Navigating and manipulating childbirth services in Afar, Ethiopia: A qualitative study of cultural safety in the birthing room.

Access to maternal health services has increased in Ethiopia during the past decades. However, increasing the demand for government birthing facility use remains challenging. In Ethiopia's Afar Region, these challenges are amplified given the poorly developed infrastructure, pastoral nature of communities, distinct cultural traditions, and the more nascent health system. This paper features semi-structured interviews with 22 women who were purposively sampled to explore their experiences giving birth in government health facilities in Afar. We used thematic analysis informed by a cultural safety framework to interpret findings. Our findings highlight how women understand, wield, and relinquish power and agency in the delivery room in government health facilities in Afar, Ethiopia. We found that Afari women are treated as 'others', that they manipulate their care as they negotiate 'cultural safety' in the health system, and that they use trust as a pathway towards more cultural safety. As the cultural safety framework calls for recognizing and navigating the diverse and fluid power dynamics of healthcare settings, the onus of negotiating power dynamics cannot be placed on Afari women, who are already multiply marginalized due to their ethnicity and gender. Health systems must adopt cultural safety in order to ensure health quality. Providers, particularly in regions with rich cultural diversity, must be trained in the cultural safety framework in order to be aware of and challenge the multidimensional power dynamics present in health encounters.

Perceptions, experiences, and preferences for partner services among Black and Latino men who have sex with men and transwomen in North Carolina.

OBJECTIVES: In the United States, sexually transmitted infections (STIs) disproportionately affect men who have sex with men (MSM) and transwomen of color. Partner services can prevent STI transmission by facilitating testing and treatment for partners of individuals diagnosed with an STI. Understanding client perspectives towards partner services is critical to their acceptance and uptake. This study examined perceptions, experiences, and preferences for partner services among Black and Latino MSM and transwomen in North Carolina. DESIGN: We conducted seven audio-recorded focus groups in English (n = 5) and Spanish (n = 2). The audio was transcribed verbatim and we inductively analyzed data using field notes, systematic coding, and thematic comparison. RESULTS: Black MSM reported the most exposure and experiences with partner services, and most perceived partner services negatively. Feeling supported and having flexibility characterized positive experiences with partner services among Black MSM; feeling judged or harassed characterized negative experiences. Black transwomen had less exposure to partner services and had a mix of positive reactions to the approach, along with concerns about client confidentiality. Most Latino participants were unaware of partner services and expressed openness to their potential. All participants preferred self-notifying and wanted flexible, discreet, supportive partner services with linkages to other wellness resources. CONCLUSION: Building off positive partner services experiences and responding to client preferences can enhance trust, acceptability, and service use.

Coping with diabetes stress among adults in rural Dominican Republic: "I don't think about it".

OBJECTIVES: As type 2 diabetes prevalence increases across Latin America, understanding local approaches to coping with diabetes stress is essential to providing care that incorporates patients' values and preferences. This study explored a local phenomenon, "no le doy mente" (I don't think about it), used by adults with type 2 diabetes in the Dominican Republic to cope with diabetes stress. METHODS: We conducted 19 qualitative in-depth interviews with adults with type 2 diabetes (10 men, 9 women) recruited from one rural clinic. Using an inductive analytic approach including iterative coding, memos, and matrices, we identified reasons, strategies, and perceived benefits of not thinking about type 2 diabetes among participants. RESULTS: Participants described not thinking about diabetes as an active process to maintain a sense of normalcy despite significant life changes following diagnosis. They avoided thinking about diabetes by staying busy, proactively managing type 2 diabetes through diet and medication, and turning to their faith. Participants perceived that enacting no le doy mente helped to protect their overall health and well-being. DISCUSSION: Future research should investigate provider perceptions of no le doy mente to align patient and provider communication and mindfulness-based stress reduction as a way to support people with type 2 diabetes avoid dwelling on negative thoughts about diabetes.

Types and sources of social support among adults living with type 2 diabetes in rural communities in the Dominican Republic.

