Factors Influencing COVID-19 Vaccine Uptake among Spanish-Speaking Pregnant People.

The coronavirus disease 2019 (COVID-19) pandemic exposed the vulnerability of pregnant women to excess morbidity and mortality, as well as the disproportionate disease burden in certain racial, ethnic, and sociodemographic groups. Vaccine hesitancy represents a major threat to public health, and crafting messages that reach vulnerable groups and address their intersectionality remains a weakness for pandemic preparedness. We sought to investigate factors that influenced vaccine acceptance and social media ad response in a mixed-methods study of Spanish-speaking women living in the rural Western United States who were pregnant or recently pregnant between November 2022 and June 2023. Direct interviews were translated, transcribed, and coded, while the ad ratings were analyzed using linear mixed models. Participants most favorably rated ads that featured doctors and text-heavy content describing benefits of vaccination. Qualitative data illustrated how information from trusted medical providers along with generational and cultural history of vaccine acceptance positively impacted perspectives on vaccination. Immigration status had varying influences on vaccination perspectives. Future vaccination campaigns targeting Spanish-speaking pregnant individuals in rural communities should use medical providers as ad messengers and dispel fears that vaccine acceptance may lead to problems with immigration status.

A Mother's Dilemma: The 5-P Model for Vaccine Decision-Making in Pregnancy.

Pregnant women are a highly vaccine-resistant population and face unique circumstances that complicate vaccine decision-making. Pregnant women are also at increased risk of adverse maternal and neonatal outcomes to many vaccine-preventable diseases. Several models have been proposed to describe factors informing vaccine hesitancy and acceptance. However, none of these existing models are applicable to the complex decision-making involved with vaccine acceptance during pregnancy. We propose a model for vaccine decision-making in pregnancy that incorporates the following key factors: (1) perceived information sufficiency regarding vaccination risks during pregnancy, (2) harm avoidance to protect the fetus, (3) relationship with a healthcare provider, (4) perceived benefits of vaccination, and (5) perceived disease susceptibility and severity during pregnancy. In addition to these factors, the availability of research on vaccine safety during pregnancy, social determinants of health, structural barriers to vaccine access, prior vaccine acceptance, and trust in the healthcare system play roles in decision-making. As a final step, the pregnant individual must balance the risks and benefits of vaccination for themselves and their fetus, which adds greater complexity to the decision. Our model represents a first step in synthesizing factors informing vaccine decision-making by pregnant women, who represent a highly vaccine-resistant population and who are also at high risk for adverse outcomes for many infectious diseases.

COVID-19 Vaccine Hesitancy among English-Speaking Pregnant Women Living in Rural Western United States.

This mixed-method study investigated vaccine hesitancy among pregnant women living in rural western United States and their response to social media ads promoting COVID-19 vaccine uptake. Thirty pregnant or recently pregnant participants who live in rural zip codes in Washington, Oregon, California, and Idaho were interviewed between November 2022 and March 2023. Interviews were transcribed and coded, while the ad ratings were analyzed using linear mixed models. The study identified five main themes related to vaccine uptake, including perceived risk of COVID, sources of health information, vaccine hesitancy, and relationships with care providers. Participants rated ads most highly that used peer-based messengers and negative outcome-based content. Ads with faith-based and elder messengers were rated significantly lower than peer messengers (p = 0.04 and 0.001, respectively). An activation message was also rated significantly less favorably than negative outcome-based content (p = 0.001). Participants preferred evidence-based information and the ability to conduct their own research on vaccine safety and efficacy rather than being told to get vaccinated. Primary concerns of vaccine-hesitant respondents included the short amount of time the vaccine had been available and perceived lack of research on its safety during pregnancy. Our findings suggests that tailored messaging using peer-based messengers and negative outcome-based content can positively impact vaccine uptake among pregnant women living in rural areas of the Western United States.

One Vax Two Lives: a social media campaign and research program to address COVID-19 vaccine hesitancy in pregnancy.

