Vulnerable Lives, Irrelevant Deaths? Dying Alone and Receiving Flawed Care in an Institution for the Aged in Lima, Peru.

This ethnographic exploration of death in the Peruvian context draws on fieldwork among abandoned-both by their families and the state-older adults in a shelter for the homeless in Lima, Peru. I examine the conditions and local forces that shape the ways people at this institution socially and physically die. My argument is that people in this long-term care facility who have lived entire lives on the margins, usually, end up having irrelevant deaths to their families, other residents of the institution, and the Peruvian state. At this shelter, dying in an irrelevant way means dying without companionship from family members and receiving poor and flawed care from the institution that shelters them.

Evaluation of the Newborn Screening Pilot for Sickle Cell Disease in Suriname Using the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) Framework.

The early detection of sickle cell disease (SCD) is vital to reduce mortality among affected children. Suriname currently lacks a newborn screening programme (NSP) for SCD. We performed a pilot programme to evaluate the scalability of such an initiative. Dried blood spots were collected from five birth centres and subjected to electrophoresis analysis. The programme scalability was evaluated using the non-adoption, abandonment, scale-up, spread, and sustainability framework. Challenges across six domains (illness, technology, value proposition, adopter system, organisation, and societal system), were categorised hierarchically as simple 😊, complicated 😐, or complex 😢. It has been proven that implementing programmes with mainly complicated challenges is difficult and those in mainly complex areas may be unachievable. SCD was detected in 33 of 5185 (0.64%) successfully screened newborns. Most of the domains were classified as simple or complicated. Disease detection and technology suitability for screening in Suriname were confirmed, with favourable parental acceptance. Only minor routine adjustment was required from the medical staff for programme implementation. Complex challenges included a reliance on external suppliers for technical maintenance, ensuring timely access to specialised paediatric care for affected newborns, and securing sustainable financial funding. Scaling up is challenging but feasible, particularly with a targeted focus on identified complex challenges.

Association between the home-to-healthcare center distance and hearing aid abandonment among older adults.

Background: Access to audiology services for older adults residing in sparsely populated regions is often limited compared to those in central urban areas. The geographic accessibility to follow-up care, particularly the influence of distance, may contribute to an increased risk of hearing aid abandonment. Objective: To assess the association between the home-to-healthcare-calibration-center distance and hearing aid abandonment among older adults fitted in the Chilean public health system. Methods: 455 patients who received hearing aids from two public hospitals in two regions were considered. Univariate and multivariate Poisson regression models with robust variance estimation were used to analyze the association between the geographical distance and hearing aid abandonment, accounting for confounding effects. Results: Approximately 18% of the sample abandoned the hearing aid, and around 50% reported using the hearing aid every day. A twofold increase in distance between home and the hearing center yielded a 35% (RR = 1.35; 95% CI: 1.04-1.74; p = 0.022) increased risk of hearing aid abandonment. Also, those in the second quintile had a 2.17 times the risk of abandoning the hearing aid compared to the first quintile (up to 2.3 km). Under the assumption that patients reside within the first quintile of distance, a potential reduction of 45% in the incidence of hearing aid abandonment would be observed. The observed risk remained consistent across different statistical models to assess sensitivity. Conclusion: A higher distance between the residence and the healthcare center increases hearing aid abandonment risk. The association may be explained by barriers in purchasing supplies required to maintain the device (batteries, cleaning elements, potential repairs, or maintenance).

Two Adverse Early Life Events Induce Differential Changes in Brain CRH and Serotonin Systems in Rats along with Hyperphagia and Depression.

