Doula Support for Hispanic Women

Purpose This quantitative study will seek to provide valuable insight into the needs and preferences of Hispanic women during labor with the potential benefit of doula support in minimizing their pain. Methods A quasi-experimental design study will be conducted, randomizing a convenient sample into two groups consisting of one experimental and one control group, with the objective of evaluating the efficacy of doula presence as a source for pain management in Hispanic women. One hundred Hispanic women will be recruited under the following criteria: 18 years or older, a single fetus pregnancy, gestational age 37 weeks and above, and no complications during pregnancy. At the completion of labor, the women will be asked their pain level using the Childbirth Pain Scale. Results The data has not yet been collected, however, the t-test is expected to result in a low p-value, determining that doula support reduces pain during labor in Hispanic women Conclusion Cultural proficiency plays a crucial role in providing effective care, particularly in the context of nursing, because nurses often have the initial interaction to identify cultural distinctions among patients. Hence, the importance of addressing the gap in research concerning the impact of doula support on labor pain among Hispanic women, as their preferences may be influenced by their cultural customs

Restart Solar: How NYC Can Renew Its Solar Program To Benefit Workers & Community

New York City intends to install 100 MW of solar on the rooftops of public buildings by 2025. Over the next nine years, this upgrading of public infrastructure could provide significant benefits for New Yorkers, and not just in terms of reducing emissions. These solar installations, impacting over 300 public buildings, can create thousands of good, union jobs for New York residents, and significantly reduce the City's electricity bill, freeing up funds for new and innovative programs that generate wealth in our communities. Despite the clear opportunities for leveraging this solar program to the benefit of communities and workers, this report finds that New York City's public rooftop solar energy initiative can do more to address the needs of our City's low-income communities and workers

Restart Solar: Energizing Environmental Justice Communities

New York City has taken the first steps towards a clean energy future by setting a goal of installing 100 megawatts (MW) of solar power on public buildings by 2025. Alongside expected private sector solar installations, this will help reduce our City's carbon emissions and our dependence on fossil fuels.Yet, if the first rounds of solar installations on over 100 public buildings are any indication of the goals of this program, the City is failing to prioritize those communities that are most in need of clean energy infrastructure. The communities that need solar the most are communities that have suffered from disproportionate amounts of environmental pollution. These are New York City's environmental justice communities, which have been hurt first and worst by environmental injustices. It is time to change that paradigm with the City's public solar program.This report was featured in a City Limits op-ed by Virginia Ribot, a climate justice organizer at El Puente and a member of Mothers Out Front: "City Views – City's Public Solar Investments Must Favor Low-Income Communities.

La microempresa como alternativa de solución a la problemática de desempleo de los desplazados en el barrio Timayu del L D.T.C.H. de Santa Marta