The COVID-19 pandemic has disproportionately affected pregnant people by increasing health risks of maternal morbidity and mortality, stillbirth, and preterm birth. Although numerous studies have supported the safety and efficacy of COVID-19 vaccination in pregnancy in preventing or mitigating the risk for these adverse outcomes, many pregnant people remain hesitant. Approximately half of US adults regularly consume news from social media platforms, which are a fertile ground for the spread of vaccine disinformation. The lack of information regarding COVID-19 vaccine safety early in the pandemic fueled vaccine myths targeting the fears of pregnant people about vaccination risks. Saddened by the spike in maternal deaths of unvaccinated individuals during the COVID-19 Delta variant surge in the fall of 2021, we created a social media campaign to promote scientific communication regarding the risks of COVID-19 disease in pregnancy and the benefits of vaccination. We called the campaign "One Vax Two Lives," which refers to the ability of 1 maternal vaccine to benefit the health and lives of both the pregnant individual and their fetus. We present a blueprint of how we leveraged a large, interdisciplinary student workforce to create a social media campaign and research program studying vaccine hesitancy, which can be replicated by other groups. Community engagement and partnerships with key stakeholders, such as the Washington State Department of Health, were essential for amplifying the campaign and providing our team with feedback on content and approach. We present the analytics of our social media advertisements, web articles, and video content that helped inform the iterative design process of the multimedia content. Moving forward, we are launching collaborative research programs to study vaccine hesitancy and inform the development of new social media content designed for pregnant individuals who are: (1) Spanish-speaking Hispanic/Latina/x, (2) Black or Afro-Latinx, and (3) residents of rural communities in the State of Washington. Data from these mixed methods studies will inform new communication campaigns to reach vaccine-hesitant individuals. Finally, we discuss lessons learned and how the most impactful elements of the campaign can be translated to related areas of maternal public health.

Consenso Argentino de Cirugía Metabólica / ARGENTINE CONSENSUS ON METABOLIC SURGERY

Introducción: la creciente pandemia de obesidad y diabetes tipo 2 (DM2) demanda opciones terapéuticas más efectivas para lograr un adecuado control metabólico y disminuir la morbimortalidad cardiovascular en este grupo de pacientes. En este contexto, la cirugía metabólica (CM) constituye una herramienta innovadora, segura y eficaz que complementa pero no reemplaza a los cambios necesarios del estilo de vida y tratamiento médico. Objetivos: el objetivo del Consenso es la fundamentación y acuerdo de utilización de una técnica quirúrgica, específicamente el Bypass Gástrico en Y de Roux (BPGYR), en el tratamiento de pacientes con DM2 que presentan un índice de masa corporal (IMC) entre 30-35 kg/m2 e inadecuado control metabólico. Conclusiones: el Consenso Argentino de Cirugía Metabólica elaborado por la Sociedad Argentina de Diabetes (SAD), la Sociedad Argentina de Nutrición (SAN) y la Sociedad Argentina de Cirugía de la Obesidad (SACO) expresa la opinión de expertos sobre la evidencia científica disponible y propone considerar a la CM en el algoritmo terapéutico de pacientes con DM2 e IMC 30-35 kg/m2 que no logran adecuado control metabólico con tratamiento médico convencional. Se describen los criterios a tener en cuenta en la selección de pacientes para CM, y se destaca el rol del equipo multidisciplinario liderado por médicos especialistas en enfermedades endocrino-metabólicas en la selección, evaluación, preparación y seguimiento de estos pacientes.

Consenso Argentino de Cirugía Metabólica / Argentine Consensus on Metabolic Surgery

Introducción: la creciente pandemia de obesidad y diabetes tipo 2 (DM2) demanda opciones terapéuticas más efectivas para lograr un adecuado control metabólico y disminuir la morbimortalidad cardiovascular en este grupo de pacientes. En este contexto, la cirugía metabólica (CM) constituye una herramienta innovadora, segura y eficaz que complementa pero no reemplaza a los cambios necesarios del estilo de vida y tratamiento médico. Objetivos: el objetivo del Consenso es la fundamentación y acuerdo de utilización de una técnica quirúrgica, específicamente el Bypass Gástrico en Y de Roux (BPGYR), en el tratamiento de pacientes con DM2 que presentan un índice de masa corporal (IMC) entre 30-35 kg/m2 e inadecuado control metabólico. Conclusiones: el Consenso Argentino de Cirugía Metabólica elaborado por la Sociedad Argentina de Diabetes (SAD), la Sociedad Argentina de Nutrición (SAN) y la Sociedad Argentina de Cirugía de la Obesidad (SACO) expresa la opinión de expertos sobre la evidencia científica disponible y propone considerar a la CM en el algoritmo terapéutico de pacientes con DM2 e IMC 30-35 kg/m2 que no logran adecuado control metabólico con tratamiento médico convencional. Se describen los criterios a tener en cuenta en la selección de pacientes para CM, y se destaca el rol del equipo multidisciplinario liderado por médicos especialistas en enfermedades endocrino-metabólicas en la selección, evaluación, preparación y seguimiento de estos pacientes

Galvanizing medical students in the administration of influenza vaccines: the Stanford Flu Crew.