BACKGROUND: Different types of stress inflicted in early stages of life elevate the risk, among adult animals and humans, to develop disturbed emotional-associated behaviors, such as hyperphagia or depression. Early-life stressed (ELS) adults present hyperactivity of the hypothalamus-pituitary-adrenal (HPA) axis, which is a risk factor associated with mood disorders. However, the prevalence of hyperphagia (17%) and depression (50%) is variable among adults that experienced ELS, suggesting that the nature, intensity, and chronicity of the stress determines the specific behavioral alteration that those individuals develop. METHODS: We analyzed corticosterone serum levels, Crh, GR, Crhr1 genes expression in the hypothalamic paraventricular nucleus, amygdala, and hippocampus due to their regulatory role on HPA axis in adult rats that experienced maternal separation (MS) or limited nesting material (LNM) stress; as well as the serotonergic system activity in the same regions given its association with the corticotropin-releasing hormone (CRH) pathway functioning and with the hyperphagia and depression development. RESULTS: Alterations in dams' maternal care provoked an unresponsive or hyper-responsive HPA axis function to an acute stress in MS and LNM adults, respectively. The differential changes in amygdala and hippocampal CRH system seemed compensating alterations to the hypothalamic desensitized glucocorticoids receptor (GR) in MS or hypersensitive in LNM. However, both adult animals developed hyperphagia and depression-like behavior when subjected to the forced-swimming test, which helps to understand that both hypo and hypercortisolemic patients present those disorders. CONCLUSION: Different ELS types induce neuroendocrine, brain CRH and 5-hydroxytriptamine (5-HT) systems' alterations that may interact converging to develop similar maladaptive behaviors.

Demographics and tenure of the Chilean urban dog population. A mathematical model.

BACKGROUND: Irresponsible dog ownership in urban areas is a public health concern with significant implications for human, animal, and environmental welfare. Factors such as abandonment, variations in adoption, insufficient supervision, emerging identification initiatives, and collective feeding impact the growth of stray dog populations and the transmission of diseases. Developing a modeling tool to understand the dynamics of canine population growth and the effect of human behavior on this phenomenon is essential. METHODS: An ordinary differential equation model was developed to depict the growth dynamics and movements of urban dog populations, distinguishing between those with owners (restricted and semi-restricted) and those without (stray and community dogs). Two equilibrium states of the system were analyzed: with and without the presence of individually owned dogs. An increase rate for the population of individually owned dogs was calculated, and a local sensitivity analysis was conducted to assess the impact of parameters on the reduction of this population. Additionally, two global sensitivity analysis methods were used to evaluate the simultaneous influence of the parameters. RESULTS: Findings indicate that system equilibrium depends on various dog categories. Although total eradication of stray and community dogs is unlikely, equilibrium levels are directly related to subpopulation growth rates, responsible ownership practices, and adoption and abandonment rates. The growth rates of the population of dogs without individual owners have a direct and proportional influence on their regulation, while adoption rates have an inverse and proportional effect. The study, through global sensitivity analysis, identifies key parameters for each dog subpopulation. For restricted dogs, environmental carrying capacity is the most variable factor; for semi-restricted dogs, awareness of responsible ownership is crucial. The abandonment of restricted dogs significantly impacts stray dog dynamics, while the transition from stray to community status is an important variable factor for community dogs. CONCLUSION: Addressing the situation of unowned dogs requires a collective effort to reduce risks associated with the spread of zoonotic diseases, environmental pollution, and biodiversity loss, thus contributing to public health and environmental conservation.

Percepção sobre abandono afetivo em idoso institucionalizado / Perception of emotional neglect in institutionalized elderly / Percepción del abandono afectivo en adultos mayores institucionalizado

Objetivo: Compreender a percepção dos idosos institucionalizados quanto ao abandono afetivo por parte de seus familiares.Método: Trata-se de um estudo exploratório, comabordagemqualitativa. Conduzido por meio de entrevistas semiestruturadas. A organização e análise dos dados foram baseadas na técnica de Minayo. O estudo foi realizado em uma Instituição de Longa Permanência para Idosos, localizada em uma cidade do nordeste de Santa Catarina.Resultados: Participaram do estudo nove idosos, com idades entre 60 e 89 anos, com diferentes estados civis (viúvos, casados e divorciados), variando sua escolaridade do nível básico ao superior, além de serem aposentados ou pensionistas. Foram identificadas quatro categorias analíticas: (1) vivência na instituição, (2) motivos para a institucionalização, (3) relacionamento familiar e (4) percepção do abandono familiar.Conclusão: alguns idosos enfatizaram sentir-se esquecidos na instituição, o que os deixa tristes e deprimidos. É crucial para a prática de a enfermagem compreender a realidade dos idosos nas Instituições de Longa Permanência, pois essa compreensão está diretamente ligada à prestação de cuidados em todos os níveis de assistência à saúde

