Large-Vessel Vasculitis and Q Fever Correlation.

Q fever is a zoonotic infection caused by the pathogen Coxiella burnetii, and patients can present with a wide spectrum of clinical manifestations, depending on whether it is an acute or a chronic infection. We present the case of a 61-year-old male with fatigue, posterior thoracalgia, intermittent fever, night sweats and weight loss for a month. After an extensive workup, he was diagnosed with acute Q fever with large-vessel vasculitis. The FDG-PET/CT scan suggested an active vasculitis specifically in the thoracic aorta, proximal abdominal aorta, subclavian and carotid vessels, suggesting an immunologic response to acute Q fever infection, barely reported worldwide. LEARNING POINTS: Large-vessel vasculitis is a possible immunologic response to acute Q fever infection.There are few data about the management and treatment of patients with Q fever related large-vessel vasculitis.

Language access research for community health: provider perspectives on language access techniques and the role of communication technology.

BACKGROUND: In the United States, 66 million people speak a language other than English at home. Patients with diverse language needs often face significant health disparities. Information and communication technologies have expanded the realm of modalities for patient-provider communication. However, the extent to which digital language access tools are utilized by healthcare providers is unknown. This research examines provider perspectives on language assistance techniques and the role of communication technology when serving patients with non-English language preference (NELP). METHODS: Between April and July 2019, an online survey was administered to 3,033 healthcare providers (doctors, nurse practitioners, pharmacists, and dentists) in Washington State. Providers reported on their language access practices and perspectives on communication technology. RESULTS: Most providers reported using ad hoc language access techniques when engaging patients with NELP, such as a patient's family member or friend (75.8%), a patient's child specifically (61.9%), or a bilingual staff member (64.3%). Professional techniques, such as in-person interpretation (53.5%), phone interpretation (57%), and video remote interpretation (38.8%), were used less often. Dissatisfaction with the language access processes of healthcare providers' place of work was associated with a higher reliance on a patient's family or friend for language interpretation. CONCLUSIONS: Findings suggest that providers might be under-utilizing professional and digital interpreter services while relying on ad hoc techniques. Such practices reveal systemic constraints on language access that might make it difficult for providers to access timely and reliable options for professional language interpretation, despite federal regulations that mandate such services for patients with NELP.

Brachybacterium atlanticum sp. nov., a novel marine bacterium isolated from the Atlantic Ocean.

A bacterial strain, PhyBa_CO2_2T, was isolated from the North Atlantic Gyre, offshore Terceira Island in the Azores. Initially, the NCBI nucleotide blast analysis based on 16S rRNA gene sequences revealed that the strain belongs to the genus Brachybacterium, with a 100 % identity with Brachybacterium paraconglomeratum LMG 19861T. However, further genomic characterization through average nucleotide identity (ANI) and digital DNA-DNA hybridization analyses showed values of 96.06 and 64.80 %, respectively. Comparative genomics also highlighted differences in gene content. The genome size of PhyBa_CO2_2T is 3.6 Mbp and the DNA G+C content is 72.1 mol%. Chemotaxonomic analysis demonstrated that the composition of the fatty acids was mainly composed of anteiso-C15 : 0 (46.04 %), iso-C16 : 0 (13.70 %) and anteiso-C17 : 0 (9.48 %), and the polar lipids were mainly diphosphatidylglycerol, phosphatidylglycerol and two unidentified glycolipids. Furthermore, the diagnostic amino acid of the cell wall was meso-diaminopimelic acid and the predominant menaquinone was MK7. Finally, phenotypic analysis revealed differences in biochemical profiles between PhyBa_CO2_2T and its closely related strains in terms of indole production, urease and ß-glucuronidase activity. Therefore, based on the genomic, chemotaxonomic and phenotypic data obtained, we concluded that strain PhyBa_CO2_2T represents a new species, for which the name Brachybacterium atlanticum sp. nov. is proposed in reference to its isolation site. The type strain is PhyBa_CO2_2T (=DSM 114113T= CECT 30695T).

Phosphate Capture Enhancement Using Designed Iron Oxide-Based Nanostructures.

