Psychosocial symptoms associated with spiritual well-being in Latino patients and caregivers coping with advanced cancer.

PURPOSE: The objective of this study was to investigate the relationship among hopelessness, anxiety, and depression, with spiritual well-being in patients and family caregivers. METHODS: A cross-sectional survey was administered to patients (n = 57) and caregivers (n = 57) that incorporated assessments that measured spiritual well-being, depression, anxiety, hopelessness, quality of life, family relationship, burden, fatalism, religiosity, and distress. Logistic regression and cross-tabulation analyses were conducted to examine the relationship between hopelessness, anxiety, and depression, with spiritual well-being. Logistic regression was used to quantify the impact of spiritual well-being on anxiety, depression, and hopelessness. Additionally, cross-tabulations with chi-square tests were conducted to explore associations between severity of hopelessness and severity of anxiety and depression. RESULTS: Logistic regression analyses showed negative associations between spiritual well-being and mental health outcomes, although not all findings were statistically significant. Among caregivers, a significant negative relationship was observed for depression (B = - 0.161, p = 0.022). Hopelessness also exhibited a negative association with spiritual well-being among caregivers (B = - 0.099, p = 0.054) and patients (B = - .152, p = 0.038). Cross-tabulations highlighted significant associations in the severity of hopelessness symptoms with anxiety and depression levels among caregivers (p < .001). CONCLUSION: Results reveal a relationship among psychosocial symptoms among Latino patient-caregivers coping with cancer. By emphasizing spiritual well-being, hopelessness, and anxiety and involving family patients and caregivers in the treatment process as a unit of care. Also, it indicates the need to develop culturally tailored interventions that aim to provide valuable assistance to Latino patients and caregivers coping with cancer.

Family functioning and psychosocial symptoms among Latinx patients coping with advanced cancer.

OBJECTIVES: This brief report aims to describe and determine the association of family functioning (e.g., cohesion and expressiveness) with psychosocial needs among Spanish Latinx patients coping with advanced cancers. METHODS: Descriptive and correlation analyses were performed on data from 103 patients coping with advanced cancer (Stages III and IV). The measures used were the Family Relationships Index, the Hospital Anxiety and Depression Scale, and the Functional Assessment of Cancer Therapy: General. RESULTS: Results indicated that most of the participants had low family function (65%). Participants with higher family functioning (35%) had high levels of quality of life [r(103) .318, p < .002]. A higher level of quality of life was also strongly associated with lower levels of anxiety [r(95) -.653, p < .000], lower levels of depression [r(95) -.733, p < .000], and lower levels of hopelessness [r(95) -.585, p = .000]. A total of 22.3% of Latinx advanced cancer patients reported poor cohesiveness; those with low cohesiveness also had higher levels of depression [r(103) -.28, p = .004] and anxiety [r(103) -.27, p = .005]. Correlations between expressiveness and hopelessness were significant; namely, those with higher expressiveness had lower hopelessness [r(103) -.274, p = .005]. SIGNIFICANCE OF RESULTS: Findings present a high correlation between family functioning and psychosocial symptoms.

Structure and assembly model for the Trypanosoma cruzi 60S ribosomal subunit.

Ribosomes of trypanosomatids, a family of protozoan parasites causing debilitating human diseases, possess multiply fragmented rRNAs that together are analogous to 28S rRNA, unusually large rRNA expansion segments, and r-protein variations compared with other eukaryotic ribosomes. To investigate the architecture of the trypanosomatid ribosomes, we determined the 2.5-Å structure of the Trypanosoma cruzi ribosome large subunit by single-particle cryo-EM. Examination of this structure and comparative analysis of the yeast ribosomal assembly pathway allowed us to develop a stepwise assembly model for the eight pieces of the large subunit rRNAs and a number of ancillary "glue" proteins. This model can be applied to the characterization of Trypanosoma brucei and Leishmania spp. ribosomes as well. Together with other details, our atomic-level structure may provide a foundation for structure-based design of antitrypanosome drugs.

Passive warming effect on soil microbial community and humic substance degradation in maritime Antarctic region.

