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Background: Venezuelan migration has experienced an unprecedented increase in the last decade, with approximately 7.7 million Venezuelan-born individuals residing in other countries as of 2024. Our study aims to identify the potential and actual demand for healthcare services (SRH) in the Venezuelan diaspora's four primary destinations within the Andean Countries: Colombia, Ecuador, Peru, and Chile., Methods: Using official data from administrative records, censuses, and sample surveys reported by the host countries and international agencies, we estimate the annual evolution of Venezuelan-born women of reproductive age (WRA) and their offspring. Additionally, we conduct two case studies focusing on Colombia and Chile to analyse the groups most vulnerable to unmet health needs., Results: The population of WRA has increased to between 5 and 6.8%, and births have risen to approximately 3-8% in host countries due to Venezuelan migration. Yet, we found a general decrease in health coverage for certain age groups of Venezuelan female migrants in host countries for the period 2017-2022, particularly in Chile. By 2022, an estimated 20% of healthcare needs remained unmet among children, girls, and younger Venezuelan women, contributing to greater health inequalities between Venezuelan-born adolescents and those from other countries of birth., Conclusions: Our findings highlight the escalating demand for and limited access to healthcare services among Venezuelan WRA in their destinations. Unmet healthcare needs are particularly prevalent among younger women by 2022, underscoring the urgency for health system to incorporate gender-responsive, equitable interventions and ensuring health rights for high-risk migrant groups such as infants, children, adolescents, and younger women. Addressing these challenges remains a critical task for the regional public health agenda in Latin America., (© 2024. The Author(s).)

Self-rated health is an indicator that can be easily identified in health surveys, widely used to measure physical, social, mental, and health aspects of the population, and predict premature mortality. In Venezuela, this information only began to be collected recently, in the National Survey of Living Conditions (ENCOVI). In this context, our study aims to analyze the demographic and socioeconomic factors associated with non-positive self-rated health among Venezuelan adults. The ENCOVI 2021 (n = 16,803) was used as a data source, assessing a probability stratified sample with questions about health, education, emigration, and other social and economic aspects. Crude and adjusted prevalence ratio analyses were performed using Poisson regression models with robust variance. The prevalence of fair/bad self-rated health among Venezuelans was 17.8%. The results indicated a strong association between outcome prevalence and age group, 3.81 times higher (95%CI: 3.29-4.41) among individuals aged 60 or more when compared to individuals aged 18 to 29 years. Also, participants experiencing severe food insecurity had a prevalence 2 times higher (95%CI: 1.61-2.47) than those who did not have any level of food insecurity. Factors such as poverty, education, recent emigration of family members, and sex also showed a significant influence, also when analyzed independently. The results show that special attention should be dedicated to the health of individuals facing hunger and of the older people.

Background: Despite nearly a quarter of Venezuelans remaining unvaccinated against coronavirus disease 2019 (COVID-19), the factors contributing to vaccine hesitancy in the country have not been thoroughly investigated., Methods: A cross-sectional study was conducted from October 15 th to 30 th , 2022, using a knowledge, attitudes, and practices (KAP) survey to identify factors associated with COVID-19 vaccine hesitancy., Results: The study analyzed data from 1,930 participants from all 24 states of Venezuela. The majority (93.4%) were vaccinated. The mean age was 40 years, predominantly female (67.3%), and held a university degree (70.6%). The mean KAP score was significantly higher among vaccinated individuals compared to unvaccinated ones (7.79 vs. 3.94 points for knowledge, 40 vs. 24 points for attitudes, and 16 vs. 10 points for practices, all p < 0.001). Increases in the scores for KAP were associated with increased odds of being vaccinated (84.6%, 25.6%, and 33% respectively for each one-point increase, all p < 0.001). Certain demographic factors such as marital status, occupation, religious beliefs, monthly income, and location influence COVID-19 vaccine knowledge. Higher income and certain occupations decrease the odds of low knowledge, while residing in specific states increases it. Attitudes towards the COVID-19 vaccine are influenced by age, health status, vaccination status, and location. Higher income and absence of certain health conditions decrease the odds of negative attitudes. Lastly, age, occupation, monthly income, and location affect vaccine practices. Advanced age and higher income decrease the odds of inappropriate practices, while residing in La Guaira state increases them., Conclusion: Factors such as age, education level, occupation, monthly income, and location were found to be associated with knowledge and attitudes towards COVID-19 vaccine among the surveyed Venezuelans., (© 2024. The Author(s).)

