Workplace health culture and trust in the occupational health office: A descriptive study of meatpacking workers.

INTRODUCTION: Worker trust in employer-provided occupational health services has not been explored in essential industries, such as meatpacking. The purpose of this study was to describe workplace health culture and trust in the occupational health office and highlight meatpacking workers' experiences with the occupational health office. METHODS: Meatpacking workers were surveyed between February 2021 and October 2022. Descriptive statistics and nonparametric tests were used to explore trust across demographic variables, including workplace health culture. Thematic analysis was used to examine the short-answer qualitative data. RESULTS: Among workers who completed surveys (n = 731), health culture was rated low (M = 1.3 (0.73); possible range 0-3). Trust in the occupational health office was also rated low (M = 8.2 (5.06); possible range 0-20). Workers' descriptions of interactions with the occupational health office were mostly unfavorable (287 negative opinion units; 97 positive opinion units) and primarily focused on quality of care, communication, the supervisor as gatekeeper to health services, and the prioritization of company interests. CONCLUSION: Meatpacking worker health may be improved by building worker trust in the occupational health office. Suggested strategies include enhanced communication, protection of confidentiality, prioritization of worker well-being, and promotion of a stronger health culture in plants and throughout the industry. Supporting workers without a regular healthcare provider to establish a relationship with a primary care provider of their choice is also recommended.

Cuidándome: A trauma-informed and cultural adaptation of a chronic disease self-management program for Latina immigrant survivors with a history of adverse childhood experiences and depression or anxiety symptoms.

OBJECTIVES: To develop a cultural and trauma-informed mental health self-management program for immigrant Latina survivors of adverse childhood experiences with depression or anxiety symptoms. METHOD: Guided by Barrera's five-stage process for cultural adaptation, we collaborated with multiple stakeholders including clinical psychologists, community health workers, and Latina immigrant women with a history of adverse childhood experiences and depression or anxiety to transform a chronic disease self-management program to be trauma informed, culturally appropriate, and focus on self-management of depression and anxiety symptoms. RESULTS: Adaptations included translating program materials to Spanish, education on how early life adversity and trauma may impact mental health, virtual delivery, more frequent and shorter sessions, and addition of graphics and written prompts in workbook materials. For the facilitator's manual, culturally relevant vignettes and guidance were added to guide participants through activities and adapt sessions based on participant needs. CONCLUSIONS: Barrera's five-stage process was useful for adapting a program to be both trauma and culturally informed for an underserved population disproportionately affected by trauma and limited access to mental health services. The adaptation demonstrated acceptability with Latina immigrant women and the promise of utilizing unlicensed personnel and technology for increasing the reach of mental health support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Puerto Rican healthcare workers' perspectives on the impact of COVID-19 pandemic on their role, patient care, and mental health.

PURPOSE: To explore the personal and work-related stressors of healthcare workers in Puerto Rico and the organizational support they received during the pandemic. DESIGN AND METHODS: We used a qualitative descriptive design and from April - November, 2021, conducted semi-structured individual interviews with Puerto Rican frontline healthcare workers (n = 12) and supervisors (n = 5). FINDINGS: Thematic analysis revealed five major themes: (a) Organizations' response to COVID-19; (b) increased complexity of patients; (c) intensified work and psychological demand for nurses; (d) overwhelmed and overworked; and (e) recommendations for healthcare leadership. Participants explained that their organizations' responses to COVID-19 were insufficient for  meeting the demands and acuity of the patients. Closure of outpatient services contributed to people presenting to hospitals with exacerbated chronic conditions - especially the elderly. With COVID-19 precautions prohibiting family visitation, nurses became responsible for total care, including emotional support of patients. In addition, the shortage of staff contributed to nurses assuming greater workloads, feeling overwhelmed and overworked, and healthcare worker resignations. Given their experiences, healthcare workers recommended that healthcare leadership show more appreciation for staff, demonstrate empathy, include frontline workers in decision-making, and provide mental health resources for staff. CONCLUSIONS: This study with Puerto Rican frontline workers and supervisors uncovers the multiple stressors experienced during the COVID-19 pandemic. Our findings underscore the need for prioritizing the well-being of healthcare workers, preparing healthcare leadership on how to support staff, and mandating nurse-to-patient ratios. CLINICAL RELEVANCE: Healthcare workers explained the barriers they experienced for providing quality care to their patients. They also presented recommendations for healthcare leadership to facilitate supporting frontline workers, which ultimately contributes to optimal patient care.

