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1.
Artículo en Inglés | MEDLINE | ID: mdl-38083403

RESUMEN

Millions suffer from sleep disorders, and sleep clinics and research institutions seek improved sleep study methods. This paper proposes the Fascia Ecosystem for Sleep Engineering to improve traditional sleep studies. The Fascia Sleep Mask is more comfortable and accessible than overnight stays at a sleep center, and the Fascia Portal and Fascia Hub allow for home-based sleep studies with real-time intervention and data analysis capabilities.A study of 10 sleep experts found that the Fascia Portal is easy to access, navigate, and use, with 44.4% finding it very easy to access, 33.3% very easy to navigate, and 60% very easy to get used to. Most experts found the Fascia Portal reliable and easy to use.Moreover, the study analyzed physiological signals during various states of sleep and wakefulness in two subjects. The results demonstrated that the Fascia dataset captured higher amplitude spindles in N2 sleep (72.20 V and 109.87 V in frontal and parietal regions, respectively) and higher peak-to-peak amplitude slow waves in N3 sleep (93.51 V) compared to benchmark datasets. Fascia produced stronger and more consistent EOG signals during REM sleep, indicating its potential to improve sleep disorder diagnosis and treatment by providing a deeper understanding of sleep patterns.


Asunto(s)
Técnicas de Diagnóstico Neurológico , Trastornos del Sueño-Vigilia , Humanos , Electroencefalografía , Sueño/fisiología , Fases del Sueño/fisiología , Trastornos del Sueño-Vigilia/diagnóstico , Sueño REM/fisiología , Técnicas de Diagnóstico Neurológico/instrumentación
2.
J Prosthet Dent ; 2023 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-37451900

RESUMEN

STATEMENT OF PROBLEM: Achieving and maintaining optimal tissue health and esthetics when immediately placing maxillary anterior implants with interim restorations has been challenging and the clinical outcomes heterogenous. PURPOSE: The purpose of this retrospective study was to evaluate the clinical outcomes of immediate placement of maxillary anterior implants with interim restorations and compare the tomographic and clinical results before and after implant placement in participants followed for 1 to 14 years. MATERIAL AND METHODS: Twenty participants receiving 25 postextraction single implants in the anterior maxilla were studied. Clinical parameters included pink esthetic score (PES) and white esthetic score (WES), peri-implant phenotype, implant probing, plaque index, and cone beam computed tomography (CBCT) to compare initial and at least 1 year after crown placement (postoperative). For qualitative variables, a descriptive analysis was carried out. The PES and WES results were analyzed by using nonparametric statistics, the median (ME) and the interquartile range (IQR) were used as summary measures, and the Wilcoxon sum of signs test was used to compare the total scores between the intervention area and the contralateral tooth. To compare pre- and postoperative data points, the paired t test was used (α=.05). RESULTS: Mean ±standard deviation (SD) time of follow-up was 7.6 ±4.2 years. Twenty participants with a mean ±SD age of 62.4 ±11.0 years old received 25 implants. Mean ±SD initial torque value at implant placement was 38.6 ±9.63 Ncm. Bone height at the top of the alveolar ridge (BH) and bone width at the middle of the alveolar ridge (BW2) showed a statistically significant decrease between the initial and subsequent CBCT measurements (both P<.001). Likewise, the bone width at the alveolar crest (BW1) showed a statistically significant decrease between the initial and post-CBCT measurements (P=.006). Facial bone integrity (FBI) revealed a statistically significant increase between the initial and postoperative time periods (P<.001). The PES index showed a median of 9.0 IQR (8-10), statistically lower than the contralateral tooth (P=.032). No significant differences were found for the WES index or for FBI, regardless of the peri-implant phenotype. CONCLUSIONS: Immediate implant placement in the maxillary anterior sextant was found to be a predictable procedure with good esthetic results when the protocol described was used. Labial bone loss is inevitable after tooth extraction but can be compensated for by filling the space with a xenograft material. Long-term gingival tissue integrity was maintained, regardless of phenotype, in periodontally healthy participants.