Type 2 diabetes management hinges on various determinants, including the role of interpersonal relationships in self-management behaviours. The aim of this study was to explore the types and sources of social support received by adults in the diabetes diagnosis and self-management processes. We conducted qualitative interviews with 28 men and women at two rural clinics in the Dominican Republic and used a combination of narrative and thematic analytic techniques to identify key sources and types of social support in their diabetes experiences. Participants described three stages in their diabetes experience: diagnosis, programme-enrolment, and long-term management. During diabetes diagnosis, most participants described receiving no support. At the programme-enrolment stage, friends and neighbours frequently provided informational or instrumental support to get to the clinic. In long-term management, cohabiting partners provided the most support, which was often assistance with their diet. Our findings highlight he need to assess and leverage distinct types and sources of social support at different stages of the diabetes experience.

Contextualizing Experiences of Diabetes-Related Stress in Rural Dominican Republic.

Type 2 diabetes (T2D) is changing the burden of disease across Latin America. In this formative, qualitative study, we explored experiences of T2D diagnosis and management among adults in rural Dominican Republic. We conducted 28 in-depth interviews (12 men, 16 women) and used inductive analysis to explore the emotional burden of T2D and identify coping strategies. We found that stress relating to T2D began at diagnosis and persisted throughout management. Stress was produced by concerns about healthy food and medication access, fears about illness-induced injury, and the cyclical process of experiencing stress. Participants identified diabetes care and free medication services as external stress-reducers. Internally, participants' mitigated stress by not thinking about diabetes (" no dar mente"). Our study highlights the importance of a contextualized understanding of diabetes-related stress and the need for individual, clinic, and community-level interventions to reduce stressors and improve health outcomes among adults with T2D.

Flower, fruit phenology and flower traits in Cordia boissieri (Boraginaceae) from northeastern Mexico.

We characterized variations in Cordia boissieri flowers and established if these variations occur between plants or between flowering events. Flowering and fruiting was measured for 256 plants. A GLM test was used to determine the relationship between flowering and fruit set processes and rainfall. We performed measurements of floral traits to detect variations within the population and between flowering events. The position of the anthers with respect to the ovary was determined in 1,500 flowers. Three out of four flowering events of >80% C. boissieri plants occurred after rainfall events. Only one flowering event occurred in a drought. Most plants flowered at least twice a year. The overlapping of flowering and fruiting only occurred after rainfall. Anthesis lasted three-to-five days, and there were two flower morphs. Half of the plants had longistylus and half had brevistylus flowers. Anacahuita flower in our study had 1-4 styles; 2-9 stamens; 6.5-41.5 mm long corolla; sepals from 4.5-29.5 mm in length; a total length from 15.5-59 mm; a corolla diameter from 10.5-77 mm. The nectar guide had a diameter from 5-30.5 mm; 4-9 lobes; and 5 distinguishable nectar guide colors. The highest variation of phenotypic expression was observed between plants.

Sistema de Lotes de Siembra de cepas de Neisseria meningitidis cultivadas en medios de origen no animal / Seed Lot System from Neisseria meningitidis strains cultured in non-animal origin media

En la producción de biológicos, especialmente aquellos obtenidos de microorganismos, resulta esencial contar con un suministro de cepas estable y bien caracterizado como materia prima para la producción. Para esto, es imprescindible conservar las cepas vacunales empleando el Sistema de Lotes de Siembra, así como contar con medios de cultivo que garanticen un óptimo crecimiento microbiano y la presencia de los antígenos de interés. En el Instituto Finlay de La Habana se trabaja en la obtención de una vacuna contra Neisseria meningitidis libre de componentes de origen animal. En el presente trabajo se elaboraron y caracterizaron Lotes de Siembra de Referencia y Trabajo de Neisseria meningitidis serogrupos A, C, Y, W135 y X cultivados en medios de origen no animal y cumpliendo con las Buenas Prácticas de Producción vigentes. Se estableció la documentación adecuada que incluye: expedientes de cada lote, los procedimientos normalizados de operación, los registros de elaboración y control de los lotes, las especificaciones de calidad y los certificados de ensayo(AU)

