Checking the Pulse of Holistic and Culturally Competent Nursing Practice in Pennsylvania.

Traditionally, underrepresented racial and ethnic groups experience marginalization, leading to inequities and disparities in health and health care. A holistic approach to care delivery can help providers meet a culturally diverse patient population's unique healing needs. A systematic assessment of nurses' cultural competency practice was conducted in Pennsylvania to reveal opportunities and provide direction for holistic, culturally competent health care services. This exploratory cross-sectional descriptive study used the Cultural Competence Education and Awareness Survey (CCEAS) to examine cultural competence practices of registered nurses employed in the state of Pennsylvania. A total of 1246 registered nurses completed the survey. Respondents expressed a strong desire for cultural competency. Education and organizational infrastructure to facilitate cultural competency could be improved. Health care leaders and policy makers at all levels should explore opportunities to strengthen nurses' culturally competent practices through ongoing professional-development activities and enhanced organizational infrastructure.

Experiencia de la formación profesional de estudiantes de enfermería de una universidad chilena bajo un modelo conceptual propio / Experience of the professional formation of nursing students in a Chilean university under its own conceptual model

RESUMEN Introducción: La formación de enfermería en el mundo se sustenta en la adopción de distintos modelos conceptuales o teorías que orientan la práctica y permiten sostener la disciplina como ciencia. No obstante, estos modelos deben estar ajustados a las necesidades de cuidados de enfermería en cada contexto. Objetivo: Describir la experiencia de la formación profesional de estudiantes de enfermería de una universidad chilena bajo un modelo conceptual propio. Métodos: Investigación cualitativa, a través de estudio de casos. Después del proceso de consentimiento informado, se incluyeron 10 estudiantes de octavo semestre de la carrera de enfermería de la Universidad Austral de Chile. Se realizaron entrevistas en profundidad grabadas para evaluar la percepción sobre la experiencia aplicando el Modelo de Necesidades Humanas de Inés Astorquiza. El análisis siguió el referencial de Miles y Huberman. Resultados: Emergieron 5 categorías: Modelo como método científico, Modelo como identidad, Valores del modelo, Proceso enseñanza aprendizaje y Aplicabilidad. Los estudiantes valoraron positivamente el Modelo de Necesidades Humanas y lo describieron como un proceso científico sistemático que guía la práctica clínica y permite priorizar cuidados de enfermería individuales, continuos y con enfoque biopsicosocial. Además, otorga identidad, sello propio y es pertinente como estrategia de enseñanza para lograr aprendizajes significativos, es simple y se puede aplicar en diversos contextos. Conclusiones: Se apoya el uso del Modelo de Necesidades Humanas como marco referencial de la formación. Con este modelo se logra un conocimiento enfermero desde una perspectiva holística, con identidad y que permite satisfacer necesidades de cuidado de enfermería contextualizados(AU)

ABSTRACT Introduction: The nursing formation is based worldwide on the use of several conceptual models or theories that guide the nursing practice and allow sustaining the discipline as science. Nevertheless, these models should be adjusted to the requirements of nursing care in each setting. Objective: To describe the experience of the professional formation of nursing students in a Chilean university under its own conceptual model. Methods: Qualitative research based on the case study. After the process of obtaining the informed consent, 10 students from the 8th semester of the nursing career in Universidad Austral de Chile were included in the study. In-depth interviews were made to evaluate the perception of the students on the experience by applying Ines Astorquiza's Model of Human Needs. The analysis followed the Miles' and Huberman's referential analysis. Results: Five categories emerged from this study: Model as a scientific method, Model as identity, Model values, Teaching-Learning Process and Applicability. The students positively assessed the Model of Human Needs and described it as a scientific and systematic process that guides the clinical practice and allows giving priority to continuous, individual nursing care with biopsychosocial approach. It also grants identity, characteristic hallmark and it is suitable to use it as teaching strategy to achieve significant levels of learning, it is a simple model that can be applied in different settings. Conclusions: The study supports the use of the Model of Human Needs as a referential framework for the nursing formation. With this model, it is possible to reach nursing knowledge from a holistic perspective, with identity and to meet nursing care requirements within a particular context(AU)