Although the maritime Antarctic has undergone rapid warming, the effects on indigenous soil-inhabiting microorganisms are not well known. Passive warming experiments using open-top chamber (OTC) have been performed on the Fildes Peninsula in the maritime Antarctic since 2008. When the soil temperature was measured at a depth of 2-5 cm during the 2013-2015 summer seasons, the mean temperature inside OTC (OTC-In) increased by approximately 0.8 °C compared with outside OTC (OTC-Out), while soil chemical and physical characteristics did not change. Soils (2015 summer) from OTC-In and OTC-Out were subjected to analysis for change in microbial community and degradation rate of humic substances (HS, the largest pool of recalcitrant organic carbon in soil). Archaeal and bacterial communities in OTC-In were minimally affected by warming compared with those in OTC-Out, with archaeal methanogenic Thermoplasmata slightly increased in abundance. The abundance of heterotrophic fungi Ascomycota was significantly altered in OTC-In. Total bacterial and fungal biomass in OTC-In increased by 20% compared to OTC-Out, indicating that this may be due to increased microbial degradation activity for soil organic matter (SOM) including HS, which would result in the release of more low-molecular-weight growth substrates from SOM. Despite the effects of warming on the microbial community over the 8-years-experiments warming did not induce any detectable change in content or structure of polymeric HS. These results suggest that increased temperature may have significant and direct effects on soil microbial communities inhabiting maritime Antarctic and that soil microbes would subsequently provide more available carbon sources for other indigenous microbes.

String sign of Kantor in a patient with Crohn's disease.

We report the case of a 29-year-old male with structuring ileocolic Crohn's disease (CD), diagnosed in 2007 and treated with oral azathioprine, oral mesalazine and intravenous infliximab, without any other surgical or medical history of interest. He presented to the Emergency Room with abdominal distention and pain, nausea, vomiting and motility problems of a three-day duration. An abdominal computerized tomography using intravenous contrast was performed.

Resources used in the treatment of perianal Crohn's disease and the results in a real-life cohort. / Recursos empleados en el tratamiento de la enfermedad de Crohn perianal y sus resultados en una serie de vida real.

OBJECTIVE: To study the multidisciplinary management of patients with Crohn's disease (CD) and perianal disease (perianal Crohn's disease, PCD), as well as to analyse a possible relationship between the recurrence of perianal symptoms, the type of fistula and the treatment used. PATIENTS AND METHODS: Descriptive, retrospective study of patients with PCD who were treated in the Inflammatory Bowel Disease Unit. Epidemiological, clinical, diagnostic and therapeutic variables were collected, as well as clinical outcome and response to treatment. RESULTS: Of the 300 patients who attended the outpatient clinic at a university hospital, 65 had PCD. Sixteen simple fistulas (24.6%) and 49 complex fistulas (75.4%) were diagnosed. The most commonly used diagnostic technique was the endoanal ultrasound (45%). Antibiotics were used in 77.4% of patients, and 70% needed anti-TNF therapy to manage the PCD. Surgery was performed on 75.4% of the patients overall. PCD recurred in 41.5% of cases, requiring a change of the biological drugs administered and/or surgery. Complex fistulas were more likely to require surgery (P=.012) and recurrence of PCD was also more common with complex fistulas (P=.036). CONCLUSION: Management of PCD must be multidisciplinary and combined. Most patients with complex PCD require treatment based on biological drugs. Despite therapy, remission of perianal symptoms is not achieved in a percentage of patients, supporting the need to develop new therapies for refractory cases.

Age as a Risk Factor for Burnout Syndrome in Nursing Professionals: A Meta-Analytic Study.

