Evaluation of the pathways for students into health professions: the training of under-represented minority students to pursue maternal and child health professions.

The Pathways for Students into Health Professions program is one of four nationally funded programs by the Maternal and Child Health Bureau of the US Department of Health and Human Services to support the training of undergraduate students, particularly from under-represented minority groups to pursue maternal and child health professions. To assess the program's impact on student ratings, knowledge, and interest in maternal and child health professions. A baseline survey on student ratings and knowledge in maternal and child health topics and careers, public health topics, and career development topics was provided to 32 students at the beginning of their first year in the program and approximately 1 year after participation. Half of the students (16 students) in the program from 2009-2011 were from traditionally underrepresented minority groups. After participation, students reported significantly higher ratings of interest in maternal and child health topics and careers and in receiving adequate academic and career guidance. Students also reported significantly higher knowledge of public health, childhood and maternal morbidity and mortality, health care disparities, and life course health development. The program's didactic, experiential, and mentorship activities are changing student ratings and knowledge in a favorable direction toward maternal and child health careers and topics. Undergraduate training programs may be an important mechanism to strengthen the pipeline of a diverse healthcare workforce.

Creating an MCH Pipeline for Disadvantaged Undergraduate Students.

PURPOSE: To address minority health disparities in maternal and child health (MCH), increasing the diversity of the MCH workforce is an important strategy. DESCRIPTION: Guided by the MCH Leadership Competencies, we developed an undergraduate pipeline program for disadvantaged students. Our target population is minority undergraduates who are interested in entering health professions but have academic challenges. We identify these students early in their undergraduate careers and expose them to the field of MCH through a 4-unit course, summer field practicum at an MCH community-based organization or agency, and volunteer experience in a student-run organization focused on helping children and families. We also provide academic advising and personal counseling by a faculty mentor and leadership training opportunities. ASSESSMENT: Since 2006, 75 students have participated in our program, of which 36 are still enrolled and 39 have graduated. Among the graduates, three (8 %) have completed graduate school and are working in a health field; 11 (28 %) are enrolled in graduate school; and 13 (33 %) are currently applying to graduate school. Of the remaining graduates, seven (18 %) are employed in a health field, and five (13 %) are working in an unrelated field. CONCLUSION: Pipeline programs should attempt to reach students as early as possible in their undergraduate careers to more effectively influence their academic trajectories. Many minority students face academic and personal challenges; therefore, intensive academic advising and one-on-one faculty mentoring are important components of pipeline programs.

Enzymatic synthesis of biodiesel from palm oil assisted by microwave irradiation.

Optimal conditions for enzymatic synthesis of biodiesel from palm oil and ethanol were determined with lipase from Pseudomonas fluorescens immobilized on epoxy polysiloxane-polyvinyl alcohol hybrid composite under a microwave heating system. The main goal was to reduce the reaction time preliminarily established by a process of conventional heating. A full factorial design assessed the influence of ethanol-to-palm oil (8:1-16:1) molar ratio and temperature (43-57 °C) on the transesterification yield. Microwave irradiations varying from 8 to 15 W were set up according to reaction temperature. Under optimal conditions (8:1 ethanol-to-oil molar ratio at 43 °C), 97.56 % of the fatty acids present in the palm oil were converted into ethyl esters in a 12-h reaction, corresponding to a productivity of 64.2 mg ethyl esters g⁻¹ h⁻¹. This represents a sixfold increase from the process carried out under conventional heating, thus proving to be a potential tool for enhancing biochemical modification of oils and fats. In general, advantages of the new process include: (1) microwaves speed up the enzyme-catalyzed reactions; (2) there are no destructive effects on the enzyme properties, such as stability and substrate specificity, and (3) the microwave assistance allows the entire reaction volume to be heated uniformly. These bring benefits of a low energy demand and a faster conversion of palm oil into biodiesel.

Developmental assessment of children with intrauterine exposure to Zika virus: cross-sectional observational study. / Evaluación del neurodesarrollo en niños con exposición intrauterina al virus del Zika: estudio observacional transversal.

