Barriers to Telehealth Utilization Among Patients of Limited Income with Chronic Conditions and a Gap in Care.

Objective: This study assessed barriers and facilitators to telehealth utilization among patients living in New York City public housing with chronic conditions and a gap in clinical care. Methods: Community health workers performed outreach to eligible patients by telephone between January and March 2021. Consenting respondents answered questions about telehealth barriers, including internet and cell phone access, ownership of digital devices, comfort with using digital devices, comfort with telehealth, cost, awareness, and availability of written materials in patients' preferred language. We obtained demographic and medical information from patients' electronic health records. We used multivariable logistic regression to estimate the association of barriers with the odds of self-reported prior telehealth utilization. Results: A total of 304 consenting patients participated in the program. The average patient had 3.1 telehealth barriers; 76% reported at least one barrier. Regression analysis showed sizable reductions in prior telehealth utilization associated with the barriers of unlimited cell phone minutes (odds ratio [OR]: 0.21 [0.05-0.88], p = 0.033), technological comfort (OR: 0.33 [0.13-0.82], p = 0.016), conceptual comfort with telehealth (OR: 0.15 [0.04-0.54], p = 0.004), and materials in the patient's preferred language (OR: 0.23 [0.07-0.79], p = 0.02). Discussion: With a high prevalence of telehealth barriers, patients with limited income, a chronic condition, and a care gap may benefit from greater technological access and supportive programs for awareness, telehealth comfort, and navigation support. Addressing telehealth barriers could increase the quality of medical care and improve health outcomes for this population.

Impacto del estrés laboral en el bienestar psicológico del personal de un hospital público de medellín, colombia

Objetivo: Determinar si el estrés laboral repercute en la percepción subjetiva de bienestar psicológico del personal asistencial de un hospital de Medellín, Colombia. Material y Método: Estudio con diseño cuantitativo, no experimental, transversal; la unidad de análisis fue el personal asistencial conformado por enfermeras/os, auxiliares de enfermería, médicos generales y especialistas; el muestreo no probabilístico intencional fue de 129 participantes; la modalidad de medición fue híbrida utilizando un cuestionario aplicado por Google Forms que midió 2 variables: Estrés laboral y Bienestar psicológico; el pilotaje se realizó con 10 participantes de diferentes departamentos del centro hospitalario; la recolección finalizó en junio de 2022; para el análisis estadístico descriptivo se aplicaron medidas de tendencia central y las correlaciones se realizaron con el coeficiente Rho de Spearman. Resultados: Los participantes mostraron un agotamiento laboral moderado y un bienestar psicológico bajo; los niveles más bajos de bienestar psicológico se correlacionaron con un mayor estrés laboral; la despersonalización y el agotamiento emocional tuvieron el mayor impacto en la reducción del bienestar psicológico; los hombres reportaron niveles más altos de bienestar psicológico que las mujeres. Conclusiones: Es importante fomentar el bienestar psicológico y la implementación de estrategias de manejo del estrés laboral en entornos laborales de la salud, no sólo desde una perspectiva organizacional, sino también cultural y social.

Objective: To determine whether occupational stress has an impact on the subjective perception of psychological well-being of the nursing staff in a hospital in Medellin, Colombia. Material and Method: Quantitative, non-experimental, cross-sectional study; the unit of analysis was the nursing staff consisting of nursing assistants, general practitioners and specialists; the non-probabilistic intentional sampling included 129 participants; the measurement modality was hybrid using a questionnaire applied through Google Forms that focused on 2 variables: Job stress and Psychological well-being; a pilot study was carried out with 10 participants from different departments of the healthcare institution; data collection ended in June 2022; for the descriptive statistical analysis measures of central tendency were applied and correlations were performed using Spearman's Rho coefficient. Results: Participants showed moderate levels of Job stress and low psychological well-being; lower levels of psychological well-being correlated with higher levels of job stress; depersonalization and emotional exhaustion had the greatest impact on reducing psychological well-being; men reported higher levels of psychological well-being than women. Conclusions: It is important to promote psychological well-being and the implementation of job stress management strategies in healthcare work environments, not only from an organizational perspective, but also from a cultural and social perspective.

