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1.
J Am Heart Assoc ; 13(14): e032568, 2024 Jul 16.
Article in English | MEDLINE | ID: mdl-38989822

ABSTRACT

BACKGROUND: Shared decision-making (SDM) has the potential to improve hypertension care quality and equity. However, research lacks diverse representation and evidence about how race and ethnicity affect SDM. Therefore, this study aims to explore SDM in the context of hypertension management. METHODS AND RESULTS: Explanatory sequential mixed-methods design was used. Quantitative data were sourced at baseline and 12-month follow up from RICH LIFE (Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone) participants (n=1212) with hypertension. Qualitative data were collected from semistructured individual interviews, at 12-month follow-up, with participants (n=36) selected based on their SDM scores and blood pressure outcome. Patients were cross- categorized based on high or low SDM scores and systolic blood pressure reduction of ≥10 or <10 mm Hg. Multinomial logistic regression analysis showed that predictors of SDM scores and blood pressure outcome were race and ethnicity (relative risk ratio [RRR], 1.64; P=0.029), age (RRR, 1.03; P=0.002), educational level (RRR, 1.87; P=0.016), patient activation (RRR, 0.98; P<0.001; RRR, 0.99; P=0.039), and hypertension knowledge (RRR, 2.2; P<0.001; and RRR, 1.57; P=0.045). Qualitative and mixed-methods findings highlight that provider-patient communication and relationship influenced SDM, being emphasized both as facilitators and barriers. Other facilitators were patients' understanding of hypertension; clinicians' interest in the patient, and clinicians' personality and attitudes; and barriers included perceived lack of compassion, relationship hierarchy, and time constraints. CONCLUSIONS: Participants with different SDM scores and blood pressure outcomes varied in determinants of decision and descriptions of contextual factors influencing SDM. Results provide actionable information, are novel, and expand our understanding of factors influencing SDM in hypertension.


Subject(s)
Decision Making, Shared , Hypertension , Patient Participation , Humans , Hypertension/ethnology , Hypertension/therapy , Hypertension/psychology , Hypertension/diagnosis , Hypertension/physiopathology , Male , Female , Middle Aged , Aged , Adult , Blood Pressure/physiology , Qualitative Research , Physician-Patient Relations , Health Knowledge, Attitudes, Practice/ethnology , Ethnicity
2.
Front Public Health ; 12: 1363971, 2024.
Article in English | MEDLINE | ID: mdl-38883197

ABSTRACT

Introduction: COVID-19 pandemic hit Bangladesh with relatively low intensity, unlike its neighbors India and European countries and USA. Methods: The present report included data of 8,480 individuals tested for COVID-19 RT-PCR of the workers and officials from readymade garments (RMG) industry in Chandra area in Gazipur. The present data looked into the clinic-demographic factors associated with the susceptibility of the condition. Result: The data elucidated the susceptibility of the individuals to SARS-CoV-2 based on age, gender, pre-existing health conditions, and the presence of symptoms. It was observed that individuals aged over 60 had the highest rate of COVID-19 positivity, and men exhibited a higher infection rate compared to women. Regardless of age, fever and cough were the most frequently reported symptoms. Two-thirds of the individuals included in this report appeared to be asymptomatic carriers. The prevalence of comorbidities among individuals who tested positive for COVID-19 was notably higher, and this exhibited a gender-specific pattern. Discussion: Although our study provides important epidemiological insights into the initial year of the pandemic among Bangladeshi populations, it can also add value for future drug and vaccine development. However, it is essential to acknowledge the limitations like - restriction of public movement, unavailability of vehicle yielding a selection bias, due to the lockdown conditions imposed owing to the pandemic and the diverse characteristics of the participants. The report emphasizes the significance of figuring out how age, gender, and underlying health conditions impact susceptibility to and transmission of COVID-19, thereby providing valuable insights for public health strategies and future research initiatives.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , COVID-19/epidemiology , Bangladesh/epidemiology , Male , Female , Adult , Middle Aged , Prevalence , Young Adult , Sex Factors , Aged , Pandemics , Adolescent , Age Factors , Comorbidity
3.
APMIS ; 132(7): 499-506, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38659394

