Drug Delivery from Stimuli-Responsive Poly(N-isopropylacrylamide-co-N-isopropylmethacrylamide)/Chitosan Core/Shell Nanohydrogels.

The synthesis of stimulus-responsive poly(N-isopropylacrylamide-co-N-isopropylmethacrylamide)/chitosan core/shell nanohydrogels made by batch emulsion polymerization in the presence of chitosan (CS) micelles is reported. The ratio of monomers required to obtain copolymers with a volume phase transition temperature (TVPT) in the range of the temperatures observed in the human body in response to an infection (38 to 40 °C) was estimated with the Fox equation. The conversion was determined by gravimetry; mean particle size, size distribution, and thermal response were measured by quasi-elastic light scattering (QLS). The core/shell structure was confirmed by TEM, and FTIR showed the presence of N-isopropyl acrilamide (NIPA), N-isopropyl methacrylamide (NIPMA), and CS in the nanohydrogels. The nanohydrogels were loaded with the drug doxycycline hyclate, and their release kinetic profile was determined at pH = 2.0 and 7.4 at their volume phase transition temperatures (TVPT). A higher amount of drug was released at acidic pH. Some mathematical models described in the literature were used to fit the experimental drug release data.

Uso de mioinositol más Bifidobacterium lactis y Lactobacillus rhamnosus para la prevención de diabetes mellitus gestacional en mujeres mexicanas.

AIM: To compare the incidence of gestational diabetes mellitus (GDM) in women with three or more risk factor to developing GDM supplemented with myo-inositol plus probiotics versus women care without supplementation. METHODS: Retrospective cohort study, group 1, women with supplementation (myo-inositol 2g plus Bifidobacterium lactis and Lactobacillus rhamnosus 5x108 UFC, twice per day, from 12-14 to 28 weeks of gestation; group 2, women with prenatal care without supplementation, matched by age and body mass index (BMI). The primary outcome was the incidence of GDM using the International Association of Diabetes and Pregnancy Study Groups criteria. RESULTS: Group 1 n=48, group 2 n=96. There were no significant baseline differences between groups in age, BMI and number of risk factors. The incidence of GDM in group 1 was n=14 (29.2%), and for group 2 n=46 (47.9%); RR: 0.61 (95% CI: 0.37-0.99; p = 0.03). CONCLUSIONS: Supplementation from 12-14 weeks of gestation with myo-inositol plus probiotics decrease the incidence of GDM in Mexican women.

OBJETIVO: Comparar la incidencia de diabetes mellitus gestacional (DMG) en mujeres con tres o más factores de riesgo para desarrollar DMG suplementadas con mioinositol más probióticos versus mujeres sin suplementación.­. MATERIAL Y ­MÉTODOS: Estudio de cohorte retrospectivo, grupo 1, mujeres con suplementación (mioinositol 2 g más Bifidobacterium lactis y Lactobacillus rhamnosus 5x108unidades formadoras de colonias, dos veces al día, de las 12-14 hasta las 28 semanas de gestación); grupo 2, mujeres con control prenatal habitual sin suplementación, pareadas por edad e índice de masa corporal (IMC). El resultado primario fue la incidencia de DMG utilizando los criterios de la Asociación Internacional de Grupos de Estudio de Diabetes y Embarazo. RESULTADOS: Grupo 1, n = 48, y grupo 2 n = 96. No hubo diferencias significativas en características basales como edad, IMC, y numero de factores de riesgo entre los grupos. La incidencia de DMG en el grupo 1 fue n = 14 (29.2%) y en el grupo 2 n = 46 (47.9%); RR: 0.61 (IC 95%: 0.37-0.99; p = 0.03). CONCLUSIONES: La suplementación desde las 12-14 semanas de gestación con mioinositol más probióticos disminuye la incidencia de DMG en mujeres mexicanas.

Association of General and Abdominal Obesity With Hypertension, Dyslipidemia and Prediabetes in the PREDAPS Study.

INTRODUCTION AND OBJECTIVES: Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). METHODS: Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30kg/m2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102cm in men/WC ≥ 88cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. RESULTS: Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). CONCLUSIONS: Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results.

Rasch analysis in the development of the NutriQoL® questionnaire, a specific health-related quality of life instrument for home enteral nutrition.

