Family and cultural influences on cervical cancer screening among immigrant Latinas in Miami-Dade County, USA.

Cervical cancer disproportionately affects minorities, immigrants and low-income women in the USA, with disparities greatest among Latino immigrants. We examined barriers and facilitators to cervical cancer screening practices among a group of immigrant Latino women in Florida, USA. Between January and May 2013, six focus group discussions, involving 35 participants, were conducted among Hispanic women in Miami to explore their knowledge, beliefs about cervical cancer and facilitators and barriers to cervical cancer screening using a theoretical framework. The data showed that family support, especially from female relatives, was an important facilitator of screening and treatment. Women, however, reported prioritising family health over their own, and some expressed fatalistic beliefs about cancer. Major obstacles to receiving a Pap smear included fear that it might result in removal of the uterus, discomfort about being seen by a male doctor and concern that testing might stigmatise them as being sexually promiscuous or having a sexually transmitted disease. Targeted education on cancer and prevention is critically needed in this population. Efforts should focus on women of all ages since younger women often turn to older female relatives for advice.

Development and Characterization of Glass-Ceramics from Combinations of Slag, Fly Ash, and Glass Cullet without Adding Nucleating Agents.

Developments in the field of materials science are contributing to providing solutions for the recycling of industrial residues to develop new materials. Such approaches generate new products and provide optimal alternatives to the final disposal of different types of industrial wastes. This research focused on identifying and characterizing slag, fly ash, and glass cullet from the Boyacá region in Colombia as raw materials for producing glass-ceramics, with the innovative aspect of the use of these three residues without the addition of nucleating agents to produce the glass-ceramics. To characterize the starting materials, X-ray diffraction (XRD), X-ray fluorescence (XRF), and Scanning Electron Microscopy (SEM) techniques were used. The results were used to evaluate the best conditions to produce mixtures of the three waste components and to determine the specific compositions of glass-ceramics to achieve products with attractive technical properties for potential industrial applications. The proposed mixtures were based on three compositions: Mixture 1, 2, and 3. The materials were obtained through thermal treatment at 1200 °C in a tubular furnace in accordance with the results of a comprehensive characterization using thermal analysis. The microstructure, thermal stability, and structural characteristics of the samples were examined through SEM, differential thermal analysis (DTA), and XRD analyses, which showed that the main crystalline phases were diopside and anorthite, with a small amount of enstatite and gehlenite. The obtained glass-ceramics showed properties of technical significance for structural applications.

Relationship of peer specialists to mental health outcomes in South Florida.

BACKGROUND: In recent years the use of peer specialists in the delivery of mental health of care across the US has increased. Although data on the benefits of using peer specialists is limited and/or equivocal, states are making policy and funding decisions to support the expansion of peer specialist services. This data is even more limited in the state of Florida where no studies were found to document the effect of peer specialists on mental health care outcomes. The purpose of this study was to assess whether local decisions to use peer specialists can be supported through the measurement of outcomes of service utilization and mental health functioning when peer specialists are involved in the treatment of individuals living with serious mental illness. METHODS: The study was conducted using service data collected by South Florida Behavioral Health Network (SFBHN). SFBHN is the Managing Entity for publicly funded mental health and substance abuse services in Miami-Dade and Monroe Counties in Florida. We compared mental health outcomes and service utilization between individuals who received peer specialist services (n = 367) and a treatment as usual group (n = 1468) matched on gender, age and severity of diagnosis in the period July 2013 and June 2015. Multilevel models were used to evaluate the functioning outcomes between the groups. Service utilization was assessed using negative binomial regression. RESULTS: Individuals in the treatment group receiving peer specialist services utilized more ambulatory/lower levels of care services and had more frequent crisis stabilization unit admissions. Those in the treatment group also displayed more functional difficulties with a variety of practical activities, employment and housing and violent temper, hostility, threatening behaviors. CONCLUSIONS: The findings of the study further support existing evidence documenting the mixed benefits of using peer services compared to treatment as usual care. Policy makers and other stakeholders are encouraged to advance mental health recovery by examining outcomes more comprehensively. Future research should include examination of the subjective benefits of peer support for recipients, understanding the impact on service utilization and a better definition of the roles, supervision and expectations of peer support programs.

