Feasibility and Acceptability of an English-as-a-Second Language Curriculum on Hepatitis B for Older Chinese American Immigrants

Asian immigrants to the U.S. have an increased prevalence of hepatitis B virus (HBV) infection compared to native born individuals; an estimated 10 percent of Chinese immigrants are infected with HBV. Using qualitative data from focus groups, we developed an English-as-a-Second Language (ESL) curriculum that aimed to improve knowledge about key hepatitis B facts. The curriculum was pilot-tested among 56 students aged 50 and older from intermediate-level ESL classes at a community-based organization that serves Chinese immigrants. Post-curriculum data showed increases in knowledge that hepatitis B can cause liver cancer (73% at pre-test vs. 91% at post-test; p value = 0.01) and that individuals can be infected with hepatitis B for life (34% vs. 81%; p valu

Factores clínicos y sociosanitarios relacionados a anemia en gestantes en el Hospital de Apoyo Sullana II-2

Objetivo: Determinar los factores clínicos y sociosanitarios relacionados con la anemia en gestantes en el Hospital de Apoyo Sullana II-2, 2020. Materiales y métodos: El estudio es de tipo observacional, analítico, retrospectivo, con una muestra de 122 historias clínicas y el instrumento fue una ficha de recolección de datos. Resultados: Los resultados indicaron que todas las mujeres embarazadas tenían anemia en niveles leves y moderados, además de un mayor número de casos de anemia en áreas rurales. En relación al trimestre de gestación, se logró identificar que en el primer trimestre 50% presentó anemia leve y 10.7% moderada, en el segundo trimestre 18% cursó con anemia leve y 19.7% moderada; mientras que en el tercer trimestre se evidenció nivel moderado de anemia en 1.6% de las pacientes, lo cual denota que gran cantidad de las gestantes con anemia se encontraban en el primer y segundo trimestre de gestación. Factores sociosanitarios como el estado civil y grado de instrucción se relacionaron con anemia, presentando p<0,05, a excepción de la edad, ya que no tuvo correlación p=0,158. Los factores clínicos asociados fueron signos y síntomas, las comorbilidades, antecedentes de anemia, paridad, tipos de parto y el control prenatal con p=0,000. Conclusiones: Se determinó que existe asociación entre los factores clínicos y anemia en gestantes, al igual que factores sociosanitarios como el estado civil y grado de instrucción; excluyendo la edad.Objective: To determine the clinical and socio-sanitary factors related to anemia in pregnant women at the Sullana II-2 Support Hospital, 2020. Materials and methods: The study was observational, analytical, retrospective, the sample was 122 medical records, the instrument was a data collection sheet. Results: The results indicated that all pregnant women had mild to moderate levels of anemia, with a higher number of anemia cases in rural areas. Regarding the trimester of gestation, it was found that in the first trimester 50% had mild anemia and 10.7% had moderate anemia. In the second trimester 18% had mild anemia and 19.7% had moderate anemia. In the third trimester, a moderate level of anemia was observed in 1.6% of the patients, which indicates that a large number of pregnant women with anemia were in the first and second trimesters of gestation. Sociosanitary factors such as marital status and level of education were related to anemia, with a p<0.05, except for age, which had no correlation (p=0.158). The associated clinical factors were signs and symptoms, comorbidities, history of anemia, parity, types of birth and prenatal care with p=0.00. Conclusions: It was determined that there is an association between clinical factors and anemia in pregnant women, as well as sociosanitary factors such as marital status and level of education, excluding age.Tesi

Cocina Mexicana para Diabeticos

Mexican Cookbook for Diabetic

La simplificación en los procesos de alimentos dentro de nuestro sistema procesal civil para lograr la efectividad de la tutela rápida requerida en dicho proceso

