Smoking Cessation Support in the Context of Other Social and Behavioral Needs in Community Health Centers.

BACKGROUND: Cigarette smoking rates remain disproportionately high among low income populations with unmet social and behavioral health needs. To address this problem, we sought to develop and evaluate the feasibility, acceptability, and preliminary effectiveness of a novel smoking cessation program for community health centers that serve these populations. METHODS: We implemented a randomized pilot trial of two smoking cessation programs in three county operated community health center (CHC) sites: (1) a systematic assessment of smoking habits and standard tools to assist with smoking cessation counseling ("Enhanced Standard Program" or ESP), and (2) another that added a structured assessment of social and behavioral barriers to smoking cessation, ("Connection to Health for Smokers" or CTHS). Clinical outcomes were evaluated between 10 to 16 weeks, supplemented with interviews of patient participants and health care team members. RESULTS: 141 adults were randomized and 123 completed the intervention (61 in ESP, 62 in CTHS). At follow-up, over half of participants reported ≥1 quit attempts (59.7% ESP and 56.5% CTHS; adjusted p = .66) while more in ESP (24.6% vs. 12.9%) were documented as not smoking in the last 7 days (adjusted p = 0.03). In addition to being in ESP, predictors of smoking cessation included higher baseline confidence in ability to quit (p = 0.02) and more quit attempts during the study (p = 0.04). Health care teams, however, generally preferred the more comprehensive approach of CTHS. CONCLUSION: Lessons learned from this pilot study may inform the development of effective smoking cessation programs for CHCs that combine elements of both interventions.

Community engagement in the development of health-related data visualizations: a scoping review.

OBJECTIVE: This scoping review aims to address a gap in the literature on community engagement in developing data visualizations intended to improve population health. The review objectives are to: (1) synthesize literature on the types of community engagement activities conducted by researchers working with community partners and (2) characterize instances of "creative data literacy" within data visualizations developed in community-researcher partnerships. METHODS: Using the 2018 PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, the review focuses on peer-reviewed journal articles from 2010 to 2022 in PubMed, Web of Science, and Google Scholar. A community engagement tool was applied to the studies by independent reviewers to classify levels of community engagement, social determinants, and vulnerable populations. RESULTS: Twenty-seven articles were included in the scoping review. Twelve articles worked with vulnerable populations. Four articles attempted to alleviate barriers to representation in their respective studies, with addressing language barriers being the most prevalent approach. Thirteen articles considered social determinants of health. Sixteen studies engaged in iterative approaches with intended users when developing the visualization or tool. DISCUSSION: Only a few significant examples of creative data literacy are incorporated in the studies. We recommend a specific focus on engaging intended users at every step of the development process, addressing language and cultural differences, and empowering intended users as data storytellers. CONCLUSIONS: There is room for deeper and more meaningful community involvement in the development of health-related data visualizations geared towards them.

Biology and quality assessment of Telenomus remus (Hymenoptera: Scelionidae) and Trichogramma spp. (Hymenoptera: Trichogrammatidae) in eggs of Spodoptera spp. for augmentative biological control programs.

The Spodoptera complex of the family Noctuidae, represented here by S. frugiperda (J.E. Smith), S. eridania (Stoll), S. albula (Walker), and S. cosmioides (Walker), is an important group of crop pests in Brazil. Spodoptera frugiperda and S. eridania are invasive in Africa, and the former also in Asia and Oceania. The egg parasitoids Telenomus remus Nixon (Hymenoptera: Scelionidae) and Trichogramma spp. (Hymenoptera: Trichogrammatidae) are potential control agents for field use against these noctuids. We evaluated the parasitism efficiency, development, and flight capacity of an isofemale line and a regular line of T. remus, and 2 genetically variable populations of Trichogramma pretiosum Riley and Trichogramma atopovirilia Oatman and Platner (Hymenoptera: Trichogrammatidae) in these 4 members of the Spodoptera complex. All parasitoids were able to develop in the 4 hosts. The parasitoids showed good flight capacity, except for the regular line of T. remus. The Trichogramma species, despite having high viability and female:male sex ratios, showed poorer parasitism performances than T. remus. The regular T. remus line also showed good parasitism capacity and high viability but had a predominance of males. In general, the isofemale line of T. remus showed good rates of parasitism and flight capacity as well as a high viability and sex ratio, proving to be a potential candidate for an augmentative biological-control program for Spodoptera spp Guenée (Lepidoptera: Noctuidae).

