Estresores de aculturación de los inmigrantes hispanos en Estados Unidos de América. Revisión sistemática exploratoria / Stressors during the process of culture adaptation of hispanic migrants in the United States of America: An exploratory systematic review / Estressores de aculturação de imigrantes hispânicos nos Estados Unidos da América. Revisão sistemática exploratoria

RESUMEN Introducción: Los inmigrantes hispanos que se desplazan hacia Estados Unidos experimentan una transición migratoria altamente estresante, padeciendo alteraciones en la salud que continúan después de su llegada, lo que puede dificultar su adaptación a la nueva cultura. Identificar los factores más estresantes en el inmigrante hispano en su proceso de aculturación es primordial para el diseño de intervenciones puntuales y oportunas, donde el personal de enfermería es un elemento central para ello. Objetivo: Identificar los estresores de aculturación que presentan los inmigrantes hispanos en Estados Unidos. Desarrollo: Mediante un análisis numérico de los datos cuantitativos y el análisis temático de los hallazgos cualitativos, sugerido por metodología para revisiones sistemáticas exploratorias, se identificaron estresores personales, del entorno, sociales y globales, que enfrentan los inmigrantes hispanos. De igual manera, se describen las principales repercusiones a la salud tales como: angustia, ansiedad, depresión, ideación suicida, riesgo de consumo de alcohol, conductas sexuales de riesgo, entre otras, que se derivan de dicho proceso de transición. Conclusiones: Los encuentros más comunes entre el profesional de enfermería se dan durante momentos de transición de las personas, por ello es importante resaltar que la transición cultural de los inmigrantes hispanos es acompañada de estresores que afectan directamente su salud. El presente estudio muestra y clasifica los estresores más comunes, evidencia la necesidad de la creación de estrategias encaminadas a la adaptación social del inmigrante hispano y el involucramiento de la enfermería tanto en el diseño como liderazgo de estas.

ABSTRACT Introduction: Hispanic migrants who settle in the United States experience a highly stressful transition period, which not only has an impact on their process of adaptation to the new culture but also on their health. Therefore, identifying stressing factors which influence the hispanic migrants during their process of culture adaptation is a key goal in the design and implementation of timely interventions led by nursing professionals. Objective: To identify stressing factors which have an influence on the process of culture adaptation of hispanic migrants in the United States. Development: Based on the numeric analysis of quantitative data, and the thematic analysis of the qualitative data which was informed by an exploratory systematic review methodology, personal, social, global stressors were identified influencing hispanic migrants in the United States. Among the identified health issues were: anguish, anxiety, depresion, suicide thoughts, alcohol consumption, and risky sexual behaviors. Conclusions: The present study showed some important stressors influencing the hispanic migrants in the United States in their process of culture adaptation. These factors can be considered by the nursing professionals who are addressing the process of social adaptation of these populations.

RESUMO Introdução: Os imigrantes hispânicos que se mudam para os Estados Unidos passam por uma transição migratória altamente estressante, sofrendo alterações de saúde que continuam após sua chegada, o que pode dificultar sua adaptação à nova cultura. Identificar os fatores mais estressantes para os imigrantes hispânicos em seu processo de aculturação é essencial para a concepção de intervenções oportunas, nas quais o pessoal de enfermagem é um elemento central para isso. Objetivo: Identificar os estressores de aculturação entre os imigrantes hispânicos nos Estados Unidos. Desenvolvimento: Através de uma análise numérica dos dados quantitativos e análise temática dos resultados qualitativos, sugeridos pela metodologia de revisões sistemáticas exploratórias, foram identificados os estresses pessoais, ambientais, sociais e globais enfrentados pelos imigrantes hispânicos. Da mesma forma, são descritas as principais repercussões na saúde, tais como: angústia, ansiedade, depressão, ideação suicida, risco de consumo de álcool, comportamentos sexuais de risco, entre outros, que são derivados deste processo de transição Conclusões: Os encontros mais comuns entre os profissionais de enfermagem ocorrem durante os momentos de transição das pessoas, portanto é importante salientar que a transição cultural dos imigrantes hispânicos é acompanhada por fatores de estresse que afetam diretamente sua saúde. Este estudo mostra e classifica os fatores de estresse mais comuns, demonstra a necessidade da criação de estratégias voltadas para a adaptação social do imigrante hispânico e o envolvimento da enfermagem tanto no desenho quanto na liderança dessas estratégias.

Point-Of-Care Testing Curriculum and Accreditation for Public Health-Enabling Preparedness, Response, and Higher Standards of Care at Points of Need.

