Philadelphia Latine Immigrant Birthing People's Perspectives on Mitigating the Chilling Effect on Prenatal Care Utilization.

RESEARCH DESIGN: Community-engaged qualitative study using inductive thematic analysis of semistructured interviews. OBJECTIVE: To understand Latine immigrants' recent prenatal care experiences and develop community-informed strategies to mitigate policy-related chilling effects on prenatal care utilization. BACKGROUND: Decreased health care utilization among immigrants due to punitive immigration policies (ie, the "chilling effect") has been well-documented among Latine birthing people both pre and postnatally. PATIENTS AND METHODS: Currently or recently pregnant immigrant Latine people in greater Philadelphia were recruited from an obstetric clinic, 2 pediatric primary care clinics, and 2 community-based organization client pools. Thematic saturation was achieved with 24 people. Participants' pregnancy narratives and their perspectives on how health care providers and systems could make prenatal care feel safer and more comfortable for immigrants. RESULTS: Participants' recommendations for mitigating the chilling effect during the prenatal period included training prenatal health care providers to sensitively initiate discussions about immigrants' rights and reaffirm confidentiality around immigration status. Participants suggested that health care systems should expand sources of information for pregnant immigrants, either by partnering with community organizations to disseminate information or by increasing access to trusted individuals knowledgeable about immigrants' rights to health care. Participants also suggested training non-medical office staff in the use of interpreters. CONCLUSION: Immigrant Latine pregnant and birthing people in greater Philadelphia described ongoing fear and confusion regarding the utilization of prenatal care, as well as experiences of discrimination. Participants' suggestions for mitigating immigration-related chilling effects can be translated into potential policy and programmatic interventions which could be implemented locally and evaluated for broader applicability.

Proliferation, Migration and Invasion of Breast Cancer Cell Lines Are Inhibited by 1,5-Disubstituted Tetrazol-1,2,3-triazole Hybrids through Interaction with p53.

The anticarcinogenic potential of a series of 1,5-disubstituted tetrazole-1,2,3-triazole hybrids (T-THs) was evaluated in the breast cancer (BC)-derived cell lines MCF-7 (ER+, PR+, and HER2-), CAMA-1 (ER+, PR+/-, and HER2-), SKBR-3 (ER+, PR+, and HER2+), and HCC1954 (ER+, PR+, and HER2+). The T-THs 7f, 7l, and 7g inhibited the proliferation of MCF-7 and CAMA-1, HCC1954, and SKBR-3 cells, respectively. The compounds with stronger effect in terms of migration and invasion inhibition were 7o, 7b, 7n, and 7k for the CAMA-1, MCF-7, HCC1954, and SKBR-3 cells respectively. Interestingly, these T-THs were the compounds with a fluorine present in their structures. To discover a possible target protein, a molecular docking analysis was performed for p53, p38, p58, and JNK1. The T-THs presented a higher affinity for p53, followed by JNK1, p58, and lastly p38. The best-predicted affinity for p53 showed interactions between the T-THs and both the DNA fragment and the protein. These results provide an opportunity for these compounds to be studied as potential drug candidates for breast cancer treatment.

UVB Inhibits Proliferation, Cell Cycle and Induces Apoptosis via p53, E2F1 and Microtubules System in Cervical Cancer Cell Lines.

Ultraviolet (UV) exposure has been linked to skin damage and carcinogenesis, but recently UVB has been proposed as a therapeutic approach for cancer. Herein, we investigated the cellular and molecular effects of UVB in immortal and tumorigenic HPV positive and negative cells. Cells were irradiated with 220.5 to 1102.5 J/m2 of UVB and cell proliferation was evaluated by crystal violet, while cell cycle arrest and apoptosis analysis were performed through flow cytometry. UVB effect on cells was recorded at 661.5 J/m2 and it was exacerbated at 1102.5 J/m2. All cell lines were affected by proliferation inhibition, cell cycle ablation and apoptosis induction, with different degrees depending on tumorigenesis level or HPV type. Analysis of the well-known UV-responsive p53, E2F1 and microtubules system proteins was performed in SiHa cells in response to UVB through Western-blotting assays. E2F1 and the Microtubule-associated protein 2 (MAP2) expression decrease correlated with cellular processes alteration while p53 and Microtubule-associated Protein 1S (MAP1S) expression switch was observed since 882 J/m2, suggesting they were required under more severe cellular damage. However, expression transition of α-Tubulin3C and ß-Tubulin was abruptly noticed until 1102.5 J/m2 and particularly, γ-Tubulin protein expression remained without alteration. This study provides insights into the effect of UVB in cervical cancer cell lines.