ABSTRACT

Reverse transcription loop-mediated isothermal amplification (RT-LAMP) is a molecular amplification method that can detect SARS-CoV-2 in a shorter time than the current gold-standard molecular diagnostic reverse transcription-polymerase chain reaction (RT-PCR). However, previously developed RT-LAMP assays have mostly relied on highly subjective visual colorimetric interpretation. In this study, an RT-LAMP assay was developed with quantitative measurement of reaction pH using a novel portable pH biosensor compared to qualitative colorimetric interpretation and gel electrophoresis, with 57 clinical COVID-19 samples used for validation of the test. The LoD of the assay is 103 copies/µL. The highest sensitivity was found in the qualitative methods (93.75%), while the highest specificity and likelihood ratio was found in the pH sensor (87.5% and 6.72). On the sensor measurement, a significant difference (p < 0.0001) was observed between the average pH of the RT-PCR (+) COVID-19 (6.15 ± 0.27), while the average pH of the RT-PCR (-) samples (6.72 ± 0.22). Correlation analysis revealed a strong correlation (r = 0.78, p < 0.0001) between the Ct values obtained from RT-PCR with the biosensor pH readout. RT-LAMP with the quantitative pH sensor readout method has the potential to be further developed as an objective molecular assay for rapid and simple detection of SARS-CoV-2.


Subject(s)
Biosensing Techniques , COVID-19 , Nucleic Acid Amplification Techniques , SARS-CoV-2 , Sensitivity and Specificity , Humans , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Nucleic Acid Amplification Techniques/methods , Hydrogen-Ion Concentration , COVID-19/diagnosis , COVID-19/virology , Biosensing Techniques/methods , Molecular Diagnostic Techniques/methods , Colorimetry/methods , COVID-19 Nucleic Acid Testing/methods , RNA, Viral/genetics , RNA, Viral/analysis , Limit of Detection
4.
JAMA Netw Open ; 7(3): e243779, 2024 Mar 04.
Article in English | MEDLINE | ID: mdl-38530311

ABSTRACT

Importance: The effect of shared decision-making (SDM) and the extent of its use in interventions to improve cardiovascular risk remain unclear. Objective: To assess the extent to which SDM is used in interventions aimed to enhance the management of cardiovascular risk factors and to explore the association of SDM with decisional outcomes, cardiovascular risk factors, and health behaviors. Data Sources: For this systematic review and meta-analysis, a literature search was conducted in the Medline, CINAHL, Embase, Cochrane, Web of Science, Scopus, and ClinicalTrials.gov databases for articles published from inception to June 24, 2022, without language restrictions. Study Selection: Randomized clinical trials (RCTs) comparing SDM-based interventions with standard of care for cardiovascular risk factor management were included. Data Extraction and Synthesis: The systematic search resulted in 9365 references. Duplicates were removed, and 2 independent reviewers screened the trials (title, abstract, and full text) and extracted data. Data were pooled using a random-effects model. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Main Outcomes and Measures: Decisional outcomes, cardiovascular risk factor outcomes, and health behavioral outcomes. Results: This review included 57 RCTs with 88 578 patients and 1341 clinicians. A total of 59 articles were included, as 2 RCTs were reported twice. Nearly half of the studies (29 [49.2%]) tested interventions that targeted both patients and clinicians, and an equal number (29 [49.2%]) exclusively focused on patients. More than half (32 [54.2%]) focused on diabetes management, and one-quarter focused on multiple cardiovascular risk factors (14 [23.7%]). Most studies (35 [59.3%]) assessed cardiovascular risk factors and health behaviors as well as decisional outcomes. The quality of studies reviewed was low to fair. The SDM intervention was associated with a decrease of 4.21 points (95% CI, -8.21 to -0.21) in Decisional Conflict Scale scores (9 trials; I2 = 85.6%) and a decrease of 0.20% (95% CI, -0.39% to -0.01%) in hemoglobin A1c (HbA1c) levels (18 trials; I2 = 84.2%). Conclusions and Relevance: In this systematic review and meta-analysis of the current state of research on SDM interventions for cardiovascular risk management, there was a slight reduction in decisional conflict and an improvement in HbA1c levels with substantial heterogeneity. High-quality studies are needed to inform the use of SDM to improve cardiovascular risk management.

