El papel de los síndromes culturales y los remedios tradicionales mexicanos en la promoción de salud de los niños

Purpose: To describe the context in which culture-bound syndromes that mothers of Mexican descent believed affected child wellness and describe how they restored health when these syndromes affected their children. Design: The findings of this come from a larger study that focused on the health promotion and protection practices used by mothers of Mexican descent in urban Texas A naturalistic design, using Spradley’s ethnographic interview techniques and participant observations, was selected to explore and describe the child health promotion and protection practices, including culture-bound syndromes, used by mothers of Mexican origin.   Method: Data collection consisted of 21 ethnographic interviews enhanced by focused home observations with nine Spanish speaking mothers.   Results: To these group of mothers, the culture-bound syndromes of empacho, fright and evil eye could affect children’s eating and sleep patterns, thereby causing an imbalance in a child’s wellbeing. Therefore the participants believed that they had be mindful of culture-bound syndromes that affected their children’s health and take care of those syndromes by using folk remedies to restore balance in their children’s’ wellbeing. Conclusion: The findings of this study provide an in-depth description of culture-bound syndromes and the folk remedies which mother of Mexican descent used to promote and protect the health of their preschool children. This knowledge provides a framework for healthcare professionals to use when working with mothers of Mexican descent who may be using folk healing to promote and protect the health of their children.Objetivo: Describir el contexto en el que los síndromes culturales de las madres de ascendencia mexicana creían que afectaban a la salud infantil y describir cómo ellas mejoraban la salud cuando estos síndromes afectaban a sus hijos. Diseño: Los resultados de este estudio se basan en una amplia investigación que se centró en la promoción de la salud y las prácticas de protección usadas por las madres de ascendencia mexicana en la ciudad de Texas. Se seleccionó un diseño naturalista, mediante las técnicas de entrevistas etnográficas de Spradley y observaciones de los participantes,  para explorar y describir la promoción de la salud infantil y las prácticas de protección, incluyendo los síndromes culturales usados por las madres de origen mexicano. Método: La recopilación de los datos consistió en 21 entrevistas etnográficas mejoradas por el enfoque de las observaciones en hogares con 9 madres de habla hispana. Resultados: Para este grupo de mujeres, los síndromes culturales del “empacho”, “mal de ojo” y “susto” podían provocar trastornos alimenticios y del sueño, causando un desajuste en el bienestar del niño. Además, las participantes creían que ellas tenían que ser conscientes de los síndromes culturales que afectaban a la salud de sus hijos y cuidar aquellos síndromes usando remedios tradicionales para promocionar y proteger la salud de sus niños. Conclusión: Los resultados de este estudio ofrecen una descripción en profundidad de los síndromes culturales y los remedios tradicionales que las madres de ascendencia mexicana usaban para promocionar y proteger la salud de sus niños. Este conocimiento ofrece un marco para que los profesionales de la salud lo usen cuando trabajen con madres de ascendencia mexicana que pueden estar usando este tipo de medios para cuidar a sus hijos

Protective Activity of Streptococcus pneumoniae Spr1875 Protein Fragments Identified Using a Phage Displayed Genomic Library

There is considerable interest in pneumococcal protein antigens capable of inducing serotype-independent immunoprotection and of improving, thereby, existing vaccines. We report here on the immunogenic properties of a novel surface antigen encoded by ORF spr1875 in the R6 strain genome. An antigenic fragment encoded by spr1875, designated R4, was identified using a Streptococcus pneumoniae phage displayed genomic library after selection with a human convalescent serum. Immunofluorescence analysis with anti-R4 antisera showed that Spr1875 was expressed on the surface of strains belonging to different serotypes. Moreover, the gene was present with little sequence variability in 27 different pneumococcal strains isolated worldwide. A mutant lacking Spr1875 was considerably less virulent than the wild type D39 strain in an intravenous mouse model of infection. Moreover, immunization with the R4 recombinant fragment, but not with the whole Spr1875 protein, induced significant protection against sepsis in mice. Lack of protection after immunization with the whole protein was related to the presence of immunodominant, non-protective epitopes located outside of the R4 fragment. In conclusion, our data indicate that Spr1875 has a role in pneumococcal virulence and is immunogenic. As the R4 fragment conferred immunoprotection from experimental sepsis, selected antigenic fragments of Spr1875 may be useful for the development of a pneumococcal protein-based vaccine

“It was Pretty Scary”: The Theme of Fear in Young Adult Women's Descriptions of a History of Adolescent Dating Abuse

The mental health impact of abusive adolescent dating relationships has not been well described, but fear related to abuse has been reported. We elaborate the theme of fear in women's descriptions of a history of adolescent dating abuse. A sample of community-based women, ages 19-34, who experienced an abusive dating relationship during adolescence (ages 11-20) was used. Data were analyzed via thematic analysis. Fear was a consistent and resonant theme. Three types of fear were identified: fear for self, fear for other relationships, and fearful expectation. These results offer important insights into the impact of abusive adolescent relationships on women's mental health

Do You Know My Child? Continuity of Nursing Care in the Pediatric Intensive Care Unit

