Best Nursing Practice: Safe and Inclusive Healthcare Environments for Transgender People: A Systematic Review.

(1) Background: The aim of this study was to review the scope of the existing scientific literature on creating safe and inclusive healthcare environments for transgender people and provide an overview of the resources and nursing skills required to do so. (2) Methods: With the research question in mind, an exploratory search of six databases was conducted to identify all relevant primary studies. After screening and selection of articles based on the inclusion and exclusion criteria, a total of 41 articles were included and reviewed. (3) Results: The results were classified under four headings: the training of health professionals, the creation of safe spaces, the nurse as facilitator, and best care practice. Most of the evidence indicates that it is essential for nurses and other healthcare staff to be trained in specific skills to provide comprehensive, high-quality care to transgender people; however, there is a lack of material and human resources to do so. (4) Conclusions: The trans-inclusive care competent nurse should use neutral language that respects the person's preferred name and pronouns in a safe healthcare environment that offers and ensures warmth, respect, and inclusivity in the care provided. This study was registered with the Open Science Framework (OSF) on 9 January 2024 (osf.io/rpj6a).

Trial design of the MOTheR HDx study: a multicenter, open-label, prospective, randomized study to explore the morbidity and mortality in patients dialyzed with the Theranova HDx in comparison with online hemodiafiltration.

Background: Dialysis patients have been maintaining a high rate of cardiovascular morbidity and mortality. For this reason, it is to introduce necessary new technical advances in clinical practice. There is a relation between toxins retention and inflammation, mortality and morbidity. Medium cut-off (MCO) membranes are a new generation of membranes that allow the removal of a greater number of medium-sized molecules compared with high-flux hemodialysis (HF-HD), but retaining albumin. MCO membranes have an increased permeability and the presence of internal filtration. Because of these special properties, MCO generated a new concept of therapy called expanded HD (HDx). Until now, online hemodiafiltration (OL-HDF) has demonstrated its superiority, in terms of survival, compared with HF-HD. However, the comparison between OL-HDF and HDx remains an unsolved question. Methods: The MOTheR HDx study trial (NCT03714386) is an open-label, multicenter, prospective, 1:1 randomized, parallel-group trial designed to evaluate the efficacy and safety of HDx compared with OL-HDF in patients treated for dialysis in Spain for up to 36 months. The main endpoint is to determinate whether HDx is non inferior to OL-HDF at reducing the combined outcome of all-cause death and stroke (ischemic or hemorrhagic), acute coronary syndrome (angina and myocardial infarction), peripheral arterial disease (amputation or revascularization) and ischemic colitis (mesenteric thrombosis). Results: The trial has already started.

The STOP Program: a Hybrid Smoking Prevention and Cessation Training for Cancer Care Providers in Colombia and Peru.

We designed and tested the feasibility of the Smoking Cessation Training Program for Oncology Practice (STOP), a hybrid (face-to-face plus web-based) educational intervention to enhance Spanish-speaking cancer care professionals' (CCPs') ability to provide brief smoking prevention and cessation counseling to cancer patients and survivors. Changes in the CCPs' competencies (knowledge, attitude, self-efficacy, and practices toward smoking and smoking cessation services) were assessed post-training. Sixty CCPs from one major cancer center in Colombia (n = 30) and Peru (n = 30) were invited to participate in a 4-module hybrid training program on smoking prevention and cessation. Demographic and pre- and post-test evaluation data were collected. The training's acceptability was measured after each module. Bivariate analysis was conducted using Wilcoxon signed-rank test to compare the CCPs' competencies before and after the delivery of the STOP Program. Effect sizes were computed over time to assess the sustainability of the acquired competencies. Twenty-nine CCPs in Colombia and 24 CCPs in Peru completed the STOP Program (96.6% and 80.0% retention rates, respectively). In both countries, 98.2% of the CCPs reported that the overall structure and organization of the program provided an excellent learning experience. The pre-post-test evaluations indicated that the CCPs significantly improved their knowledge, attitude, self-efficacy, and practices toward smoking, smoking prevention, and cessation services. We found that the CCPs' self-efficacy and practices increased over time (1-, 3-, and 6-month assessments after completing the 4 educational modules). The STOP Program was effective and well-received, demonstrating remarkable changes in CCPs' competencies in providing smoking prevention and cessation services to cancer patients.

Case report: Multisystem inflammatory syndrome in children associated with COVID-19, macrophage activation syndrome, and incomplete Kawasaki disease.

Background: Multisystem inflammatory syndrome in children (MIS-C), is a severe complication of coronavirus disease 2019 (COVID-19), characterized by persistent fever, systemic inflammatory response, and organ failure. MIS-C with a history of COVID-19 may share clinical features with other well-defined syndromes such as macrophage activation syndrome, Kawasaki disease, hemophagocytic syndrome and toxic shock syndrome. Case 1: An 11-year-old male with a history of hypothyroidism and precocious puberty with positive antibody test for COVID-19 was admitted for fever, poor general condition, severe respiratory distress, refractory shock, and multiple organ failure. His laboratory examination showed elevated inflammatory parameters, and bone marrow aspirate showed hemophagocytosis. Case 2: A 13-year-old male with a history of attention deficit hyperactivity disorder and cognitive delay presented clinical manifestations of Kawasaki disease, fever, conjunctival congestion, exanthema, and hyperemia in oral mucosa, tongue, and genitals, with refractory shock and multiple organ failure. Reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies for COVID-19 were negative, inflammation parameters were elevated, and bone marrow aspirate showed hemophagocytosis. Patients required intensive care with invasive mechanical ventilation, vasopressor support, intravenous gamma globulin, systemic corticosteroids, low molecular weight heparin, antibiotics, and monoclonal antibodies and, patient 2 required renal replacement therapy. Conclusions: Multisystemic inflammatory syndrome in children can have atypical manifestations, and identifying them early is very important for the timely treatment and prognosis of patients.