During the manufacturing of biological products derived from microorganisms, stable and well-characterized cells to be used as production source should be provided. In this sense, it is essential to preserve strains using Seed Lot System as well as to have culture media ensuring an optimal growth of microorganisms and the presence of the relevant antigens. Currently, Finlay Institute from Havana works in obtaining a free- from-animal-origin-component vaccine against Neisseria meningitidis serogroups A, C, Y and W. Reference and Working Seed Lots from Neisseria meningitidis serogroups A, C, Y, W and X were developed and characterized, using culture media free from animal-origin components and in compliance with current Good Manufacturing Practices. New documentation was established, including: lot master files, standard operational procedures, lot records, quality control specifications and assay certificates(AU)

Validación del método m­hidroxibifenilo para la cuantificación de ácido urónico en polisacáridos purificados de Streptococcus pneumoniae / Validation of the m-hydroxibiphenil method for the quantitation of uronic acid in purified Streptococcus pneumoniae polysaccharides

Introducción: la complejidad y diversidad estructural de los polisacáridos capsulares de Streptococcus pneumoniae hace que la metodología analítica necesaria para la caracterización y control de calidad sea engorrosa. El método colorimétrico m‒hidroxibifenil desarrollado por Blumenkrantz y Asboe‒Hansen en el año 1973, permite contrarrestar las desventajas del método propuesto en la Farmacopea Europea 6ta Edición, 2011. Objetivo: validar el método m‒hidroxibifenilo para cuantificar ácido urónico en polisacáridos purificados de streptococcus pneumoniae. Métodos: se determinó el tiempo de vigencia de la solución de tetraborato de sodio responsable de generar la respuesta analítica y se seleccionó una metodología para la cuantificación de ácido urónico por el método del m‒hidroxibifenilo se emplea una solución estándar de ácido galacturónico a 1 mg/mL. Se realizó una evaluación de los parámetros de validación: linealidad, exactitud, precisión, rango y especificidad, según exigencias actuales. Además se comparó con el método del carbazol descrito en la Farmacopea Europea 6ta Edición, 2011 para la cuantificación de ácido urónico. Resultados: se demostró que el tiempo de vida útil de la solución de tetraborato de sodio fue de 24 h. El método del m‒hidroxibifenilo fue específico, lineal, exacto y preciso en el rango de 2‒20 µg/mL porque se cumplieron satisfactoriamente los criterios de aceptación establecidos para cada uno de ellos. La comparación del método propuesto con el método normalizado reveló que no existieron diferencias estadísticamente significativas entre ambos(AU) Conclusión: el método colorimétrico del m‒hidroxibifenilo resultó válido para el control de calidad de las muestras de polisacárido purificado de Streptococcus pneumoniae, dando resultados comparables con el método recomendado en la Farmacopea Europea, 2011(AU)

Introduction: complexity and diversity in the structure of Streptococcus pneumoniae capsular makes the analytical methodology for characterization and quality control a troublesome aspect. The colorimetric m/hydroxibiphenil method devised by Blumenklrantz and Asboe-Hansen in 1973 allows reducing the disadvantages of the suggested method in the European Pharmacopea 6th edition, 2011. Objective: to validate the m-hydroxybiphenil method for quantitation of uronic acid in purified Streptococcus pneumonia polysaccharides. Methods: the length of validity of a sodium tetraborate solution, responsible for generating the analytical response, was estimated, and additionally, a methodology for quantitation of uronic acid by the m-hydroxybiphenil method was selected in which a standard galacturonic acid solution at 1mg/ml was used. The validation parameters were evaluated as follows: linearity, accuracy, precision, range and specificity, according to the present requirements. This method was compared with the carbazol method described in the European Pharmacopea 6th edition, 2011 for quantitation of uronic acid. Results: it was demonstrated that the useful lifetime of the sodium tetraborate solution was 24 hours. The m-hydroxybiphenil method was specific, linear, accurate and precise in the range of 2 to 20 ?g/mL because the set acceptance criteria were satisfactorily complied with for each of them. The comparison of the suggested method with the standardized method yielded that no statistically significant differences exist between them. Conclusions: the colorimetric m-hydroxybiphenil method proved to be valid for the quality control of purified Streptococcus pneumonia polysaccharide samples and the results are comparable to those of the recommended method in the European Pharmacopea, 2011(AU)

