Family Descriptions of the Influence of Cultural Factors on Transitions in Serious Illness

Nearly 65 million Americans served as care provider to an ill or disabled adult, and over 1.6 million Americans participated in the care of a family member in hospice. Families experience transitions, or changes, throughout the serious illness trajectory. Throughout transitions in serious illness, families participate in the care, support, and decision-making for their ill family member. Families\u27 lives are often disrupted during this time and families experience emotional, physical and psychological distress during transitions. In spite of this, families are rarely included in care, and little is known about how families make sense of transitions. Culture, and the factors that shape it, can impact family interpretations of illness and meanings of illness transitions. This qualitative study explored family descriptions of the influence of four cultural factors (kinship/family, knowledge systems, community/social systems, and faith/religion) on transitions in serious illness during an understudied transitional time span, from the point of diagnosis up to the EOL phase. Eleven participant interviews were gathered from twelve family members of persons recently deceased due to serious illness. Data collection and analysis were guided by the concepts of culture and transitions in illness and conventional content analysis methods. Seven themes emerged from the data that described the influence of cultural factors on family transitions in serious illness: (1) family takes care of family; (2) we\u27re going to fight this ; (3) seeing and experience were believing; (4) families figured it out ; (5) community eased the family burden; (6) health professionals both eased and hindered family transitions; and (7) God was always in the background . Findings support the need for provision of patient-centered, family-focused, culturally congruent nursing care to seriously ill persons and their families across the illness continuum. Implications for nursing education and research are also discussed

Modelling in vitro digestion as strategy in developing tailored food for specific consumer population.

In recent years there has been an increasing interest of consumers for food with enhanced nutritional characteristics, spurring the industries to look for unconventional raw materials for novel food design. However, the use of alternative ingredients may result in interesting modifications in the quality as well as in the nutritional characteristics of the final product. Thus, the selection of ingredients is essential, since food formulation directly influences its structural features that in turns, may greatly affect the bioaccessibility, the digestibility and ultimately the bioavailability of some nutrients (e.g., starch and proteins). In this context, the in vitro digestion modelling shows great potential since it can provide useful information about the digestive fate of different food products throughout the human gastrointestinal tract. Considering these recent trends, the primary aims of this PhD research project were: 1) setting up a dynamic in vitro digestion apparatus able to mimic both the physical and the chemical conditions encountered in the human digestive system, thereby improving our understanding about the mechanism of food disintegration, the impact of food structure on nutrients bioaccessibility and the kinetics of nutrients hydrolysis; 2) using static and semi-dynamic in vitro digestion models to understand how food structure can affect nutrients bioaccessibility and digestibility. For this purpose, cereal-based products (pasta and bread) were used as model foods and the use of lentil flour as highly nutritious ingredient has been investigated

Searching for molecular insight on hybridization in Nothofagus spp. forest at Lagunas de Epulauquen, Argentina = Estudio de la hibridación a nivel molecular en bosques de Nothofagus spp. en Lagunas de Epulauquen, Argentina

Los bosques en Lagunas de Epulauquen (36º49’S; 71º04’O) han sido considerados como la población más septentrional de Nothofagus obliqua en Argentina. En años recientes se ha cuestionado su verdadero estatus. La convergencia de rutas migratorias y la hibridación histórica con Nothofagus alpina fueron las hipótesis planteadas como posible origen de esta distinción.Lagunas de Epulauquen forests (36°49'S; 71°04'W) have been considered the northernmost population of Nothofagus obliqua in Argentina. Recently, however, its taxonomic status has been questioned due to its morphological, architectural and genetic distinctiveness. The convergence of migratory routes and hybridization with Nothofagus alpina are the two main hypotheses proposed to explain the distinctiveness of this population. Despite its unique characteristics, no evaluation of its putative origin has been carried out. In order to test the hypothesis of hybridization we analyzed nuclear Adh and ITS fragment sequences together with 12 nuclear microsatellites. These nuclear regions were selected based on their previously reported divergence between N. obliqua and N. alpina. The survey was conducted in 12 individuals from Lagunas de Epulauquen, and individuals from N. obliqua (8), N. alpina (1), N. macrocarpa (2), N. glauca (4) and N. leonii (2). By combining a phylogenetic analysis with a principal coordinate analysis of microsatellite data, we showed that Lagunas de Epulauquen individuals were closely related to other N. obliqua individuals, while hybridization with N. alpina was not detected. Our results indicate that hybridization processes could be discarded as the origin of the Lagunas de Epulauquen distinctiveness. The hypothesis of the convergence of two N. obliqua migratory routes at this latitude was reinforced based on detected patterns of genetic diversity. Notwithstanding, its high geographical isolation seems to be also a key evolutionary factor to explain the distinctiveness of this population. Lagunas de Epulauquen population could be therefore included within Argentinean N. obliqua domestication and conservation programs.EEA BarilocheFil: Azpilicueta, Maria Marta. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Unidad de Genética Ecológica y Mejoramiento Forestal; ArgentinaFil: El Mujtar, Veronica Andrea. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Unidad de Genética Ecológica y Mejoramiento Forestal; ArgentinaFil: Gallo, Leonardo Ariel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche. Unidad de Genética Ecológica y Mejoramiento Forestal; Argentin