Although past research has highlighted the possibility of a direct relationship between the age of nursing professionals and burnout syndrome, results have been far from conclusive. The aim of this study was to conduct a wider analysis of the influence of age on the three dimensions of burnout syndrome (emotional exhaustion, depersonalization, and personal accomplishment) in nurses. We performed a meta-analysis of 51 publications extracted from health sciences and psychology databases that fulfilled the inclusion criteria. There were 47 reports of information on emotional exhaustion in 50 samples, 39 reports on depersonalization for 42 samples, and 31 reports on personal accomplishment in 34 samples. The mean effect sizes indicated that younger age was a significant factor in the emotional exhaustion and depersonalization of nurses, although it was somewhat less influential in the dimension of personal accomplishment. Because of heterogeneity in the effect sizes, moderating variables that might explain the association between age and burnout were also analyzed. Gender, marital status, and study characteristics moderated the relationship between age and burnout and may be crucial for the identification of high-risk groups. More research is needed on other variables for which there were only a small number of studies. Identification of burnout risk factors will facilitate establishment of burnout prevention programs for nurses. © 2016 Wiley Periodicals, Inc.

Factors Associated with Shiga Toxin-Producing Escherichia coli Shedding by Dairy and Beef Cattle.

UNLABELLED: Shiga toxin-producing Escherichia coli (STEC) is an important foodborne pathogen that can cause hemorrhagic colitis and hemolytic-uremic syndrome. Cattle are the primary reservoir for STEC, and food or water contaminated with cattle feces is the most common source of infections in humans. Consequently, we conducted a cross-sectional study of 1,096 cattle in six dairy herds (n = 718 animals) and five beef herds (n = 378 animals) in the summers of 2011 and 2012 to identify epidemiological factors associated with shedding. Fecal samples were obtained from each animal and cultured for STEC. Multivariate analyses were performed to identify risk factors associated with STEC positivity. The prevalence of STEC was higher in beef cattle (21%) than dairy cattle (13%) (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.25, 2.47), with considerable variation occurring across herds (range, 6% to 54%). Dairy cattle were significantly more likely to shed STEC when the average temperature was >28.9°C 1 to 5 days prior to sampling (OR, 2.5; 95% CI, 1.25, 4.91), during their first lactation (OR, 1.8; 95% CI, 1.1, 2.8), and when they were <30 days in milk (OR, 3.9; 95% CI, 2.1, 7.2). These data suggest that the stress or the negative energy balance associated with lactation may result in increased STEC shedding frequencies in Michigan during the warm summer months. Future prevention strategies aimed at reducing stress during lactation or isolating high-risk animals could be implemented to reduce herd-level shedding levels and avoid transmission of STEC to susceptible animals and people. IMPORTANCE: STEC shedding frequencies vary considerably across cattle herds in Michigan, and the shedding frequency of strains belonging to non-O157 serotypes far exceeds the shedding frequency of O157 strains, which is congruent with human infections in the state. Dairy cattle sampled at higher temperatures, in their first lactation, and early in the milk production stage were significantly more likely to shed STEC, which could be due to stress or a negative energy balance. Future studies should focus on the isolation of high-risk animals to decrease herd shedding levels and the potential for contamination of the food supply.

Study protocol of a randomized clinical trial evaluating the effectiveness of a primary care intervention using the Nintendo™ Wii console to improve balance and decrease falls in the elderly.

BACKGROUND: Balance alteration is a risk factor for falls in elderly individuals that has physical, psychological and economic consequences. The objectives of this study are to evaluate the usefulness of an intervention utilizing the Nintendo™ Wii console in order to improve balance, thereby decreasing both the fear of falling as well as the number of falls, and to evaluate the correlation between balance as determined by the console and the value obtained in the Tinetti tests and the one foot stationary test. METHODS/DESIGN: This is a controlled, randomized clinical trial of individual assignment, carried out on patients over 70 years in age, from five primary care centers in the city of Mataró (Barcelona). 380 patients were necessary for the intervention group that carried out the balance board exercises in 2 sessions per week for a 3 month period, and 380 patients in the control group who carried out their usual habits. Balance was evaluated using the Tinetti test, the one foot stationary test and with the console, at the start of the study, at the end of the intervention (3 months) and one year later. Quarterly telephone follow-up was also conducted to keep track of falls and their consequences. DISCUSSION: The study aimed to connect the community with a technology that may be an easy and fun way to assist the elderly in improving their balance without the need to leave home or join rehabilitation groups, offering greater comfort for this population and decreasing healthcare costs since there is no need for specialized personnel. TRIAL REGISTRATION: Current Control Trial NCT02570178.