Objetivo: Determinar se o estresse no trabalho tem impacto sobre a percepção subjetiva do bem-estar psicológico da equipe de enfermagem de um hospital em Medellín, Colômbia. Material e Método: Estudo quantitativo, não experimental, transversal; a unidade de análise foi a equipe de enfermagem composta por auxiliares de enfermagem, clínicos gerais e especialistas; a amostragem intencional não probabilística incluiu 129 participantes; a medição foi híbrida e utilizou um questionário aplicado por meio do Google Forms que se concentrou em 2 variáveis: estresse no trabalho e bem-estar psicológico; um estudo piloto foi realizado com 10 participantes de diferentes departamentos do hospital; a coleta de dados foi concluida em junho de 2022; para a análise estatística descritiva, foram aplicadas medidas de tendência central e as correlações foram realizadas usando o coeficiente Rho de Spearman. Resultados: Os participantes apresentaram níveis moderados de estresse no trabalho e baixo bem-estar psicológico; níveis mais baixos de bem-estar psicológico se correlacionaram com níveis mais altos de estresse no trabalho; a despersonalização e a exaustão emocional tiveram o maior impacto na redução do bem-estar psicológico; os homens relataram níveis mais altos de bem-estar psicológico do que as mulheres. Conclusões: E importante promover o bem-estar psicológico e implementar estratégias de gerenciamento do estresse em ambientes de trabalho da saúde, não apenas de uma perspectiva organizacional, mas também de uma perspectiva cultural e social.

Ultrasound-Assisted Extraction of Bioactive Compounds from Annatto Seeds, Evaluation of Their Antimicrobial and Antioxidant Activity, and Identification of Main Compounds by LC/ESI-MS Analysis.

This study evaluated the antimicrobial activity (i.e., against Bacillus cereus and Staphylococcus aureus) and the antioxidant activity (i.e., ABTS, FRAP, and DPPH) of annatto seeds extract obtained by ultrasound-assisted extraction. A response surface design with three levels such as pH (2-11), solvent concentration (50-96 %), seed-to-solvent ratio (1:2-1:10), and treatment time (0-30 min) was employed to determine the optimal experimental conditions. Thus, a pH of 7.0, seed-to-solvent ratio of 1:7, and treatment time of 20 min were selected as optimal rendering an extract having a 0.62% of bixin, 3.81 mg gallic acid/mg equivalent of polyphenol compounds (ABTS 1035.7, FRAP 424.7, and DPPH 1161.5 µM trolox/L), and a minimal inhibitory concentration against Bacillus cereus and Staphylococcus aureus of 32 and 16 mg/L, respectively. Further, the main bioactive compounds identified by LC/ESI-MS were bixin and catechin, chlorogenic acid, chrysin, butein, hypolaetin, licochalcone A, and xanthohumol.

Optimization of the Microwave-Assisted Extraction Process of Bioactive Compounds from Annatto Seeds (Bixa orellana L.).

This study deals with the extraction, optimization, and evaluation of the antioxidant and antimicrobial activities of bioactive compounds obtained from the seeds of annatto using microwave-assisted extraction as compared to leaching. Annatto seeds were subjected to a microwave treatment of 2450 MHz and power of 700 watts using a response surface design involving four factors: pH (4⁻11), solvent concentration (ethanol) (50⁻96 %), solvent-to-seed ratio (2⁻10), and microwave exposure time (0⁻5 min). The contents of polyphenol compounds and bixin were taken as response variables. Subsequently, the antioxidant and antimicrobial activities were assessed at the optimal processing conditions predicted by the experimental design. Microwaves, solvent concentration, and the solvent-to-seed ratio showed a statistically significant effect for the extraction of polyphenol compounds and bixin. Thus, microwaves accelerated the extraction of those compounds and the slight increase in temperature caused some degradation of the polyphenol compounds. The microwave-assisted extraction increased the contents of polyphenols and bixin along with their antioxidant activity as compared to leaching extraction. However, this technique does not significantly improve the antimicrobial activity against Bacillus cereus and Staphylococcus aureus.