Las personas jornaleras y la COVID-19: prevención y condiciones laborales en Sonora, México

Objetivo. Analizar la relación de las condiciones sociolaborales con el cuidado de la salud ante la COVID-19 entre la población jornalera en dos municipios de Sonora, México. Metodología. A través de entrevistas semiestructuradas y observaciones de campo, se evaluaron las prácticas de cuidado y las disposiciones sanitarias implementadas por los centros de trabajo agrícola. Se realizaron 22 entrevistas, 18 en el municipio de Hermosillo, y 4 en San Miguel de Horcasitas. Resultados. Las actividades agrícolas en México no cesaron, las personas continuaron sus labores en un contexto diverso de medidas preventivas. Encontramos una disparidad en las distintas unidades productivas, las cuales llevaron a cabo protocolos orientados al cuidado de la cosecha, pero en detrimento de la salud humana. El medio de transporte agrícola y la práctica de pagos en las localidades carecieron de acciones suficientes para prevenir el contagio. Conclusiones. Las condiciones sociolaborales obstaculizan la mitigación de la pandemia. Bajo ese panorama, necesariamente las autoridades competentes deben homogeneizar los protocolos sanitarios ante la COVID-19.

Objective: To analyze the relationship between socio-labor conditions and health care in the face of COVID-19 among the farmworkers in two municipalities of Sonora, Mexico. Method: . Through semi-structured interviews and field observations, the care practices and health provisions implemented by the agricultural work centers were analyzed. Twenty-two interviews were conducted, 18 in the municipality of Hermosillo and 4 in San Miguel de Horcasitas. Results: Agricultural activities in Mexico did not cease and farmworkers continued their work in a diverse context of prevention measures. We found a disparity between the different productive units, which carried out protocols oriented to the care of the harvest to the detriment of human health. The means of agricultural transport lacked sufficient attention in terms of contagion prevention. The practice of payments in the localities without a sanitary protocol was evident. Conclusion: The intervention of the health authorities is necessary to homogenize the prevention protocols in the face of COVID-19. Socio-labor conditions are an obstacle to pandemic mitigation.

Effectiveness and implementation of an online intervention (MINDxYOU) for reducing stress and promote mental health among healthcare workers in Spain: a study protocol for a stepped-wedge cluster randomized trial.

BACKGROUND: The World Health Organization has formally recognized that healthcare professionals are at risk of developing mental health problems; finding ways to reduce their stress is mandatory to improve both their quality of life and, indirectly, their job performance. In recent years, particularly since the COVID-19 pandemic outbreak, there has been a proliferation of online interventions with promising results. The purpose of the present study is twofold: to test the effectiveness of an online, self-guided intervention, MINDxYOU, to reduce the stress levels of healthcare workers; and to conduct an implementation study of this intervention. Additionally, an economic evaluation of the intervention will be conducted. METHODS: The current study has a hybrid effectiveness-implementation type 2 design. A stepped wedge cluster randomized trial design will be used, with a cohort of 180 healthcare workers recruited in two Spanish provinces (Malaga and Zaragoza). The recruitment stage will commence in October 2022. Frontline health workers who provide direct care to people in a hospital, primary care center, or nursing home setting in both regions will participate. The effectiveness of the intervention will be studied, with perceived stress as the main outcome (Perceived Stress Scale), while other psychopathological symptoms and process variables (e.g., mindfulness, compassion, resilience, and psychological flexibility) will be also assessed as secondary outcomes. The implementation study will include analysis of feasibility, acceptability, adoption, appropriateness, fidelity, penetration, and sustainability. The incremental costs and benefits, in terms of quality-adjusted life years, will be examined by means of cost-utility and cost-effectiveness analyses. DISCUSSION: MINDxYOU is designed to reduce healthcare workers' stress levels through the practice of mindfulness, acceptance, and compassion, with a special focus on how to apply these skills to healthy habits and considering the particular stressors that these professionals face on a daily basis. The present study will show how implementation studies are useful for establishing the framework in which to address barriers to and promote facilitators for acceptability, appropriateness, adoption, feasibility, fidelity, penetration, and sustainability of online interventions. The ultimate goal is to reduce the research-to-practice gap. TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov on 29/06/2022; registration number: NCT05436717.

