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BACKGROUND: The death of a child is one of the most devastating events a family can face, resulting in significant physical and psychosocial morbidity. Bereavement support programs have been developed in high-income contexts to address this need. However, little is known about implementing bereavement programs in low-and middle-income countries (LMICs). Here, we describe the implementation of a bereavement program for parents whose children died due to cancer or other catastrophic illnesses. METHODS: We conducted a retrospective analysis to describe the implementation of a hospital-based End of Life (EoL) care and bereavement program. This program was developed in several stages, including an assessment of bereaved families, development program guidelines, staff training, piloting of the program, refinement, and standardization. The program was developed between 2019 and 2021 in a nonprofit, teaching hospital and referral center for southwestern Colombia. RESULTS: Several tools were developed as key components of the bereavement program: a virtual bereavement course; guidance for EoL and bereavement communication and care, memory making, and follow-up calls; a condolence letter template, and group support workshops. A total of 956 healthcare professionals were trained, 258 follow-up calls to bereaved parents were made, 150 individual psychological follow-ups to parents with complicated grief occurred, 79 condolence letters were sent, and 10 support group workshops were carried out. Challenges were identified and overcome, such as limited resources and staff, and cultural perceptions of death. In 2021, this program received an award by the hospital as the Best Strategy to Humanize Healthcare. CONCLUSIONS: This study highlights the feasibility of developing and implementing EoL and bereavement care programs for parents and families within hospitals in LMICs. Lack of resources, staff, and training are some of the identified challenges to implementation. Utilizing methodological tools allows us to identify facilitator factors and deliverable outcomes of our EoL and bereavement program. This model provides a valuable framework for resource-limited settings.

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OBJECTIVE: Determine the association between intimate partner violence against Peruvian women and adequate regulation of the emotions and behaviors of children between 24 and 59 months old. METHODS: This cross-sectional study analyzed secondary data obtained from the ENDES-2019. The dependent variable was the regulation of emotions and behaviors in 24 to 59-month-old children. The independent variable was partner violence (physical, sexual, verbal or psychological) against mothers at some point in their life. Prevalence ratios (PR) were calculated and adjusted with their 95% confidence interval (CI) to evaluate the association between intimate partner violence and adequate regulation of emotions and behaviors. RESULTS: Data from 8,473, 15 to 49-year-old mothers and their children aged 24 to 59 months were analyzed. Intimate partner violence was reported by 57.1% of the women, and 31.6% of the children showed adequate regulation of emotions and behaviors. The probability of children of mothers who were victims of intimate partner violence adequately regulating their emotions and behaviors was low (aPR = 0.81, 95% CI: 0.75-0.88), with an aPR = 0.82 (95% CI: 0.76-0.89) and an aPR = 0.84 (95% CI: 0.76-0.93) for those with mothers suffering psychological or physical violence, respectively, with no differences in children of mothers suffering sexual violence by their partner. CONCLUSIONS: Six out of 10 Peruvian women have suffered partner violence at some point in their life, and only three out of 10 children between 24 and 59 months old adequately regulate their emotions and behaviors. Children of mothers suffering physical and verbal or psychological violence by their partners were less likely to regulate their emotions and behaviors adequately.

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Depression is more frequent in women, affecting the early stages of child development. This study aimed to determine the association between maternal depression and self-regulation of emotions and behaviors in Peruvian children under five years. A cross-sectional analytical study of data collected by the 2019 Demographic and Family Health Survey (ENDES) was conducted. The outcome variable was emotion and behavior regulation in children aged 24 to 59 months, and exposure was the presence of depression in women aged 15 to 49 years during the 14 days prior to the survey using the Patient Health Questionnaire (PHQ-9). A generalized linear model of the binomial family was used for reporting crude prevalence ratios and adjusted. The overall prevalence of children who did not self-regulate their emotions and behaviors was 68.8%, while 3.8% of the mothers had moderate depressive symptoms and 2.2% severe symptoms. Regarding the association of interest, moderate and severe depressive symptoms of mothers decreased the probability of children regulating emotions and behaviors in the first model, whereas in the second model, an association was only found with severe depressive symptoms. In conclusion, children of mothers with moderate and severe depressive symptoms had a lower probability of self-regulating their emotions and behaviors. Therefore, it is necessary to develop maternal education, nutritional and social support programs and mental health strategies from the first level of care aimed at reducing social, economic and child factors to reduce the risk of depression in mothers and low early childhood development, which could reduce the risk of developing mental health disorders in adolescence and adulthood.

