex main peak and T wave onset, peak and end spatial loops was used for Rr estimation. On a subset of the Physionet MGH/MF dataset, the proposed method yielded more accurate Rr estimates (minimum mean absolute error (MAE), 2.82 bpm) than the frequency tracking algorithm (minimum MAE, 4.53 bpm) and Fourier-based frequency estimation (minimum MAE, 4.94 bpm) using each lead alone, outperforming also the weighted multi-signal oscillator-based algorithm estimates for two or three lead (minimum MAE, 3.04 bpm). It was also shown that the FD of the three orthogonalized leads from Principal Component algorithm, improve the performance of Rr estimation.

Isogeneic MSC application in a rat model of acute renal allograft rejection modulates immune response but does not prolong allograft survival

Application of mesenchymal stromal cells (MSCs) has been proposed for solid organ transplantation based on their potent immuno-modulatory effects in vitro and in vivo. We investigated the potential of MSCs to improve acceptance of kidney transplants in an MHC-incompatible rat model including isogeneic kidney transplantation (RTx) as control. MSCs were administered i.v. or i.a. at time of transplantation. No immunosuppression was applied. Renal function was monitored by serum-creatinine, histopathology, immunochemistry for graft infiltrating cells and expressions of inflammatory genes. We demonstrated the short-term beneficial effects of MSC injection. In the long term, however, MSC-related life-threatening/shortening events (thrombotic microangiopathy, infarctions, infections) were evident despite decreased T- and B-cell infiltration, lower interstitial inflammation and downregulated inflammatory genes particularly after i.a. MSC injection. We conclude that i.a. MSC administration provides efficient immunomodulation after allogeneic RTx, although timing and co-treatment strategies need further fine-tuning to develop the full potential of powerful cell therapy in solid organ transplantation.

Respiration effect on single and multi lead ECG delineation strategies

The main purpose of this work is to study the influence of the mechanical effect of the respiration over T wave end delineation. The performance of automatic delineation systems based in Wavelet Transform (WT) was compared, considering single lead (SL), post processing selection rules (SLR) and multi lead (ML) approaches. The T wave locations obtained over real and simulated ECG signals were analyzed together with the respective respiratory signal (ECG-derived or simulated). The linear relation between the variations on obtained marks and the mechanical effect of the respiration was measured using spectral coherence. With respect to the ML strategy we also explored the evolution of the vectorcardiographic spatial loop using the direction of maximum projection of the WT in the region close to the T wave end (T(e)). The relation between this direction and the respiration is also explored. The marks obtained from the SLR and ML delineation strategies show advantage over the SL strategy based marks. The coherence around the respiratory frequency between the respiratory signal and the error in T end marks was found to be higher using SLR (a minimum of 0.92) than using ML (a maximum of 0.80). According to obtained results, the multi lead delineation presents a lower sensibility to the mechanical effect of the respiration for the T wave end delineation, particularly the obtained with ML.

[Interaction of work demands in the genesis of mental suffering]

Current working conditions and new forms of work organization are affecting workers' health in numerous ways which can only be explained by more complex theories and methodologies than those used traditionally. The authors analyze some important elements of the work process and the interaction among work demands as determinants of mental and psychosomatic disorders and fatigue (MPDF) among workers in a Mexican industrial plant. The workers studied (n = 830) were male, with a mean age of 32. MPDF represent one-third of the disease burden among these workers. An association was observed with the number of years worked, type of activity, and job area. Job-related demands and work organization, including excessive work, strict supervision, dangerous work, unnatural positions, and intense and hard physical labor were also closely related to these conditions. The most relevant problem is the combination of many different demands. Interaction among the combinations was found to be additive or synergistic. In the latter condition the risk of morbid effects increases beyond merely an additive effect.

[Resistance of human immunodeficiency virus (HIV) to zidovudine. Genotypic analysis in strains isolated from Chilean patients]

BACKGROUND

Resistance of HIV to AZT is the result of mutations in the pol gene that codifies the enzyme reverse transcriptase.

