Being a mother of preterm multiples in the context of socioeconomic disadvantage: perceived stress and psychological symptoms / Ser mãe de múltiplos prematuros no contexto de desvantagem socioeconômica: estresse percebido e sintomas psicológicos

Abstract Objective: This study aimed to examine the differences between mothers of preterm multiples and mothers of preterm singletons regarding perceived stress and maternal psychological symptoms, and to explore the putative adverse amplified effect of socioeconomic disadvantage. Method: Ninety-five mothers of 1-year-olds born preterm participated in this cross-sectional study. Data collection was carried out in two public hospitals from Northern Portugal. To assess maternal perceived daily stress and psychological symptoms, mothers completed two questionnaires. Mothers reported on socioeconomic factors, including family poverty, parent unemployment, and low education, and two groups of family socioeconomic disadvantage were created. A child medical risk index was calculated. Results: Results indicated that mothers of preterm multiples reported higher levels of stress than mothers of preterm singletons. Moreover, and specifically regarding psychological functioning, mothers of preterm multiples reported more symptoms than mothers of preterm singletons, but only when living in a context of socioeconomic adversity. Conclusions: The results of the present study have important implications for practice. Mothers of preterm multiples are at higher risk to present mental health difficulties, in comparison to mothers of singletons, especially when exposed to socioeconomic adversities. The development of psychosocial intervention programs and public policies are of decisive importance in helping mothers of multiples adjust to parenthood.

Resumo Objetivo: Examinar as diferenças entre mães de múltiplos prematuros e mães de filhos únicos prematuros a respeito de estresse percebido e sintomas psicológicos maternos e explorar o efeito adverso amplificado putativo da desvantagem socioeconômica. Método: Participaram deste estudo transversal 95 mães de crianças de um ano nascidas prematuras. A coleta de dados foi feita em dois hospitais públicos do norte de Portugal. Para avaliar o estresse diário percebido e os sintomas psicológicos maternos, as mães responderam dois questionários. As mães relataram fatores socioeconômicos, incluindo pobreza familiar, desemprego dos pais e baixo nível de escolaridade, e foram criados dois grupos de desvantagem socioeconômica familiar. Foi calculado um índice de risco médico infantil. Resultados: Os resultados indicaram que as mães de múltiplos prematuros relataram maiores níveis de estresse do que as mães de filhos únicos prematuros. Além disso e especificamente com relação ao funcionamento psicológico, as mães de múltiplos prematuros relataram mais sintomas do que as mães de filhos únicos prematuros, porém apenas quando moravam em um contexto de adversidade socioeconômica. Conclusões: Os resultados deste estudo possuem importantes implicações para a prática. As mães de múltiplos prematuros apresentam maior risco de dificuldades de saúde mental, em comparação a mães de filhos únicos, principalmente quando expostas a adversidades socioeconômicas. O desenvolvimento de programas de intervenção psicossocial e políticas públicas é de importância decisiva ao ajudar as mães de filhos múltiplos a se ajustarem à maternidade.

Being a mother of preterm multiples in the context of socioeconomic disadvantage: perceived stress and psychological symptoms.

OBJECTIVE: This study aimed to examine the differences between mothers of preterm multiples and mothers of preterm singletons regarding perceived stress and maternal psychological symptoms, and to explore the putative adverse amplified effect of socioeconomic disadvantage. METHOD: Ninety-five mothers of 1-year-olds born preterm participated in this cross-sectional study. Data collection was carried out in two public hospitals from Northern Portugal. To assess maternal perceived daily stress and psychological symptoms, mothers completed two questionnaires. Mothers reported on socioeconomic factors, including family poverty, parent unemployment, and low education, and two groups of family socioeconomic disadvantage were created. A child medical risk index was calculated. RESULTS: Results indicated that mothers of preterm multiples reported higher levels of stress than mothers of preterm singletons. Moreover, and specifically regarding psychological functioning, mothers of preterm multiples reported more symptoms than mothers of preterm singletons, but only when living in a context of socioeconomic adversity. CONCLUSIONS: The results of the present study have important implications for practice. Mothers of preterm multiples are at higher risk to present mental health difficulties, in comparison to mothers of singletons, especially when exposed to socioeconomic adversities. The development of psychosocial intervention programs and public policies are of decisive importance in helping mothers of multiples adjust to parenthood.

Integrative taxonomy of Goezia spinulosa (Nematoda: Raphidascarididae) from arapaimas in the northwestern Brazil.