Biology and trapping of stable flies (Diptera: Muscidae) developing in pineapple residues (Ananas comosus) in Costa Rica.

Pineapple production in Costa Rica increased nearly 300-fold during the last 30 yr, and >40,000 hectares of land are currently dedicated to this crop. At the end of the pineapple cropping cycle, plants are chopped and residues incorporated into the soil in preparation for replanting. Associated with increased pineapple production has been a large increase in stable fly, Stomoxys calcitrans (L.), populations. Stable flies are attracted to, and oviposit in, the decomposing, chopped pineapple residues. In conjunction with chemical control of developing larvae, adult trapping is an important control strategy. In this study, four blue-black fabric traps, Nzi, Vavoua, Model H, and Ngu, were compared with a white sticky trap currently used for stable fly control in Costa Rica. Overall, the white sticky trap caught the highest number of stable flies, followed by the Nzi, Vavoua, Model H, and Ngu. Collections on the white sticky trap increased 16 d after residues were chopped; coinciding with the expected emergence of flies developing in the pineapple residues. During this same time period, collections in the blue-black fabric traps decreased. Sex ratio decreased from >7:1 (females:males) 3-7 d after chopping to 1:1 at 24-28 d. White sticky, Nzi and Vavoua traps collected similar numbers of colonizing flies 3-7 d after residues were chopped. However, white sticky traps collected more flies once emergence from the pineapple residues began. Although white sticky traps collected more flies than fabric traps, they remain labor intensive and environmentally unsound because of their disposable and nonbiodegradable nature.

Print and digital reading habits and comprehension in children with and without special education needs.

BACKGROUND: Text comprehension is a major obstacle for many Primary school students with special education needs (SEN). Reading episodes bring students opportunities to be exposed to new vocabulary and knowledge, potentially boosting their development of text comprehension skills. AIMS: Our study seeks to understand how reading frequency (leisure and academic) and reading medium (print and digital) contribute to the development of text comprehension during Primary school in students with and without SEN. METHODS AND PROCEDURES: We tested 2289 Spanish students from fourth to sixth grade, from which 212 had an official decision of SEN. Students self-reported their reading frequency (as a measure of their reading habits) and completed a standardized text comprehension test. We employed multiple regression models with a robust maximum likelihood estimator to test associations between reading frequency and comprehension. OUTCOMES AND RESULTS: Students' comprehension was positively associated with their leisure print reading habits, and negatively associated with their frequency of academic digital reading. Those associations were independent of SEN status. CONCLUSIONS AND IMPLICATIONS: Results highlight the importance of promoting leisure reading in print to all students, regardless of SEN status. In addition, caution is advised when encouraging Primary school children to use digital texts when the emphasis is on comprehending texts for acquiring knowledge.

Safety and efficacy of electric cardioversion in the emergency department: analysis of associated factors according to gender. / Eficacia y seguridad de la cardioversión eléctrica en urgencias: factores asociados y perspectiva de sexo.

OBJECTIVE: To explore the safety and effectiveness of electric cardioversion to treat atrial fibrillation in a hospital emergency department (ED). METHODS: Retrospective observational study in a hospital ED. We reviewed episodes of atrial fibrillation in patients aged 18 years orolder treated with cardioversion in our ED or referred for scheduling of cardioversion. Clinical outcome measures were conversion to sinus rhythm, immediate adverse effects (hypotension, arrythmia, or bronchial aspiration), revisiting within 90 days for atrial fibrillation, and complications (stroke, major bleeding, heart failure, or death). We studied factors associated with recurrence and adverse effects according to sex. RESULTS: Cardioversion was used in 365 episodes (median patient age, 67 years); 38.6% were women. Cardioversion was applied in the ED in 75.1% of the episodes, and 24.9% were referred for scheduled cardioversion. Sinus rhythm was restored in 90.7% of the episodes. Emergency cardioversion was more effective than a scheduled procedure (odds ratio [OR], 4.258; 95% CI, 2.046-8.859; P < .001). No serious immediate adverse effects were reported, but 16.7% of the patients revisited for atrial fibrillation within 90 days. Factors associated with revisits were heart failure (hazard ratio [HR], 2.603; 95% CI, 1.298-5.222; P = .007), sleep apnea (HR, 2.598; 95% CI, 1.163-5.803; P = .020), and, in women, hypertension (HR, 3.706; 95% CI, 1.051-13.068; P = .042). Eleven patients developed late adverse events, including stroke (n = 2), major bleeding (n = 1), heart failure (n = 5), and death (n = 3). CONCLUSIONS: Cardioversion is a useful, effective, and safe treatment for atrial fibrillation in the ED, although there are frequent recurrences. Factors associated with recurrence differ according to sex.