Objective: To understand the perception of institutionalized elderly individuals regarding the emotional abandonment by their family members.Methodology: This is an exploratory study, using qualitative methods. Conducted through semi-structured interviews. Data organization and analysis were based on Minayo's technique. The study was conducted at a Long-Term Care Institution for the Elderly located in a city in northeastern Santa Catarina.Results: Nine elderly individuals participated in the study, ranging in age from 60 to 89 years old, with different marital statuses (widowed, married, and divorced), ranging in education from basic to higher levels, and being retirees or pensioners. Four analytical categories were identified: (1) experience in the institution, (2) reasons for institutionalization, (3) family relationships, and (4) perception of family abandonment.Conclusion: Some elderly individuals emphasized feeling forgotten in the institution, which makes them feel sad and depressed. Understanding the reality of the elderly in Long-Term Care Institutions is crucial for nursing practice, as this understanding is directly linked to providing care at all levels of healthcare assistance in the Health Care Network

Objetivo: Comprender la percepción de las personas mayores institucionalizadas con respecto al abandono afectivo por parte de sus familiares. Metodología:Se trata de un estudio exploratorio, utilizando métodos cualitativos. Realizado a través de entrevistas semiestructuradas. La organización y análisis de los datos se basaron en la técnica de Minayo. El estudio se llevó a cabo en una Institución de Larga Estadía para Personas Mayores lubicada en una ciudad del noreste de Santa Catarina. Resultados:Nueve personas mayores participaron en el estudio, con edades comprendidas entre 60 y 89 años, con diferentes estados civiles (viudos, casados y divorciados), variando en educación desde niveles básicos hasta superiores, y siendo jubilados o pensionistas. Se identificaron cuatro categorías analíticas: (1) experiencia en la institución, (2) motivos para la institucionalización, (3) relaciones familiares y (4) percepción del abandono familiar. Conclusión:Algunas personas mayores enfatizaron sentirse olvidadas en la institución, lo que los hace sentir tristes y deprimidas. Es crucial para la práctica de enfermería comprender la realidad de los adultos mayores en las Instituciones de Larga Estancia, ya que esta comprensión está directamente vinculada con la prestación de cuidados en todos los niveles de asistencia sanitaria en la Red de Atención a la Salud.

Síndromes geriátricos y abandono

Fundamento: el abandono en la vejez es un condicionante de muchos trastornos de salud y constituye en mayor medida una condición de gran incidencia a nivel mundial. Objetivo: comparar los síndromes geriátricos y el abandono en pacientes adultos mayores. Métodos: se realizó un estudio transversal, descriptivo, analítico y correlacional, en la Unidad de Medicina Familiar No. 33 del Instituto Mexicano del Seguro Social de Tabasco. La muestra se conformó con 203 pacientes de 60 años y más, que acudieron a consulta de Medicina Familiar y Atención Médica Continua. Se aplicaron 3 instrumentos: la escala de Pfeiffer, el International Consultation on Incontinence Questionnaire Short-Form, la Escala de Percepción de Abandono del Adulto Mayor y se interrogó sobre el consumo de medicamentos prescritos y automedicados. Resultados: existió relación entre los síndromes geriátricos y el abandono, como se comprobó en la correlación entre las variables analizadas. El deterioro cognitivo leve, moderado y severo, se encontró en bajas proporciones. El 40,7 % de los pacientes aceptó tener incontinencia urinaria. La presencia de polifarmacia se encontró en altas proporciones. Conclusiones: los síndromes geriátricos presentes en el estudio fueron: deterioro cognitivo, polifarmacia e incontinencia urinaria, más la presencia de ser soltero, viudo o divorciado muestran una relación significativa para sufrir abandono.

Foundation: abandonment in old age is a condition of many health disorders and is, to a greater extent, a condition of high incidence worldwide. Objective: to compare geriatric syndromes and abandonment in older adult patients. Methods: a cross-sectional, descriptive, analytical and correlational study was carried out in the Family Medicine Unit No. 33 of the Mexican Social Security Institute of Tabasco. The sample was made up of 203 patients aged 60 and over, who attended Family Medicine and Continuing Medical Care consultations. Three instruments were applied: the Pfeiffer scale, the International Consultation on Incontinence Questionnaire Short-Form, the Perception of Abandonment Scale for the Elderly, and questions were asked about the consumption of prescribed and self-medicated medications. Results: there is a relationship between geriatric syndromes and abandonment, as verified in the correlation between the variables analyzed. Mild, moderate and severe cognitive impairment was found in low proportions. 40.7 % of the patients accepted having urinary incontinence. The presence of polypharmacy was found in high proportions. Conclusions: the geriatric syndromes present in the study such as: cognitive impairment, polypharmacy and urinary incontinence, plus the presence of being single, widowed or divorced show a significant relationship to suffering abandonment.

