Implementing a Produce Prescription Program in Partnership With a Community Coalition.

Healthy eating reduces risk for chronic disease, but can be out of reach for many Americans experiencing food insecurity. Produce Prescription Programs (PPPs) have emerged as an intervention to address barriers related to fruit and vegetable consumption. Using a social prescribing model, PPPs connect patients with referrals to community resources to reduce barriers to healthy eating. There is evidence of success of PPPs at improving dietary intake, yet little discussion within the literature of practical aspects of implementation. As interest grows around establishing PPPs within communities, increased attention to strategic planning and implementation remains necessary to develop robust and effective programming. We describe implementing the Pontiac Prescription for Health pilot program, highlighting the participatory planning process with partners. Development and implementation included a program model, recruitment methods and materials, a voucher contract and tracking system with produce vendors, physical activity opportunities, culturally competent health education sessions, and evaluation tools. We offer insight into lessons learned and practical implications for future "on-the-ground" planning and implementation. Engaging in a rigorous participatory planning process with all community partners, allowing adequate time to establish service agreements and a voucher system with vendors, and engaging program participants in different ways and spaces throughout the community can enhance program success.

Getting the word out: Methods of learning about research and motivations for participation in a study focusing on a reproductive-aged Latina/x population.

Background: Although one of the fastest-growing populations in the USA, Latinx individuals remain underrepresented in research. In this study, we aimed to identify how Latina/Latinx participants of the Environment, Leiomyomas, Latinas, and Adiposity Study (ELLAS) learned about the research study and what motivated them to participate. Materials and Methods: Using a standardized survey tool, bilingual staff interviewed participants and asked them, 1) how they heard about ELLAS and 2) to identify and rank their top three reasons for participating in ELLAS. Results: "Word of mouth" through a friend or relative was the most common method of learning about ELLAS (49.0%), followed by a "community outreach event" (29.3%). The three most common reasons for participating in ELLAS were "to learn more about women's health" (83.3%), "to receive a free health assessment" (79.4%), and "to contribute to scientific knowledge" (59.5%). Correlation between demographic and socioeconomic characteristics and participant responses indicated that there are different reasons for participation based on these factors. Conclusions: Community engagement and word of mouth are vital to the successful recruitment of Latina/Latinx participants to research studies. Latinx participants are most motivated to participate by health benefits and health education, as well as altruistic aspects of research studies. Therefore, establishing mutually beneficial relationships within Latinx communities and appealing to motivations for research participation with close attention to the demographics of participants can both expand and allow for targeted recruitment efforts for this underrepresented group in research studies.

Contraction of fibrin-derived matrices and its implications for in vitro human skin bioengineering.

It is well-known that fibroblasts play a fundamental role in the contraction of collagen and fibrin hydrogels when used in the production of in vitro bilayered skin substitutes. However, little is known about the contribution of other factors, such as the hydrogel matrix itself, on this contraction. In this work, we studied the contraction of plasma-derived fibrin hydrogels at different temperatures (4, 23, and 37°C) in an isotonic buffer (phosphate-buffered saline). These types of hydrogels presented a contraction of approximately 30% during the first 24 hr, following a similar kinetics irrespectively of the temperature. This kinetics continued in a slowed down manner to reach a plateau value of 40% contraction after 10-15 days. Contraction of commercial fibrinogen hydrogels was studied under similar conditions and the kinetics was completed after 8 hr, reaching values between 20 and 70% depending on the temperature. We attribute these substantial differences to a modulatory effect on the contraction due to plasma proteins which are initially embedded in, and progressively released from, the plasma-based hydrogels. The elastic modulus of hydrogels measured at a constant frequency decreased with increasing temperature in 7-day gels. Rheological measurements showed the absence of a strain-hardening behavior in the plasma-derived fibrin hydrogels. Finally, plasma-derived fibrin hydrogels with and without human primary fibroblast and keratinocytes were prepared in transwell inserts and their height measured over time. Both cellular and acellular gels showed a height reduction of 30% during the first 24 hr likely due to the above-mentioned intrinsic fibrin matrix contraction.