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BACKGROUND: The cardiovascular system of owl monkeys has been studied due to frequent postmortem findings of heart disease in asymptomatic animals. The silent aspect and the difficulty of early diagnosis intensify the importance of studying the cardiovascular system in this species. METHODS: Echocardiogram evaluation was carried out on 60 animals, grouped into suspect or non-suspect of having heart diseases, and evaluated through electrocardiogram, hematology, and biochemical tests. RESULTS: Doppler echocardiography indicated two animals with suspicion of left ventricular hypertrophy and eight with dilated cardiomyopathy. Suspect animals had higher cardiac measurements and reduced shortening fraction. Troponin I was detectable in two animals (0.128 ng/mL and 0.584 ng/mL), and serum albumin concentration was significantly higher in non-suspect animals (P < .05). CONCLUSIONS: The importance of echocardiographic measurements of IVSd, IVSs, LVIDd, LVIDs, LVPWd, LVPWs, LA, EF, and FS in the cardiac evaluation of captive owl monkeys was evidenced.

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Os androgênios, por agirem de forma positiva no desenvolvimento folicular, estão sendo atualmente utilizados na reprodução humana assistida como uma alternativa para melhorar a resposta ovariana de mulheres consideradas más respondedoras. Esta revisão sistemática avalia o efeito do desidroepiandrosterona (DHEA) na resposta à estimulação ovariana de mulheres más respondedoras submetidas às técnicas de reprodução assistida. Os artigos para este estudo foram pesquisados no PubMed e publicados entre 1999 e 2013. Vinte e sete artigos foram avaliados e 18 deles foram selecionados, incluindo estudos experimentais e observacionais. O DHEA foi associado a um maior número de folículos recrutados, de oócitos selecionados e melhor qualidade embrionária, à diminuição do risco de aneuploidias e à maior taxa de gravidez clínica e nascidos vivos. Apesar de o DHEA apresentar efeito positivo na resposta ovariana de mulheres más respondedoras, os resultados obtidos foram pouco consistentes. Mais estudos controlados e randomizados devem ser realizados antes de se implantar o DHEA de rotina no tratamento de más respondedoras submetidas à reprodução humana assistida.(AU)

Androgens are currently being used in assisted human reproduction as an alternative to improve ovarian response of women considered poor responder by acting positively in follicular development. This systematic review evaluates the effects of dehydroepiandrosterone (DHEA) in response to ovarian stimulation of poor responder women undergoing assisted reproductive techniques. All articles for this study were searched in PubMed and published between 1999 and 2013. Twenty seven articles were evaluated and 18 of them were selected, including experimental and observational studies. DHEA was associated with a greater number of follicles, oocyte selected and better embryo quality, the decreased risk of aneuploidy and higher rates of clinical pregnancy and live birth. Although DHEA has positive effect on the ovarian response of poor responder women, the results were inconsistent. More randomized controlled trials should be conducted before using DHEA in routine treatment of poor responders undergoing assisted reproduction.(AU)

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Rubbing behaviors are well known in several primate species and are usually seen as scent-marking behaviors, with several functions proposed but still widely debated. The genus Alouatta is highly sexually dimorphic and a suitable subject for the study of sexual and hierarchical divergences associated with rubbing behavior: males should mark more than females, and dominant individuals more than subordinate ones. Three wild groups of Southern brown howler monkeys, Alouatta guariba clamitans, were studied at Morro Geisler, Indaial, Brazil, from September 2004 to February 2005. One hundred and twenty-three rubbing episodes were registered; data on performers and associated contexts showed that anogenital, dorsum and hyoid regions were the most often rubbed. Adult males rubbed significantly above expected levels, whereas subordinated females and juveniles tended to rub below the expected levels. Females were the main performers of anogenital rubbing, often preceded by defecation. The predominance of rubbing in males probably serves an important function in intrasexual communication and social interactions. Intrasexual competition can also lead to a relationship between rubbing and social status in females. Hyoid and sternum rubbing by males are probably agonistic signals associated with extragroup conflict. The possible cleaning function of anogenital rubbing does not preclude a communicative function. Whether rubbing behavior in howlers is solely for the function of scent marking or can also be a visual signal (e.g. as a display or to color the substrate with pigment) requires further study.