Eficacia de la magnetoterapia en pacientes ecuatorianos con síndrome de pinzamiento del hombro / Effectiveness of the magnetotherapy in Ecuadorian patients with shoulder impingement syndrome

Se realizó un estudio cuasiexperimental, longitudinal y prospectivo, en 60 pacientes con síndrome de pinzamiento del hombro, atendidos en la consulta de Rehabilitación del Hospital José María Velasco Ibarra, en la ciudad de Tena, Ecuador, desde agosto del 2014 a marzo del 2015, con vistas a determinar la eficacia de la magnetoterapia en ellos. El funcionamiento del hombro fue evaluado con el test de Constant-Murley, que se aplicó antes y después del tratamiento, y en el procesamiento estadístico de la información los resultados obtenidos mediante el cálculo porcentual se compararon a través de la prueba de homogeneidad marginal de Stuart-Maxwell, con 95 por ciento de confiabilidad. En la serie predominaron el sexo femenino (63,3 por ciento), el grupo etario de 60 y más años (41,8 por ciento) y la bursitis subacromial (46,6 por ciento) como principal causa de la afección. La rápida evolución de los pacientes demostró la eficacia de la magnetoterapia, por lo que se recomienda su empleo en estos casos(AU)

A quasi-experiment, longitudinal and prospective study, in 60 patients with shoulder impingement syndrome, assisted in the Rehabilitation Service of José María Velasco Ibarra Hospital, in Tena city, Ecuador, was carried out from August, 2014 to March, 2015, aimed at determining the effectiveness of magnetotherapy in them. The shoulder performance was evaluated with the Constant-Murley test that was applied before and after the treatment, and in the statistical processing of the information the results obtained by means of the percentage calculation were compared through the Stuart-Maxwell marginal homogeneity test, with 95 percent of confidence. In the series the female sex (63.3 percent), the age group of 60 years and over (41.8 percent) and the subacromial bursal synovitis (46.6 percent) prevailed as main cause of the disorder. The quick clinical course of the patients demonstrated the effectiveness of the magnetotherapy, reason why its use is recommended in these cases(AU)

Eficacia de la magnetoterapia en pacientes ecuatorianos con síndrome de pinzamiento del hombro / Effectiveness of the magnetotherapy in Ecuadorian patients with shoulder impingement syndrome

Se realizó un estudio cuasiexperimental, longitudinal y prospectivo, en 60 pacientes con síndrome de pinzamiento del hombro, atendidos en la consulta de Rehabilitación del Hospital "José María Velasco Ibarra", en la ciudad de Tena, Ecuador, desde agosto del 2014 a marzo del 2015, con vistas a determinar la eficacia de la magnetoterapia en ellos. El funcionamiento del hombro fue evaluado con el test de Constant-Murley, que se aplicó antes y después del tratamiento, y en el procesamiento estadístico de la información los resultados obtenidos mediante el cálculo porcentual se compararon a través de la prueba de homogeneidad marginal de Stuart-Maxwell, con 95 % de confiabilidad. En la serie predominaron el sexo femenino (63,3 %), el grupo etario de 60 y más años (41,8 %) y la bursitis subacromial (46,6 %) como principal causa de la afección. La rápida evolución de los pacientes demostró la eficacia de la magnetoterapia, por lo que se recomienda su empleo en estos casos.

A quasi-experiment, longitudinal and prospective study, in 60 patients with shoulder impingement syndrome, assisted in the Rehabilitation Service of "José María Velasco Ibarra" Hospital, in Tena city, Ecuador, was carried out from August, 2014 to March, 2015, aimed at determining the effectiveness of magnetotherapy in them. The shoulder performance was evaluated with the Constant-Murley test that was applied before and after the treatment, and in the statistical processing of the information the results obtained by means of the percentage calculation were compared through the Stuart-Maxwell marginal homogeneity test, with 95% of confidence. In the series the female sex (63.3%), the age group of 60 years and over (41.8%) and the subacromial bursal synovitis (46.6%) prevailed as main cause of the disorder. The quick clinical course of the patients demonstrated the effectiveness of the magnetotherapy, reason why its use is recommended in these cases.