Zika virus infection affects the development of the nervous system. This study describes the cognitive, adaptative, communicative, social and motor neurodevelopment of children exposed to Zika virus in utero. We used the Batelle scale to assess neurodevelopment three years after birth. Thirty children were included, who had a mean age at evaluation of 37.5 (IQR: 35.7-39.2) months. We found the following equivalent ages in months for each area: motor 25.8 (SD: 7.8), adaptive 26.7 (SD: 5.8), communicative 30.2 (SD: 6.9), social personal 33.5 (SD: 8.3) and cognitive 35.6 (SD: 5.9). Children showed development delay for their chronological age, 25 children were delayed in one of the five areas assessed. A high rate of children exposed to Zika virus during gestation presented delayed developmental age, mainly regarding the adaptive and motor areas.

El virus del Zika produce desenlaces adversos para el desarrollo del sistema nervioso. Este estudio describe el neurodesarrollo cognitivo, adaptativo, comunicativo, social y motor de niños expuestos intrauterinamente al virus del Zika y hace una evaluación del neurodesarrollo con la escala de Battelle a los tres años después del nacimiento. Participaron 30 niños con una media de edad al momento de la evaluación de 37,5 (RIC: 35,7-39,2) meses. Se halló una edad equivalente en meses en las áreas: motora 25,8 (DE: 7,8), adaptativa 26,7 (DE: 5,8), comunicativa 30,2 (DE: 6,9), personal social 33,5 (DE: 8,3) y cognitiva 35,6 (DE: 5,9). Los niños presentaron retraso en el desarrollo para la edad cronológica, 25 niños presentaban retraso en una de las cinco áreas evaluadas. Una alta proporción de niños expuestos al virus del Zika durante la gestación presentaron retraso en el desarrollo, principalmente en el dominio adaptativo y motor.

Access to and utilization of health care by subgroups of Latino children.

BACKGROUND: Latinos make up the largest group of minority children in the United States. Despite great diversity among Latino children, studies have traditionally treated them as a monolithic group. Few studies have examined patterns and determinants of access to and use of health care for different subgroups of Latino children. OBJECTIVES: To delineate differences in access and utilization patterns between white and subgroups of Latino children, after adjusting for important predisposing, enabling, and need factors. RESEARCH DESIGN: National Health Interview Survey data (1998-2006) were used to study children of Mexican, Puerto Rican, Cuban, and other Latino ancestry, as well as white children. Data were adjusted for predisposing, enabling, and need factors in incremental models. Additional analyses were conducted to test for effect modification of health insurance and language use on the associations between the subgroups and health care access and utilization. RESULTS: Children of Mexican ancestry were found to have the most consistent pattern of poorer access to health care and use of services compared with the other subgroups. Multivariate analyses demonstrated persistent variability between Latino subgroups. Adjustment for predisposing, enabling, and need factors did not fully explain subgroup differences. CONCLUSIONS: Efforts to understand health care services for Latino children will require further examination of specific subgroups, and interventions to improve access and utilization should not be limited to health insurance coverage and language services.

Covalent attachment of Candida rugosa lipase on chemically modified hybrid matrix of polysiloxane-polyvinyl alcohol with different activating compounds.

Candida rugosa lipase was immobilized by covalent binding on hybrid matrix of polysiloxane-polyvinyl alcohol chemically modified with different activating agents as glutaraldehyde, sodium metaperiodate and carbonyldiimidazole. The experimental results suggested that functional activating agents render different interactions between enzyme and support, producing consequently alterations in the optimal reaction conditions. Properties of the immobilized systems were assessed and their performance on hydrolytic and synthetic reactions were evaluated and compared with the free enzyme. In hydrolytic reactions using p-nitrophenyl palmitate as substrate all immobilized systems showed higher thermal stability and optima pH and temperature values in relation to the free lipase. Among the activating compounds, carbonyldiimidazole resulted in a total recovery of activity on the support and the highest thermal stability. For the butyl butyrate synthesis, the best performance (molar conversion of 95% and volumetric productivity of 2.33 g L(-1)h(-1)) was attained with the lipase immobilized on POS-PVA activated with sodium metaperiodate. The properties of the support and immobilized derivatives were also evaluated by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopies and chemical composition (FTIR).

Health care access, use of services, and experiences among undocumented Mexicans and other Latinos.