Hepatoprotective, Antihyperlipidemic and Radical Scavenging Activity of Hawthorn (Crataegus oxyacantha) and Rosemary (Rosmarinus officinalis) on Alcoholic Liver Disease.

Alcohol catabolism produces oxidative stress, causing cell death and inflammation in liver tissue principally. Hawthorn (Crataegus oxyacantha) and Rosemary (Rosmarinus officinalis) are medicinal plants that have shown a potent antioxidant activity related with anti-inflammatory properties. The objective of this study was the evaluation of Hawthorn and Rosemary methanol extracts as preventive treatment in alcoholic liver disease (ALD). ALD rat model was used to measure serum hepatic enzyme levels (AST, ALT, γ-GT and ACP), total bilirubin, liver glycogen, lipid peroxidation, total antioxidant capacity (TAC) and serum lipid profile (total cholesterol, triglycerides, LDL and HDL) as well as histopathological analysis in hepatic tissues was recorder. Phytotreatments showed preventive effect, decreasing AST, γ-GT, lipid peroxidation and bilirubin indictors while TAC and liver glycogen stores increase. Interestingly, Rosemary diminished the levels of ALT and ACP. Remarkable both treatments show liver tissue damage reduction. Hawthorn proved antihyperlipidemic effect, eviting increase in all lipid indicators, while Rosemary showed antihyperlipidemic effect only in LDL levels without affecting HDL levels. The results indicate that Hawthorn and Rosemary treatments have different mechanisms of action; however they show hepatoprotective effect against ALD in rat model. Hawthorn and Rosemary could be used to prevent or help in the treatment of ALD.

5p and 3p Strands of miR-34 Family Members Have Differential Effects in Cell Proliferation, Migration, and Invasion in Cervical Cancer Cells.

The micro RNA (miR)-34 family is composed of 5p and 3p strands of miR-34a, miR-34b, and miR-34c. The 5p strand's expression and function is studied in cervical cancer. The 3p strand's function and regulation remain to be elucidated. To study the function of the passenger strands of miR-34 family members, we overexpressed 5p and 3p strands using a synthetic miRNA in cervical cell lines. Cell proliferation was evaluated using crystal violet. Migration and invasion were tested using transwell assays, Western blot, and zymography. Possible specific targets and cell signaling were investigated for each strand. We found that miR-34a-5p inhibited proliferation, migration, and cell invasion accompanied by matrix metalloproteinase 9 (MMP9) activity and microtubule-associated protein 2 (MAP2) protein reduction. We also found that miR-34b-5p and miR-34c-5p inhibit proliferation and migration, but not invasion. In contrast, miR-34c-5p inhibits MMP9 activity and MAP2 protein, while miR-34b-5p has no effect on these genes. Furthermore, miR-34a-3p and miR-34b-3p inhibit proliferation and migration, but not invasion, despite the later reducing MMP2 activity, while miR-34c-3p inhibit proliferation, migration, and cell invasion accompanied by MMP9 activity and MAP2 protein inhibition. The difference in cellular processes, MMP2 and MMP9 activity, and MAP2 protein inhibition by miR-34 family members suggests the participation of other regulated genes. This study provides insights into the roles of passenger strands (strand*) of the miR-34 family in cervical cancer.

Quantitative measurement of oxidative damage in erythrocytes as indicator in benzene intoxications.

