Community clinic-based lifestyle change for prevention of metabolic syndrome: Rationale, design and methods of the ‘Vida Sana/healthy life’ program

Purpose and Objectives: The risk of diseases associated with Metabolic Syndrome (MetS) is higher for Hispanics living in the northeastern United States than for other racial and ethnic groups. Higher risk of diabetes, high blood lipids, obesity and limited access to continuity of care are all factors that also contribute to disproportionately poorer chronic disease outcomes for Hispanics. Intervention approach: This article describes the planning and implementation of, and evaluation plans for the Vida Sana Program (VSP), a community-based group intervention created to address the identified MetS risks by encouraging healthier diet and physical activity behaviors among a low-income, largely Spanish speaking, and literacy limited uninsured population. Developed in response to recent calls for culturally-tailored interventions, VSP is conducted by trained bicultural/bilingual Navegantes, who deliver a culturally sensitive, fun and engaging eight-week, in-person educational series through group meetings. The intervention also includes a 40-page colorful, picture and graphic enhanced booklet to be used in the group setting and at home. The intervention focused on screening for MetS-associated disease risk factors, understanding chronic disease management, encouraging medication adherence, increasing physical activity, and healthful dietary changes such as limiting alcohol, sodium, unhealthy fats and excess carbohydrate intake, while emphasizing portion control, whole grains and healthy fats. Conclusions: This creative, community-based approach fills an important gap in the community and in the public health literature, is well liked by health literacy limited patients, and will provide an important model of successfully engaging the Hispanic community on these important health issues

Clinical outcomes of a community clinic-based lifestyle change program for prevention and management of metabolic syndrome: Results of the ‘Vida Sana/Healthy Life’ program

Introduction: As US Hispanic populations are at higher risk than non-Hispanics for cardiovascular disease and Type 2 diabetes targeted interventions are clearly needed. This paper presents the four years results of the Vida Sana Program (VSP), which was developed and is implemented by a small clinic serving mostly Spanish-speaking, limited literacy population. Methods: The eight-week course of interactive two-hour sessions taught by Navegantes, bilingual/cultural community health workers, was delivered to participants with hypertension, or high lipids, BMI, waist circumference, glucose or hemoglobin A1C (A1C). Measures, collected by Navegantes and clinic nurses, included blood chemistries, blood pressure, anthropometry, and an assessment of healthy food knowledge. Results: Most participants (67%) were female, Hispanic (95%), and all were 18 to 70 years of age. At baseline, close to half of participants were obese (48%), had high waist circumference (53%), or elevated A1C (52%), or fasting blood glucose (57%). About one third had high blood pressure (29%) or serum cholesterol (35%), and 22% scored low on the knowledge assessment. After the intervention, participants decreased in weight (-1.0 lb), BMI (-0.2 kg/m2), WC (-0.4 inches), and cholesterol (-3.5 mg/dl, all p\u3c0.001). Systolic blood pressure decreased (-1.7 mm Hg, p\u3c0.001), and the knowledge score increased (6.8 percent, p\u3c0.001). Discussion: VSP shows promising improvements in metabolic outcomes, similar to other programs with longer duration or higher intensity interventions. VSP demonstrates an important model for successful community-connected interventions

Viscoelastic gels of guar and xanthan gum mixtures provide long-term stabilization of iron micro- and nanoparticles

Iron micro- and nanoparticles used for groundwater remediation and medical applications are prone to fast aggregation and sedimentation. Diluted single biopolymer water solutions of guar gum (GG) or xanthan gum (XG) can stabilize these particles for few hours providing steric repulsion and by increasing the viscosity of the suspension. The goal of the study is to demonstrate that amending GG solutions with small amounts of XG (XG/GG weight ratio 1:19; 3 g/L of total biopolymer concentration) can significantly improve the capability of the biopolymer to stabilize highly concentrated iron micro- and nanoparticle suspensions. The synergistic effect between GG and XG generates a viscoelastic gel that can maintain 20 g/L iron particles suspended for over 24 h. This is attributed to (i) an increase in the static viscosity, (ii) a combined polymer structure the yield stress of which contrasts the downward stress exerted by the iron particles, and (iii) the adsorption of the polymers to the iron surface having an anchoring effect on the particles. The XG/GG viscoelastic gel is characterized by a marked shear thinning behavior. This property, coupled with the low biopolymer concentration, determines small viscosity values at high shear rates, facilitating the injection in porous media. Furthermore, the thermosensitivity of the soft elastic polymeric network promotes higher stability and longer storage times at low temperatures and rapid decrease of viscosity at higher temperatures. This feature can be exploited in order to improve the flowability and the delivery of the suspensions to the target as well as to effectively tune and control the release of the iron particle

Validation of the ICRP model for caesium intake by lactating mothers with Italian data after the Chernobyl fallout.

In the aftermath of the Chernobyl nuclear power plant accident, a research group of the Italian National Institute of Health (Istituto Superiore di Sanità) carried out two research programmes on maternal milk. One concerned the transfer of caesium radionuclides from the diet to breast milk. In the other, the activity concentrations of (137)Cs were also determined in urine and placenta. The first study estimated the mothers' average (137)Cs dietary intake, in the second study the intake was evaluated individually for each subject. In 2004, the International Commission on Radiological Protection published modified systemic biokinetic models which also account for transfer to breast milk. The model for caesium radionuclides was implemented and tested by the authors with the experimental data described above. A good agreement was obtained between measured data and model simulations of (137)Cs activity concentration in human milk. The model, however, tends to systematically overestimate (137)Cs activity concentration in urine, in which case the agreement is to be considered satisfactory in terms of order of magnitude

Weight gain and weight management concerns for patients on β-blockers

β-blocking medications are first-line therapy for young patients with uncomplicated hypertension. They are also prescribed to 55% to 80% of those discharged from the hospital with a diagnosis of myocardial infarction. These drugs are known to decrease cardiovascular morbidity and mortality, but they also have metabolic adverse effects. One that is not widely known is that these drugs cause a decrease in resting metabolic rate, and taking these medications may result in a small weight gain. With continued use, there is an additional difficulty with weight loss, should that be a goal in managing high blood pressure. This article reviews the available research and offers a pragmatic approach to this clinical issue. Copyright © 2010 Lippincott Williams & Wilkins

Council Directive 98/83/EC on the quality of water intended for human consumption: calculation of derived activity concentrations

In December 1998, a European Directive on drinking water was published. It is a revision of the 1980 directive on the same issue and for the first time regulates radioactivity, establishing a parametric value for tritium and for the Total Indicative Dose (TID). In order to draw up a proposal for an environmental monitoring plan to be published by the EU able to guarantee the level of protection required by the TID, the National Institute of Health (Istituto Superiore di Sanita') was requested to calculate the derived reference levels for ingestion for different age classes, using the dose coefficient of the 96/29 EURATOM Directive and certain annual intakes. This report presents the database obtained and some subsequent elaborations for health authorities and other personnel involvedConsiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7, Rome Istituto Superiore di Sanita' - Viale Regina Elena, 299, Rome / CNR - Consiglio Nazionale delle RichercheSIGLEITItal