Phosphates in high concentrations are harmful pollutants for the environment, and new and cheap solutions are currently needed for phosphate removal from polluted liquid media. Iron oxide nanoparticles show a promising capacity for removing phosphates from polluted media and can be easily separated from polluted media under an external magnetic field. However, they have to display a high surface area allowing high removal pollutant capacity while preserving their magnetic properties. In that context, the reproducible synthesis of magnetic iron oxide raspberry-shaped nanostructures (RSNs) by a modified polyol solvothermal method has been optimized, and the conditions to dope the latter with cobalt, zinc, and aluminum to improve the phosphate adsorption have been determined. These RSNs consist of oriented aggregates of iron oxide nanocrystals, providing a very high saturation magnetization and a superparamagnetic behavior that favor colloidal stability. Finally, the adsorption of phosphates as a function of pH, time, and phosphate concentration has been studied. The undoped and especially aluminum-doped RSNs were demonstrated to be very effective phosphate adsorbents, and they can be extracted from the media by applying a magnet.

Estilo de vida e literacia em saúde de estudantes de enfermagem / Lifestyle and health literacy of nursing students

A adoção de um estilo de vida adequado, previne inúmeras mortes prematuras no mundo. O estilo de vida dos estudantes é tipicamente influenciado e moldado à medida que entram num período de transição, como é a entrada no ensino superior. Estes adquirem hábitos, que na maioria dos casos se mantêm na idade adulta. É fundamental, fomentar a literacia em saúde, de modo, a favorecer a adoção de um estilo de vida saudável com influência direta na saúde. O objetivo geral do estudo foi contribuir para o conhecimento do estilo de vida e da literacia em saúde dos estudantes de enfermagem. Estudo quantitativo, tipo exploratório: descritivo-correlacional, transversal, com amostra não probabilística por conveniência, constituída por 126 participantes. Instrumento de recolha de dados dividido em três partes: caraterização sociodemográfica e de saúde (elaborado pela autora); questionário Europeu de Literacia e Saúde (HLS-EU-T) de Pedro, Amaral e Escoval (2016) e o questionário ?Estilo de Vida Fantástico? de Silva, Brito e Amado (2014). Os principais resultados revelam média de idade de 20,71±3,92 anos, maioritariamente do sexo feminino (88,10%). O nível médio de literacia em saúde geral de 34,67±6,37 pontos é ?suficiente?. O estilo de vida global médio é ?Bom?, 83,59±13,47 pontos sendo o domínio mais deficitário: ?Trabalho/Tipo de personalidade?. As variáveis relacionadas com estilo de vida, estatisticamente significativa, são: doenças crónicas (p=0,023), autoavaliação de saúde (p<0,001), deslocação da residência (p=0,018), escolha do curso como primeira opção (p=0,046) e habilitações literárias da mãe (p=0,046). O estilo de vida correlaciona-se forte e positivamente com a literacia em saúde global (r=0,352; p<0,001). As variáveis relacionadas com a literacia em saúde, de forma estatisticamente significativa, são: autoavaliação da saúde (p=0,001), deslocação da residência (p=0,016) e escolha do curso como primeira opção (p=0,033). A dimensão da promoção da saúde teve piores resultados. Conclui-se que níveis inadequados e problemáticos de literacia em saúde evidenciam níveis baixos de estilo de vida saudável. É necessário melhorar o nível de literacia em saúde dos jovens, contribuindo para a diminuição de comportamentos de risco para a saúde e consequentemente diminuição dos gastos em saúde.

Enfermeiro de referência na pessoa com doença renal crónica em hemodiálise / Reference nurse for people with chronic kidney disease on hemodialysis