3.
Palliat Med Rep ; 3(1): 186-193, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36203712

RESUMEN

Background: Family and meaning-making resources are culturally congruent and help support Latinx coping with cancer. Objectives: To explore Latinx advanced cancer patients' perspectives on the role of family and meaning/purpose in adjustment to advanced cancer. Methods: A qualitative study was conducted. In-depth interviews were performed and transcripts were analyzed using the method from applied thematic analysis. Setting/Subject: Participants were patients with any advanced cancer diagnosis, recruited from Memorial Sloan Kettering Cancer Center (MSKCC), New York; Lincoln Medical Center (LMC), New York; and Ponce Health Science University (PHSU), Puerto Rico. Measurements: Sociodemographic and semistructured interview. Results: N = 24 in-depth interviews were completed by Latinx advanced cancer patients (Stage III and IV). When evaluating patients' perspectives on the role of family and meaning/purpose in adjustment to advanced cancer, the team generated three categories: (1) family support, (2) family communication, and (3) include support for the family. Many patients reported the importance of family as a source of meaning and social support in the process of cancer diagnosis and treatment. They also reported communication as central to process information and planning. Also, participants describe their desire to incorporate family members into therapy and for encouraging them to seek counseling. Conclusions: Results highlight the need to include syntonic cultural values such as family and meaning for Latinx individuals coping with advanced cancer in psychological interventions.

4.
BMJ Open ; 12(4): e045487, 2022 04 04.
Artículo en Inglés | MEDLINE | ID: mdl-35379609

RESUMEN

INTRODUCTION: Literature suggests couple-based interventions that target quality of life and communication can lead to positive outcomes for patients with cancer and their partners. Nevertheless, to date, an intervention to address the needs of Latino families coping with advanced cancer has not been developed. Meta-analytic evidence suggests that culturally adapted evidenced-based intervention targeting a specific cultural group is four times more effective. Our goal is to culturally adapt a novel psychosocial intervention protocol entitled 'Caregivers-Patients Support to Latinx coping advanced-cancer' (CASA). We hypothesised that combine two evidence-based interventions and adapting them, we will sustain a sense of meaning and improving communication as patients approach the end of life among the patient-caregiver dyad. METHODS AND ANALYSIS: To culturally adapt CASA, we will follow an innovative hybrid research framework that combines elements of an efficacy model and best practices from the ecological validity model, adaptation process model and intervention mapping. As a first step, we adapt a novel psychosocial intervention protocol entitled protocol entitled 'Caregivers-Patients Support to Latinx coping advanced-cancer' (CASA). The initial CASA protocol integrates two empirically based interventions, meaning-centred psychotherapy and couple communication skills training. This is an exploratory and prepilot study, and it is not necessary for a size calculation. However, based on recommendations for exploratory studies of this nature, a priori size of 114 is selected. We will receive CASA protocol feedback (phase 1b: refine) by conducting 114 questionnaires and 15 semistructured interviews with patients with advanced cancer and their caregivers. The primary outcomes of this study will be identifying the foundational information needed to further the develop the CASA (phase IIa: proof-of-concept and phase IIb: pilot study). ETHICS AND DISSEMINATION: The Institutional Review Board of Ponce Research Institute approved the study protocol #1907017527A002. Results will be disseminated through peer-reviewed publications.


Asunto(s)
Psicoterapia , Calidad de Vida , Adaptación Psicológica , Hispánicos o Latinos , Humanos , Proyectos Piloto , Psicoterapia/métodos
5.
J Prosthet Dent ; 127(4): 533-537, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33549340

RESUMEN

This clinical report with an 8-year follow-up describes the multidisciplinary management of a patient diagnosed with amelogenesis imperfecta. The rehabilitation included horizontal-guided bone regeneration, implant placement, use of a fixed interim prosthesis to preview the correction of occlusal disharmonies, and placement of a custom screw-retained definitive implant-supported restoration with a design that was retrievable and minimized maintenance problems.


Asunto(s)
Amelogénesis Imperfecta , Implantes Dentales , Amelogénesis Imperfecta/cirugía , Tornillos Óseos , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos
6.
Conscious Cogn ; 83: 102955, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32652511

RESUMEN

We explore the application of a wide range of sensory stimulation technologies to the area of sleep and dream engineering. We begin by emphasizing the causal role of the body in dream generation, and describe a circuitry between the sleeping body and the dreaming mind. We suggest that nearly any sensory stimuli has potential for modulating experience in sleep. Considering other areas that might afford tools for engineering sensory content in simulated worlds, we turn to Virtual Reality (VR). We outline a collection of relevant VR technologies, including devices engineered to stimulate haptic, temperature, vestibular, olfactory, and auditory sensations. We believe these technologies, which have been developed for high mobility and low cost, can be translated to the field of dream engineering. We close by discussing possible future directions in this field and the ethics of a world in which targeted dream direction and sleep manipulation are feasible.


