Be Well Communities™: mobilizing communities to promote wellness and stop cancer before it starts.

PURPOSE: Increasingly, cancer centers are delivering population-based approaches to narrow the gap between known cancer prevention strategies and their effective implementation. Leveraging successful healthy community initiatives, MD Anderson developed Be Well Communities™, a model that implements evidence-based actions to directly impact people's lives. METHODS: In partnership with local organizations, MD Anderson's Be Well Communities team executed and evaluated 16 evidence-based interventions to address community priorities in healthy diets, physical activity, and sun safety. Evaluation included assessing the effectiveness of evidence-based interventions, stakeholders' perceptions of collaboration, and the population-level impact on dietary and physical activity behaviors among students using the School Physical Activity and Nutrition Survey and the System for Observing Fitness Instruction Time. Two-tailed t-tests were used to compare tested parameters at baseline and follow-up. p values less than .05 were considered significant. RESULTS: This model achieved its early outcomes, including effectively implementing evidence-based interventions, building strong partnerships, increasing access to healthy foods, improving the built environment, and increasing healthy food and water consumption and moderate to vigorous physical activity among students (p < .001). CONCLUSIONS: Be Well Communities is an effective model for positively impacting community health which could be leveraged by others to deliver evidence-based actions to improve population health.

A pilot food prescription program promotes produce intake and decreases food insecurity.

Food insecurity is associated with limited food resources that may lead to poor nutritional intake and diet-related chronic disease. Food prescription programs offer an avenue for facilitating access to fresh and healthy nonperishable food while reducing food insecurity. The purpose of this pilot study is to examine the feasibility, perceptions, and impact of a collaborative food prescription program in an area with a high rate of food insecurity. The study was a single group pre-post evaluation design. Participants were recruited from two school-based clinics and one Federally Qualified Health Center in north Pasadena, an area with a high rate of food insecurity in Harris County, TX. Adult, food insecure participants were screened at health clinics for eligibility. Participants received nutrition education materials and 30 pounds of a variety of fresh produce plus four healthy, nonperishable food items every 2 weeks for up to 12 visits at a local food pantry. Surveys and tracking tools monitored food insecurity, program dosage, reach, fidelity, acceptability, and program costs. Surveys and key informant interviews assessed perceptions of health care providers, implementation staff, and participants. Participants (n = 172) in the program reported a 94.1% decrease in the prevalence of food insecurity (p < .01) at the end of the program. An average of 29.2 pounds of fruits and vegetables were distributed per family per distribution, and 99% of participants reported eating "all" or "most" of the food provided. Program costs were $12.20 per participant per redemption. Interviews revealed that providers and participants felt the program was well received and highly needed. This pilot study demonstrates the framework and feasibility of a collaborative clinic-based food prescription program to address food insecurity. Future research should examine the sustained impact of such programs on behavioral and health outcomes.

Contribution of bioavailable iron and zinc to the diet of Honduran children under 24 month / Aporte de hierro y zinc bioaccesible a la dieta de niños hondureños menores de 24 meses

Objective: In the present study we analyzed 18 baby food (10 made from traditional Honduran recipes, and 8 industrial baby food sold in that country) involving the staple food of Honduran excluded infants breast milk and infant formulas. Material and methods: The content and bioaccesibility (soluble and dialysable fractions) of Fe and Zn were determined. For thisin vitro gastrointestinal digestion in a first phase of gastric digestion (pepsin) followed by a second phase of intestinal digestion (with pancreatin and bile salts) was simulated. The atomic absorption spectrometry mineral content measured in soluble and dialyzable fractions. Results: Traditional porridges from Honduras (PTH) showed low density of micronutrients being the PTH prepared based on "rice with beans and greens", "rice with ground beans" and "beans with banana" which had a higher content values of 1.96, 1.56, and 1.46 mg Fe/100 g, respectively, although in vitroavailability values below 50% of its content. For Zn in these recipes, the values found were very low being below the detection limit. In relation to industrial porridges (PIH), those of "rice", "wheat with milk" and "5 cereals" they had a higher content of Fe (9.4, 8.53 and 7.56 mg Fe/100 g, respectively). Its availability in vitro was greater than 70% in all cases. PIH Zn showed values of 1.36, and 0.99 mg Zn/100 g samples of "wheat with milk" and "wheat with honey", respectively, and increased availability of 75%. Conclusions: It is shown that PTH have some limitations in its formulation that makes the selected micronutrients are in fewer and even less bioaccessible, compared with PIH, so review is recommended to avoid supplementation of these micronutrients and help improve the nutritional status of the child population as Honduran model country in Central America.