Possible Role of Matrix Metalloproteinases and TGF-ß in COVID-19 Severity and Sequelae.

The costs of coronavirus disease 2019 (COVID-19) are devastating. With millions of deaths worldwide, specific serological biomarkers, antiviral agents, and novel therapies are urgently required to reduce the disease burden. For these purposes, a profound understanding of the pathobiology of COVID-19 is mandatory. Notably, the study of immunity against other respiratory infections has generated reference knowledge to comprehend the paradox of the COVID-19 pathogenesis. Past studies point to a complex interplay between cytokines and other factors mediating wound healing and extracellular matrix (ECM) remodeling that results in exacerbated inflammation, tissue injury, severe manifestations, and a sequela of respiratory infections. This review provides an overview of the immunological process elicited after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Also, we analyzed available data about the participation of matrix metalloproteinases (MMPs) and transforming growth factor-beta (TGF-ß) in immune responses of the lungs. Furthermore, we discuss their possible implications in severe COVID-19 and sequela, including pulmonary fibrosis, and remark on the potential of these molecules as biomarkers for diagnosis, prognosis, and treatment of convalescent COVID-19 patients. Our review provides a theoretical framework for future research aimed to discover molecular hallmarks that, combined with clinical features, could serve as therapeutic targets and reliable biomarkers of the different clinical forms of COVID-19, including convalescence.

Addressing tobacco use in the context of complex social needs: A new conceptual framework and approach to address smoking cessation in community health centers.

Objective: This article presents a new conceptual framework "Connection to Health for Smokers" (CTHS), its application to address smoking cessation, and its acceptability in community health centers (CHCs). Methods: CTHS, an online interactive patient educational tool comprehensively implements the "5 A's" (ask, advise, assess, assist, and arrange) within the context of patients' social and behavioral health needs. Semi-structured interviews were conducted with five health educators (nurses) who administered CTHS with 62 patients to evaluate the acceptability of the program. Thematic analyses were conducted with interview transcripts. Results: CHC health educators viewed CTHS has enhanced patient-centered communication, was able to identify patients' needs beyond tobacco use, and individualize action planning to integrate social and behavioral health needs. Conclusion: CTHS received enthusiasm from CHC health educators as a helpful tool to address tobacco use among their patients. Comprehensive on-site smoking cessation programs at CHCs that provide a structured evidence-based approach informed by an understanding of each patient's coexisting social and behavioral health needs may play an important role in reducing tobacco use disparities in the United States. Innovation: CTHS offers a new promising framework to comprehensively integrate the 5A's within the context of social and behavioral determinants of health for smoking cessation.

School Climate and Responsibility as Predictors of Antisocial and Prosocial Behaviors and Violence: A Study towards Self-Determination Theory.