Asunto(s)
Sueños/fisiología , Estimulación Física , Sensación/fisiología , Sueño REM/fisiología , Humanos
7.
Aging Male ; 23(5): 1283-1288, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32410487

RESUMEN

AIM: To investigate if overweight and obesity were associated with a higher degree of biochemical recurrence (BCR) after radical prostatectomy, in Mexican men with prostate cancer (PCa). METHODS: We included 180 men with PCa, who underwent radical prostatectomy (RP). Body mass index (BMI) was determined and the degree of PCa aggressiveness was established according to the D'Amico classification. Postoperative follow-up of all patients was performed with PSA quantification every/6 weeks after surgery and then at 3-month intervals for 1 year, followed every/6 months for 5 years. Postoperative BCR was defined as two consecutive increases in PSA levels ≥0.4 ng/mL, after RP. RESULTS: Sixty eight percent of the patients presented overweight or obesity. We found that only intermediate/high risk patients presented an increased risk factor for BCR-free survival (HR = 4.39; 95% CI = 1.74-11.24; p = 0.002). The median follow-up of all men has been 7.9 years and no significant differences in BCR-free survival time has been observed between the BMI groups. CONCLUSIONS: The overweight and obesity do not represent a risk factor to present BCR after RP for PCa. However, an intermediate/high risk, according to the D'Amico's classification, constitutes a risk factor to present BCR after radical prostatectomy, which is not related to the BMI.


Asunto(s)
Recurrencia Local de Neoplasia , Neoplasias de la Próstata , Humanos , Masculino , Recurrencia Local de Neoplasia/epidemiología , Obesidad/complicaciones , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Antígeno Prostático Específico , Neoplasias de la Próstata/complicaciones , Neoplasias de la Próstata/cirugía , Estudios Retrospectivos , Factores de Riesgo
8.
Front Psychiatry ; 11: 240, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32292361

RESUMEN

Major depression is a prevalent psychiatric disorder among people living with HIV (PWH). Major depression symptoms, including suicidal ideation, can hinder clinical care engagement and anti-retroviral treatment adherence. Research suggests that inquiry about major depression symptomatology and suicidal ideation should be standard practice when offering primary care services to PWH. However, studies examining depression and suicidal ideation inquiry are scarce. This study's aim was to describe medical students' clinical skills for dealing with major depression symptomatology and suicidal ideation among PWH in Puerto Rico. A total of 100 4th year medical students participated in a Standardized Patient simulation with a trained actor posing as a PWH and with a previous major depression diagnosis. One-way frequency tables were used to characterize the sample and the percentage of each observed clinical skill. Two key findings stem from these results only 10% of the participants referred the patient to psychological/psychiatric treatment, and only 32% inquired about suicidal ideation. Our findings highlight the need for enhancing medical students' competencies regarding mental health issues, particularly when providing services to at risk populations such as PWH within primary care settings.

9.
Fam Process ; 58(4): 832-854, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31077610

RESUMEN

This is a longitudinal randomized control trial on the impact of adding a parent psychoeducation intervention (TEPSI) as part of cognitive-behavioral therapy (CBT) for adolescents with Major Depressive Disorder (MDD) in a Puerto Rican sample. We tested the efficacy of adding 8 group sessions of TEPSI to 12 sessions of individual CBT on reducing depressive symptoms, MDD diagnosis, and improving family functioning. Participants (n = 121) were randomized to individual CBT with or without TEPSI. No main group effects were found for most patient domains including depression symptoms, as well as presence of adolescent's MDD diagnosis at posttreatment. Results did show a main effect of CBT over time for depression symptoms, suicide ideation, family criticism, and the presence of MDD diagnosis decreasing from pre- to postintervention. A year post treatment, almost 70% of adolescents in both conditions (CBT and CBT + TEPSI) remained in remission. A main effect was obtained for treatment in the adolescent's perception of familism and family emotional involvement. The primary hypothesis that family psychoeducation would optimize CBT for depression in adolescents was not supported. Both conditions yielded similar clinical end points. The culturally adapted CBT was found effective with Latino/a adolescents showing clinically significant improvements from pretreatment to posttreatment and remained stable at a 1-year follow-up. Regarding family outcomes, adolescents in CBT + TEPSI remained stable from pretreatment to posttreatment on family emotional involvement, while adolescents in CBT-alone showed an increase. The implication of these findings is discussed.