5.
J Am Heart Assoc ; 13(5): e031886, 2024 Mar 05.
Article in English | MEDLINE | ID: mdl-38420759

ABSTRACT

BACKGROUND: Asian people in the United States have different sociodemographic and health-related characteristics that might affect cardiovascular disease (CVD) risk by ethnicity and birthplace. However, they are often studied as a monolithic group in health care research. This study aimed to examine heterogeneity in CVD risk factors on the basis of birthplace among the 3 largest Asian subgroups (Chinese, Asian Indian, and Filipino) compared with US-born non-Hispanic White (NHW) adults. METHODS AND RESULTS: A cross-sectional analysis was conducted using the 2010 to 2018 National Health Interview Survey data from 125 008 US-born and foreign-born Chinese, Asian Indian, Filipino, and US-born NHW adults. Generalized linear models with Poisson distribution were used to examine the prevalence and prevalence ratios of self-reported hypertension, diabetes, high cholesterol, physical inactivity, smoking, and overweight/obesity among Asian subgroups compared with US-born NHW adults. The study included 118 979 US-born NHW and 6029 Asian adults who self-identified as Chinese (29%), Asian Indian (33%), and Filipino (38%). Participants' mean (±SD) age was 49±0.1 years, and 53% were females. In an adjusted analysis, foreign-born Asian Indians had significantly higher prevalence of diabetes, physical inactivity, and overweight/obesity; foreign-born Chinese had higher prevalence of physical inactivity, and foreign-born Filipinos had higher prevalence of all 5 CVD risk factors except smoking compared with NHW adults. CONCLUSIONS: This study revealed significant heterogeneity in the prevalence of CVD risk factors among Asian subgroups by ethnicity and birthplace, stressing the necessity of disaggregating Asian subgroup data. Providers should consider this heterogeneity in CVD risk factors and establish tailored CVD prevention plans for Asian subgroups.


Subject(s)
Cardiovascular Diseases , Diabetes Mellitus , Adult , Female , Humans , United States/epidemiology , Middle Aged , Male , Ethnicity , Cardiovascular Diseases/epidemiology , Overweight , Risk Factors , Prevalence , Cross-Sectional Studies , Obesity/epidemiology , Diabetes Mellitus/epidemiology , Heart Disease Risk Factors
6.
Res Social Adm Pharm ; 20(4): 451-456, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38355311

ABSTRACT

INTRODUCTION: The lack of human resources for disease prevention and control is evident in times of health crisis, such as the COVID-19 pandemic. In public health emergencies, the capacity for adequate assistance and guaranteed access to pharmacological treatment are fundamental and contribute to impact reduction. We aimed to analyze the profile, performance, and characteristics related to the self-perception of preparedness among pharmacists who responded to the COVID-19 pandemic in Brazil. METHOD: A cross-sectional study was conducted in two stages: content validation of a questionnaire and its application to a representative sample of pharmacists in Rio de Janeiro. The snowball technique was used to recruit participants. A logistic regression model was adjusted to determine the effects of the factors on the probability of a pharmacist feeling prepared to act during the pandemic. RESULTS: Six experts approved and validated the questionnaire, and 376 pharmacists were included in the study, 60.6 % of whom were in places specially designated by health authorities to diagnose and treat COVID-19. Professionals participated in various activities related to pandemic demands, including medication management and population guidance. Postgraduate degrees increased the odds of participants feeling prepared to act during the pandemic. Furthermore, pharmacists who worked in reference facilities were more likely to feel ready than those who worked in other places. Professionals who knew treatment guidelines were almost three times more likely to feel prepared than the ones without the knowledge of treatment guidelines. Training or guidance on how to act during the pandemic increased pharmacists' odds of feeling prepared by 2.58 times. CONCLUSION: Pharmacists actuated from diagnosis to treatment and participated in the health activities required during the pandemic. Factors contributing to the self-perception of preparedness were identified. Such factors can be targets for interventions to promote the preparedness of the workforce for future health emergencies.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/therapy , Pharmacists , Pandemics/prevention & control , Cross-Sectional Studies , Emergencies , Professional Role , Brazil/epidemiology , Perception
7.
Rev Saude Publica ; 57: 83, 2023.
Article in English, Portuguese | MEDLINE | ID: mdl-37971177

ABSTRACT

OBJECTIVE: To analyze the consumption of drugs for Alzheimer's disease on the Brazilian private market and its geographical distribution from 2014 to 2020. METHODS: National data from the Brazilian National System of Controlled Product Management were used, regarding sales of donepezil, galantamine, rivastigmine, and memantine from January 2014 to December 2020. Sales data were used as a proxy for drug consumption and expressed as defined daily dose/1,000 inhabitants/year at national, regional, federative unit and microregion levels. RESULTS: Drug consumption went from 5,000 defined daily doses/1,000 inhabitants, in 2014, to more than 16,000/1,000 inhabitants, in 2020, and all federative units showed positive variation. The Brazilian Northeast had the highest cumulative consumption in the period but displayed microregional disparities while the North region had the lowest consumption. Donepezil and memantine were the most consumed drugs, with the highest growth in consumption from 2014 to 2020. CONCLUSION: The consumption of medicines indicated to treat Alzheimer's disease tripled in Brazil between 2014 and 2020, which may relate to the increase in the prevalence of the disease in the country, greater access to health services, and inappropriate use. This challenges managers and healthcare providers due to population aging and the increased prevalence of chronic-degenerative diseases.


