Psychosocial symptoms associated with spiritual well-being in Latino patients and caregivers coping with advanced cancer.

PURPOSE: The objective of this study was to investigate the relationship among hopelessness, anxiety, and depression, with spiritual well-being in patients and family caregivers. METHODS: A cross-sectional survey was administered to patients (n = 57) and caregivers (n = 57) that incorporated assessments that measured spiritual well-being, depression, anxiety, hopelessness, quality of life, family relationship, burden, fatalism, religiosity, and distress. Logistic regression and cross-tabulation analyses were conducted to examine the relationship between hopelessness, anxiety, and depression, with spiritual well-being. Logistic regression was used to quantify the impact of spiritual well-being on anxiety, depression, and hopelessness. Additionally, cross-tabulations with chi-square tests were conducted to explore associations between severity of hopelessness and severity of anxiety and depression. RESULTS: Logistic regression analyses showed negative associations between spiritual well-being and mental health outcomes, although not all findings were statistically significant. Among caregivers, a significant negative relationship was observed for depression (B = - 0.161, p = 0.022). Hopelessness also exhibited a negative association with spiritual well-being among caregivers (B = - 0.099, p = 0.054) and patients (B = - .152, p = 0.038). Cross-tabulations highlighted significant associations in the severity of hopelessness symptoms with anxiety and depression levels among caregivers (p < .001). CONCLUSION: Results reveal a relationship among psychosocial symptoms among Latino patient-caregivers coping with cancer. By emphasizing spiritual well-being, hopelessness, and anxiety and involving family patients and caregivers in the treatment process as a unit of care. Also, it indicates the need to develop culturally tailored interventions that aim to provide valuable assistance to Latino patients and caregivers coping with cancer.

Family functioning and psychosocial symptoms among Latinx patients coping with advanced cancer.

OBJECTIVES: This brief report aims to describe and determine the association of family functioning (e.g., cohesion and expressiveness) with psychosocial needs among Spanish Latinx patients coping with advanced cancers. METHODS: Descriptive and correlation analyses were performed on data from 103 patients coping with advanced cancer (Stages III and IV). The measures used were the Family Relationships Index, the Hospital Anxiety and Depression Scale, and the Functional Assessment of Cancer Therapy: General. RESULTS: Results indicated that most of the participants had low family function (65%). Participants with higher family functioning (35%) had high levels of quality of life [r(103) .318, p < .002]. A higher level of quality of life was also strongly associated with lower levels of anxiety [r(95) -.653, p < .000], lower levels of depression [r(95) -.733, p < .000], and lower levels of hopelessness [r(95) -.585, p = .000]. A total of 22.3% of Latinx advanced cancer patients reported poor cohesiveness; those with low cohesiveness also had higher levels of depression [r(103) -.28, p = .004] and anxiety [r(103) -.27, p = .005]. Correlations between expressiveness and hopelessness were significant; namely, those with higher expressiveness had lower hopelessness [r(103) -.274, p = .005]. SIGNIFICANCE OF RESULTS: Findings present a high correlation between family functioning and psychosocial symptoms.

Structure and assembly model for the Trypanosoma cruzi 60S ribosomal subunit.

Ribosomes of trypanosomatids, a family of protozoan parasites causing debilitating human diseases, possess multiply fragmented rRNAs that together are analogous to 28S rRNA, unusually large rRNA expansion segments, and r-protein variations compared with other eukaryotic ribosomes. To investigate the architecture of the trypanosomatid ribosomes, we determined the 2.5-Å structure of the Trypanosoma cruzi ribosome large subunit by single-particle cryo-EM. Examination of this structure and comparative analysis of the yeast ribosomal assembly pathway allowed us to develop a stepwise assembly model for the eight pieces of the large subunit rRNAs and a number of ancillary "glue" proteins. This model can be applied to the characterization of Trypanosoma brucei and Leishmania spp. ribosomes as well. Together with other details, our atomic-level structure may provide a foundation for structure-based design of antitrypanosome drugs.

Passive warming effect on soil microbial community and humic substance degradation in maritime Antarctic region.