The metabolism of aromatic hydrocarbons by the organism forms products that cause cell death depending on the type of exposure. Benzene exposure has been linked to oxidative stress, hepatic damage, aplastic anemia, and hematopoietic cancer as lymphoid and myeloid leukemia. However, there are not fast methods to evaluate chronic benzene exposure in human blood. The objective of this work was the evaluation of the correlation between oxidative damage with benzene exposure and the level of cellular plasma membrane stability (CPMS) in erythrocytes to use it as a future indicator to determine the grade of benzene intoxications. CPMS in vitro assays were used to evaluate damage for benzene, toluene, and xylene. Erythrocytes CPMS assays in vitro shows a progressive reduction with benzene, toluene, and xylene suggesting that aromatic hydrocarbons complexity favors CPMS damage. Eight groups of Wistar rats (n = 5) were used to study the level of damage on CPMS by acute and chronic benzene administration. Enzymatic, metabolic, histological, and oxidative damage tests were performed. Acute administration (100 µL/100 g/single dose) showed a decrease of 66.7% in CPMS, while 63.6% for chronic administration (5 µL/100 g/every 2 days/3 months) showing a correlation with liver damage principally (transaminases activity increase, glycogen level decrease, and high oxidative damage). Tissue damage was observed in bone marrow, kidney, spleen, and lungs. Benzene produces damage on CPMS depending on the exposure time and dose. The CPMS technique could be used as an important aromatic hydrocarbons intoxication indicator.

Genotoxic and cytotoxic evaluation of Jatropha dioica Sessé ex Cerv. by the micronucleus test in mouse peripheral blood.

Jatropha dioica Sessé ex Cerv. is a medicinal plant credited with low cytotoxicity in vitro. Thus, the objective of this work was to evaluate the possible genotoxic and cytotoxic effect in vivo of the J. dioica aqueous extract by means of micronucleus assay in mouse peripheral blood. Four different J. dioica aqueous extract dose-units were evaluated (30, 60, 100, and 300 mg/kg). The extract was administered orally to male Balb-C-strain mice every 24 h during 5 days. Blood samples were taken at 0, 24, 48, 72, 96, and 120 h from the mouse's tail and were performed in duplicate extensions. The number of Polychromatic Erythrocytes (PCE), Polychromatic Micronucleus Erythrocytes (PCEMN), and Micronucleus Erythrocytes (MNE) was determined at the different sampling times in the different study groups. Our results showed that the group that received 60 mg/kg of cyclophosphamide (positive control) presented a significant decrease in the PCE (p = 0.044) proportion and a significant increase in MNE (p = 0.032, p = 0.0001). The groups that received the different J. dioica aqueous extract doses did not present either a PCE decrease or an increase in PCEMN and MNE. J. dioica exerts neither a genotoxic nor a cytotoxic effect on mouse peripheral blood at high doses.

[Health-worker barriers to syphilis screening in pregnant women in Bolivia's Los Andes network]. / Barreras del personal de salud para el tamizaje de sífilis en mujeres embarazadas de la Red Los Andes, Bolivia.

OBJECTIVE: Identify health-worker barriers that keep pregnant women who receive prenatal care from being screened for syphilis (Los Andes Health Network, Bolivia). METHODS: Semi-structured interviews were done with 46 health care providers and 249 clinical health records of pregnant women were analyzed in eight public health facilities in the Los Andes network. RESULTS: Health-worker barriers to syphilis screening in pregnant women included lack of time by personnel to raise awareness of the benefit of syphilis screening; some mentioned that syphilis tests should only be done in facilities that attend deliveries and have a laboratory; lack of communication between clinicians and laboratory personnel; and problems with provision of supplies and reagents. The clinical record review found that only 55.4% contained syphilis laboratory results and only 37.4% of perinatal clinical histories had records of laboratory results. The interviews found that providers believe that syphilis screening is done in 100% of pregnant women receiving prenatal care. CONCLUSION: Syphilis screening is not being done according to Bolivia's strategy for the elimination of congenital syphilis, and is not done on more than half of pregnant women in prenatal care with perinatal clinical history records. This is not perceived by health professionals and can become a barrier to syphilis screening in pregnant women.

Use of Mature miRNA Strand Selection in miRNAs Families in Cervical Cancer Development.

