COVID-19 antibody positivity over time and pregnancy outcomes in seven low-and-middle-income countries: A prospective, observational study of the Global Network for Women's and Children's Health Research.

OBJECTIVES: To determine COVID-19 antibody positivity rates over time and relationships to pregnancy outcomes in low- and middle-income countries (LMICs). DESIGN: With COVID-19 antibody positivity at delivery as the exposure, we performed a prospective, observational cohort study in seven LMICs during the early COVID-19 pandemic. SETTING: The study was conducted among women in the Global Network for Women's and Children's Health's Maternal and Newborn Health Registry (MNHR), a prospective, population-based study in Kenya, Zambia, the Democratic Republic of the Congo (DRC), Bangladesh, Pakistan, India (two sites), and Guatemala. POPULATION: Pregnant women enrolled in an ongoing pregnancy registry at study sites. METHODS: From October 2020 to October 2021, standardised COVID-19 antibody testing was performed at delivery among women enrolled in MNHR. Trained staff masked to COVID-19 status obtained pregnancy outcomes, which were then compared with COVID-19 antibody results. MAIN OUTCOME MEASURES: Antibody status, stillbirth, neonatal mortality, maternal mortality and morbidity. RESULTS: At delivery, 26.0% of women were COVID-19 antibody positive. Positivity increased over the four time periods across all sites: 13.8%, 15.4%, 21.0% and 40.9%. In the final period, positivity rates were: DRC 27.0%, Kenya 33.1%, Pakistan 32.8%, Guatemala 37.0%, Zambia 37.8%, Bangladesh 47.2%, Nagpur, India 57.4% and Belagavi, India 62.4%. Adjusting for site and maternal characteristics, stillbirth, neonatal mortality, low birthweight and preterm birth were not significantly associated with COVID-19. The adjusted relative risk (aRR) for stillbirth was 1.27 (95% CI 0.95-1.69). Postpartum haemorrhage was associated with antibody positivity (aRR 1.44; 95% CI 1.01-2.07). CONCLUSIONS: In pregnant populations in LMICs, COVID-19 antibody positivity has increased. However, most adverse pregnancy outcomes were not significantly associated with antibody positivity.

The Dynamics of Implicit Intergroup Biases of Victims and Ex-combatants in Post-conflict Scenarios.

Strong group identities arise in intergroup conflict scenarios and perpetuate sectarian violence even in post-conflict scenarios. In particular, out-group negative implicit associations are predictors of decreased intergroup forgiveness, as well as increased distrust and aggression against the out-group. Thus, the presence of implicit intergroup (i.e., ex-combatants and victims) biases seems to be a relevant factor in post-conflict scenarios. Here, we aimed to explore whether negative biases toward the out-group are boosted by (a) previous exposure to conflict violence or (b) identification with an armed violent group. One hundred and twenty-eight participants, 65 ex-combatants from Colombian guerrillas and 63 victims of the armed conflict, were assessed with a modified version of the implicit association test (IAT). Our results revealed that the victim group showed a significant negative bias against ex-combatants. However, no bias toward the out-group (i.e., victims) or in-group favoritism was observed in the ex-combatant group. Similarly, we found that IAT scores were not associated with sociodemographical variables (i.e., sex, years of education, or type of dwelling), the levels of combat exposure, victimization armed-conflict-related experiences, or child abuse antecedents. Our results showed an unexpected lack of in-group bias in ex-combatants, potentially triggered by the effect of current demobilization and reintegration processes. Thus, negative associations with the out-group will persist in the framework of societal condemnation of the out-group. In contrast, these negative biases will tend to be abolished when entering in conflict with larger societal reintegration processes. The results reinforce the idea that reintegration may benefit from interventions at the societal level, including all actors of the conflict. In addition, our findings highlight the importance of implementing victim interventions aimed at reducing stigma and revengeful actions in spaces of collective disarmament.

El legado de las enfermeras sanitarias en el cuidado de la salud chilena / Legacy of sanitary nurses in the care of chilean health

RESUMEN Chile, durante los inicios del siglo XX, evidencia una crisis social que impactó en las condiciones de salud de la gran mayoría de la población y es durante este período que se dan los primeros pasos de la profesionalización de la enfermera y el inicio en la formación de la enfermería sanitaria. Objetivo: Describir las prácticas de cuidado otorgado por las enfermeras sanitarias en Chile que marcaron la transformación de las condiciones de salud de la población. Material y métodos: A partir de los relatos de vida de las enfermeras que trabajaron en los servicios de salud de Chile, antes y durante la década de 1970, primero se caracteriza la identidad de las enfermeras salubristas formadas en la década del 20, y luego se interpreta el legado del cuidado sociocultural aplicado en las comunidades. Resultados: El cuidado estaba sustentado en un tramado sociocultural y son las enfermeras sanitarias quienes operacionalizan las macropolíticas sanitarias. Conclusión: La construcción de identidad de las enfermeras sanitarias emerge como eje transversal a lo largo de este período, y se le reconoce la urgencia que asumió en la intervención de las necesidades en salud y su compromiso ético por el resguardo del cuidado de las personas, familias y comunidades.