Validación del método m-hidroxibifenilo para la cuantificación de ácido urónico en polisacáridos purificados de Streptococcus pneumoniae / Validation of the m-hydroxibiphenil method for the quantitation of uronic acid in purified Streptococcus pneumoniae polysaccharides

Introducción: la complejidad y diversidad estructural de los polisacáridos capsulares de Streptococcus pneumoniae hace que la metodología analítica necesaria para la caracterización y control de calidad sea engorrosa. El método colorimétrico m‒hidroxibifenil desarrollado por Blumenkrantz y Asboe‒Hansen en el año 1973, permite contrarrestar las desventajas del método propuesto en la Farmacopea Europea 6ta Edición, 2011. Objetivo: validar el método m‒hidroxibifenilo para cuantificar ácido urónico en polisacáridos purificados de streptococcus pneumoniae. Métodos: se determinó el tiempo de vigencia de la solución de tetraborato de sodio responsable de generar la respuesta analítica y se seleccionó una metodología para la cuantificación de ácido urónico por el método del m‒hidroxibifenilo se emplea una solución estándar de ácido galacturónico a 1 mg/mL. Se realizó una evaluación de los parámetros de validación: linealidad, exactitud, precisión, rango y especificidad, según exigencias actuales. Además se comparó con el método del carbazol descrito en la Farmacopea Europea 6ta Edición, 2011 para la cuantificación de ácido urónico.Resultados: se demostró que el tiempo de vida útil de la solución de tetraborato de sodio fue de 24 h. El método del m‒hidroxibifenilo fue específico, lineal, exacto y preciso en el rango de 2‒20 μg/mL porque se cumplieron satisfactoriamente los criterios de aceptación establecidos para cada uno de ellos. La comparación del método propuesto con el método normalizado reveló que no existieron diferencias estadísticamente significativas entre ambos. Conclusión: el método colorimétrico del m‒hidroxibifenilo resultó válido para el control de calidad de las muestras de polisacárido purificado de Streptococcus pneumoniae, dando resultados comparables con el método recomendado en la Farmacopea Europea, 2011(AU)

Introduction: complexity and diversity in the structure of Streptococcus pneumoniae capsular makes the analytical methodology for characterization and quality control a troublesome aspect. The colorimetric m/hydroxibiphenil method devised by Blumenklrantz and Asboe-Hansen in 1973 allows reducing the disadvantages of the suggested method in the European Pharmacopea 6th edition, 2011. Objective: to validate the m-hydroxybiphenil method for quantitation of uronic acid in purified Streptococcus pneumonia polysaccharides. Methods: the length of validity of a sodium tetraborate solution, responsible for generating the analytical response, was estimated, and additionally, a methodology for quantitation of uronic acid by the m-hydroxybiphenil method was selected in which a standard galacturonic acid solution at 1mg/ml was used. The validation parameters were evaluated as follows: linearity, accuracy, precision, range and specificity, according to the present requirements. This method was compared with the carbazol method described in the European Pharmacopea 6th edition, 2011 for quantitation of uronic acid. Results: it was demonstrated that the useful lifetime of the sodium tetraborate solution was 24 hours. The m-hydroxybiphenil method was specific, linear, accurate and precise in the range of 2 to 20 ?g/mL because the set acceptance criteria were satisfactorily complied with for each of them. The comparison of the suggested method with the standardized method yielded that no statistically significant differences exist between them. Conclusions: the colorimetric m-hydroxybiphenil method proved to be valid for the quality control of purified Streptococcus pneumonia polysaccharide samples and the results are comparable to those of the recommended method in the European Pharmacopea, 2011(AU)

Ethnobotany in Rayones, Nuevo León, México.