O presente relatório, elaborado no contexto do curso de Mestrado em Enfermagem Médico-Cirúrgica, na Vertente Nefrológica, demonstra a aquisição de competências do Enfermeiro Especialista, apresentando-se as reflexões consequentes das atividades desenvolvidas em estágios e, também, explana as competências de mestre que foram adquiridas com a concretização de uma revisão scoping com o título: "Enfermeiro de Referência na pessoa com doença renal crónica em hemodiálise". As pessoas com Doença Renal Crónica (DRC) enfrentam grandes dificuldades na adaptação ao tratamento de Hemodiálise (HD), por ser um processo terapêutico complexo, exaustivo, exigente e sujeito a várias complicações, pelo que necessitam de ajuda consistente e permanente por parte da equipa de enfermagem. As pessoas em HD necessitam de alterar a sua dinâmica de vida, sendo fundamental manterem um papel ativo, de forma a evitar ou reduzir complicações intra e interdialíticas, na possível redução da morbilidade/mortalidade e na promoção do seu bem-estar físico, psicológico, social e espiritual. Devido a esta problemática, torna-se essencial que os cuidados de enfermagem sejam individualizados e centrados na promoção da adaptação da pessoa às limitações ocasionadas pela doença e respetivo tratamento. A Metodologia de Enfermeiro de Referência (MER) baseia-se num modelo de prestação de cuidados que valoriza uma intervenção holística, centrada na pessoa e com uma intervenção individualizada. O Enfermeiro de Referência assume a responsabilidade total da gestão dos cuidados de uma pessoa com DRC (ou várias) específica(s), durante todo o período terapêutico. Com a revisão scoping constatou-se que o Enfermeiro de Referência em Nefrologia deve estabelecer um acompanhamento individualizado e contínuo a cada pessoa, guiado pela melhor evidência científica. Adicionalmente, este profissional tem um papel fundamental na educação e formação desta população, sendo a sua principal função capacitar as pessoas para encarar esta nova condição de saúde. Desta forma, cada pessoa deve tornar-se responsável pela sua saúde, garantindo a redução de possíveis complicações e promovendo a adaptação a este tratamento e condição de vida

This report, prepared in the context of the master's degree in Medical-Surgical Nursing with specialisation in Nephrology, proves the acquisition of skills of the specialist nurse through reflection on the activities developed in internships and it also demonstrates the master skills that were gained from carrying out a scoping review with the title: 'Primary Nurse for the patient with chronic kidney disease on hemodialysis'. The patient with chronic kidney disease (CKD) faces great difficulties in adapting to hemodialysis (HD) treatment, as it is a complex therapeutic process. It is a very exhaustive, demanding treatment and subject to several complications, so people need consistent and permanent help from the nursing team. People in HD need to change their life dynamics, an active role is vital in order to avoid or reduce intra and interdialytic complications, in the possible reduction of morbidity/mortality and in the promotion of their physical, psychological and social well being. Due to this problem, it is essential that nursing care is individualised and focused on promoting the patient's adaptation to the limitations caused by the disease and treatment. The Primary Nurse Methodology (PNM) is based on a care delivery model that values a holistic, person-centred and individualized intervention. The Primary Nurse assumes full responsibility for the management of the care of a specific patient (or several) during the entire therapeutic period. With the scoping review, it was found that the Primary Nurse in nephrology should establish an individualised and continuous follow-up to each patient, guided by the best scientific evidence. We conclude that the intervention conducted by the Primary Nurse through support, education and prevention of complications is an essential tool to reduce and control symptoms. It was found that this professional also has a vital role in the education and training of the population, with their main function being to enable the patient to face this new health condition. Therefore, the patient becomes responsible for their health, ensuring the reduction of possible complications and promoting adaptation to this treatment and life condition.

Emiliania huxleyi-Bacteria Interactions under Increasing CO2 Concentrations.

The interactions established between marine microbes, namely phytoplankton-bacteria, are key to the balance of organic matter export to depth and recycling in the surface ocean. Still, their role in the response of phytoplankton to rising CO2 concentrations is poorly understood. Here, we show that the response of the cosmopolitan Emiliania huxleyi (E. huxleyi) to increasing CO2 is affected by the coexistence with bacteria. Specifically, decreased growth rate of E. huxleyi at enhanced CO2 concentrations was amplified in the bloom phase (potentially also related to nutrient concentrations) and with the coexistence with Idiomarina abyssalis (I. abyssalis) and Brachybacterium sp. In addition, enhanced CO2 concentrations also affected E. huxleyi's cellular content estimates, increasing organic and decreasing inorganic carbon, in the presence of I. abyssalis, but not Brachybacterium sp. At the same time, the bacterial isolates only survived in coexistence with E. huxleyi, but exclusively I. abyssalis at present CO2 concentrations. Bacterial species or group-specific responses to the projected CO2 rise, together with the concomitant effect on E. huxleyi, might impact the balance between the microbial loop and the export of organic matter, with consequences for atmospheric carbon dioxide.

