Help-Seeking Behavior and Health Care Navigation by Bhutanese Refugees

The objective of this study was to document barriers to care, help-seeking behaviors, and the impact of a community-based patient navigation intervention on patient activation levels among Bhutanese refugees in the U.S. Data sources comprised 35 intake and 34 post-intervention interviews with program participants, 14 intake and 14 post-intervention interviews with patient navigators, and 164 case notes. Textual data were analyzed using the constant comparison method. Patient activation level was assessed at both time points. Participants had limited English proficiency (97 %), limited literacy (69 %), and the lowest level of patient activation (69 %). Participants routinely experienced complex insurance access, coverage, and payment problems and had limited healthcare-related life skills. Help-seeking began within social networks, with high reliance on bilingual, literate family members perceived to have experience with “the system.” Help-seeking was not stigmatized and was instead consistent with societal norms valuing mutual assistance. Participants preferred helpers to act as proxies and required repeated social modeling by peers to gain confidence applying healthcare-related life skills. Following the intervention, only one-third reported the lowest level of patient activation (35 %) and one-third were highly activated (32 %). Bhutanese refugees overcome healthcare access barriers by seeking help from a network of support that begins within the community. Community health workers serving as patient navigators are readily sought out, and this approach is concordant with cultural expectations for mutual assistance. Community health workers serving immigrant groups should model healthcare-related life skills in addition to providing direct assistance.     

Consequences of infertility in developing countries: results of a questionnaire and interview survey in the South of Vietnam

Background  

This study explores the psychological, socio-cultural and economic consequences of infertility on couples' life. The purpose of this research is to improve knowledge about the potentially serious implications of infertility in the South of Vietnam.     

Regulatory T Cells in SLE: Biology and Use in Treatment

T regulatory cells (Tregs) represent a phenotypically and functionally heterogeneous group of lymphocytes that exert immunosuppressive activities on effector immune responses. Tregs play a key role in maintaining immune tolerance and homeostasis through diverse mechanisms which involve interactions with components of both the innate and adaptive immune systems. As in many autoimmune diseases, Tregs have been proposed to play a relevant role in the pathogenesis of systemic lupus erythematosus (SLE), an autoimmune disease characterized by a progressive breakdown of tolerance to self-antigens and the presence of concomitant hyperactive immune responses. Here, we review how Tregs dysfunction in SLE has been manipulated experimentally and preclinically in the attempt to restore, at last in part, the immune disturbances in the disease.     

Quantitative analysis of spherical microbubble cavity array formation in thermally cured polydimethylsiloxane for use in cell sorting applications

Microbubbles are spherical cavities formed in thermally cured polydimethylsiloxane (PDMS) using the gas expansion molding technique. Microbubble cavity arrays are generated by casting PDMS over a silicon wafer mold containing arrays of deep etched pits. To be useful in various high throughput cell culture and sorting applications it is imperative that uniform micron-sized cavities can be formed over large areas (in²). This paper provides an in-depth quantitative analysis of the fabrication parameters that effect the microbubble cavity formation efficiency and size. These include (1) the hydrophobic coating of the mold, (2) the mold pit dimensions, (3) the spatial arrangement of the pit openings, (4) the curing temperature of PDMS pre-polymer, (5) PDMS thickness, and (6) the presence and composition of residual gas in the PDMS pre-polymer mixture. Results suggest that the principles of heterogeneous nucleation and gas diffusion govern microbubble cavity formation, and that surface tension prevents detachment of the vapor bubble that forms in the PDMS over the pit. Paramerters are defined that enable the fabrication of large format arrays with uniform cavity size over 6 in² with a coefficient-of-variation <10 %. The architecture of the microbubble cavity is uniquely advantageous for cell culture. Large format arrays provide a highly versatile system that can be adapted for use in various high-throughput cell sorting applications. Herein, we demonstrate the use of microbubble cavity arrays to dissect the cellular heterogeneity that exists in a tumorigenic cutaneous squamous cell carcinoma cell line at the single cell level.     

Photorefractivity of Perylene Bisimide‐Sensitized Poly(4‐(diphenylamino)benzyl acrylate)

A perylene bisimide derivative of N,N′‐diisopropylphenyl‐1,6,7,12‐tetrachloroperylene‐3,4,9,10‐tetracarboxyl bisimide (PBI) is synthesized and used as a sensitizer for a photorefractive (PR) polymer composite. Small amount (0.1 wt%) of PBI sensitizer gives the maximum PR performance of composite based on poly(4‐(diphenylamino)benzyl acrylate) (PDAA) (45 wt%), 2‐(4‐(azepan‐1‐yl)benzylidene)malononitrile (35 wt%), and (4‐(diphenylamino)phenyl)methanol (24.9 wt%). High external diffraction efficiency of 49%, response time of 47 ms, and sensitivity of 28 cm² J^?1 are obtained under an applied electric field of 40 V μm^?1 at writing beam of 532 nm. PBI sensitizer effectively forms a charge‐transfer complex with PDAA, which favors the generation of the charge carriers followed by the space‐charge formation. Furthermore, low PBI concentration contributes to low absorption coefficient at 532 nm, which leads to better PR performance.

     

Gravity Compensation Method for Combined Accelerometer and Gyro Sensors Used in Cardiac Motion Measurements

A miniaturized accelerometer fixed to the heart can be used for monitoring of cardiac function. However, an accelerometer cannot differentiate between acceleration caused by motion and acceleration due to gravity. The accuracy of motion measurements is therefore dependent on how well the gravity component can be estimated and filtered from the measured signal. In this study we propose a new method for estimating the gravity, based on strapdown inertial navigation, using a combined accelerometer and gyro. The gyro was used to estimate the orientation of the gravity field and thereby remove it. We compared this method with two previously proposed gravity filtering methods in three experimental models using: (1) in silico computer simulated heart motion; (2) robot mimicked heart motion; and (3) in vivo measured motion on the heart in an animal model. The new method correlated excellently with the reference (r ² > 0.93) and had a deviation from reference peak systolic displacement (6.3 ± 3.9 mm) below 0.2 ± 0.5 mm for the robot experiment model. The new method performed significantly better than the two previously proposed methods (p < 0.001). The results show that the proposed method using gyro can measure cardiac motion with high accuracy and performs better than existing methods for filtering the gravity component from the accelerometer signal.