Synthesis and characterization of pH-responsive nanoscale hydrogels for oral delivery of hydrophobic therapeutics.

pH-responsive, polyanionic nanoscale hydrogels were developed for the oral delivery of hydrophobic therapeutics, such as common chemotherapeutic agents. Nanoscale hydrogels were designed to overcome physicochemical and biological barriers associated with oral delivery of hydrophobic therapeutics such as low solubility and poor permeability due to P-glycoprotein related drug efflux. Synthesis of these nanoscale materials was achieved by a robust photoemulsion polymerization method. By varying hydrophobic monomer components, four formulations were synthesized and screened for optimal physicochemical properties and in vitro biocompatibility. All of the responsive nanoscale hydrogels were capable of undergoing a pH-dependent transition in size. Depending on the selection of the hydrophobic monomer, the sizes of the nanoparticles vary widely from 120nm to about 500nm at pH 7.4. Polymer composition was verified using Fourier transform infrared spectroscopy and 1H-nuclear magnetic resonance spectroscopy. Polymer biocompatibility was assessed in vitro with an intestinal epithelial cell model. All formulations were found to have no appreciable cytotoxicity, defined as greater than 80% viability after polymer incubation. We demonstrate that these nanoscale hydrogels possess desirable physicochemical properties and exhibit agreeable in vitro biocompatibility for oral delivery applications.

Towards a national model for organ donation requests in Australia: evaluation of a pilot model.

OBJECTIVE: To evaluate whether structural elements of a collaborative requesting model were observed in practice, and explore the impact of specialised communications training and elements of the model on consent rates. DESIGN: A national observational study captured staff observations of the organ donation requesting process. SETTING: DonateLife staff in 15 hospitals collected data from medical, nursing and allied health professionals who participated in the donation requesting process over a 12-month period. PARTICIPANTS: Data were collected from 201 family donation conversations (FDCs). MAIN OUTCOME MEASURES: Whether structural elements of the model were observed in practice, and rates of consent to donate. RESULTS: For most cases, there was a team planning meeting (87.0%); a gap in time between the meeting at which family understands brain death or the inevitability of death and the FDC for most cases (72.0%); and at least one trained requester present at the FDC (80.7%). Consent rates were significantly different according to who led the FDC: an untrained treating clinical specialist (45.2%); a trained treating clinical specialist (54.8%); or a trained requester who was not part of the treating clinical team (74.5%) (χ2=11.92, P=0.003). Logistic regression showed that the odds ratio (OR) for consent was significantly greater when the patient was on the Australian Organ Donor Register (OR, 9.3; CI, 3.5-24.5) and when the FDC was led by an FDC-trained requester who was not part of the treating clinical team (OR, 6.8; CI, 2.3-19.9). CONCLUSIONS: Structural elements of the model were observed in most cases, indicating that the model is feasible and acceptable. We showed that the highest consent rates were achieved when FDCs were led by professionals who had completed the specialised communications training and were not part of the treating clinical team for that patient.

The influence of social determinants on sexual risk among out-of-school African American female adolescents.

Formative research was conducted to understand the social determinants of HIV risk among African American female adolescents as part of a systematic adaptation of an evidence-based behavioral HIV prevention intervention, the Women's CoOp. Semi-structured in-depth interviews were conducted between November 2008 and April 2009 with 20 African American female adolescents aged 16-18 who reported engaging in sex, using alcohol or other drugs, and dropping out of school. All interviews were audio recorded, transcribed, and coded for key themes and emergent content patterns. The findings indicate that while female adolescents are knowledgeable about HIV and other sexually transmitted infections (STIs), myriad social factors relate to their level of risk. Interpersonal relationships, primarily with older boyfriends and friends, played a pivotal role in their decision-making regarding sex risk behavior, substance use, and educational attainment. A lack of viable employment opportunities, exacerbated by the lack of a high school education, resulted in some young women trading sex to make money. In addition, violence, victimization, and gang involvement are pervasive in their communities. Out-of-school African American female adolescents face a plethora of issues that are directly and indirectly related to their sex risk behaviors and consequently their HIV/STI risk. To reach a vulnerable population disproportionately affected by HIV and other STIs, these factors must be addressed in prevention interventions, when feasible. The findings were incorporated into the intervention adaptation that is currently being tested in a randomized controlled trial.