Radzynski Rocznik Humanistyczny最新文献

{"title":"Addressing Challenges to Providing Health Care in a Short Term Medical Mission: Diabetes Outcomes in Migrant Farmworkers","authors":"Mary Winston","doi":"10.18130/v3qf9q","DOIUrl":"https://doi.org/10.18130/v3qf9q","url":null,"abstract":"The Farmworker Family Health Program (FWFHP), a nurse led mobile migrant health clinic, provides health care to Hispanic migrant farmworkers in an annual two week service learning trip. The FWFHP shares many similarities with international programs where care is provided to underserved populations in resource poor areas called short term medical missions (STMMs). Questions have been raised concerning the effectiveness of these venues due to lack of outcome evaluations and failure to address challenges to providing clinically and culturally competent, sustainable and accountable care. Nurses frequently contribute their time and expertise in STMMs but few outcomes studies emanate from the discipline. A mixed methods case study framed by the Quality Health Outcomes Model was employed to describe how the nurse led FWFHP addresses challenges to providing care and to provide an analysis of outcomes of diabetes (DM) care given during the 2012 FWFHP. The FWFHP was found to have multiple structures in place which promote clinical and cultural competencies, sustainability and accountability resulting in both quantifiable and perceived benefits in the community served. Sixty-four percent (288/447) of adult patients had one or more risks for DM. Seventy-six percent (219/288) of those with risk received risk reduction education. Seventy-seven (77/288, 26.7%) individuals with risk received referral for follow up; 19.5% (15/77) of those sought follow-up after being seen at the FWFHP. Blood glucoses (BG) were significantly lower at follow-up compared to initial levels at the FWFHP (p=0.008, n=8). There were no significant statistical differences in comparisons of initial and follow-up blood pressure, weight or body mass index (BMI). The nurse led FWFHP effectively targets DM and provides risk information which has been previously proven to increase adoption of healthy behaviors. Reduction of BG levels found at follow-up could be a measure of positive behavioral changes resulting from FWFHP activities. The FWFHP model can be adapted for use by STMM organizers in structuring their programs in a variety of domestic and international settings. Findings concerning the small number of farmworkers who followed up have relevance for all STMMs. Even though follow-up may be facilitated, barriers to follow- up access likely persist after mission providers depart. Factors affecting access to follow- up care such as distance, cost and transportation should be considered when planning all STMM health care. Strategies for removing these barriers as well as ongoing research on whether patients receive appropriate care over time are needed.","PeriodicalId":33824,"journal":{"name":"Radzynski Rocznik Humanistyczny","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147907348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children of Incarcerated Parents: The Impact of Parental Incarceration on Prisoners and Their Families","authors":"Caitlin Novero Clarke","doi":"10.18130/v3k23d","DOIUrl":"https://doi.org/10.18130/v3k23d","url":null,"abstract":"No abstract provided","PeriodicalId":33824,"journal":{"name":"Radzynski Rocznik Humanistyczny","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147910670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue Engineering Sites for Pancreatic Islet Transplantation","authors":"Daniel T. Bowers","doi":"10.18130/v32m2w","DOIUrl":"https://doi.org/10.18130/v32m2w","url":null,"abstract":"Pancreatic islet transplantation, a curative treatment for Type 1 Diabetes, is restricted from broad application due to hypoxia as well as innate and specific immunity. Encapsulation technology offers the ability to exclude cellular immunity, however clinical success has not yet been achieved. This thesis aims to prepare a transplantation site for islets using a novel encapsulation device through three approaches. Firstly, Aim 1 was to investigate the pre-seeding of accessory cells to the biomimetic nanofibers and evaluate the dimensional stability of these fibers. Cell pre-seeding did not have a significant effect on nanofiber implant volume however porcine decellularized dermis was much more dimensionally stable. Secondly, Aim 2 sought to equip the encapsulation device with boron dye based hypoxia sensors. Using a novel polymer conjugated form of the dye, nanofibers were electrospun that displayed reduced signal decay in a hydrated environment for 3 weeks. Hypoxia, due to a 5X cell density increase in vitro (13.9 vs 6.7 PPM) and after islets are infused in vivo, is evident with spatiotemporal resolution. Thirdly, Aim 3 is to evaluate the ability of the device to precondition a space for islet transplant by neovascularization and immunomodulation. Vessel length density in dorsal skinfold window chambers is increased by FTY720 loaded fibers over the unloaded fibers in healthy mice and moderately diabetic animals (Day 0 - 3.37%, Day 7 - 4.22%, p<0.05). Local release of FTY720 decreases the proportion of inflammatory macrophages in surrounding subcutaneous tissue (ratio of inflammatory to non-inflammatory: 14:1 vs 8:1). The