Current Issue : April - June Volume : 2014 Issue Number : 2 Articles : 7 Articles
Background. Native Americans disproportionately experience adverse childhood experiences (ACEs) as well as health disparities,\r\nincluding high rates of posttraumatic stress, depression, and substance abuse.Many ACEs have been linked to methylation changes\r\nin genes that regulate the stress response, suggesting that these molecular changes may underlie the risk for psychiatric disorders\r\nrelated to ACEs. Methods.We reviewed published studies to provide evidence that ACE-related methylation changes contribute to\r\nhealth disparities in Native Americans. This frameworkmay be adapted to understand how ACEs may result in health disparities in\r\nother racial/ethnic groups. Findings. Here we provide evidence that links ACEs to methylation differences in genes that regulate the\r\nstress response. Psychiatric disorders are also associated withmethylation differences in endocrine, immune, and neurotransmitter\r\ngenes that serve to regulate the stress response and are linked to psychiatric symptoms and medical morbidity.We provide evidence\r\nlinking ACEs to these epigenetic modifications, suggesting that ACEs contribute to the vulnerability for developing psychiatric\r\ndisorders in Native Americans. Conclusion. Additional studies are needed to better understand how ACEs contribute to health and\r\nwell-being. These studies may inform future interventions to address these serious risks and promote the health and well-being of\r\nNative Americans....
The aim of this study was to analyze maternal and child health indicators and infant mortality rate (IMR) at the cities located\r\nat the 18th Health Division (HD) in Parana State, Brazil. In this ecological study we analyzed all live births and infant deaths\r\nwhich occurred from 2000 to 2009 at the 18th HD, collecting data from the Mortality Information Database and the Live Births\r\nInformation Database. The variables assessed were grouped into maternal, pregnancy and delivery, and neonatal variables. The\r\nanalysis was conducted using themean percentage of each variable and the IMR calculated for both periods: from 2000 to 2004 and\r\nfrom 2005 to 2009.The IMR was reduced considerably, following Brazilâ��s and Paran�´a Stateâ��s trend. Maternal indicators went down\r\nregarding the mean percentage of teenage mothers and low education, whereas they went up regardingmother with 35 years old or\r\nolder and mothers without a partner. Pregnancy indicators showed increased prematurity and cesarean birth. Neonatal indicators\r\nraised in black/brown skin color and low birth weights percentages. This study provides a better understanding of maternal and\r\nchild health in the cities located at the 18th HD, supplying grounds to plan actions regarding the real needs of each specific city....
Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to\r\nexplore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses\r\nfromgovernment hospitals and health clinics fromPeninsularMalaysia.Multistage cluster sampling was used to recruit 1000 nurses\r\nfromfour states ofMalaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version\r\n16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities\r\nduring the past 12 months. All attendance for the various activities was below 50%.Workshops were the most popular CPE activity\r\n(345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of\r\nfuture CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure\r\nthat nurses upgrade their knowledge and skills; however, it is recommended that policymakers and nurse leaders in the continuing\r\nprofessional development unit of health service facilities plan CPE activities to meet registered nurses� (RNs) needs and not simply\r\norganizational requirements....
The involvement of African Americans in research has long been expressed as a concern by the scientific community.While efforts\r\nhave been undertaken to identify factors inhibiting the participation of African Americans in health-related research, few efforts\r\nhave been undertaken to have highlight factors associated with their engagement of health-related research. An exploratory study\r\nof factors presumed to be associated with participation in health-related research was conducted among a nonprobability sample\r\nof African Americans (?? = 212) from a large urban community in the Midwest. The study was guided by a framework that\r\nhypothesized the influence of knowledge, beliefs, and perceptions about genetics and the involvement of providers in decisionmaking\r\non willingness to participate in health-related genetic research.Theresults revealed that knowledge, beliefs, and perceptions\r\nabout genetics and the involvement of providers were associated with willingness to engage in health-related genetic research\r\n(?? < .05). The most interesting, however, was that 88.7% of the participants who had not previously been involved in a healthrelated\r\nstudy who expressed a willingness to participate reported that they ââ?¬Å?had never been asked.ââ?¬Â Study findings suggest the need\r\nfor research that further examines factors associated with the involvement of African Americans in health-related genetic research....
Chronic stable angina (CSA) is a significant problem in the United States that can negatively impact patient quality of life (QoL).\r\nAn accurate assessment of the severity of a patient�s angina, the impact on their functional status, and their risk of cardiovascular\r\ncomplications is key to successful treatment of CSA. Active communication between the patient and their healthcare provider is\r\nnecessary to ensure that patients receive optimal therapy.Healthcare providers should be aware of atypical symptoms ofCSA in their\r\npatients, as patients may continue to suffer from angina despite the availability of multiple therapies. Patient questionnaires and\r\nsymptomchecklists can help patients communicate proactively with their healthcare providers. This paper discusses the prevalence\r\nof CSA, its impact on QoL, and the tools that healthcare providers can use to assess the severity of their patients� angina and the\r\nimpact on QoL....
A qualitative intervention was used to explore how older adults living in a long-termcare environment (nursing home) understand\r\nhope and experience being participants in a group in which a hope intervention was carried out. A group project in which each\r\nsession focused intentionally on a hope strategy was carried out with a convenience sample of 10 women (ages 75ââ?¬â??99) who\r\nwere members of an existing group. Data were analyzed using thematic analysis of the interviews (conducted before the group\r\nintervention was carried out and again at the end), field notes, and collaborative conversations regarding emerging themes. Findings\r\nfrom this study suggest that hope is not static and that it can change over time in response to oneââ?¬â?¢s situations and circumstances.\r\nAlso evident in this study is the potential for using a group process in long-term care to foster hope in an intentional way to make\r\nit more visible in the lives of the residents and their environment suggesting that one is ââ?¬Å?never too old for hope.ââ?¬Â...
The Trp719Arg allele of KIF6 rs20455, a putative risk factor for CHD especially in those with elevated low-density lipoprotein\r\ncholesterol (LDL-C), was investigated in Filipino-American women (FAW, ?? = 235) participating in health screenings in four\r\ncities. The rs20455 genotype of each subject was determined by a multiplex assay using a Luminex-OLA procedure. The risk\r\nallele Trp719Arg was present in 77% of the subjects. The genotype distribution was 23% Trp/Trp, 51% Arg/Trp, and 26% Arg/Arg.\r\nGenotype did not predict the presence of CHD risk factors. Moreover, LDL-C, HDL-C, and triglycerides mean values did not\r\nvary as a function of genotype. However, those with the Arg/Arg genotype on statin medication exhibited a significantly higher\r\nmean triglycerides level (?? < 0.01). Approximately 60% of participants regardless of genotype exhibited LDL-C levels =100mg/dL\r\nbut were not taking medication. Approximately 43% of those with the Trp719Arg risk allele on statins exhibited elevated LDL-C\r\nlevels. Our study suggests that the Trp719Arg allele of KIF 6 rs20455 is common among Filipino-American women; thus, even with\r\nborderline LDL-C levels would benefit from statin treatment. Secondly, many participants did not exhibit guideline recommended\r\nLDL-C levels including many who were on statin drugs....
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