The impact of policy and policy communication on COVID-19 vaccination inequalities among Venezuelan refugees and migrants in Colombia: a comparative cross-sectional interrupted time-series analysis.

INTRODUCTION: Equitable access to vaccines for migrants and refugees is necessary to ensure their right to health and to achieve public health goals of reducing vaccine-preventable illness. Public health policies require regulatory frameworks and communication to effect uptake of effective vaccines among the target population. In Colombia, the National COVID-19 Vaccination Plan implicitly included Venezuelan refugees and migrants; however, initial communication of the policy indicated that vaccine availability was restricted to people with regular migration status. We estimated the impact of a public announcement, which clarified access for refugees and migrants, on vaccination coverage among Venezuelans living in Colombia. METHODS: Between 30 July 2021 and 5 February 2022, 6221 adult Venezuelans participated in a cross-sectional, population-based health survey. We used a comparative cross-sectional time-series analysis to estimate the effect of the October 2021 announcement on the average biweekly change in COVID-19 vaccine coverage of Venezuelans with regular and irregular migration status. RESULTS: 71% of Venezuelans had an irregular status. The baseline (preannouncement) vaccine coverage was lower among people with an irregular status but increased at similar rates as those with a regular status. After the announcement, there was a level change of 14.49% (95% CI: 1.57 to 27.42, p=0.03) in vaccination rates among individuals with irregular migration status with a 4.61% increase in vaccination rate per biweekly period (95% CI: 1.71 to 7.51, p=0.004). By February 2022, there was a 26.2% relative increase in vaccinations among individuals with irregular migration status compared with what was expected without the announcement. CONCLUSION: While there was no policy change, communication clarifying the policy drastically reduced vaccination inequalities across migration status. Lessons can be translated from the COVID-19 pandemic into more effective global, regional and local public health emergency preparedness and response to displacement.

Caracterización de la disfunción tiroidea en adultos con enfermedad renal crónica en diálisis / Characterization of thyroid dysfunction in adults with chronic renal disease in dialysis

Resumen Introducción: existe una clara relación entre la disfunción tiroidea y la enfermedad renal crónica (ERC) que se evidencia por el aumento de la prevalencia de hipotiroidismo primario a medida que disminuye la tasa de filtración glomerular. Objetivo: caracterizar los pacientes adultos con disfunción tiroidea y enfermedad renal crónica en terapia dialítica. Métodos: e realizó un estudio observacional de tipo descriptivo, transversal, que caracterizó y recolectó datos de laboratorio en pacientes mayores de 18 años con ERC. Estos pacientes se encontraban en terapia dialítica en una unidad renal de la ciudad de Cartagena (Colombia) y se les practicó un control de TSH en el año 2016. Resultados: se incluyeron 350 pacientes con registro de TSH. La mediana de edad fue de 59 años y el 49.1% eran mujeres. La principal causa de la ERC fue la hipertensión (36.3%) y la principal comorbilidad fue el hiperpatioidismo (56%). En relación con la disfunción tiroidea, se evidenció que el 25.4% de la población presentó niveles de TSH mayores a 4.5 uIU/mL. Dentro de este segmento, un 5.7% se encontraba en rango de hipotiroidismo (TSH>10 uIU/mL). Conclusiones: la prevalencia de la disfunción tiroidea fue mayor en la muestra, en comparación con la población general. No obstante, se requieren estudios adicionales con medición de T4L para realizar una adecuada categorización.

Abstract Background: There is a clear relationship between thyroid dysfunction and chronic kidney disease (CKD), which is evidenced by the increase in the prevalence of primary hypothyroidism when the glomerular filtration rate decreases. Objectives: Characterize adult patients with thyroid dysfunction and chronic kidney disease on dialysis therapy. Methods: An observational, descriptive, cross-sectional study was carried out that characterized and collected laboratory reports of patients >18 years of age with CKD in dialysis therapy of a renal unit of the city of Cartagena/Bolívar with TSH control in 2016. Results: 350 patients with TSH registry were included, with a median age of 59 years and 49.1% were women. The main cause and comorbidity of CKD was hypertension in 36.3% and hyperpatioidism in 56% respectively. In relation to thyroid dysfunction, 25.4% of the population had TSH levels> 4.5 uIU/mL, of which 5.7% had TSH levels> 10 uIU/mL (hypothyroidism). Conclusions: The prevalence of thyroid dysfunction was higher than in the general population, however additional studies with measurement of FT4 are necessary to achieve an adequate categorization.

Elementos constitutivos para una bioética en Humberto Maturana

A través de este escrito, se hará una presentación de los elementos conceptuales que, desde la biología, ha planteado Humberto Maturana Romecín para elaborar toda una teoría unitaria explicativa de la vida y de lo humano y que conllevan a la necesidad de plantearse una Bioética, tanto en su aspecto biológico, como en su vivencia. Dicha bioética hace parte de una biofilosofía que se levanta como paradigma explicativo de lo humano desde lo biológico, y permite, así, la descripción del fenómeno del vivir y todas sus estructuras emergentes, desde una perspectiva ontológica constitutiva.

This paper introduces the conceptual elements that Mr. Humerto Maturana Romecín has set -from biology- to elaborate a unitary theory of life and humanity, and this fact requires a bioethical approach from both its biological aspect and its experience. That bioethical approach is a part of a bio philosophy that raises as an explicative paradigm of humanity from biology and, therefore, allows the description of the phenomenon of living and all of its emerging structures, from a constitutive ontological view.

Através este escrito, se fará uma apresentação dos elementos conceituais que, desde a biologia, propôs Humberto Maturana Romecín para elaborar toda uma teoria unitária explicativa da vida e do humano e que implicam à necessidade de propor-se uma Bioética, tanto em seu aspecto biológico, como em sua vivência. Dita bioética faz parte de uma biofilosofia que se levanta como paradigma explicativo do humano desde o biológico, e permite, assim, a descrição do fenômeno do viver e todas suas estruturas emergentes, desde uma perspectiva ontológica constitutiva.