Tbr1 Misexpression Alters Neuronal Development in the Cerebral Cortex.

Changes in the transcription factor (TF) expression are critical for brain development, and they may also underlie neurodevelopmental disorders. Indeed, T-box brain1 (Tbr1) is a TF crucial for the formation of neocortical layer VI, and mutations and microdeletions in that gene are associated with malformations in the human cerebral cortex, alterations that accompany autism spectrum disorder (ASD). Interestingly, Tbr1 upregulation has also been related to the occurrence of ASD-like symptoms, although limited studies have addressed the effect of increased Tbr1 levels during neocortical development. Here, we analysed the impact of Tbr1 misexpression in mouse neural progenitor cells (NPCs) at embryonic day 14.5 (E14.5), when they mainly generate neuronal layers II-IV. By E18.5, cells accumulated in the intermediate zone and in the deep cortical layers, whereas they became less abundant in the upper cortical layers. In accordance with this, the proportion of Sox5+ cells in layers V-VI increased, while that of Cux1+ cells in layers II-IV decreased. On postnatal day 7, fewer defects in migration were evident, although a higher proportion of Sox5+ cells were seen in the upper and deep layers. The abnormal neuronal migration could be partially due to the altered multipolar-bipolar neuron morphologies induced by Tbr1 misexpression, which also reduced dendrite growth and branching, and disrupted the corpus callosum. Our results indicate that Tbr1 misexpression in cortical NPCs delays or disrupts neuronal migration, neuronal specification, dendrite development and the formation of the callosal tract. Hence, genetic changes that provoke ectopic Tbr1 upregulation during development could provoke cortical brain malformations.

The Mediating Role of Home-School Dissonance in Linking Maternal Discrimination to Latin American-Origin Adolescent Academic Performance.

Latin American-origin parents play an important role in supporting the formal education of their youth, but cultural, linguistic, and systemic barriers make parent involvement difficult. The aim of the present study was to examine how Latina mothers' experiences with discrimination were associated with short-term changes in their adolescent children's academic performance, directly and indirectly through mothers' appraisal of home-school dissonance. Data were drawn from an ongoing longitudinal study of 547 mother-youth dyads in suburban Atlanta. Results showed a significant indirect relationship between mothers' experiences of discrimination and declines in adolescents' grade point average by way of increased home-school dissonance. Thus, Latina mothers' discriminatory experiences may have spillover effects on adolescent academic achievement through increasing proximal barriers to parent involvement.

Patterns of Adverse Childhood Experiences, Social Problem-Solving, and Mental Health Among Latina Immigrants.

Researchers have established the long-term negative impact of adverse childhood experiences (ACEs) on mental health. Evidence also shows that different types of ACEs often co-occur and that ACEs profiles have differential impact on mental health. However, this prior research has often omitted first-generation Latino immigrants-a growing segment of the population, with potentially higher risk for ACEs, decreased access to mental health services, and increased risk for remaining in poor mental health. In this study, we conducted a cluster analysis using a sample of 336 Latina immigrant to examine: (1) patterns of ACEs, and (2) the mediating role of social problem-solving in the association between ACEs and mental health (depression, anxiety, and post-traumatic stress disorder symptoms [PTSD]) and life satisfaction. We identified 5 clusters: (a) Global ACEs (n = 52, 15.5%), (b) Community Violence and Physical Abuse (n = 80, 23.8%), (c) Physical and Emotional Abuse (n = 72, 21.4%), (d) Household Dysfunction with Physical and Emotional Abuse (n = 56, 16.7%), and (e) Low ACEs (n = 76, 22.6%). The clusters differed by social problem-solving, chronic life burden, mental health, and life satisfaction. Compared to the Low Abuse cluster, the Community Violence and Physical Abuse, and Global ACEs clusters were significantly more likely to have higher depression, anxiety, and PTSD symptoms. Social problem-solving was independently associated with all mental health variables and life satisfaction, and mediated the association between ACEs and depression and anxiety for those in the Community Violence and Physical Abuse cluster. Our study sheds light on how ACEs are experienced by Latina immigrants. Social problem-solving also emerged as a significant determinant of mental health and life satisfaction, and may be a point of intervention for improving mental health in this population.