Arapaima gigas, a fish with a high market value, has been farmed in different localities within Brazil. Among its parasites, adults of Goezia spinulosa are reported to cause ulcers in the stomach and to result in the death of farmed fingerlings. Due to the veterinary importance of this nematode in cultured arapaimas, an integrative taxonomic study is proposed, combining morphological, ultrastructural and genetic profiles of this parasite. The fish were obtained from semi-intensive fish farming in Acre State, Brazil. The fish measured 7-42cm in total length and the intensity of infection was 1-60 parasites per fish. The site of infection was mainly the stomach. Morphological and ultrastructural analyses of G. spinulosa showed the importance of its spiny body in firmly attaching the worm to the gastric mucosa, resulting in lesions, ulcers and deep gastric perforations of the stomach wall. New sequences for partial 18S rDNA, ITS1, 5.8S and ITS2 rDNA, partial 28S rDNA, cox1 mtDNA and for cox2 mtDNA are presented. Phylogenetic reconstructions based on the partial 18S and 28S rDNA shows species of Goezia occur in a clade well separated from other genera in both analyses. Both the partial 18S and 28S rDNA genes represented good genetic markers for distinguishing genera of the Raphidascarididae, with exception of Hysterothylacium. This integrated taxonomic study produced a robust profile for G. spinulosa that will aid the diagnosis of both adults and larval stages from arapaimas and possible intermediate hosts.

Orientatractis moraveci n. sp. and Rondonia rondoni Travassos, 1920 (Nematoda: Atractidae), parasites of Pimelodus blochii (Osteichthyes, Pimelodidae) from the Acre and Xapuri Rivers, Western Amazon, Brazil.

The fish fauna in the State of Acre represents 10·7% of all fish species recorded from Brazil, but, despite this, there are few fish parasite studies in this area. The recent expansion of fish farming in Acre prompted a need for helminthological studies of the most commonly consumed fish species in the area, Pimelodus blochii (Pimelodidae). The aim of this study was to analyse the helminth fauna of P. blochii from the Acre and Xapuri Rivers in Northwestern Brazil. Numerous nematodes were collected from the intestine and two species of the family Atractidae were identified: Rondonia rondoni Travassos, 1920 and Orientatractis moraveci n. sp. The new species is distinguished from its congeners mainly by having: 10 pairs of caudal papillae (3 pairs pre-cloacal, 2 pairs ad-cloacal and 5 pairs post-cloacal); unequal spicules of 161-198 and 69-100 µ m long; and a gubernaculum 38-58 µ m long with an antero-lateral process. Morphological and ultrastructural data on O. moraveci n. sp. and R. rondoni are presented, in addition to new genetic data based on partial 18S rDNA and 28S rDNA. The taxonomic status of Labeonema synodontisi (Vassiliadès, 1973) is discussed, suggesting that it should be returned to the genus Raillietnema.

Identification and ultrastructural characterization of the Wolbachia symbiont in Litomosoides chagasfilhoi.

BACKGROUND: Filarial nematodes are arthropod-transmitted parasites of vertebrates that affect more than 150 million people around the world and remain a major public health problem throughout tropical and subtropical regions. Despite the importance of these nematodes, the current treatment strategies are not efficient in eliminating the parasite. The main strategy of control is based on chemotherapy with diethylcarbamazine, albendazole and ivermectin. In the 1970s, it was found that some filarids possess endosymbiotic bacteria that are important for the development, survival and infectivity of the nematodes. These bacteria belong to the genus Wolbachia, which is a widespread and abundant intracellular symbiont in worms. Knowledge about the structure of the bacteria and their relationship with their nematode hosts may allow new perspectives for the control of filarial nematodes. METHODS: In this study, we used transmission electron microscopy combined with three-dimensional approaches to observe the structure of the endosymbiont of the filarial nematode Litomosoides chagasfilhoi, an experimental model for the study of lymphatic filariasis. In addition, the bacterium was classified based on PCR analyses. RESULTS: The bacterium was mainly found in the hypodermis and in the female reproductive system in close association with host cell structures, such as the nucleus and endoplasmic reticulum. Our ultrastructural data also showed that the symbiont envelope is composed of two membrane units and is enclosed in a cytoplasmic vacuole, the symbiosome. Molecular data revealed that the bacterium of L. chagasfilhoi shares 100% identity with the Wolbachia endosymbiont of Litomosoides galizai. CONCLUSIONS: Here we described ultrastructural aspects of the relationship of the Wolbachia with the filarial nematode Litomosoides chagasfilhoi and the findings lead us to consider this relationship as a mutualistic symbiosis.

Morphological aspects of Angiostrongylus costaricensis by light and scanning electron microscopy.

Angiostrongylus costaricensis is a parasitic nematode that can cause severe gastrointestinal disease, known as abdominal angiostrongiliasis, in humans. This paper presents the characterization of first- and third-stage larvae and male and female adult worms of A. costaricensis by scanning electron and light microscopy. Several novel anatomical structures were identified by scanning electron microscopy, including details of the cuticular striations of the spicules in male worms and a protective flap of the cuticle covering the vulvar aperture in female worms. Other taxonomic features revealed by light microscopy include the gubernaculum and the esophageal-intestinal valve. The use of two microscopy techniques allowed a detailed characterization of the morphology of this nematode. A number of previously identified taxonomic features, such as the striated nature of the spicules and the lateral alae were confirmed; however, the use of scanning electron microscopy resulted in a reassessment of the correct number of papillae distributed around the oral opening and behind the cloacal opening. These observations, in combination with light microscopy-based characterization of the gubernaculum and esophageal valves, have allowed a more detailed description of this nematode taxonomy.