Objectives: To develop awareness of benefits of point-of-care testing (POCT) education in schools of public health, to identify learning objectives for teaching POCT, to enable public health professionals and emergency responders to perform evidence-based diagnosis and triage effectively and efficiently at points of need, and to better improve future standards of care for public health practice, including in limited-resource settings and crisis situations. Methods: We surveyed all U.S. schools of public health, colleges of public health, and public health schools accredited by the Council on Education in Public Health (CEPH). We included accredited public health programs, so that all states offering public health education were represented. We analyzed survey data, public health books, and board certification guidelines. We used PubMed to identify public health curriculum papers, and assessed 2019 CEPH accreditation requirements. We merged POCT knowledge bases to design a new curriculum for teaching public health students and practitioners the principles and practice of POCT. Results: Public health curricula, certification requirements, and textbooks generally do not include POCT instruction. Only one book, Global Point of Care: Strategies for Disasters, Emergencies, and Public Health Resilience, and one online course on public health preparedness address POCT and public health intervention issues. The topic, POC HIV/HCV ED testing, appeared in one course and POC diagnostics in local clinics, in another. Papers on public health curriculum have not incorporated POCT. No curriculum addresses POCT in isolation units during quarantine, despite evidence that recent Ebola virus disease cases in the U.S. and elsewhere proved unequivocally the need for POCT. The modular learning objectives identified in this paper were customized for public health students. Public health graduates can use boot camps, online credentialing, and self-study to acquire POCT skills. Conclusions: Enhancing accreditation requirements, academic training, board certification, and field experience will generate public health healthcare professionals who will rely upon evidence-based medical decision making at points of care, including during crises when time is of the essence. A POCT-enabled public health workforce can help prevent and stop outbreaks. Public health-based medical professionals urgently need the skills necessary to perform POCT and prepare America and other nations for threats portending significant adverse medical, economic, social, and cultural impact.

Neutrophils from allergic asthmatic patients produce and release metalloproteinase-9 upon direct exposure to allergens.

BACKGROUND: Asthma is characterized by airway inflammation and remodelling in which matrix metalloproteinases (MMPs) play an important role. MMP-9 is the major MMP found in the bronchoalveolar lavage fluids and bronchial biopsies from patients with allergic asthma after allergen challenge, where it correlates with the count of neutrophils and macrophages. However, the cellular sources of MMP-9 in this inflammatory condition have not yet been clearly identified. This work was undertaken to analyse whether neutrophils may be a source of MMP-9 in the allergic asthma condition upon allergen challenge. METHODS: Neutrophils from allergic asthmatic patients were in vitro stimulated, and the levels of MMP-9 release were measured in the cell culture supernatants using enzyme-linked immunosorbent assay (ELISA) and zymography. RESULTS: We show that MMP-9 is released by neutrophils, but not by eosinophils from allergic asthmatic patients in response to allergens to which the patients were sensitized. Neutrophils also released MMP-9 in response to anti-IgE Abs, and agonist Abs against FcεRI, FcεRII/CD23 and galectin-3. Inhibitors of transcription and translation, actinomycin D and cycloheximide, partially cancelled this process, suggesting that MMP-9 is also de novo synthesized in response to stimuli. We also show evidence that the MAPKs, p38 and extracellular signal-regulated kinase, as well as the transcription factor NF-κB, are involved, as specific chemical inhibitors of these cell-signalling pathways abolished the anti-IgE/allergen-dependent MMP-9 release. CONCLUSIONS: These data demonstrate that the exposure of neutrophils to allergens leads to generation of MMP-9, which may then lead to remodelling in asthma.

Neutrophil defensins: their possible role in allergic asthma.

BACKGROUND: Neutrophil defensins, originally identified as broad-spectrum antimicrobial peptides, have been implicated in the regulation of inflammatory and immunological processes. OBJECTIVES: To investigate whether the in vitro challenge of neutrophils from patients with bronchial asthma with allergens stimulated the release of alpha-defensins and whether levels released were dependent on lung infections. METHOD: The neutrophils were cultivated with different agonists and the concentration of alpha-defensin in cell-free supernatant was measured with enzyme-linked immunosorbent assay (ELISA). RESULTS: Neutrophils from allergic patients released alpha-defensins via an allergen-dependent mechanism. Our results indicate that the in vitro activation of neutrophils is highly allergen-specific. In this context, allergens other than those which produced clinical symptoms did not elicit alpha-defensin release, and allergens had no effect on neutrophils from healthy donors. However, neutrophils from both allergic patients and healthy controls were able to release alpha-defensins upon treatment with PMA. In the allergen-stimulated neutrophils, cells from asthmatic patients stimulated with a sensitizing allergen showed a significantly higher production of alpha-defensin under respiratory tract infection than cells from the same patients without such an infection. CONCLUSION: Neutrophils from allergic patients release alpha-defensins via an allergen-dependent mechanism.

Spiroplasma infection in Drosophila melanogaster: what is the advantage of killing males?