Two new species of Miersia and their phylogenetic placements alongside the recently described M.putaendensis (Gilliesieae, Allioideae, Amaryllidaceae).

Two new species of the Chilean endemic genus Miersia (Gilliesieae, Allioideae, Amaryllidaceae) are described, M.stellata and M.raucoana, alongside morphological descriptions, a distribution map, illustrations, conservation status assessments, and an updated key to all species of Miersia. Additionally, phylogenetic analyses of DNA sequences were performed to inquire into the evolutionary affinities of both new species and the recently described, M.putaendensis, within the tribe Gilliesieae.

Erratum: Corrigendum: García N, Cuevas C, Sepúlveda JE, Cádiz-Véliz A, Román MJ (2022) Two new species of Miersia and their phylogenetic placements alongside the recently described M.putaendensis (Gilliesieae, Allioideae, Amaryllidaceae). PhytoKeys 211: 107-124. doi: 10.3897/phytokeys.211.87842.

[This corrects the article DOI: 10.3897/phytokeys.211.87842.].

Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences.

As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with 21 adults with depressive symptoms to understand the role that past health care discrimination plays in shaping help-seeking for depression treatment and receiving preferred treatment modalities. We recruited to achieve heterogeneity of racial/ethnic backgrounds and history of health care discrimination in our participant sample. Participants were Hispanic/Latino (n = 4), non-Hispanic/Latino Black (n = 8), or non-Hispanic/Latino White (n = 9). Twelve reported health care discrimination due to race/ethnicity, language, perceived social class, and/or mental health diagnosis. Health care discrimination exacerbated barriers to initiating and continuing depression treatment among patients from diverse backgrounds or with stigmatized mental health conditions. Treatment preferences emerged as fluid and shaped by shared decisions made within a trustworthy patient-provider relationship. However, patients who had experienced health care discrimination faced greater challenges to forming trusting relationships with providers and thus engaging in shared decision-making processes.

Disparities in Suicidality by Gender Identity Among Medicare Beneficiaries.

INTRODUCTION: Suicidality is higher for gender minorities than the general population, yet little is known about suicidality in disabled or older adult gender minorities. METHODS: This study used 2009-2014 Medicare claims to identify people with gender identity-related diagnosis codes (disabled, n=6,678; older adult, n=2,018) and compared their prevalence of suicidality with a 5% random non-gender minority beneficiary sample (disabled, n=535,801; older adult, n=1,700,008). Correlates of suicidality were assessed (via chi-square) for each of the 4 participant groups separately, and then disparities within eligibility status (disabled or older adult) were assessed using logistic regression models, adjusting first for age and mental health chronic conditions and then additionally for Medicaid eligibility, race/ethnicity, or U.S. region (each separately). The primary hypotheses were that gender minority beneficiaries would have higher suicidality but that suicidality disparities would persist after adjusting for covariates. Data were analyzed between 2017 and 2019. RESULTS: Gender minority beneficiaries had higher unadjusted suicidality than non-gender minority beneficiaries in the disabled cohort (18.5% vs 7.1%, p<0.001). Significant suicidality predictors in all 4 groups included the following: age (except in older adult gender minorities), Medicaid eligibility, depression or behavioral health conditions, avoidable hospitalizations, and violence victimization. In age- and mental health-adjusted logistic regression models, gender minorities had higher odds of suicidality than non-gender minority beneficiaries (disabled, OR=1.95, p<0.0001; older adult, OR=2.10, p<0.0001). Disparities were not attenuated after adjusting for Medicaid eligibility, race/ethnicity, or region. CONCLUSIONS: Heightened suicidality among identified gender minority Medicare beneficiaries highlights a pressing need to identify and reduce barriers to wellness in this population.