Background: Although the use of technology is a trend, since the COVID-19 pandemic, its use has been exacerbated, especially in educational processes, causing techno-stress among teachers., Purpose: In order to contribute to the lack of validated and adapted instruments in Latin America, this study aimed to analyze the psychometric properties and factorial structure of the Spanish version of the technostress scale in a large sample of Ecuadorian teachers., Methods: A non-probabilistic intentional sample of 2850 teachers (mean age 40 years, SD= 9.65; 65% female) from various schools throughout the Ecuadorian territory was surveyed online using a cross-sectional design. Data analysis included exploratory (EFA) and confirmatory factor analysis (CFA), factorial invariance, assessment of internal consistency, sex differences in technostress scale scores and convergent validity., Results: The EFA yielded a structure of four factors: skepticism, fatigue, anxiety and inefficiency. Through CFA, the hierarchical model that included a general factor and four nested factors had a better fit, and that model remained invariant across sex, age and public and private institutions. Total omega value (ω) was 0.962 for the total scale and hierarchical omega values (ωh) were 0.886 for the general factor, as well as 0.30, 0.22, 0.12 and 0.21 for the respective nested factors (skepticism, fatigue, anxiety and inefficiency). Moreover, the Resources, Experiences, Demands for Information and Communication Technologies (RED/TIC) scores were significantly higher among women, although effect sizes of comparison of those sex differences were very small. Finally, the RED/TIC scores correlated with the Depression, Anxiety and Stress Scale (DASS-21)., Conclusion: The RED/TIC scale has adequate psychometric properties in primary and high school teachers, and its use in that population is supported, which provides a valuable tool for the evaluation and detection of technostress in teachers and facilitates the investigation of this multifactorial phenomenon in Latin America., Competing Interests: The authors report that there are no conflicts of interest in this work., (© 2023 Ortega-Jiménez et al.)

Research on violence in indigenous communities refers to traditional practices of competition for scarce goods and clashes with other populations over their territories. Violence against children is not described, and authors of some studies state a tradition of good treatment towards them. In our study we shows that the situation has changed and new forms of violence are affecting 725,000 inhabitants from 51 indigenous groups of Venezuela, especially those composed of children and adolescents. The method used was interviews with key informants and for secondary census, civil society data and journalists' reports. Results describe the existence of four types of violence: (a) structural violence, derived from the shortage of food and medicines that have caused deaths due to malnutrition and lack of medical attention, prostitution, girl trafficking and forced emigration; (b) violence of organized crime, which exercise control of illegal mining and affect the Yanomami and Pemón peoples, as workforce for the production of coca and drug trafficking with the Yupka people; and contraband of gasoline in the Wayúu people; (c) domestic violence due to cultural changes derived from new patterns of alcohol consumption or the use of physical punishment of children between Piaroa and Yekuana peoples; and (d) the illegal violence of the State for the imposition of mining with the Pemón people or the repression for the protests with the Warao and Inga peoples. In the article we show the great difference between the official discourse of protection of indigenous peoples and the realities of violence, criminal exploitation and violation of rights suffered by indigenous children and adolescents.

