Obstetric violence: a Latin American legal response to mistreatment during childbirth

Over the last several years, a new legal construct has emerged in Latin America that encompasses elements of quality of obstetric care and mistreatment of women during childbirth - both issues of global maternal health import. Termed "obstetric violence," this legal construct refers to disrespectful and abusive treatment that women may experience from health care providers during pregnancy, childbirth, and the postpartum period, as well as other elements of poor quality care, such as failure to adhere to evidence-based best practices. This new legal term emerged out of concerted efforts by women's groups and networks, feminists, professional organizations, international and regional bodies, and public health agents and researchers to improve the quality of care that women receive across the region.Fil: Williams, Caitlin R.. University of North Carolina; Estados UnidosFil: Jerez, Celeste. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto Interdisciplinario de Estudios de Género; ArgentinaFil: Klein, Karen. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Correa, Malena. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Belizan, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Cormick, Gabriela. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. University of Cape Town; Sudáfric

Home range size and overlap in <i>Liolaemus multimaculatus</i> (Squamata: Liolamidae) in pampean coastal dunes of Argentina

The home range is the space used by individuals to carry out their life cycles. The Sand dune lizard (Liolaemus multimaculatus) is a vulnerable species, endemic to the pampas coasts of Buenos Aires and Río Negro Provinces in Argentina. The aim of this work was to assess home range size and overlap of the Sand dune lizard. The study was carried out at Mar Chiquita Provincial Reserve. Home range and overlap were calculated using the minimum convex polygon method. The mean ± SD home range size for all individuals was 45.90 ± 74.37 m2 and no differences were observed between males and females (p = 0.49). However, an analysis without outlier individuals showed more accurate values for females (21.31 ± 17.59 m2) and males (33.52 ± 24.62 m2), and differences between sex were observed (p = 0.04). The relationship between body size and home range size was not significant (p = 0.41). Home range overlap was high (22 to 58%; Fig. 2) and did not show differences between males and females (p > 0.05 in all cases). Our results showed some similarities with the Brazilian sand lizard (Liolaemus lutzae) in which home range value is only up to 1.5 units higher than in L. multimaculatus. Further studies about this species' social system are necessary to understand the observed patterns.Facultad de Ciencias Naturales y Muse

Short and long term outcomes of 200 patients supported by continuous-flow left ventricular assist devices

AIM: To study the institutional experience over 8 years with 200 continuous-flow (CF) - left ventricular assist devices (LVAD). METHODS: We evaluated our institution\u27s LVAD database and analyzed all patients who received a CF LVAD as a bridge to transplant (BTT) or destination therapy from March 2006 until June 2014. We identified 200 patients, of which 179 were implanted with a HeartMate II device (Thoratec Corp., Pleasanton, CA) and 21 received a Heartware HVAD (HeartWare Inc., Framingham, MA). RESULTS: The mean age of our LVAD recipients was 59.3 years (range 17-81), 76% (152/200) were males, and 49% were implanted for the indication of BTT. The survival rate for our LVAD patients at 30 d, 6 mo, 12 mo, 2 years, 3 years, and 4 years was 94%, 86%, 78%, 71%, 62% and 45% respectively. The mean duration of LVAD support was 581 d (range 2-2595 d). Gastrointestinal bleeding (was the most common adverse event (43/200, 21%), followed by right ventricular failure (38/200, 19%), stroke (31/200, 15%), re exploration for bleeding (31/200, 15%), ventilator dependent respiratory failure (19/200, 9%) and pneumonia (15/200, 7%). Our driveline infection rate was 7%. Pump thrombosis occurred in 6% of patients. Device exchanged was needed in 6% of patients. On multivariate analysis, preoperative liver dysfunction, ventilator dependent respiratory failure, tracheostomy and right ventricular failure requiring right ventricular assist device support were significant predictors of post LVAD survival. CONCLUSION: Short and long term survival for patients on LVAD support are excellent, although outcomes still remain inferior compared to heart transplantation. The incidence of driveline infections, pump thrombosis and pump exchange have declined significantly in recent years

Right Ventricular Failure Following Left Ventricular Assist Device Implant: An Intermacs Analysis

Purpose: Right heart failure (RHF) management following LVAD include inotropes, right ventricular mechanical support and heart transplant. We analyzed the outcomes of severe RHF following implant of a fully magnetically levitated or hybrid magnetic centrifugal durable LVAD. Methods: In this INTERMACS analysis we identified patients who developed severe RHF following LVAD from 2013 until 2020 as bridge to recovery or transplant. Patients were categorized in three groups based on RHF treatment strategy: inotrope support (group 1), temporary mechanical support (group 2), and durable centrifugal RVAD (group 3). Kaplan Meier and Cox-regression survival analysis between groups was undertaken. Logistic regression analysis for new onset dialysis was conducted. Results: 2509 patients developed severe RHF after LVAD. 2199 (87.6%) patients were managed with inotropes (group 1), 233 (9.3%) with temporary RVAD (group 2) and 77 (3.1%) with durable RVAD (group 3). Group 1 had fewer patients with INTERMACS profile 1 and 2 (21.6%, p\u3c0.001). One year survival was 84.6%, 59.3%, and 63.8% in groups 1,2, and 3 (mortality HR=2.4 and 3.3 for groups 2 and 3 vs. group 1, p\u3c0.05). One year survival to transplant was 27%, 36.5%, and 53.6% in groups 1, 2, and 3, respectively (p\u3c0.05). Group 2 had higher incidence of new onset dialysis (42.6%, p=0.049). Conclusion: Survival with RHF following LVAD implant varies based on treatment strategy; inotrope support is associated with increased survival. Patients with durable RVAD are more likely to survive to transplant. Patient selection studies for durable RVAD with contraindications for transplant are necessary

