Subject(s)
Biomimetic Materials/therapeutic use , Diabetes Mellitus/drug therapy , Endocrinology/trends , Gastrointestinal Agents/therapeutic use , Hypoglycemic Agents/therapeutic use , Incretins/therapeutic use , Endocrinology/methods , Glucagon-Like Peptide-1 Receptor , Humans , Receptors, Glucagon/agonistsABSTRACT
This study was undertaken among Latinos receiving treatment from a community mental health center in New York City. The primary mental health concern was schizophrenia. We conducted three focus groups and present the viewpoints of consumers, family members, and providers. Using qualitative content analysis we identified four predominant categories: (1) the importance of family ties; (2) stigma about mental illness; (3) respect and trust in interpersonal relationships; and (4) facilitators and barriers to implementing Family Psychoeducation. Analysis of transcripts revealed specific subthemes for each category. Implications for imparting culturally sensitive material into mental health services for Latinos are discussed.
Subject(s)
Acculturation , Community Mental Health Services/statistics & numerical data , Family , Hispanic or Latino/psychology , Mental Disorders/ethnology , Patient Acceptance of Health Care/ethnology , Community Mental Health Centers , Cultural Characteristics , Cultural Competency , Female , Focus Groups , Health Services Accessibility , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/therapy , New York City , Patient Acceptance of Health Care/psychology , Patient Education as Topic , Psychotherapy/methods , Psychotropic Drugs/therapeutic use , Qualitative Research , Social ValuesSubject(s)
Autistic Disorder/psychology , Autistic Disorder/therapy , Internship and Residency , Music , Physician-Patient Relations , Adult , Child , Female , HumansABSTRACT
In this report, we describe the use of an attenuated regulatory mutant of a rabbit enteropathogenic Escherichia coli (rEPEC) as a live vaccine vector to deliver heterologous protein antigens using two dedicated transport systems, a Salmonella autotransporter and the E. coli hemolysin apparatus. We previously reported that an isogeneic ler (LEE encoded regulator) mutant of rEPEC O103:H2 is attenuated and immunogenic in rabbits. We first evaluated the Salmonella autotransporter MisL containing the immunodominant B-cell epitope of the circumsporozoite protein from Plasmodium falciparum, (NANP)8, fused to the C-terminal translocator domain under the control of the constitutive Tac17 promoter. The rEPEC ler mutant was able to express and to translocate the (NANP)8 passenger peptide to the bacterial surface. We next investigated the delivery of Shiga toxin B subunit (Stx1B) from human enterohemorrhagic E. coli by the rEPEC ler mutant via the MisL autotransporter or the E. coli hemolysin secretion apparatus. The autotransporter and hemolysin plasmids expressed similar levels of Stx1B (30-40 ng/ml/OD600). Only 6% of Stx1B was found in the autotransporter supernatants; the rest was cell-associated, with a small fraction of the Stx1B surface-exposed as determined by immunofluorescence. In contrast, 88% of Stx1B was secreted into culture supernatants by the hemolysin secretion system. In an in vivo study, no significant protection was observed in rabbits inoculated with the ler mutant harboring the Stx1B-autotransporter plasmid following experimental challenge with RDEC-H19A, the prototype rEPEC containing an Stx-converting phage. In contrast, rabbits inoculated with the rEPEC ler mutant containing the Stx1B-hemolysin fusion were partially protected from RDEC-H19A infection as demonstrated by decreased weight loss (p<0.008) when compared to rabbits inoculated with the parent ler mutant. Our results suggest that attenuated rEPEC are capable of serving as vaccine vectors to express heterologous protein antigens from different cellular locations and deliver these antigens to the intestinal mucosa. With this system, secreted proteins may be more effective than cell-associated antigens in generating protection.