Aberrant miRNA expression is well recognized as a cancer hallmark, nevertheless miRNA function and expression does not always correlate in patients tissues and cell lines studies. In addition to this issue, miRNA strand usage conduces to increased cell signaling pathways modulation diversifying cellular processes regulation. In cervical cancer, 20 miRNA families are involved in carcinogenesis induction and development to this moment. These families have 5p and 3p strands with different nucleotide (nt) chain sizes. In general, mature 5p strands are larger: two miRNAs of 24 nt, 24 miRNAs of 23 nt, 35 miRNAs of 22 nt and three miRNAs of 21 nt. On the other hand, the 3p strands lengths observed are: seven miRNAs of 23 nt, 50 miRNAs of 22 nt, six miRNAs of 21 nt and four miRNAs of 20 nt. Based on the analysis of the 20 miRNA families associated with cervical cancer, 67 3p strands and 65 5p strands are selected suggesting selectivity and specificity mechanisms regulating cell processes like proliferation, apoptosis, migration, invasion, metabolism and Warburg effect. The insight reviewed here could be used in the miRNA based therapy, diagnosis and prognosis approaches.

Differential Effect of 4H-Benzo[d] [1, 3]oxazines on the Proliferation of Breast Cancer Cell Lines.

BACKGROUND: A family of 4H-benzo[d][1,3]oxazines were obtained from a group of N-(2-alkynyl)aryl benzamides precursors via gold(I) catalysed chemoselective 6-exo-dig C-O cyclization. METHOD: The precursors and oxazines obtained were studied in breast cancer cell lines MCF-7, CAMA-1, HCC1954 and SKBR-3 with differential biological activity showing various degrees of inhibition with a notable effect for those that had an aryl substituted at C-2 of the molecules. 4H-benzo[d][1,3]oxazines showed an IC50 rating from 0.30 to 157.4 µM in MCF-7, 0.16 to 139 in CAMA-1, 0.09 to 93.08 in SKBR-3, and 0.51 to 157.2 in HCC1954 cells. RESULTS: We observed that etoposide is similar to benzoxazines while taxol effect is more potent. Four cell lines responded to benzoxazines while SKBR-3 cell line responded to precursors and benzoxazines. Compounds 16, 24, 25 and 26 have the potent effect in cell proliferation inhibition in the 4 cell lines tested and correlated with oxidant activity suggesting a possible mechanism by ROS generation. CONCLUSION: These compounds represent possible drug candidates for the treatment of breast cancer. However, further trials are needed to elucidate its full effect on cellular and molecular features of cancer.

Teratogen Potential Evaluation of the Aqueous and Hydroalcoholic Leaf Extracts of Crataegus oxyacantha in Pregnancy Rats.

Crataegus oxyacantha is used in the treatment of cardiovascular diseases. The aim of this study was to evaluate the transplacental genotoxicity effect of aqueous (AE) and hydroalcoholic extract (HE) of leaves C. oxyacantha in a rat model and the quantification of malondialdehyde (MDA) in the liver. Three different doses of the AE and HE of the C. oxyacantha leaf were administered orally (500, 1000 and 2000 mg/kg) to Wistar rats during 5 days through the pregnancy term (16-21 days), and sampling in rats occurred every 24 h during the last 6 days of gestation, while only one sample was taken in neonates at birth. A sample of the mother's and the neonate's liver was taken for the determination of MDA. The results show that, at the hepatic level, the evaluated doses of extracts C. oxyacantha in pregnant rats and their pups did not show cytotoxicity. However, the AE and HE generated cytotoxic and genotoxic damage in the short term. On the other hand, only the AE showed a teratogenic effect. Based on these results, the AE and HE of the C. oxyacantha leaf should not be administered during pregnancy.

Gold(I)-Catalyzed Synthesis of 4H-Benzo[d][1,3]oxazines and Biological Evaluation of Activity in Breast Cancer Cells.