Association between maternal and child mental health among US Latinos: variation by nativity, ethnic subgroup, and time in the USA.

Few studies have examined the association between maternal and youth mental health among US Latinos, or its variation by nativity, country of origin, ethnic subgroup, and time in the mainland US. Using 2007-2014 Medical Expenditure Panel Survey data linking Latino youth (N = 15,686 aged 5-17 years) and their mothers, we estimated multivariate models of the relationship between probable maternal mental illness (a composite of measures) and youth mental health impairment (Columbia Impairment Scale). Children of mothers with probable mental illness were more than three times as likely to have impairment as children of mothers without mental illness (p < 0.01). In adjusted models, there was an 8.5-point (95% CI 5.1, 11.8) increased prevalence of child impairment associated with mother's probable mental illness among mainland US-born youth and mothers and a 6.0-point (95% CI 3.7, 8.3) increased prevalence among US-born youth of foreign/island-born mothers. There was no significant difference in the prevalence of youth impairment associated with maternal mental illness when both youth and mother were born outside of the mainland US. For the Puerto Rican subgroup, the association between maternal and youth mental health was greatest among island-born mothers and mainland US-born youth; for the Mexican subgroup, the link was strongest among US-born mothers and youth. While there were large point differences between those groups, the difference was not statistically significant. This study suggests a protective effect of island/foreign-born nativity on symptom association between Latino mothers and children. Considerations for future research and practice stemming from this finding are discussed.

Trends in Mental Health Care Use in Medicare from 2009 to 2014 by Gender Minority and Disability Status.

Purpose: This study examines trends in Medicare beneficiaries' mental health care use from 2009 to 2014 by gender minority and disability status. Methods: Using 2009 to 2014 Medicare claims, we modeled mental health care use (outpatient mental health care, inpatient mental health care, and psychotropic drugs) over time, adjusting for age and behavioral health diagnoses. We compared trends for gender minority beneficiaries (identified using diagnosis codes) to trends for a 5% random sample of other beneficiaries, stratified by original entitlement reason (age vs. disability). Results: Adjusted outpatient and inpatient mental health care use decreased and differences generally narrowed between gender minority and other beneficiaries over the study period. Among beneficiaries qualifying through disability, the gap in the number of outpatient and inpatient visits (among those with at least one visit in a given year) widened. Psychotropic drug use rose for all beneficiaries, but the proportion of gender minority beneficiaries in the aged cohort who had a psychotropic medication prescription rose faster than for other aged beneficiaries. Conclusions: Mental health care needs for Medicare beneficiaries may be met increasingly by using psychotropic medications rather than outpatient visits, and this pattern is more pronounced for identified gender minority (especially aged) beneficiaries. These trends may indicate a growing need for research and provider training in safe and effective psychotropic medication prescribing alongside gender-affirming treatments such as hormone therapy, especially for aged gender minority individuals who likely already experience polypharmacy.

¿Cómo resignifica sus experiencias una víctima del conflicto armado colombiano a partir de sus sueños? / ¿How does a victim of the colombian armed conflict re-signify their experiences from their dreams?

Este artículo presenta un acercamiento a los sueños como herramienta de autoconocimiento, y su relación con la capacidad de resignificar ciertos eventos de la vida. Se precisa desde las experiencias de una víctima del conflicto armado colombiano, por medio de un estudio de caso. Se vislumbra el andamiaje del conflicto armado en Colombia; se precisa en los fenómenos oníricos como proceso psíquico y representación simbólica que permite la exteriorización de la información inconsciente. Y finalmente, se concreta la importancia de la resignificación como entrada de entendimiento y reparación del significado, y las características comunes contenidas en las experiencias oníricas del caso estudiado.

This article presents an approach to the dreams as a tool for self-knowledge, and its relationship with the ability to re-signify certain life events. It is required from the experiences of a victim of the Colombian armed conflict, through a case study. In addition; observing the scaffolding of the armed conflict in Colombia; Emphasis is placed on dream phenomena as a psychic process and symbolic representation that allows the externalization of unconscious information. And finally, the importance of resignification is determined as an entrance of understanding and repair of meaning, and the common characteristics contained in the dream experiences of the case studied.