[Benefits of early social transition in transgender minors. Family perspectives: qualitative study.] / Beneficios de la transición social temprana en menores transgénero. Perspectivas de familias: estudio cualitativo.

OBJECTIVE: The term trans brings together all transgender identities. The early social transition towards the affirmed gender has benefits in the child's development. For families, transit is a period of great uncertainty, requiring support aimed at families of trans minors. The aim of this paper was to explore the needs and experiencies of parents and close-relatives who supported the social transition of their children. METHODS: We worked with focus groups of functional families of transgender minors who had begun the transition (n=14), with a medium-high educational level and who belonged to urban areas of Tenerife. Through a semi-structured interview, they commented on their experiences in the process of supporting the social transition of their children. The data was recorded in a video recording and processed through content analysis and categorization. RESULTS: Early social transition had positive and immediate benefits on child development as well as in the reduction of anxiety. There was a general improvement in mood, self-esteem, and social and family relationships. The accompaniment of specialists and associations helped in the different social situations and favoured resilience. CONCLUSIONS: Early social transition is positive in the personal and socio-family sphere of the minor. To improve their resilience, families demand accompaniment in this process, as well as meeting other trans people who serve as transpositive references. In addition, they point out the need for specific training in health professionals.

OBJETIVO: El término trans aglutina a todas las identidades transgénero. La transición social temprana hacia el género sentido tiene beneficios en el desarrollo del menor. Para las familias, el tránsito es un periodo de grandes incertidumbres, siendo necesario el acompañamiento dirigido a las familias de menores trans. El objetivo del artículo fue explorar, desde una perspectiva paterna y familiar, las necesidades y experiencias sobre el tránsito de menores trans que sirvieran de referente a otros padres/madres que apoyan el tránsito social de sus hijos e hijas. METODOS: Se trabajó con grupos focales de familias funcionales de menores transgénero que habían iniciado la transición (n=14), de nivel educativo medio-alto y que pertenecían a zonas urbanas de Tenerife. Mediante entrevista semiestructurada, comentaron sus experiencias en el proceso de dar soporte al tránsito social de sus hijos e hijas. Los datos fueron registrados en una videograbación y se procesaron mediante análisis de contenido y categorización. RESULTADOS: La transición social temprana tuvo beneficios positivos e inmediatos en el desarrollo del menor, además de en la disminución de la ansiedad. Hubo una mejora general en el humor, la autoestima y las relaciones tanto sociales como familiares. El acompañamiento de especialistas y asociaciones ayudó en las distintas situaciones sociales y favoreció la resiliencia. CONCLUSIONES: El tránsito social temprano es positivo en la esfera personal y sociofamiliar del menor. Para mejorar su resiliencia, las familias demandan acompañamiento en este proceso, así como conocer otras personas trans que les sirvan como referentes transpositivos. Además, señalan la necesidad de formación específica en los profesionales sanitarios.

Beneficios de la transición social temprana en menores transgénero. Perspectivas de familias: estudio cualitativo / Benefits of early social transition in transgender minors. Family perspectives: qualitative study

FUNDAMENTOS: El término trans aglutina a todas las identidades transgénero. La transición social temprana hacia el género sentido tiene beneficios en el desarrollo del menor. Para las familias, el tránsito es un periodo de grandes incertidumbres, siendo necesario el acompañamiento dirigido a las familias de menores trans. El objetivo del artículo fue explorar, desde una perspectiva paterna y familiar, las necesidades y experiencias sobre el tránsito de menores trans que sirvieran de referente a otros padres/madres que apoyan el tránsito social de sus hijos e hijas.MÉTODOS: Se trabajó con grupos focales de familias funcionales de menores transgénero que habían iniciado la transición (n=14), de nivel educativo medio-alto y que pertenecían a zonas urbanas de Tenerife. Mediante entrevista semiestructurada, comentaron sus experiencias en el proceso de dar soporte al tránsito social de sus hijos e hijas. Los datos fueron registrados en una videograbación y se procesaron mediante análisis de contenido y categorización. RESULTADOS: La transición social temprana tuvo beneficios positivos e inmediatos en el desarrollo del menor, además de en la disminución de la ansiedad. Hubo una mejora general en el humor, la autoestima y las relaciones tanto sociales como familiares. El acompañamiento de especialistas y asociaciones ayudó en las distintas situaciones sociales y favoreció la resiliencia. CONCLUSIONES: El tránsito social temprano es positivo en la esfera personal y sociofamiliar del menor. Para mejorar su resiliencia, las familias demandan acompañamiento en este proceso, así como conocer otras personas trans que les sirvan como referentes transpositivos. Además, señalan la necesidad de formación específica en los profesionales sanitarios.(AU)