Many national organizations call for medical students to receive more public health education in medical school. Nonetheless, limited evidence exists about successful servicelearning programs that administer preventive health services in nonclinical settings. The Flu Crew program, started in 2001 at the Stanford University School of Medicine, provides preclinical medical students with opportunities to administer influenza immunizations in the local community. Medical students consider Flu Crew to be an important part of their medical education that cannot be learned in the classroom. Through delivering vaccines to where people live, eat, work, and pray, Flu Crew teaches medical students about patient care, preventive medicine, and population health needs. Additionally, Flu Crew allows students to work with several partners in the community in order to understand how various stakeholders improve the delivery of population health services. Flu Crew teaches students how to address common vaccination myths and provides insights into implementing public health interventions. This article describes the Stanford Flu Crew curriculum, outlines the planning needed to organize immunization events, shares findings from medical students' attitudes about population health, highlights the program's outcomes, and summarizes the lessons learned. This article suggests that Flu Crew is an example of one viable service-learning modality that supports influenza vaccinations in nonclinical settings while simultaneously benefiting future clinicians.

At the crossroads of Greek and Roman medicine: the contribution of Latin papyri. 1. Medical texts; 2. Iatromagical papyri.

1. Far fewer Latin medical papyri, whether paraliterary, documentary or magical, have survived compared to Greek medical papyri, but they nonetheless provide interesting information about medical practices in the Graeco-Roman world, the relationship between Greek and Latin medical languages, and the choices made to use one rather than the other, a subject that has never been exhaustively studied. As part of the update undertaken by CEDOPAL since 2008 of the Corpus papyrorum Latinarum, published fifty years ago by the late Robert Cavenaile, we have inventoried Latin papyri containing medical references, classifying them by type or nature of content, provenance, form, layout, and writing. We finally analyse their content and what it reveals about the reception of Greek medicine by Latin or Latin-speaking writers. 2. The second section presents the only iatromagical papyrus in Latin known at the present time, P. Held. inv. lat. 5 (Suppl. Mag. 1.36, ca. fifth/sixth centuries, Fustat [?]), and compares its content with that of the Greek iatromagical papyri (dating from the first century B.C. to the seventh century A.D.) on one hand, and on the other hand with iatromagical formulae in Latin that have been preserved on metal leaves coming from Italy, Hungary, France, and England.

Factores de riesgo cardiovascular en una población joven de Coronel Oviedo, Paraguay

Introducción: Las enfermedades cardiovasculares constituyen la primera causa de mortalidad a nivel mundial. Las causas implicadas en las mismas están bien definidas y son los denominados factores de riesgo cardiovascular. Es de utilidad conocer la frecuencia de estos factores en la población adulta joven, de modo a tomar medidas preventivas. Objetivo: determinar la prevalencia de hipertensión arterial, diabetes mellitus, sobrepeso, obesidad y tabaquismo en población joven del área urbana de la ciudad de Coronel Oviedo, Paraguay. Material y método: se realizó un estudio, observacional, descriptivo de corte transversal, entre los meses de junio a agosto del 2012. Se incluyó a 139 sujetos entre 20 y 40 años, del área urbana de la ciudad de Coronel Oviedo, seleccionados mediante muestreo aleatorio simple, utilizando las recomendaciones del método progresivo paso a paso (steps) de vigilancia de factores de riesgo, de la Organización Mundial de la Salud y la Organización Panamericana de la Salud. Resultados: la edad media fue 28,8 años, la distribución según sexo fue de 63% femenino y 37% masculino. El estudio demostró que 21% padece de hipertensión arterial, 8% diabetes mellitus, 36% sobrepeso, 14% obesidad y 18% tabaquismo. El 61% de los encuestados presentaba factores de riesgo cardiovascular, distribuidos de la siguiente manera: 1 factor de riesgo 37%, 2 factores de riesgo 19% y 3 o más factores de riesgo 6%. Conclusiones: los factores de riesgo cardiovascular más frecuentes fueron el sobrepeso, hipertensión arterial y tabaquismo.