Le raffigurazioni di felini in ambra nella Penisola italiana

Si prendono qui in esame le ambre figurate preromane che rappresentano felini. Tra i rinvenimenti della Penisola italiana si contano ad oggi 33 esemplari, ma molti altri sono conservati in musei stranieri, senza indicazione del luogo di ritrovamento; coprono un arco cronologico compreso tra la metà del VII e il IV secolo a.C. e provengono da Etruria padana, Piceno, regioni meridionali (attuali Puglia, Basilicata e Campania) e area etrusco-laziale. Al di fuori della Penisola, alcune ambre sono state portate alla luce in Serbia, Israele e Siria. I manufatti italici fungevano per lo più da pendagli e, talvolta, rivestivano un arco di fibula. Dal punto di vista iconografico, si tratta soprattutto di protomi, di felini in posizione accovacciata, di scene con più animali e di altri unica. Lo studio stilistico delle ambre figurate in forma di felini ci permette di ricostruire infine parte delle vie di scambio attive durante l’età del ferro, delineando, ad esempio, la circolazione dei medesimi modelli lungo la sponda adriatica italiana nei secoli VI e V a.C.In this paper, we discuss pre-Roman carved ambers representing felines. There are currently 33 examples found on the Italian Peninsula, but many others are stored in foreign museums without information about their provenance. They are dated between the middle of the 7th and 4th century BC and come from Po Valley Etruria, Piceno, southern regions (present-day Puglia, Basilicata and Campania), and the Etruscan-Latial area. Outside the Peninsula, some ambers have been found in Serbia, Israel and Syria. The Italic artefacts were mostly used as pendants and sometimes covered the bow of a fibula. Iconographically, they are mainly protomes, felines in a crouching position, scenes with different animals, and other unica. The stylistic study of carved ambers shaped as felines allows us to reconstruct part of the trade routes active during the Iron Age, outlining, for example, the circulation of the same models along the Italian Adriatic shore in the 6th and 5th century BC

Stand development stages and recruitment patterns influence fine-scale spatial genetic structure in two Patagonian Nothofagus species

Key message: Nothofagus alpina (Poepp. et Endl.) Oerst. and Nothofagus obliqua (Mirb.) Oerst forests have strong fine-scale spatial genetic structures. The intensity of genetic structure patterns differed according to species, stand development stages, life stages, and spatial arrangement of regeneration groups. This data becomes useful for forest management as it provides an understanding of how populations evolve as well as of the consequences of disturbances and enables the establishment of sampling strategies. Context: The understanding of fine-scale spatial genetic structure in natural populations is useful for forest management. Although Nothofagus alpina (Poepp. et Endl.) Oerst. and N. obliqua (Mirb.) are important species of the Patagonian forest, little is known about the genetic structure of their populations. Aims: The main objectives were to investigate the differences in fine-scale spatial genetic structure among mature tree populations of both species considering two stands at different development stages. Genetic structure was also evaluated among life stages and spatial distribution groups of regeneration within the old-growth stand. Methods: Genetic structure was examined by microsatellite DNA analysis of regeneration and mature tree populations of both species (around 1300 individuals). Gene dispersal distance was additionally estimated. Results: In both stands and species, strong fine-scale spatial genetic structure and short dispersal distance were found. This pattern was stronger in the early successional forest, in N. obliqua populations, in earlier life stages, and in scattered regeneration. Conclusion: Stand development stages and recruitment patterns influence the fine-scale spatial genetic structure of both Nothofagus species. However, the genetic structure also differs between species.Estación Experimental Agropecuaria BarilocheFil: Sola, Georgina. Universidad Nacional del Comahue; ArgentinaFil: Sola, Georgina. Consejo Nacional de Investigaciones Cientificas y Tecnicas; ArgentinaFil: Marchelli, Paula. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estacion Experimental Agropecuaria Bariloche. Grupo de Ecologia Forestal; ArgentinaFil: Marchelli, Paula. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Instituto de Investigaciones Forestales y Agropecuarias Bariloche; ArgentinaFil: Gallo, Leonardo Ariel. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estacion Experimental Agropecuaria Bariloche. Area Forestal; ArgentinaFil: Chauchard, Luis. Universidad Nacional del Comahue; ArgentinaFil: El Mujtar, Veronica Andrea. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Bariloche; ArgentinaFil: El Mujtar, Veronica Andrea. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Instituto de Investigaciones Forestales y Agropecuarias Bariloche; Argentin