BACKGROUND: The term trans brings together all transgender identities. The early social transition towards the affirmed gender has benefits in the child’s development. For families, transit is a period of great uncertainty, requiring support aimed at families of trans minors. The aim of this paper was to explore the needs and experiencies of parents and close-relatives who supported the social transition of their children. METHODS: We worked with focus groups of functional families of transgender minors who had begun the transition (n=14), with a medium-high educational level and who belonged to urban areas of Tenerife. Through a semi-structured interview, they commented on their experiences in the process of supporting the social transition of their children. The data was recorded in a video recording and processed through content analysis and categorization. RESULTS: Early social transition had positive and immediate benefits on child development as well as in the reduction of anxiety. There was a general improvement in mood, self-esteem, and social and family relationships. The accompaniment of specialists and associations helped in the different social situations and favoured resilience.CONCLUSIONS: Early social transition is positive in the personal and socio-family sphere of the minor. To improve their resilience, families demand accompaniment in this process, as well as meeting other trans people who serve as transpositive references. In addition, they point out the need for specific training in health professionals.(AU)

Measles Serostatus in Mothers and Their Newborns in Antioquia, Colombia: Implications for Measles Elimination.

To describe the serostatus of measles IgG antibodies in pregnant women and newborns, placental transfer, and factors that determine being below the threshold of 150 mIU/mL, a cross-sectional study was conducted. Blood samples of 790 pregnant women at the time of delivery and 734 umbilical cord samples were analyzed from eight hospitals in the Aburrá Valley of Antioquia, Colombia. Measles IgG antibody measurement was performed with ELISA. The proportion of individuals with antibodies < 150 mIU/mL was 13.9% (95% CI: 12.2-15.8) in pregnant women and 11.1% (95% CI: 9.2-13.4) in newborns. The geometric mean of the antibody level of the pregnant women was 552 mIU/mL (95% CI: 504-605) and in the umbilical cord 662 mIU/mL (95% CI: 604-727). A positive correlation between pregnant woman and umbilical cord antibodies was found. The median ratio of measles IgG antibodies in umbilical cord/pregnant woman was 1.22 for all participants. A seroprevalence below the threshold of 150 mIU/mL was found in newborns whose mothers were born between 1983 and 1994, compared with those born before that period, when exposure to the wildtype virus was common (adjusted prevalence ratio: 3.6, 95% CI: 1.3-9.6). These findings suggest that there are gaps in measles immunity among women of childbearing age, before pregnancy. To close this immune gap and support efforts to maintain measles control, serological screening for measles antibodies should be routinely included in reproductive health and antenatal care programs to identify women without immunity who should be vaccinated before pregnancy or after delivery.

Virtual Reality and Simulation Videos as Effective Training Tools for Creating Safe and Inclusive Environments for Transgender People.

BACKGROUND: University education is undergoing a paradigm shift towards active methodologies, such as virtual reality and training videos, which have proven to be valuable resources, especially in the health sciences. The scarcity of existing research on the topic prompted us to conduct this study, which seeks to measure the knowledge gained from the aforementioned tools by users, their level of satisfaction with them, and their perceived utility. METHODS: This is a quasi-experimental intervention study analysing the impact of virtual objects as learning resources for undergraduate nursing students. RESULTS: Fifty-four participants completed the training, yielding highly significant differences between their mean scores, with a high statistical power and a large effect size. A total of 85.46% of participants confirmed that the virtual resources helped them considerably to empathise with the experiences of trans people in healthcare settings. Students were comfortable using the virtual resources, very satisfied with the methodology employed, and would recommend the training received. CONCLUSIONS: University teaching must adapt to meet the current legislations and changing health needs of society, and teaching staff must be prepared to implement new active teaching methodologies that make learning a more dynamic process. Considering these results, our study serves as a guide for other nursing educators who seek to promote inclusive healthcare regarding gender diversity. This study is not registered.

Fundamentos físicos del gesto técnico del pitcher / Fundamentos físicos do gesto técnico do lançador / Physical foundations of the pitcher's technical gesture

RESUMEN La codicia por lanzar duro en el béisbol, más el desconocimiento mecánico-energético del aporte y lo que evita la correcta ejecución de las fases del gesto técnico del pitcher, resultaron ser las principales causas de las lesiones y el motivo de una investigación explicativa, a través de la aplicación de métodos físicos cinemáticos, dinámicos y energéticos, en el estudio de la manifestación de leyes físicas durante la observación no participativa de su desempeño, al lanzar la pelota, tanto en lanzadores nacionales como internacionales y de testimonios de personas con experiencias como pitcher. El objetivo de este artículo consistió en proponer una explicación física de cómo funciona la biomecánica del cuerpo del pitcher durante los gestos técnicos del lanzamiento para garantizar una bola rápida y minimizar lesiones. Con este trabajo, se pretendió, además, instruir al pitcher de cómo funciona la biomecánica de su cuerpo durante el lanzamiento de la pelota, aprovechando ventaja de la altura del montículo con argumentos desde la ciencia Física; esto contribuyó a lanzamientos más rápidos, elegantes y a minimizar lesiones. Como resultado, se elaboró una explicación física por fases para el pitcher, además, un sistema masa-resorte aislado para experimentar movimientos biomecánicos y energéticos, que evidenciaron en su desempeño manifestaciones de las leyes físicas de la mecánica clásica de Newton, de la conservación de la energía mecánica, del momento cinético y del momento angular.