Subject(s)
Alzheimer Disease , Humans , Alzheimer Disease/drug therapy , Alzheimer Disease/epidemiology , Donepezil/therapeutic use , Memantine/therapeutic use , Brazil/epidemiology , Cholinesterase Inhibitors/therapeutic use , Piperidines/therapeutic use , Phenylcarbamates/therapeutic use , Indans/therapeutic use
9.
J Med Internet Res ; 25: e47566, 2023 09 13.
Article in English | MEDLINE | ID: mdl-37703088

ABSTRACT

BACKGROUND: Mobile health (mHealth) technology has the potential to support shared decision-making (SDM) and improve hypertension control. However, our understanding of the variations in individuals' involvement in SDM and mHealth usage across different racial and ethnic groups in the United States is still limited. OBJECTIVE: This study aimed to investigate the extent of involvement in SDM and the usage of mHealth technology in health-related activities among US adults with hypertension from diverse racial and ethnic backgrounds and to examine whether the mHealth usage differed by individuals' level of engagement in SDM. METHODS: This study used cross-sectional data from the 2017 to 2020 Health Information National Trends Survey, which was conducted on US adults with self-reported hypertension, and race and ethnicity data were included. The exposure of interest was race and ethnicity. The outcomes were SDM and mHealth usage. SDM was assessed using an item: "In the past 12 months, how often did your health professional: involve you in decisions about your healthcare as much as you wanted?" mHealth usage was defined as using a smartphone or tablet to engage in (1) making health decisions, (2) discussing health decisions with health providers, (3) tracking health progress, and (4) sharing health information. Weighted multivariable logistic regression models were used to examine the association between race and ethnicity and SDM or mHealth usage adjusted for covariates and stratified by the level of engagement in SDM. RESULTS: This study included 4893 adults with hypertension, and the mean age was 61 (SD 13) years. The sample was 53% female, 61% (n=3006) non-Hispanic White, 19% (n=907) non-Hispanic Black or African American, 12% (n=605) Hispanic, 4% (n=193) non-Hispanic Asian, and 4% (n=182) non-Hispanic other. Compared to the non-Hispanic White adults, non-Hispanic Black adults were more likely to use mHealth to make health decisions (adjusted odds ratio [aOR] 1.70, 95% CI 1.23-2.34), share health information (aOR 1.46, 95% CI 1.02-2.08), and discuss health decisions with health providers (aOR 1.38, 95% CI 1.02-1.87). Significant associations were observed specifically among those who were always involved in SDM. Asian adults were less likely to be involved in SDM (aOR 0.51, 95% CI 0.26-0.99) and were more likely to use mHealth to track progress on a health-related goal (aOR 2.07, 95% CI 1.28-3.34) than non-Hispanic White adults. Hispanic adults were less likely to use mHealth to share health information (aOR 0.47, 95% CI 0.33-0.67) and discuss health decisions with health providers (aOR 0.65, 95% CI 0.46-0.94) compared to non-Hispanic White adults. CONCLUSIONS: This study observed racial and ethnic disparities in SDM and mHealth usage among US adults with hypertension. These findings emphasize the significance of comprehending the involvement of SDM and the usage of mHealth technology within racially and ethnically diverse populations.