Sin lugar a dudas, el desplazamiento forzado por el conflicto armado interno es un factor que está modificando paulatinamente, la geografía humana y social del País y marcando directa o indirectamente y en diversos grados a Colombia. Como es sabido, la secuela más próxima del desplazamiento forzado por el conflicto armado interno, es la insatisfacción de las necesidades básicas de la población afectada, asociada con una situación de desprotección y vulnerabilidad que afecta especialmente a los niños y niñas, a las mujeres y ancianos. No menos importante es que la sociedad, en su conjunto, se sensibilice y comprometa con todos los colombianos que enfrentan la pérdida de su territorio, la ruptura de sus lazos familiares y/o comunitarios y el debilitamiento de su identidad cultural. Es desde las ONGs y las Iglesias que se empezó a plantear algunas respuestas de atención a esta etapa, con limitados recursos pero con una actitud de real de compromiso, estos sectores fueron llevando esperanza y aliento a una población que no encontraba mayor amparo. El apoyo brindado por estas instituciones tuvo una fuerte incidencia en lo que se llamo la "ayuda humanitaria", que tuvo la finalidad de proteger y garantizar la sobrevivencia de los desplazados. Fueron aquí intensos los programas de apoyo legal y social. Donde más se pudo avanzar es en la difusión de la problemática y en la organización de las victimas. El trabajo de difusión sirvió para ir comprometiendo a otros actores en la atención de dicha problemática, de manera particular al estado y la comunidad internacional; la organización de desplazados fue un instrumento importante para apoyar el trabajo de difusión pero sobre todo para hacer de ellos actores directos de su reivindicación. Por todo lo anterior, el presente trabajo realizado entre diciembre de 1999 y junio de 2003, intenta aportar un granito de arena en la solución de la problemática de la PDI (Población Desplazada Interna). El objeto de estudio fue la Población Desplazada, asentada en el Barrio Timayú, del Distrito de Santa Marta. Inicialmente, se escogió una muestra de 50 familias asentadas en el barrio Divino Niño; pero, fue imposible trabajar con este grupo por su negativa para brindar algún tipo de información. No fue fácil realizar la investigación, por el recelo al momento de brindar información, tanto por parte de las instituciones (Red de Solidaridad, Defensoría del Pueblo, Procuraduría, entre otras), como por parte del objeto de estudio. La primera parte de este trabajo, presenta la manera utilizada para la obtención de la información y cómo se sistematizó, así como la conceptualización del desplazamiento y la normatividad existente sobre el mismo (anteproyecto). La segunda parte, presenta las cifras y el estado actual del fenómeno y un análisis que permitió evaluar la magnitud del desplazamiento forzado, precisar el impacto causado por éste en las familias asentadas en el barrio Timayú, así como a esta comunidad receptora, así como la caracterización de esta comunidad. En la tercera parte, se consigna las prioridades y necesidades vistas tanto por parte de los desplazados, de los residentes y de las Instituciones, así como las ayudas que prestan algunas instituciones tanto nacionales como internacionales. La última parte, presenta las conclusiones a que llegaron los investigadores, así como las recomendaciones sugeridas a partir de los hallazgos. En los anexos se muestran algunas fotografías de las condiciones infrahumanas en que viven los desplazados en esta comunidad, así como algunas graficas con cifras representativas, facilitadas por la RSS (Red de Solidaridad Social).Sin lugar a dudas, el desplazamiento forzado por el conflicto armado interno es un factor que está modificando paulatinamente, la geografía humana y social del País y marcando directa o indirectamente y en diversos grados a Colombia. Como es sabido, la secuela más próxima del desplazamiento forzado por el conflicto armado interno, es la insatisfacción de las necesidades básicas de la población afectada, asociada con una situación de desprotección y vulnerabilidad que afecta especialmente a los niños y niñas, a las mujeres y ancianos. No menos importante es que la sociedad, en su conjunto, se sensibilice y comprometa con todos los colombianos que enfrentan la pérdida de su territorio, la ruptura de sus lazos familiares y/o comunitarios y el debilitamiento de su identidad cultural. Es desde las ONGs y las Iglesias que se empezó a plantear algunas respuestas de atención a esta etapa, con limitados recursos pero con una actitud de real de compromiso, estos sectores fueron llevando esperanza y aliento a una población que no encontraba mayor amparo. El apoyo brindado por estas instituciones tuvo una fuerte incidencia en lo que se llamo la "ayuda humanitaria", que tuvo la finalidad de proteger y garantizar la sobrevivencia de los desplazados. Fueron aquí intensos los programas de apoyo legal y social. Donde más se pudo avanzar es en la difusión de la problemática y en la organización de las victimas. El trabajo de difusión sirvió para ir comprometiendo a otros actores en la atención de dicha problemática, de manera particular al estado y la comunidad internacional; la organización de desplazados fue un instrumento importante para apoyar el trabajo de difusión pero sobre todo para hacer de ellos actores directos de su reivindicación. Por todo lo anterior, el presente trabajo realizado entre diciembre de 1999 y junio de 2003, intenta aportar un granito de arena en la solución de la problemática de la PDI (Población Desplazada Interna). El objeto de estudio fue la Población Desplazada, asentada en el Barrio Timayú, del Distrito de Santa Marta. Inicialmente, se escogió una muestra de 50 familias asentadas en el barrio Divino Niño; pero, fue imposible trabajar con este grupo por su negativa para brindar algún tipo de información. No fue fácil realizar la investigación, por el recelo al momento de brindar información, tanto por parte de las instituciones (Red de Solidaridad, Defensoría del Pueblo, Procuraduría, entre otras), como por parte del objeto de estudio. La primera parte de este trabajo, presenta la manera utilizada para la obtención de la información y cómo se sistematizó, así como la conceptualización del desplazamiento y la normatividad existente sobre el mismo (anteproyecto). La segunda parte, presenta las cifras y el estado actual del fenómeno y un análisis que permitió evaluar la magnitud del desplazamiento forzado, precisar el impacto causado por éste en las familias asentadas en el barrio Timayú, así como a esta comunidad receptora, así como la caracterización de esta comunidad. En la tercera parte, se consigna las prioridades y necesidades vistas tanto por parte de los desplazados, de los residentes y de las Instituciones, así como las ayudas que prestan algunas instituciones tanto nacionales como internacionales. La última parte, presenta las conclusiones a que llegaron los investigadores, así como las recomendaciones sugeridas a partir de los hallazgos. En los anexos se muestran algunas fotografías de las condiciones infrahumanas en que viven los desplazados en esta comunidad, así como algunas graficas con cifras representativas, facilitadas por la RSS (Red de Solidaridad Social)

