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Biomedical subjects

H Bernal

Publications and source records attributed to H Bernal.

17 recordsLinked to original sources

Plasma-electrolytes in natives to hypoxia after marathon races at different altitudes.

PURPOSE: It is well known that altitude natives differ from sea level natives in aspects of fluid and electrolyte homeostasis. METHODS: To evaluate exercise and environmental influences on the electrolyte and water status in hypoxia adapted subjects, we investigated 11 well-trained marathon runners (33.7 +/- 0.7 yr, 60.5 +/- 1.9 kg), native to an altitude above 2600 m, before and after two marathon races. One competition was held at moderate altitude (AM, 2650 m, 14 degrees C, 55% RH, running time 3 h 6 min +/- 22 min) and another under tropical conditions (HM, 470 m, 28 degrees C, 70% RH, running time 2 h 54 min +/- 30 min). Blood samples were taken 3 d before, immediately after, 1 h after, and 24 h after the races. RESULTS: The loss in body fluid was calculated to be 2.15 L during AM and 5.05 L during HM, respectively. It was compensated mostly by ingested fluids without electrolyte content and by metabolically produced water, which led to hyponatremia during AM (plasma [Na+] from 144.3 +/- 0.7 to 131.7 +/- 2.1 mmol x L(-1)). Severe dehydration without significant changes in plasma [Na+] could be detected after HM. Serum antidiuretic hormone concentrations and serum aldosterone concentrations significantly increased during both races and remained at a high level for at least 1h after both competitions. Serum atrial natriuretic peptide (ANP) concentrations were at a high level at rest, increasing during HM, and decreasing during AM. CONCLUSION: Under tropical conditions, we found a severe state of dehydration characterized by an extended ANP-response, which was not prevented by water intake during the race. Under hypoxic conditions, however, we found that hyponatremia had developed. This can be partly explained by pure water intake and metabolically produced water, and also, possibly, by a special hypoxia-induced effect.

Adult↗

A model for delivering culture-relevant care in the community.

The increase in cultural diversity of the urban populations of the United States is presenting a challenge for the delivery of culturally relevant care by community health care nurses. We developed a model for delivering such care built on key theoretical concepts derived from community health nursing, transcultural nursing, self-efficacy, and social support theories.

Community Health Nursing↗

Influences on the cultural self-efficacy of community health nurses.

This paper presents the results of factor and regression analyses conducted on the Cultural Self-Efficacy Scale to determine the underlying conceptual structure, and relationship to demographic variables. The Cultural Self-Efficacy Scale was first used with a sample of 190 community health nurses in Connecticut. It has an estimated total scale internal consistency of .97. In 1988, data were collected to examine cross-cultural self-efficacy of nurses working in a variety of settings, including health departments. The principal factor analysis revealed a four factor structure that is conceptually meaningful. Taken together, the four factors accounted for 90% of the total scale variance. Regression analyses showed significant relationships between perceptions of efficacy and demographic variables of race, education, and experience.

Adult↗

Acculturation and stress in a low-income Puerto Rican community.

In this study, the acculturative stress experienced by Puerto Rican migrants to the urban U.S. is examined. Acculturative stress is defined as length of residence in a novel cultural environment while lacking psychosocial resources to support adaptation to that environment. In a sample of 67 patients seen in a public health nursing agency, it was found that acculturative stress was associated with poorer health status, more behavioral problems, and higher levels of ethnomedical belief. The implications of these results for research on stress and adaptation are discussed.

Acculturation↗

Correlates of self-efficacy in diabetes self-care among Hispanic adults with diabetes.

PURPOSE: The purpose of this study was to examine factors associated with increased diabetes self-efficacy among insulin-requiring Hispanic adults with diabetes. METHODS: A cross-sectional survey design was used to obtain self-reported data on a nonrandom sample of 97 insulin-requiring Hispanic adults with diabetes. The Insulin Management Diabetes Self-Efficacy Scale (IMDSES) was translated into Spanish and administered with a demographic questionnaire by trained bilingual/bicultural interviewers in each respondent's own home. Factor analysis of the IMDSES revealed 4 subscales that corresponded with major diabetes self-care management behaviors. RESULTS: Respondents gave low to average self-efficacy ratings on their ability to manage all aspects of their disease. Behaviors that required problem solving in changing circumstances received the lowest scores. Attending diabetes classes and having home nursing visits were associated with an increased sense of self-efficacy, particularly as it related to diet and insulin. English-speaking ability was associated with a general sense of self-efficacy in managing diabetes care. CONCLUSIONS: The model tested was able to explain modest levels of self-efficacy, particularly in 2 of the most important diabetes management areas, insulin and diet management.

Adult↗