Intenção de abandono profissional em professores de acordo com níveis de ensino / Intention of Professional Abandonment in Teachers according to Education Levels

Resumo. Objetivo. Identificar os preditores sociodemográficos, laborais, estressores psicossociais, foco regulatório para a obtenção das metas no trabalho, trabalho emocional e a síndrome de burnout para a intenção de abandono profissional em professores brasileiros de acordo com os cinco níveis de ensino: Infantil, Fundamental, Médio, Graduação e Pós-graduação. Método. Utilizou-se uma amostra não probabilística de 1284 professores brasileiros distribuídos em cinco níveis de ensino que responderam a um instrumento on-line que continha cinco seções: questionário de dados sociodemográficos e laborais, Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo, Escala Geral de Focus Regulatório, Escala de Emoções no Trabalho e a Escala de Avaliação de Estressores Psicossociais no Contexto Laboral. Resultados. Os resultados obtidos por meio da análise de regressão linear múltipla revelaram preditores diferenciados de acordo com os níveis de ensino. As variáveis que explicaram os modelos foram maiores índices de síndrome de burnout, pressão pela responsabilidade, conflito e ambiguidade de papel, sobrecarga de papéis, insegurança na carreira, variabilidade emocional, maior formação acadêmica e remuneração e menores índices de satisfação com a vida, menor tempo de trabalho e idade, não ter outra atividade profissional e trabalhar em instituição privada. A síndrome de burnout foi preditora em todos os níveis.

Abstract. Objective. To identify the sociodemographic, work predictors, psychosocial stressors, regulatory focus to achieve goals at work, and emotional labor for professional abandonment intention in Brazilian teachers according to the five levels of education: kindergarten, elementary, secondary, undergraduate, and postgraduate. Method. A non-probabilistic sample of 1,284 Brazilian teachers distributed across five levels of education was used, who responded to an online instrument that contained five sections: sociodemographic and labor data questionnaire, Burnout questionnaire, General Regulatory Focus Scale, Emotions Labor Scale and the Psychosocial Stressors Assessment Scale in the Work Context. Results. The results obtained through multiple linear regression analyses revealed different predictors according to educational levels. The variables that explained the models were higher rates of burnout syndrome, pressure for responsibility, role conflict and ambiguity, role overload, career insecurity, emotional variability, higher academic training and remuneration and lower rates of satisfaction with life, lower length of work and age, not having another professional activity, and working in a private institution. Burnout syndrome was a predictor at all levels.

Clayton copula for survival data with dependent censoring: An application to a tuberculosis treatment adherence data.

Ignoring the presence of dependent censoring in data analysis can lead to biased estimates, for example, not considering the effect of abandonment of the tuberculosis treatment may influence inferences about the cure probability. In order to assess the relationship between cure and abandonment outcomes, we propose a copula Bayesian approach. Therefore, the main objective of this work is to introduce a Bayesian survival regression model, capable of taking into account the dependent censoring in the adjustment. So, this proposed approach is based on Clayton's copula, to provide the relation between survival and dependent censoring times. In addition, the Weibull and the piecewise exponential marginal distributions are considered in order to fit the times. A simulation study is carried out to perform comparisons between different scenarios of dependence, different specifications of prior distributions, and comparisons with the maximum likelihood inference. Finally, we apply the proposed approach to a tuberculosis treatment adherence dataset of an HIV cohort from Alvorada-RS, Brazil. Results show that cure and abandonment outcomes are negatively correlated, that is, as long as the chance of abandoning the treatment increases, the chance of tuberculosis cure decreases.

Survival and prognostic factors in pediatric patients with medulloblastoma treated at a national pediatric hospital in Peru: a retrospective cohort.