Objetivo: en el presente estudio se han analizado 18 alimentos infantiles (10 elaborados con recetas tradicionales hondureñas y 8 papillas industriales comercializadas en ese país), que suponen la base de la alimentación de los lactantes hondureños excluida la leche materna y las fórmulas infantiles. Material y métodos: se determinó el contenido y bioacesiblidad (fracciones solubes y dializables) de Fe y Zn. Para ello se simuló una digestión in vitro gastrointestinal con una primera fase de digestión gástrica (con pepsina), seguida de una segunda fase de digestión intestinal (con pancreatina y sales biliares). La espectrometría de absorción atómica midió el contenido mineral en las fracciones soluble y dializable. Resultados: las papillas tradicionales hondureñas (PTH) mostraron baja densidad de los micronutrientes estudiados, siendo las PTH elaboradas con base de "arroz con frijoles y hojas verdes", "arroz con frijol molido" y "frijoles con plátano" las que presentaron un contenido superior con valores de 1,96, 1,56, y 1,46 mg Fe/100 g, respectivamente, aunque con valores de disponibilidad in vitro inferiores al 50% de su contenido. Para el Zn en estas recetas, los valores encontrados fueron muy bajos y están por debajo del límite de detección. En relación a las papillas industriales (PIH), las de "arroz", "trigo con leche" y "5 cereales" presentaron un mayor contenido de Fe (9,4, 8,53 y 7,56 mg Fe/100 g, respectivamente). Su disponibilidad in vitro fue mayor del 70% en todos los casos. Las PIH mostraron valores de Zn de 1,36, y 0,99 mg Zn/100 g en las muestras de "trigo con leche" y "trigo con miel", respectivamente, y una disponibilidad mayor del 75%. Conclusión: queda demostrado que las PTH poseen algunas limitaciones en su formulación que hace que los micronutrientes seleccionados se encuentren en menor cantidad e incluso menos bioaccesibles, frente a los PIH, por lo que se recomienda su revisión para evitar la suplementación de estos micronutrientes y ayudar a mejorar el estado nutricional de la población infantil hondureña como país modelo de la región centroamericana.

Aporte de hierro y zinc bioaccesible a la dieta de niños hondureños menores de 24 meses / Contribution of bioavailable iron and zinc to the diet of Honduran children under 24 month

