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1.
J Nurs Adm ; 54(1): 40-46, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38117151

RESUMEN

ABSTRACT: Effective peer feedback is critical for the self-regulation of nursing practice and safe, high-quality care, yet peer feedback conversations can be challenging and anxiety provoking. As current literature revealed no consistent approach, taskforce members designed and implemented an innovative and standardized peer feedback program using brain science to support nurses' skills in speaking up. The new program resulted in an increase in nurses' self-reported willingness to provide peer feedback, and improvements in safety culture and nurse-sensitive quality outcomes.


Asunto(s)
Encéfalo , Miedo , Humanos , Retroalimentación , Ansiedad , Comunicación
2.
Int J Mol Sci ; 24(24)2023 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-38139086

RESUMEN

Given the need to improve the sensitivity of non-invasive methods to detect colorectal neoplasia, particularly adenomas, we compared a fecal test using a monoclonal antibody (Mab) raised against constituents of colonic adenomas designated Adnab-9 (Adenoma Antibody 9), recognizing an N-linked 87 kDa glycoprotein, to gFOBT, which is shown to reduce CRC mortality. p87 immunohistochemistry testing is significantly more sensitive (OR 3.64[CI 2.37-5.58]) than gFOBT (guaiac-based fecal occult blood test) for adenomas (<3 in number), advanced adenomas (OR 4.21[CI 2.47-7.15]), or a combination of the two (OR 3.35[CI 2.47-4.53]). p87 immunohistochemistry shows regional Paneth cell (PC) expression mainly in the right-sided colon and is significantly reduced in the ceca of African Americans (p < 0.0001). In a subset of patients, we obtained other body fluids such as urine, colonic effluent, and saliva. Urine tests (organ-specific neoantigen) showed a significant difference for advanced adenomas (p < 0.047). We conclude that fecal p87 testing is more sensitive than gFOBT and Adnab-9 and could be used to better direct the colonoscopy screening effort.


Asunto(s)
Adenoma , Neoplasias Colorrectales , Humanos , Guayaco , Sangre Oculta , Tamizaje Masivo/métodos , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/prevención & control , Colonoscopía/métodos , Adenoma/diagnóstico , Sensibilidad y Especificidad , Detección Precoz del Cáncer/métodos
3.
J Interpers Violence ; 37(17-18): NP15130-NP15152, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-33678044

RESUMEN

The current study examined the prevalence and mental health associated with physical and sexual dating violence among adolescents using an intersectional analysis. Data were obtained from 88,219 adolescents in the Youth Risk Behavior Surveillance Survey. Gender, race/ethnicity, sexual orientation, and experiences with teen dating violence were measured for each youth. Tested two- and three-way interactions demonstrate varied outcomes by social identification and emphasize the need for an intersectional approach in dating violence research. Adolescent dating violence was most prevalent among girls (10% physical, 13% sexual); adolescents were racially identified as Native North American (13% physical, 10% sexual), Hawaiian/Pacific Islander (12% physical, 14% sexual), or multiracial (11% physical, 12% sexual), and lesbian, gay, bisexual, or questioning their sexual orientation (LGBQ) adolescents (19% physical, 20% sexual). The intersectional groups with the highest rates of physical and sexual dating violence included Latinx GBQ boys (26% physical, 26% sexual) and Hawaiian/Pacific Islander GBQ boys (29% physical, 32% sexual). Among girls, highest rates were observed among Hawaiian/Pacific Islander LBQ (24% physical, 23% sexual). Externalizing symptoms associated with physical dating violence were most robust for risky sexual behavior (OR = 4.0), followed by physical fighting (OR = 3.0), and weapon carrying (OR = 2.5); they were also associated with sexual dating violence (ORs = 1.9-2.2). Internalizing symptoms were comparably associated with both types of dating violence (ORs = 2.6-2.9 physical and ORs = 2.4-2.8 sexual). Findings suggest first that an intersectional approach is especially informative in teen dating violence prevention and intervention and second that teen dating violence interventions and prevention programming should use a trauma-informed, gender-responsive, culturally sensitive, and LGBQ inclusive approach.


Asunto(s)
Conducta del Adolescente , Violencia de Pareja , Adolescente , Etnicidad , Femenino , Identidad de Género , Humanos , Violencia de Pareja/psicología , Masculino , Salud Mental , Conducta Sexual/psicología
4.
Onco (Basel) ; 2(2): 129-144, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37841494

RESUMEN

Whole genome sequencing (WGS) has helped to revolutionize biology, but the computational challenge remains for extracting valuable inferences from this information. Here, we present the cancer-associated variants from the Cancer Genome Atlas (TCGA) WGS dataset. This set of data will allow cancer researchers to further expand their analysis beyond the exomic regions of the genome to the entire genome. A total of 1342 WGS alignments available from the consortium were processed with VarScan2 and deposited to the NCI Cancer Cloud. The sample set covers 18 different cancers and reveals 157,313,519 pooled (non-unique) cancer-associated single-nucleotide variations (SNVs) across all samples. There was an average of 117,223 SNVs per sample, with a range from 1111 to 775,470 and a standard deviation of 163,273. The dataset was incorporated into BigQuery, which allows for fast access and cross-mapping, which will allow researchers to enrich their current studies with a plethora of newly available genomic data.

