QUALITY OF MATERNITY CARE IN RURAL TEXAS (MEXICAN-AMERICAN)

The purpose of the study was to describe regionalized systems of perinatal care serving predominantly low income Mexican-American women in rural underserved areas of Texas. The study focused upon ambulatory care; however, it provided a vehicle for examination of the health care system. The questions posed at the onset of the study included: (1) How well do regional organizations with various patterns of staffing and funding levels perform basic functions essential to ambulatory perinatal care? (2) Is there a relationship between the type of organization, its performance, and pregnancy outcome? (3) Are there specific recommendations which might improve an organization's future performance?^ A number of factors--including maldistribution of resources and providers, economic barriers, inadequate means of transportation, and physician resistance to transfer of patients between levels of care--have impeded the development of regionalized systems of perinatal health care, particularly in rural areas. However, studies have consistently emphasized the role of prenatal care in the early detection of risk and treatment of complications of pregnancy and childbirth, with subsequent improvement in pregnancy outcomes.^ This study has examined the "system" of perinatal care in rural areas, utilizing three basic regional models--preventive care, limited primary care, and fully primary care. Information documented in patient clinical records was utilized to compare the quality of ambulatory care provided in the three regional models.^ The study population included 390 women who received prenatal care in one of the seven study clinics. They were predominantly hispanic, married, of low income, with a high proportion of teenagers and women over 35. Twenty-eight percent of the women qualified as migrants.^ The major findings of the study are listed below: (1) Almost half of the women initiated care in the first trimester. (2) Three-fourths of the women had or exceeded the recommended number of prenatal visits. (3) There was a low rate of clinical problem recognition. Additional follow-up is needed to determine the reasons. (4) Cases with a tracer condition had significantly more visits with monitoring of the clinical condition. (5) Almost 90% of all referrals were completed. (6) Only 60% of mothers had postpartum follow-up, while almost 90% of their newborns received care. (7) The incidence of infants weighing 2500 grams or less was 4.2%. ^

DISTRIBUTION OF NEONATAL HYPOTHYROIDISM IN TEXAS (SCREENING)

The State of Texas began mandatory screening for neonatal hypothyroidism in February 1980. The data from the first three years of the program's operation were compiled and incidence rates were calculated. Incidence rates include summary rates for the Texas population as well as specific rates by sex, race, geographic area, and month of the year.^ Differences in incidence rates were studied to determine whether these differences may be attributed to bias in data collection, or bias due to differences in blood thyroxine levels associated with sex, race, or geographic location.^ An attempt was made to definitively identify the type of neonatal hypothyroidism for each case from Harris County. Incidence rates were used to study relationships between specific diagnoses and race and sex. ^

Association of coping styles & adolescent substance use

Adolescent substance use is a serious public health concern with long-lasting consequences. Although specific coping behaviors have been associated with adolescent substance use, less is known about the role of multidimensional coping styles that account for both positive and negative coping behaviors. This study examined the association of coping styles and substance use (alcohol, marijuana, and other illicit drugs) of 1,019 ethnically diverse high school students. Coping styles were categorized by high or low negative coping behaviors (e.g. distraction, social withdrawal, self-criticism, blame others, wishful thinking, resignation, and negative emotional regulation) and high or low positive coping behaviors (e.g. cognitive restructuring, problem-solving, social support, and positive emotional regulation). My hypothesis that high positive coping, regardless of the use of negative coping behaviors, would be protective against substance use was rejected. Logistic regression analyses controlling for age, gender, race, and parent education indicated that adolescents who relied primarily on adaptive coping were 45-67% less likely to report lifetime or past year substance use than any other coping style. However, mixed copers (i.e. high in both positive and negative coping behaviors) were 2 to 3 times as likely to report substance use than their adaptive coping counterparts.^

The role of the conserved N -terminal domain of STAT3 in STAT3 dephosphorylation and nuclear export