BACKGROUND: We compared access to health care, use of services, and health care experiences for Mexicans and other Latinos by citizenship and immigrant authorization status. METHODS: We acquired data from the 2003 California Health Interview Survey, with 42,044 participants representative of noninstitutionalized households. Participants were differentiated by ethnicity/race, national origin, and citizenship/immigration authorization status. Outcome measures included having a usual source of care, problems in obtaining necessary care, use of physician and emergency department care, and 3 experiences with health care. Multivariate analyses measured the associations of citizenship/immigration authorization status with the outcome measures among foreign-born Mexicans and other Latinos vs their US-born counterparts. RESULTS: In multivariate analyses, undocumented Mexicans had 1.6 fewer physician visits (P < .01); compared with US-born Mexicans; other undocumented Latinos had 2.1 fewer visits (P < .01) compared with their US-born counterparts. Both undocumented groups were less likely to report difficulty obtaining necessary health care than US-born Mexicans (odds ratio, 0.68; P < .01) and other US-born Latinos (odds ratio, 0.40; P < .01), respectively. Undocumented Mexicans were less likely to have a usual source of care (odds ratio, 0.70; P < .01) and were more likely to report negative experiences than US-born Mexicans (odds ratio, 1.93; P < .01). Findings were similar for other undocumented Latinos, with the exception of having a usual source of care. Patterns of access to and use of health care services tended to improve with changing legal status. CONCLUSION: In this large sample, undocumented Mexicans and other undocumented Latinos reported less use of health care services and poorer experiences with care compared with their US-born counterparts, after adjustment for confounders in multivariate analyses.

Bioreactor coupled with electromagnetic field generator: effects of extremely low frequency electromagnetic fields on ethanol production by Saccharomyces cerevisiae.

The effect of extremely low frequency (ELF) magnetic fields on ethanol production by Saccharomyces cerevisiae using sugar cane molasses was studied during batch fermentation. The cellular suspension from the fermentor was externally recycled through a stainless steel tube inserted in two magnetic field generators, and consequently, the ethanol production was intensified. Two magnetic field generators were coupled to the bioreactor, which were operated conveniently in simple or combined ways. Therefore, the recycle velocity and intensity of the magnetic field varied in a range of 0.6-1.4 m s(-1) and 5-20 mT, respectively. However, under the best conditions with the magnetic field treatment (0.9-1.2 m s(-1) and 20 mT plus solenoid), the overall volumetric ethanol productivity was approximately 17% higher than in the control experiment. These results made it possible to verify the effectiveness of the dynamic magnetic treatment since the fermentations with magnetic treatment reached their final stage in less time, i.e., approximately 2 h earlier, when compared with the control experiment.

Kinetics of gas-phase hydrolysis of ethyl acetate catalyzed by immobilized lipase.

Reactions catalyzed by supported enzymes present important advantages when compared with those in aqueous media or organic solvents: separation of enzymes from substrate is easily accomplished, enzyme stability may be improved, and control of the reaction products is more accurate. We present the experimental results of the kinetic study of ethyl acetate hydrolysis in gaseous phase catalyzed by a commercial immobilized lipase (Lipozyme IM; Novo Nordisk). The hydrolysis reaction was studied as a function of ethyl ester and water partial pressure at a constant temperature of 318 K. The amount of biocatalyst used was varied between 100 and 300 mg, and the reaction was studied in a flow-through glass microreactor. Under the conditions used, water was an important parameter in the gas-phase reaction. Activation energy was 24.8 kJ/mol and the overall order of reaction was one. Finally, a Bi-Bi reaction mechanism is proposed.

A public health approach to pediatric residency education: responding to social determinants of health.

OBJECTIVE: To evaluate the impact of a public health approach to pediatric residency education on learner knowledge, skills, attitudes, beliefs, and career choice. BACKGROUND: Incorporating public health principles into traditional residency education can give pediatricians the population-oriented perspective to address social determinants of health. METHODS: The Community Health and Advocacy Training (CHAT) program is an educational intervention with a public health framework. From 2001-2007, 215 categorical pediatric residents and 37 residents in the CHAT program were evaluated by using an annual survey of community pediatrics exposure, knowledge, attitudes, and beliefs. American Board of Pediatrics (ABP) examination passage rates for both groups were also examined, as was career choice after graduation. RESULTS: While interns in both the categorical and CHAT programs scored similarly on attitudes, beliefs, skills, and knowledge of community pediatrics, the postgraduate level-3 (PL-3) year CHAT residents scored higher in attitudes (P < .001) and skills (P < .05). Exposure to both didactic (P < .05) and practical (P < .001) community pediatrics curricular experiences were higher for CHAT residents than for categorical residents. No significant differences between ABP examination scores were found for the 2 groups, although 100% of CHAT graduates passed on the first try compared to 91% of categorical graduates during this time period. A greater percentage of CHAT graduates (82%) than categorical graduates (53%) reported pursuing careers in primary care. CONCLUSION: With a public health approach to residency education, residents gain the knowledge, attitudes, and skills to address child health problems from a population perspective. Participation in such a curriculum still resulted in high passage rates on the ABP examination.