Self-determination theory and Vallerand's hierarchical model have been studied taking into account different types of social factors that can result in different consequences. The purpose of this work was to see if responsibility and social climate could predict antisocial and prosocial behavior and violence. For this, 429 students (M = 11.46, SD = 1.92) participated in the study, answering a questionnaire with five variables: school climate, responsibility, motivation, satisfaction of psychological needs, prosocial and antisocial behavior, and violence. The main results indicated that most variables correlated positively and directly, except in the case of antisocial behavior and violence. On the other hand, a prediction model (X2 = 584.145 (98); RMSEA = 0.104 [90% CI = 0.096, 0.112]; TLI = 0.849; CFI = 0.894) showed that responsibility and school climate can predict basic psychological needs, and that these needs can improve autonomous motivation, which, in turn, could positively predict on improving prosocial behavior and reducing antisocial behavior and violence. In conclusion, school climate and responsibility can encourage the development of positive consequences in the classroom, specifically in terms of prosocial behavior and the reduction of violence and antisocial behavior.

Receiving Real-Time Clinical Feedback: A Workshop and OSTE Assessment for Medical Students.

BACKGROUND: Many programs designed to improve feedback to students focus on faculty's ability to provide a safe learning environment, and specific, actionable suggestions for improvement. Little attention has been paid to improving students' attitudes and skills in accepting and responding to feedback effectively. Effective "real-time" feedback in the clinical setting is dependent on both the skill of the teacher and the learner's ability to receive the feedback. Medical students entering their clinical clerkships are not formally trained in receiving feedback, despite the significant amount of feedback received during this time. METHODS: We developed and implemented a one-hour workshop to teach medical students strategies for effectively receiving and responding to "real-time" (formative) feedback in the clinical environment. Subjective confidence and skill in receiving real-time feedback were assessed in pre- and post-workshop surveys. Objective performance of receiving feedback was evaluated before and after the workshop using a simulated feedback encounter designed to re-create common clinical and cognitive pitfalls for medical students, called an objective structured teaching exercise (OSTE). RESULTS: After a single workshop, students self-reported increased confidence (mean 6.0 to 7.4 out of 10, P<0.01) and skill (mean 6.0 to 7.0 out of 10, P=0.10). Compared to pre-workshop OSTE scores, post-workshop OSTE scores objectively measuring skill in receiving feedback were also significantly higher (mean 28.8 to 34.5 out of 40, P=0.0131). CONCLUSION: A one-hour workshop dedicated to strategies in receiving real-time feedback may improve effective feedback reception as well as self-perceived skill and confidence in receiving feedback. Providing strategies to trainees to improve their ability to effectively receive feedback may be a high-yield approach to both strengthen the power of feedback in the clinical environment and enrich the clinical experience of the medical student.

Potential high-quality growing tea regions in Ecuador: an alternative cash crop for Ecuadorian small landholders.

BACKGROUND: Agriculture is the main means of subsistence for most of the population in developing countries. Crops that can increase their value with in situ processing have a big impact on the small landholder's economics. Moreover, crops such as coffee and cocoa beans have been very important for Ecuadorian farmers. In this study, we wanted to analyze if the climatic conditions exist for growing high-quality tea in Ecuador and determine the areas that will be less affected by global climate change in the future. RESULTS: We used a GIS (geographic information systems) based analysis, together with ecological niche modeling to determine areas in Ecuador where Ceylon and Nilgiris tea varieties could be grown, which will maintain similar ecological conditions in the future, and have a high agricultural aptitude. In total, there are more than 150 000 ha in Ecuador that could be converted to high-quality tea plantations, most of them in the coastal provinces, with some specific areas in the Andean foothills. CONCLUSION: Ecuador has a significant amount of land with the potential to grow high-quality tea, with no significant ecological niche modifications due to climate change in the long-term future. Tea is a viable and potentially highly profitable crop for small landholders and should be considered by local stakeholders. © 2019 Society of Chemical Industry.

Perception and knowledge of early pregnancy assessment units among perinatal practitioners in Europe.