AIM

To assess the resistance to antiretroviral drugs in Chilean patients infected with HIV.

MATERIAL AND METHODS

The presence of mutations was searched in 22 patients infected with HIV. The emergence or persistence of these mutations was studied in sequential samples of 19 patients. The presence of the mutation that confers resistance to didanosine (DDI) was studied in those subjects exposed to the drug. Polymerase chain reaction techniques were used to analyze mutations in codons 41, 70 and 215 of the pol gene (resistance to AZT) and the mutation in codon 71 (resistance to DDI).

RESULTS

On admission, none of the patients without previous exposure to AZT had drug resistance mutations. Seven of 12 patients (58.3%) that had received AZT had mutations in codon 215. In two, they were associated to a mutation in codon 41 and in two, a mutation in codon 70. After a mean follow up of 14 months, 13 of 15 patients (86%) that received AZT had viral strains genotypically resistant to the drug. In nine of these, the resistance was associated with disease progression. None of the 10 patients that received DDI had the mutation in codon 74 that confers resistance to the drug. However, in one of these patients, that never received AZT, a virus with a mutation in codon 215 was detected.

CONCLUSIONS

A high percentage of patients that have received monotherapy with AZT have genotypic resistance to the drug. This resistance is associated with clinical and immunological derangement in 70% of these subjects.

[Natural history of human immunodeficiency virus infection in a cohort of Chilean patients]

We characterized clinical manifestations and the risk to develop AIDS in a cohort of 32 patients infected with human immunodeficiency virus without AIDS A multivariate analysis was performed to determine association between the progression of infection and control variables (socioeconomic level, age, sex and sexual preferences) and causal variables (psycho-social changes, significant clinical events, stress scoring and sexual activity). The cumulative AIDS incidence, defined as a CD4 lymphocyte count below 200 cells/cm3 was 50% at 6.5 years and 82% at 8 years. Using clinical criteria to define AIDS, 50% developed the disease at 8 years of follow up. Among studied factors, only age (faster progression at higher age) and time of evolution were associated with progression in stages before AIDS, the most frequent diseases were acute diarrhea, sexual transmission diseases, oral candidiasis, sinusitis and varicella zoster infections. The reduction; of CD4 lymphocytes-below 200 cells/cm3 always preceded the symptoms of the disease. Two patients have remained more than eight years without clinical or immunological deterioration.

Participatory research on workers' health

The concern for workers' health has increased in Latin America during the last decade both on the part of research institutions and trade unions. A special emphasis has been given to active participation of workers not just in the transformation of working conditions to improve health but also in generation of knowledge. This paper presents an action oriented participatory research methodology based on a collective questionnaire that permits the recollection of data on characteristics of the labour process, risks and health damage. A comparison between the information on risks, health damage and the relationship risks-damage obtained with this methodology and those of an individual questionnaire applied at the same steel factory shows that the results produced are very similar. In view of these findings it is concluded that the participatory methodology has some important advantages over traditional methodologies since it provides qualitative information on the labour process, a precise picture of the main risks and how they are produced and semi-quantitative data on health damage, and at the same time, generates a process of consciousness and organization among workers that enables them to promote health oriented action.

Increased stimulation of alkaline phosphatase by small doses of colchicine entrapped in liposomes. A biochemical test to detect effective liposome-hepatocyte interaction

The subcutaneous administration of colchicine encapsulated in small unilamellar vesicles reduced the initial toxicity peak and maintained for several days an adequate level of the drug in the liver. Colchicine is an excellent marker for effective liposome-hepatocyte interaction since it fulfills the following criteria: (a) When taken up by the hepatocytes within liposomes, it is active and induces the synthesis of alkaline-phosphatase two to three times over control values. The injection of at least ten times more free colchicine is necessary to attain a similar induction. (b) If released from extracellular liposomes, colchicine is cleared rapidly from the circulation. The results show that liposomes, in spite of their reduced aqueous compartment (approximately 1.0 microliter/mumole of lipid), can achieve clinical utility when administered subcutaneously because of their efficient interaction with parenchymal cells and their continual arrival from the injection site.