Pilot Study of Skin Cancer Risk Reduction Behaviors, Cancer Communication, and Skin Cancer Beliefs in Hispanics

Purpose: Given rising rates of deadly melanoma skin cancer in Hispanics, the study objective was to examine skin cancer-related risk reduction behaviors and beliefs to dictate content for culturally targeted skin cancer prevention strategies for Hispanics. Methods/Data Source: An anonymous survey was administered to waiting room volunteers in a primary care facility in Albuquerque, New Mexico to assess skin cancer risk reduction behaviors, screening, cancer information seeking and communication, as well as skin cancer beliefs in Hispanics (n=48) and Non-Hispanic Whites (n=36). Results: We found lower levels of sun protection clothing use among Hispanics compared to Non-Hispanic Whites, but comparable use of sunscreen and shade-seeking among these groups. Hispanic ethnicity was the most important predictor of skin cancer misconceptions, with skin cancer information overload and misconceptions reported more often in Hispanics. Conclusions: This study demonstrates the need for culturally relevant information for ethnic minority populations such as Hispanics who have shown an increased risk of presenting with later stage, more aggressive melanoma skin cancer

A Pseudopterane Diterpene Isolated From the Octocoral Pseudopterogorgia acerosa Inhibits the Inflammatory Response Mediated by TLR-Ligands and TNF-Alpha in Macrophages

Several diterpenoids isolated from terrestrial and marine environments have been identified as important anti-inflammatory agents. Although considerable progress has been made in the area of anti-inflammatory treatment, the search for more effective and safer compounds is a very active field of research. In this study we investigated the anti-inflammatory effects of a known pseudopterane diterpene (referred here as compound 1) isolated from the octocoral Pseudopterogorgia acerosa on the tumor necrosis factor- alpha (TNF-α) and TLRs- induced response in macrophages. Compound 1 inhibited the expression and secretion of the inflammatory mediators TNF-α, interleukin (IL)-6, IL-1β, nitric oxide (NO), interferon gamma-induced protein 10 (IP-10), ciclooxygenase (COX)-2, inducible nitric oxide synthase (iNOS) and monocyte chemoattractant protein-1 (MCP-1) induced by LPS in primary murine macrophages. This effect was associated with the inhibition of IκBα degradation and subsequent activation of NFκB. Compound 1 also inhibited the expression of the co-stimulatory molecules CD80 and CD86, which is a hallmark of macrophage activation and consequent initiation of an adaptive immune response. The anti-inflammatory effect was not exclusive to LPS because compound 1 also inhibited the response of macrophages to TNF-α and TLR2 and TLR3 ligands. Taken together, these results indicate that compound 1 is an anti-inflammatory molecule, which modulates a variety of processes occurring in macrophage activation.Several diterpenoids isolated from terrestrial and marine environments have been identified as important anti-inflammatory agents. Although considerable progress has been made in the area of anti-inflammatory treatment, the search for more effective and safer compounds is a very active field of research. In this study we investigated the anti-inflammatory effects of a known pseudopterane diterpene (referred here as compound 1) isolated from the octocoral Pseudopterogorgia acerosa on the tumor necrosis factor- alpha (TNF-α) and TLRs- induced response in macrophages. Compound 1 inhibited the expression and secretion of the inflammatory mediators TNF-α, interleukin (IL)-6, IL-1β, nitric oxide (NO), interferon gamma-induced protein 10 (IP-10), ciclooxygenase (COX)-2, inducible nitric oxide synthase (iNOS) and monocyte chemoattractant protein-1 (MCP-1) induced by LPS in primary murine macrophages. This effect was associated with the inhibition of IκBα degradation and subsequent activation of NFκB. Compound 1 also inhibited the expression of the co-stimulatory molecules CD80 and CD86, which is a hallmark of macrophage activation and consequent initiation of an adaptive immune response. The anti-inflammatory effect was not exclusive to LPS because compound 1 also inhibited the response of macrophages to TNF-α and TLR2 and TLR3 ligands. Taken together, these results indicate that compound 1 is an anti-inflammatory molecule, which modulates a variety of processes occurring in macrophage activation