ABSTRACT During the early twentieth century, Chile shows a social crisis that impacted on the health conditions of the vast majority of the population, and it is during this period that the first steps towards the professionalization of nursing are taken and the sanitary nurse training begins. Objective: Describe the care practices provided by health nurses in Chile that marked the transformation of the health conditions of the population. Method: From the life stories of the nurses who worked in the health services in Chile, before and during the decade of the 1970s, the identity of the health-care nurses trained in the 1920s was first characterized, and then the legacy of the socio-cultural care applied in the communities was interpreted. Results: The care was supported by a socio-cultural network and it is the health nurses who operationalized the health macro-policies. Conclusion: The construction of the identity of health nurses emerges as a transversal axis throughout this period, and they are recognized for the urgency with which they assumed the intervention of health needs and for their ethical commitment to safeguard the care of individuals, families and communities.

Body frame size in school children is related to the amount of adipose tissue in different depots but not to adipose distribution.

OBJECTIVES: The main aim of this study was to test the hypothesis that body frame size is related to the amount of fat in different adipose tissue depots and to fat distribution in schoolchildren. METHODS: Children aged between 5 and 10 years were included in this cross-sectional study (n = 565). Body frame size, adiposity markers (anthropometric, skinfolds thickness, and ultrasound measures), and fat distribution indices were analyzed. Correlation coefficients adjusted by reliability were estimated and analyzed by sex; the significance of the difference between two correlation coefficients was assessed using the Fisher z-transformation. RESULTS: The sample included primarily urban children; 58.6% were normal weight, 16.1% overweight, 19.6% obese, and the rest were underweight. Markers of subcutaneous adiposity, fat mass and fat-free mass, and preperitoneal adiposity showed higher and significant correlations with the sum of the biacromial + bitrochanteric diameter than with the elbow diameter, regardless of sex. The fat distribution conicity index presented significant but weak correlations; and visceral adipose tissue, hepatic steatosis, and the waist-for-hip ratio were not significantly correlated with body frame size measures. CONCLUSIONS: Body frame size in school children was related to the amount of adipose tissue in different depots, but not adipose distribution. More studies are needed to confirm this relationship and its importance to predict changes in visceral fat deposition during growth.

No more postural restrictions in posterior canal benign paroxysmal positional vertigo.

OBJECTIVE: To establish if postural restrictions are useful after repositioning maneuvers in posterior canal benign paroxysmal positional vertigo (BPPV). STUDY DESIGN: Prospective double-blind consecutive case study. SETTING: This study was conducted at a tertiary referral hospital. PATIENTS: Three hundred ninety-one consecutive patients diagnosed of posterior canal BPPV with a positive Dix-Hallpike test. INTERVENTION: Two hundred seven patients diagnosed during the first year of our study were instructed to follow postural restrictions after repositioning maneuvers, and 184 patients who were diagnosed in the second year of our study did not receive any postural restriction after treatment. All of them were reevaluated 10 days later, and they were followed up until their symptoms resolved. MAIN OUTCOME MEASURES: We compared the success rates of each treatment analyzing the number of maneuvers needed until symptoms resolved, recurrence rate, and subjective recovery at the end of treatment between both groups. RESULTS: There were no statistical differences in number of maneuvers needed to resolve symptoms between patients who restricted their movements (80.2% of success with 1 maneuver) and those who did not (72.3%). Recurrence rate was not statistically different among groups (2.3 and 3.1%), and almost all patients declared to feel better after treatment in both groups (97.1 and 98.9%). CONCLUSION: Efficacy of Epley maneuver is not improved by postural restrictions. Therefore, we do not recommend any postural restrictions to patients with posterior canal BPPV.

Ageing evokes an intrinsic pro-apoptotic signalling pathway in rat cochlea.

CONCLUSIONS: These findings support the hypothesis that age-related apoptosis evokes an intrinsic pathway of pro-apoptotic signalling within the rat cochlea. OBJECTIVES: The aim of this study was to explore the effects of ageing on cochlear apoptosis in rats, as well as the different signalling pathways involved. MATERIALS AND METHODS: Female Sprague Dawley rats of different ages were used (mean age 7.72+/-1.93 months, n=100). Luciferase assays were used to determine the different caspase activities and ATP levels in rat cochlear protein extracts. Protein and gene expression was examined by Western blotting and real-time RT-PCR assays, respectively. RESULTS: Caspase-3/7 activity, as well as caspase-3 gene expression, were statistically higher in early-mature rats (EM, 276,139+/-13 669 RLUs (relative light units), p<0.001; and 390+/-50 arbitrary units, p=0.0017, respectively) or in aged-mature rats (AM, 371,020+/-26,457, p<0.0001; and 1510+/-90, p<0.0001, respectively) than younger rats (YR 147,129+/-8485 and 0.14+/-0.004, respectively). An increased caspase-9 activity with ageing was also observed (YR 49,932+/-2046 RLUs vs EM 260,890+/-5939, p<0.0001 or AM 118,241+/-12,423, p<0.0001). Caspase-8 activity was not affected significantly by age. Bax protein expression also increased by age (YR 38,200+/-1790 arbitrary units vs EM 76,549+/-5450, p<0.05), in contrast to Bcl-xL protein expression (YR 27,000+/-5000 arbitrary units vs EM 10,200+/-5000, p<0.005).