OBJECTIVE: The objectives of this study were to determine the overall survival (OS) and event-free survival (EFS) rates of patients with medulloblastoma treated in a national pediatric hospital in Peru, as well as to identify demographic, clinical, imaging, postoperative, and histopathological characteristics and prognostic factors associated with OS and EFS. METHODS: The authors conducted a retrospective study analyzing information from the medical records of children with a diagnosis of medulloblastoma who underwent surgical treatment at the Instituto Nacional de Salud del Niño-San Borja, a public hospital in Lima, Peru, from 2015 to 2020. Clinical-epidemiological variables, degree of disease extension, risk stratification, extent of resection, postoperative complications, status of oncological treatment received, histological subtype, and neurological sequelae were taken into account. The Kaplan-Meier method and Cox regression analysis were used to estimate OS, EFS, and prognostic factors. RESULTS: Of the 57 children evaluated with complete medical records, only 22 children (38.6%) underwent complete oncological treatment. OS was 37% (95% CI 0.25-0.55) at 48 months. EFS was 44% (95% CI 0.31-0.61) at 23 months. High-risk stratification-meaning patients with ≥ 1.5 cm2 of residual postoperative tumor, those younger than 3 years, those with disseminated disease (HR 9.69, 95% CI 1.40-67.0, p = 0.02), and those who underwent subtotal resection (HR 3.78, 95% CI 1.09-13.2, p = 0.04)-was negatively associated with OS. Failure to receive complete oncological treatment was negatively associated with OS (HR 20.0, 95% CI 4.84-82.6, p < 0.001) and EFS (HR 7.82, 95% CI 2.47-24.7, p < 0.001). CONCLUSIONS: OS and EFS of patients with medulloblastoma in the author's milieu are below those reported in developed countries. Incomplete treatment and treatment abandonment in the authors' cohort were also high compared with high-income country statistics. Failure to complete oncological treatment was the most important factor associated with poor prognosis, both in terms of OS and EFS. High-risk patients and subtotal resection were negatively associated with OS. Interventions are needed to promote the completion of adjuvant oncological therapy for medulloblastoma in the disadvantaged Peruvian population.

Dropout in youth and adult education: a multilevel analysis of students and schools in Chile.

Introduction: School dropout is an increasing worldwide phenomenon, marked by inequality and educational exclusion. In Chile, many students who have dropped out of regular schools attempt to reenter youth and adult education (YAE). However, some of them drop out again from YAE. Objective: The aim of this study was to identify and jointly analyze school and individual factors that influence dropout in YAE. Methods: This secondary multilevel analysis of official datasets from Chile's Ministry of Education focused on students enrolled in YAE (N = 10,130). Results: According to the findings, YAE dropout can be explained by the individual risk factors of age (19-24 years), low academic achievement, and school-level factors such as number of teachers (raw and student-to-teacher ratio), economic resources, and school management quality. Discussion: We discuss the need to develop school-level protective factors that build connections, foster student engagement, and ultimately, promote students' permanence and progress in YAE.

When legal procedures facilitate abandonment. New forms of Ghosting / Cuando los procedimientos judiciales facilitan el abandono. Nuevas formas de Ghosting.

Ghosting has become a way to end abruptly short/casual relationships. It is the practice of ending a personal relationship suddenly and without explanation withdrawing from all communication. Nowadays at family courts, the quality of psychology expert witness reports is limited to transcribe the interviewed person words, without applying any professional method tending to elaborate a diagnosis.On the other side, usually the formal procedures mandated by the law are not followed, may be due to the excessive amount of work. These two reasons lead to impose home exclusion or different kind of restrictions to see one or more members of the family, measures that facilitate de abrupt termination of the family bond, developing serious psychological consequences to the excluded person. Attempts are made to warn about the need for real expert reports that help judges to improve decision-making, to not facilitate long term family relationships ending.

El ghosting (fantasmeo o desaparición) se estableció como una forma de terminación de relaciones breves y sin compromiso. Consiste simplemente en cortar todo tipo de comunicación y no dar señales de vida de forma abrupta. Por otro lado, los informes psicológicos en los tribunales de familia, habitualmente se limitan a transcribir los dichos de las partes entrevistadas, sin efectuar ningún otro acto profesional que no sea el mero relato. Esto, sumado al no seguimiento de los procedimientos de la ley, terminan facilitando el cese abrupto no de relaciones cortas, sino parejas de larga data, o hasta inclusive matrimonios, mediante exclusiones de hogares o imposición de perímetros de exclusión, con las innumerables consecuencias para la persona ghosteada y la familia. Se intenta advertir, sobre la necesidad de la realización de verdaderos informes periciales, que ayuden a los magistrados a mejorar la toma de decisiones, que no faciliten la finalización abrupta de relaciones familiares de larga data.