Background: Between the 1950s and 2000, Venezuela showed one of the most substantial improvements in infant mortality rates in Latin America. However, the recent economic crisis alongside an increase in infectious and parasitic diseases might be reversing previous patterns. Because no official updated mortality statistics have been published since 2013, the effect of these recent events has been difficult to assess accurately. We therefore aimed to estimate infant mortality rate trends and report the effect of the crisis., Methods: We estimated infant mortality rates using direct methods (ie, death counts from Venezuelan Ministry of Health via yearbooks and notifiable diseases bulletins, and birth records published by the UN Economic Commission for Latin America and the Caribbean and the Venezuelan National Institute of Statistics) and indirect methods (using census data and a Living Conditions Survey ENCOVI 2016). We shaped yearly estimations using a semiparametric regression model, specifically a P-Spline model with a cubic thin plate base. The primary objective was to estimate infant mortality rate trends from 1985 to 2016., Findings: Around 2009, the long-term decline in infant mortality rate stopped, and a new pattern of increase was observed. The infant mortality rate reached 21·1 deaths per 1000 livebirths (90% CI -17·8 to 24·3) in 2016, almost 1·4 times the rate of 2008 (15·0, -14·0 to 16·1). This increase represents a huge setback on previous achievements in reducing infant mortality., Interpretation: Our conservative estimation indicates that Venezuela is in the throes of a humanitarian crisis. The increase in infant mortality rate in 2016 compared with 2008 takes the country back to the level observed at the end of the 1990s, wiping out 18 years of expected progress, and leaves the Venezuelan Government far from achieving the target of nine deaths per 1000 livebirths stated in the UN Millennium Development Goals., Funding: None., (Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Venezuela, the country with the largest oil reserves in the world, is facing the worst economic, social and political crisis in its history; which has notably affected the quality of life of the workforce and the entire population., Objectives: Identify and analyze the main social factors derived from the Venezuelan crisis, which are affecting the workers' health and working conditions., Methods: Document study. Several sources of information from the last twenty years were consulted, ranging from public statistics and reports, newspaper articles, and results of scientific research. The information gathered was carefully studied to ensure that only reliable sources were used to ultimately reach valid conclusions., Results: Both workers from the formal and informal sector and their families are struggling to fulfill their basic needs. Low salaries and soaring inflation have resulted in a dramatic reduction in the purchasing power of the people. General violence and high prices of basic goods are some of the major problems affecting workers both inside and outside of their working environment. Being a formal employee is no longer a guarantee for an acceptable quality of life. As a result, over 1.6 million Venezuelans have left their country since 2015 in a migration crisis never seen before in Latin America., Conclusion: Quality of life and wellbeing of most of the Venezuelan population has being deteriorated in the last 5 years and Occupational Safety and Health (OSH) is not a priority for enterprises in the middle of the economic emergency and general deterioration of daily life.Despite the relevance of this problem, research on the subject is very limited. Recent and pertinent data is needed to properly identify and measure the risks and negative consequences that workers and families are exposed caused by the ongoing crisis., Competing Interests: The authors have no competing interests to declare., (© 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.)

The so-called on- and off-cells of the rostral ventromedial medulla (RVM) send their axons to the spinal dorsal horn. Activation of on-cells precedes and coincides with a facilitation, and activation of off-cells coincides with an inhibition, of withdrawal reflexes elicited by noxious agents. Considerable evidence supports the notion that on- and off-cells modulate nocifensive reflexes during opioid and non-opioid action and also during normal circumstances and during peripheral neuropathy and inflammation. Yet it is unclear whether on- and off-cells act upon sensory spinal circuits that might lead to ascending projections and the experience of pain. Here, in deeply anesthetized rats we recorded single unit discharges from pairs of one on-like or off-like cell in RVM and a nociceptive neuron in the spinal dorsal horn with input from a hind paw. Both ongoing activity and responses to a calibrated noxious stimulus applied to the paw were documented during basal conditions and during development of paw inflammation. Probably due to the strong barbiturate anesthesia, off-like cells were depressed and did not yield interpretable results. However, we showed for the first time that during the increase in neuronal activity that results from paw inflammation the activity of spinal nociceptive neurons reflects the activity of their partner on-like cells in a highly correlated manner. This implies a tight relationship between spinal sensory and RVM modulatory functions that may underlie inflammation-induced hyperreflexia and clinically relevant hyperalgesia., (Copyright © 2018 Elsevier B.V. All rights reserved.)

This study examined whether spelling tasks contribute to the prediction of the handwriting status of children with poor and good handwriting skills in a cross-sectional study with 276 Spanish children from Grades 1 and 3. The main hypothesis was that the spelling tasks would predict the handwriting status of the children, although this influence would decrease with age due to a gradual automatization of handwriting skills. The results confirmed this hypothesis. Another interesting result was that the pattern of pseudoword and irregular word spellings as predictors of handwriting status changed from Grade 1 to Grade 3. In Grade 1, the pseudoword spelling task made a significant contribution, whereas the irregular word spelling task did not. The opposite pattern was found in Grade 3. These results may be a consequence of progressive acquisition of orthographic representations. The orthographic role of the task of writing the alphabet in order from memory in the prediction model was also analyzed. The writing of the alphabet in order from memory task made a significant contribution to the prediction of handwriting status of the children beyond the orthographic influence of spelling tasks. The additional effect of this task on the prediction of handwriting status is presumably due to the fact that this measure is based on fluency.