Although the maritime Antarctic has undergone rapid warming, the effects on indigenous soil-inhabiting microorganisms are not well known. Passive warming experiments using open-top chamber (OTC) have been performed on the Fildes Peninsula in the maritime Antarctic since 2008. When the soil temperature was measured at a depth of 2-5 cm during the 2013-2015 summer seasons, the mean temperature inside OTC (OTC-In) increased by approximately 0.8 °C compared with outside OTC (OTC-Out), while soil chemical and physical characteristics did not change. Soils (2015 summer) from OTC-In and OTC-Out were subjected to analysis for change in microbial community and degradation rate of humic substances (HS, the largest pool of recalcitrant organic carbon in soil). Archaeal and bacterial communities in OTC-In were minimally affected by warming compared with those in OTC-Out, with archaeal methanogenic Thermoplasmata slightly increased in abundance. The abundance of heterotrophic fungi Ascomycota was significantly altered in OTC-In. Total bacterial and fungal biomass in OTC-In increased by 20% compared to OTC-Out, indicating that this may be due to increased microbial degradation activity for soil organic matter (SOM) including HS, which would result in the release of more low-molecular-weight growth substrates from SOM. Despite the effects of warming on the microbial community over the 8-years-experiments warming did not induce any detectable change in content or structure of polymeric HS. These results suggest that increased temperature may have significant and direct effects on soil microbial communities inhabiting maritime Antarctic and that soil microbes would subsequently provide more available carbon sources for other indigenous microbes.

String sign of Kantor in a patient with Crohn's disease.

We report the case of a 29-year-old male with structuring ileocolic Crohn's disease (CD), diagnosed in 2007 and treated with oral azathioprine, oral mesalazine and intravenous infliximab, without any other surgical or medical history of interest. He presented to the Emergency Room with abdominal distention and pain, nausea, vomiting and motility problems of a three-day duration. An abdominal computerized tomography using intravenous contrast was performed.

Resources used in the treatment of perianal Crohn's disease and the results in a real-life cohort. / Recursos empleados en el tratamiento de la enfermedad de Crohn perianal y sus resultados en una serie de vida real.

OBJECTIVE: To study the multidisciplinary management of patients with Crohn's disease (CD) and perianal disease (perianal Crohn's disease, PCD), as well as to analyse a possible relationship between the recurrence of perianal symptoms, the type of fistula and the treatment used. PATIENTS AND METHODS: Descriptive, retrospective study of patients with PCD who were treated in the Inflammatory Bowel Disease Unit. Epidemiological, clinical, diagnostic and therapeutic variables were collected, as well as clinical outcome and response to treatment. RESULTS: Of the 300 patients who attended the outpatient clinic at a university hospital, 65 had PCD. Sixteen simple fistulas (24.6%) and 49 complex fistulas (75.4%) were diagnosed. The most commonly used diagnostic technique was the endoanal ultrasound (45%). Antibiotics were used in 77.4% of patients, and 70% needed anti-TNF therapy to manage the PCD. Surgery was performed on 75.4% of the patients overall. PCD recurred in 41.5% of cases, requiring a change of the biological drugs administered and/or surgery. Complex fistulas were more likely to require surgery (P=.012) and recurrence of PCD was also more common with complex fistulas (P=.036). CONCLUSION: Management of PCD must be multidisciplinary and combined. Most patients with complex PCD require treatment based on biological drugs. Despite therapy, remission of perianal symptoms is not achieved in a percentage of patients, supporting the need to develop new therapies for refractory cases.

Age as a Risk Factor for Burnout Syndrome in Nursing Professionals: A Meta-Analytic Study.

Although past research has highlighted the possibility of a direct relationship between the age of nursing professionals and burnout syndrome, results have been far from conclusive. The aim of this study was to conduct a wider analysis of the influence of age on the three dimensions of burnout syndrome (emotional exhaustion, depersonalization, and personal accomplishment) in nurses. We performed a meta-analysis of 51 publications extracted from health sciences and psychology databases that fulfilled the inclusion criteria. There were 47 reports of information on emotional exhaustion in 50 samples, 39 reports on depersonalization for 42 samples, and 31 reports on personal accomplishment in 34 samples. The mean effect sizes indicated that younger age was a significant factor in the emotional exhaustion and depersonalization of nurses, although it was somewhat less influential in the dimension of personal accomplishment. Because of heterogeneity in the effect sizes, moderating variables that might explain the association between age and burnout were also analyzed. Gender, marital status, and study characteristics moderated the relationship between age and burnout and may be crucial for the identification of high-risk groups. More research is needed on other variables for which there were only a small number of studies. Identification of burnout risk factors will facilitate establishment of burnout prevention programs for nurses. © 2016 Wiley Periodicals, Inc.