Este es un ensayo clínico longitudinal aleatorizado y controlado sobre el efecto de agregar una intervención psicoeducativa para los padres (TEPSI, en inglés) como parte de la terapia cognitivo-conductual (TCC) para adolescentes con trastorno depresivo mayor (TDM) en una muestra puertorriqueña. Evaluamos la eficacia de agregar 8 sesiones grupales de TEPSI a 12 sesiones de TCC individual en la reducción de síntomas depresivos, en el diagnóstico de TDM y en la mejora del funcionamiento familiar. Los participantes (n = 121) fueron distribuidos al azar a la TCC individual con o sin TEPSI. No se encontraron efectos grupales principales en la mayoría de las áreas de los pacientes, como en los síntomas de depresión ni en la presencia de un diagnóstico de TDM en los adolescentes después del tratamiento. Los resultados sí demostraron un efecto principal de la TCC con el tiempo para los síntomas de depresión, las ideas suicidas, la crítica familiar y la presencia de un diagnóstico de TDM que disminuye desde antes hasta después de la intervención. Un año después del final del tratamiento, casi el 70 % de los adolescentes en ambas condiciones (TCC y TCC + TEPSI) se mantuvo en remisión. Se obtuvo un efecto principal del tratamiento en la percepción de los adolescentes del familismo y la implicación emocional familiar. No se respaldó la hipótesis principal de que la psicoeducación familiar optimizaría la TCC para la depresión en los adolescentes. Ambas condiciones dieron variables clínicas similares. Se descubrió que la TCC culturalmente adaptada fue eficaz con los adolescentes latinos, ya que demostró mejoras clínicas considerables desde antes del tratamiento hasta después del tratamiento y permaneció estable un año después al momento del seguimiento. Con respecto a los resultados familiares, los adolescentes de la TCC + TEPSI se mantuvieron estables desde antes del tratamiento hasta después del tratamiento en la implicación emocional familiar, mientras que los adolescentes de la TCC sola demostraron un aumento. Se debaten las implicancias de estos resultados.


Asunto(s)
Terapia Cognitivo-Conductual/métodos , Trastorno Depresivo Mayor/terapia , Terapia Familiar/métodos , Padres/educación , Educación del Paciente como Asunto/métodos , Adolescente , Adulto , Trastorno Depresivo Mayor/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Padres/psicología , Puerto Rico , Resultado del Tratamiento
10.
Am J Public Health ; 109(S1): S94-S101, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30699023

RESUMEN

Many evidence-based interventions (EBIs) have been developed to prevent or treat major health conditions. However, many EBIs have exhibited limited adoption, reach, and sustainability when implemented in diverse community settings. This limitation is especially pronounced in low-resource settings that serve health disparity populations. Often, practitioners identify problems with existing EBIs originally developed and tested with populations different from their target population and introduce needed adaptations to make the intervention more suitable. Although some EBIs have been extensively adapted for diverse populations and evaluated, most local adaptations to improve fit for health disparity populations are not well documented or evaluated. As a result, empirical evidence is often lacking regarding the potential effectiveness of specific adaptations practitioners may be considering. We advocate an expansion in the emphasis of adaptation research from researcher-led interventions to research that informs practitioner-led adaptations. By presenting a research vision and strategies needed to build this area of science, we aim to inform research that facilitates successful adaptation and equitable implementation and delivery of EBIs that reduce health disparities.


Asunto(s)
Práctica Clínica Basada en la Evidencia , Disparidades en Atención de Salud/etnología , Médicos , Humanos , Salud de las Minorías , Proyectos de Investigación
11.
Int. braz. j. urol ; 44(5): 874-881, Sept.-Oct. 2018. tab
Artículo en Inglés | LILACS | ID: biblio-975640