The first gold(I)-catalyzed cycloisomerization procedure applied to the synthesis of substituted 4H-benzo[d][1,3]oxazines has been developed starting from N-(2-alkynyl)aryl benzamides. The chemoselective oxygen cyclization via the 6-exo-dig pathway yielded the observed heterocycles in modest to good chemical yields under very mild reaction conditions. The obtained oxazines were assayed on the breast cancer (BC)-derived cell lines MCF-7 and HCC1954 with differential biological activity. The newly synthesized 4H-benzo[d][1,3]oxazine compounds showed several degrees of cell proliferation inhibition with a remarkable effect for those compounds having a substituted aryl at C-2 of the molecules. The 4H-benzo[d][1,3]oxazines showed an IC50 ranking from 3.1 to 95 µM in MCF-7 and HCC1954 cells. These compounds represent potential drug candidates for BC treatment. However, additional assays are needed to elucidate their complete effect over the cellular and molecular hallmarks of cancer.

Cytotoxic and Genotoxic Evaluation of the Aqueous and Hydroalcoholic Leaf and Bark Extracts of Crataegus oxyacantha in Murine Model.

Crataegus oxyacantha has been mainly used in traditional medicine for the treatment of cardiovascular diseases. However, its safety profile has not been fully established, since only the genotoxic effects of C. oxyacantha fruit have been described. Therefore, the objective of this work was evaluating the cytotoxicity and genotoxicity of the aqueous and hydroalcoholic leaf and bark extracts of C. oxyacantha by means of the micronucleus test in a murine model. Doses of 2000, 1000, and 500 mg/kg of both extracts were administered orally for 5 days in mice of the Balb-C strain. Peripheral blood smears were performed at 0, 24, 48, 72, and 96 h after each administration. The number of polychromatic erythrocytes (PCEs), micronucleated polychromatic erythrocytes (MNPCEs), and micronucleated erythrocytes (MNEs) was determined at the different sampling times. Our results showed that the leaf and bark of C. oxyacantha increase the number of MNEs at the 2000 mg/kg dose, and only the aqueous leaf extract decreases the number of PCEs at the same dose. Therefore, the aqueous and hydroalcoholic leaf and bark extracts of C. oxyacantha showed genotoxic effects, and only the aqueous leaf extract exhibited cytotoxic effects.

Surgical Patients' Perception About Behaviors of Humanized Nursing Care.

INTRODUCTION: One of the greatest challenges that health professionals face is providing humanized care, especially when technological advancements contribute to the depersonalization of care delivery. In this sense, nursing care not only requires the nurse to be scientific, academic, and clinical but also a humanitarian and moral agent, as a partner in human transactions. METHOD: Quantitative, descriptive, and transversal study. In a nonprobabilistic sampling for convenience, in 150 surgical patients, with more than 3 days of hospital stay, the instrument "Perception of Behaviors of Humanized Nursing Care" was used (third version). The study adhered to the legal and ethical research guidelines in Mexico. RESULTS: According to the general objective of the study, the findings determined were that 67% of the participants perceived humanized nursing care as favorable. CONCLUSION: More than half of the patients always perceived behaviors of humanized care, provided by nurses, during their hospitalization in surgical services.

A shortened treatment with rosemary tea (rosmarinus officinalis) instead of glucose in patients with diabetes mellitus type 2 (TSD).

BACKGROUND: Rosemary leaves powder has been reported to reduce in a dose-dependent manner, glucose levels, lipid profile and lipid peroxidation in humans. However, patients should ingest high doses of powder contained in capsules. This formulation constitutes the intake of 10 capsules per day, so the active metabolite must first, be released and then absorbed (for which, rosemary leaf powder must be mixed with gastric juice). AIM: Evaluate whether a shortened dose and time of treatment as well as the pharmaceutical presentation in rosemary tea (Rosmarinus officinalis) instead of powder have a therapeutic effect in the treatment of T2D. METHOD: The complementary therapy with Rosemary tea (2g/1 litre of water per day) were evaluate on resistance to insulin, oxidative stress, biochemical parameters and anthropometric measurements in forty patients T2D under treatment with metformin and/or glibenclamide afther giving your authorization through informed consent. RESULTS: The data indicated that Rosemary tea intake after 90 days, statistically decreased (p < 0.05) anthropometric parameters like the body mass index and waist-hip ratio. Remarkably, this treatment decreased the percentages of glycated hemoglobin, insulin resistance, and the pancreatic ß-cell function and lastly, a significant difference in lipid peroxide levels was found. CONCLUSION: These data show that shortening time and dose, as well as changing the formulation of the Rosemary plant constitutes a promising treatment for drug-resistant T2D patients.

