The social ecology of COVID-19 prevalence and risk in Montreal, QC, Canada.

This descriptive study examined the social ecology of COVID-19 risk exposure across Montreal (Quebec, Canada) by comparing fifteen neighborhoods with contrasting COVID-19 prevalence. Census 2016 data were combined with an online survey (n = 502) of residents living in the targeted neighborhoods. Chi-square and t-test were used to analyze the differences in sample proportions and means. As of October 1, 2020, compared to the least affected Montreal neighborhoods, the most Impacted neighborhoods had a 2.6 times higher COVID-19 prevalence (2370.9 active cases per 100,000 residents) and a 2.5 times higher death rate (260.6 deaths per 100,000 people). High prevalence neighborhoods were lower income, more highly racialized, denser, and had a larger share of public transit users than least affected neighborhoods. Compared with respondents from the least affected neighborhoods, survey respondents in high prevalence neighborhoods were more likely to report a lower income, hold at-risk occupations, live in apartment buildings, use public transit, and perceive themselves at risk of becoming infected with COVID-19 and less capable of avoiding COVID-19 transmission, but less likely to comply with stay-at-home recommendations. No significant differences between neighborhoods were found in terms of compliance with recommended COVID-19 hygiene preventive measures (mask wearing and hand washing). RESULTS: suggest that at-risk occupations and a lower capacity to avoid COVID-19 exposure, but not differences in compliance with public sanitary directives, were key factors associated with higher neighborhood prevalence of COVID-19.

Liquid Resin Infusion Process Validation through Fiber Optic Sensor Technology.

In the proposed work, a fiber-optic-based sensor network was employed for the monitoring of the liquid resin infusion process. The item under test was a panel composed by a skin and four stringers, sensorized in such a way that both the temperature and the resin arrival could be monitored. The network was arranged with 18 Fiber Bragg Gratings (FBGs) working as temperature sensors and 22 fiber optic probes with a modified front-end in order to detect the resin presence. After an in-depth study to find a better solution to install the sensors without affecting the measurements, the system was investigated using a commercial Micron Optics at 0.5 Hz, with a passive split-box connected in order to be able to sense all the sensors simultaneously. The obtained results in terms of resin arrival detection at different locations and the relative temperature trend allowed us to validate an infusion process numerical model, giving us better understanding of what the actual resin flow was and the time needed to dry preform filling during the infusion process.

Morphological and Rheological Guided Design for the Microencapsulation Process of Lactobacillus paracasei CBA L74 in Calcium Alginate Microspheres.

The intestinal microbiota is a real ecosystem composed of several bacterial species and a very huge amount of strains that through their metabolic activities play a crucial role in the development and performance of the immune system and other functions. Microbiota modulation by probiotics establishes a new era into the pharmaceutical and healthcare market. Probiotics play, in fact, an important role in helping and sustaining human health, but in order to produce benefits, their viability must be preserved throughout the production process up to consumption, and in addition, their bioactivity required to be safeguarded while passing through the gastrointestinal tract. In this frame, encouraging results come from encapsulation strategies that have proven to be very promising in protecting bacteria and their viability. However, specific effort has to be dedicated to the design optimization of the encapsulation process and, in particular, to the processing parameters that affect capsules microstructure. Herein, focusing on calcium alginate microspheres, after a preliminary selection of their processing conditions based on size distribution, we implemented a micro-rheological analysis, by using the multiple-particle tracking technique, to correlate the inner microstructure to the selected process conditions and to the viability of the Lactobacillus paracasei CBA L74. It was assessed that the explored levels of cross-linking, although changing the microorganism constriction, did not affect its viability. The obtained results confirm how this technology is a promising and a valid strategy to protect the microorganism viability and ensure its stability during the production process.

Evaluating the impact of onsite diabetes education teams in primary care on clinical outcomes.