Subject(s)
Hypertension , Telemedicine , United States , Humans , Adult , Female , Middle Aged , Male , Cross-Sectional Studies , Ethnicity , Hypertension/therapy , Technology
10.
J Am Heart Assoc ; 12(10): e027433, 2023 05 16.
Article in English | MEDLINE | ID: mdl-37158060

ABSTRACT

Background The Latino population is a growing and diverse share of the US population. Previous studies have examined Latino immigrants as a homogenous group. The authors hypothesized that there would be heterogeneity in cardiovascular disease risk factors among Latino immigrant subgroups (from Mexico, Puerto Rico, Cuba, Dominican Republic, Central America, or South America) compared with non-Latino White adults. Methods and Results A cross-sectional analysis of the 2010 to 2018 National Health Interview Survey (NHIS) among 548 739 individuals was performed. Generalized linear models with Poisson distribution were fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and current smoking, adjusting for known confounders. The authors included 474 968 non-Latino White adults and 73 771 Latino immigrants from Mexico (59%), Puerto Rico (7%), Cuba (6%), Dominican Republic (5%), Central America (15%), and South America (9%). Compared with White adults, Mexican immigrants had the highest prevalence of overweight/obesity (prevalence ratio [PR], 1.17 [95% CI, 1.15-1.19]); Puerto Rican individuals had the highest prevalence of diabetes (PR, 1.63 [95% CI, 1.45-1.83]); individuals from Central America had the highest prevalence of high cholesterol (PR, 1.16 [95% CI, 1.04-1.28]); and individuals from the Dominican Republic had the highest prevalence of physical inactivity (PR, 1.25 [95% CI, 1.18-1.32]). All Latino immigrant subgroups were less likely to be smokers than White adults. Conclusions The authors observed advantages and disparities in cardiovascular disease risk factors among Latino immigrants. Aggregating data on Latino individuals may mask differences in cardiovascular disease risk and hinder efforts to reduce health disparities in this population. Study findings provide Latino group-specific actionable information and targets for improving cardiovascular health.


Subject(s)
Cardiovascular Diseases , Heart Disease Risk Factors , Hispanic or Latino , Adult , Humans , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/ethnology , Cholesterol , Cross-Sectional Studies , Diabetes Mellitus/epidemiology , Hispanic or Latino/ethnology , Hispanic or Latino/statistics & numerical data , Hypercholesterolemia , Hyperlipidemias , Obesity/epidemiology , Overweight , Prevalence , Puerto Rico/ethnology , Risk Factors , United States/epidemiology , Cuba/ethnology , Central America/ethnology , Mexico/ethnology , South America/ethnology , Dominican Republic/ethnology , White/statistics & numerical data
11.
Rev. saúde pública (Online) ; 57: 83, 2023. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1522874

ABSTRACT

ABSTRACT OBJECTIVE To analyze the consumption of drugs for Alzheimer's disease on the Brazilian private market and its geographical distribution from 2014 to 2020. METHODS National data from the Brazilian National System of Controlled Product Management were used, regarding sales of donepezil, galantamine, rivastigmine, and memantine from January 2014 to December 2020. Sales data were used as a proxy for drug consumption and expressed as defined daily dose/1,000 inhabitants/year at national, regional, federative unit and microregion levels. RESULTS Drug consumption went from 5,000 defined daily doses/1,000 inhabitants, in 2014, to more than 16,000/1,000 inhabitants, in 2020, and all federative units showed positive variation. The Brazilian Northeast had the highest cumulative consumption in the period but displayed microregional disparities while the North region had the lowest consumption. Donepezil and memantine were the most consumed drugs, with the highest growth in consumption from 2014 to 2020. CONCLUSION The consumption of medicines indicated to treat Alzheimer's disease tripled in Brazil between 2014 and 2020, which may relate to the increase in the prevalence of the disease in the country, greater access to health services, and inappropriate use. This challenges managers and healthcare providers due to population aging and the increased prevalence of chronic-degenerative diseases.


RESUMO OBJETIVO Analisar o consumo de medicamentos para a doença de Alzheimer no mercado privado brasileiro e sua distribuição geográfica entre os anos de 2014 e 2020. MÉTODOS Foram utilizados dados do Sistema Nacional de Gerenciamento de Produtos Controlados relativos às vendas de donepezila, galantamina, rivastigmina e memantina, entre janeiro de 2014 a dezembro de 2020, em todo o território nacional. Os dados de venda foram utilizados como proxy para o consumo dos medicamentos, avaliado em dose diária definida (DDD)/1.000 habitantes/ano em nível nacional, regional, por unidade federativa e microrregião. RESULTADOS O consumo dos medicamentos passou de 5.000 DDD/1.000 habitantes em 2014 para mais de 16.000 DDD/1.000 habitantes em 2020, e todas as unidades de federação apresentaram variação positiva. A região Nordeste apresentou o maior consumo acumulado no período, porém exibiu disparidades microrregionais. A região Norte apresentou o menor consumo. Os medicamentos mais consumidos foram donepezila e memantina, os quais também apresentaram maior crescimento do consumo no intervalo de tempo entre os anos de 2014 e 2020. CONCLUSÃO O consumo de medicamentos para o tratamento da doença de Alzheimer triplicou no Brasil entre os anos de 2014 e 2020, o que pode estar relacionado ao aumento da prevalência da doença no país e/ou maior acesso a serviços de saúde, assim como estar ligado, também, à utilização inapropriada destes medicamentos. Este é um desafio para gestores e profissionais de saúde num cenário de envelhecimento populacional e aumento da prevalência de doenças crônico-degenerativas.