Factors Associated with Shiga Toxin-Producing Escherichia coli Shedding by Dairy and Beef Cattle.

UNLABELLED: Shiga toxin-producing Escherichia coli (STEC) is an important foodborne pathogen that can cause hemorrhagic colitis and hemolytic-uremic syndrome. Cattle are the primary reservoir for STEC, and food or water contaminated with cattle feces is the most common source of infections in humans. Consequently, we conducted a cross-sectional study of 1,096 cattle in six dairy herds (n = 718 animals) and five beef herds (n = 378 animals) in the summers of 2011 and 2012 to identify epidemiological factors associated with shedding. Fecal samples were obtained from each animal and cultured for STEC. Multivariate analyses were performed to identify risk factors associated with STEC positivity. The prevalence of STEC was higher in beef cattle (21%) than dairy cattle (13%) (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.25, 2.47), with considerable variation occurring across herds (range, 6% to 54%). Dairy cattle were significantly more likely to shed STEC when the average temperature was >28.9°C 1 to 5 days prior to sampling (OR, 2.5; 95% CI, 1.25, 4.91), during their first lactation (OR, 1.8; 95% CI, 1.1, 2.8), and when they were <30 days in milk (OR, 3.9; 95% CI, 2.1, 7.2). These data suggest that the stress or the negative energy balance associated with lactation may result in increased STEC shedding frequencies in Michigan during the warm summer months. Future prevention strategies aimed at reducing stress during lactation or isolating high-risk animals could be implemented to reduce herd-level shedding levels and avoid transmission of STEC to susceptible animals and people. IMPORTANCE: STEC shedding frequencies vary considerably across cattle herds in Michigan, and the shedding frequency of strains belonging to non-O157 serotypes far exceeds the shedding frequency of O157 strains, which is congruent with human infections in the state. Dairy cattle sampled at higher temperatures, in their first lactation, and early in the milk production stage were significantly more likely to shed STEC, which could be due to stress or a negative energy balance. Future studies should focus on the isolation of high-risk animals to decrease herd shedding levels and the potential for contamination of the food supply.

Study protocol of a randomized clinical trial evaluating the effectiveness of a primary care intervention using the Nintendo™ Wii console to improve balance and decrease falls in the elderly.

BACKGROUND: Balance alteration is a risk factor for falls in elderly individuals that has physical, psychological and economic consequences. The objectives of this study are to evaluate the usefulness of an intervention utilizing the Nintendo™ Wii console in order to improve balance, thereby decreasing both the fear of falling as well as the number of falls, and to evaluate the correlation between balance as determined by the console and the value obtained in the Tinetti tests and the one foot stationary test. METHODS/DESIGN: This is a controlled, randomized clinical trial of individual assignment, carried out on patients over 70 years in age, from five primary care centers in the city of Mataró (Barcelona). 380 patients were necessary for the intervention group that carried out the balance board exercises in 2 sessions per week for a 3 month period, and 380 patients in the control group who carried out their usual habits. Balance was evaluated using the Tinetti test, the one foot stationary test and with the console, at the start of the study, at the end of the intervention (3 months) and one year later. Quarterly telephone follow-up was also conducted to keep track of falls and their consequences. DISCUSSION: The study aimed to connect the community with a technology that may be an easy and fun way to assist the elderly in improving their balance without the need to leave home or join rehabilitation groups, offering greater comfort for this population and decreasing healthcare costs since there is no need for specialized personnel. TRIAL REGISTRATION: Current Control Trial NCT02570178.

Biology and trapping of stable flies (Diptera: Muscidae) developing in pineapple residues (Ananas comosus) in Costa Rica.