Introduction: Cardiovascular diseases are the first cause of mortality worldwide. The implicated causes of them are well defined and are called cardiovascular risk factors. It is useful to know the frequency of these factors in the young adult population in order to take preventive measures. Objective: To determine the prevalence of arterial hypertension, diabetes mellitus, overweight, obesity and smoking in the young population of the urban area of Coronel Oviedo, Paraguay. Material and methods: A cross-sectional, descriptive observational study was carried out from June to August, 2012. One hundred thirty nine subjects, who were between 20 and 40 years of age from the urban area of Coronel Oviedo, were included. They were selected by simple random sampling using the recommendations of the stepwise approach to Surveillance (STEPS) for risk factors of the World Health Organization and the Pan American Health Organization. Results: Mean age was 28.8 years, distribution by sex was 63% women and 37% men. The study showed that 21% suffered arterial hypertension, 8% diabetes mellitus, 36% overweight, 14% obesity and 18% smoking. Sixty one percent presented cardiovascular risk factors distributed as follows: one risk factor 37%, two risk factors 19% and three or more risk factors 6%. Conclusions: The most frequent cardiovascular risk factors were overweight, arterial hypertension and smoking.

Conocimientos acerca del virus del Palpiloma Humano en estudiantes del nivel escolar básico del Colegio Nacional DR. Pedro P. Peña de Coronel Oviedo en elaño 2014 / Knowledge about the Human Papillomavirus in students of the basic school level of the National School DR. Pedro P. Peña of Coronel Oviedo in 2014

Introducción: En los países del primer mundo, alrededor del 40% de las mujeres jóvenes se infectan con el VPH en un periodo de tres años a partir de su primera relación sexual; y en todo el mundo, del 50 al 80% de las mujeres sexualmente activas se infectan con el VPH por lo menos una vez en la vida. Objetivo: Evaluar el nivel de conocimiento acerca del virus del papiloma humano de Coronel Oviedo en el año 2014. Material y métodos: Estudio cuantitativo, observacional, descriptivo de corte trasversal. Resultados; De 155 alumnos encuestados, predomino el sexo masculino, el mayor porcentaje procedía de la zona urbana. En cuanto a la etiología un 85% afirmo que es viral, el 76% señalo que el VPH se trasmite por relaciones sexuales sin protección, el 95% de los alumnos encuestados desconoce si afecta a ambos sexos, el 89% de la población estudiada afirmo que tener múltiples parejas sexuales es un factor de riesgo para la adquisición del VPH, el 65% desconoce la manifestación clínica y ningún encuestado afirmo que la verruga lo es. Conclusiones: En lo que respecta a conocimientos de la etiología y factores de riesgo los resultados fueron buenos, lo que compete al modo de trasmisión el resultado fue regular, y por ultimo lo que respecta a genero afectado y manifestación clínica el resultado fue malo

Estudio piloto para la adaptación del Inventario de Apego a Padres y Pares (IPPA) en una muestra de adolescentes argentinos / Pilot study in the adaptation of inventory of parent and peer attachment in a sample of argentine adolescents

En la Programación Científica anterior¹ se confirmó que la falla en el vínculo primario constituye un factor etiopatológico durante la adolescencia² . El estudio del Apego resulta valioso para comprender cómo inluencia el vínculo primario, en aquel que se mantiene con los pares en la adolescencia. Se halló que la adaptación al castellano (Pardo, Pineda, Carillo & Castro, 2006) del Inventario de Apego a Padres y Pares (IPPA Armsden & Greenberg 1987), dejaba sin clasificar un 30% de los sujetos argentinos. Como se trata del instrumento que más se ha trabajado en distintos países y por distintos autores, el mismo puede servir de base para la posible creación de un nuevo instrumento; por lo cual el objetivo es traducir y adaptar el IPPA en una muestra no clínica argentina. Se presenta un estudio piloto, parte de un trabajo en curso. Se autoadministró el instrumento en Escuelas de Capital Federal, zona Sur y Norte del Gran Buenos Aires. Se obtuvo una muestra de 233 adolescentes argentinos de ambos sexos de 13-18 años. Se hallaron diecinueve combinatorias no contempladas en la adaptación al castellano existente y quince respecto del original.

In previous research project it was conirmed that failures in the primary link are an etiopathological factor during adolescence. The study of Attachment is meaningful to understand how the primary attachment figure influences peers relationships during adolescence. Adaptation into Spanish (Pardo, Pineda, Carillo & Castro, 2006) of the IPPA (Inventory of Parent and Peer Attachment, Armsden & Greenberg, 1987) left nearly 30% of argentine adolescents outside of the proposed classification. As the IPPA is one of the most used instruments in many countries and by many authors, it can be useful for a further construction of a new instrument. The aim of this project is to translate and adapt the IPPA and administer it to a non-clinical argentine sample. Results of this pilot study are presented. The IPPA was self-administered in different schools of Capital Federal, and South and North of Gran Buenos Aires. The sample consisted of 233 argentine adolescents of ages 13 and 18, both genders. Results show nineteen clusters not included in the Colombian adaptation as well as ifteen in the original version.