Effects of the COVID-19 pandemic on the behavior and physical health of dogs in Rio de Janeiro state: Reflections on the quality of life of dogs and their owners.

The COVID-19 pandemic changed the routines of people, consequently changing the daily lives of their pets. Behavioral and emotional changes caused by the stress resulting from restrictions of social isolation and their consequences in the human-animal relationship have been discussed. However, there are still no studies that identify the factors that affect behavior and which are the most susceptible groups. The purpose of this study is to identify behavioral and emotional changes on dogs during the COVID-19 pandemic and their effects on the quality of life of animals and their owners. The methodology used was online questionnaires, which were posted on social networks aimed to dog owners in Rio de Janeiro state, Brazil. The results showed that age, sex, dog size, type of home, and restrictions imposed differently affected the type of behavioral change. However, the most frequent type of change was the worsening of previous conditions. Neutered behaviors directly interfered in the lives of owners and their pets, as owners managed the situation and sought information without guidance from a veterinarian, with the possibly consequence of worsening the situation in the future. Veterinarians should actively investigate behavioral changes that have occurred through anamnesis to avoid abandonment and instability in the human-animal relationship.

Cães em situação de rua no município de Descalvado-SP: Uma análise visual e quantitativa / Street dogs in the municipality of Descalvado-SP: A visual and quantitative analysis

Alicerçado na necessidade de estabelecer políticas de bem-estar animal e promoção da saúde pública pela importância dos animais errantes na transmissão de zoonoses, objetivou-se estudar a dinâmica populacional de cães em situação de rua no município de Descalvado -SP, a percepção dos munícipes relacionada com a causa de proteção animal e também da legislação vigente Federal, Estadual e Municipal. Para contabilizar a separação dos setores urbanos e rurais, foi utilizada a ferramenta Clip do programa Qgis, setorizando o município de Descalvado em zona Norte, Sul, Leste, Oeste, Central e Distrito Industrial. Para a aplicação dos questionários foi selecionado 0,5% da população de cada zona estabelecida do município e os achados foram correlacionados a legislação e as políticas públicas existentes, analisando a eficácia das mesmas. Como podemos notar, de maneira resumida, os entrevistados cobram do poder público local por melhorias, mas também, maior responsabilidade da população. Além da análise qualitativa através da leitura e percepção dos relatos, foi realizado uma análise da repetição de palavras chave, através da confecção da nuvem de palavras, importante ferramenta que destaca os termos mais citados pelas pessoas entrevistadas, das quais se destaca "fiscalização, leis e conscientização", revelando a necessidade dos direcionamentos das políticas públicas. Os dados nos levam a concluir que apesar da existência de legislação, ainda há pouca aplicação de penalidades. No município, as zonas com maiores índices de cães em situação de rua foram Oeste e Sul, regiões periféricas e com população de baixa renda.(AU)

Based on the need to establish animal welfare policies and public health promotion due to the importance of stray animals in the transmission of zoonoses, the objective was to study the population dynamics of homeless dogs in the city of Descalvado -SP, the perception of citizens related to the cause of animal protection and also to the current Federal, State and Municipal legislation. To account for the separation of urban and rural sectors, the Clip tool of the Qgis program was used, sectoring the municipality of Descalvado into North, South, East, West, Central and Industrial District. For the application of the questionnaires, 0.5% of the population from each established area of the municipality was selected and the findings were correlated with existing legislation and public policies, analyzing their effectiveness. As we can see, in summary, the interviewees demand from the local government for improvements, but also, greater responsibility of the population. In addition to the qualitative analysis through the reading and perception of the reports, an analysis of the repetition of key words was carried out, through the creation of the word cloud, an important tool that highlights the terms most cited by the people interviewed, of which "oversight, laws and awareness", revealing theneed for public policy directions. The data lead us to conclude that despite the existence of legislation, there is still little application of penalties. In the city, the areas with the highest rate of stray dogs were West and South, peripheral regions and with low-income population.(AU)

Prophylactic treatment abandonment in people bitten by suspected rabid animals, El Salvador, 2013-2017.