Pineapple production in Costa Rica increased nearly 300-fold during the last 30 yr, and >40,000 hectares of land are currently dedicated to this crop. At the end of the pineapple cropping cycle, plants are chopped and residues incorporated into the soil in preparation for replanting. Associated with increased pineapple production has been a large increase in stable fly, Stomoxys calcitrans (L.), populations. Stable flies are attracted to, and oviposit in, the decomposing, chopped pineapple residues. In conjunction with chemical control of developing larvae, adult trapping is an important control strategy. In this study, four blue-black fabric traps, Nzi, Vavoua, Model H, and Ngu, were compared with a white sticky trap currently used for stable fly control in Costa Rica. Overall, the white sticky trap caught the highest number of stable flies, followed by the Nzi, Vavoua, Model H, and Ngu. Collections on the white sticky trap increased 16 d after residues were chopped; coinciding with the expected emergence of flies developing in the pineapple residues. During this same time period, collections in the blue-black fabric traps decreased. Sex ratio decreased from >7:1 (females:males) 3-7 d after chopping to 1:1 at 24-28 d. White sticky, Nzi and Vavoua traps collected similar numbers of colonizing flies 3-7 d after residues were chopped. However, white sticky traps collected more flies once emergence from the pineapple residues began. Although white sticky traps collected more flies than fabric traps, they remain labor intensive and environmentally unsound because of their disposable and nonbiodegradable nature.

Print and digital reading habits and comprehension in children with and without special education needs.

BACKGROUND: Text comprehension is a major obstacle for many Primary school students with special education needs (SEN). Reading episodes bring students opportunities to be exposed to new vocabulary and knowledge, potentially boosting their development of text comprehension skills. AIMS: Our study seeks to understand how reading frequency (leisure and academic) and reading medium (print and digital) contribute to the development of text comprehension during Primary school in students with and without SEN. METHODS AND PROCEDURES: We tested 2289 Spanish students from fourth to sixth grade, from which 212 had an official decision of SEN. Students self-reported their reading frequency (as a measure of their reading habits) and completed a standardized text comprehension test. We employed multiple regression models with a robust maximum likelihood estimator to test associations between reading frequency and comprehension. OUTCOMES AND RESULTS: Students' comprehension was positively associated with their leisure print reading habits, and negatively associated with their frequency of academic digital reading. Those associations were independent of SEN status. CONCLUSIONS AND IMPLICATIONS: Results highlight the importance of promoting leisure reading in print to all students, regardless of SEN status. In addition, caution is advised when encouraging Primary school children to use digital texts when the emphasis is on comprehending texts for acquiring knowledge.

Case studies about smart contracts in healthcare.

The Internet of Things (IoT) such as devices and sensors are a fast growth reality which our bureaucratical and archaic institutional system is not yet ready to embrace its functionalities. In the health system, many developments are made, and smart devices are the key to preventing, studying, investigating, and solving a lot of diseases and improving our health system. But along with this, innovation is necessary for the hospitals, for example, to have a proper system that provides storage of health data information and respects the General Data Protection Regulation (GDPR) with the use of smart contracts that secure the integrity and disclosure of the patient's data, since the majority of hospitals still use paper, physical records to store data. In this study, we will briefly analyse and explain three different suggested methods to deal with the challenges that Internet of Medical Things (IoMT) encounters. We will not choose which one is the best because of the different features and the countries they are proposed but will emphasize the benefits and challenges which one has.

Relation between digital tool practices in the language arts classroom and reading comprehension scores.

Concerns about the negative effects of digitalization on students' reading comprehension, empirically backed by recent meta-analyses, question the efficacy of digital tools in the language arts classroom. By analyzing data from 4 and 8th grade US students from NAEP 2017, we aimed to test the generalization of the negative association between screens use and reading comprehension test scores within language arts classrooms, and to identify teachers' practices to support comprehension, which could reduce such a negative relationship. We used data from 149,400 4th grade and 144,900 8th grade students to predict their reading comprehension scores based on their frequency of use of digital devices in the language arts class, as well as on the specific learning activities performed with such devices. Results revealed that amount of daily use of digital devices was negatively related to scores on a reading comprehension test. In addition, teachers' uses of digital tools to support students' reading comprehension showed positive relations for student use of digital devices for reading projects, and negative relations for activities addressing specific reading skills, such as building and practicing vocabulary. We discuss these results in light of our current understanding of the effects of digitalization on reading.

Acceptance of Caregiver-Patient Support to Latinx Coping with Advanced Cancer (CASA) Intervention: A Caregiver Case Study.

