The Nature of Employment in a High Socio-economic Hardship Community: Data from the Greater Lawndale Healthy Work Survey.

OBJECTIVES: This cross-sectional survey aimed to examine employment characteristics and their associations with employment precarity in two high socio-economic hardship Chicago neighborhoods. METHODS: We used a community-based participatory approach to develop and administer a survey to residents who perceived their work situations to be precarious. RESULTS: 489 residents were surveyed. Responses were skewed towards the most precarious work situations, with the majority of respondents employed outside of a traditional arrangement. Those in the highest precarity category were most likely to identify as Latinx and born outside of the United States. Unstable, low quality employment conditions were nearly all significantly associated with highest precarity work situations. CONCLUSIONS: Precarious employment is an important predictor of other employment conditions, and characterizing these at a hyperlocal level allows for a nuanced understanding of work as a determinant of health.

Percutaneous transient occlusion of the transtricuspid flow: a new method to evaluate the right ventricle-dependent coronary circulation in pulmonary atresia with intact ventricular septum.

Pulmonary atresia with an intact ventricular septum is characterised by heterogeneity in right ventricle morphology and coronary anatomy. In some cases, the presence of ventriculocoronary connections may promote coronary artery stenosis or interruption, and aortic diastolic pressure may not be sufficient to drive coronary blood flow. This requires a correct evaluation (currently done by angiography) which depends on whether the patient can be offered decompression of the right ventricle. To date, there is no objective method to do so, so we designed a percutaneous, transitory technique with the purpose of occluding the transtricuspid anterograde flow. The manoeuverer was performed in a 25-day-old female with pulmonary atresia with intact ventricular septum, right ventricle at suprasystemic level, and selective coronarography was not conclusive, the anterior descendant with stenosis in its middle third and from this point, thinner with to-fro flow. Occlusion was performed with a balloon catheter. We re-evaluated the coronary flow and the normalised anterior descendant flow. We hope that with this new method, we can give a more accurate diagnosis and determine the cases in which the coronary circulation is truly not right ventricle dependent to offer a greater number of patients biventricular or 1.5 ventricular repairs and thereby improve their quality of life and survival, the ones that turn out to be right ventricular dependant; offer them an early reference for cardiac transplant or in case it is not available to consider univentricular palliation knowing that this probably would not reduce the risk of ischaemia and/or death over time.

Transcatheter resolution of an aneurism of the pulmonary trunk with residual ductus arteriosus after thoracoscopic clipping: a new approach.

Patent ductus arteriosus is the most common cardiac anomaly in our country. In the last few decades, there has been a lot of interest in developing less invasive techniques like video-assisted thoracoscopic clipping; nevertheless, this also has some complications. We present an 8-year-old female, which had been treated with video-assisted thoracoscopic clipping of patent ductus arteriosus. Five years later, she presented with a large aneurysm of the ductus arteriosus extending to the pulmonary trunk and a residual patent ductus arteriosus. A Cardia ASD occluder of 24 mm was placed in the aneurysm, and the residual ductus arteriosus was then closed with an Amplatzer Plug vascular II device of 10 mm, with a good outcome. The development of an aneurysm after video-assisted patent ductus arteriosus closure is apparently a non-reported complication; therefore, there are also no reports for its treatment. That is why we present this case as an option for its resolution.

Community Resident Perceptions of and Experiences with Precarious Work at the Neighborhood Level: The Greater Lawndale Healthy Work Project.

Work is a key social determinant of health. Community health and well-being may be impacted in neighborhoods with high proportions of people engaged in precarious work situations compounded by health inequities produced by other social determinants associated with their residential geography. However, little is known about how community residents experience work at the neighborhood level nor how work impacts health at the community-level, particularly in communities with a high proportion of residents engaged in precarious work. We sought to understand, through participatory research strategies, how work is experienced at the community level and to identify community interventions to establish a culture of healthy work. As part of a mixed-methods community health assessment, community researchers conducted focus groups with residents in two high social and economic hardship neighborhoods on Chicago's southwest side. Community and academic researchers engaged in participatory data analysis and developed and implemented member-checking modules to engage residents in the data interpretation process. Twelve focus group discussions (77 community resident participants) were completed. Three major themes emerged: systematic marginalization from the pathways to healthy work situations; contextual and structural hostility to sustain healthy work; and violations in the rights, agency, and autonomy of resident workers. Findings were triangulated with findings from the concept-mapping research component of the project to inform the development of a community health survey focused on work characteristics and experiences. Listening to residents in communities with a high proportion of residents engaging in precarious work allows for the identification of nuanced community-informed intervention points to begin to build a culture of healthy work.