Genome Damage in Rats after Transplacental Exposure to Jatropha dioica Root Extract.

Jatropha dioica is traditionally used owing to its antiviral, antifungal, and antimicrobial properties. But, toxicological information regarding J. dioica root total extract is currently limited. The aim of this work was to evaluate in a rat model, the transplacental genotoxicity effect of J. dioica aqueous root total extract. Three different J. dioica aqueous root total extract doses (60, 100, and 300 mg/kg) were administered orally to Wistar rats during 5 days through the pregnancy term (16-21 days). Pregnant rats were sampled every 24 h during the last 6 days of gestation, and pubs were sampled at birth. Genome damage in dams and their newborn pups transplacentally exposed to J. dioica was evaluated by in vivo micronuclei assay. We evaluated the frequency of micronucleated erythrocytes (MNE), micronucleated polychromatic erythrocytes (MNPCE), and polychromatic erythrocytes (PCE) in peripheral blood samples from pups and MNPCE and PCE in pregnant rats. No genotoxic effect was observed after oral administration of the three different doses of aqueous root total extract of J. dioica in pregnant or in their newborn pubs, after transplacental exposure. A significant decrease in PCE frequency was noted in samples from pubs of rats treated with the highest dose of J. dioica extract. The aqueous total root extract of J. dioica at the highest dose tested in our research do have cytotoxic effect in pups transplacentally exposed to this plant extract. Moreover, neither a genotoxic nor a cytotoxic effect was observed in pregnant rats. In the present work, there was no evidence of genome damage in the rat model after transplacental exposure to J. dioica aqueous root total extract.

Percepción de la simulación clínica como experiencia de aprendizaje en estudiantes de Licenciatura en Enfermería / Perception of Clinical Simulation as a Learning Experience in Undergraduate Nursing Students / Percepção da simulação clínica como experiência de aprendizagem em discentes de Licenciatura em Enfermagem

Introducción: la simulación clínica es una herramienta de aprendizaje que integra conocimiento, destreza, participación y compromiso del estudiante, permite la reproducción, retroalimentación, valoración y reflexión. Supone una oportunidad para generar competencias que favorecen la formación de un pensamiento crítico, razonamiento y juicio clínico, habilidades de comunicación, trabajo en equipo, resolución de problemas y toma de decisiones. Objetivo: identificar la percepción de los estudiantes de la Licenciatura en Enfermería sobre la simulación clínica como experiencia de aprendizaje en una institución pública universitaria en el noreste de México. Metodología: se empleó un enfoque cuantitativo, diseño descriptivo y transversal en 477 estudiantes de enfermería. Se utilizó el cuestionario "Percepción de los estudiantes de enfermería respecto a la simulación clínica como experiencia de aprendizaje". Se consideraron aspectos éticos normativos establecidos en México. Resultados: la percepción de los estudiantes acerca de la simulación clínica como herramienta de aprendizaje fue muy buena en 49,5 % y buena en 44,9 %, lo que indica que fue una experiencia positiva. Conclusiones: la percepción de la simulación clínica como experiencia de aprendizaje mostrada por los estudiantes fue positiva. Esta favoreció la actitud para trabajar en equipo, fortaleció el liderazgo, comunicación, integración de la teoría y generación de pensamiento crítico.

Introduction: clinical simulation is a learning tool that integrates knowledge, skills, participation and commitment of the student, allows reproduction, feedback, assessment and reflection. It is an opportunity to generate competencies that favor the formation of critical thinking, clinical reasoning and judgment, communication skills, teamwork, problem solving and decision making. Objective: to identify the perception of undergraduate nursing students on clinical simulation as a learning experience in a public university institution in northeastern Mexico. Methodology: a quantitative approach, descriptive and cross-sectional design was used in 477 nursing students. The questionnaire "Nursing students' perception of clinical simulation as a learning experience" was used. Ethical normative aspects established in Mexico were considered. Results: students' perception of clinical simulation as a learning tool was very good in 49.5% and good in 44.9%, indicating that it was a positive experience. Conclusions: the perception of clinical simulation as a learning experience shown by students was positive. It favored the attitude to work in a team, strengthened leadership, communication, integration of theory and generation of critical thinking.

