RESUMO
In the United States, nursing is the largest healthcare profession, with over 3.2 million registered nurses (RNs) nationwide and comprised of mostly women. Foreign-trained RNs make up 15 percent of the RN workforce. For over half a century, the U.S. healthcare industry has recruited these RNs in response to nurse shortages in hospitals and nursing homes. Philippines-trained RNs make up 1 out of 20 RNs in this country and continue to be the largest group of foreign-trained nurses today. Recently, the news media has publicized the many deaths of Filipino RNs as a result of the COVID-19 pandemic in the United States. Given the imperial historical ties between these two countries in the context of the nursing profession and the enduring labor inequities that persist, this nationally representative study is one of the few to our knowledge to not only quantitatively examine the current work differences in characteristics and experiences of Philippines-trained RNs and U.S.-trained white RNs practicing in the United States today, but to also do so from an intersectionality lens. The overall aim of this paper is to illuminate how these differences may serve as potential factors contributing to the disproportionate number of Filipino nurses' COVID-19 related vulnerability and deaths in the workplace.
RESUMO
Hypertension affects a third of U.S. adults and is especially high among Asian American groups. The Racial and Ethnic Approaches to Community Health for Asian AmeRicans (REACH FAR) project delivers culturally adapted, evidence-based hypertension-related programs to Bangladeshi, Filipino, Korean, and Asian Indian communities in New York and New Jersey through 26 sites: ethnic grocery stores, restaurants, and Muslim, Christian, and Sikh faith-based organizations. Knowledge of the implementation mechanisms of culturally adapted programs is limited and is critical to inform the design and execution of such programs by and in community sites. We applied four categories of the Consolidated Framework for Implementation Research-intervention and individuals' characteristics, inner and outer setting-to analyze factors influencing implementation outcomes, that is, site leaders' perceptions about adopting, adapting, and sustaining REACH FAR. We conducted semistructured interviews with 15 leaders, coded them for implementation outcomes, and recoded them to identify contextual factors. Our findings show that REACH FAR resonated in sites where leaders perceived unhealthy diet and lifestyles in their communities (intervention characteristics), sites had historically engaged in health programs as a public-service mission (inner setting), and leaders identified with this mission (individuals' characteristics). Site leaders strived to adapt programs to respond to community preferences (outer setting) without compromising core objectives (inner setting). Leaders noted that program sustainability could be impeded by staff and volunteer turnover (inner setting) but enhanced by reinforcing programs through community networks (outer setting). The findings suggest that to facilitate implementation of culturally adapted health behavior programs through community sites, interventions should reinforce sites' organizational commitments and social ties.
Assuntos
Asiático , Hipertensão , Adulto , Redes Comunitárias , Humanos , Hipertensão/prevenção & controle , Restaurantes , SupermercadosRESUMO
Minority populations, including Asian Americans, face disparities in hypertension compared with non-Hispanic whites. This underscores the need for culturally adapted programs in settings that reach Asian American communities, such as faith-based organizations. We worked collaboratively with community partners to culturally adapt and implement an evidence-based community blood pressure monitoring program for Asian Americans (Asian Indians, Koreans, Filipinos, and Bangladeshis) in metropolitan New York during 2015 and 2016. The program included regularly scheduled volunteer-led screening and counseling events with congregants at faith-based organizations. Among participants with complete 6-month data (n = 348), health-related self-efficacy significantly improved after 6 months, and systolic and diastolic blood pressure was significantly reduced in some subgroups; reductions were highest in participants who self-reported a previous diagnosis of hypertension. Among Asian Americans, faith-based programs may be a replicable, low-cost, sustainable way to increase health-related self-efficacy and decrease blood pressure, specifically among individuals with self-reported hypertension.