The aim of this study was to prepare molecularly imprinted polymers (MIPs) with ampicillin (AMP) and to evaluate the feasibility of these materials for being used as solid phase extraction sorbent for the selective preconcentration and determination of AMP in cow milk samples. MIPs were synthesized by bulk polymerization using methacrylic acid or methyl methacrylate as monomer and ethylene glycol dimethacrylate as cross-linker at different ratios. Characterization of the MIPs were carried out by Fourier-transform infrared spectrometry. The variables affecting the molecularly imprinted solid-phase extraction (MISPE) procedure were optimized. AMP recoveries were higher than 98%, and RSD less than 7%. A preconcentration factor of 20 was reached, which was sufficient to determine AMP at levels allowed by the EU (4μgkg -1 ) in cow milk. The selectivity of the AMP-MIP was evaluated in presence of other structurally related β-lactam antibiotics (amoxicillin, oxacillin, penicillin G)., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The paper describes a new and selective analytical sample treatment for quantitative extraction and preconcentration of erythromycin in presence of other macrolide antibiotics in sheep milk samples. The methodology is based on the use of a molecular imprinted polymer (MIP) employed as solid phase extraction sorbent (MISPE). The synthesized material by bulk polymerization using erythromycin (ERY) as template was evaluated as solid phase extraction sorbent, in a novel sample treatment technique that can be coupled to high-performance liquid chromatography with diode-array detector (HPLC-DAD). MIP selectivity was studied for other macrolide antibiotics with similar structures, such as tylosin (TYL), spiramycin (SPI), josamycin (JOS), roxithromycin (ROX) and ivermectin (IVER) getting recoveries for these interferents lower than 35%, for all cases except for ROX, which recoveries were around 85%. The variables affecting the molecularly imprinted solid-phase extraction (MISPE) procedure were optimized to select the best conditions of selectivity and sensitivity to determine ERY at concentration levels established by EU legislation in sheep milk. Under the selected experimental conditions, quantification limit was 24.1 µg kg(-1). Recoveries were higher than 98%, with RSDs between 0.7% and 2%. The proposed MISPE-HPLC method was validated and successfully applied to ERY analysis in sheep milk samples., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The following paper explores how working in Venezuela, a country that has gone through 20 years of economic and political problems, has highlighted the gap between clinical and community approaches in dealing with the sufferings of our consultants. Our efforts to develop theoretical and practical tools that can address the historical and political dimensions of people's lives are reviewed. These efforts illustrate how the community paradigm can help expand clinical perspectives, thus allowing a practise which can address the needs of people who have neither the time nor the economic means to engage in a traditional therapeutic relationship. The shift in perspective, the revision of our "therapeutic" stance and the use of de-naturalisation and problematization are illustrated.

The term M@TIC, is that which encompasses all Medicine Assisted by Technology on Information and Communication. The development of these techniques brings up many ethical and legal conflicts, mainly because medical science has developed much faster than the law. Justice cannot be properly served if we do not have the regulations to help mankind to avoid aberrant behavior by medical practitioners in this field. M@TIC is still regarded as an experimental research procedure. Not all that is technically feasible is ethically acceptable. There are many potential risks associated with M@TIC and it is largely considered, and so it is understood by doctors, that any damage to the patient would be the fault of the system, never the responsibility of the doctor. It frightens one to think that this fact may be used, in the future, as a shield to protect negligent medical doctors from malpractice suits.

This article analyzes the relationship between population growth and ethical principles relating to poverty. The paper is a critical approach to the thesis presented by Peter Singer in his book Practical Ethics. The first part briefly examines the principal topics of his thesis. The author then analyzes the basis of Singer's theory with respect to the following questions: 1. Is overpopulation the main reason for poverty? Is it possible to establish an association between the poverty phenomenon and population growth? 2. Is Singer s demographic perspective valid? 3. Can problems of resource distribution be ignored when talking about poverty from an ethical perspective? 4. Is it true that birth control policy was successfully implemented in Mexico, Colombia, and Brazil? 5. Does Singer s position on population growth have a negative influence on the "collective imagination"? The paper concludes by suggesting some useful arguments for understanding an ethical perspective towards poverty.