BACKGROUND: Home enteral nutrition (HEN) is a therapeutic method used in patients who are unable to ingest the required amounts of nutrients but retain a functional gastrointestinal tract. The objective of this study was to compose a specific questionnaire for measuring health-related quality of life (HRQoL) in HEN patients irrespective of their underlying condition and HEN route of administration. METHODS: Literature review, focus groups and semi-structured interviews were used to propose an initial version of the questionnaire which was answered by 165 participants. The responses were analyzed using the Rasch methodology. Firstly, the appropriateness of response options was assessed. Then, the differential item functioning (DIF) was evaluated. Finally, the item fit statistics, infit and outfit, were determined. RESULTS: Rasch analysis was performed on the responses given to the 43 items included in the initial questionnaire. Four items were excluded because more than 50% of respondents answered that the situation proposed did not apply to them. Seven items that showed overlapping and disordered categories were also removed. Pairwise DIF analysis were performed in subgroups defined by underlying disease and administration route. Eleven items presented DIF and were eliminated from the questionnaire. Finally, four items were deleted after analyzing the fit statistics, three of which did not fit the Rasch model and one did not belong to either of the dimensions. The final version of NutriQoL® includes 17 items. CONCLUSIONS: NutriQoL® is a useful instrument to assess the HRQoL of HEN patients with any disease and any administration route.

Development and validation of a specific questionnaire to assess health-related quality of life in patients with home enteral nutrition: NutriQoL® development.

INTRODUCTION: Home enteral nutrition (HEN) is indicated in patients with a functional gastrointestinal tract but who are unable to meet their nutritional requirements with normally consumed foodstuffs. HEN allows patients to remain in their social and family environment, thus reducing complications and costs associated with hospital admission, while increasing health-related quality of life (HRQoL). HRQoL in patients with HEN is mainly evaluated by generic instruments, which are not sensitive enough to identify certain specific patient-related outcomes of HEN. OBJECTIVE: To develop a specific instrument to measure HRQoL in patients receiving HEN whose results allow interpretation regardless of the underlying disease and nutritional support administration route: the NutriQoL® questionnaire. MATERIALS AND METHODS: The development of the NutriQoL entailed a literature review, focus groups with experts, semistructured interviews with patients, an assessment of face validity and feasibility, and Rasch analysis conducted on data from a sample of 141 patients and 24 caregivers. RESULTS: Of the 52 items initially proposed on the basis of the literature review, expert focus group, and semi-structured interviews with patients and caregivers, 17 items were finally selected through the development process to make up the final version of the NutriQoL, as well as a visual analog scale for global HRQoL scoring. The selected items were evaluated as adequate for frequency, importance, and clarity. Furthermore, they have been shown to be independent of the underlying condition and HEN administration route. CONCLUSION: A new instrument for measuring the HRQoL of patients with HEN in Spain has been developed, whose results are independent of the underlying condition and administration route. The next step will be the validation of the questionnaire to ensure that the instrument is valid, reliable, and sensitive to health status changes in patients, to be used periodically in usual clinical practice.

Reliability and Responsiveness of NutriQoL® Questionnaire.

INTRODUCTION: NutriQoL® (Nestlé Health Science, Vevay, Switzerland) is a questionnaire developed to assess the health-related quality-of-life (HRQoL) of patients with home enteral nutrition (HEN) irrespective of their underlying condition and route of administration. The aim of this work is assessing the questionnaire's reliability and responsiveness to change. METHODS: Two cohorts of patients with HEN and their primary caregivers were enrolled to assess reliability and responsiveness, respectively. All participants had to be 18 years of age or older, without mental deterioration (≤3 or 4 errors in the Pfeiffer's test) and with sufficient functional status (>40 points on Karnovsky's performance status scale). When the patients' ability to respond to the questionnaire was impaired due to underlying disease, their caregivers answered on their behalf. NutriQoL was administered in two and three visits to reliability and responsiveness cohorts, respectively. Test-retest reliability and internal consistency were assessed by the intra-class correlation coefficient (ICC) and the Cronbach's α, respectively. Responsiveness was evaluated by standardized effect size and standardized response mean between basal visit and third visit. Finally, the minimal clinically important difference (MCID) was estimated. RESULTS: A total of 54 and 86 participants were recruited to the reliability and responsiveness cohort, respectively. Thirty-five caregivers were selected to assess the inter-observer reliability. ICC values confirmed the good reproducibility level (ICC >0.75) of the questionnaire in both "physical functioning and activities of daily living" and "social life" domains and total score. The assessment of internal consistency in both domains of the questionnaire showed good internal consistency in visit 2. ICC showed the excellent agreement level between caregiver and patient in the global NutriQoL score. Finally, patients classified as having a minimal change in their health reported a mean (standard deviation) MCID in NutriQoL score of 0.63 (11.51). CONCLUSION: NutriQoL is a reliable and unique instrument to measure the HRQoL in HEN patients. NutriQoL detects changes in the health status of the patient. Nevertheless, further research is needed to determine the full extent of the questionnaire responsiveness.