Prevalência de programas de promoção da saúde em unidades básicas de saúde no Brasil

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil.OBJETIVO Estimar a prevalência de programas de promoção da saúde nas unidades básicas de saúde no Brasil. MÉTODOS Estudo transversal descritivo realizado por meio de entrevistas telefônicas com coordenadores de unidades básicas de saúde. Do total de 42.486 unidades básicas de saúde cadastradas pelo Ministério da Saúde, 1.600 foram aleatoriamente selecionadas. As unidades foram amostradas nas cinco regiões do País de acordo com a proporção de unidades em cada região. Foi analisada a presença ou não de cinco programas de promoção da saúde: promoção de atividade física, cessação de tabagismo, cessação de uso de álcool e drogas ilícitas, alimentação saudável e ambiente saudável. Foram coletados dados sobre o tipo de ações desenvolvidas nos programas e a presença ou não da Estratégia de Saúde da Família na unidade. RESULTADOS A maioria das unidades básicas de saúde (62,0%) referiu ter pelo menos três programas de promoção da saúde e apenas 3,0% não tinha nenhum. A promoção do ambiente saudável e da alimentação saudável foram os programas mais prevalentes (77,0% e 72,0%, respectivamente), enquanto o controle do tabaco e do álcool foram referidos em 54,0% e 42,0% das unidades de saúde, respectivamente. A promoção de atividade física foi referida em menos de 40,0% das unidades e teve grande variação regional, com prevalência de 51,0% nas unidades do Sudeste e apenas 21,0% nas do Norte. A maioria das unidades de saúde (61,0%) oferecia Estratégia de Saúde da Família, porém não foi verificada maior prevalência de programas de promoção da saúde nessas unidades em relação às outras. CONCLUSÕES Este estudo mostrou que programas de promoção da saúde estão presentes na maioria das unidades básicas de saúde. Políticas públicas devem fortalecer a infraestrutura das unidades básicas de saúde e melhorar a capacitação dos trabalhadores de saúde para executar adequadamente a agenda de promoção de saúde do governo brasileiro

\u3ci\u3ePseudomonas syringae\u3c/i\u3e Hrp type III secretion system and effector proteins

Pseudomonas syringae is a member of an important group of Gram-negative bacterial pathogens of plants and animals that depend on a type III secretion system to inject virulence effector proteins into host cells. In P. syringae, hrpyhrc genes encode the Hrp (type III secretion) system, and avirulence (avr) and Hrpdependent outer protein (hop) genes encode effector proteins. The hrpyhrc genes of P. syringae pv syringae 61, P. syringae pv syringae B728a, and P. syringae pv tomato DC3000 are flanked by an exchangeable effector locus and a conserved effector locus in a tripartite mosaic Hrp pathogenicity island (Pai) that is linked to a tRNALeu gene found also in Pseudomonas aeruginosa but without linkage to Hrp system genes. Cosmid pHIR11 carries a portion of the strain 61 Hrp pathogenicity island that is sufficient to direct Escherichia coli and Pseudomonas fluorescens to inject HopPsyA into tobacco cells, thereby eliciting a hypersensitive response normally triggered only by plant pathogens. Large deletions in strain DC3000 revealed that the conserved effector locus is essential for pathogenicity but the exchangeable effector locus has only a minor role in growth in tomato. P. syringae secretes HopPsyA and AvrPto in culture in a Hrp-dependent manner at pH and temperature conditions associated with pathogenesis. AvrPto is also secreted by Yersinia enterocolitica. The secretion of AvrPto depends on the first 15 codons, which are also sufficient to direct the secretion of an Npt reporter from Y. enterocolitica, indicating that a universal targeting signal is recognized by the type III secretion systems of both plant and animal pathogens