Latinos frequently assume caregiver roles when the need arises in their social nucleus. Because of their active role, caregivers are heavily involved in their family member's cancer trajectory. Therefore, there is a need for culturally adapted interventions that integrate the caregiver and cancer patient. The objective is to present a case study of a former caregiver's experience and acceptance of the cultural adaptation of Caregiver-Patient Support to Latinx Coping with Advanced Cancer (CASA) intervention. We conducted a case study with a male caregiver between the ages of 20 and 30. A male caregiver expressed his experience and acceptance of a psychosocial intervention. He conveyed moderate to high acceptance of intervention components through anecdotes and opinions based on his experiences as a caregiver for multiple family members. Finally, he reported distress, but he presented little to no symptoms of caregiver burden, depression, anxiety, and hopelessness. It is crucial to culturally adapt interventions that integrate caregivers when they play a big part in their loved one's cancer journey. Integrating their perspective when adapting an intervention may assist in providing essential information that will benefit the patient and caregiver.

Importance of Communication Skills Training and Meaning Centered Psychotherapy Concepts among Patients and Caregivers Coping with Advanced Cancer.

Latinos are more likely to be diagnosed with advanced cancer and have specific existential and communication needs. Concepts within Meaning-Centered Psychotherapy (MCP) interventions and Communications Skills Training (CST) assist patients in attending to these needs. However, Latino-tailored MCP interventions have yet to be adapted for advanced cancer patients and caregivers. A cross-sectional survey was administered to Latino advanced cancer patients and caregivers where participants rated the importance of the goals and concepts of MCP and CST. Fifty-seven (n = 57) Latino advanced cancer patients and fifty-seven (n = 57) caregivers completed the survey. Most participants rated MCP concepts as extremely important, ranging from 73.75% to 95.5%. Additionally, 86.8% favored finding meaning in their life after a cancer diagnosis. Participants (80.7%) also selected the concept of finding and maintaining hope to cope with their cancer diagnosis. Finally, participants found CST concepts and skills acceptable, ranging from 81.6% to 91.2%. Results indicate the acceptability of Meaning-Centered Therapy and Communication Skills Training among Latino advanced cancer patients and caregivers coping with advanced cancer. These results will inform the topics to be discussed in a culturally adapted psychosocial intervention for advanced cancer patients and their informal caregivers.

Safety of the Administration of an Inactivated PCV2a/PCV2b/Mycoplasma Hyopneumoniae Vaccine to Pregnant and Lactating Sows and Gilts.

Porcine Circovirus type 2 (PCV2) vaccination of gilts during acclimation has become a routine practice in commercial pig farms to homogenize herd immunity to PCV2 and reduce the impact of diseases associated with PCV2 infection, namely reproductive, respiratory, systemic, and other PCV2-associated diseases. The periodic mass vaccination of sows, with the same objectives, is also common. To ensure mass vaccination is an appropriate health management tool, demonstrating that the vaccine is safe in different sow/gilt physiological stages is necessary. The objective of the present studies was to evaluate safety of a PCV2a/PCV2b/Mycoplasma hyopneumoniae (PCV2a2bMHP) killed vaccine in sows and gilts during gestation and lactation, under controlled experimental pen conditions, and during gestation, mimicking mass vaccination, under field conditions. Safety was assessed by monitoring for immediate adverse reactions after vaccination, rectal temperatures after vaccination (controlled experimental pen studies only), local and systemic reactions, and reproductive performance (studies conducted during pregnancy) or lactation performance (studies conducted during lactation). In total, 416 sows/gilts were enrolled, and more than 4000 piglets were observed during their first week of life, under field conditions. In both controlled experimental and field studies, no immediate anaphylactic type reactions were observed after vaccination and the incidence of adverse events, such as depression or decreased appetite, was acceptable for what is expected in a swine herd. In the studies conducted during gestation, vaccination did not significantly increase rectal temperature of the vaccinated animals. Sow reproductive outcomes were not affected by vaccination. The farrowing rate of animals participating in the field study was higher than the historic averages of the farms. In the laboratory studies conducted during the first and second half of gestation, no differences in reproductive outcome were observed between vaccinated and non-vaccinated animals. However, sows vaccinated during lactation experienced a transient hyperthermia which did not affect milk production since the piglets' average daily weight gain was not affected. The previously described results confirm that the administration of a PCV2a2bMHP vaccine was safe in the tested conditions. All the anticipated benefits of sow and gilt PCV2 vaccination, such as homogenization of PCV2 antibody titers or reduction in PCV2 circulation in the herd, would not be masked by potential adverse events due to herd vaccination. In conclusion, the administration of a PCV2a2bMHP vaccine to sows and gilts during different stages of gestation and during lactation is safe.