El proceso de alimentos ha sido diseñado legalmente como un proceso célere y eficaz que tiene como finalidad que los beneficiarios en esta caso, los menores en estado de necesidad obtengan lo indispensable para cubrir sus necesidades básicas como alimentación, salud, vivienda y educación dentro de la sociedad sin que se vulnere ninguno de sus derechos, por tal razón, este proceso es tomado además como un mecanismo de defensa rápido que le permite al menor alimentado, que uno de sus padres en representación del menor en estado de necesidad acuda ante el órgano competente para solicitar una pensión alimenticia que le permita solventar sus necesidades económicas de manera rápida, debido a que este proceso esta categorizado como un procedimiento rápido y ágil que trabaja conjuntamente con los principios de celeridad y tutela rápida a favor del menor o el sujeto en estado de necesidad. No obstante, en base al estudio generado en la presente investigación se ha logrado determinar que el proceso de alimentos no está cumpliendo con la objetivo de brindar un pensión rápida y proporcional al menor en estado de necesidad por la falta viabilidad en el procedimiento por parte de los jueces; Lo que ha generado un que en la práctica no se cumpla con los plazos cortos que brinda este proceso, generando así una grave vulneración al menor en estado de necesidad. Por ello, es importante precisar que este problema se ha generado por la sobrecarga procesal que existe en los juzgados de paz letrado, afectando notable al Principio del interés superior del niño, es decir, del menor alimentado por lo que es necesario crear lineamientos mínimos de solución normativo en base a una Simplificación del Proceso de Alimentos, en base al principio de oralidad en el Proceso procesal civil en la Audiencia Única, el formado de Conciliación y la Unificación de la Audiencia Única en el Traslado de la Demanda del Artículo 168° código del niño y del adolecente, con la finalidad de disminuir la carga procesal de los juzgados Paz Letrado y evitar que se siga vulnerado el Principio del interés superior del niño

MEDICIÓN DE CONTENIDO GÁSTRICO POR ULTRASONIDO EN RELACIÓN A LAS HORAS DE AYUNO EN PACIENTE PROGRAMADO PARA CIRUGÍA ELECTIVA.

Una de las principales complicaciones a las que se enfrenta el anestesiólogo en procedimientos electivos o de urgencia que involucran la instrumentación de la vía aérea superior es la aspiración pulmonar. La Sociedad Americana de Anestesiología ha generado las guías de ayuno preoperatorio que dictan 2h para líquidos claros, 6h para comida ligera y 8h para comida con grasa. Durante muchos años las normas indicaban que un ayuno de al menos 8 h para líquidos y sólidos era lo más apropiado para reducir el riesgo de broncoaspiración. Sin embargo, estudios de fisiología y metabolismo han demostrado que un ayuno excesivo provoca un contenido gástrico mayor y con el pH más bajo, hipoglucemia, deshidratación y mayor grado de estrés y ansiedad. La ultrasonografía aplicada a la anestesiología ha cobrado en los últimos años gran relevancia debido a que es de gran utilidad. La versatilidad ha permitido que se implemente en el período perioperatorio para la evaluación del contenido y volumen gástrico, parámetro de gran importancia en especial en situaciones de intubación de urgencia con el objetivo de hacer un manejo más racional y disminuir el riesgo de aspiración. Seasocia el volumen de contenido gástrico con las horas de ayuno en pacientes programados para cirugía electiva en el hospital de la Cruz Roja Mexicana, Delegación Distrito Federal. Se observa que el ayuno excesivo provoca un contenido gástrico mayor, sin embargo se necesitan investigaciones a futuro. Se hace hincapié en la utilización del ultrasonido como evaluación complementaria.UAEM, la autora

Estimating The Costs And Cost-effectiveness Of Promoting Mammography Screening Among US-based Latinas