Assessing the State of Obesity Care: Quality, Access, Guidelines, and Standards

BACKGROUND: An international panel of obesity medicine experts from multiple professional organizations examined patterns of obesity care and current obesity treatment guidelines to identify areas requiring updating in response to emerging science and clinical evidence. AIMS: The panel focused on multiple medical health and societal issues influencing effective treatment of obesity and identified several unmet needs in the definition, assessment, and care of obesity. METHODS: The panel was held in Leesburg, Virginia in September 2019. RESULTS: The panelists recommended addressing these unmet needs in obesity medicine through research, education, evaluation of delivery and payment of care, and updating clinical practice guidelines (CPG) to better reflect obesity\u27s pathophysiological basis and heterogeneity, as well as the disease\u27s health, sociocultural, and economic complications; effects on quality of life; need for standards for quantitative comparison of treatment benefits, risks, and costs; and the need to more effectively integrate obesity treatment guidelines into routine clinical practice and to facilitate more direct clinician participation to improve public understanding of obesity as a disease with a pathophysiological basis. The panel also recommended that professional organizations working to improve the care of people with obesity collaborate via a working group to develop an updated, patient-focused, comprehensive CPG establishing standards of care, addressing identified needs, and providing for routine, periodic review and updating. CONCLUSIONS: Unmet needs in the definition, assessment and treatment of obesity were identified and a blueprint to address these needs developed via a clinical practice guideline that can be utilized worldwide to respond to the increasing prevalence of obesity

Evaluation of the care provided by the outpatient clinic of the league of combat against STD/AIDS, health center, S.P., 1994-1997

Este trabalho analisou a assistência médica prestada pelos alunos da Liga de Combate a DST/AIDS, da Faculdade de Medicina de Ribeirão Preto - USP, no curso de três anos emeio, junto ao Programa de Prevenção e Controle de Aids do Centro de Saúde Escola. Foi utilizada a metodologia de avaliação em saúde (processo e resultados), que contemplou o estudo da assistência médica em um período contínuo de seguimento, sendo analisados os diagnósticos formulados, os exames laboratoriais e complementares prescritos, as medidas curativas e de promoção da saúde e prevenção de doenças. Foram estudados sessenta e seis (66) indivíduos, sendo 48,5% comunicantes de portadores do Vírus da Imunodeficiência Humana ou de doentes de aids, 27,3% portadores do HIV e 24,2% de doentes de aids. Houve maioria de pacientes masculinos, embora a relação homem:mulher cresça de 1:1, 2:1 e 3,5:1 no sentido comunicantes, portadores e doentes, com uma frequência modal de 40,9% na faixa etária de trinta (30) e trinta e nove (39) anos, o grau de escolaridade e as ocupações foram característicos de nível socioeconômico baixo. Formularam-se diagnósticos de deficiência da imunidade celular, exposição a doenças transmissíveis (aids, tuberculose e outras doenças infecciosas), infecções respiratórias agudas, doenças sexualmente transmissíveis, parasitoses, entre as principais. Em média, a clientela permaneceu 3,2 meses em seguimento, recebeu 2,4 consultas e 47,7% dela abandonouo atendimento. Os alunos participaram ativamente da pesquisa; a metodologia e as informações quantitativas contribuíram para a avaliação da qualidade da assistência médica, tendo o serviço de saúde correspondido como alternativa institucional para formação e assistência mais próxima da comunidade.The medical care provided by the students of the League of Combat against STD/AIDS belonging to the Faculty of Medicine of Ribeirão Preto - USP over a period of three and a half years was evaluated. We used the method of health evaluation based on the study of medical care during a continuous period of monitoring. The aim was to assess the quality of the care provided, analyzed in terms of the diagnoses formulated, of laboratory and complementary tests, of curative measures and of health promotion and disease prevention. A total of 66 individuals were studied, 48.5% of them being communicants of patients with HIV and AIDS, 27.3% HIVinfected patients, and 24.2% patients with AIDS. Most patients were males, although the man:woman ratio has been growing from 1:1, 2:1 and 3.5:1 in the following order: communicants, infected subjects and patients, with a modal frequency of 40.9% in the 30 to 39 year age range. Educational level and occupation were characteristic of a low socioeconomic level. The followingdiagnoses were made: cell immune deficiency; contacts with patients with aids, tuberculosis and other infectious diseases; infectious respiratory disease; sexually transmitted diseases; and parasitosis. The clients were followed up on average for a period of 3.2 months and received 2.4 visits, and 47.7% of them abandoned treatment. The students participated actively in the research, the methodology and the quantitative information obtained permitted the assessment of the quality of care, with the health service corresponding to the expectations for an institutional alternative for training and for providing care closer to the community