OBJETIVO: Conocer la seguridad y eficacia de la cardioversión eléctrica (CVE) en la fibrilación auricular (FA) en un servicio de urgencias hospitalario (SUH). METODO: Estudio observacional y retrospectivo realizado en un SUH. Se revisaron los episodios de FA en pacientes con edad igual o mayor a 18 años a los que se les realizó CVE en el SUH o se les programó de forma diferida. Las variables resultado fueron: reversión a ritmo sinusal (RS), efectos adversos inmediatos (hipotensión, arritmia y broncoaspiración), reconsulta a 90 días por FA y desarrollo de complicaciones (ictus, hemorragia mayor, insuficiencia cardiaca y mortalidad). Se estudiaron los factores asociados a recurrencia y efectos adversos, y se analizaron las diferencias por sexo. RESULTADOS: Se incluyeron 365 episodios de CVE (67 años; 38,6% mujeres); el 75,1% se realizó en el SUH y el 24,9% se derivaron para CVE diferida. El 90,7% revirtieron a RS. La CVE urgente fue más efectiva que la diferida (OR 4,258; IC 95% 2,046-8,859; p < 0,001). No hubo efectos adversos inmediatos graves. El 16,7% de pacientes reconsultaron por FA en los 90 días posteriores. Los factores asociados a reconsulta fueron insuficiencia cardiaca (HR 2,603; IC 95% 1,298-5,222; p = 0,007), apnea del sueño (HR 2,598; IC 95% 1,163-5,803; p = 0,020) y, en mujeres, hipertensión arterial (HR 3,706;IC 95% 1,051-13,068; p = 0,042). Tras la CVE, 11 pacientes presentaron eventos adversos tardíos que incluyeron ictus (n = 2), hemorragia mayor (n = 1), insuficiencia cardiaca (n = 5) y muerte (n = 3). CONCLUSIONES: La CVE es útil, eficaz y segura para la FA en los SUH, aunque las recurrencias son frecuentes. Los factores asociados a recurrencia difieren entre sexos.

Social and Health-related Changes in Hispanic Cancer Patients during the COVID-19 Lockdown.

OBJECTIVE: The current study aimed to explore changes in health-related behaviors and social practices in Hispanic cancer patients during a government-mandated lockdown and their relationship to sociodemographic and clinical characteristics. METHODS: Secondary analyses were conducted on data gathered by a longitudinal cohort study to describe the unmet needs of Hispanic cancer patients living in Puerto Rico exposed to Hurricane Maria in 2017, earthquakes in 2020, and COVID-19. However, our study solely focuses on the data from the COVID-19 pandemic period. RESULTS: Most participants were women (n = 72) with breast cancer (81.2%). Participants exhibited changes in religious practices (60%), physical activity (58.4%), and sedentary behavior (50%); 31.4% experienced changes in eating habits and sleeping patterns. Responses to the study questionnaire involved staying connected with family (85.5%) through phone calls (78.2%); 69.9% of the participants reported observing shifts in the family dynamics. A strong majority endorsed the government-imposed isolation measures (95.6%). Patients not undergoing treatment were likelier (r = -0.324; P = .010) to support the measures. Finally, younger patients experienced more work-related changes (r = -0.288; P = .017) and were less inclined (r = -0.293; P = .011) to find the isolation measures appropriate. CONCLUSION: This paper describes the lockdown related changes in health and social behaviors sustained by cancer patients, changes which could potentially impact their overall health and health-related quality of life. Our results fill an existing gap in our findings and contribute to understanding the experiences of cancer patients (in particular, Hispanic patients) during the COVID-19 pandemic.