RESUMO A ganância de jogar duro no basebol, mais a ignorância mecânico-energética da contribuição e o que impede a correta execução das fases do gesto técnico do lançador, revelaram-se as principais causas de lesões e a razão de uma pesquisa explicativa, através da aplicação de métodos físicos cinemáticos, dinâmicos e energéticos, no estudo da manifestação das leis físicas durante a observação não participativa do seu desempenho, ao lançar a bola, tanto em lançadores nacionais como internacionais e testemunhos de pessoas com experiências como lançadores. O objetivo deste artigo é propor uma explicação física de como funciona a biomecânica do corpo do lançador durante os gestos técnicos de lançamento para garantir uma bola rápida e minimizar as lesões. Com este trabalho, pretende-se também instruir o lançador sobre como funciona a biomecânica do seu corpo durante o lançamento da bola, tirando partido da altura do monte com argumentos da ciência física. Isto contribui para campos mais rápidos e mais elegantes e para minimizar as lesões. Como resultado, foi elaborada uma explicação física por fases para o jarro, além disso, um sistema isolado de suspensão em massa para experimentar movimentos biomecânicos e energéticos, que evidenciou no seu desempenho, manifestações das leis físicas da mecânica clássica de Newton, da conservação da energia mecânica, do momento cinético e do momento angular.

ABSTRACT The greed to throw hard in baseball, plus the mechanical-energetic ignorance of the contribution and what prevents the correct execution of the phases of the pitcher's technical gesture, turned out to be the main causes of injuries and the reason for an explanatory research, through the application of physical kinematic, dynamic and energetic methods, in the study of the manifestation of physical laws during the non-participatory observation of their performance, when throwing the ball, both in national and international pitchers and testimonies of people with experiences as pitchers. The objective of this article is to propose a physical explanation of how the biomechanics of the pitcher's body works during the technical gestures of pitching to guarantee a fast ball and minimize injuries. With this work, it is also intended to instruct the pitcher on how the biomechanics of his body works during the pitching of the ball, taking advantage of the height of the mound with arguments from the physical science. This contributes to faster, more elegant pitches and to minimize injuries. As a result, a physical explanation by phases was elaborated for the pitcher, in addition, an isolated mass-spring system to experiment biomechanical and energetic movements, which evidenced in their performance manifestations of the physical laws of Newton's classical mechanics, conservation of mechanical energy, kinetic momentum and angular momentum.

Los componentes de la condición física, su relación con el estado de salud en estudiantes universitarios / As componentes da aptidão física, a sua relação com o estado de saúde nos estudantes universitários / The components of physical fitness, its relationship to health status in universities students

RESUMEN El presente artículo pretende interiorizar la importancia y los beneficios de la práctica regular de actividad física. El objetivo de este trabajo consistió en realizar un estudio de los componentes de la condición física relacionada con la salud en los estudiantes de la carrera de Licenciatura en estudios Socio-Culturales de la Universidad de Pinar del Río "Hermanos Saíz Montes de Oca". Se seleccionaron aleatoriamente a 19 estudiantes de primer año de dicha carrera. Se utilizaron los métodos de investigación del nivel teórico y empírico como el análisis de documentos y la medición. Los valores obtenidos, en cuanto al porciento de grasa, indican que el factor de riesgo que conlleva la excesiva acumulación de grasas puede traer como consecuencia la aparición de varias enfermedades crónicas no transmisibles. Además, se evidencia que el 73 % de la muestra investigada presenta deficiencias en la potencia aeróbica máxima, o sea para suministrar el oxígeno necesario a los músculos durante un esfuerzo físico máximo. De manera general, la muestra alcanza un nivel aceptable que les permite mantener un esfuerzo a intensidad media o baja con suficiente aporte de oxígeno. Por ello es necesario el estricto cumplimiento de un plan de acciones que estén orientadas a la modificación de la composición corporal de los estudiantes objeto de estudio.

RESUMO Este artigo visa interiorizar a importância e os benefícios da prática regular da atividade física. O objetivo deste trabalho era realizar um estudo das componentes da condição física relacionadas com a saúde nos alunos do curso de licenciatura em Estudos Sócio-Culturais da Universidade de Pinar del Río "Hermanos Saíz Montes de Oca". Dezanove estudantes do primeiro ano desta carreira foram selecionados de forma aleatória. Foram utilizados métodos teóricos e empíricos de investigação, tais como análise e medição de documentos. Os valores obtidos em termos de percentagem de lípidos indicam que o factor de risco de acumulação excessiva de lípidos pode levar ao aparecimento de várias doenças crónicas não transmissíveis. Além disso, é evidente que 73 % da amostra investigada apresenta deficiências na potência aeróbica máxima, ou seja, para fornecer o oxigénio necessário aos músculos durante um esforço físico máximo. Em geral, a amostra atinge um nível aceitável que lhes permite manter um esforço a média ou baixa intensidade com suficiente fornecimento de oxigénio. Por conseguinte, é necessário o cumprimento rigoroso de um plano de ações orientadas para a modificação da composição corporal dos estudantes em estudo.