Introduction: Around the world 60,000 people die from rabies each year. The main form of exposure to rabies is by the bite of animals infected with the virus. More than 20,000 cases of rabies-transmitting animal bites are reported each year, in El Salvador, a country located in Central America. People exposed should be managed with rabies prophylaxis. Objective: To determine the abandonment of post-exposure prophylaxis (PEP) cumulative incidence (CI) in humans bitten by suspected rabid animals in El Salvador from 2013 to 2017. Methodology: This is an ecological study based on the cases of bites by suspected rabid animals reported between 2013 and 2017 in the public health system of El Salvador. Descriptive and correlation analysis was performed using Statistical Package for the Social Sciences (SPSS) version 24. The municipality CI, expressed per 100,000 inhabitants. Results: The national CI of abandonment PEP in humans bitten by suspected rabid animals was 25.6 × 100,000 inhabitants. Simple bivariate correlation analysis shows that the departments with the highest CI of bites caused by cats, wild animals, and bites on the neck (R 2 = 0.99 P < 0.05) are mostly associated with dropping out of the PEP. Conclusion: In El Salvador, the abandonment CI of PEP is lower than other countries, however, bites by rabid suspected animal are frequent, this represents a public health problem due to the presence of the rabies virus in wild animals and the high lethality of the disease. Municipalities where head bites are common are the most related to the abandonment of PEP.

A synthesized model of tuberculosis transmission featuring treatment abandonment.

In this paper, we propose and justify a synthesized version of the tuberculosis transmission model featuring treatment abandonment. In contrast to other models that account for the treatment abandonment, our model has only four state variables or classes (susceptible, latent, infectious, and treated), while people abandoning treatment are not gathered into an additional class. The proposed model retains the core properties that are highly desirable in epidemiological modeling. Namely, the disease transmission dynamics is characterized by the basic reproduction number $ \mathscr{R}_0 $, a threshold value that determines the number of possible steady states and their stability properties. It is shown that the disease-free equilibrium is globally asymptotically stable (GAS) only if $ \mathscr{R}_0 < 1 $, while a strictly positive endemic equilibrium exists and is GAS only if $ \mathscr{R}_0 > 1. $ Analysis of the dependence of $ \mathscr{R}_0 $ on the treatment abandonment rate shows that a reduction of the treatment abandonment rate has a positive effect on the disease incidence and results in avoiding disease-related fatalities.

The association between non-permanence of dogs in households and non-compliance with the principles of responsible animal guardianship: A survey in a medium-sized city in Brazil.

The permanence of a dog in a household is relevant in terms of public health and animal welfare because it implies that the animal is receiving better care and is unlikely to be abandoned. We have performed a survey in a medium-sized city in southeastern Brazil in order to identify predictors associated with the non-permanence of dogs in households as determined one year after the first visit. During the first of two visits to randomly selected domiciles, guardians were asked to complete a structured questionnaire regarding the traits and history of each dog in the household, features of the domicile, characteristics of the guardian and adherence to the principles of responsible companion animal guardianship (RCAG). A second visit to each domicile was performed one year later in order to establish in loco whether the dog still resided in the domicile and, where appropriate, to apply a further questionnaire concerning the fate of the missing animal. The total sample population comprised 513 dogs, of which 98 (19.1%) were verified as no longer resident in the domicile on the occasion of the second visit. Of the absent dogs, 59 had died as a result of fights with stray animals, traffic accidents, diseases or old age, 13 had been sent to alternative addresses, 8 had been donated to third parties and 7 had escaped from the domicile. The fates of the remaining 11 animals were not divulged by the guardians. Multiple regression analysis revealed that the risk of non-permanence was significantly higher (p < 0.05) among male dogs, those that were infested with ticks, had free access to the streets or resided in domiciles near a wooded area, but was significantly lower among wormed and neutered dogs. The adoption of RCAG principles is associated with the permanence of dogs in households and, consequently, in reduction of the stray population, animal well-being and prevention of zoonoses. On this basis, it is important to raise awareness about the concepts of RCAG and to strengthen accountability of guardians that do not take proper care of their animals.