Subject(s)
Dementia , Drug Utilization , Drugs from the Specialized Component of Pharmaceutical Care , Prescription Drugs , Alzheimer Disease , Brazil , Memantine , Chronic Disease , Rivastigmine , Donepezil , Galantamine
12.
Sci Rep ; 12(1): 17306, 2022 10 15.
Article in English | MEDLINE | ID: mdl-36243755

ABSTRACT

Salinity has a significant negative impact on production of rice. To cope with the increased soil salinity due to climate change, we need to develop salt tolerant rice varieties that can maintain their high yield. Rice landraces indigenous to coastal Bangladesh can be a great resource to study the genetic basis of salt adaptation. In this study, we implemented a QTL analysis framework with a reciprocal mapping population developed from a salt tolerant landrace Horkuch and a high yielding rice variety IR29. Our aim was to detect genetic loci that contributes to the salt adaptive responses of the two different developmental stages of rice which are very sensitive to salinity stress. We identified 14 QTLs for 9 traits and found that most are unique to specific developmental stages. In addition, we detected a significant effect of the cytoplasmic genome on the QTL model for some traits such as leaf total potassium and filled grain weight. This underscores the importance of considering cytoplasm-nuclear interaction for breeding programs. Finally, we identified QTLs co-localization for multiple traits that highlights the possible constraint of multiple QTL selection for breeding programs due to different contributions of a donor allele for different traits.


Subject(s)
Oryza , Salt Tolerance , Oryza/genetics , Plant Breeding , Potassium , Salt Tolerance/genetics , Seedlings/genetics , Soil
14.
Article in English | MEDLINE | ID: mdl-35270252

ABSTRACT

Acculturation and immigration-related factors may impact preventive, routine cardiovascular risk (CV) screening among African immigrants. We examined the associations between length of stay, percent of life spent in the U.S. (proxy for acculturation), and CV screening. Outcomes were recent screening for hypertension, diabetes, and dyslipidemia. Multivariable logistic regression analyses were used to examine these relationships. Among 437 African immigrants, 60% were males, mean age was 47 years, 61% had lived in the U.S. for ≥10 years, mean length of stay was 15 years, and 81% were employed. Only 67% were insured. In the 12 months prior, 85% had screened for hypertension, 45% for diabetes, and 63% for dyslipidemia. African immigrants with a ≥10-year length of U.S. stay had 2.20 (95%Confidence Intervals: 1.31−3.67), and those with >25% years of life spent in the U.S. had 3.62 (95%CI: 1.96−6.68) higher odds of dyslipidemia screening compared to those with a <10-year length of stay and ≤25% years of life spent in the U.S., respectively. Overall, screening for CV risk higher in African immigrants who have lived longer (≥10 years) in the U.S. Recent African immigrants may experience challenges in accessing healthcare. Health policies targeting recent and uninsured African immigrants may improve access to CV screening services.


Subject(s)
Cardiovascular Diseases , Diabetes Mellitus , Emigrants and Immigrants , Hypertension , Acculturation , Female , Heart Disease Risk Factors , Humans , Male , Middle Aged , Risk Factors , United States/epidemiology
16.
J Oncol Pharm Pract ; 28(4): 884-891, 2022 Jun.
Article in English | MEDLINE | ID: mdl-33779371