Rapid redistribution of STAT subcellular localization is an essential feature of cytokine signaling. To elucidate the molecular basis of STAT3 function, which plays a critical role in controlling innate immune responses in vivo, we initiated studies to determine the mechanisms controlling STAT3 nuclear trafficking. We found that STAT3 is transported to the nucleus in the absence of cytokine treatment, as judged by indirect immunofluorescence studies in the presence of leptomycin B, an inhibitor of CRM1-dependent nuclear export, suggesting that the non-phosphorylated STAT3 protein contains a functional nuclear import signal. An isoform lacking the STAT3 N-terminal domain (Δ133STAT3) retains the ability to undergo constitutive nuclear localization, indicating that this region is not essential for cytokine-independent nuclear import. Δ133STAT3 is also transported to the nucleus following stimulation with interleukin-6 (IL-6). Interestingly, IL-6-dependent tyrosine phosphorylation of Δ133STAT3 appears to be prolonged and the nuclear export of the protein delayed in cells expressing endogenous STAT3, consistent with defective Δ133STAT3 dephosphorylation. Endogenous STAT3 does not promote the nuclear export of Δ133STAT3, although dimerization between endogenous Stat3 and Δ133STAT3 is detected readily. Thus, the STAT3 N-terminal domain is not required for dimerization with full-length STAT3, yet appears to play a role in proper export of Stat3 from the nucleus following cytokine stimulation. STAT3-deficient cells reconstituted with Δ133STAT3 show enhanced and prolonged Stat1 signaling in response to IL-6, suggesting that induction of the STAT3-dependent negative regulator SOCS3 is impaired. In fact, Δ133STAT3 fails to induce SOCS3 mRNA efficiently. These studies collectively indicate that the STAT3 N-terminal region may be important for IL-6-dependent target gene activation and nuclear dephosphorylation, while dispensable for nuclear import. STAT3 is an oncogene. STAT3 is constitutively activated in primary tumors of many types. Thus far, research in the design of STAT3 protein inhibitors has focused on the SH2 and DNA-binding domains of STAT3. Interference with these domains eliminates all signaling through STAT3. If the N-terminal domain is involved in tetramerization on a subset of target genes, inhibition of this region may lead to a more selective inhibition of some STAT3 functions while leaving others intact. ^

Attitudes of health-care workers toward pregnant, HIV -positive women

The management of HIV infection with antiretroviral drugs has succeeded in increasing survival rates, but the subject of pregnancy in HIV-positive women continues to garner debate. Discrimination and stigma have been identified as barriers to health care, suggesting that women with HIV may be disinclined to seek prenatal care if health-care workers exhibit negative attitudes toward the women's pregnancies. To optimize prenatal and medical care for women with HIV infection, it is important to understand the general social conditions and cultural context in which these women have children. Goffman's treatise on stigma, Foucault's discussion of the knowledge/power matrix, and Bandura's Social Cognitive Theory offer theoretical perspectives by which we can evaluate the gender, race, and class issues that are inherent in pregnancy decision-making for women with HIV infection. It is also necessary to evaluate prevailing attitudes on childbearing toward HIV-positive women and to review the historical background of prejudice in which HIV-positive women make decisions regarding childbearing. ^ This qualitative study used a survey instrument and one-on-one interviews with HIV-infected women to elicit their perceptions of how they were treated by care providers when they became pregnant. It also included interviews with health-care workers to determine what their feelings are about pregnancy within the context of HIV infection. Results of the ethnographic inquiry reveal that most of the women had negative experiences at some point during a pregnancy, but that the situation improved when they sought care from a provider who was familiar with HIV infection. The health-care providers interviewed were firm in their belief that HIV-positive women deserved optimal care and treated the women with respect, but these are individuals who are also experts in providing care to HIV-positive patients. The question remains as to what kind of care HIV-positive women are receiving generally and what types of attitudes they are being subjected to if they see less experienced providers. Further research is also needed to determine whether HIV-positive women from a broader ethnic representation and higher socioeconomic status experience similar negative attitudes. ^

Investigar problemas ambientales en Antropología Social Pertinencia Social y Científica: una aproximación al campo. En: Avá, nº 18

Este texto abordará la importancia de la investigación de problemas ambientales en antropología social. Podemos afirmar que la relación entre sociedad y naturaleza se ha mantenido como tema de interés desde los inicios de la antropología como disciplina, primeramente, con aportes desde el determinismo ambiental, y luego, con estudios sobre la etnociencia, las clasificaciones y conocimiento de la flora y fauna (Conklin, 955; Berlin, 1973), la adaptación ecológica y ecosistemas (Steward, 1968; Rappaport, 1968), y la relación entre hombres y otras especies (White, 1949; Ingold, 1986; Haraway, 2003; Raffles, 2010). Este interés se ha acentuado en las últimas décadas al incrementar la atención en la situación climática, la crisis ecológica y los problemas ambientales Haenn & Wilk, 2006) que han dado un giro a la forma en que experimentamos nuestro entorno, así como en las construcciones y entendimientos de estos problemas.

Microfiltración en restauraciones coronarias completas libres de metal

En el presente trabajo se estudió la microfiltración de núcleos de alúmina cementados con cemento de resina autoacondicionante y con cemento de ionómero de vidrio convencional. Una vez preparadas las muestras se sumergieron en azul de metileno, para luego ser cortadas longitudinalmente. Los cortes fueron observados en una lupa estereoscópica, estableciéndose su grado de filtración por penetración del colorante. El análisis estadístico demostró que las muestras cementadas con cemento de resina tuvieron menor filtración que las cementadas con ionómero de vidrio.