5.
Molecules ; 26(18)2021 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-34577130

RESUMEN

One in five cancers is attributed to infectious agents, and the extent of the impact on the initiation, progression, and disease outcomes may be underestimated. Infection-associated cancers are commonly attributed to viral, and to a lesser extent, parasitic and bacterial etiologies. There is growing evidence that microbial community variation rather than a single agent can influence cancer development, progression, response to therapy, and outcome. We evaluated microbial sequences from a subset of infection-associated cancers-namely, head and neck squamous cell carcinoma (HNSC), liver hepatocellular carcinoma (LIHC), and stomach adenocarcinoma (STAD) from The Cancer Genome Atlas (TCGA). A total of 470 paired tumor and adjacent normal samples were analyzed. In STAD, concurrent presence of EBV and Selemonas sputigena with a high diversity index were associated with poorer survival (HR: 2.23, 95% CI 1.26-3.94, p = 0.006 and HR: 2.31, 95% CI 1.1-4.9, p = 0.03, respectively). In LIHC, lower microbial diversity was associated with poorer overall survival (HR: 2.57, 95% CI: 1.2, 5.5, p = 0.14). Bacterial within-sample diversity correlates with overall survival in infection-associated cancers in a subset of TCGA cohorts.


Asunto(s)
Neoplasias Hepáticas , Carcinoma de Células Escamosas de Cabeza y Cuello , Neoplasias Gástricas , Biomarcadores de Tumor , Regulación Neoplásica de la Expresión Génica , Humanos , Pronóstico
6.
BMC Bioinformatics ; 21(Suppl 9): 523, 2020 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-33272199

RESUMEN

Cancer is one of the leading causes of morbidity and mortality in the globe. Microbiological infections account for up to 20% of the total global cancer burden. The human microbiota within each organ system is distinct, and their compositional variation and interactions with the human host have been known to attribute detrimental and beneficial effects on tumor progression. With the advent of next generation sequencing (NGS) technologies, data generated from NGS is being used for pathogen detection in cancer. Numerous bioinformatics computational frameworks have been developed to study viral information from host-sequencing data and can be adapted to bacterial studies. This review highlights existing popular computational frameworks that utilize NGS data as input to decipher microbial composition, which output can predict functional compositional differences with clinically relevant applicability in the development of treatment and prevention strategies.


Asunto(s)
Secuenciación de Nucleótidos de Alto Rendimiento , Microbiota/genética , Neoplasias/microbiología , Especificidad de Órganos/genética , Biología Computacional , Humanos
7.
Comput Struct Biotechnol J ; 18: 631-641, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32257046

RESUMEN

Identification of microbial composition directly from tumor tissue permits studying the relationship between microbial changes and cancer pathogenesis. We interrogated bacterial presence in tumor and adjacent normal tissue strictly in pairs utilizing human whole exome sequencing to generate microbial profiles. Profiles were generated for 813 cases from stomach, liver, colon, rectal, lung, head & neck, cervical and bladder TCGA cohorts. Core microbiota examination revealed twelve taxa to be common across the nine cancer types at all classification levels. Paired analyses demonstrated significant differences in bacterial shifts between tumor and adjacent normal tissue across stomach, colon, lung squamous cell, and head & neck cohorts, whereas little or no differences were evident in liver, rectal, lung adenocarcinoma, cervical and bladder cancer cohorts in adjusted models. Helicobacter pylori in stomach and Bacteroides vulgatus in colon were found to be significantly higher in adjacent normal compared to tumor tissue after false discovery rate correction. Computational results were validated with tissue from an independent population by species-specific qPCR showing similar patterns of co-occurrence among Fusobacterium nucleatum and Selenomonas sputigena in gastric samples. This study demonstrates the ability to identify bacteria differential composition derived from human tissue whole exome sequences. Taken together our results suggest the microbial profiles shift with advanced disease and that the microbial composition of the adjacent tissue can be indicative of cancer stage disease progression.

