Acculturative stress, mental health symptoms, and the role of salivary inflammatory markers among a Latino sample.

OBJECTIVES: Exposure to psychosocial stressors is associated with increases in adverse mental health outcomes and inflammatory markers. Limited research has investigated if acculturative stress, related to cultural adaptation in Latinos, one of the fastest growing minority groups in the United States, follows a similar pattern. This study hypothesized that acculturative stress would be associated with increased mental health symptoms as well as increases in salivary inflammatory markers. In addition, it was hypothesized that higher levels of salivary inflammatory markers would mediate the pathways between acculturative stress and mental health symptoms. The ability of salivary inflammatory markers to moderate the relationship between acculturative stress and mental health symptoms was also tested. METHOD: One hundred and fifty-four Latino participants were recruited from a local university. Participants completed measures of acculturative stress, perceived stress, state/trait anxiety, and depressive symptoms. Saliva samples measured C-reactive protein (CRP) and interleukin (IL)-1ß. RESULTS: Acculturative stress was significantly associated with increases in perceived stress, state/trait anxiety and depressive symptoms. Salivary inflammatory markers did not mediate the relationship between acculturative stress and mental health symptoms. Alternatively, CRP, but not IL-1ß, moderated the relationship between acculturative stress and state anxiety, such that when salivary CRP levels were low, there was a positive association between acculturative stress and state anxiety symptoms. DISCUSSION: Results suggests that the interplay between acculturative stress and salivary inflammation might indicate risk for anxiety in vulnerable populations. (PsycINFO Database Record

Análisis sociodemográfico, metodológico y diagnóstico de los informes periciales en psiquiatría y psicología para la toma de decisiones legales en el Centro de Estudios en Derecho y Salud (Medellín, Colombia) / Socio-demographic, methodological and diagnostic analysis of expert reports in psychiatry and psychology for legal decision-making Centro de Estudios en Derecho y Salud (Medellín, Colombia) / Análise sociodemográfica, metodológica e diagnóstica de relatórios de especialistas em psiquiatria e psicologia para tomada de decisões legais no Centro de Estudios en Derecho y Salud (Medellín, Colombia)

El objetivo del presente estudio fue analizar las características sociodemográficas, metodológicas y diagnósticas de los informes periciales en psiquiatría y psicología realizados en el Centro de Estudios en Derecho y Salud entre 2011 y 2020. Se optó por un enfoque cuantitativo, descriptivo con intención analítica, transversal, con diseño retrospectivo. Se analizó la información obtenida en 145 peritajes. Se adelantó un análisis univariado para todas las variables sociodemográficas, metodológicas y diagnósticas de los informes periciales, según su naturaleza cualitativa o cuantitativa, y un análisis bivariado a través de tablas de contingencia para las variables mencionadas, con intervalos de confianza del 95 % para cada una de las medidas de prevalencia. Se encontró que la mayoría de peritajes fueron solicitados por el área del derecho contencioso-administrativo. Los diagnósticos más prevalentes fueron el trastorno adaptativo, el trastorno por estrés postraumático y el trastorno depresivo. Si bien los informes revisados cumplen con los lineamientos mínimos de ley, se encontraron algunas falencias relacionadas con la ausencia de información. Se espera que estos hallazgos permitan la reflexión por parte de los auxiliares de la justicia sobre los requerimientos de los informes periciales con miras a la humanización de la justicia y el apoyo a la toma de decisiones legales.

The aim of this study was to analyse the socio-demographic, methodological and diagnostic characteristics of the expert reports in psychiatry and psychology carried out at the Centre for Law and Health Studies between 2011 and 2020. We opted for a quantitative, descriptive approach with analytical, cross-sectional, retrospective design. The information obtained from 145 expert opinions was analysed. A univariate analysis was carried out for all sociodemographic, methodological and diagnostic variables in the expert reports, according to their qualitative or quantitative nature, and a bivariate analysis through contingency tables for the aforementioned variables, with confidence intervals of 95 % for each of the prevalence measures. It was found that the majority of expert opinions were requested by the area of contentious-administrative law. The most prevalent diagnoses were adjustment disorder, post-traumatic stress disorder and depressive disorder. Although the reports reviewed comply with the minimum legal guidelines, there were some shortcomings related to the absence of information. It is hoped that these findings will allow for reflection on the part of justice officials on the requirements of expert reports with a view to the humanisation of justice and support for legal decision-making.

O objetivo deste estudo foi analisar as características sociodemográficas, metodológicas e diagnósticas dos laudos periciais em psiquiatria e psicologia realizados no Centro de Estudos em Direito e Saúde entre 2011 e 2020. Optou-se por uma abordagem quantitativa e descritiva com desenho analítico, transversal e retrospectivo. Foram analisadas as informações obtidas de 145 pareceres de especialistas. Foi realizada uma análise univariada para todas as variáveis sociodemográficas, metodológicas e diagnósticas dos laudos periciais, de acordo com sua natureza qualitativa ou quantitativa, e uma análise bivariada por meio de tabelas de contingência para as variáveis mencionadas, com intervalos de confiança de 95 % para cada uma das medidas de prevalência. Verificou-se que a maioria dos pareceres foi solicitada pela área de direito contencioso-administrativo. Os diagnósticos mais prevalentes foram transtorno de ajustamento, transtorno de estresse pós-traumático e transtorno depressivo. Embora os relatórios analisados estejam em conformidade com as diretrizes legais mínimas, houve algumas deficiências relacionadas à ausência de informações. Espera-se que esses resultados permitam uma reflexão por parte dos envolvidos no sistema judiciário sobre os requisitos dos laudos periciais, com vistas à humanização da justiça e ao apoio à tomada de decisões legais.

Acculturative stress is associated with trajectory of anxiety symptoms during pregnancy in Mexican-American women.

Over half of pregnant women report anxiety symptoms and these symptoms may be precipitated by stressful experiences. Anxiety rates may be higher in Mexican-American women who experience sociocultural stressors, such as acculturation, acculturative stress and discrimination. However, the role of such stressors on the trajectory of anxiety symptoms across pregnancy is not yet known. Mexican-American women (n=151) completed surveys across pregnancy about acculturation, acculturative stress, perceived discrimination, and state anxiety. Multilevel modeling found that acculturation (Anglo orientation, b=0.050, SE=0.379, t (137.561)=0.134, p=0.894; Mexican orientation, b=0.775, SE=0.692, t (133.424)=1.121, p=0.264) and perceived discrimination (b=-1.259, SE=0.921, t (137.489)=-1.367, p=0.174) were not associated with the trajectory of anxiety symptoms. However, acculturative stress, even while controlling for perceived stress, was associated with high levels of anxiety symptoms that were elevated early in pregnancy (b=-0.045, SE=0.022, t (135.749)=-2, p=0.047). This work highlights the unique role of acculturative stress in risk for prenatal anxiety in early pregnancy.

Innovative solutions: the C.O.R.E. to sociocultural care in nursing.

Terminal weaning of patients follows a standardized medical care protocol. However, the evidence found for optimal terminal weaning protocols may lack individualization for the patient and family. As nursing students in the critical care unit, we have designed a conceptual model that bridges the gap between cultural diversity and terminal weaning. This conceptual model integrates comfort, organization, rituals, and environment into the process of terminal weaning. The model assists nurses in all specialties, particularly critical care, to provide culturally appropriate end-of-life care for the patient and their family.