RESUMEN

ABSTRACT Purpose: To provide data of the incidence and management of common urological malignancies in renal transplant recipients. Materials and Methods: We conducted a retrospective analysis of a prospective database from August 1967 to August 2015. A descriptive analysis of the sample was performed. Results: Among 1256 consecutive RTR a total of 88 patients developed malignancies (7%). There were 18 genitourinary tumors in the 16 patients (20.45 % of all malignant neoplasms), incidence of 1.27%. The most common neoplasm encounter was renal cancer (38.8%), followed by urothelial carcinoma (33.3%). Median follow-up of transplantation was 197 months (R, 36-336). Mean time from RT to cancer diagnosis 89±70 months (R, 12-276). CsA and AZA was the most common immunosuppression regimen in 68.75%. Mean follow-up after diagnosis was 103±72 months (R 10-215). Recurrence free survival rate of 100%. Overall survival of 89.5% of the sample; there were two non-related cancer deaths during follow-up. Conclusions: The incidence of neoplasms in RTR was lower than in other series, with favorable functional and oncologic results after treatment. This suggests that actions to reduce the risk of these malignancies as well as a strict follow-up are mandatory for an early detection and treatment.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Anciano , Adulto Joven , Trasplante de Riñón/efectos adversos , Neoplasias Urogenitales/terapia , Neoplasias Urogenitales/epidemiología , Incidencia , Estudios Prospectivos , Estudios Retrospectivos , Trasplante de Riñón/estadística & datos numéricos , México/epidemiología , Persona de Mediana Edad
12.
J Clin Psychol ; 74(11): 1907-1923, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30091201

RESUMEN

Mental health treatments can be more effective when they align with the culture of the client and when therapists demonstrate multicultural competence. We summarize relevant research findings in two meta-analyses. In the meta-analysis examining culturally adapted interventions, the average effect size across 99 studies was d = 0.50 (0.35 after accounting for publication bias). In the second meta-analysis on 15 studies of therapist cultural competence, the results differed by rating source: Client-rated measures of therapist cultural competence correlated strongly (r = 0.38) with treatment outcomes but therapists' self-rated competency did not (r = 0.06). We describe patient considerations and research limitations. We conclude with research supported therapeutic practices that help clients benefit from modifications to treatment related to culture.


Asunto(s)
Competencia Cultural/psicología , Diversidad Cultural , Psicoterapia/métodos , Humanos , Relaciones Profesional-Paciente , Investigación , Resultado del Tratamiento
13.
Int Braz J Urol ; 44(5): 874-881, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29757570

RESUMEN

PURPOSE: To provide data of the incidence and management of common urological malignancies in renal transplant recipients. MATERIALS AND METHODS: We conducted a retrospective analysis of a prospective database from August 1967 to August 2015. A descriptive analysis of the sample was performed. RESULTS: Among 1256 consecutive RTR a total of 88 patients developed malignancies (7%). There were 18 genitourinary tumors in the 16 patients (20.45% of all malignant neoplasms), incidence of 1.27%. The most common neoplasm encounter was renal cancer (38.8%), followed by urothelial carcinoma (33.3%). Median follow up of transplantation was 197 months (R, 36-336). Mean time from RT to cancer diagnosis 89±70 months (R, 12-276). CsA and AZA was the most common immunosuppression regimen in 68.75%. Mean follow-up after diagnosis was 103±72 months (R 10-215). Recurrence free survival rate of 100%. Overall survival of 89.5% of the sample; there were two non-related cancer deaths during follow up. CONCLUSIONS: The incidence of neoplasms in RTR was lower than in other series, with favorable functional and oncologic results after treatment. This suggests that actions to reduce the risk of these malignancies as well as a strict follow-up are mandatory for an early detection and treatment.


Asunto(s)
Trasplante de Riñón/efectos adversos , Neoplasias Urogenitales/epidemiología , Neoplasias Urogenitales/terapia , Adolescente , Adulto , Anciano , Femenino , Humanos , Incidencia , Trasplante de Riñón/estadística & datos numéricos , Masculino , México/epidemiología , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos , Adulto Joven
14.
Rev. colomb. ciencias quim. farm ; 47(1): 86-104, ene.-abr. 2018. tab, graf
Artículo en Español | LILACS | ID: biblio-959999