Nimbolide inhibits pancreatic cancer growth and metastasis through ROS-mediated apoptosis and inhibition of epithelial-to-mesenchymal transition.

The mortality and morbidity rates of pancreatic cancer are high because of its extremely invasive and metastatic nature. Its lack of symptoms, late diagnosis and chemo-resistance and the ineffective treatment modalities warrant the development of new chemo-therapeutic agents for pancreatic cancer. Agents from medicinal plants have demonstrated therapeutic benefits in various human cancers. Nimbolide, an active molecule isolated from Azadirachta indica, has been reported to exhibit several medicinal properties. This study assessed the anticancer properties of nimbolide against pancreatic cancer. Our data reveal that nimbolide induces excessive generation of reactive oxygen species (ROS), thereby regulating both apoptosis and autophagy in pancreatic cancer cells. Experiments with the autophagy inhibitors 3-methyladenine and chloroquine diphosphate salt and the apoptosis inhibitor z-VAD-fmk demonstrated that nimbolide-mediated ROS generation inhibited proliferation (through reduced PI3K/AKT/mTOR and ERK signaling) and metastasis (through decreased EMT, invasion, migration and colony forming abilities) via mitochondrial-mediated apoptotic cell death but not via autophagy. In vivo experiments also demonstrated that nimbolide was effective in inhibiting pancreatic cancer growth and metastasis. Overall, our data suggest that nimbolide can serve as a potential chemo-therapeutic agent for pancreatic cancer.

Inmunopotenciadores para la acuicultura / Immune–potentiators for the Aquaculture

La acuicultura es una de las actividades económicas de mayor crecimiento para la producción de alimentos. Unode sus principales retos es la obtención de grandes volúmenes de producción con la mayor calidad posible. Esto conlleva a una reducción de la aplicación de antibióticos y productos quimioterapéuticos. Una de las estrategias más prometedoras es la aplicación de inmunopotenciadores, principalmente en los cultivos intensivos. El objetivode este trabajo fue revisar los principales inmunopotenciadores, así como las tendencias y retos de su uso mundial. Se resumen las particularidades moleculares y funcionales de los mismos y se hace énfasis en los más estudiados: levamisol, ß-glucanos, lipopolisacárido, vitamina C, extractos de plantas y hormonas. Todos estos compuestos de naturaleza heterogénea inciden mayoritariamente en los componentes de la inmunidad innata de los peces, fortaleciendo y potenciando la resistencia a enfermedades; adicionalmente algunos de ellostienen funciones antiestrés y favorecen su crecimiento. Se concluye que los inmunopotenciadores constituyen una estrategia viable para reducir las pérdidas por problemas sanitarios en el sector de la acuicultura; pero aún quedan por solucionar aspectos como la vía de administración y la etapa de inmunización adecuada para cadaespecie y tipo de cultivo(AU)

Aquaculture represents one of the fastest–growing animal food–producing sectors worldwide. One of the mainchallenges is to obtain high–volume production with the highest possible quality, this leads to reduce the use ofantibiotics and chemotherapeutics. A promising solution to these problems is the application of immune–potentiatiors mainly in intensive farming. This article aims to review the main immune–potentiators, as well as thetrends and challenges of global use of them. It summarizes the main molecular and functional characteristics withemphasis on those most studied such as levamisole, ß-glucans, lipopolysaccharide, vitamin C, plant extracts andhormones. All these heterogeneous compounds, mostly affect the innate immunity of fish, strengthening andenhancing disease resistance and some of them additionally have anti–stress effect and promote fish growth. Weconclude that immune–potentiators are a viable strategy to reduce losses for health problems in aquaculture field,however, aspects such as administration route and appropriate immunization phase for each species remains tobe solved(AU)

Pilot scale production of the vaccine adjuvant Proteoliposome derived Cochleates (AFCo1) from Neisseria meningitidis serogroup B.