BACKGROUND: Trough collections of plants and interviews with 110 individuals, an ethnobotanical study was conducted in order to determine the knowledge and use plant species in Rayones, Nuevo Leon, Mexico. The aim of this study was to record all useful plants and their uses, to know whether differences exist in the knowledge about the number of species and uses between women and men, and to know if there is a correlation between the age of individuals and knowledge of species and their uses. METHODS: A total of 110 persons were interviewed (56 men, 56 women). Semistructured interviews were carried out. The data were analyzed by means of Student t test and the Pearson Correlation Coeficient. RESULTS: A total of 252 species, 228 genera and 91 families of vascular plants were recorded. Astraceae, Fabaceae and are the most important families with useful species and Agave and Opuntia are the genera with the highest number of useful species. One hundred and thirty six species are considered as medicinal. Agave, Acacia and Citrus are the genera with the highest number of medicinal species. Other uses includes edible, spiritual rituals, construction and ornamentals. There was a non-significant correlation between the person's age and number of species, but a significant very low negative correlation between the person's age and number of uses was found. CONCLUSIONS: Knowing their medicinal uses is an important issue for the people of Rayones. Boiling and preparing infusions are the main ways of using plants by residents. The leaves, the branches, and the fruits are the most commonly used parts. Almost 18% of the flora is used for wood and construction purposes. Several uses such as cosmetic, shampoo, firming skin tonics and health hair products recorded in Rayones has not been reported for other areas in the state of Nuevo León. In Rayones, women have a greater knowledge about plants and their uses than men, particularly, medicinal plants, but, men have a greater knowledge about wood and construction species.

Chemical composition and rumen digestion of forage from kleingrass (Panicum coloratum)

El estudio evaluó y comparó, estacionalmente, el contenido nutricional y degradabilidad efectiva de la materia seca (DEMS), proteína cruda (DEPC) y pared celular (DEFDN) de la planta completa, hojas y tallos del zacate klein, sembrado en el noreste de México. El consumo potencial de minerales por bovinos, contenidos en la planta completa del zacate klein, fue también estimado. La colecta manual de plantas fue llevada a cabo en cada estación, en una predera no irrigada de aproximadamente 20ha. Los valores de proteína cruda, Ca,P,Mg,K,Na,Fe,Zn,Cu,Mn,Dems,DEPC,DEFDN fueron significativamente más elevados en primavera que en otras estaciones. Contrariamente, la pared celular y sus componentes (celulosa, hemicelulosa y lignina) fueron significativamente más bajos en primavera que en otras estaciones. Las hojas del zacate klein resultaron con mayor calidad nutritiva y degradabilidad efectiva que los tallos. En el zacate klein, el contenido total de Ca,K y Fe (en todas las estaciones del año), de Mg (excepto en invierno), y Zn y Mn (excepto en invierno y verano) fue suficiente para satisfacer los requerimientos de bovinos en crecimiento; sin embargo P,Na y Cu fueron deficientes en todas las estaciones. En este estudio las hojas tuvieron mejor calidad nutritiva que los tallos; además, la precipitación y el estado de la madurez de la planta tuvieron influencia sobre la calidad nutritiva y degradabilidad ruminal del zacate klein

Ulcera fistulizada por picadura de animal marino: estudio de un caso tratado con laser de Helio-Neón / Necrotic ulcer for stings of marine animal: study of a case treated with Helium-Neon laser

Se presenta un paciente masculino de 30 años de edad, que sufrió en el dorso del pie derecho una picadura de animal marino (raya) cuando cruzaba la desembocadura de un río. No se procedió de inmediato a realizar las medidas específicas para neutralizar la acción proteolítica de la sustancia inoculada; 48 horas después del accidente presentó edema del pie derecho y fiebre. A la semana siguiente presentaba una úlcera necrótica en el sitio de inoculación con un trayecto fistuloso que llegaba hasta las partes blandas de la región plantar. El paciente fue tratado con laser gaseoso de Helio-Neón obteniendo la curación total sin recidivas a las 20 sesiones.