ABSTRACT

This study aimed to implement pharmaceutical care using the therapeutic outcome monitoring (TOM) method for pharmacotherapeutic follow-up of oncological patients. This was a prospective longitudinal study involving patients undergoing oral chemotherapy. The study environment was an outpatient pharmacy at a tertiary-level oncology hospital. Ninety patients who received oral chemotherapy were evaluated, and 27 patients were followed up in accordance with the exclusion criteria and acceptability of participation in the study. The patients were predominantly diagnosed with gynecological tumors, with a mean age of 57.56 ± 13.06. The average consumption of drugs per patient was 4.63 ± 4.85, and more than 55% of patients had undergone oral antineoplastic therapy for more than a year. The main therapeutic groups used were drugs that acted on the gastrointestinal tract and metabolism (34%). All patients had at least one drug-related problem (DRP). In total, 133 DRP were identified. Approximately 33% of patients had DRPs related to antineoplastic therapy; non-adherence, incorrect administration, and the probability of adverse events were among the frequently reported DRPs. We identified 43 negative outcomes associated with medication (NOM), with untreated health problems (47%) and non-quantitative insecurity (30%) being the most frequently reported. 81 pharmaceutical interventions were performed, and 96% were accepted. The main errors avoided with the interventions were untreated health problems, misuse, and interruptions associated with medication administration. The TOM method effectively achieved the desired results of therapy, improving the use of medicines, and thus increasing patient safety.


Subject(s)
Antineoplastic Agents , Drug-Related Side Effects and Adverse Reactions , Neoplasms , Pharmaceutical Services , Adult , Aged , Antineoplastic Agents/adverse effects , Drug-Related Side Effects and Adverse Reactions/drug therapy , Humans , Longitudinal Studies , Middle Aged , Neoplasms/drug therapy , Prospective Studies , Treatment Outcome
17.
Front Plant Sci ; 13: 1089109, 2022.
Article in English | MEDLINE | ID: mdl-36743539

ABSTRACT

Introduction: Salinity is a complex environmental stress that affects the growth and production of rice worldwide. But there are some rice landraces in coastal regions that can survive in presence of highly saline conditions. An understanding of the molecular attributes contributing to the salinity tolerance of these genotypes is important for developing salt-tolerant high yielding modern genotypes to ensure food security. Therefore, we investigated the role and functional differences of two K+ salt-responsive transporters. These are OsTPKa or Vacuolar two-pore potassium channel and OsHAK_like or a hypothetical protein of the HAK family. These transporters were selected from previously identified QTLs from the tolerant rice landrace genotype (Horkuch) and sensitive genotype (IR29). Methods: In silico comparative sequence analysis of the promoter sequences of two these genes between Horkuch and IR29 was done. Real-Time expression of the selected genes in leaves and roots of IR29 (salt-sensitive), I-14 and I-71 (Recombinant Inbred Lines of IR29(♀)× Horkuch), Horkuch and Pokkali (salt-tolerant) under salt-stress at different time points was analyzed. For further insight, OsTPKa and OsHAK_like were chosen for loss-of-function genomic analysis in Horkuch using the CRISPR/Cas9 tool. Furthermore, OsTPKa was chosen for cloning into a sensitive variety by Gateway technology to observe the effect of gain-of-function. Results: The promoter sequences of the OsTPKa and OsHAK_like genes showed some significant differences in promoter sequences which may give a survival advantage to Horkuch under salt-stress. These two genes were also found to be overexpressed in tolerant varieties (Horkuch and Pokkali). Moreover, a coordinated expression pattern between these two genes was observed in tolerant Horkuch under salt-stress. Independently transformed plants where the expression of these genes was significantly lowered, performed poorly in physiological tests for salinity tolerance. On the other hand, positively transformed T0 plants with the OsTPKa gene from Horkuch consistently showed growth advantage under both control and salt stress. Discussion: The poor performance of the transgenic plants with the down-regulated genes OsTPKa and OsHAK_like under salt stress supports the assumption that OsTPKa and OsHAK_like play important roles in defending the rice landrace Horkuch against salt stress, minimizing salt injury, and maintaining plant growth. Moreover, the growth advantage provided by overexpression of the vacuolar OsTPKa K+ transporter, particularly under salt stress reconfirms its important role in providing salt tolerance. The QTL locus from Horkuch containing these two transporters maybe bred into commercial rice to produce high-yielding salt tolerant rice.