Introdução: a simulação clínica é uma ferramenta de aprendizagem que integra conhecimento, destreza, participação e comprometimento do discente, permite reprodução, retroalimentação, valoração e reflexão. Oportuniza a geração de competências que favorecem a formação de pensamento crítico, razoamento e julgamento clínico, habilidades de comunicação, trabalho em equipe, solução de problemas e tomada de decisão. Objetivo: identificar a percepção dos alunos da Licenciatura em Enfermagem sobre a simulação clínica como experiência de aprendizagem em uma instituição pública universitária no nordeste do México. Metodologia: usou-se enfoque quantitativo, de desenho descritivo e transversal em 477 discentes de enfermagem. Foi utilizado o questionário "Percepção dos discentes de enfermagem sobre a simulação clínica como experiência de aprendizagem". Aspectos éticos normativos estabelecidos no México foram considerados. Resultados: a percepção dos alunos sobre a simulação clínica como ferramenta de aprendizagem foi muito boa em 49,5 % e boa em 44,9 %, indicando que foi uma experiência positiva. Conclusões: a percepção da simulação clínica como experiência de aprendizagem mostrada pelos alunos foi positiva. Isso favoreceu a atitude para trabalhar em equipe, fortaleceu a liderança, comunicação, integração da teoria e geração de pensamento crítico.

Tipos instruccionales y regulación verbal. Comparación entre niños y adultos / Types of instructions and verbal regulation. Comparative study between children and adults

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The aim of these paper was to evaluate the effect of three types of instructions (general, precise, and specific) on the performance of a problem solving task and its relation with verbal regulation using the Tower of London (TOL) as methodological tool. Participants (30 adults and 30 children) held a session of 24 trials of different complexity, carried out according to the number of movements required to reach the goal (4, 5 and 6). The results showed significant differences between children and adults in all dependent variables, acording on the number of movements required in trials. Although less strongly, differences were also observed as a result of the type of instruction to which the participants were exposed. The analysis of verbal reports served as indicators of the type of verbal regulation that mediated the performance. It is discussed the need to elaborate comparative studies that allow to systematically evaluate the types of verbal regulation deployed during problem solving tasks in participants of different ages

Barreras del personal de salud para el tamizaje de sífilis en mujeres embarazadas de la Red Los Andes, Bolivia / Health-worker barriers to syphilis screening in pregnant women in Bolivia, Los Andes network

RESUMEN Objetivo Identificar barreras del personal de salud por las cuales las embarazadas que asisten al control prenatal no se realizan el tamizaje de sífilis (Red de Salud Los Andes, Bolivia). Métodos Se realizaron 46 entrevistas semiestructuradas a proveedores de salud y se analizaron los registros de 249 expedientes clínicos de embarazadas de ocho establecimientos públicos de salud de la Red Los Andes. Resultados Entre las barreras del personal de salud para el tamizaje de sífilis en embarazadas se identificaron el tiempo insuficiente del personal para sensibilizar sobre el beneficio del tamizaje de sífilis, algunos mencionaron que las pruebas de sífilis se deberían hacer solo en centros donde atienden partos y tienen laboratorio, la poca comunicación entre el personal de la consulta médica y laboratorio, así como también problemas de abastecimiento de suministros y reactivos. En la revisión de expedientes clínicos se observó que 55,4% contaba con los resultados de laboratorio de sífilis en sus expedientes y solo 37,4% de historias clínicas perinatales contaba con registro de resultados de laboratorios. A través de las entrevistas, se pudo observar que los proveedores perciben que el tamizaje de sífilis se realiza al 100% de las embarazadas que asisten al control prenatal. Conclusión El tamizaje para sífilis no se está realizando según lo establecido en la estrategia de país para la eliminación de la sífilis congénita, y no llega a más de la mitad de embarazadas en control prenatal con registros en las historias clínicas perinatales. Esto no es percibido por los profesionales de la salud y puede transformarse en una barrera para el tamizaje de sífilis en mujeres embarazadas.