Male-killing bacteria are maternally inherited agents that cause death of sons of infected females. Their transmission rate is commonly high but imperfect and also sensitive to different environmental factors. Therefore, the proportion of infected females should be reduced in each generation. In order to explain male-killers spread and persistence in host population, a mechanism resulting in the relative increase of infected females must outweigh the losses caused by the imperfect transmission. The resource release hypothesis states that the males' death results in increased resources available to sibling females which would otherwise be used by their male siblings. Infected females are then expected: to be larger than uninfected females in natural populations; or to have higher viability; or to have shorter development times; or any combination of these outcomes. Here, we tested the resource release hypothesis by measuring body size of infected and uninfected wild-caught Drosophila melanogaster females and carried out other fitness related measures in the laboratory. Wild-caught infected females produced more daughters than uninfected females in their first days in the laboratory. However, although no significant difference in viability was found in a controlled experiment with infected and uninfected flies from a standard laboratory strain, there was a decrease in development time probably mediated by reduced competition. Fitness effects conditioned by the host genetic background are pointed out as a possible explanation for this difference between wild and laboratory flies. Our findings are discussed in the context of the resource advantage hypothesis.

Incomplete transposition of the common femoral artery and vein.

Anatomical variations of the great saphenous vein, femoral artery and femoral vein at the inguinal level are rare. Modifications in the anatomical relationships among theses vessel can cause technical difficulties. There are two reports in the literature of the complete transposition of the femoral artery and vein. Both patients had large varicose veins only in the limb that presented the variation, which suggested an extrinsic compression. In the present paper, we report a case study of a patient with an incomplete transposition of the femoral artery and vein. Specifically, the common femoral vein and the saphenofemoral junction were completely overlapped by the common femoral artery. Although this anatomical variation did not present any clinical signs, it required a more complex surgical procedure.

[Nursing aspects in men with urinary catheters at the Nursing Service of the District of Trento]. / Aspetti assistenziali nei maschi portatori di catetere vescicale, assistiti dal Servizio infermieristico del Distretto di Trento.

The whole male population with indwelling catheter of the Trento health district has been included in a survey of the quality of the home nursing services. The epidemiological and in depth analysis of the characteristics and motivation of the high degree of heterogeneity of medical prescribing behaviors and of the nursing practices suggest that an important effort of rationalization (on the basis of pre adopted protocols) is both needed and possible.

[Acquired pneumonias in the community of Andoain]. / Neumonías adquiridas en la comunidad de Andoain.

OBJECTIVE: To discover the clinical-epidemiological characteristics of pneumonias in our community. DESIGN: Descriptive study. SETTING: Andoain Health Centre. PATIENTS AND OTHERS PARTICIPANTS: There were 8,862 people in the reference population. All the cases of acquired pneumonia in the community were recorded. This register included those diagnosed in the Health Centre and in Casualty Departments and hospitals where patients were referred, between June 1 1991 and September 30 1992. The inclusion criteria were: acute fever chart and/or acute respiratory infection accompanied by a radiological image of pneumonic condensation. INTERVENTIONS: The model treatment was 500 mg of Erythromycin at six-hourly intervals for 14 days. 500 mg of Cefuroxim every twelve hours was added in cases considered at risk. MEASUREMENTS AND MAIN RESULTS: A total of 97 pneumonias were recorded, which represented an incidence of 8.82 pneumonias per thousand inhabitants per year. 63% were male. The average age was 42 (SD 19.25). 83% were diagnosed at the Health Centre. One-third presented a recent viral infection. Half had some risk factor: tobacco use was the most common. Response to treatment was satisfactory. Five percent had some complication. No death was recorded. CONCLUSIONS: Pneumonia is a frequent cause of attendance at Primary Care centres. There are several clear clinical symptoms, a good response to treatment with Erythromycin and virtual absence of complications [corrected].

Demonstration of endogenous "imipramine like" material in rat brain.

The extraction and partial purification of an endogenous "imipramine- like" material from rat brain is described. The endogenous factor obtained after gel filtration and silica chromatography inhibits [3H] imipramine specific binding and mimics the inhibitory effect of imipramine on [3H] serotonin uptake in both brain and platelet preparations. The effects of the endogenous material are dose-dependent and it inhibits [3H] imipramine binding in a competitive fashion. The factor is unevenly distributed in the brain with high concentration in the hypothalamus and low concentration in the cerebellum.

Demonstration of an imipramine endacoid in rat brain.

The partial purification and characterization of an imipramine endacoid from rat brain is reported. High affinity 3H-imipramine binding as well as 3H-serotonin uptake in both brain and platelet preparations is inhibited in a dose-dependent fashion by the endogenous substance. The effect of the endogenous factor appears to be specific since it does not affect the binding of other drugs to their membrane receptors. The substance is resistant to proteolytic enzymes and is unevenly distributed in rat brain being highly concentrated in the hypothalamus and striatum. Its concentration in rat brain is not changed after repeated electroconvulsive shock treatment.