Cafecitos Supporting Nurses in the Time of COVID-19: A Commentary From the NAHN-Westchester and NAHN-New York Chapters.

Nurses have been called superheroes during this pandemic because of our compassion for our patients, but we need compassion, too. Through this state of emergency, quarantine, and isolation, the Cafecitos in the virtual world let us navigate this shared experience together.

Referential Choices in a Collaborative Storytelling Task: Discourse Stages and Referential Complexity Matter.

During a narrative discourse, accessibility of the referents is rarely fixed once and for all. Rather, each referent varies in accessibility as the discourse unfolds, depending on the presence and prominence of the other referents. This leads the speaker to use various referential expressions to refer to the main protagonists of the story at different moments in the narrative. This study relies on a new, collaborative storytelling in sequence task designed to assess how speakers adjust their referential choices when they refer to different characters at specific discourse stages corresponding to the introduction, maintaining, or shift of the character in focus, in increasingly complex referential contexts. Referential complexity of the stories was manipulated through variations in the number of characters (1 vs. 2) and, for stories in which there were two characters, in their ambiguity in gender (different vs. same gender). Data were coded for the type of reference markers as well as the type of reference content (i.e., the extent of the information provided in the referential expression). Results showed that, beyond the expected effects of discourse stages on reference markers (more indefinite markers at the introduction stage, more pronouns at the maintaining stage, and more definite markers at the shift stage), the number of characters and their ambiguity in gender also modulated speakers' referential choices at specific discourse stages, For the maintaining stage, an effect of the number of characters was observed for the use of pronouns and of definite markers, with more pronouns when there was a single character, sometimes replaced by definite expressions when two characters were present in the story. For the shift stage, an effect of gender ambiguity was specifically noted for the reference content with more specific information provided in the referential expression when there was referential ambiguity. Reference content is an aspect of referential marking that is rarely addressed in a narrative context, yet it revealed a quite flexible referential behavior by the speakers.

Reducing Adverse Polypharmacy in Patients With Borderline Personality Disorder: An Empirical Case Study.

OBJECTIVE: Polypharmacy is common and especially challenging in the context of borderline personality disorder in light of impulsivity and self-harm associated with the disorder, risk of adverse drug-drug interactions, and financial burden. Reduction in polypharmacy could be conceptualized as a high priority in the treatment of borderline personality disorder. This case aims to demonstrate that potential. METHOD: This case report presents outcomes data for an individual with borderline personality disorder during the course of an extended psychiatric hospitalization. Symptomatic change is based on the Patient Health Questionnaire Somatic, Anxiety, and Depression Symptoms scales and World Health Organization 5-Item Well-Being Index. Change in polypharmacy is presented both in terms of absolute number and complexity of the medication regimen. Clinical outcomes data are provided at 2, 12, and 24 weeks postdischarge. RESULTS: During a 56-day hospitalization, the patient demonstrated clinical improvement across clinical domains-all occurred within the context of reduced number (43%) and complexity (40%) of her medication regimen. Symptomatic improvement was sustained up to 6 months postdischarge. CONCLUSIONS: Despite good intentions, polypharmacy can be associated with iatrogenic harm and contribute to functional impairment, especially in the context of borderline personality disorder, in which symptomatic fluctuations are part of the illness itself. A reduction in the patient's high-risk polypharmacy during treatment represents a noteworthy treatment outcome in and of itself. Additional measures of medication risk and liability have the potential to become markers of clinical effectiveness.