Juan: a 9-year-old Latino boy with ADHD.

CASE: Juan, a 9-year-old Latino male, was referred to a community clinic by his third-grade teacher for evaluation of classroom behavior problems. He is an only child and lives with both parents. At home, Juan speaks Spanish with his parents although he occasionally speaks English with his father. His father came to the U.S. from Mexico as a small child and completed the 12 grade in the U.S. Juan's mother completed 8 grade in Mexico and immigrated to the U.S. as a teenager.Juan's mother reported that he has had no significant medical problems. Her report of his behavior included an inability to focus on tasks at hand and easy distractibility. She was concerned that the principal of the school mentioned that Juan may be asked to repeat the 3 grade or change schools. In the clinic, Juan sat quietly but appeared to be daydreaming and attentive to the conversation. The pediatrician called the principal who expressed frustration with Juan's behavior. In class, he was very fidgety, did not pay attention and usually did not answer questions. He also bothered other students when they were working. The principal explained that because Juan's school was a Spanish language immersion school, there were no special education services available. If a student at the school required special education services, he or she would be transferred to another school in the same school district. An evaluation for an Individualized Education Plan (IEP) indicated that Juan had above average cognitive ability (90 percentile), with superior ability to problem solve and process information simultaneously (99 percentile). The Woodcock Johnson III (Spanish version) indicated average achievement in academic skills, with low average in reading fluency, comprehension and spelling. On the Test of Auditory-Perceptual Skills, Juan tested generally low average in all domains, and was at the 14 percentile for both auditory number and auditory word memory. On the Test of Visual-Perceptual Skills, Juan scored above the 92 percentile. Juan did not qualify for special education services on the basis on the standardized tests. However, because of the individual attention required by Juan, a transfer to another school was considered inevitable if his classroom behaviors did not improve. Juan's mother and teacher filled-out the NICHQ Vanderbilt Assessment Scale. Their responses were consistent with the diagnosis of ADHD, inattentive type. In discussion of treatment options with the family, the possibility of stimulant medication use was raised. Juan's mother was opposed to the medication because of what she had heard from her friends-that these medications had bad side effects and did not work most of the time. Juan's father, however, was in favor of the medication because it might assist Juan to stay at the school. After several clinical visits that included further information about ADHD, behavioral treatment, and reviewing information from the school, Juan's parents agreed to a trial of medication. Juan was evaluated for a follow-up visit 2 weeks after starting fourth grade; he had been taking a stimulant medication for one month. He seemed much happier about school and was proud to report that he has completed all of his assignments in school as well as homework assignments, and he did well on a math quiz. Juan's mother was also pleased with his progress. The pediatrician called the principal, who reported that Juan was an entirely different student. He now sat at his desk and wrote down the assignments. He seemed eager to learn and able to be attentive in the classroom. The principal was amazed at the difference.

Enzymatic hydrolysis of soybean oil using lipase from different sources to yield concentrated of polyunsaturated fatty acids.

The ability of three commercially available lipases to mediate the hydrolysis of the soybean oil to yield concentrated of essential fatty acids was evaluated. The tested lipases were from microbial (Candida rugosa and Thermomyces lanuginosa) and animal cells (Porcine pancreatic lipase). In terms of free fatty acids, microbial lipases were more effective to promote the enzymatic hydrolysis of the soybean oil (over 70%) than the porcine pancreatic lipase (24%). In spite of this, porcine pancreatic lipase (PPL) showed the most satisfactory specificity towards both essential fatty acids and was, therefore, chosen to carry out additional studies. An experimental design was performed taking into consideration the enzyme and NaCl amounts as independent variables. The main effects were fitted by multiple regression analysis to a linear model and maximum fatty acids concentration could be obtained using 3.0 wt% of lipase and 0.08 wt% of NaCl. The mathematical model representing the hydrolysis degree was found to describe adequately the experimental results. Under these conditions, concentrations of 29.5 g/L and 4.6 g/L for linoleic and linolenic acids, respectively, were obtained.