RESUMEN

RESUMEN Justificación. El dolor tiene alta prevalencia en la población general, siendo mayor en pacientes hospitalizados, con cifras cercanas al 80%. El control del dolor no siempre es adecuado debido a varios factores, siendo uno de los más importantes, el escaso conocimiento en el manejo de los analgésicos. Como una de las primeras medidas de mejoramiento asistencial para reducir el dolor en un hospital, debe conocerse la prevalencia de este síntoma y, asimismo, debe analizarse el abordaje terapéutico realizado. Por este motivo este estudio tuvo como objetivo analizar el uso de analgésicos en pacientes de un hospital de cuarto nivel en Bogotá, Colombia, identificar los analgésicos más utilizados, el rango de dosis, las posibles interacciones y reacciones adversas a medicamentos (RAM) existentes. Resultados. El 78,9% de los pacientes hospitalizados presentaban dolor. Se prescribió analgésicos en 561 pacientes hospitalizados. Los más utilizados fueron: acetaminofén (33,3%) y tramadol (29,7%). El rango de duración de la terapia analgésica más común fue de 1 a 5 días (81,7%). Se identificaron 37 casos de sobredosificación y tres de terapia duplicada. Se presentaron 28 casos de reacciones adversas a medicamento (RAM). Discusión. El adecuado tratamiento del dolor cobra vital importancia al evaluar la satisfacción del paciente. Se encuentran diferentes tendencias de uso de analgésicos en pacientes hospitalizados, siendo los más utilizados el acetaminofén y los antiinflamatorios no esteroidéos (AINE). Se debe seguir investigando en este tema, para tener mayor evidencia que permita generar lineamientos para un adecuado alivio del dolor.


Summary Justification. Pain has a high prevalence in the general population, being higher in inpatient, with figures close to 80%. Pain management is not always suitable due to several factors, one of the most important the lack of knowledge in the management of analgesics. One of the first measures of improving care to reduce pain in a hospital should be determine the prevalence of this symptom and analyze the therapeutic approach performed. That is why the aim of this study was to analyze the use of analgesics in patients of a fourth-level hospital in Bogotá, Colombia, identify the most commonly used analgesics, range of doses, possible interactions and adverse drugs reactions. Results. The 78.9% of the patients were pain. Analgesics were prescribed in 561 hospitalized patients. The most used were acetaminophen (33.3%) and tramadol (29.7%). The most common range of duration of analgesic therapy was 1-5 days (81.7%). 37 cases of overdosing and 3 cases of duplicate therapy were identified. 28 cases of adverse drug reactions (ADRs) were presented. Discussion. Proper treatment of pain plays a vital role in assessing patient satisfaction. There are different trends analgesic use in inpatient, being the most used acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). It should further investigate on this issue to have stronger scientific evidence to dictate a universal application guidelines for proper pain relief.

15.
Community Ment Health J ; 54(6): 707-716, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29127563

RESUMEN

Latinos with bipolar disorder (BD) have a high rate of nonadherence to psychiatric medication and treatment for other medical conditions such as cardiovascular disease (CVD) risk factors than non-Latinos with BD. The aim of this study is to identify patients' perspectives on the reasons for nonadherence to psychiatric medication and for CVD risk factors conditions in outpatients with BD. Three focus group sessions were held for a total of 22 adults ranging from 23 to 60 years old. Participants had BD, Type I/II and CVD risk factors. Audio-recordings of focus groups were transcribed and a content analysis was performed. Reasons identified as barriers to adherence were somewhat different for BD medications in comparison to CVD risk factors suggesting the need for integrated interventions targeting these barriers to adherence for both BD and CVD risk factors.


Asunto(s)
Antipsicóticos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Trastorno Bipolar/psicología , Conocimientos, Actitudes y Práctica en Salud , Cumplimiento de la Medicación/psicología , Adulto , Índice de Masa Corporal , Enfermedades Cardiovasculares , Femenino , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud/etnología , Humanos , Masculino , Persona de Mediana Edad , Relaciones Profesional-Paciente , Puerto Rico , Investigación Cualitativa , Factores de Riesgo , Estereotipo , Adulto Joven
16.
Prev Sci ; 18(6): 681-688, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28573426

RESUMEN

Mayor advancements have been achieved in research on the cultural adaptation of prevention and treatment interventions that are conducted with diverse ethnocultural groups. This commentary addresses conceptual, ethical, contextual, and methodological issues related to cultural adaptations. The articles in this special issue represent a major contribution to the study of cultural adaptations in prevention science. We frame our analysis of fidelity to core intervention components using a conceptual approach that examines (a) the propositional model (theory of change), (b) the procedural model (theory of action, methods), and (c) the philosophical assumptions that undergird these models. Regarding ethics, we caution against imposing the norms, values, and world views of the Western dominant society onto vulnerable populations such as ethnocultural groups. Given that the assumption of universality in behavioral science has been questioned, and as randomized clinical trials (RCTs) seldom examine the ecological validity of evidence-based interventions and treatments (EBI/T), imposing such interventions onto ethnocultural groups is problematic since these interventions contain values, norms, beliefs, and worldviews that may be contrary to those held by many ethnocultural groups. Regarding methods, several innovative designs are discussed that serve as alternatives to the RCT and represent an important contribution to prevention science. Also, we discuss guidelines for conducting cultural adaptations. Finally, the articles in this special issue make a major contribution to the growing field of cultural adaptation of preventive interventions with ethnocultural groups and majority-world populations.