Objetivo: en el presente estudio se han analizado 18 alimentos infantiles (10 elaborados con recetas tradicionales hondureñas y 8 papillas industriales comercializadas en ese país), que suponen la base de la alimentación de los lactantes hondureños excluida la leche materna y las fórmulas infantiles. Material y métodos: se determinó el contenido y bioacesiblidad (fracciones solubes y dializables) de Fe y Zn. Para ello se simuló una digestión in vitro gastrointestinal con una primera fase de digestión gástrica (con pepsina), seguida de una segunda fase de digestión intestinal (con pancreatina y sales biliares). La espectrometría de absorción atómica midió el contenido mineral en las fracciones soluble y dializable. Resultados: las papillas tradicionales hondureñas (PTH) mostraron baja densidad de los micronutrientes estudiados, siendo las PTH elaboradas con base de «arroz con frijoles y hojas verdes», «arroz con frijol molido» y «frijoles con plátano» las que presentaron un contenido superior con valores de 1,96, 1,56, y 1,46 mg Fe/100 g, respectivamente, aunque con valores de disponibilidad in vitro inferiores al 50% de su contenido. Para el Zn en estas recetas, los valores encontrados fueron muy bajos y están por debajo del límite de detección. En relación a las papillas industriales (PIH), las de «arroz», «trigo con leche» y «5 cereales» presentaron un mayor contenido de Fe (9,4, 8,53 y 7,56 mg Fe/100 g, respectivamente). Su disponibilidad in vitro fue mayor del 70% en todos los casos. Las PIH mostraron valores de Zn de 1,36, y 0,99 mg Zn/100 g en las muestras de «trigo con leche» y «trigo con miel», respectivamente, y una disponibilidad mayor del 75%. Conclusión: queda demostrado que las PTH poseen algunas limitaciones en su formulación que hace que los micronutrientes seleccionados se encuentren en menor cantidad e incluso menos bioaccesibles, frente a los PIH, por lo que se recomienda su revisión para evitar la suplementación de estos micronutrientes y ayudar a mejorar el estado nutricional de la población infantil hondureña como país modelo de la región centroamericana (AU)

Objective: In the present study we analyzed 18 baby food (10 made from traditional Honduran recipes, and 8 industrial baby food sold in that country) involving the staple food of Honduran excluded infants breast milk and infant formulas. Material and methods: The content and bioaccesibility (soluble and dialysable fractions) of Fe and Zn were determined. For this in vitro gastrointestinal digestion in a first phase of gastric digestion (pepsin) followed by a second phase of intestinal digestion (with pancreatin and bile salts) was simulated. The atomic absorption spectrometry mineral content measured in soluble and dialyzable fractions. Results: Traditional porridges from Honduras (PTH) showed low density of micronutrients being the PTH prepared based on «rice with beans and greens», «rice with ground beans» and «beans with banana» which had a higher content values of 1.96, 1.56, and 1.46 mg Fe/100 g, respectively, although in vitro availability values below 50% of its content. For Zn in these recipes, the values found were very low being below the detection limit. In relation to industrial porridges (PIH), those of «rice», «wheat with milk» and «5 cereals» they had a higher content of Fe (9.4, 8.53 and 7.56 mg Fe/100 g, respectively). Its availability in vitro was greater than 70% in all cases. PIH Zn showed values of 1.36, and 0.99 mg Zn/100 g samples of «wheat with milk» and «wheat with honey», respectively, and increased availability of 75%. Conclusions: It is shown that PTH have some limitations in its formulation that makes the selected micronutrients are in fewer and even less bioaccessible, compared with PIH, so review is recommended to avoid supplementation of these micronutrients and help improve the nutritional status of the child population as Honduran model country in Central America (AU)

Desequilibrios ácido-básicos en pacientes de la sala de terapia intensiva / Acid-base imbalance in patients admitted to the Intensive Care Unit

Para valorar la frecuencia de presentación y la letalidad de los trastornos ácido-básicos diagnosticados en la sala de terapia intensiva se llevó a cabo un estudio prospectivo con 100 pacientes ingresados consecutivamente a partir del 1 de noviembre de 1999, de los cuales se obtuvieron 1 108 informes de hemogasometrías arteriales y se agruparon estos resultados según las anormalidades documentadas. Se comprobó que el 76 porciento de los estudios mostraba algún desequilibrio ácido-básico, con predominio marginal de los mixtos. La alcalosis respiratoria simple (27,6 porciento) y la combinación de ésta con acidosis metabólica (22,7 porciento) fueron las combinaciones más frecuentes. Todos los trastornos, con excepción de la alcalosis respiratoria simple y la acidosis respiratoria simple, presentaron letalidad igual o mayor que el 65 porciento, y sobresalió la asociación de acidosis respiratoria con alcalosis metabólica (89 porciento). La validación estadística fue con la técnica de chi cuadrado, y se consideró significativa la p<0,05. Estos resultados sugieren la necesidad de prevenir y tratar precozmente los desequilibrios ácido-básicos en las unidades de terapia intensiva