EVALUATION OF GUIDELINE DIRECTED MEDICAL THERAPY IN A PHARMACIST-LED HEART FAILURE CLINIC

Background: Guideline directed medical therapy (GDMT) for the treatment of heart failure with reduced ejection fraction (HFrEF) improves morbidity and mortality. According to the CHAMP-HF registry, only 15% of patients with HFrEF achieve target dosing. Published literature reports increased achievement of GDMT by 25-40% through a multidisciplinary approach. However, the pharmacists’ role on the impact of GDMT is not well described. The purpose of this study is to evaluate the impact that the CVD Ambulatory Care Pharmacy Clinic has on achievement of GDMT for patients with HFrEF. Methods: This is the interim analysis of an IRB approved retrospective cohort study. This study compares achievement of GDMT in HFrEF patients managed by the pharmacy clinic versus the control group. GDMT is defined as achievement of target dosing or maximum tolerated doses. Control group represents those not seen by CVD Pharmacy clinic. Inclusion criteria includes adult patients with EF ≤ 45%, hospitalization in the previous 12 months, followed by a cardiologist within the health system, and not on maximum tolerated doses of GDMT. The primary outcome is the number of patients on GDMT 12 months after the initial visit. Secondary outcomes include days from initial visit until GDMT, number of patients on moderate dosing of GDMT and change in EF after GDMT. Patients were enrolled from October 1, 2019 through September 30, 2020. Results: Achievement of GDMT at 12 months was 67.2% (39/58) in the intervention group compared to 16.2% (7/43) in the control (P \u3c0.001). Days to GDMT was a median of 95.5 [57-175.5] days and 143 [64-214] days for the intervention and control group respectively (P = 0.493). In the intervention group, 50% (29/58) of patients achieved moderate dosing at 12 months compared to 11.6% (5/43) in the control group (P\u3c0.001). Patients in the intervention group who had an echo after achieving GDMT had a median increase in EF of 12% [5-20] after GDMT achievement. For all patients who achieved GDMT, 32.6% (15/46) achieved target dosing of medications. Conclusion: The CVD Ambulatory Care Pharmacy Clinic was associated with higher rates of GDMT achievement compared to the control and a shorter time to GDMT achievement

The Student Movement Volume 105 Issue 13: AU Students Speak out Against Anti-AAPI Violence

NEWS James White Library Offers Useful Resources to Students, Amanda Cho The Office of Diversity and Inclusion and the Center for Faith Engagement Host Asian American and Pacific Islander Forum, Jenae Rogers The Office of Research and Creative Scholarship Hosts the Undergraduate Research and Honors Scholar Symposium, Caralynn Chan PULSE My Experience with Robinhood, Matthew Jarrard Nature Spots on Campus, Gloria Oh Pilipino Culture Night, Interviews by Masy Domecillo HUMANS Interview with T Bruggemann, Terika Williams Interviewing Andrews University\u27s AAPI Students on Allyship, Interviewed by Abigail Lee Senior Spotlight: Hailey Kim, Interviewed by Celeste Richardson ARTS & ENTERTAINMENT Creative Spotlight: Marcel Mattox, Interviewed by Joshua Deonarine AAPI Documentaries You Need to Watch, Megan Napod Asian Women, Courtesy of Hollywood, Hannah Cruse IDEAS Flying Sparks: The Implications of the Rise in AAPI Hate, Alannah Tjhatra The Three P\u27s of Perspective, Kyara Samuels THE LAST WORD Respecting Apoliticism, Daniel Selfhttps://digitalcommons.andrews.edu/sm-105/1017/thumbnail.jp

The Student Movement Volume 105 Issue 1: Back with a Bang

NEWS Suicide Awareness Month in the Chaos of 2020, Kavya Mohanram AUSA Lighthouse Vespers: The Gospel in Motion, Caralynn Chan IDEAS A Summer Recap, Alannah Tjhatra How to Survive a Pandemic, Solana Campbell Writing Cards to Senior Citizens, Sung Been Han PULSE Change Day at Michiana Fil-Am: Dual Perspectives from a Student and an Organizer, Masy Domecillo Honors Agape Feast, Jessica Rim HUMANS Chef Linda Brinegar, Interviewed by Alyssa Henriquez Summer During a Global Pandemic, Interviewed by Ben Lee Teaching During COVID-19, Interviewed by Celeste Richardson The Wellness Center Reopening, Interviewed by Terika Williams ARTS & ENTERTAINMENT A Tribute to Chadwick Boseman, Megan Napod Corn and Watermelon for Everyone!, Megan Napod Local Hotspots: (but not the coronavirus kind), Hannah Cruse Radiant Recitals, Isabella Koh THE LAST WORD Where is Home?, Daniel Selfhttps://digitalcommons.andrews.edu/sm-105/1001/thumbnail.jp