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BACKGROUND: Pharmacists serve a critical role in providing health care, especially in medically underserved areas. Despite the opioid crisis and legislation in most states allowing pharmacists to dispense naloxone without a prescription from another provider, pharmacists face multiple barriers to dispensing naloxone. OBJECTIVE: This study tested the effectiveness of CONSIDER New Mexico, an innovative educational initiative designed to increase naloxone dispensing by pharmacies. METHODS: A quasi-experimental study was conducted in New Mexico in 2019-2020. Community pharmacists and pharmacy technicians were recruited from a purposive sample of pharmacies. Data were collected through pre- and postintervention surveys with 65 pharmacists and 44 technicians from 49 pharmacies. Data analysis included hybrid fixed-effects regression models of variables associated with pre-post intervention change in intent to dispense naloxone and generalized least squares with maximum likelihood estimation for pre-post intervention change in naloxone dispensing. RESULTS: Positive intervention effects were observed for measures of normative beliefs, self-efficacy, and intent to dispense naloxone (P < 0.05). Changes in normative beliefs and self-efficacy were associated with greater intent to offer naloxone to patients (P < 0.05). In addition, the median number of naloxone prescriptions dispensed per month increased 3.5 times after intervention. A statistically significant positive association was observed between the intervention and naloxone dispensing after adjusting for other factors (P < 0.001). Pharmacies providing more than 4 additional health services were more likely to increase naloxone dispensing postintervention than pharmacies offering not more than 2 services (P < 0.01). This difference averaged 19 naloxone prescriptions per month. Estimated change in dispensing postintervention was statistically significantly lower at independent, clinic-based, and other pharmacies where an average of 36 fewer naloxone prescriptions were dispensed per month compared with chain drug stores (P = 0.03). CONCLUSION: The CONSIDER New Mexico intervention effectively increased self-efficacy, intent to dispense, and naloxone dispensing. Findings will inform future research examining widespread dissemination and implementation of the intervention and the sustainability of intervention effects.

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BACKGROUND: Population aging will lead to a dramatic increase in dementia prevalence, which will disproportionally affect racial minorities. The presence of racial differences in dementia prevalence has been widely reported in United States, but there are no relevant studies on this topic in low- and middle-income countries. METHODS: In a cross-sectional survey, 2944 older Cubans were recruited at a community-based level aimed to identify the effects of self-identified race and genetic admixture on cognitive performance. Dementia diagnosis was established using 10/66 Dementia and DSM-IV criteria. APOE-ε4 genotype was determined in 2511 (85%) and genetic admixture was completed for all dementia cases and in a randomly selected sample of cognitive healthy participants (218 dementia cases and 367 participants without dementia). RESULTS: The overall prevalence of dementia was 8.7%, without large or statistically significant differences on dementia prevalence (p = .12) by self-identified race. Mean cognitive scores were similar across racial groups (p = .46). After controlling for age, sex, and education, greater proportion of African ancestry was not associated with cognitive performance (p = .17). CONCLUSIONS: We found no evidence of an independent effect of self-identified race and/or population ancestry on dementia prevalence or cognitive performance. This suggests that observed differences in dementia prevalence among diverse populations may be driven primarily by social determinants of health.

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Introduction: Little is known about risk factors of dementia in Latin American countries. We aimed to identify socio-demographic, health and lifestyle risk factors of incident dementia in Cuban older adults. Methods: Data were from 1,846 participants in the Cuban cohort of the 10/66 Dementia Research Group. Participants completed questionnaires, health examinations, and cognitive tests at baseline (2003-2006) and 4.5 years later (2007-2010). Associations between risk factors (baseline) and incident dementia (follow-up) were examined using logistic regression. Results: Just over 9% of participants developed dementia. Overall, older age and low physical activity were associated with incident dementia. In those 65-74 years of age, depression, stroke and low physical activity were associated with incident dementia. In those ≥75 years of age, low physical activity, never eating fish, and smoking were associated with incident dementia. Conclusions: Modifiable lifestyle factors play an important role in developing dementia in Cuban older adults. This knowledge opens up opportunities for preventive strategies.

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RESUMEN Fundamento: La creciente prevalencia de diabetes mellitus tipo 2 (DM2) desde las edades pediátricas, ha convertido a la morbimortalidad relacionada con ella en un problema importante de salud pública. La detección precoz de factores de riesgo de DM2 en adolescentes, permitiría realizar acciones preventivas con enfoque de riesgo, que conducirían a disminuir la incidencia de esta entidad, siendo un pilar fundamental de la atención primaria. Objetivo: Identificar la presencia de factores de riesgo de DM2 en adolescentes. Método: Se realizó un estudio descriptivo transversal en un área de salud (Policlínico "Raúl Gómez García") con una muestra de 96 adolescentes. Se recogieron variables como edad, sexo, antecedentes de diabetes gestacional, bajo peso al nacer, tiempo de lactancia materna, historia familiar de DM2, consumo de frutas/vegetales, actividades físicas y resultantes del examen físico. Resultados: El 62,50% de los adolescentes pertenecía al sexo femenino y la adolescencia temprana. El inadecuado consumo de frutas y vegetales con 81,25% fue el factor de riesgo más común, seguido del sedentarismo con un 45,83%. Todos los adolescentes poseían al menos un factor de riesgo, y el 72,92% poseía 3 o más con predominio en el sexo femenino (p=0,022) Conclusiones: Existe una alta frecuencia de factores de riesgo para el desarrollo de DM2 en los adolescentes, con predominio de factores modificables. La mayoría de los adolescentes poseían un riesgo metabólico incrementado al presentar 3 o más factores de riesgo, en especial las féminas.