Detección de Acanthamoeba por reacción en cadena de la polimerasa en tiempo real en líquidos de conservación de lentes de contacto / Detection of Acanthamoeba sp. by real-time polymerase chain reaction in contact lens solutions

RESUMEN Objetivo: Estandarizar una técnica de reacción en cadena de la polimerasa en tiempo real para la detección del parásito e identificar Acanthamoeba en líquidos conservantes de lentes de contacto. Métodos: Se realizó un estudio descriptivo observacional de corte transversal sobre la técnica de reacción en cadena de la polimerasa en tiempo real para la detección de Acanthamoeba, en el Instituto de Investigaciones en Ciencias de la Salud de la ciudad de Asunción, en Paraguay. Se analizaron 110 líquidos conservantes aportados por usuarios sanos de lentes de contacto, mediante reacción en cadena de la polimerasa en tiempo real y cultivo en medio PAGE - SDS. Resultados: Se estandarizó con éxito la técnica de reacción en cadena de la polimerasa en tiempo real con límite de sensibilidad de 1 pg/µL. Se aisló Acanthamoeba a partir de una muestra (1 por ciento) por método de cultivo, mientras que la carga parasitaria en el líquido conservante fue inferior al límite de detección de la reacción en cadena de la polimerasa en tiempo real. El ADN obtenido del cultivo de dicha muestra fue positivo para Acanthamoeba por este método. Conclusión: El sistema estandarizado presenta buena sensibilidad y podrá ser incorporado en los laboratorios que cuentan con acceso a equipos de reacción en cadena de la polimerasa en tiempo real para un diagnóstico rápido y más eficiente en casos de sospechas de queratitis amebiana. Recomendamos el uso combinado de métodos moleculares y cultivo para aumentar la potencia del diagnóstico, sobre todo en muestras donde la carga parasitaria es muy baja(AU)

ABSTRACT Objective: Standardize a real-time polymerase chain reaction technique for detection of the parasite and identify Acanthamoeba in contact lens solutions. Methods: A cross-sectional observational descriptive study was conducted about a real-time polymerase chain reaction technique for detection of Acanthamoeba at the Institute of Health Sciences Research in the city of Asunción, Paraguay. A total 110 solutions were analyzed, which were provided by healthy contact lens users, by real-time polymerase chain reaction and culture in SDS-PAGE medium. Results: Successful standardization was achieved of the real-time polymerase chain reaction technique with a sensitivity limit of 1 pg/µl. Acanthamoeba was isolated from one sample (1 percent) by culture, whereas the parasite load in the contact lens solution was below the detection limit of the real-time polymerase chain reaction technique. The DNA obtained from the culture of that sample was positive for Acanthamoeba by the real-time polymerase chain reaction technique method. Conclusion: The system standardized exhibits good sensitivity and may be incorporated into laboratories with real-time polymerase chain reaction technique equipment for a rapid and more efficient diagnosis of suspected amoebic keratitis. We recommend the combined use of molecular methods and culture to enhance diagnostic power, mainly in samples where the parasite load is very low(AU)

Sak and Sak4 recombinases are required for bacteriophage replication in Staphylococcus aureus.

DNA-single strand annealing proteins (SSAPs) are recombinases frequently encoded in the genome of many bacteriophages. As SSAPs can promote homologous recombination among DNA substrates with an important degree of divergence, these enzymes are involved both in DNA repair and in the generation of phage mosaicisms. Here, analysing Sak and Sak4 as representatives of two different families of SSAPs present in phages infecting the clinically relevant bacterium Staphylococcus aureus, we demonstrate for the first time that these enzymes are absolutely required for phage reproduction. Deletion of the genes encoding these enzymes significantly reduced phage replication and the generation of infectious particles. Complementation studies revealed that these enzymes are required both in the donor (after prophage induction) and in the recipient strain (for infection). Moreover, our results indicated that to perform their function SSAPs require the activity of their cognate single strand binding (Ssb) proteins. Mutational studies demonstrated that the Ssb proteins are also required for phage replication, both in the donor and recipient strain. In summary, our results expand the functions attributed to the Sak and Sak4 proteins, and demonstrate that both SSAPs and Ssb proteins are essential for the life cycle of temperate staphylococcal phages.

Evaluación inicial del paciente pediátrico: ¿cómo se debe realizar? / Initial Assessment of the Pediatric Patient: How to Perform?

En el servicio de urgencias de pediatría es fundamental reconocer de forma precoz lossignos clínicos que indican amenaza para la vida del paciente y que se deben manejarágil y oportunamente. Ello se constituye en un reto para el personal de salud que loasiste, pues se requiere una valoración inicial rápida enfocada en un punto de vistafisiopatológico que analice la afectación hemodinámica y la insuficiencia respiratoria,a fin de prevenir un paro cardiorrespiratorio. Esta primera aproximación que sepropone se denomina triángulo de evaluación pediátrica (TEP), basado en apariencia(aspecto general), respiración y circulación, a partir del cual se realiza un examenvisual y uno auditivo en los primeros segundos de la llegada del paciente pediátrico alservicio de urgencias. Este permite una categorización del estado clínico y tomar unadecisión adecuada...

In the pediatric emergency department, it is essentialto recognize early clinical signs that indicatethreat to the patient’s life and should behandled quickly, becoming a challenge for themedical team assisting. It requires a quick initialassessment of the critically ill patient, approachingit from a physiological point of viewby analyzing the hemodynamic and respiratorycompromise, preventing cardiac arrest. Thisfirst approach is called the Pediatric AssessmentTriangle based on general appearance, breathingand circulation, in which visual and auditoryexamination is performed in the first seconds ofthe arrival of the pediatric patient to the emergencyroom allowing categorization of the clinicalstatus to make the right decision...