ABSTRACT This article aims to internalize the importance and benefits of the regular practice of physical activity. The objective of this work consisted in carrying out a study of the components of health-related physical fitness in students of the Bachelor's Degree in Socio-Cultural Studies of the University of Pinar del Río "Hermanos Saíz Montes de Oca". Nineteen first year students of this career were randomly selected. Theoretical and empirical research methods were used, such as document analysis and measurement. The values obtained, in terms of the percentage of fat, indicate that the risk factor of excessive fat accumulation can lead to the appearance of several chronic non-communicable diseases. In addition, it is evident that 73 % of the investigated sample presents deficiencies in the maximum aerobic power, that is, to supply the necessary oxygen to the muscles during a maximum physical effort. In general, the sample reaches an acceptable level that allows them to maintain an effort at medium or low intensity with sufficient oxygen supply. Therefore, it is necessary to strictly comply with a plan of actions aimed at modifying the body composition of the students under study.

Estimation of endogenous intestinal losses of acid hydrolyzed ether extract in growing and finishing pigs using the linear regression method.

The approach of this experiment was to apply the regression method for the estimation of endogenous intestinal losses of ether extract (EEE) when pigs are fed complete diets ad libitum and using dietary levels of fat typical of those employed in commercial situations. A total of 40 gilts (PIC 337 sires × C22 or C29) were allotted to individual pens and randomly assigned to diets (8 pigs per treatment) with 5 different levels of acid hydrolyzed ether extract (AEE). The dietary treatments consisted of a corn-soybean meal diet with no added fat (L1); a corn-soy diet with 6% each of corn distiller's dried grains with solubles (DDGS), corn germ meal, and wheat middlings (L2); the L2 diet but with 12% each of corn DDGS, corn germ meal, and wheat middlings (L3); the L2 diet plus soybean oil to equalize the NE concentration of the L2 diet with L1 (L4); and the L3 diet plus soybean oil to equalize the NE concentration of the L3 diet with L1 (L5). Pigs received feed and water ad libitum for the growing period (initial BW = 38.5 ± 1.2 kg) and the finishing period (initial BW = 73.82 ± 2.9 kg). A quadratic broken-line model was employed to estimate the response of apparent total tract digestibility (ATTD) of AEE to dietary AEE level. The average true total tract digestibility (TTTD) of AEE and endogenous losses of AEE were estimated using regression analysis of dietary AEE intake (g/kg of DM) against apparent digested AEE (g/kg of DMI). The ATTD of AEE increased in curvilinear fashion as dietary AEE level increased in growing and in finishing pigs (P < 0.001). This suggests an influence of EEE on the ATTD of AEE estimates. The linear regression of apparent digested AEE against dietary AEE intake (L1-L5; P < 0.001, R 2 = 0.99 for growing pigs and P < 0.001, R 2 = 0.99 for finishing pigs) estimated greater EEE (P < 0.05) and TTTD of AEE (P < 0.05) for growing than finishing pigs. Estimated EEE from growing pigs ranged between 18.1 and 20.2 g/kg of DMI, while TTTD of AEE ranged between 96.40% and 100.70%. In finishing pigs, EEE ranged between 21.6 and 23.8 g/kg of DMI and TTTD of AEE ranged between 91.30% and 95.25%. In conclusion, EEE under practical conditions is estimated to be 19.2 g/kg of DMI in growing and 22.7 g/kg of DMI in finishing pigs.

Effects of continuously infusing glucose or casein into the terminal ileum on biomarkers of metabolism, inflammation, and intestinal morphology in growing pigs.

Study objectives were to determine the effects of continuously infusing glucose (GLC) or casein (CAS) into the terminal ileum on biomarkers of metabolism, inflammation, and intestinal morphology in growing pigs. Crossbred gilts (n = 19; 81 ± 3 kg body weight [BW]) previously fitted with T-cannulas at terminal ileum were used in the current experiment. Following 4 d of acclimation, pigs were enrolled in 2 experimental 4-d periods (P). During P1, pigs were housed in individual pens and fed ad libitum for collection of baseline parameters. At the beginning of P2, pigs were assigned to 1 of 3 infusion treatments: 1) control (CON; water; 3 liters/d; n = 7), 2) GLC (dextrose 50%; 500 g/d; n = 6;), or 3) CAS (casein sodium salt; 300 g/d; n = 6). Water, GLC, and CAS solutions were continuously infused at a rate of 125 mL/h for the entirety of P2. Animals were euthanized at the end of P2, and intestinal tissue was collected. During P2, average daily feed intake differed across treatments and was reduced in GLC compared with CON pigs (14%), while CAS pigs consumed an intermediate amount (P = 0.05). Average daily gain and final BW were similar across treatments. A treatment by time interaction was observed for blood urea nitrogen (BUN; P < 0.01), as it decreased in GLC (21%) while it gradually increased in CAS (76%) pigs relative to CON pigs. Mild hyperthermia occurred with both GLC and CAS infusions relative to CON (+0.3 and 0.2 °C, respectively; P < 0.01). Blood neutrophils increased in CAS relative to CON pigs (26%) but remained similar between CON and GLC treatments (P < 0.01). Blood monocytes decreased in GLC relative to CON pigs (24%) while CAS pigs had an intermediate value (P = 0.03). Circulating lipopolysaccharide binding protein tended to decrease in GLC (29%) relative to CON pigs but remained similar between CON and CAS pigs (P = 0.10). Plasma tumor necrosis factor-alpha was similar across treatments. Ileum villus height:crypt depth was increased in CAS compared with CON pigs (33%; P = 0.05) while GLC pigs had an intermediate value. Colon myeloperoxidase-stained area increased in CAS compared with CON pigs (45%; P = 0.03) but remained similar between GLC and CON pigs. In summary, continuously infusing GLC or CAS into the terminal ileum appeared to stimulate a mild immune response and differently altered BUN patterns but had little or no effects on blood inflammatory markers, intestinal morphology, or key production parameters.