ABSTRACT Objective Identify health-worker barriers that keep pregnant women who receive prenatal care from being screened for syphilis (Los Andes Health Network, Bolivia). Methods Semi-structured interviews were done with 46 health care providers and 249 clinical health records of pregnant women were analyzed in eight public health facilities in the Los Andes network. Results Health-worker barriers to syphilis screening in pregnant women included lack of time by personnel to raise awareness of the benefit of syphilis screening; some mentioned that syphilis tests should only be done in facilities that attend deliveries and have a laboratory; lack of communication between clinicians and laboratory personnel; and problems with provision of supplies and reagents. The clinical record review found that only 55.4% contained syphilis laboratory results and only 37.4% of perinatal clinical histories had records of laboratory results. The interviews found that providers believe that syphilis screening is done in 100% of pregnant women receiving prenatal care. Conclusion Syphilis screening is not being done according to Bolivia’s strategy for the elimination of congenital syphilis, and is not done on more than half of pregnant women in prenatal care with perinatal clinical history records. This is not perceived by health professionals and can become a barrier to syphilis screening in pregnant women.

Conocimiento, actitud y barreras en enfermeras hacia las medidas de prevención de úlceras por presión / Knowledge, attitude and barriers in nurses towards prevention measures of pressure ulcers

RESUMEN Objetivo: Identificar el nivel de conocimiento, actitud y barreras hacia las medidas de prevención de las úlceras por presión en el personal de enfermería que labora en servicios de hospitalización adultos. Material y método: Estudio descriptivo y transversal realizado en un hospital de Seguridad Social, en una muestra de 119 enfermeras y auxiliares de enfermería que laboran con pacientes adultos en riesgo de desarrollar úlceras por presión. Se aplicaron tres cuestionarios autocumplimentados: Valoración de conocimientos hacia la prevención de úlceras por presión (PUKAT); Actitud hacia la prevención de las úlceras por presión (APuP) y un apartado de Barreras de prevención e intervención. Se respetó el reglamento de la Ley General de Salud en Materia de Investigación de México. Resultados: Se identificó un 53,78% de respuestas correctas, lo que mostró un conocimiento bajo hacia las medidas de prevención. La actitud mostrada fue positiva con una media de 40,1 DE 3,5. Las barreras identificadas en prevención fueron "falta de personal" (81,51%), "pacientes que no cooperan" (67,22%) y "falta de tiempo" (64,70%); en intervención: "falta de ayudantes para la movilización" (91,59%), "falta de enfermeras" (80,67%) y "falta de tiempo" (72,26%). Conclusiones: Las enfermeras y auxiliares de enfermería mostraron un conocimiento bajo hacia las medidas de prevención de las úlceras por presión, con una actitud positiva. El personal de enfermería que labora en UCI y Medicina interna mostró tener una mejor actitud y las barreras más identificadas corresponden a falta de enfermeras, tiempo y personal que las asista en la movilización.

ABSTRACT Objective: To identify the level of knowledge, attitude and barriers in nursing staff working in adult in patient services towards prevention measures of pressure ulcers. Material and Methods: Quantitative, descriptive and transversal study conducted in a hospital of Social Security, in a sample of 119 nurses and nursing assistants who work with adult patients at risk of developing pressure ulcers. For data collection three self-filled questionnaires were applied: "Knowledge Rating of the pressure ulcers prevention"(PUKAT); "Attitude towards prevention of pressure ulcers" (APuP) and a section of barriers to prevention and intervention. The guidelines about informed consent and risks for research in Mexico were complied. Results: 56.63 % of correct answers were identified, which showed a low awareness towards prevention measures. Positive attitude was shown, with a mean of 40.10. The barriers identified in prevention were "lack of staff" (81.51%), "uncooperative patients" (67.22%), "lack of time" (64.70%); and in intervention: "lack of helpers for mobilization" (91.59%), "lack of nurses" (80.67%) and "lack of time" (72.26%). Conclusions: Nurses and nursing assistants showed low knowledge, but showed positive attitude, nursing staff working in ICU and internal medicine showed a better attitude, and the main identified barriers in the study are a lack of nurses, time and personnel that assist in the mobilization.