La Polifarmacia como un problema de salud en el Adulto mayor / Polypharmacy: A Health Problem in the Elder?

En el contexto cubano actual, los estudios demográficos revelan que la esperanza de vida está casi en los niveles de las naciones del llamado Primer Mundo, lo cual se traduce en una expectativa para todos los sectores en los que repercute el incremento de la población del adulto mayor, entre ellos el sector de la salud. De ahí que se haya decidido realizar un estudio transversal y descriptivo acerca de la polifarmacia en los ancianos ingresados en el servicio de Gerontología y Geriatría, del Hospital Docente Clínico Quirúrgico de 10 de Octubre; con el propósito de corroborar que la polifarmacia constituye un problema que afecta la salud del anciano y que está se vincula con el grado de funcionabilidad del geronte.Fueron tomados como muestra 154 pacientes, de un universo de 600 ingresados, en un semestre. Para obtener la información necesaria se aplicó una encuesta y además se utilizaron otros métodos de carácter teórico, empírico y estadístico, teniendo en cuenta datos generales como edad, sexo, grado de escolaridad, enfermedades padecidas, utilización o no de medicamentos, forma de prescripción y capacidad funcional de los pacientes. Entre los principales resultados se destacan la relación entre la polifarmacia y la automedicación, así como su prevalencia en las Enfermedades Crónicas No Transmisibles (ECNT) y su elevado índice en el sexo femenino (con 61,90 por ciento); los grupos de medicamentos más consumidos fueron analgésicos, hipotensores, AINES, y psicofármacos(AU)

Nowadays, the Cuban reality shows that the demographic studies evidence that the life expectant it is almost equal to the ones of the developing countries, resulting in an expectative for all the sectors in which have repercussion the elder´s population increase and among them the health sector. Due to in the this, a descriptive and transversal study has been done about the polypharmacy in the admitted elders in the service of Gerontology and Geriatrics of 10 de Octubre Teaching and Surgical- Clinical Hospital with the aim to verify that polypharmacy constitutes a problem that affects the elder´s health and that it is closely related with functionality degree of the gerontist. During a semester, from a universe of 600 admitted elders a sample of 154 was taken. In order to obtained the needed information, an inquire was applied and other methods of theoretical, empirical and statistical character were used taking into consideration general information such as age, sex, school level acquired, suffering diseases, use or not use of medicines, way of prescription and functional capacity of the patients. Polypharmacy and self medication relation outstand among the main results, as well as its prevalence in the Non Transmittable Chronic Diseases (NTCD) and its high level in the feminine sex (61, 90 percent). The most consumed group of medicine was psychopharmacs, analgesics and hypotensors(AU)

Conductas de salud y factores de riesgo en la salud sexual y reproductiva de una población universitaria / Health behaviors and risk factors in sexual and reproductive health of a university population

Este estudio, iniciado en el año 2008, tuvo como objetivo describir los factores de riesgo y las conductas de la salud sexual y reproductiva de una población universitaria. Se realizó un estudio observacional de corte transversal, con una muestra conformada por 491 estudiantes de una universidad de Bogotá. Los resultados muestran que el género predominante fue el femenino (63,1%,), con una edad promedio de 20,4±2,6 años; el 80% inició su actividad sexual y la edad entre los 15 y los 18 años. El método anticonceptivo más usado es el preservativo y el 37,9% tiene conocimientos escasos sobre anticoncepción. La prevalencia de infecciones de transmisión sexual es baja, pero sólo la mitad han recibido tratamiento. El 10% de la población se ha realizado la prueba para el virus de inmunodeficiencia humana. El 10% de la población ha presentado embarazos, de los cuales el 75,3% no han sido planeados y el 47,4% han terminado en aborto, de los cuales el 80% han sido inducidos. Hay cifras altas de antecedentes familiares de cáncer. El 84% de los hombres no se realizan el auto examen de testículo. En las mujeres, el 56% se realiza auto examen de seno. La prevalencia de citologías es baja (38%), no todas han reclamado el resultado y aquellas que presentaron anormalidades (78%) no recibieron tratamiento. El 86,9% de los estudiantes desean que la universidad desarrolle el programa de salud sexual y reproductiva; el medio preferido es la consulta personalizada y la pagina web con asesoría en línea. El análisis de los resultados permite anotar que los jóvenes requieren programas de promoción de la salud que conlleven a que éstos asuman su sexualidad con autonomía, responsabilidad e información adecuada, en el marco de sus derechos sexuales y reproductivos.