Bodyweight Perceptions among Texas Women: The Effects of Religion, Race/Ethnicity, and Citizenship Status

Despite previous work exploring linkages between religious participation and health, little research has looked at the role of religion in affecting bodyweight perceptions. Using the theoretical model developed by Levin et al. (Sociol Q 36(1):157–173, 1995) on the multidimensionality of religious participation, we develop several hypotheses and test them by using data from the 2004 Survey of Texas Adults. We estimate multinomial logistic regression models to determine the relative risk of women perceiving themselves as overweight. Results indicate that religious attendance lowers risk of women perceiving themselves as very overweight. Citizenship status was an important factor for Latinas, with noncitizens being less likely to see themselves as overweight. We also test interaction effects between religion and race. Religious attendance and prayer have a moderating effect among Latina non-citizens so that among these women, attendance and prayer intensify perceptions of feeling less overweight when compared to their white counterparts. Among African American women, the effect of increased church attendance leads to perceptions of being overweight. Prayer is also a correlate of overweight perceptions but only among African American women. We close with a discussion that highlights key implications from our findings, note study limitations, and several promising avenues for future research

Palynological investigations in the Orce Archaeological Zone, Early Pleistocene of Southern Spain

Palynological investigations in the Orce Archaeological Zone (OAZ) (Guadix-Baza Basin, Granada, Spain), Venta Micena 1 (VM1), Barranco Leon (BL) and Fuente Nueva 3 (FN3) are presented. This archaeological region is con-nected with the first Homo populations in Western Eurasia during the Early Pleistocene. The VM1 pollen record is characterized by Ephedra, and to a lesser extent, Pinus, Juniperus and evergreen Quercus, occassionally accompa-nied by Olea, Genisteae, Erica, deciduous Quercus, Alnus, Castanea, Fraxinus, Salix and Phillyrea. BL is dominated by Juniperus, Olea, Pinus, Poaceae, and evergreen Quercus. FN3 is characterized by an open Mediterranean woodland dominated by evergreen Quercus, Pinus, Juniperus and Olea, accompanied by deciduous Quercus, Castanea, Populus, Salix, Ulmus, Fraxinus, Pistacia, Phillyrea, Genisteae, Erica, Cistus, and Ephedra fragilis. Relic Tertiary taxa in OAZ include Carya, Pterocarya, Eucommia, Zelkova, and Juglans. The Early Pleistocene OAZ vegetation is a mosaic of different landscapes embracing mesophytes, thermophytes, xerophytes, xerothermophytes, and Mediterra-nean elements. These finds are compared with former pollen analyses in the region and beyond within the Ibe-rian Peninsula. (c) 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).Peer reviewe

Clinical Genetics Lacks Standard Definitions and Protocols for the Collection and Use of Diversity Measures

Genetics researchers and clinical professionals rely on diversity measures such as race, ethnicity, and ancestry (REA) to stratify study participants and patients for a variety of applications in research and precision medicine. However, there are no comprehensive, widely accepted standards or guidelines for collecting and using such data in clinical genetics practice. Two NIH-funded research consortia, the Clinical Genome Resource (ClinGen) and Clinical Sequencing Evidence-generating Research (CSER), have partnered to address this issue and report how REA are currently collected, conceptualized, and used. Surveying clinical genetics professionals and researchers (n = 448), we found heterogeneity in the way REA are perceived, defined, and measured, with variation in the perceived importance of REA in both clinical and research settings. The majority of respondents (>55%) felt that REA are at least somewhat important for clinical variant interpretation, ordering genetic tests, and communicating results to patients. However, there was no consensus on the relevance of REA, including how each of these measures should be used in different scenarios and what information they can convey in the context of human genetics. A lack of common definitions and applications of REA across the precision medicine pipeline may contribute to inconsistencies in data collection, missing or inaccurate classifications, and misleading or inconclusive results. Thus, our findings support the need for standardization and harmonization of REA data collection and use in clinical genetics and precision health research