Cuidados médicos-veterinários para com felino deficiente e FAIDS+ adotado: relato de caso / Veterinary medical care for disabled feline adopted and FAIDS+: case report

O presente trabalho relata o caso de um felino deficiente visual, vítima do abandono - que estava alojado em um abrigo ­ e foi adotado. O felino é um macho, castrado, deficiente visual, de 4 kg adotado em uma ONG, que ao ser escolhido para a adoção foi testado para FIV/FELV, apresentando resultado positivo para FIV e negativo para FELV. Ao longo de quatro anos, com seus adotantes, manifestou diversas afecções relacionadas à retrovirose, tais como dermatofitose, complexo gengivite estomatite felino e outros sinais secundários a FIV. Houve sempre muita compaixão dos tutores para com o felino. A convivência do felino com os familiares e demais animais sempre foi agradável e trouxe muitos momentos de felicidade, e o fato do animal ser FAIDS+ nunca afetou, negativamente, a relação com todos que passaram a conviver com ele.(AU)

This work reports the case of a blind feline, victim of abandonment - who was housed in a shelter - and was adopted. The cat is a male, castrated, blind, 4 kg adopted in an ONG, which when chosen for adoption was tested for FIV/FELV, showing positive results for FIV and negative for FELV. Over four years with her adopters, he manifested several conditions related to retroviruses, such as dermatophytosis, feline stomatitis gingivitis complex and other signs secondary to FIV. There was always a lot of compassion from the tutors towards the feline. The feline's coexistence with family members and other animals was always pleasant and brought many moments of happiness, and the fact that the animal was FAIDS+ never negatively affected the relationship with everyone who started living with it.(AU)

Land-use changes and precipitation cycles to understand hydrodynamic responses in semiarid Mediterranean karstic watersheds.

Non-planned agricultural land abandonment is affecting natural hydrological processes. This is especially relevant in vulnerable arid karstic watersheds, where water resources are scarce but vital for sustaining natural ecosystems and human settlements. However, studies assessing the spatiotemporal evolution of the hydrological responses considering land-use changes and precipitation cycles for long periods are rare in karstic environments. In this research, we selected a representative karstic watershed in a Mediterranean semiarid domain, since in this belt, karst environments are prone to land degradation processes due to human impacts. Geographic Information Systems-based tools and hydrological modeling considering daily time steps were combined with temporal analysis of climate variables (wavelet analysis) to demonstrate possible interactions and vulnerable responses. Observed daily flow data were used to calibrate/validate these hydrological models by applying statistic indicators such as the NSE efficiency and a self-developed index (the ANSE index). This new index could enhance goodness-of-fit measurements obtained with traditional statistics during the model optimization. We hypothesize that this is key to adding new inputs to this research line. Our results revealed that: i) changes in the type of sclerophyllous vegetation (Quercus calliprinos, ilex, rotundifolia, suber, etc.) from 81.5% during the initial stage (1990) to natural grasslands by 81.6% (2018); and, ii) decreases in agricultural areas (crops) by approximately 60% and their transformation into coniferous forests, rock outcrops, sparsely natural grasslands, etc. in the same period. Consequently, increases in the curve number (CN) rates were identified as a result of land abandonment. As a result, an increase in peak flow events jointly with a relevant decrease of the average flow rates (water scarcity) in the watershed was predicted by the HEC-HMS model and verified through the observed data. This research provides useful information about the effects of anthropogenic changes in the hydrodynamic behaviour of karstic watersheds and water resource impacts, especially key in water-scarce areas that depict important hazards for the water supply of related populations and natural ecosystems.

Dropout in brief psychotherapy for major depressive disorder: Randomized clinical trial.

The aim of this paper is to analyse the factors associated with the dropout from brief psychotherapy for adults with major depressive disorder (MDD) treated at a mental health outpatient clinic. This is a randomized clinical trial with two models of psychotherapy: cognitive behavioural therapy (CBT) and supportive expressive dynamic psychotherapy (SEDP). MDD and anxiety disorders were evaluated through the Mini International Neuropsychiatric Interview-Plus. The personality disorders were evaluated by the Millon Clinical Multiaxial Inventory-III. The severity of depressive symptoms was measured using the Beck Depression Inventory-II and resilience through Resilience Scale. Of the 215 participants, 41.9% abandoned psychotherapy (n = 90), and, of these, 54.4% (n = 49) abandoned after the fourth session. The proportion of psychotherapy dropout was higher among those with nonwhite skin colour, belonging to economic classes C and D, who had children and whose depressive symptoms were moderate. Presence of obsessive-compulsive personality trait was protective against dropout. The damage caused by this abrupt interruption is evident for all those involved in the psychotherapeutic process, so the clinician should pay attention to the predictors found in this study in order to develop strategies that promote therapeutic adherence.