Asunto(s)
Adaptación Psicológica , Diversidad Cultural , Ética , Humanos
17.
Cancer Biomark ; 19(3): 297-303, 2017 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-28453464

RESUMEN

BACKGROUND: Obesity constitutes a risk factor for the development of aggressive forms of prostate cancer. It has been proposed, that prostate cancer has a genetic predisposition and that PPARGC1A and ADIPOQ polymorphisms play a role in the development of this condition. OBJECTIVE: To analyse the association of two PPARGC1A and ADIPOQ polymorphisms as well as their haplotypes, with the development of aggressive prostate cancer in Mexican-Mestizo men with overweight or obesity. SUBJECTS AND METHODS: Two hundred fifty seven men with prostate cancer of Mexican-Mestizo origin were included. Body mass index (BMI) was determined and the degree of prostate cancer aggressiveness by the D'Amico classification. DNA was obtained. Rs7665116 and rs2970870 of PPARGC1A, and rs266729 and rs1501299 of ADIPOQ were studied by real-time PCR allelic discrimination. Pairwise linkage disequilibrium, between single nucleotide polymorphisms was calculated and haplotype analysis was performed. RESULTS: A higher-risk (D'Amico classification) was observed in 21.8% of patients. An association of cancer aggressiveness with rs2970870 of PPARGC1A, and rs501299 of ADIPOQ, as well as with one haplotype of ADIPOQ was documented. CONCLUSIONS: This is the first study regarding the relationship of PPARGC1A and ADIPOQ polymorphisms, and the aggressiveness of prostate cancer in men with overweight or obesity.


Asunto(s)
Adiponectina/genética , Obesidad/genética , Sobrepeso/genética , Coactivador 1-alfa del Receptor Activado por Proliferadores de Peroxisomas gamma/genética , Neoplasias de la Próstata/genética , Estudios Transversales , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Humanos , Masculino , México , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/etnología , Sobrepeso/complicaciones , Sobrepeso/etnología , Polimorfismo de Nucleótido Simple , Neoplasias de la Próstata/etnología , Neoplasias de la Próstata/patología , Estudios Retrospectivos , Factores de Riesgo
18.
J Consult Clin Psychol ; 85(1): 58-71, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28045288

RESUMEN

OBJECTIVE: There is a dearth of empirical studies aimed at examining the impact of differential cultural adaptation of evidence-based clinical and prevention interventions. This prevention study consisted of a randomized controlled trial aimed at comparing the impact of 2 differentially culturally adapted versions of the evidence-based parenting intervention known as Parent Management Training, the Oregon Model (PMTOR). METHOD: The sample consisted of 103 Latina/o immigrant families (190 individual parents). Each family was allocated to 1 of 3 conditions: (a) a culturally adapted PMTO (CA), (b) culturally adapted and enhanced PMTO (CE), and (c) a wait-list control. Measurements were implemented at baseline (T1), treatment completion (T2) and 6-month follow up (T3). RESULTS: Multilevel growth modeling analyses indicated statistically significant improvements on parenting skills for fathers and mothers (main effect) at 6-month follow-up in both adapted interventions, when compared with the control condition. With regard to parent-reported child behaviors, child internalizing behaviors were significantly lower for both parents in the CE intervention (main effect), compared with control at 6-month follow-up. No main effect was found for child externalizing behaviors. However, a Parent × Condition effect was found indicating a significant reduction of child externalizing behaviors for CE fathers compared with CA and control fathers at posttest and 6-month follow-up. CONCLUSION: Present findings indicate the value of differential cultural adaptation research designs and the importance of examining effects for both mothers and fathers, particularly when culturally focused and gender variables are considered for intervention design and implementation. (PsycINFO Database Record