Zika virus RNA persistence and recovery in water and wastewater: An approach for Zika virus surveillance in resource-constrained settings.

During the 2015-2016 Zika virus (ZIKV) epidemic in the Americas, serological cross-reactivity with other flaviviruses and relatively high costs of nucleic acid testing in the region hindered the capacity for widespread diagnostic testing. In such cases where individual testing is not feasible, wastewater monitoring approaches may offer a means of community-level public health surveillance. To inform such approaches, we characterized the persistence and recovery of ZIKV RNA in experiments where we spiked cultured ZIKV into surface water, wastewater, and a combination of both to examine the potential for detection in open sewers serving communities most affected by the ZIKV outbreak, such as those in Salvador, Bahia, Brazil. We used reverse transcription droplet digital PCR to quantify ZIKV RNA. In our persistence experiments, we found that the persistence of ZIKV RNA decreased with increasing temperature, significantly decreased in surface water versus wastewater, and significantly decreased when the initial concentration of virus was lowered by one order of magnitude. In our recovery experiments, we found higher percent recovery of ZIKV RNA in pellets versus supernatants from the same sample, higher recoveries in pellets using skimmed milk flocculation, lower recoveries of ZIKV RNA in surface water versus wastewater, and lower recoveries from a freeze thaw. We also analyzed samples collected from Salvador, Brazil during the ZIKV outbreak (2015-2016) that consisted of archived samples obtained from open sewers or environmental waters thought to be contaminated by sewage. Although we did not detect any ZIKV RNA in the archived Brazil samples, results from these persistence and recovery experiments serve to inform future wastewater monitoring efforts in open sewers, an understudied and important application of wastewater monitoring.

Important End-of-Life Topics among Latino Patients and Caregivers Coping with Advanced Cancer.

There is a known end-of-life related disparity among Latino individuals, and there is a need to develop culturally sensitive interventions to help patients and caregivers cope with advanced cancer. Latino patients and caregivers coping with advanced cancer were asked to list important end-of-life topics to culturally inform a psychosocial intervention adaptation process. A qualitative study was conducted, and semi-structured interviews were performed, audio-recorded, and transcribed. Recordings and transcriptions were reviewed and analyzed using thematic content coding. The semi-structured interview described and demonstrated intervention components and elicited feedback about each. Free listing method was used to assess important topics among Latino advanced cancer patients (n = 14; stage III and IV) and caregivers. Patients and caregivers were given a list of 15 topics and asked which topics they deemed important to integrate into the intervention. Overall, more than half of the participants considered it important to include 13 of the 15 topics related to daily activities (eight subcategories), psychosocial support (three subcategories), discussing diagnosis and support (three subcategories), and financial difficulties (one subcategory). Patient-caregivers reported importance in most end-of-life topics. Future research and intervention development should include topics related to psychosocial support, daily activities, discussing diagnosis and support, and financial difficulties.

Ambulatory Sedation for Dental Procedures-Case of Cuenca, Ecuador.

In recent years, the dental treatment of children under sedation and/or general anesthesia on an outpatient basis has been developed as a behavioral management model in pediatric dentistry. The objective of this study was to establish the percentage of pediatric patients who required deep sedation on an outpatient basis in dental offices in the city of Cuenca, Ecuador. An observational study was conducted with a sample of 450 records of school- and preschool-age patients, where the variables were type and time of treatment, age, and sex. Statistical data were analyzed using the statistical program SPSS V.27 (IBM, Armonk, NY, USA). The highest percentage of children who received sedation were of preschool age. In general, there were three types of procedures per session, the most frequent being restorations (67%), followed by pulp treatment (49.8%) and, less frequently, minor surgery. The need for sedation for dental procedures is high in preschool patients, and ambulatory sedation has contributed to meeting this need. However, a regulation for its use is required at a national level.