Can the digestibility of corn distillers dried grains with solubles fed to pigs at two stages of growth be enhanced through management of particle size using a hammermill or a roller mill?

The objective of this study was to determine the impact of reducing the mean particle size (PS) of corn distillers dried grains with solubles (DDGS) with a hammermill (HM) or with a roller mill (RM) on the apparent total tract digestibility (ATTD) of dry matter (DM), gross energy (GE), N, acid hydrolyzed ether extract (AEE), and fiber components in growing and finishing pigs. Twenty-four growing barrows were housed in individual pens and were randomly assigned to a 3 × 2 factorial design (n = 8): three grinding methods [either corn DDGS ground with an HM to a PS of 450 µm; corn DDGS ground with an RM to a PS of 450 µm; and corn DDGS with a PS of 670 µm (not further ground)] and two body weight (BW) periods (growing pigs with an average initial BW of 54.7 ± 0.9 kg, and finishing pigs with an average initial BW of 107.8 ± 1.5 kg BW). Fecal samples were collected for each BW period in the last 3 d of an 11-d feeding period. Titanium dioxide was used as an indigestible marker. Digestibility data were analyzed using the MIXED procedure of SAS. Results showed that finishing pigs tended to have better ATTD of DM than growing pigs (P = 0.09) and had increased ATTD of GE and N than growing pigs (P = 0.03 and P < 0.01, respectively). On the other hand, growing pigs had better ATTD of AEE than finishing pigs (P = 0.01). Pig BW period did not affect the ATTD of neutral detergent fiber (NDF), acid detergent fiber (ADF), and hemicellulose. Reducing the mean PS of corn DDGS with either HM or RM (from 670 to 450 µm) improved the ATTD of DM and GE (P < 0.01 and P < 0.01), tended to improve the ATTD of N (P = 0.08), and improved the ATTD of AEE (P < 0.01). No effect of reducing PS was observed for the ATTD of NDF, ADF, or hemicellulose. There were no differences between HM and RM in any of the ATTD variables tested. In conclusion, reducing PS of corn DDGS from 670 to 450 µm either with an HM or with an RM improved the digestibility of DM, GE, and AEE and modestly improved the digestibility of N in growing and finishing pigs. However, reducing the PS of corn DDGS did not affect the digestibility of fiber components.

Prevalence of soil transmitted helminths in school-aged children, Colombia, 2012-2013.

BACKGROUND: This study aims to establish the prevalence of soil-transmitted helminth (STH) intestinal infections, nutritional status, and anemia in school children aged 7 to 10 years old in the biogeographic provinces of Colombia in 2012-2013. STH prevalence in the country has not been described within the last 30 years and it is needed in order to establish policies its control in the country. METHODOLOGY: National Survey of STH in school-aged children with a multistage stratified probability sampling was conducted. The overall prevalence and intensity of STH infection, as well as for each parasite, (A. lumbricoides, T. trichiura and hookworms) were calculated for the country and for each of the nine biogeographic provinces. PRINCIPAL FINDINGS: Stool samples were collected from 6045 children in eight out of nine biogeographic provinces. The combined prevalence of STH in the country was 29.6%. T. trichiura was the most prevalent helminth (18.4%), followed by A. lumbricoides (11.3%), and hookworms (6.4%). For A. lumbricoides and hookworms, the highest prevalence values were found in the Amazonía province (58.0% and 35.7%, respectively). Regarding STH intensity, most cases showed moderate intensity (41.3%) for A. lumbricoides, and light intensity, for T. trichiura and hookworms. The national prevalence of anemia in school-aged children was 14.2%, lowest in the Nor-Andina province (3.5%), and highest in the Territorios Insulares oceánicos del Caribe province (45.1%). SIGNIFICANCE: Colombia has a moderate risk of STH infection in school-aged populations, with considerable variation in the prevalence values among the biogeographic provinces. Like any public health issue, this problem should be handled with a comprehensive approach that involves deworming programs and strategies for STH control according to the specific epidemiological and socioeconomic conditions and sanitation service coverage in each biogeographic province. The program should be further supported by intersectoral action to improve living conditions, particularly the excreta disposal, promoted at municipality levels.

Enhancing digestibility of corn fed to pigs at two stages of growth through management of particle size using a hammermill or a roller mill.