Evaluación fitoquímica de 3 especies de Erythroxylum / Phytochemical evaluation of 3 species of Erythroxylum

Se seleccionó al género Erythroxylum como uno de los más promisorios para estudios de procesos antivirales. Las especies de este género fueron colectadas en diferentes épocas de los años 2000 y 2001 en varias localidades de la provincia de Pinar del Río, Cuba. Se estudió la composición fitoquímica de las hojas y extractos de las especies Erythroxylum confusum Britt, Erythroxylum alaternifolium var. alaternifolium y Erythroxylum minutifolium Griseb var. minutifolium, estos 2 últimos endémicos de Cuba. Tanto para las hojas como para los extractos, se encontró correspondencia en la composición de metabolitos presentes: flavonoides, alcaloides, triterpenos y/o esteroides y fenoles y/o taninos, entre las especies tamizadas y lo informado en la literatura para el género

Evaluación fitoquímica de 3 especies de Erythroxylum / Phytochemical evaluation of 3 species of Erythroxylum

Se seleccionó al género Erythroxylum como uno de los más promisorios para estudios de procesos antivirales. Las especies de este género fueron colectadas en diferentes épocas de los años 2000 y 2001 en varias localidades de la provincia de Pinar del Río, Cuba. Se estudió la composición fitoquímica de las hojas y extractos de las especies Erythroxylum confusum Britt, Erythroxylum alaternifolium var. alaternifolium y Erythroxylum minutifolium Griseb var. minutifolium, estos 2 últimos endémicos de Cuba. Tanto para las hojas como para los extractos, se encontró correspondencia en la composición de metabolitos presentes: flavonoides, alcaloides, triterpenos y/o esteroides y fenoles y/o taninos, entre las especies tamizadas y lo informado en la literatura para el género(AU)

Antioxidative constituents from the leaves of Hypericum styphelioides.

Two new compounds have been isolated from the leaves of Hypericum styphelioides. Their structures have been established on the basis of mass spectrometry and 2D NMR techniques as 1,3,5-trihydroxy-2-(2',2'-dimethyl-4'-isopropenyl)cyclopentanylxanthone (1) and 3,5-dihydroxybenzophenon-4-beta-d-glucoside (2). Known compounds 5-O-demethylpaxanthonin (3) and 3-geranyl-1-(3-methylbutanoyl)phloroglucinol (4) were also isolated and characterized. Compounds 1-4 were evaluated for their antioxidative properties in Trolox equivalent antioxidant activity (TEAC) and chemiluminescence (CL) assays.

Identificación fitoquímica de las hojas y ramas de la Helietta cubensis Monach-Moldenke, especie endémica de Cuba / Phytochemical identification of the leaves and branches of Helietta cubensis Monach-Moldenke, an endemic species from Cuba

Se describe el tamizaje fitoquímico preliminar de las hojas y ramas de la Helietta cubensis Monach -Moldenke, especie endémica cubana que crece en la cima de los mogotes de Pinar del Río. La detección de los metabolitos secundarios se realizó mediante reactivos de identificación específicos para cada familia de compuestos. En ambas partes de la especie se identificaron en alta abundancia flavonoides y lactonas/coumarinas; en baja concentración se detectaron triterpenos/esteroides, lípidos/aceites esenciales, saponinas y carotenos y no la presencia de aminas y alcaloides. Mediante el análisis por cromatografía de capa fina se pudo corroborar los resultados obtenidos en la identificación de alcaloides, flavonoides y coumarinas. En general, los resultados obtenidos fueron homogéneos para ambas partes de la planta, y constituyen el primer reporte de la composición química para esta especie

Identificación fitoquímica de las hojas y ramas de la Helietta cubensis Monach-Moldenke, especie endémica de Cuba / Phytochemical identification of the leaves and branches of Helietta cubensis Monach-Moldenke, an endemic species from Cuba

Se describe el tamizaje fitoquímico preliminar de las hojas y ramas de la Helietta cubensis Monach -Moldenke, especie endémica cubana que crece en la cima de los mogotes de Pinar del Río. La detección de los metabolitos secundarios se realizó mediante reactivos de identificación específicos para cada familia de compuestos. En ambas partes de la especie se identificaron en alta abundancia flavonoides y lactonas/coumarinas; en baja concentración se detectaron triterpenos/esteroides, lípidos/aceites esenciales, saponinas y carotenos y no la presencia de aminas y alcaloides. Mediante el análisis por cromatografía de capa fina se pudo corroborar los resultados obtenidos en la identificación de alcaloides, flavonoides y coumarinas. En general, los resultados obtenidos fueron homogéneos para ambas partes de la planta, y constituyen el primer reporte de la composición química para esta especie(AU)