Prevalence of Lynch syndrome among patients with newly diagnosed endometrial cancers.

BACKGROUND: Lynch syndrome (LS) is a hereditary condition that increases the risk for endometrial and other cancers. The identification of endometrial cancer (EC) patients with LS has the potential to influence life-saving interventions. We aimed to study the prevalence of LS among EC patients in our population. METHODS: Universal screening for LS was applied for a consecutive series EC. Tumor testing using microsatellite instability (MSI), immunohistochemistry (IHC) for mismatch-repair (MMR) protein expression and MLH1-methylation analysis, when required, was used to select LS-suspicious cases. Sequencing of corresponding MMR genes was performed. RESULTS: One hundred and seventy-three EC (average age, 63 years) were screened. Sixty-one patients (35%) had abnormal IHC or MSI results. After MLH1 methylation analysis, 27 cases were considered suspicious of LS. From these, 22 were contacted and referred for genetic counseling. Nineteen pursued genetic testing and eight were diagnosed of LS. Mutations were more frequent in younger patients (<50 yrs). Three cases had either intact IHC or MSS and reinforce the need of implement the EC screening with both techniques. CONCLUSION: The prevalence of LS among EC patients was 4.6% (8/173); with a predictive frequency of 6.6% in the Spanish population. Universal screening of EC for LS is recommended.

Phosphorylation controls the localization and activation of the lumenal carbonic anhydrase in Chlamydomonas reinhardtii.

BACKGROUND: Cah3 is the only carbonic anhydrase (CA) isoform located in the thylakoid lumen of Chlamydomonas reinhardtii. Previous studies demonstrated its association with the donor side of the photosystem II (PSII) where it is required for the optimal function of the water oxidizing complex. However this enzyme has also been frequently proposed to perform a critical function in inorganic carbon acquisition and CO(2) fixation and all mutants lacking Cah3 exhibit very poor growth after transfer to low CO(2) conditions. RESULTS/CONCLUSIONS: In the present work we demonstrate that after transfer to low CO(2), Cah3 is phosphorylated and that phosphorylation is correlated to changes in its localization and its increase in activity. When C. reinhardtii wild-type cells were acclimated to limiting CO(2) conditions, the Cah3 activity increased about 5-6 fold. Under these conditions, there were no detectable changes in the level of the Cah3 polypeptide. The increase in activity was specifically inhibited in the presence of Staurosporine, a protein kinase inhibitor, suggesting that the Cah3 protein was post-translationally regulated via phosphorylation. Immunoprecipitation and in vitro dephosphorylation experiments confirm this hypothesis. In vivo phosphorylation analysis of thylakoid polypeptides indicates that there was a 3-fold increase in the phosphorylation signal of the Cah3 polypeptide within the first two hours after transfer to low CO(2) conditions. The increase in the phosphorylation signal was correlated with changes in the intracellular localization of the Cah3 protein. Under high CO(2) conditions, the Cah3 protein was only associated with the donor side of PSII in the stroma thylakoids. In contrast, in cells grown at limiting CO(2) the protein was partly concentrated in the thylakoids crossing the pyrenoid, which did not contain PSII and were surrounded by Rubisco molecules. SIGNIFICANCE: This is the first report of a CA being post-translationally regulated and describing phosphorylation events in the thylakoid lumen.

[Validation of the Spanish version of the Evidence Based Practice Questionnaire in Nurses]. / Validación de la versión española del cuestionario sobre la práctica basada en la evidencia en enfermería.