Asunto(s)
Asistencia Sanitaria Culturalmente Competente/métodos , Educación no Profesional/métodos , Emigrantes e Inmigrantes/psicología , Hispánicos o Latinos/psicología , Responsabilidad Parental/etnología , Adulto , Femenino , Humanos , Masculino
19.
Urol Oncol ; 35(3): 111.e9-111.e14, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-27843028

RESUMEN

BACKGROUND: Mitochondrial dysfunction has been associated with the development of cancer and obesity, being prostate cancer more aggressive in obese men. It has been suggested that the mitochondrial transcription factor A (TFAM) plays a central role in these events. OBJECTIVE: The aim of this study was to analyze the possible association of 3 TFAM polymorphisms, as well as their haplotypes, with the development of aggressive prostate cancer in overweight or obese Mexican Mestizo men. SUBJECTS AND METHODS: A total of 257 unrelated men with histologically confirmed prostate cancer, of Mexican Mestizo ethnic origin, were included. Body mass index was determined and the degree of prostate cancer aggressiveness was demarcated by the D'Amico classification. DNA was obtained from blood leukocytes. The rs1937, rs1049432, and rs11006132, as well as their haplotypes, were studied by real-time polymerase chain reaction allelic discrimination. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated; haplotype analysis was performed. RESULTS: A higher risk (D'Amico classification) was documented in 56 patients (21.8%). We did not find a significant association among those polymorphisms analyzed; however, one haplotype was significantly associated with cancer aggressiveness. CONCLUSIONS: To our knowledge, this constitutes the first study regarding the relationship of 3 TFAM polymorphisms, as well as their haplotypes, and the aggressiveness of prostate cancer in overweight or obese men; the most frequent haplotype was associated with cancer aggressiveness.


Asunto(s)
Adenocarcinoma/genética , Adenocarcinoma/patología , Proteínas de Unión al ADN/genética , Haplotipos , Proteínas Mitocondriales/genética , Sobrepeso/genética , Neoplasias de la Próstata/genética , Neoplasias de la Próstata/patología , Factores de Transcripción/genética , Adenocarcinoma/sangre , Anciano , Alelos , Índice de Masa Corporal , Estudios Transversales , ADN/aislamiento & purificación , Frecuencia de los Genes , Humanos , Calicreínas/sangre , Leucocitos , Desequilibrio de Ligamiento , Masculino , México , Persona de Mediana Edad , Mitocondrias/patología , Clasificación del Tumor , Estadificación de Neoplasias , Sobrepeso/sangre , Polimorfismo de Nucleótido Simple , Próstata/patología , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/sangre , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Factores de Riesgo , Análisis de Secuencia de ADN
20.
Aging Male ; 19(3): 187-191, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27187822

RESUMEN

Mitochondrial defects have been related to obesity and prostate cancer. We investigated if Mexican-Mestizo men presenting this type of cancer, exhibited somatic mutations of ATP6 and/or ND3.Body mass index (BMI) was determined; the degree of prostate cancer aggressiveness was demarcated by the Gleason score. DNA from tumor tissue and from blood leukocytes was amplified by the polymerase chain reaction and ATP6 and ND3 were sequenced. We included 77 men: 20 had normal BMI, 38 were overweight and 19 had obesity; ages ranged from 52 to 83. After sequencing ATP6 and ND3, from DNA obtained from leukocytes and tumor tissue, we did not find any somatic mutations. All changes observed, in both genes, were polymorphisms. In ATP6 we identified, in six patients, two non-synonymous nucleotide changes and in ND3 we observed that twelve patients presented non-synonymous polymorphisms. To our knowledge, this constitutes the first report where the complete sequences of the ATP6 and ND3 have been analyzed in Mexican-Mestizo men with prostate cancer and diverse BMI. Our results differ with those reported in Caucasian populations, possibly due to ethnic differences.


Asunto(s)
Complejo I de Transporte de Electrón/fisiología , ATPasas de Translocación de Protón Mitocondriales/fisiología , Obesidad/genética , Sobrepeso/genética , Polimorfismo Genético , Neoplasias de la Próstata/genética , Anciano , Anciano de 80 o más Años , Complejo I de Transporte de Electrón/genética , Humanos , Masculino , México , Persona de Mediana Edad , ATPasas de Translocación de Protón Mitocondriales/genética , Metástasis de la Neoplasia/genética , Obesidad/complicaciones , Sobrepeso/complicaciones , Neoplasias de la Próstata/complicaciones , Neoplasias de la Próstata/patología
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