Expression of Intratumoral IGF-II Is Regulated by the Gene Imprinting Status in Triple Negative Breast Cancer from Vietnamese Patients

African American women suffer higher incidence and mortality of triple negative breast cancer (TNBC) than Caucasian women. TNBC is very aggressive, causing the worst clinical outcome. We previously demonstrated that tumors from these patients express high IGF-II and exhibit high activation of the IGF signaling pathways. IGF-II gene expression is imprinted (monoallelic), promotes tumor progression, and metastasis and regulates Survivin, a TNBC prognostic marker. Since BC mortality has increased among young Vietnamese women, we analyzed 48 (paired) TNBC samples from Vietnamese patients to assess IGF-II expression. We analyzed all samples by qrtPCR for identification of IGF-II heterozygosity and to determine allelic expression of the IGF-II gene. We also analyzed the tissues for proIGF-II and Survivin by RT-PCR and Western blotting. A total of 28 samples displayed IGF-II heterozygosity of which 78% were biallelic. Tumors with biallelic IGF-II gene expression exhibited the highest levels of proIGF-II and Survivin. Although 100% of these tissues corresponding normal samples were biallelic, they expressed significantly lower levels of or no proIGF-II and Survivin. Thus, IGF-II biallelic gene expression is differentially regulated in normal versus tumor tissues. We propose that intratumoral proIGF-II is dependent on the IGF-II gene imprinting status and it will promote a more aggressive TNBC

Enhancement of cutaneous immunity during aging by blocking p38 mitogen-activated protein (MAP) kinase-induced inflammation

Background Immunity decreases with age, which leads to reactivation of varicella zoster virus (VZV). In human subjects age-associated immune changes are usually measured in blood leukocytes; however, this might not reflect alterations in tissue-specific immunity. Objectives We used a VZV antigen challenge system in the skin to investigate changes in tissue-specific mechanisms involved in the decreased response to this virus during aging. Methods We assessed cutaneous immunity based on the extent of erythema and induration after intradermal VZV antigen injection. We also performed immune histology and transcriptomic analyses on skin biopsy specimens taken from the challenge site in young (65 years) subjects. Results Old human subjects exhibited decreased erythema and induration, CD4+ and CD8+ T-cell infiltration, and attenuated global gene activation at the site of cutaneous VZV antigen challenge compared with young subjects. This was associated with increased sterile inflammation in the skin in the same subjects related to p38 mitogen-activated protein kinase–related proinflammatory cytokine production (P < .0007). We inhibited systemic inflammation in old subjects by means of pretreatment with an oral small-molecule p38 mitogen-activated protein kinase inhibitor (Losmapimod; GlaxoSmithKline, Brentford, United Kingdom), which reduced both serum C-reactive protein levels and peripheral blood monocyte secretion of IL-6 and TNF-α. In contrast, cutaneous responses to VZV antigen challenge were increased significantly in the same subjects (P < .0003). Conclusion Excessive inflammation in the skin early after antigen challenge retards antigen-specific immunity. However, this can be reversed by inhibition of inflammatory cytokine production that can be used to promote vaccine efficacy and the treatment of infections and malignancy during aging

The role of prostaglandin E2 (PGE 2) in toll-like receptor 4 (TLR4)-mediated colitis-associated neoplasia

<p>Abstract</p> <p>Background</p> <p>We have previously found that TLR4-deficient (TLR4-/-) mice demonstrate decreased expression of mucosal PGE ₂and are protected against colitis-associated neoplasia. However, it is still unclear whether PGE ₂is the central factor downstream of TLR4 signaling that promotes intestinal tumorigenesis. To further elucidate critical downstream pathways involving TLR4-mediated intestinal tumorigenesis, we examined the effects of exogenously administered PGE ₂in TLR4-/- mice to see if PGE ₂bypasses the protection from colitis-associated tumorigenesis.</p> <p>Method</p> <p>Mouse colitis-associated neoplasia was induced by azoxymethane (AOM) injection followed by two cycles of dextran sodium sulfate (DSS) treatment. Two different doses of PGE ₂(high dose group, 200 μg, n = 8; and low dose group, 100 μg, n = 6) were administered daily during recovery period of colitis by gavage feeding. Another group was given PGE ₂during DSS treatment (200 μg, n = 5). Inflammation and dysplasia were assessed histologically. Mucosal Cox-2 and amphiregulin (AR) expression, prostanoid synthesis, and EGFR activation were analyzed.</p> <p>Results</p> <p>In control mice treated with PBS, the average number of tumors was greater in WT mice (n = 13) than in TLR4-/- mice (n = 7). High dose but not low dose PGE ₂treatment caused an increase in epithelial proliferation. 28.6% of PBS-treated TLR4-/- mice developed dysplasia (tumors/animal: 0.4 ± 0.2). By contrast, 75.0% (tumors/animal: 1.5 ± 1.2, P < 0.05) of the high dose group and 33.3% (tumors/animal: 0.3 ± 0.5) of the low dose group developed dysplasia in TLR4-/- mice. Tumor size was also increased by high dose PGE ₂treatment. Endogenous prostanoid synthesis was differentially affected by PGE ₂treatment during acute and recovery phases of colitis. Exogenous administration of PGE ₂increased colitis-associated tumorigenesis but this only occurred during the recovery phase. Lastly, PGE ₂treatment increased mucosal expression of AR and Cox-2, thus inducing EGFR activation and forming a positive feedback mechanism to amplify mucosal Cox-2.</p> <p>Conclusions</p> <p>These results highlight the importance of PGE ₂as a central downstream molecule involving TLR4-mediated intestinal tumorigenesis.</p