Nitrofurantoin-induced agranulocytosis.

Idiosyncratic drug-induced agranulocytosis is a rare life-threatening adverse reaction characterised by an absolute neutrophil count <500 cells/µL of blood. Nitrofurantoin has been associated with haematological adverse events, but few agranulocytosis cases worldwide have been reported. We present a case of a 68-year-old woman who presented with fever and agranulocytosis following treatment with nitrofurantoin. Extensive workup for agranulocytosis, including a bone marrow aspirate, was unremarkable. Treatment with nitrofurantoin was discontinued, which led to a complete recovery of the complete blood count. This case stresses the importance of monitoring treatments, given that widely used drugs are not free from severe adverse reactions.

Morphometrical Study of the European Shorthair Cat Skull Using Computed Tomography.

This study aimed to perform a morphometric analysis of the skull of the European shorthair cat by using computed tomographic images. Thirty-seven computed tomography (CT) studies of healthy cats' heads were used for linear measurements and index calculations of the skull and cranium. The following values were determined: skull length = 8.94 ± 0.45 cm, cranial length = 8.21 ± 0.42 cm, nasal length = 0.73 ± 0.17 cm, cranial width = 4.28 ± 0.26 cm, cranial index = 52.18 ± 3.75%, internal height of cranium = 2.88 ± 0.29 cm, external height of cranium = 3.35 ± 0.12 cm, internal length of the cranium = 5.53 ± 0.28 cm, external length of the cranium = 6.32 ± 0.28 cm, internal cranium index = 45.62 ± 4.77%, external cranium index = 53.06 ± 2.07%, internal cranium and skull index = 61.93 ± 2.38%, external cranium and skull index = 70.70 ± 1.72%, width of the foramen magnum = 1.34 ± 0.07 cm, height of the foramen magnum = 1.01 ± 0.09 cm, and foramen magnum index = 75.37 ± 5.76%. It was also found that the population was homogeneous, with the exception of nasal length (NL), and that there was a sexual dimorphism present, with males exhibiting higher dimensions. This work contributed to characterizing the morphometry of the cranium and skull of the domestic cat, a knowledge of utmost importance for the diagnosis and treatment of conditions affecting this complex anatomical region.

Ervilia castanea (Mollusca, Bivalvia) populations adversely affected at CO2 seeps in the North Atlantic.

Sites with naturally high CO2 conditions provide unique opportunities to forecast the vulnerability of coastal ecosystems to ocean acidification, by studying the biological responses and potential adaptations to this increased environmental variability. In this study, we investigated the bivalve Ervilia castanea in coastal sandy sediments at reference sites and at volcanic CO2 seeps off the Azores, where the pH of bottom waters ranged from average oceanic levels of 8.2, along gradients, down to 6.81, in carbonated seawater at the seeps. The bivalve population structure changed markedly at the seeps. Large individuals became less abundant as seawater CO2 levels rose and were completely absent from the most acidified sites. In contrast, small bivalves were most abundant at the CO2 seeps. We propose that larvae can settle and initially live in high abundances under elevated CO2 levels, but that high rates of post-settlement dispersal and/or mortality occur. Ervilia castanea were susceptible to elevated CO2 levels and these effects were consistently associated with lower food supplies. This raises concerns about the effects of ocean acidification on the brood stock of this species and other bivalve molluscs with similar life history traits.

Canine lymphoma and vector-borne diseases: Molecular and serological evaluation of a possible complicity.