Cardiometabolic Risk Profiles in Patients With Impaired Fasting Glucose and/or Hemoglobin A1c 5.7% to 6.4%: Evidence for a Gradient According to Diagnostic Criteria: The PREDAPS Study.

It has been suggested that the early detection of individuals with prediabetes can help prevent cardiovascular diseases. The purpose of the current study was to examine the cardiometabolic risk profile in patients with prediabetes according to fasting plasma glucose (FPG) and/or hemoglobin A1c (HbA1c) criteria.Cross-sectional analysis from the 2022 patients in the Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS Study) was developed. Four glycemic status groups were defined based on American Diabetes Association criteria. Information about cardiovascular risk factors-body mass index, waist circumference, blood pressure, cholesterol, triglycerides, uric acid, gamma-glutamyltransferase, glomerular filtration-and metabolic syndrome components were analyzed. Mean values of clinical and biochemical characteristics and frequencies of metabolic syndrome were estimated adjusting by age, sex, educational level, and family history of diabetes.A linear trend (P < 0.001) was observed in most of the cardiovascular risk factors and in all components of metabolic syndrome. Normoglycemic individuals had the best values, individuals with both criteria of prediabetes had the worst, and individuals with only one-HbA1c or FPG-criterion had an intermediate position. Metabolic syndrome was present in 15.0% (95% confidence interval: 12.6-17.4), 59.5% (54.0-64.9), 62.0% (56.0-68.0), and 76.2% (72.8-79.6) of individuals classified in normoglycemia, isolated HbA1c, isolated FPG, and both criteria groups, respectively.In conclusion, individuals with prediabetes, especially those with both criteria, have worse cardiometabolic risk profile than normoglycemic individuals. These results suggest the need to use both criteria in the clinical practice to identify those individuals with the highest cardiovascular risk, in order to offer them special attention with intensive lifestyle intervention programs.

Modifiable risk factors associated with prediabetes in men and women: a cross-sectional analysis of the cohort study in primary health care on the evolution of patients with prediabetes (PREDAPS-Study).

BACKGROUND: Prediabetes is a high-risk state for diabetes development, but little is known about the factors associated with this state. The aim of the study was to identify modifiable risk factors associated with the presence of prediabetes in men and women. METHODS: Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS-Study) is a prospective study on a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects without glucose metabolism disorders. It is being conducted by 125 general practitioners in Spain. Data for this analysis were collected during the baseline stage in 2012. The modifiable risk factors included were: smoking habit, alcohol consumption, low physical activity, inadequate diet, hypertension, dyslipidemia, and obesity. To assess independent association between each factor and prediabetes, odds ratios (ORs) were estimated using logistic regression models. RESULTS: Abdominal obesity, low plasma levels of high-density lipoprotein cholesterol (HDL-cholesterol), and hypertension were independently associated with the presence of prediabetes in both men and women. After adjusting for all factors, the respective ORs (95% Confidence Intervals) were 1.98 (1.41-2.79), 1.88 (1.23-2.88) and 1.86 (1.39-2.51) for men, and 1.89 (1.36-2.62), 1.58 (1.12-2.23) and 1.44 (1.07-1.92) for women. Also, general obesity was a risk factor in both sexes but did not reach statistical significance among men, after adjusting for all factors. Risky alcohol consumption was a risk factor for prediabetes in men, OR 1.49 (1.00-2.24). CONCLUSIONS: Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population.

Occupational safety beliefs among Latino residential roofing workers.

BACKGROUND: This analysis describes beliefs about work safety and personal protective equipment (PPE) among Latino roofing workers, it delineates their perceptions of work environment characteristics that affect work safety and PPE use, and it describes how they experience work injuries and the consequences of these injuries. METHODS: In-depth interviews were completed with 10 current and former Latino residential roofers. Interview transcripts were subjected to systematic qualitative analysis. RESULTS: Participants' valued productivity over safety, and this had a negative influence on their safety behavior and reduced their PPE use. They understood that roofing was hazardous. They limited use of PPE when they felt it reduced productivity and when it was uncomfortable. Work environment characteristics that affected safety included company size, the physical demands of the job, lack of training, the need for work, general life stress, and distractions at work. An injury had to result in lost work time to be considered significant. Access to health care is limited by employers not providing Workers' compensation. DISCUSSION: Future research is needed to substantiate these descriptive results and to delineate factors that are associated with safety behavior and use of PPE. Interventions, based on a lay health educator model, are needed to improve safety in this population. Safety regulations need to be evaluated and their enforcement needs to be improved.

[Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS): basis and methodology].

The PREDAPS study aims to determine the risk of developing diabetes and the risk of vascular complications in patients with prediabetes and identify factors associated with those risks. It is a prospective observational study of a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects with no alterations in glucose metabolism. The data at baseline were obtained from patients attending primary care centers in Spain throughout 2012. Subjects with prediabetes were classified into three groups: those who had only altered the fasting blood glucose levels -between 100 and 125mg/dl-, those who had only altered the HbA1c level -between 5.7 and 6.4% - and those who had altered both parameters. Information on sociodemographic characteristics, personal and family history, lifestyle and drug therapy was obtained from medical records and the interview with the doctor in the consultation. It was also performed a physical examination to determine weight, height, waist circumference and blood pressure were performed and blood and urine analysis. The PREDAPS study may help to reduce uncertainty in individual prevention strategies in subjects with prediabetes. Annual monitoring of patients recruited for five years will enable to know the risk of developing diabetes type 2 and the risk of macro-and microvascular complications in the three groups of subjects with prediabetes and determine the factors associated with those risks.

3-D jobs and health disparities: The health implications of Latino chicken catchers' working conditions.

OBJECTIVES: This study uses qualitative data to describe the tasks performed by chicken catchers, their organization of work, and possible health and safety hazards encountered. METHODS: Twenty-one Latino immigrant chicken catchers for North Carolina poultry-processing plants were interviewed to obtain their perceptions of the job and its hazards. Interviews were recorded and transcribed (n = 10) or detailed notes recorded (n = 11). Transcripts and notes were subjected to qualitative analysis. RESULTS: Chicken catching takes place in a highly contaminated and hazardous work environment. The fast pace of work, low level of control over work intensity, and piece rate compensation all result in high potential for work-related injury and illness, including trauma, electrical shock, respiratory effects, musculoskeletal injuries, and drug use. Workers receive little safety or job training. CONCLUSIONS: Chicken catching is characterized by a work environment and organization of work that promote injury and illness.

Employer, use of personal protective equipment, and work safety climate: Latino poultry processing workers.

BACKGROUND: This analysis describes the work safety climate of Latino poultry processing workers and notes differences by worker personal characteristics and employer; describes the use of common personal protective equipment (PPE) among workers; and examines the associations of work safety climate with use of common PPE. METHODS: Data are from a cross-sectional study of 403 Latino poultry processing workers in western North Carolina. RESULTS: Work safety climate differed little by personal characteristics, but it did differ consistently by employer. Provision of PPE varied; for example, 27.2% of participants were provide with eye protection at no cost, 57.0% were provided with hand protection at no cost, and 84.7% were provided with protective clothing at no cost. PPE use varied by type. Provision of PPE at no cost was associated with lower work safety climate; this result was counter-intuitive. Consistent use of PPE was associated with higher work safety climate. CONCLUSIONS: Work safety climate is important for improving workplace safety for immigrant workers. Research among immigrant workers should document work safety climate for different employers and industries, and delineate how work safety climate affects safety behavior and injuries.

Oil-in-alcohol highly concentrated emulsions as templates for the preparation of macroporous materials.

New oil-in-alcohol highly concentrated emulsions were formulated and were used as a templates to obtain macroporous poly(furfuryl alcohol) monoliths by a one-step method. The oil-in-alcohol highly concentrated emulsions were prepared by stepwise addition of the oil phase to the surfactant-alcohol solution and were characterized by optical microscopy and by laser diffraction. The typical structure of highly concentrated emulsions, with close-packed polyhedral droplets, has been observed. Poly(furfuryl alcohol) monoliths were obtained by polymerizing in the external phase of these emulsions. These materials are mainly macroporous and retain the size distribution and morphology from the highly concentrated emulsions. The internal structure of the monoliths was observed by scanning electron microscopy. The images showed an interconnected network with pore size similar to the droplet size of the highly concentrated emulsions used as templates.

Personal protective equipment and work safety climate among Latino poultry processing workers in Western North Carolina, USA.