ABSTRACT Foundation: The increasing prevalence of diabetes mellitus type 2 (DM2) from the pediatric ages, has made its morbidity and mortality a major public health problem. Early detection of DM2 risk factors in adolescents, would allow preventive actions with a risk approach, which would lead to decrease the incidence of this condition, being a fundamental pillar of primary care . Objective: To identify the presence of DM2 risk factors in adolescents. Method: A cross-sectional descriptive study was conducted in a health area ("Raúl Gómez García" Polyclinic) with a sample of 96 adolescents. Variables such as age, sex, history of gestational diabetes, low birth weight, breastfeeding time, family history of DM2, fruit / vegetable intake, physical activity and physical examination results were collected. Results: The 62.50% of the adolescents belonged to the feminine sex and the early adolescence. The inadequate consumption of fruits and vegetables with 81.25% was the most common risk factor, followed by a sedentary lifestyle with 45.83%. All adolescents had at least one risk factor, and 72.92% had 3 or more with a predominance in females (p = 0.022). Conclusion: There is a high frequency of risk factors for developing of DM2 in adolescents, with a predominance of modifiable factors. Most adolescents had an increased metabolic risk when presenting 3 or more risk factors, especially females.

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Las proteínas arabinogalactanos (AGPs) son macromoléculas que se encuentran prácticamente en todos los órganos de las plantas, siendo asociadas con varios aspectos del crecimiento y desarrollo vegetal. Estas moléculas se caracterizan bioquímicamente por contener carbohidratos y proteínas en relación 9:1. El carbohidrato está compuesto principalmente por arabinogalactanos tipo II; mientras que la parte proteica está organizada en dominios que definen a las AGPs como clásicas o no clásicas. Las primeras se caracterizan además por presentar una secuencia C-terminal que predice la incorporación de un grupo glicosilfosfatidilinositol (GFI), que permite su unión a la membrana plasmática. En cultivos de células vegetales se reportan varias especies que liberan AGPs al medio de cultivo. Se presenta una revisión de las características bioquímicas de las AGPs liberadas al medio y de las propuestas sobre los mecanismos bioquímicos y celulares por los cuales las AGPs participan en la diferenciación y crecimiento de las células vegetales. Los cultivos de células liberan al medio de cultivo AGPs clásicas y no clásicas, y se propone que podrían provenir de la membrana plasmática o la pared celular. Las AGPs intervienen en el control del crecimiento celular, además de estar relacionadas con la embriogénesis somática y la organogénesis, procesos de diferenciación celular importantes en los sistemas de micropropagación de plantas. El mecanismo bioquímico por el cual las AGPs participan en el crecimiento celular y la diferenciación implica que éstas, o los productos de su degradación, quizás actúen como moléculas de señalización.

The arabinogalactan proteins (AGPs) are macromolecules found in practically all plant organs, being associated with several aspects of the plant growth and development. These molecules contain carbohydrates and proteins in a 9:1 relation. The carbohydrate moiety is composed mainly of type II arabinogalactans, whereas the protein has particular amino acid domains that allow classifying the AGPs into two groups, classical and non-classical. In addition, the former are characterized by a C-terminal tail that predicts the incorporation of a glycosylphosphatidylinositol group (GPI) that allows the attachment of the AGPs to the plasma membrane. Plant cell cultures of several species release AGPs into the culture medium. The biochemical characteristics of the AGPs released into the medium, and the proposed biochemical and cellular mechanisms by which AGPs participate in plant cell differentiation and growth are reviewed. The plant cells release classical as well as non-classical AGPs into the culture medium. The origin of these AGPs could likely be the plasma membrane or the cell wall. They are involved in the control of cellular growth and differentiation processes, aspects that have fundamental importance in the induction of somatic embryogenesis and organogenesis, key steps in plant micropropagation programs. The biochemical mechanism by which the AGPs participate in cell growth and differentiation implies that the AGPs or their degradation products participate like signal molecules.

As proteínas arabinogalactanos (AGPs) são macromoléculas que se encontram praticamente em todos os órgãos das plantas, sendo associadas com vários aspectos do crescimento e desenvolvimento vegetal. Estas moléculas se caracterizam bioquímicamente por conter carboidratos e proteínas em relação 9:1. O carboidrato está composto principalmente por arabinogalactanos tipo II; enquanto que a parte protéica está organizada em domínios que definem as AGPs como clássicas ou não clássicas. As primeiras se caracterizam, além disso, por apresentar uma sequência C-terminal que prediz a incorporação de um grupo glicosilfosfatidilinositol (GFI), que permite sua união à membrana plasmática. Em cultivos de células vegetais se relatam várias espécies que liberam AGPs ao meio de cultivo. Apresenta-se uma revisão das características bioquímicas das AGPs liberadas ao meio e das propostas sobre os mecanismos bioquímicos e celulares pelos quais as AGPs participam na diferenciação e crescimento das células vegetais. Os cultivos de células liberam ao meio de cultivo AGPs clássicas e não clássicas, e se propõe que poderiam provir da membrana plasmática ou da parede celular. As AGPs intervêm no controle do crescimento celular, além de estar relacionadas com a embriogênese somática e a organogênese, processos de diferenciação celular importantes nos sistemas de micropropagação de plantas. O mecanismo bioquímico pelo qual as AGPs participam no crescimento celular e a diferenciação, implica que estas, ou os produtos de sua degradação, talvez atuem como moléculas de sinalização.