BACKGROUND: Parents of children with complex, chronic conditions report a desire for continuity of care, but relatively little is known about the ways in which nursing continuity of care occurs and the extent to which it is delivered in the inpatient setting. OBJECTIVES: The objective of this analysis, which arose from a study on best practices in parent/nurse interactions in the pediatric intensive care unit (PICU), was to explore the delivery of continuity of nursing care in the PICU from the perspective of both parents and nurses. METHODS: A qualitative, grounded theory study using situational analysis was conducted with seven parents, and 12 nurse participants from a single PICU. Data sources included in-depth interviews, observation, and organizational written materials. Data were coded and analyzed using memoing and situational and positional maps to highlight emerging themes, context, and positions within the data. RESULTS: Parents repeatedly endorsed a desire for continuity of nursing care, wanting to ensure that the bedside nurse valued their child as an individual and understood the complexities of the child’s care regimen. Nurses understood this need but faced both contextual and personal challenges to achieving continuity, including fluctuations in staffing needs, training demands, fear of emotional entanglement, and concern for missed learning opportunities. DISCUSSION: Continuity of nursing care is highly valued by parents of children with CCC in the PICU, but significant barriers to optimal delivery exist within the current critical care environment. Mechanisms for supporting nurses to deliver continuity of care are needed, as are alternative ways to help parents feel that all nurses caring for their child have the knowledge necessary to deliver safe and compassionate care

What Impact Do Hospital and Unit-Based Rules Have Upon Patient and Family-Centered Care in the Pediatric Intensive Care Unit?

Patient and family-centered care (PFCC) is the foundation for pediatric healthcare. The existence of hospital rules can, however, impact the extent to which PFCC is delivered. This qualitative, grounded theory study identified the existence of explicit and implicit rules in a pediatric intensive care unit, all of which negatively affected the family's ability to receive care that was attentive to their needs. The rules also placed the registered nurse in the challenging position of serving as rule enforcer and facilitator of PFCC. Further work is needed to explore how to adapt the hospital environment to better meet families' needs

Do You Know My Child? Continuity of Nursing Care in the Pediatric Intensive Care Unit.

BACKGROUND: Parents of children with complex, chronic conditions report a desire for continuity of care, but relatively little is known about the ways in which nursing continuity of care occurs and the extent to which it is delivered in the inpatient setting. OBJECTIVES: The objective of this analysis, which arose from a study on best practices in parent/nurse interactions in the pediatric intensive care unit (PICU), was to explore the delivery of continuity of nursing care in the PICU from the perspective of both parents and nurses. METHODS: A qualitative, grounded theory study using situational analysis was conducted with seven parents, and 12 nurse participants from a single PICU. Data sources included in-depth interviews, observation, and organizational written materials. Data were coded and analyzed using memoing and situational and positional maps to highlight emerging themes, context, and positions within the data. RESULTS: Parents repeatedly endorsed a desire for continuity of nursing care, wanting to ensure that the bedside nurse valued their child as an individual and understood the complexities of the child’s care regimen. Nurses understood this need but faced both contextual and personal challenges to achieving continuity, including fluctuations in staffing needs, training demands, fear of emotional entanglement, and concern for missed learning opportunities. DISCUSSION: Continuity of nursing care is highly valued by parents of children with CCC in the PICU, but significant barriers to optimal delivery exist within the current critical care environment. Mechanisms for supporting nurses to deliver continuity of care are needed, as are alternative ways to help parents feel that all nurses caring for their child have the knowledge necessary to deliver safe and compassionate care

Please Ask Gently: Using Culturally Targeted Communication Strategies to Initiate End-of-Life Care Discussions With Older Chinese Americans.

BackgroundHealth-care providers (HCPs) find facilitating end-of-life (EOL) care discussions challenging, especially with patients whose ethnicities differ from their own. Currently, there is little guidance on how to initiate and facilitate such discussions with older Chinese Americans (≥55 years) and their families.ObjectiveTo explore communication strategies for HCPs to initiate EOL care discussions with older Chinese Americans in the San Francisco Bay Area.DesignThis qualitative (focused) ethnographic study included field observations and individual semistructured interviews with 14 community-dwelling older Chinese Americans who lived independently at home, 9 adult children, and 7 HCPs. Responses were analyzed using open coding, memos, and comparison across participants.ResultsThe study participants emphasized the importance of assessing readiness for early EOL care discussions. All recommended using indirect communication approaches to determine older Chinese Americans' readiness. Indirect communication can be culturally targeted and applied at both system-wide (ie, health-care system) and individual (ie, HCP) levels. To institutionalize the practice, health-care facilities should implement EOL care discussion inquiries as part of routine during check-in or intake questionnaires. In individual practice, using depersonalized communication strategies to initiate the discussion was recommended to determine older Chinese Americans' readiness.ConclusionAssessing readiness should be an essential and necessary action for early EOL care discussions. Culturally targeted assessment of older Chinese Americans includes using indirect communication approaches to initiate an EOL care discussion to determine their readiness. In addition to health-care system integration, providers should implement and evaluate proposed EOL discussion initiation prompts with their older Chinese American patients