Oral contraceptives combined with interferon β in multiple sclerosis

Objective: To test the effect of oral contraceptives (OCs) in combination with interferon b (IFN-b) on disease activity in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: One hundred fifty women with RRMS were randomized in a 1:1:1 ratio to receive IFNb-1a subcutaneously (SC) only (group 1), IFN-b-1a SC plus ethinylstradiol 20 mg and desogestrel 150 mg (group 2), or IFN-b-1a SC plus ethinylestradiol 40 mg and desogestrel 125 mg (group 3). The primary endpoint was the cumulative number of combined unique active (CUA) lesions on brain MRI at week 96. Secondary endpoints included MRI and clinical and safety measures. Results: The estimated number of cumulative CUA lesions at week 96 was 0.98 (95% confidence interval [CI] 0.81–1.14) in group 1, 0.84 (95% CI 0.66–1.02) in group 2, and 0.72 (95% CI 0.53–0.91) in group 3, with a decrease of 14.1% (p 5 0.24) and 26.5% (p 5 0.04) when comparing group 1 with groups 2 and 3, respectively. The number of patients with no gadoliniumenhancing lesions was greater in group 3 than in group 1 (p 5 0.03). No significant differences were detected in other secondary endpoints. IFN-b or OC discontinuations were equally distributed across groups. Conclusions: Our results translate the observations derived from experimental models to patients, supporting the anti-inflammatory effects of OCs with high-dose estrogens, and suggest possible directions for future research

Sulbactam pivoxil powder attributes and compatibility study with excipients

Background: Sulbactam pivoxil is an irreversible β-lactamase inhibitor that can be used with β-lactam antibiotics to improve antibacterial therapy by the oral route. Relevant properties of this drug for pharmaceutical manufacturing are not available in the open literature. In this work, a solid-state characterization of sulbactam pivoxil at the molecular, particle, and bulk levels was performed. Results: Particles exhibited a mean diameter of about 350 μm, irregular shape crystals, and good flow properties. This work presents for the first time the crystal structure of this β-lactamase inhibitor obtained by X-ray diffraction analysis. Fourier-transform infrared results showed the characteristic bands of aliphatic hydrocarbons and ester groups. The differential scanning calorimetry curve exhibited a sharp endothermic peak at 109 °C corresponding to sulbactam pivoxil melting. The thermogravimetric curve revealed a mass loss at 184 °C associated with a decomposition process. This powder showed a moisture content of 0.34% and a water activity of 0.463. Potential interactions between sulbactam pivoxil and common pharmaceutical excipients were evaluated by thermal analysis. The endothermic peak and the enthalpies of melting were preserved in almost all the analyzed mixtures. Conclusion: The powder was constituted by micro-sized crystals of sulbactam pivoxil that had suitable physicochemical properties for processing in controlled humidity environments. Thermal analyses suggested that sulbactam pivoxil is compatible with most of the evaluated excipients. The information obtained in the present study is relevant for the development, manufacturing, and storage of formulations that include sulbactam pivoxil.Fil: Gallo, Loreana Carolina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Planta Piloto de Ingeniería Química. Universidad Nacional del Sur. Planta Piloto de Ingeniería Química; ArgentinaFil: González Vidal, Noelia Luján. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca; ArgentinaFil: Ferreira, Fabio F.. Universidad Federal do Abc; BrasilFil: Ramírez Rigo, María Veronica. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Planta Piloto de Ingeniería Química. Universidad Nacional del Sur. Planta Piloto de Ingeniería Química; Argentin