The use of new adjuvants in vaccine formulations is a subject of current research. Only few parenteral adjuvants have been licensed. We have developed a mucosal and parenteral adjuvant known as AFCo1 (Adjuvant Finlay Cochleate 1, derived from proteoliposomes of N. meningitidis B) using a dialysis procedure to produce them on lab scale. The immunogenicity of the AFCo1 produced by dialysis has been already evaluated, but it was necessary to demonstrate the feasibility of a larger-scale manufacturing process. Therefore, we used a crossflow diafiltration system (CFS) that allows easy scale up to obtain large batches in an aseptic environment. The aim of this work was to produce AFCo1 on pilot scale, while conserving the adjuvant properties. The proteoliposomes (raw material) were resuspended in a buffer containing sodium deoxycholate and were transformed into AFCo1 under the action of a calcium forming buffer. The detergent was removed from the protein solution by diafiltration to a constant volume. In this CFS, we used a hollow fiber cartridge from Amicon (polysulfona cartridge of 10 kDa porosity, 1mm channel diameter of fiber and 0.45 m² area of filtration), allowing production of a batch of up to 20 L. AFCo1 were successfully produced by tangential filtration to pilot scale. The batch passed preliminary stability tests. Nasal immunization of BALB/c mice, induced specific saliva IgA and serum IgG. The induction of Th1 responses were demonstrated by the induction of IgG2a, IFNγ and not IL-5. The adjuvant action over Neisseria (self) antigens and with co-administered (heterologous) antigens such as ovalbumin and a synthetic peptide from haemolytic Streptococcus B was also demonstrated.

Self-concept in older adults: an integrative review of empirical literature.

The aging process leads to normative age-related bodily and functional declines and numerous social changes and life events that potentially threaten the self-concept. Despite these changes, the majority of older adults are able to maintain a positive sense of self and remain resilient. This article presents an integrative review of the empirical literature addressing self-concept in older adults.

Intranasal administration of proteoliposome-derived cochleates from Vibrio cholerae O1 induce mucosal and systemic immune responses in mice.

Conservative estimates place the death toll from cholera at more than 100,000 persons each year. A particulate mucosal vaccine strategy combining antigens and immune stimulator molecules from Vibrio cholerae to overcome this problem is described. Proteoliposomes extracted from V. cholerae O1 were transformed into cochleates (AFCo2, Adjuvant Finlay cochleate 2) through a calcium inducible rotary dialysis method. Light microscopy was carried out and tubules of 16.25+/-4.57 microm in length were observed. Western blots were performed to verify the immunochemical properties of the main AFCo2 incorporated antigens, revealing full recognition of the outer membrane protein U (OmpU), lipopolysaccharide (LPS), and mannose-sensitive hemagglutinin (MSHA) antigens. AFCo2 were administered by the intranasal route using a two or three dose schedule and the immune response against V. cholerae antigens was assessed. Three AFCo2 doses were required to induce significant (p<0.05), antigen specific IgA in saliva (1.34+/-0.135) and feces (0.60+/-0.089). While, two or three doses of AFCo2 or proteoliposomes induce similar specific IgG and vibriocidal activity responses in sera. These results show for the first time that AFCo2 can be obtained from V. cholerae O1 proteoliposomes and have the potential to protect against the pathogen when administered intranasally.

Mucosal immunization using proteoliposome and cochleate structures from Neisseria meningitidis serogroup B induce mucosal and systemic responses.

Most pathogens either invade the body or establish infection in mucosal tissues and represent an enormous challenge for vaccine development by the absence of good mucosal adjuvants. A proteoliposome-derived adjuvant from Neisseria meningitidis serogroup B (AFPL1, Adjuvant Finlay Proteoliposome 1) and its derived cochleate form (Co, AFCo1) contain multiple pathogen-associated molecular patterns as immunopotentiators, and can also serve as delivery systems to elicit a Th1-type immune response. The present studies demonstrate the ability of AFPL1and AFCo1 to induce mucosal and systemic immune responses by different mucosal immunizations routes and significant adjuvant activity for antibody responses of both structures: a microparticle and a nanoparticle with a heterologous antigen. Therefore, we used female mice immunized by intragastric, intravaginal, intranasal or intramuscular routes with both structures alone or incorporated with ovalbumin (OVA). High levels of specific IgG antibody were detected in all sera and in vaginal washes, but specific IgA antibody in external secretions was only detected in mucosally immunized mice. Furthermore, antigen specific IgG1 and IgG2a isotypes were all induced. AFPL1 and AFCo1 are capable of inducing IFN-gamma responses, and chemokine secretions, like MIP-1alpha and MIP-1beta. However, AFCo1 is a better alternative to induce immune responses at mucosal level. Even when we use a heterologous antigen, the AFCo1 response was better than with AFPL1 in inducing mucosal and systemic immune responses. These results support the use of AFCo1 as a potent Th1 inducing adjuvant particularly suitable for mucosal immunization.