"The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: a 10/66 Dementia Research Group population-based survey"

<p>Abstract</p> <p>Background</p> <p>The number of older people is set to increase dramatically worldwide. Demographic changes are likely to result in the rise of age-related chronic diseases which largely contribute to years lived with a disability and future dependence. However dependence is much less studied although intrinsically linked to disability. We investigated the prevalence and correlates of dependence among older people from middle income countries.</p> <p>Methods</p> <p>A one-phase cross-sectional survey was carried out at 11 sites in seven countries (urban sites in Cuba, Venezuela, and Dominican Republic, urban and rural sites in Peru, Mexico, China and India). All those aged 65 years and over living in geographically defined catchment areas were eligible. In all, 15,022 interviews were completed with an informant interview for each participant. The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, dementia, physical impairments and self-reported diagnoses. Dependence was interviewer-rated based on a key informant's responses to a set of open-ended questions on the participant's needs for care. We estimated the prevalence of dependence and the independent contribution of underlying health conditions. Site-specific prevalence ratios were meta-analysed, and population attributable prevalence fractions (PAPF) calculated.</p> <p>Results</p> <p>The prevalence of dependence increased with age at all sites, with a tendency for the prevalence to be lower in men than in women. Age-standardised prevalence was lower in all sites than in the USA. Other than in rural China, dementia made the largest independent contribution to dependence, with a median PAPF of 34% (range 23%-59%). Other substantial contributors were limb impairment (9%, 1%-46%), stroke (8%, 2%-17%), and depression (8%, 1%-27%).</p> <p>Conclusion</p> <p>The demographic and health transitions will lead to large and rapid increases in the numbers of dependent older people particularly in middle income countries (MIC). The prevention and control of chronic neurological and neuropsychiatric diseases and the development of long-term care policies and plans should be urgent priorities.</p

MRI-derived g-ratio and lesion severity in newly diagnosed multiple sclerosis

Myelin loss is associated with axonal damage in established multiple sclerosis. This relationship is challenging to study in vivo in early disease. Here, we ask whether myelin loss is associated with axonal damage at diagnosis, by combining non-invasive neuroimaging and blood biomarkers. We performed quantitative microstructural MRI and single molecule ELISA plasma neurofilament measurement in 73 patients with newly diagnosed, immunotherapy naïve relapsing-remitting multiple sclerosis. Myelin integrity was evaluated using aggregate g-ratios, derived from magnetization transfer saturation (MTsat) and neurite orientation dispersion and density imaging (NODDI) diffusion data. We found significantly higher g-ratios within cerebral white matter lesions (suggesting myelin loss) compared with normal-appearing white matter (0.61 vs 0.57, difference 0.036, 95% CI 0.029 to 0.043, p &amp;lt; 0.001). Lesion volume (Spearman’s rho rs= 0.38, p &amp;lt; 0.001) and g-ratio (rs= 0.24 p &amp;lt; 0.05) correlated independently with plasma neurofilament. In patients with substantial lesion load (n = 38), those with higher g-ratio (defined as greater than median) were more likely to have abnormally elevated plasma neurofilament than those with normal g-ratio (defined as less than median) (11/23 [48%] versus 2/15 [13%] p &amp;lt; 0.05). These data suggest that, even at multiple sclerosis diagnosis, reduced myelin integrity is associated with axonal damage. MRI-derived g-ratio may provide useful additional information regarding lesion severity, and help to identify individuals with a high degree of axonal damage at disease onset. York, Martin et al. simultaneously measured g-ratio and plasma neurofilament in 73 relapsing-remitting multiple sclerosis patients at diagnosis using advanced MRI and single molecule ELISA. They demonstrate that g-ratio of cerebral white matter lesions varies at diagnosis, and show that high g-ratio of lesions is associated with elevated plasma neurofilament