Evaluación de selladores de fosas y fisuras realizados con resina y con ionómeros vítreos

En el presente trabajo se evaluaron 4 casos clínicos de pacientes con riesgo de caries pero que poseían molares sin lesiones, a los cuales se les colocó selladores de fosas y fisuras: en dos pacientes con resina y en dos pacientes con ionómero de vidrio. Los mismos fueron controlados en su permanencia en boca, los de resina en 6 meses y los de ionómero en 2 años, no encontrándose diferencias clínicas entre los materiales utilizados, debido a la diferencia en el tiempo de control de los mismos. Paralelamente, se realizó un trabajo in vitro con dos grupos de 10 molares cada uno, tratados el grupo 1 con sellador a base de resina y el grupo 2 con sellador de ionómero de vidrio. Luego de someter las muestras a la acción de un colorante (azul de metileno) se seccionaron longitudinalmente y se observaron en una lupa estereoscópica para ver si el colorante había penetrado o no por la interfase sellador/esmalte. No se encontraron diferencias estadísticamente significativas (a>0.05) entre los grupos analizados.

Porcelanas de uso odontológico : fundamentos para su selección

En este trabajo se presentan las distintas alternativas para seleccionar los materiales para restauraciones rígidas de porcelana libre de metal, basando esta selección en cuatro aspectos fundamentales: propiedades mecánicas, propiedades ópticas, capacidad de adaptación y posibilidades de adhesión. Ademas, se ilustran algunos de estos aspectos con la presentación de tres casos clínicos.

Efecto de la potencia de la unidad de fotopolimerización y del tiempo de fotoactivación sobre la transmitancia de las resinas reforzadas

Las propiedades ópticas de las resinas reforzadas resultan de vital importancia para el logro de restauraciones estéticas, sobre todo en lo referente a color y traslucidéz de las mismas, así como el mantenimiento de esas propiedades en función del tiempo. Ellas dependen de la composición del material y de su manipulación (tiempo de aplicación de una radiación electromagnética adecuada y la potencia de la unidad de fotopolimerización). Una de las formas de observar el comportamiento de estos materiales ante una radiación electromagnética, luego de polimerizados, es medir la transmitancia. El objetivo de este trabajo fue comparar la transmitancia de las resinas reforzadas polimerizadas con distintos tiempos de exposición a la fuente lumínica y diferentes potencias de la misma. Para ello se emplearon muestras de un mismo material de iguales dimensiones, divididos en dos grupos. La variable del grupo 1 fue el tiempo de exposición a la luz, mientras que la del grupo 2 fue la potencia de la fuente de fotoactivación. Para observar la transmitancia de las muestras fue empleado un espectrofotómetro UV- visible, que relaciona la transmitancia con diferentes longitudes de onda, permitiéndonos comparar curvas que representan el comportamiento del material. Los resultados que fueron observados muestran las coincidencias de las mencionadas curvas en ambos grupos y entre las muestras del mismo grupo, para las longitudes de onda cercanas a la luz visible, no así para las correspondientes a las ultravioletas. Pasado un mes de almacenamiento de las muestras, se observaron algunas diferencias en las lecturas de las curvas.

¿Hannah Arendt y la servidumbre voluntaria? : Repensando la hipótesis de Miguel Abensour

Nuestro objetivo es reexaminar la pregunta que hace una década formulara M. Abensour en su artículo "¿Hannah Arendt: crítica del totalitarismo y servidumbre voluntaria?" y proponer una respuesta diferente a la que dio por entonces el filósofo francés. En este sentido, planteamos que hay una mayor cercanía entre La Boétie y Arendt que la que supone Abensour. La hipótesis que nos guía es que habría en Arendt una reflexión sobre la preeminencia del poder sobre la violencia y la dominación, que va más allá de la oposición tajante entre poder y dominación que podría suponerse en un inicio

¿Hannah Arendt y la servidumbre voluntaria? : Repensando la hipótesis de Miguel Abensour

Nuestro objetivo es reexaminar la pregunta que hace una década formulara M. Abensour en su artículo "¿Hannah Arendt: crítica del totalitarismo y servidumbre voluntaria?" y proponer una respuesta diferente a la que dio por entonces el filósofo francés. En este sentido, planteamos que hay una mayor cercanía entre La Boétie y Arendt que la que supone Abensour. La hipótesis que nos guía es que habría en Arendt una reflexión sobre la preeminencia del poder sobre la violencia y la dominación, que va más allá de la oposición tajante entre poder y dominación que podría suponerse en un inicio