The experimental objective was to determine the role of mean particle size (PS), grinding method, and body weight (BW) category on nutrient, fiber, and energy digestibility of corn. A total of 48 barrows were housed in individual pens and randomly assigned to one of six dietary treatments for 11 d at two BW categories (55 kg and 110 kg). The six treatments consisted of corn ground at three different targeted mean PSs (300, 500, and 700 µm) using either a roller mill or a hammermill. Fecal samples were collected for the last 3 d of each feeding period. Titanium dioxide was used as an indigestible marker. Digestibility data were analyzed as a linear mixed model using the MIXED procedure of SAS. Finishing pigs had greater apparent total tract digestibility (ATTD) of dry matter (DM), gross energy (GE), and N than growing pigs (P = 0.02, P = 0.01, and P <0.01, respectively). The ATTD of DM, GE, and N was similar in pigs fed hammermilled corn across all PS treatments. However, in roller-milled corn, they increased as PS was reduced (P < 0.05). The ATTD of acid-hydrolyzed ether extract (AEE) in growing pigs was similar between corn ground at 700 and 500 µm, but it was increased by further reducing PS to 300 µm (P < 0.05). In finishing pigs, the ATTD of AEE increased as mean PS decreased from 700 to 300 µm (P < 0.05). The ATTD of AEE was similar in hammermilled corn at all three PS treatments. On the other hand, the ATTD of AEE was similar in corn ground in a roller mill to 700 and 500 µm, but it increased when PS was reduced to 300 µm (P < 0.05). In conclusion, reducing PS of corn with a roller mill increased digestibility of energy and nutrients, but there was less effect using a hammermill. It is possible that differences in SD, distribution, chemical composition, and the shape of the particles resulting from the two grinding processes help to explain the different response.

The effect of lactose and a prototype Lactobacillus acidophilus fermentation product on digestibility, nitrogen balance, and intestinal function of weaned pigs.

The objective of this study was to determine the effects of lactose (LA) and a prototype Lactobacillus acidophilus fermentation product (FP) on growth performance, diet digestibility, nitrogen (N) balance, and intestinal function of weaned pigs. Twenty-eight newly weaned pigs [approximately 21 d of age; initial body weight (BW) = 5.20 ± 0.15 kg] were housed in metabolism crates and assigned to one of four treatments (n = seven pigs per treatment) corresponding to a 2 × 2 factorial design: with (LA+; 15% inclusion) or without (LA-) LA and with (FP+) or without (FP-) the prototype FP (1 g of FP per kilogram of diet; Diamond V, Cedar Rapids, IA). Feed and water were provided ad libitum. At day 5, pigs were orally given lactulose and mannitol to assess small intestinal permeability. Fecal samples were collected on days 5-9 to determine the apparent total tract digestibility (ATTD) of dry matter (DM), gross energy (GE), and N. Total urine output and fecal samples were collected on days 10-13 to determine N retention. On day 15, all pigs were euthanized to collect intestinal lumen and tissue samples. Data were analyzed for the main effects of LA and FP and their interaction using the MIXED procedure of SAS. Lactose improved average daily feed intake (ADFI; P = 0.017), the ATTD of DM (P = 0.014), the ATTD of GE (P = 0.028), and N retention (P = 0.043) and tended to increase the butyric acid concentration in the colon (P = 0.062). The FP tended to increase the digestibility of N (P = 0.090). Neither LA nor the FP affected intestinal barrier function or inflammation markers. The interaction between LA and FP affected intestinal morphology: in the jejunum, pigs fed LA+FP- had increased villus height compared with those fed LA+FP+ and LA-FP-, whereas LA+FP+ was intermediate (interaction P = 0.034). At the terminal ileum, pigs fed LA-FP+ and LA+FP- had increased villus height and villus: crypt compared with those fed LA-FP-, whereas LA+FP+ was intermediate (interaction P = 0.007 and P = 0.007, respectively). In conclusion, the addition of LA brings important nutritional attributes to nursery diets by improving feed intake, digestibility of DM and GE, and the N retention of weaned pigs; however, the functional capacity of LA to improve markers of intestinal function is limited. On the other hand, the FP showed only a mild increase in the digestibility of N but a limited capacity to improve markers of intestinal function.

Effects of grinding method and particle size of wheat grain on energy and nutrient digestibility in growing and finishing pigs.

Feed grains are processed to improve their value in pig diets by exposing kernel contents to enzymatic and microbial action. The objective of this study was to quantify the effect of reducing mean particle size (PS) of wheat grain ground with two different grinding methods (GMs) on the apparent total tract digestibility (ATTD) of nutrients and energy in growing and finishing pigs. Forty-eight barrows were housed in individual pens for 11 d for two periods. Pigs were randomly assigned to a 3 × 2 × 2 factorial experimental design: three target mean PS of wheat grain (300, 500, and 700 µm), two GMs (roller mill and hammermill), and two body weight (BW) periods (growing period; initial BW of 54.9 ± 0.6 kg and finishing period; initial BW of 110.7 ± 1.4 kg). Diets contained one of six hard red wheat grain samples, vitamins, minerals, and titanium dioxide as an indigestible marker. Feed allowance provided 2.5 (for the two lightest pigs in each treatment) or 2.7 (for the remaining six pigs in each treatment) times the estimated daily maintenance energy requirement for each growth stage. Fecal samples were collected for the last 3 d of each period. Data were analyzed as a linear mixed model with pig as a random effect and PS, GM, and BW period and their interactions as fixed effects utilizing the MIXED procedure of SAS. Growing pigs had greater (P < 0.05) ATTD of dry matter (DM), gross energy (GE), N, acid hydrolyzed ether extract (AEE), and neutral detergent fiber (NDF) by lowering mean PS from 700 to 500 µm using either a roller mill or a hammermill. However, digestibility did not increase when PS was reduced from 500 to 300 µm, except for AEE (P < 0.05). Finishing pigs had greater ATTD of DM, GE, N, AEE, and NDF by lowering mean PS with a hammermill from 700 to 500 µm (P < 0.05), but it was greater for 500 µm than for 300 µm (P < 0.05). Using a roller mill reduced the ATTD of DM and NDF by lowering PS from 700 to 300 µm (P < 0.05). The ATTD of GE decreased by lowering PS from 700 to 500 µm with a roller mill (P < 0.05) for finishing pigs. The ATTD of N and AEE for finishing pigs were similar from 700 to 300 µm when ground by a roller mill. These data suggest that the PS that maximized digestibility for a hammermill is 500 µm for both growing and finishing pigs. However, for the roller mill, the PS resulting in the best digestibility were 500 and 700 µm for growing and finishing pigs, respectively.