OBJECTIVE: To investigate perceptions of early pregnancy assessment units (EPAUs) among perinatal practitioners working in Belgium, France, and Switzerland. METHODS: A prospective multinational survey was conducted between September 1, 2015, and May 21, 2016. Obstetricians, gynecologists, medical doctors, radiologists, and midwives were recruited during meetings, via e-mail invitations, or through the websites of regional obstetrics and gynecology scientific societies. The survey comprised 17 questions that assessed the participants' knowledge, interest, and management of early pregnancy. RESULTS: Of the 871 individuals invited to participate in the survey, 306 (35.1%) responded. Most of the participants were gynecologists and/or obstetricians (225 [73.5%]). A total of 258 (84.3%) participants had no or limited knowledge about EPAUs. Furthermore, 211 (69.0%) participants reported incorrect management when they visualized a gestational sac without embryo and 265 (86.6%) misinterpreted changes in serum levels of chorionic gonadotropin during early pregnancy. In all, 201 (65.7%) participants were interested in collaboration with an EPAU; however, only 125 (40.8%) had sufficient time and resources available to support a patient's psychological distress after early pregnancy loss or salpingectomy. CONCLUSION: Knowledge about early management of pregnancy was limited among the perinatal practitioners surveyed; however, the concept of EPAUs was welcomed by many.

Needs, Perceived Support, and Hospital Readmissions in Patients with Severe Mental Illness.

People with severe mental illness have multiple and complex needs that often are not addressed. The purpose of this study was to analyse needs and support perceived and the relationship with hospital readmission. We assessed 100 patients with severe mental illness at discharge from an acute inpatient unit in terms of needs (Camberwell Assessment of Needs), clinical status (The Brief Psychiatric Rating Scale), and social functioning (Personal and Social Performance); we also followed up these patients for 1 year. The group of patients who were readmitted had more total needs than did the non-readmitted, in addition to more unmet needs, although the differences were not significant. The highest risk factor for rehospitalisation was the number of previous admissions. In addition, the help of informal carers in alleviating psychological distress was associated with the risk of readmission. The main conclusion concerns the role of the psychological support provided by informal networks in preventing readmission.

Assessment of the role of micropore size and N-doping in CO2 capture by porous carbons.

The role of micropore size and N-doping in CO2 capture by microporous carbons has been investigated by analyzing the CO2 adsorption properties of two types of activated carbons with analogous textural properties: (a) N-free carbon microspheres and (b) N-doped carbon microspheres. Both materials exhibit a porosity made up exclusively of micropores ranging in size between <0.6 nm in the case of the pristine materials and up to 1.6 nm for the highly activated carbons (47% burnoff). The N-doped carbons possess ~3 wt % of N heteroatoms that are incorporated into several types of functional groups (i.e., pyrrole/pyridone, pyridine, quaternary, and pyridine-N-oxide). Under conventional operation conditions (i.e., T ~ 0-25 °C and P(CO2) ~ 0-1 bar), CO2 adsorption proceeds via a volume-filling mechanism, the size limit for volume-filling being ~0.7-0.8 nm. Under these circumstances, the adsorption of CO2 by nonfunctionalized porous carbons is mainly determined by the volume of the micropores with a size below 0.8 nm. It was also observed that the CO2 capture capacities of undoped and N-doped carbons are analogous which shows that the nitrogen functionalities present in these N-doped samples do not influence CO2 adsorption. Taking into account the temperature invariance of the characteristic curve postulated by the Dubinin theory, we show that CO2 uptakes can be accurately predicted by using the adsorption data measured at just one temperature.

Antioxidant cosmeto-textiles: skin assessment.