BACKGROUND: Job-appropriate personal protective equipment (PPE) is important for decreasing the high rates of occupational injury experienced by poultry processing workers. OBJECTIVES: This analysis describes the job-appropriate PPE provided to poultry processing workers by their employers and the PPE used by these workers, and it delineates the association of work safety climate with job-appropriate PPE. METHODS: Data are from a cross-sectional study of 403 Latino poultry processing workers in North Carolina. RESULTS: Most poultry processing workers are not provided with nor use job-appropriate PPE; however, more workers use PPE than are provided. The provision and use of PPE differs by employer. Work safety climate was associated with use of job-appropriate PPE. CONCLUSIONS: Poultry processing workers should be provided with job-appropriate PPE. Workers' use of PPE is an indicator of safety climate. Further research about work safety climate and other work organization characteristics and job safety characteristics is needed.

Ethnographic evaluation of a lay health promoter program to reduce occupational injuries among Latino poultry processing workers.

We evaluated a lay health promoter program providing occupational health and safety education to immigrant Latino poultry processing workers in western North Carolina. While such programs are advocated for addressing the health education deficits of immigrant and disadvantaged populations, their application in occupational health has been limited to farmworkers. A community-university partnership recruited and trained promoters to deliver lessons on musculoskeletal injuries, slips and falls, and workers' rights to workers individually or in small groups in the community. Evaluation showed 841 workers received education during a 28-month period. Using ethnographic data, an evaluation showed that promoters' work led to changes in behavior and attitudes in the community. Promoters also reported substantial changes in self-esteem and independence. Promoters' supervisors reported challenges and strategies experienced by the promoters. Promoter programs in occupational health and safety are feasible approaches to supplement training provided in the workplace.

Evidence of organizational injustice in poultry processing plants: Possible effects on occupational health and safety among Latino workers in North Carolina.

BACKGROUND: Over 250,000 workers are employed in poultry processing, one of the most dangerous industries in the US. These jobs are increasingly held by immigrant workers who are frequently undocumented, lack knowledge of workers' rights to workplace safety, and who are reluctant to pursue their rights. This situation creates the potential for organizational injustice, made visible through abusive supervisory practices, and leads to situations in which occupational illnesses and injuries are likely to occur. METHODS: This paper draws on data collected during the research phases of a community-based participatory research and social justice project. Two hundred survey interviews and 26 in-depth interviews were collected in representative, community-based samples in western North Carolina. Analyses describe associations between one aspect of organizational injustice, abusive supervision, and worker injuries. RESULTS: Workers' reports of abusive supervision are associated with a variety of specific and summary health indicators. The associations are stronger for women than for men. These suggest that the use of relative power within the plant may be the basis for injuries and illnesses. Three types of power relations are described that form the basis for these abusive interactions in the plant: ethnicity (American vs. Latino), immigration status ("good papers" vs. undocumented), and rank (supervisor vs. worker). Two factors modify these relations: kinship (preferences and privileges for family members) and gender. CONCLUSIONS: Among Latino immigrants working in poultry plants, power differences reflecting organizational injustice in the form of abusive supervision may promote occupational illnesses and injuries, particularly for women.

Using lay health promoters in occupational health: outcome evaluation in a sample of Latino poultry-processing workers.

Lay Health Promoters (LHPs) are widely used in community health education, but their use and evaluation in occupational health has been limited to farm workers. Evaluation data were collected from 30 randomly selected Latino poultry processing workers who had an encounter with an LHP who delivered Maria's Story, an occupational health lesson about cumulative trauma disorders (CTDs). Participants had good recall of Maria's Story. Most participants (n = 18, 60%) could identify the primary occupational health exposure linked to CTDs, more than 50% of participants (n = 16) could recall one or more ways of preventing CTDs, and 43.3% (n = 13) described in detail recommended treatments. Nearly one-half (n = 12) reported an occupational health behavior change after hearing Maria's Story. The results of this study suggest that LHPs may be effective in promoting occupational health and reducing occupational health disparities among ethnic minorities in high-risk occupations.

Work-family conflict: experiences and health implications among immigrant Latinos.

Work-family conflict research has focused almost exclusively on professional, White adults. The goal of this article was to expand the understanding of culture and industry in shaping experiences and consequences of work-family conflict. Using in-depth interview data (n = 26) and structured survey data (n = 200) from immigrant Latinos employed in the poultry processing industry, the authors evaluated predictions drawn from emerging models emphasizing the influence of cultural characteristics such as collectivism and gender ideology on work-family conflict. Results indicated that immigrant Latinos in poultry processing experienced infrequent work-to-family conflict; both the level and the antecedents of work-to-family conflict differed by gender, with physical demands contributing to greater conflict for women but not men. In addition, there was little evidence that work-family conflict was associated with health in this population. These results demonstrate how traditional models of work-family conflict need to be modified to reflect the needs and circumstances of diverse workers in the new global economy.