18.
Braz. J. Pharm. Sci. (Online) ; 58: e19175, 2022. tab, graf
Article in English | LILACS | ID: biblio-1374572

ABSTRACT

Abstract he aim of this work was to develop an oral solution of captopril at 5 mg/mL preservative-free. Two formulations were prepared, one containing sweetener (formulation 1) and the other without this excipient (formulation 2). The results found of validation parameters from analytical method performed by HPLC for captopril were, linearity 0.9998, the limit of detection 15.71 µg/mL, the limit of quantification 47.60 µg/mL, repeatability 1.05%, intermediate precision 2.42%, accuracy intraday 101,53%, accuracy inter-day 99.85%. Moreover, the results found for captopril disulfide were, linearity 0.9999, limit of detection 0.65 µg/mL, limit of quantification 1.96 µg/mL, repeatability 2.28%, intermediate precision 1.51%, accuracy intraday 101.36%, accuracy inter-day 100.29%. The appearance of formulations was clear and colorless, pH measures were 3.12 and 3.04, dosage of captopril and captopril disulfide were 99.45% and 99.82%, 0.24% and 0.12% for formulation 1 and formulation 2, respectively. The stability study demonstrated that the concentration of captopril and captopril disulfide in the formulations was > 90% and below 3%, respectively. The in vivo palatability study in animals and humans showed that Formulation 1 containing the sweetener had better acceptance. Thus, the sweetener was able to improve the unpleasant taste of the formulation


Subject(s)
Pediatrics/classification , Captopril/analysis , Chemistry, Pharmaceutical/classification , Drug Stability , Preservatives, Pharmaceutical/pharmacology , Sweetening Agents , Taste , Chromatography, High Pressure Liquid/methods , Drug Evaluation
19.
AAPS PharmSciTech ; 23(1): 22, 2021 Dec 14.
Article in English | MEDLINE | ID: mdl-34907488

ABSTRACT

The assessment of drug taste is crucial for pediatric treatments so that formulations can be developed to enhance their effectiveness. In this study, in vivo and in vitro methods were applied to evaluate the taste of tablets of three drugs administered to children without taste-masking excipients to treat tropical diseases, namely artesunate-mefloquine (ASMQ), praziquantel (PZQ), and benznidazole (BNZ). In the first method, a model of rat palatability was adapted with recirculation to ensure sample dispersion, and the data were analyzed using ANOVA (single factor, 95%). The taste assessment results (in vivo) indicated an aversion to the three medicines, denoted by the animals retracting themselves to the bottom of the box after the first contact with the drugs. For the placebo samples, the animals behaved normally, indicating that taste perception was acceptable. The second method was based on the in vitro analysis of capacitance data from a homemade impedimetric electronic tongue. Consistent with the in vivo taste assessment results, the data points obtained with PZQ, ASMQ, and BNZ were far away from those of their placebos in a map built with the multidimensional projection technique referred to as Interactive Document Mapping (IDMAP). A combined analysis of the results with the two methods allowed us to confirm the bitterness of the three drugs, also pointing to electronic tongues as a promising tool to replace in vivo palatability tests.


Subject(s)
Mefloquine , Praziquantel , Animals , Artesunate , Child , Humans , Nitroimidazoles , Rats , Tablets , Taste
20.
Nurse Educ Today ; 106: 105055, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34304102

ABSTRACT

BACKGROUND: Peer review of teaching is important for both the faculty and student experience. Enhanced awareness of student learning experiences and a deeper reflection on teaching makes this process attractive to faculty leaders, staff and students. Evidence suggests that teachers who are reviewed gain confidence, anticipate improvement in teaching and are inclined to discuss their teaching with colleagues in the future. OBJECTIVE: To describe the development of a peer review of teaching process by the Faculty Peer Review of Teaching Taskforce at a school of nursing. METHODS: A five-step Design for Six Sigma methodology was used and includes: Define, Measure, Analyze, Design, Verify (DMADV). In keeping with this methodology we: (1) established a Faculty Peer Review of Teaching Taskforce; (2) conducted a literature review on best practices; (3) reviewed peer institution practices; and (4) surveyed faculty to obtain their perspectives on the qualities of good teaching and the peer review of teaching process. Twenty-seven of the 68 full-time faculty members returned Qualtrics surveys (return rate = 39.7%). RESULTS: Review of the literature yielded four major themes, including post-observation discussion and systematic assignment of peer review pairs. Variation in practices across institutions was identified, from formal structured processes, to peer review conducted only in special circumstances. Survey findings revealed that faculty members overwhelmingly endorse the qualities of good teaching, agree that the peer review process should be required, and that peer reviewers should have several years of teaching experience. CONCLUSIONS: Our faculty were supportive of a peer review teaching process. As teaching demands continue to increase given the evolving complexities of nursing care, teaching platforms (i.e. online, hybrid), and diverse student body, we hope the process we develop may serve as a model for other higher education schools to enhance and maintain excellence in teaching for both the faculty and student experience.


Subject(s)
Faculty , Peer Review , Humans , Peer Group , Teaching
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