Mechanical, Adhesive and Surface Properties of a Zirconia-Reinforced Lithium Silicate CAD/CAM Ceramic Exposed to Different Etching Protocols.

The aim of this investigation was to evaluate the effect of etching protocols on bond strength, surface roughness, and mechanical properties of a zirconia-reinforced lithium silicate (ZLS) CAD/CAM-ceramic. In total, 100 bars (ISO 6872), 75 plaques, and 25 cubes were cut from ZLS blocks(Vita Suprinity®). The surfaces were standardized, crystallized and divided into five groups: 1. control (no/treatment-C), 2. 5%-Hydrofluoric-acid (HF)/20 s (HF5%20s), 3.HF5%60s, 4.HF10%20s, and 5.HF10%60s. Flexural strength (FS) (three-point bending test, 1 mm/min), roughness (Pa), and micro-shear bond-strength (µSBS) tests were performed. The data were statistically analyzed with one-way ANOVA, Tukey's test (p ˂ 0.05) and Weibull (FS data). C showed higher Pa (1.176 ± 0.370 µm) than HF10%60s (0.627 ± 0.236 µm) and all other groups. Groups C and 20 s showed the most irregular surface patterns. The FS results were not influenced by etching protocols, while the Weibull modulus was, with the 5%HF groups being the most reliable (m: 5.63/6.70), while C and HF10%60s (m: 2.78/2.73) were the least reliable. All fractures originated from surface defects on the treated side of specimens. The 5%HF groups showed higher µSBS (20 s: 21.35 ± 4.70 MPa; 60 s: 23.50 ± 4.27 MPa) than the 10%HF groups (20 s: 14.51 ± 2.47 MPa; 60 s: 16.54 ± 3.12 MPa) and C (6.46 ± 2.71 MPa). The most prevalent failure pattern was "mixed" for etched groups, and "adhesive" for C. Etching protocols affect the evaluated properties by roughening materials' surface and, in some cases, regularizing surface defects. The best overall outcomes were achieved when applying 5%HF.

Hispanic Cancer Survivors Exposed to Multiple Natural Disasters: Pre-Post-Disaster Changes in Anxiety, Depression, PTSD, Perceived Stress, and Physical Symptom Burden.

BACKGROUND: Studies evaluating the effects of natural disasters on cancer outcomes are scarce, especially among USA ethnic minority groups, and none have focused on the effects of concurrent natural disasters and the COVID-19 pandemic. The goal of this secondary data analysis is to explore the impact of concurrent exposure to COVID-19 and earthquakes on psychological distress and symptom burden among Puerto Rican cancer survivors. METHODS: This secondary data analysis (n = 101) was part of a longitudinal case-control cohort study (n = 402) aimed at describing unmet psychological needs among Puerto Rican cancer patients and non-cancer subjects previously exposed to Hurricane María in 2017. The research team pooled data from participants (cancer survivors and non-cancer group) from their baseline assessments and from follow-up assessments conducted during January-July 2020 (earthquake and the lockdown period). A descriptive, paired t-test, non-parametric mean rank test, and two-sided Pearson correlation analyses were performed. RESULTS: Psychological distress and cancer symptom burden diminished over time. Resilience was significantly correlated with all the psychological and symptom burden variables during both pre- and post-earthquake and COVID-19 assessment periods. CONCLUSIONS: The results support the role of resilience, social support, and post-traumatic growth as potential protective factors preventing psychological distress and diminishing cancer symptom burden among cancer survivors exposed to natural disasters and the COVID-19 pandemic.

Investigation of Psychometric Properties and Correlation with Psychological Distress after Hurricane Hazards in Puerto Rico.