Lymphoma is the most common haematological malignancy in dogs and its aetiology is largely unknown. The presence of canine vector-borne agents (CVBD) in lymphoma tissues has been described and its causative effects questioned. We intended to evaluate the presence and extent of Leishmania infantum, Ehrlichia canis, Anaplasma phagocytophilum and Bartonella henselae infection in dogs with lymphoma. Sixty-one dogs, living in the Lisbon metropolitan area, with a diagnosis of lymphoma were enrolled. Immunofluorescence assays were used to detect serum IgG's. The presence of DNA from CVBD agents in tumour tissue was assessed by PCR. All dogs tested negative for B. henselae, A. phagocytophilum and E. canis by both serology and PCR. Regarding L. infantum, 8.2% (n = 5) of the dogs had a positive serologic result. L. infantum DNA was detected in two samples of diffuse large B-cell lymphoma (DLBCL). These results show an increased, but not significant, seropositivity (8.2% vs 7.9%) and molecular detection (3.3% vs 1.2%) for L. infantum in dogs with lymphoma, when compared to the reported canine population in the same geographical area. We could not identify an association between lymphoma and E. canis, A. phagocytophilum, B. henselae or Leishmania infantum infection in the studied population. Nevertheless, further studies, following dogs trough their CVBD disease evolution, are worthwhile and may help clarify a possible role of CVBD agents in lymphomagenesis.

Global variability in seawater Mg:Ca and Sr:Ca ratios in the modern ocean.

Seawater Mg:Ca and Sr:Ca ratios are biogeochemical parameters reflecting the Earth-ocean-atmosphere dynamic exchange of elements. The ratios' dependence on the environment and organisms' biology facilitates their application in marine sciences. Here, we present a measured single-laboratory dataset, combined with previous data, to test the assumption of limited seawater Mg:Ca and Sr:Ca variability across marine environments globally. High variability was found in open-ocean upwelling and polar regions, shelves/neritic and river-influenced areas, where seawater Mg:Ca and Sr:Ca ratios range from ∼4.40 to 6.40 mmol:mol and ∼6.95 to 9.80 mmol:mol, respectively. Open-ocean seawater Mg:Ca is semiconservative (∼4.90 to 5.30 mol:mol), while Sr:Ca is more variable and nonconservative (∼7.70 to 8.80 mmol:mol); both ratios are nonconservative in coastal seas. Further, the Ca, Mg, and Sr elemental fluxes are connected to large total alkalinity deviations from International Association for the Physical Sciences of the Oceans (IAPSO) standard values. Because there is significant modern seawater Mg:Ca and Sr:Ca ratios variability across marine environments we cannot absolutely assume that fossil archives using taxa-specific proxies reflect true global seawater chemistry but rather taxa- and process-specific ecosystem variations, reflecting regional conditions. This variability could reconcile secular seawater Mg:Ca and Sr:Ca ratio reconstructions using different taxa and techniques by assuming an error of 1 to 1.50 mol:mol, and 1 to 1.90 mmol:mol, respectively. The modern ratios' variability is similar to the reconstructed rise over 20 Ma (Neogene Period), nurturing the question of seminonconservative behavior of Ca, Mg, and Sr over modern Earth geological history with an overlooked environmental effect.

The Role of Architecture and Design in the Management of Parkinson's Disease: A Systematic Review.

BACKGROUND: Parkinson's disease (PD) is a neurological condition characterized by the development of daily disabling symptoms. Although the architecture and design of a PD patient's environment can hinder or facilitate full participation in daily activities, their putative role in the management of these patients has received little attention to date. OBJECTIVE: We conducted a systematic review to evaluate the evidence of architectural and design features in the management of people with PD. METHODS: An electronic database search of observational and experimental studies was conducted in MEDLINE and Embase from inception to May 2020, with two independent reviewers identifying the studies. Falls, fear of falling, postural instability, gait impairment/disability, and functional mobility were our outcomes of interest. RESULTS: Thirty-six studies were included, among which nineteen were observational and seventeen were experimental studies (overall participants = 2,965). Pavement characteristics, notably unstable surfaces and level differences, were found to be a major cause of falling. Ground-based obstacles and confined/narrowed spaces were found to disturb gait, increase postural instability, and decrease functional mobility. Housing type did not appear to increase risk of falling, nor to significantly explain concerns about falling. CONCLUSION: Findings suggest a need to adjust architectural features of the surrounding space to ensure appropriate care and provide a safe environment to PD patients. More evidence about the impact of such modifications on PD outcomes is needed.

Moving towards home-based community-centred integrated care in Parkinson's disease.