Synthesis of the O-linked hexasaccharide containing b-D-Galp-(1→2)- D-Galf in Trypanosoma cruzi mucins. Differences on sialylation by trans-sialidase of the two constituent hexasaccharides

The hexasaccharide b-D-Galp-(1?2)-[b-D-Galp-(1?3)]-b-D-Galp-(1?6)-[b-D-Galp(1?2)-b-D-Galf(1?4)]- D-GlcNAc (10) and its b-D-Galf-(1?2)-b-D-Galf containing isomer (7) are the largest carbohydrates in mucins of some strains of Trypanosoma cruzi. The terminal b-D-Galp units are sites of sialylation by the parasite trans-sialidase. Hexasaccharide 10 was chemically synthesized for the first time by a [3+3] nitrilium based convergent approach, using the trichloroacetimidate method of glycosylation. The 1 H NMR spectrum of its alditol was identical to the spectrum of the product released by b-elimination from the parasite mucin. The trans-sialylation reaction studied on the benzyl glycoside of 10 showed two monosialylated products whose relative abundance changed with time. On the other hand, only one product was produced by sialylation of the benzyl glycoside of 7. A preparative synthesis of the latter and spectroscopic analysis of the product unequivocally established the sialylation site at the less hindered (1?3)-linked galactopyranose.Fil: Agusti, Rosalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; ArgentinaFil: Giorgi, María Eugenia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; ArgentinaFil: Mendoza, Veronica Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; ArgentinaFil: Kashiwagi, Gustavo Adolfo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; ArgentinaFil: Muchnik, Rosa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; ArgentinaFil: Gallo, Carola. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones en Hidratos de Carbono. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones en Hidratos de Carbono; Argentin

Use of irrigation device for duct dilatation during sialendoscopy

Background: Continuous irrigation of the duct with isotonic saline is one of the fundamental stages of a successful sialendoscopic procedure. It allows for an adequate luminal distension for the removal of debris and mucous plugs and for the conservative treatment of strictures. This procedure, which commonly involves the use of a medical syringe, can be laborious, and it is often necessary to interrupt irrigation during surgery due to the high resistance to saline. Setting: Academic university hospital. Method: We propose the use of an irrigation device which consists of a high-pressure syringe barrel, an ergonomic piston handle, and a gauge used to monitor the inflation and deflation of balloon catheters. The system allows for a simple and safe dilation, ensuring good visualization of the salivary duct lumen during sialendoscopy. Conclusions: The irrigation system described can be widely used to perform a diagnostic or interventional sialendoscopy more effectively than with a typical manual irrigation procedure

Effect of Repeated Arthrocentesis on Cytology of Synovial Fluid

Repeated arthrocentesis is necessary to diagnose and monitor the evolution of joint diseases, but the procedure may worsen any inflammation and lead to an alteration in synovial fluid. The aim of this study was to determine the effect of repeated arthrocentesis on synovial fluid cytology in healthy horses with normal joints. The experimental study was approved by Ethics Committee (University of Pisa, Italy). Four horses were enrolled in this study on the basis of inclusion criteria and underwent repeated arthrocentesis of the intercarpal joint of both left and right forelimbs. The synovial fluid samples were processed for total protein concentration, total nucleated cell count, and differential leukocyte count. Data distribution was performed with the Komolgorovâ\u80\u93Smirnov test, and a Friedman test for repeated measures and Dunn's test as post hoc were performed in order to verify differences related to sampling times comparing each time point. Significance was set at P <.05. All horses remained free of lameness throughout the study period. Statistical differences were found for macrophage and lymphocyte related to sampling time. Our results support the finding that repeated arthrocentesis does not induce detectable synovial fluid alterations. Although mild statistically significant changes in macrophage and lymphocyte populations were found, the values were always within normal ranges, suggesting that these changes were not clinically significant. Moreover, the cytologic alterations rapidly solved. In conclusion, repeated arthrocentesis does not cause long term and clinically relevant alterations in synovial fluid cytology in healthy horses with normal joints