BACKGROUND: Puerto Rico (PR) is highly vulnerable to hurricanes, which severely impact cancer survivors by causing healthcare disruptions and increasing stress. This study investigates the reliability and factor structure of the Hurricane Hazards Inventory (HHI) and its relationship with psychological distress among cancer survivors and non-cancer controls in PR. METHODS: Using secondary data from a longitudinal study following Hurricane Maria (HM), the baseline assessment included sociodemographic data from participants, HHI, Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder (GAD-7). Statistical analyses involved descriptive statistics, Exploratory Factor Analysis (EFA), and Partial Least Squares Structural Equation Modeling (PLS-SEM). RESULTS: Among 260 participants, 78.7% were women, with a median age of 58.0 years. EFA reduced the HHI to 17 items grouped into three factors explaining 62.6% of the variance with excellent reliability (Cronbach's alpha 0.91). The three factors also showed good to excellent reliability (alpha 0.81 to 0.92). The median HHI score was 11.0 (range 4.0-26.5) out of 68. PLS-SEM revealed a direct effect of being a cancer survivor and tertiary hazards on depression and anxiety. CONCLUSION: The HHI is a valid and reliable tool for assessing mental health impact in cancer survivors after hurricanes. However, the study had limitations, including its small sample size and lack of control for all confounding variables. Future research with larger and more diverse samples is needed to further validate the HHI and examine its generalizability.

Case studies about smart contracts in healthcare.

The Internet of Things (IoT) such as devices and sensors are a fast growth reality which our bureaucratical and archaic institutional system is not yet ready to embrace its functionalities. In the health system, many developments are made, and smart devices are the key to preventing, studying, investigating, and solving a lot of diseases and improving our health system. But along with this, innovation is necessary for the hospitals, for example, to have a proper system that provides storage of health data information and respects the General Data Protection Regulation (GDPR) with the use of smart contracts that secure the integrity and disclosure of the patient's data, since the majority of hospitals still use paper, physical records to store data. In this study, we will briefly analyse and explain three different suggested methods to deal with the challenges that Internet of Medical Things (IoMT) encounters. We will not choose which one is the best because of the different features and the countries they are proposed but will emphasize the benefits and challenges which one has.

Relation between digital tool practices in the language arts classroom and reading comprehension scores.

Concerns about the negative effects of digitalization on students' reading comprehension, empirically backed by recent meta-analyses, question the efficacy of digital tools in the language arts classroom. By analyzing data from 4 and 8th grade US students from NAEP 2017, we aimed to test the generalization of the negative association between screens use and reading comprehension test scores within language arts classrooms, and to identify teachers' practices to support comprehension, which could reduce such a negative relationship. We used data from 149,400 4th grade and 144,900 8th grade students to predict their reading comprehension scores based on their frequency of use of digital devices in the language arts class, as well as on the specific learning activities performed with such devices. Results revealed that amount of daily use of digital devices was negatively related to scores on a reading comprehension test. In addition, teachers' uses of digital tools to support students' reading comprehension showed positive relations for student use of digital devices for reading projects, and negative relations for activities addressing specific reading skills, such as building and practicing vocabulary. We discuss these results in light of our current understanding of the effects of digitalization on reading.

Acceptance of Caregiver-Patient Support to Latinx Coping with Advanced Cancer (CASA) Intervention: A Caregiver Case Study.

Latinos frequently assume caregiver roles when the need arises in their social nucleus. Because of their active role, caregivers are heavily involved in their family member's cancer trajectory. Therefore, there is a need for culturally adapted interventions that integrate the caregiver and cancer patient. The objective is to present a case study of a former caregiver's experience and acceptance of the cultural adaptation of Caregiver-Patient Support to Latinx Coping with Advanced Cancer (CASA) intervention. We conducted a case study with a male caregiver between the ages of 20 and 30. A male caregiver expressed his experience and acceptance of a psychosocial intervention. He conveyed moderate to high acceptance of intervention components through anecdotes and opinions based on his experiences as a caregiver for multiple family members. Finally, he reported distress, but he presented little to no symptoms of caregiver burden, depression, anxiety, and hopelessness. It is crucial to culturally adapt interventions that integrate caregivers when they play a big part in their loved one's cancer journey. Integrating their perspective when adapting an intervention may assist in providing essential information that will benefit the patient and caregiver.