8.
Child Abuse Negl ; 93: 139-148, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31103836

RESUMEN

BACKGROUND: Adverse childhood experience (ACE) and intimate partner violence (IPV) have sustained, deleterious effects on physical and mental health. Few studies have examined how to help Latina survivors of ACEs and/or IPV regain control of their health. OBJECTIVE: To inform interventions for this population, we examined whether mastery of stress and patient activation mediate the relationship between a history of ACE and/or IPV and mental and physical health. PARTICIPANTS AND SETTING: We recruited 235 Latina women (M age = 29.6, SD = 5.75) from primary care clinics. METHOD: For this cross-sectional study, we used linear regressions to examine the association between ACEs, history of IPV, and health, and the sobel's test to determine whether patient activation and mastery of stress mediated the relationships between ACEs, IPV, and health. RESULTS: Most women reported at least one ACE (61.7%, n = 137) and 22.2% (n = 55) reported a history of IPV. Mastery of stress mediated the relationship between ACE and physical health (b= -3.16 p = .002) and mental health (b= -3.83, p < .001). Mastery of stress also mediated the relationship between history of IPV and physical health (b= -2.62, p = .008) and mental health (b= -2.74, p = .006). Patient activation was not associated with a history of trauma or mental health. CONCLUSION: While past experiences of trauma cannot be changed, results from this study suggest that improving an individual's mastery of stress may be a point of intervention for improving mental and physical health among survivors of ACEs and IPV.


Asunto(s)
Adaptación Psicológica , Adultos Sobrevivientes del Maltrato a los Niños , Experiencias Adversas de la Infancia , Estado de Salud , Hispánicos o Latinos/psicología , Violencia de Pareja/etnología , Salud Mental/etnología , Estrés Psicológico , Adulto , Adultos Sobrevivientes del Maltrato a los Niños/psicología , Niño , Maltrato a los Niños/etnología , Estudios Transversales , Femenino , Humanos , Violencia de Pareja/psicología , Modelos Lineales , Estrés Psicológico/etnología , Estrés Psicológico/psicología , Salud de la Mujer/etnología
9.
P R Health Sci J ; 36(2): 92-100, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-28622406

RESUMEN

Over the past several decades, Puerto Ricans have faced increased health threats from chronic diseases, particularly diabetes and hypertension. The patient-provider relationship is the main platform for individual disease management, whereas the community, as an agent of change for the community's health status, has been limited in its support of individual health. Likewise, traditional research approaches within communities have placed academic researchers at the center of the process, considering their knowledge was of greater value than that of the community. In this paradigm, the academic researcher frequently owns and controls the research process. The primary aim is contributing to the scientific knowledge, but not necessarily to improve the community's health status or empower communities for social change. In contrast, the community-based participatory research (CBPR) model brings community members and leaders together with researchers in a process that supports mutual learning and empowers the community to take a leadership role in its own health and well-being. This article describes the development of the community-campus partnership between the University of Puerto Rico School of Medicine and Piñones, a semi-rural community, and the resulting CBPR project: "Salud para Piñones". This project represents a collaborative effort to understand and address the community's health needs and health disparities based on the community's participation as keystone of the process. This participatory approach represents a valuable ally in the development of long-term community-academy partnerships, thus providing opportunities to establish relevant and effective ways to translate evidence-based interventions into concrete actions that impact the individual and community's wellbeing.


Asunto(s)
Investigación Participativa Basada en la Comunidad , Disparidades en el Estado de Salud , Promoción de la Salud , Humanos , Puerto Rico
10.
Explore (NY) ; 13(3): 186-197, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28373062

RESUMEN

CONTEXT: Physical inactivity, poor nutrition, and chronic stress threaten the health of African-American youth in urban environments. Conditions often worsen in summer with diminished access to healthy foods and safe venues for physical activity. OBJECTIVE: A public-private partnership was formed to develop and evaluate an integrative health intervention entitled "Mission Thrive Summer" (MTS). METHODS: The MTS setting was an urban farm and adjacent school in a low-income community in Baltimore, Maryland. The intervention included farming, nutrition education, cooking, physical activity, yoga, mindfulness, and employment. Mixed-methods outcomes evaluation was conducted. Quantitative measures included accelerometry and self-reported health behaviors, using the Child and Adolescent Mindfulness Measure, Perceived Stress Scale, Physical Activity Questionnaire for Adolescents (PAQA), CDC Youth Risk Behavior Survey, and Block Kids Food Screener (BKFS). Outcomes were compared pre- and post-intervention using paired t-tests. Qualitative evaluation was based on participant and parent interviews. PARTICIPANTS: In total, 36 African-American 9th- and 10th-grade students joined MTS (17 in 2013, 26 in 2014, and 7 participating both years). RESULTS: In total, 88% of participants completed MTS. Accelerometry revealed that participants took 7158 steps and burned 544 calories per day during MTS. Participants experienced statistically significant improvements in self-reported physical activity (PAQA) and dietary habits (BKFS). Surveys did not detect changes in stress or mindfulness (P > .05). Qualitative data demonstrated new knowledge and skills, increased self-efficacy, health behavior change, and program enjoyment. CONCLUSIONS: MTS was feasible among African-American high school students in Baltimore. Mixed-methods outcomes evaluation provided preliminary evidence of health behavior change during the summer and at follow-up.


Asunto(s)
Negro o Afroamericano , Ejercicio Físico , Conducta Alimentaria , Promoción de la Salud/métodos , Adolescente , Agricultura , Baltimore , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Atención Plena , Estudiantes , Yoga
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