BACKGROUND: To evaluate the impact of integrating diabetes education teams in primary care on glycemic control, lipid, and blood-pressure management in type 2 diabetes patients. METHODS: A historical cohort design was used to assess the integration of teams comprising nurse and dietitian educators in 11 Ontario primary-care sites, which delivered individualized self-management education. Of the 771 adult patients with A1C ≥ 7% recruited, 487 patients attended appointments with the diabetes teams, while the remaining 284 patients did not. The intervention's primary goal was to increase the proportion of patients with A1C ≤7%. Secondary goals were to reduce mean A1C, low-density lipoprotein, total cholesterol-high density lipoprotein, and diastolic and systolic blood pressure, as recommended by clinical-practice guidelines. RESULTS: After 12 months, a higher proportion of intervention-group patients reached the target for A1C, compared with the control group. Mean A1C levels fell significantly among all patients, but the mean reduction was larger for the intervention group than the control group. Although more intervention-group patients reached targets for all clinical outcomes, the between-group differences were not statistically significant, except for A1C. CONCLUSIONS: Nurse and dietitian diabetes-education teams can have a clinically meaningful impact on patients' ability to meet recommended A1C targets. Given the study's historical cohort design, results are generalizable and applicable to day-to-day primary-care practice. Longer follow-up studies are needed to investigate whether the positive outcomes of the intervention are sustainable.

Impact of diabetes education teams in primary care on processes of care indicators.

AIMS: To evaluate the impact of the integration of onsite diabetes education teams in primary care on processes of care indicators according to practice guidelines. METHODS: Teams of nurse and dietitian educators delivered individualized self-management education counseling in 11 Ontario primary care sites. Of the 771 adult patients with HbA1c ≥7% who were recruited in a prospective cohort study, 487 patients attended appointments with the education teams, while the remaining 284 patients did not (usual care group). Baseline demographic, clinical information, and patient care processes (diabetes medical visit, HbA1c test, lipid profile, estimated glomerular filtration rate, and albumin-to-creatinine ratio, measuring blood pressure, performing foot exams, provision of flu vaccine, and referral for dilated retinal exam) were collected from patient charts one year before (pre period) and after (post period) the integration began. A multi-level random effects model was used to analyze the effect of group and period on whether the process indicators were met based on practice guidelines. RESULTS: Compared to the usual care group, patients seen by the education teams had significant improvements on indicators for semi-annual medical visit and annual foot exam. No significant improvements were found for other process of care indicators. CONCLUSIONS: Onsite education teams in primary care settings can potentially improve diabetes management as shown in two process of care indicators: medical visits and foot exams. The results support the benefits of having education teams in primary care settings to increase adherence to practice guidelines.

Food Insecurity Screening Among Families of Children With Diabetes.

Little is known about screening in clinical settings for food insecurity (FI) among households of children with diabetes. This study evaluated the acceptability and feasibility of an FI screening initiative in a pediatric diabetes clinic that was implemented to help diabetes dietitian educators tailor management plans for families of children with type 1 or type 2 diabetes facing FI. The initiative comprised three validated screening questions, a care algorithm, a community resource handout, and a poster. In total, 50 families of children and adolescents aged 0-18 years with type 1 or type 2 diabetes were screened for FI. In-person semi-structured interviews combining open-ended and Likert-scale questions were conducted with 37 of the screened families and the three diabetes dietitian educators who conducted the screening. Perceived barriers and facilitators of the screening initiative were identified using content analysis, and Likert-scale questionnaires rated interviewees' comfort level with the screening questions. A reflective journal kept by an onsite research interviewer also facilitated the data interpretation process. Most families felt comfortable answering the screening questions. Families with FI appreciated the opportunity to express their concerns and learn about affordable food resources. However, ∼20% of these families described stigma and fear of judgment by clinicians if they screened positive for FI. Diabetes educators also felt comfortable with the screening questions but reported lack of time to screen all families and to follow-up with resources after a positive screen. A self-reported intake form was recommended to ensure that everyone is systematically screened. A standardized and respectful method of assessing FI could help clinicians better tailor treatment plans and support for families of children with diabetes who face FI. Based on these findings, similar FI screening initiatives should be implemented in other clinical settings as part of routine clinical practice.