People living with Parkinson's disease (PwP) experience a wide range of motor and non-motor symptoms associated with increasing complexity of care delivery. A multispecialty approach has been presented as an intuitive solution for tailored and comprehensive care delivery. Nevertheless, past trials of both multidisciplinary or interdisciplinary care models in PD suggested no measurable change to a small benefit in quality of life (QoL) and failed to show economic sustainability. We propose a home-based community-centred integrated care (iCARE-PD) for PwP as a pragmatic solution to harness the potential of existing care resources using an integrated care strategy, enable self-management support and implement technology-enabled care. The iCARE-PD model is based on Freeman's concept of continuity of care and the expanded Chronic Care Model for organization of care strategies. A home-based community-centred integrated care has immediate implications for clinical practice, with potential benefits in rural areas or lower-income countries, by enhancing access to care with optimized costs. There is a need to establish which and how interventions may be used as an instrument of care in each local deployment of the iCARE-PD model. We put forward a multidisciplinary framework to generate the evidence supportive of its implementation as the standard of care in the future and delineate the core strategies to secure the implementation of this care approach across different health care systems to ensure feasibility and economic sustainability. We envision this model becoming a paradigm of personalized care transferable to people with atypical forms of neurodegenerative parkinsonism.

Supercritically dried superparamagnetic mesoporous silica nanoparticles for cancer theranostics.

Mesoporous silica nanoparticles with a superparamagnetic iron oxide core were prepared in this work, in order to obtain multifunctional platforms with adequate features for cancer theranostics. Three different core-shell nanocomplexes were obtained: IO-OAm/mSiO2, IO-APTES/mSiO2 and IO/SiO2/mSiO2. In the case of IO-OAm/mSiO2 and IO-APTES/mSiO2, iron oxide (IO) was obtained by thermal decomposition, having in this case a coating of oleylamine (OAm) that was in the second formulation exchanged by (3-aminopropyl)triethoxysilane ligand (APTES). Regarding the IO/SiO2/mSiO2 formulation, iron oxide was synthesized by microemulsion. The mesoporous silica shell (mSiO2) on the IO nanoparticles was obtained by sol-gel and the final materials were dried by supercritical fluids drying. VSM confirmed the superparamagnetic behaviour of the nanoparticles, leading to MS of 4.0, 1.8 and 10.2 emu·g-1, for IO-OAm/mSiO2, IO-APTES/mSiO2 and IO/SiO2/mSiO2, respectively. NMR relaxometry has shown the potential of these nanoparticles to be used as T2 contrast agents, with r2 values as high as 63.93 s-1·mM-1 Fe. The three types of nanoparticles exhibited loading contents of epirubicin of ~3% and drug release percentages of 19% for IO-OAm/mSiO2, 24% for IO-APTES/mSiO2 and 31% for IO/SiO2/mSiO2. The cytotoxicity of drug-loaded and non-loaded most promising nanoparticles was assessed, showing high potential of these platforms for application as anticancer drug carriers.

Interpretation of lumbar cerebrospinal fluid leukocytosis after cranial surgery: The relevance of aseptic meningitis.

Raised white cell count (WCC) in lumbar CSF is a commonly used marker of meningitis. The effect of cranial neurosurgery per se on lumbar WCC is not established. At this single centre, many patients undergo ICPM followed by lumboperitoneal shunt (LPS), with lumbar CSF WCC samples taken during insertion. We aimed to determine the effect of ICP bolt insertion on lumbar CSF WCC. We undertook a retrospective analysis of lumbar CSF samples in patients who had recently undergone 24-h ICPM. Thirty-three patients (16F:7M) aged 43.31 ± 12.1 years (mean ± SD) had lumbar CSF samples after ICPM. Fourteen had CSF sampled within 6 weeks and 19 after 6 weeks of ICPM. Twenty-five samples were taken during LPS insertion, 5 during lumbar drainage/puncture and 3 during LPS revision. All 33 patients were afebrile at the point of CSF sampling. The mean lumbar WCC within 6 weeks of ICPM was significantly higher than the mean lumbar WCC after 6 weeks, being 15.4 ± 18.0 and 2.32 ± 1.79 cells/microlitre respectively respectively. There was no significant increase in RBC. In patients with raised CSF WCC, 60% of raised WCC were predominantly lymphoctyes and 40% predominantly neutrophils. Only one patient grew an organism (S. aureus). We conclude that lumbar CSF WCC can be raised following minor intracranial surgery, despite no clinical sign of infection. We caution against using lumbar CSF WCC values independently as the only marker of infection following neurosurgery.