Impact of increasing the levels of insoluble fiber and on the method of diet formulation measures of energy and nutrient digestibility in growing pigs.

The objective of this study was to determine the differences in response to distillers dried grains with solubles (DDGS) level under constant nutrient or floating nutrient concentrations. A total of 21 ileal-cannulated gilts (33.1 ± 0.4 kg body weight) were randomly allotted to one of seven dietary treatments in a 3-period incomplete Latin square design (n = 9). Treatments consisted of a 0% DDGS basal diet, plus diets containing 15%, 30%, or 45% DDGS. Diets were formulated using one of two different formulation methods: 1) constant nutrient (CNU) where nutrients were held equal to the basal diet or 2) constant ingredients (CIN) where DDGS were added at the expense of corn and all other ingredients remained constant, so nutrient levels were allowed to "float." Chromic oxide was added to the diets at 0.5% as an indigestible marker. Increasing the level of DDGS decreased the apparent ileal digestibility (AID) of dry matter (DM), gross energy (GE), starch, dispensable amino acids (AA), and fiber components (P < 0.050). The decrease in the AID of Lys, Met, Thr, and Trp was more pronounced under CNU compared with the CIN formulation method (P < 0.050). The decrease in the AID of hemicellulose was less pronounced under CNU compared with the CIN formulation method (P = 0.045). There was a DDGS level × formulation method interaction for the AID of acid hydrolyzed ether extract (AEE; P = 0.015); for the CNU formulation method, increasing level of DDGS decreased the AID of AEE from 0% to 30% and remained similar from 30% to 45% DDGS, whereas the CIN had no effect on the AID of AEE. Increasing the level of DDGS decreased the apparent total tract digestibility (ATTD) of DM, GE, and fiber components (P < 0.050), except for acid detergent fiber, which was not affected. The decrease in the ATTD of insoluble dietary fiber and total dietary fiber was less pronounced under CNU compared with CIN (P < 0.050). The ATTD of AEE decreased for CNU compared with CIN (P < 0.010). In conclusion, increasing the insoluble fiber level in the form of DDGS decreased the digestibility of most dietary components, including DM, GE, starch, insoluble fiber, and AA. The CNU and CIN formulation methods are equivalent when evaluating the digestibilities of DM, GE, starch, crude protein, and AA (when they were not added in purified synthetic forms). Differences between CNU and CIN formulation methods were detected for the digestibility of insoluble fiber, fat, and essential AA (when added as crystalline AA).

Measuring Explicit Prejudice and Transphobia in Nursing Students and Professionals.

Trans* people frequently report attitudes of prejudice/transphobia in health professionals. Conversely, health professionals indicate the lack of adequate training to care for these people and its impact on the quality of care provided. OBJECTIVE: Our objective was to evaluate the explicit prejudices/transphobia of health students and professionals and compare them with the general population in Tenerife. METHODS: A descriptive cross-sectional study was carried out with the Genderism and Transphobia Scale (GTS) and the Negative Attitude towards Trans* people Scale (EANT) with a total of 602 participants. RESULTS: We found a low mean level of explicit prejudice/transphobia, with little/no differences between occupation groups. Explicit transphobia was correlated with being a man, less educated, and heterosexual, and not personally knowing a trans* person. Men and women were less transphobic about trans* people whose identities coincided with their own. CONCLUSION: All participants showed a low mean level of explicit transphobia. This result is not incompatible with unconscious prejudice, which may translate to discriminatory behaviors. Interventions to change negative attitudes are still needed, since even a small percentage of transphobic health professionals could exert a considerable negative impact on health care. In professionals without transphobic attitudes, the barriers identified by trans* people might be a problem due to the lack of specific training.

Trans* Pregnancy and Lactation: A Literature Review from a Nursing Perspective.

Pregnancy and lactation involve two aspects that are socially and culturally associated with women. However, there are a few biological differences between male and female breast tissue. Lactation and pregnancy are viable processes that do not depend on sex. Even for the latter, it is only necessary to have an organ capable of gestation. Ways to favor mammogenesis and lactogenesis in trans* women have been established. There are protocols to promote lactation in trans* women, usually used for adoptive mothers or those whose children have been born through gestational surrogacy. Chestfeeding a baby could be the cause of feelings as diverse as gender dysphoria in the case of trans* men, and euphoria and affirmation of femininity in trans* women. This study involves a review of the available scientific literature addressing medical aspects related to pregnancy and lactation in trans* individuals, giving special attention to nursing care during perinatal care. There are scarce studies addressing care and specifically nursing care in trans* pregnancy and lactation. Our study indicates the factors that can be modified and the recommendations for optimizing the care provided to these individuals in order to promote and maintain the lactation period in search of improvement and satisfaction with the whole process.