Purpose: We characterize the costs and cost-effectiveness of a community health worker (CHW)-based intervention to promote screening mammography among US-based non-adherent Latinas. Methods: The parent study was a randomized controlled trial for 536 Latinas aged 42-74 years old who had sought care within a safety net health center in Western Washington. Participants were block-randomized within clinic to the control arm (usual care) or intervention arm (CHW-led motivational interviewing intervention). We used the perspective of the organization implementing promotional activities to characterize costs and cost-effectiveness. Cost data were categorized as program set-up and maintenance (initial training, booster/annual training) program implementation (administrative activities, intervention delivery); and, overhead/miscellaneous expenses. Cost-effectiveness was calculated as the incremental cost of screening for each additional woman screened between the intervention and control arms. Results: The respective costs per participant for standard care and the intervention arm were $69.96 and$300.99. There were no study arm differences in 1-year QALYs among women who completed a 12-month follow-up survey (intervention= 0.8827, standard care = 0.8841). Most costs pertained to program implementation and administrative activities specifically. The incremental cost per additional woman screened was $2,595.32. Conclusions: Our findings are within the ranges of costs and cost-effectiveness for other CHW programs to promote screening mammography among underserved populations. Our strong study design and focus on non-adherent women provides important strengths to this body of work, especially give implementation and dissemination science efforts regarding CHW-based health promotion for health disparity populations

System Dynamics Modeling for Cancer Prevention and Control: A systematic review

Cancer prevention and control requires consideration of complex interactions between multilevel factors. System dynamics modeling, which consists of diagramming and simulation approaches for understanding and managing such complexity, is being increasingly applied to cancer prevention and control, but the breadth, characteristics, and quality of these studies is not known. We searched PubMed, Scopus, APA PsycInfo, and eight peer-reviewed journals to identify cancer-related studies that used system dynamics modeling. A dual review process was used to determine eligibility. Included studies were assessed using quality criteria adapted from prior literature and mapped onto the cancer control continuum. Characteristics of studies and models were abstracted and qualitatively synthesized. 32 studies met our inclusion criteria. A mix of simulation and diagramming approaches were used to address diverse topics, including chemotherapy treatments (16%), interventions to reduce tobacco or e-cigarettes use (16%), and cancer risk from environmental contamination (13%). Models spanned all focus areas of the cancer control continuum, with treatment (44%), prevention (34%), and detection (31%) being the most common. The quality assessment of studies was low, particularly for simulation approaches. Diagramming-only studies more often used participatory approaches. Involvement of participants, description of model development processes, and proper calibration and validation of models showed the greatest room for improvement. System dynamics modeling can illustrate complex interactions and help identify potential interventions across the cancer control continuum. Prior efforts have been hampered by a lack of rigor and transparency regarding model development and testing. Supportive infrastructure for increasing awareness, accessibility, and further development of best practices of system dynamics for multidisciplinary cancer research is needed

HPV vaccine knowledge and beliefs among Cambodian American parents and community leaders.

BACKGROUND: The cervical cancer incidence rate among Cambodian American women is 15.0 per 100,000, compared to 7.7 per 100,000 among non-Latina white women. HPV infection has been identified as a universal risk factor for cervical cancer. The HPV vaccine was recently approved in the United States for females aged 9-26 years. There is little information about HPV vaccination knowledge and beliefs in Southeast Asian communities. METHODS: We conducted 13 key informant interviews with Cambodian community leaders, as well as four focus groups with Cambodian parents (37 participants). Two of the focus groups included fathers and two of the focus groups included mothers. Interview and focus group questions addressed HPV vaccine barriers and facilitators. RESULTS: Participants had limited knowledge about HPV infection and the HPV vaccine. Barriers to HPV vaccination included a lack of information about the vaccine, as well as concerns about vaccine safety, effectiveness, and financial costs. The most important facilitators were a health care provider recommendation for vaccination and believing in the importance of disease prevention. DISCUSSION: Future cervical cancer control educational programs for Cambodians should promote use of the HPV vaccine for age-eligible individuals. Health care providers who serve Cambodian communities should be encouraged to recommend HPV vaccination