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This work sought to determine the number and genus of rumen ciliate protozoa in caatinga sheep raising, before and four hours after feeding them. There were collected 10 mL of ruminal fluid which was fixed in 10 mL of 10% formalin. After counting and identification of genera, the variables were submitted to variance analysis, the means compared by Tukey test and accomplished of simple correlation test between protozoa and chemical composition diet. Among found genera there was predominance of Entodinium (around 90%). Holotricha subclass only Isotricha genus was registered which represented 1.94% of population. The percentage of protozoa only varied (P

Objetivou-se com este trabalho determinar o número e gênero de protozoários ciliados no rúmen de ovinos criados na caatinga antes da alimentação e quatro horas após. Foram coletados 10 mL de fluido ruminal, fixados em 10 mL de formalina a 10 %. Após contagem e identificação dos gêneros, as variáveis foram submetidas à análise de variância, as médias comparadas pelo teste de Tukey, sendo, ainda, realizado o teste de correlação simples entre protozoários e a composição química da dieta. Dentre os gêneros encontrados, houve predominância do gênero Entodinium (em torno de 90%). Da subclasse Holotricha, foi registrado somente o gênero Isotricha que representou em média 1,94% da população. A percentagem de protozoários só variou (P

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This work sought to determine the number and genus of rumen ciliate protozoa in caatinga sheep raising, before and four hours after feeding them. There were collected 10 mL of ruminal fluid which was fixed in 10 mL of 10% formalin. After counting and identification of genera, the variables were submitted to variance analysis, the means compared by Tukey test and accomplished of simple correlation test between protozoa and chemical composition diet. Among found genera there was predominance of Entodinium (around 90%). Holotricha subclass only Isotricha genus was registered which represented 1.94% of population. The percentage of protozoa only varied (P

Objetivou-se com este trabalho determinar o número e gênero de protozoários ciliados no rúmen de ovinos criados na caatinga antes da alimentação e quatro horas após. Foram coletados 10 mL de fluido ruminal, fixados em 10 mL de formalina a 10 %. Após contagem e identificação dos gêneros, as variáveis foram submetidas à análise de variância, as médias comparadas pelo teste de Tukey, sendo, ainda, realizado o teste de correlação simples entre protozoários e a composição química da dieta. Dentre os gêneros encontrados, houve predominância do gênero Entodinium (em torno de 90%). Da subclasse Holotricha, foi registrado somente o gênero Isotricha que representou em média 1,94% da população. A percentagem de protozoários só variou (P

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PURPOSE: To assess the influence of ovarian endometrioma during IVF. METHODS: Patients were submitted to cystectomy by the laparoscopic route for exeresis of ovarian endometrioma. Group I (n = 28) consisted of patients without ovarian endometrioma and group II (n = 14) consisted of patients with recurrence of ovarian endometrioma during IVF. RESULTS: Fertilization and cleavage rates were higher in group I and the pregnancy rate per transfer was similar in the two groups. CONCLUSIONS: The presence of endometrioma during IVF causes a worsening of oocyte fertilization and embryo cleavage but does not affect the pregnancy rate per transfer.

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Dentro del proyecto Maniapure en área de la salud se ha consolidado. Se han incorporado líderes de la comunidad que toman las riendas de su propio desarrollo. Hay que seguir aportando proyectos y recursos para el desarrollo en higiene ambiental, además apoyar los proyectos del área de educación-cultura y de formación para el trabajo, determinando de esta manera un incremento de la calidad de vida de estos dignos y notables pobladores.

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