Too Little Information: Accessibility of Information About Language Services on Hospital Websites.

Hospital websites are an important resource to patients with limited English proficiency (LEP) seeking information about a facility's language assistance services. We sought to identify the types of such services described on hospital websites in a diverse state and compare them by hospital characteristics. Washington State acute care hospital websites were systematically reviewed in February 2018 for translated content and information about language assistance services. Hospital characteristics included annual admissions and revenue, bed size and the proportion of populations with LEP in the hospital's county. Of 93 hospitals, 10.8% provided translated websites. Interpreter services were mentioned on 81.7% of websites; access required navigation through 1-4 English webpages. Larger bed-size, higher revenue, and more admissions were positively associated with providing language services information (p < 0.01), whereas county-level population with LEP was not (p = 0.17). Many hospital websites are not translated or lack easily accessible information about language assistance services and consequently may not be a useful resource to patients with LEP.

[Prevalence of domestic violence in pregnant women from 20 to 35 years in a family medicine unit]. / Prevalencia de violencia intrafamiliar en embarazadas de 20 a 35 años de una unidad de medicina familiar.

BACKGROUND: Violence against women is one of the most important health problems in recent times. In Mexico, it is reported a prevalence of 21.5% during pregnancy; however, it seems to be underdiagnosed. The objective is to determine the prevalence of domestic violence in pregnant women from 20 to 35 years at the Unidad de Medicina Familiar (UMF) 171 of the Instituto Mexicano del Seguro Social (IMSS). METHODS: It was performed a cross-sectional descriptive study with a sample of 102 pregnant women to which we applied a sociodemographic questionnaire and the Severity of Violence Against Women Scale (ISVP). RESULTS: 19 women (18.6%) suffered violence; of these, 10.8% (n=11) experienced physical violence, 5.9% (n=6) psychological violence, and 4% (n=4) sexual violence. We used chi squared between the variable violence and each of the sociodemographic factors: 52.6% women (n=10) were married (p=0.005), 26.3% (n=5) had a bachelor's degree (p=0.074), 57.8% (n=11) had planned their pregnancy, 47.3% (n=9) were in the third trimester of pregnancy, and 78.95% (n=15) worked as laborers, shop-keepers or professionals (p=0.016). CONCLUSIONS: Among pregnant women belonging in UMF 171 of IMSS, domestic violence is a problem with a prevalence of 18.6%.

Introducción: la violencia contra la mujer es uno de los problemas sanitarios de mayor relevancia en los últimos tiempos. Durante el embarazo se reporta un 21.5 % de prevalencia en nuestro país y se cree que esta está subdiagnosticada. El objetivo fue conocer la prevalencia de violencia intrafamiliar en embarazadas de 20 a 35 años de la Unidad de Medicina Familiar 171 (UMF 171) del Instituto Mexicano del Seguro Social. Métodos: estudio transversal-descriptivo con pacientes embarazadas de 20 a 35 años con una muestra de 102 embarazadas a las cuales se les aplicó un cuestionario sociodemográfico y el instrumento índice de severidad de violencia de pareja (ISVP). Se utilizó media, porcentajes y chi cuadrada para los resultados. Resultados: el 18.6 % de las participantes (n = 19) padeció violencia. De estas la violencia física se presentó en el 10.8 % (n = 11), seguida de la violencia psicológica en un 5.9 % (n = 6) y la violencia sexual en 4 % (n = 4). Se empleó chi cuadrada entre la variable violencia y cada uno de los factores sociodemográficos: 52.6 % (n = 10) eran casadas (p 0.005), 26.3 % (n = 5) tenían licenciatura (p 0.074), 57.8 % (n = 11) habían planeado su embarazo, 47.3 % (n = 9) cursaban el tercer trimestre de embarazo y 78.95 % (n = 15) tenían un trabajo entre obreras, comerciantes o profesionistas (p 0.016). Conclusiones: la violencia intrafamiliar es un problema presente en las embarazadas de la UMF 171, con una prevalencia de 18.6 %.