Café y diabetes mellitus / No disponible

No disponible

Self-disclosure of sexually transmitted diseases: an integrative review.

In the United States, there are currently more than 65 million individuals living with a sexually transmitted disease (STD), and approximately 19 million new infections will continue to occur each year. To decrease the transmission of potentially dangerous and life-altering STDs, self-disclosure of sexual and drug history and sexual orientation is paramount. This integrative review examines the concept of self-disclosure of STDs, suggests areas of additional research, and proposes a comprehensive public health campaign, with a specific focus on the recent human papillomavirus epidemic to improve the physical and psychological health of all individuals.

Review of intervention studies on depression in persons with multiple sclerosis.

Depression is prevalent among persons with multiple sclerosis (MS), an acquired neurologic disability that affects predominantly women. The purpose of this article is to review intervention studies on depression in persons with MS. An integrative review of eight intervention studies published from 2000 to 2005 has revealed that various interventions could potentially alleviate depression. Although no definite conclusions can be made from this review, there is reasonable evidence that cognitive behavioral approaches are beneficial in the treatment of depression and in helping people adjust to, and cope with, having MS.

Neumoencéfalo tras punción dural inadvertida en un paciente sometido a resección transuretral de próstata / Pneumoaphalus after inadvertent dual puncture in a patient subjected transurethral resection of prostate

La técnica epidural, es uno los procedimientos más utilizados en la práctica anestésica diaria; lo que determina el éxito de la anestésia epidural, es la localización del espacio epidural. La prueba de la pérdida de resistencia con aire, es ampliamente utilizada por los anestesiólogos para identificar dicho espacio. La incidencia de cuerpos adversos asociados al uso de aire es desconocida, lo que puede ser debido a un subregistro, a un difícil reconocimiento de los efectos, o al hecho de ser considerado trivial. Las complicaciones asociadas a esta técnica incluyen: neumoencéfalo, compresión de la médula espinal y los nervios raquídeos, embolismo venoso aéreo, analgésia inadecuada y parestesia. Nosotros reportamos el caso de un paciente masculino de 52 años de edad que presentó cefalea de fuerte intensidad, de inicio abrupto, durante la realización de la técnica epidural para resección transuretral de próstata, seguido por pérdida de la conciencia y paro cardiorrespiratorio. La tomografía axial computarizada reportó la presencia de neumoencéfalo. El paciente presentó evolución satisfactoria en tres días, con el empleo de altas concentraciones de oxígeno, sin secuelas neurológicas

La pesquisa: su importancia en el diagnóstico precoz del cáncer / Investigation: its important in the diagnosis precocious of the cancer

Se entiende por Pesquisa la búsqueda de una enfermedad en una población de individuos asintomáticos. El método de pesquisa debe ser fácil, económico, no invasivo y bien tolerado por el paciente. El objetivo de este trabajo es demostrar en cifras de nuestros casos y las de otros centros con mayor número de pacientes, que el diagnóstico precoz del cáncer obtenido a través de la pesquisa, mejora la sobrevida, pudiendo lograrse la erradicación de la enfermedad. Se analizan los métodos de pesquisa de los cánceres de mayor incidencia en nuestro medio, a saber; cuello uterino, mama, estómago, pulmón, próstata, etc. Se concluye en la necesidad de divulgar esta información, ya que las campañas de pesquisas existentes en el país no abarcan a toda la población a riesgo. Es por medio de la educación y concientización de nuestra población que lograremos vencer este flagelo, debemos recordar que pensar en el cáncer es encontrarlo y diagnosticarlo a tiempo es curarlo