Assuntos
Asiático , Assistência à Saúde Culturalmente Competente/métodos , Atenção à Saúde/métodos , Hipertensão , Serviços Preventivos de Saúde , Asiático/psicologia , Asiático/estatística & dados numéricos , Monitorização Ambulatorial da Pressão Arterial/métodos , Monitorização Ambulatorial da Pressão Arterial/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hipertensão/diagnóstico , Hipertensão/etnologia , Hipertensão/prevenção & controle , Masculino , Área Carente de Assistência Médica , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Avaliação de Programas e Projetos de Saúde , AutoeficáciaAssuntos
Asiático/educação , Assistência à Saúde Culturalmente Competente/normas , Promoção da Saúde/métodos , Bangladesh/etnologia , Feminino , Estilo de Vida Saudável , Humanos , Índia/etnologia , Masculino , New Jersey , New York , Filipinas/etnologia , Saúde Pública , República da Coreia/etnologiaRESUMO
Anosmin-1, encoded by the KAL1 gene, is an extracellular matrix (ECM)-associated protein which plays essential roles in the establishment of olfactory and GNRH neurons during early brain development. Loss-of-function mutations of KAL1 results in Kallmann syndrome with delayed puberty and anosmia. There is, however, little comprehension of its role in the developed brain. As reactivation of developmental signal pathways often takes part in tumorigenesis, we investigated if anosmin-1-mediated cellular mechanisms associated with brain tumors. Our meta-analysis of gene expression profiles of patients' samples and public microarray datasets indicated that KAL1 mRNA was significantly upregulated in high-grade primary brain tumors compared with the normal brain and low-grade tumors. The tumor-promoting capacity of anosmin-1 was demonstrated in the glioblastoma cell lines, where anosmin-1 enhanced cell motility and proliferation. Notably, anosmin-1 formed a part of active ß1 integrin complex, inducing downstream signaling pathways. ShRNA-mediated knockdown of anosmin-1 attenuated motility and growth of tumor cells and induced apoptosis. Anosmin-1 may also enhance the invasion of tumor cells within the ECM by modulating cell adhesion and activating extracellular proteases. In a mouse xenograft model, anosmin-1-expressing tumors grew faster, indicating the role of anosmin-1 in tumor microenvironment in vivo. Combined, these data suggest that anosmin-1 can facilitate tumor cell proliferation, migration, invasion, and survival. Therefore, although the normal function of anosmin-1 is required in the proper development of GNRH neurons, overexpression of anosmin-1 in the developed brain may be an underlying mechanism for some brain tumors.
Assuntos
Neoplasias Encefálicas/metabolismo , Proteínas da Matriz Extracelular/metabolismo , Glioblastoma/metabolismo , Integrina beta1/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Animais , Apoptose/fisiologia , Neoplasias Encefálicas/patologia , Linhagem Celular Tumoral , Movimento Celular/fisiologia , Proteínas da Matriz Extracelular/genética , Feminino , Glioblastoma/patologia , Xenoenxertos , Humanos , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID , Proteínas do Tecido Nervoso/genética , Análise de Sequência com Séries de Oligonucleotídeos , RNA/química , RNA/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transdução de SinaisRESUMO
Kallmann syndrome is a multigenic human developmental disorder where the molecular pathogenesis is still only partially understood and there is no single unifying animal model. The protein anosmin-1, encoded by the KAL1 gene, is associated with the X-linked form of the disease. The biology and molecular structure of anosmin-1 has been investigated systematically over the years by various cell culture experiments, biochemical analyses and animal models. Anosmin-1 is an extracellular matrix-associated protein which plays pleiotropic roles in neuronal development, migration and organogenesis.
Assuntos
Proteínas da Matriz Extracelular/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Bulbo Olfatório/anormalidades , Animais , Embrião de Mamíferos/metabolismo , Desenvolvimento Embrionário , Proteínas da Matriz Extracelular/química , Genes Ligados ao Cromossomo X , Heparitina Sulfato/metabolismo , Humanos , Síndrome de Kallmann/metabolismo , Proteínas do Tecido Nervoso/química , Neurônios/fisiologia , Estrutura Terciária de Proteína/fisiologia , Receptor Tipo 1 de Fator de Crescimento de Fibroblastos/fisiologia , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologiaRESUMO
Although the international migration of nurses has played a formative role in increasing the racial and ethnic diversity of the health care labor force, nursing historians have paid very little attention to the theme of international migration and the experiences of foreign-trained nurses, A focus on international migration complements two new approaches in nursing history: the agenda to internationalize its frameworks, and the call to move away from "great women, great events" and toward the experiences of "ordinary" nurses. This article undertakes a close reading of the life and work of Filipino American nurse Ines Cayaban to reconceptualize nursing biography in an international framework that is attentive to issues of migration, race, gender, and colonialism. It was a Hannah keynote lecture delivered by the author on June 5, 2008, as part of the CAHN/ACHN (Canadian Association for the History of Nursing/Association Canadienne pour l'Histoire du Nursing) International Nursing History Conference.