Resveratrol, a natural product, has been reported to have antioxidant activities such as the scavenging of free radicals. This compound could be used in the dermocosmetic field to protect the skin from oxidative stress. In this work, the percutaneous profile of resveratrol in ethanol solutions through pig skin was determinated by an in vitro methodology. The percutaneous absorption of resveratrol was measured and compared with trolox, an analogous of Vitamin E. Both antioxidants were found in all skin sections (stratum corneum, epidermis, and dermis). Besides, the free radical scavenging activity of resveratrol and trolox has been evaluated using DPPH method. The effective dose (ED50) of compounds and DPPH radical inhibition in each skin layer were evaluated. Under the conditions used for these experiments, it can be deduced that resveratrol is more efficient than trolox as an antioxidant, also in the inner skin layers. The cosmeto-textiles with an active substance incorporated into their structure are increasingly used in the cosmetics and pharmaceutical industries. The action of several cosmeto-textiles on the skin was assessed by in vitro and in vivo methodologies. Samples of these cosmeto-textiles were prepared with resveratrol incorporated into cotton and polyamide fabrics. An in vitro percutaneous absorption was used to demonstrate the delivery of the resveratrol from the textile to the different skin layers (stratum corneum, epidermis, and dermis). Additionally, these cosmeto-textiles containing the antioxidant were applied onto the forearms of volunteers to evaluate the textiles' efficacy in skin penetration. The antioxidant's antiradical capacity was evaluated using the DPPH method. Results showed that resveratrol could be detected in the dermis, epidermis, and stratum corneum (SC) by an in vitro percutaneous absorption method and was also detected in the outermost layers of the SC by an in vivo method (stripping). A smaller amount of resveratrol was penetrated through the skin layers when cosmeto-textiles were used compared to direct topical application of the antioxidant solution. The cosmeto-textiles investigated can act as a reservoir system capable of progressively deliver the active substance to the skin layers. From the skin penetration profiles and the antioxidant efficacy assessment of resveratrol, it is possible to ameliorate the inherent antioxidant capacity of skin.

Biofunctional textiles prepared with liposomes: in vivo and in vitro assessment.

A sun filter, ethyl hexyl methoxycinnamate (EHMC) used as a tracer, was vehiculized by liposomes made up of internal wool lipids (IWL) or phosphatidylcholine (PC) and applied onto cotton and polyamide fabrics by exhaustion treatments. After topical applications of textiles on human volunteers, skin properties were evaluated by non-invasive biophysical techniques. Two methodologies based on percutaneous absorption were used to determine the content of the active principle penetration into the skin. PC liposomes showed more affinity for the fabric than IWL liposomes. Moreover, polyamide fabrics absorbed a slightly higher percentage of liposomes than cotton fabrics. A significantly higher amount of EHMC skin penetration was found when the biofunctional textiles were topically applied than when formulations were applied onto the skin. Moreover, the polyamide was the fibre with the highest released properties in all cases.

Lepidopteran larva consumption of soybean foliage: basis for developing multiple-species economic thresholds for pest management decisions.

BACKGROUND: Defoliation by Anticarsia gemmatalis (Hübner), Pseudoplusia includens (Walker), Spodoptera eridania (Cramer), S. cosmioides (Walker) and S. frugiperda (JE Smith) (Lepidoptera: Noctuidae) was evaluated in four soybean genotypes. A multiple-species economic threshold (ET), based upon the species' feeding capacity, is proposed with the aim of improving growers' management decisions on when to initiate control measures for the species complex. RESULTS: Consumption by A. gemmatalis, S. cosmioides or S. eridania on different genotypes was similar. The highest consumption of P. includens was 92.7 cm(2) on Codetec 219RR; that of S. frugiperda was 118 cm(2) on Codetec 219RR and 115.1 cm(2) on MSoy 8787RR. The insect injury equivalent for S. cosmoides, calculated on the basis of insect consumption, was double the standard consumption by A. gemmatalis, and statistically different from the other species tested, which were similar to each other. CONCLUSIONS: As S. cosmioides always defoliated nearly twice the leaf area of the other species, the injury equivalent would be 2 for this lepidopteran species and 1 for the other species. The recommended multiple-species ET to trigger the beginning of insect control would then be 20 insect equivalents per linear metre.