Prevención de lesiones de piel: educación en el equipo de salud y familiares de personas hospitalizadas / Prevention of skin lesions: Education in health staff and relatives of people hospitalized

Introducción. Las lesiones de piel como las úlceras por presión y dermatitis asociada a la incontinencia son un problema asociado a la edad, movilidad, humedad, alimentación, eliminación o estado mental y afectan negativamente la calidad de vida de las personas y su familia; su prevención mediante educación permite disminuir su aparición y contribuye a brindar un cuidado de calidad. Objetivo. Fortalecer los conocimientos en prevención de lesiones de piel del equipo de enfermería y cuidadores de personas hospitalizadas en el área de medicina interna y la unidad de cuidado intensivo de un hospital universitario de Bogotá, D.C. Materiales y métodos. Estudio de intervención prospectiva con prueba de entrada diagnóstica para identificar el conocimiento del equipo de enfermería. Se realizaron tres intervenciones educativas y, posteriormente, se aplicó una prueba que estableció los cambios logrados. Del mismo modo, se aplicó un cuestionario de intervención a tres cuidadores permanentes, identificando qué actividades preventivas conocían y cómo las realizaban; finalmente, se suministró un folleto de apoyo con tópicos generales de cuidado de la piel. Resultados. Participaron 21 personas, cuya caracterización identificó que el grado de conocimiento es superior a mayor edad y más tiempo de experiencia laboral. Se establecieron cambios positivos en los conocimientos del equipo de enfermería entre el porcentaje de la prueba de entrada diagnóstica (76.81%) y la prueba posterior a la intervención (84.41%). Conclusión. Es importante realizar intervenciones educativas permanentes a los implicados en el cuidado preventivo de lesiones de piel para generar trasformaciones positivas en el equipo de salud y los cuidadores.

Introduction. Skin lesions such as pressure ulcers and dermatitis associated to incontinence are a problem linked to age, mobility, moisture, food, elimination or mental state, which adversely affect the quality of life of individuals and their families. Their prevention through education can reduce their appearance and contribute to providing quality care. Objectives. To strengthen the knowledge in terms of prevention of skin lesions of nurses and caregivers of people hospitalized at a Bogota's University Hospital in the internal medicine and intensive care units. Material and methods. A prospective intervention study, with an input diagnostic test to identify the knowledge of the nursing team, followed by three educational interventions. Then a test was applied to chart the changes achieved. Additionally, a questionnaire intervention was applied to three permanent caregivers, identifying what preventive activities were known by them and the procedures they used to carry out such activities. Finally, a supporting booklet on general skin care topics was provided. Results. 21 people participated in this study and whose characterization identified that the knowledge degree is higher in older and more experienced workers. Positive changes were established in the knowledge of the nursing team, including the percentage of diagnostic input test (76.81%) and the post-test intervention (84.41 %). Conclusion. It is important to make permanent educational interventions to those involved in preventive care of skin lesions in order to generate positive transformations in health care staff and caregivers.

Biopsia hepática en pediatría: caracteristicas clínico epidemiológicas y diagnóstico histológico más frecuente Instituto Nacional de Salud del Niño 2005-2009 / Liver biopsy in children: epidemiological and clinical characteristics most common histological diagnosis National Institute of Child Health 2005-2009

OBJETIVOS: Determinar las características clínico epidemiológicas y el diagnóstico histológico más frecuente de los pacientes a quienes se les realizó biopsia hepática en el Instituto Nacional de Salud del Niño. METODOLOGÍA: Estudio descriptivo, transversal y retrospectivo. Se incluyeron los pacientes registrados en el servicio de Anatomía Patológica del Instituto Nacional de Salud del Niño a quienes se les realizó biopsia hepática entre Enero del 2005 Y Diciembre del 2009. Se excluyeron los pacientes registrados sin número de historiaclínica o con historias incompletas. Se consignaron los datos pre biopsia: edad, sexo, peso, indicación de biopsia hepática, hemoglobina o hematocrito, recuento plaquetario y perfil de coagulación; y los datos relacionados al procedimiento: técnica de biopsia hepática, tipo de sedación, tipo de aguja utilizada, complicaciones y diagnóstico histológico. Se revisaron las láminas de los pacientes en cuyas historias no se encontró el informe de anatomía patológica. Se realizó la comparación de proporciones para determinar si existen diferencias en edad, sexo y técnica de biopsia hepática en los pacientes que presentaron y no presentaron complicaciones. RESULTADOS: Se incluyeron 351 biopsias hepáticas realizadas a 326 pacientes con edades entre 1 mes y 17 años al momento de la biopsia. La indicación de biopsia hepática fue síndrome colestásico en el 41,03 por ciento. El 58,97 por ciento de biopsias se realizaron por punción percutánea dirigida por laparoscopia. El 10,22 por ciento presentaron complicaciones menores luego del procedimiento y el 4,64 por ciento presentaron complicaciones mayores. Hubo más complicaciones mayores en el sexo femenino (p = 0,05) y en la biopsia en cuña por laparoscopia (p=0.005). El diagnóstico histológico fue atresia de vías biliares en el 14,53 por ciento, seguido por hepatitis crónica (14,25 por ciento), hepatitis neonatal (11,68 por ciento) y cirrosis (9,12 por ciento)...