BACKGROUND: The lack of adequate instruments prevents the possibility of assessing the competence of health care staff in evidence-based decision making and further, the identification of areas for improvement with tailored strategies. The aim of this study is to report about the validation process in the Spanish context of the Evidence-Based Practice Questionnaire (EBPQ) from Upton y Upton. METHODS: A multicentre, cross-sectional, descriptive psychometric validation study was carried out. For cultural adaptation, a bidirectional translation was developed, accordingly to usual standards. The measuring model from the questionnaire was undergone to contrast, reproducing the original structure by Exploratory Factorial Analysis (EFA) and Confirmatory Factorial Analysis (CFA), including the reliability of factors. RESULTS: Both EFA (57.545% of total variance explained) and CFA (chi(2)=2359,9555; gl=252; p < 0.0001; RMSEA=0,1844; SRMR=0,1081), detected problems with items 7, 16, 22, 23 and 24, regarding to the original trifactorial version of EBPQ. After deleting some questions, a reduced version containing 19 items obtained an adequate factorial structure (62.29% of total variance explained), but the CFA did not fit well. Nevertheless, it was significantly better than the original version (chi(2)=673.1261; gl=149; p < 0.0001; RMSEA=0.1196; SRMR=0.0648). CONCLUSIONS: The trifactorial model obtained good empiric evidence and could be used in our context, but the results invite to advance with further refinements into the factor "attitude", testing it in more contexts and with more diverse professional profiles.

Validación de la versión española del cuestionario sobre la práctica basada en la evidencia en enfermería / Validation of the spanish version of the evidence based practice questionnaire in nurses

Fundamento. La falta de instrumentos adecuados impideconocer la competencia de los profesionales en la toma dedecisiones basadas en la evidencia e identificar áreas de mejoraen las que intervenir con estrategias “ad hoc”. El objetivo dela investigación es validar en el entorno español del Evidence-Based Practice Questionnaire (EBPQ) (Upton y Upton, 2006).Métodos. Se llevó a cabo un estudio multicéntrico, descriptivoy transversal de validación psicométrica. Se siguió unproceso de traducción-retrotraducción según los estándareshabituales. Se contrastó el modelo de medida del cuestionario,replicando la estructura original anglosajona mediante análisisfactorial exploratorio (AFE) y confirmatorio (AFC), incluyendoanálisis de la fiabilidad de los factores.Resultados. Tanto el AFE (57,545% de la varianza totalexplicada) como el AFC (chi2=2359,9555; gl=252; p<0,0001;RMSEA=0,1844; SRMR=0,1081) han detectado problemas enlos ítems 7, 16, 22, 23 y 24 sobre la versión original trifactorialdel EBPQ. Una versión reducida de 19 ítems presenta una estructurafactorial exploratoria adecuada (62,29% de varianza totalexplicada), aunque el AFC no mostró adecuación, fue significativamentemejor que en la versión original (chi2=673.1261;gl=149; p<0,0001; RMSEA=0,1196; SRMR=0,0648).Conclusiones: El modelo trifactorial (EBPQ-19) ha obtenidosuficiente evidencia empírica para su sustentación ypuede ser aplicado en nuestro medio, aunque los resultadosinvitan a refinar el factor “actitud”, mediante el contraste enmuestras en otros contextos y con mayor heterogeneidad deperfiles profesionales(AU)

Background: The lack of adequate instruments preventsthe possibility of assessing the competence of health care staffin evidence-based decision making and further, theidentification of areas for improvement with tailoredstrategies. The aim of this study is to report about thevalidation process in the Spanish context of the Evidence-Based Practice Questionnaire (EBPQ) from Upton y Upton.Methods: A multicentre, cross-sectional, descriptivepsychometric validation study was carried out. For culturaladaptation, a bidirectional translation was developed, accordinglyto usual standards. The measuring model from the questionnairewas undergone to contrast, reproducing the original structure byExploratory Factorial Analysis (EFA) and Confirmatory FactorialAnalysis (CFA), including the reliability of factors.Results: Both EFA (57.545% of total variance explained)and CFA (chi2=2359,9555; gl=252; p<0.0001; RMSEA=0,1844;SRMR=0,1081), detected problems with items 7, 16, 22, 23 and24, regarding to the original trifactorial version of EBPQ. Afterdeleting some questions, a reduced version containing 19 itemsobtained an adequate factorial structure (62.29% of total varianceexplained), but the CFA did not fit well. Nevertheless, it wassignificantly better than the original version (chi2=673.1261;gl=149; p<0.0001; RMSEA=0.1196; SRMR=0.0648).Conclusions: The trifactorial model obtained goodempiric evidence and could be used in our context, but theresults invite to advance with further refinements into thefactor “attitude”, testing it in more contexts and with morediverse professional profiles(AU)