nanofiber morphology and local release of FTY720 has been shown to improve islet health in vitro. Using the dimensionally stable ECM from Aim 1 an in vivo void is maintained (confirmed by ultrasound) in order to ensure that the 2nd procedure to deliver islets can be done without disturbing the tissue implant interface. Therefore, a FTY720 releasing nanofiber membrane could address both innate and specific immunity while also increasing vasculature even in the diabetic environment. These findings improve major challenges, including the need to monitor oxygenation, facing islet transplant as well as other tissue engineering applications.","PeriodicalId":33824,"journal":{"name":"Radzynski Rocznik Humanistyczny","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147920340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulnerable Populations in Nicaragua: Exploring Health Experiences of Creole Women in Bluefields","authors":"Emma McKim Mitchell","doi":"10.18130/v3tj9p","DOIUrl":"https://doi.org/10.18130/v3tj9p","url":null,"abstract":"Background: The Atlantic Coast of Nicaragua is characterized by geographic and ethnic diversity. Research on women's health in Nicaragua has focused on intimate partner violence and reproductive health issues, with the majority of research on the hegemonic Mestisa population. Little is known about the unique health experiences of women of ethnic minorities living on the Atlantic Coast of Nicaragua. The purpose of this study was therefore to describe health experiences of childbearing/childrearing aged Creole women in Bluefields, Nicaragua to increase understanding of disparities and inequities related to culture, gender and socioeconomic status. Design and Methods: Using ethnographic and photovoice research methods, the cultural context in which Creole women experiences health was explored in Bluefields Nicaragua. Twelve Creole women participants ranging in age from 18 – 45 participated in the photovoice portion of the study and, after focus groups discussing women's health issues, they photographed the health issues identified with disposable cameras. After photos were developed, participants described the meaning behind and reason for taking each photograph. Note: Abstract extracted from PDF text","PeriodicalId":33824,"journal":{"name":"Radzynski Rocznik Humanistyczny","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147903927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smooth Muscle Cells and Myofibroblasts Employ Distinct Transcriptional Mechanisms for Smooth Muscle a-Actin Expression","authors":"Qiong Gan","doi":"10.18130/v32z3q","DOIUrl":"https://doi.org/10.18130/v32z3q","url":null,"abstract":"There has been considerable controversy regarding the lineage relationship between smooth muscle cells (SMCs) and myofibroblasts, since both these cell types express common cell-selective markers such as smooth muscle α-actin (SM α-actin). Both SMCs and myofibroblasts play an integral role in injury-repair processes in a wide range of human diseases involving cardiovascular abnormalities. Examples include vein graft remodeling, atherosclerosis, and myocardial remodeling that accompanies renovascular hypertension, tissue fibrosis, and tumor formation. Within the tunica media of normal vessels, the major function of vascular SMCs is to provide tension and structural support. Although myofibroblasts appear within normal tissues where certain mechanical tension is needed, such as in the alveoli, they are mainly activated under pathological conditions when tissue reparation and contraction are required. However, the origins and identities of SMCs and myofibroblasts within these diseases are elusive and complicated because these cells exhibit variable functions including force production, secretion of inflammatory cytokines, and multiple phenotypes. Paradoxically, most investigators use the same marker gene, SM α-actin to identify both myofibroblasts and SMCs in their studies. Although the exact functions of these two cell types within disease states are still unknown, it is critical to distinguish these two cell types to elucidate their roles and introduce cell-specific prophylaxis and treatment. Of major interest, we previously showed that two highly conserved MCAT elements within the SM α-actin promoterIX conferred differential activity in cultured SMCs versus cultured myofibroblasts in that mutation of MCAT elements decreased SM α-actin promoter activity in myofibroblasts whereas the same mutation has no effect on SM α-actin promoter activity in SMCs. These results suggest that there are cell-selective mechanisms that regulate SM α-actin gene transcription. The major focus of this thesis project was to determine the role of MCAT elements within the SM α-actin promoter in vivo in SMCs versus myofibroblasts. Before describing the thesis project in detail, I will review what is known about the identification of SMCs and myofibroblasts, as well as what is known about SM α-actin transcriptional regulation, and provide a summary of our current understanding of MCAT element and transcriptional enhancer factor-1 (TEF-1)-dependent gene transcription. Note: Abstract extracted from PDF text","PeriodicalId":33824,"journal":{"name":"Radzynski Rocznik Humanistyczny","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147911001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}