A collaboration team to build social service partnerships within a safety-net health system.

BACKGROUND: To facilitate safety-net healthcare system partnerships with community social service providers, the Los Angeles County Department of Health Services (LAC DHS) created a new collaboration team to spur cross-agency social and medical referral networks and engage communities affected by health disparities as part of a Sect. 1115 Medicaid waiver in Los Angeles County entitled Whole Person Care-Los Angeles (WPC-LA). METHODS: This observational research reviews three years of collaboration team implementation (2018-2020) through Medicaid-reportable engagement reports, a collaboration team qualitative survey on challenges, facilitators, and recommendations for community engagement. Member reflections for survey findings were conducted with the collaboration team and LAC DHS WPC-LA leadership. RESULTS: Collaboration team Medicaid engagement reports (n = 144) reported > 2,700 events, reaching > 70,000 individuals through cross-agency and community-partnered meetings. The collaboration team survey (n = 9) and member reflection sessions portrayed engagement processes through outreach, service assessments, and facilitation of service partnerships. The collaboration team facilitated community engagement processes through countywide workgroups on justice-system diversion and African American infant and maternal health. Recommendations for future safety net health system engagement processes included assessing health system readiness for community engagement and identifying strategies to build mutually beneficial social service partnerships. CONCLUSIONS: A dedicated collaboration team allowed for bi-directional knowledge exchange between county services, populations with lived experience, and social services, identifying service gaps and recommendations. Engagement with communities affected by health disparities resulted in health system policy recommendations and changes.

Bacterial Colony Phenotyping with Hyperspectral Elastic Light Scattering Patterns.

The elastic light-scatter (ELS) technique, which detects and discriminates microbial organisms based on the light-scatter pattern of their colonies, has demonstrated excellent classification accuracy in pathogen screening tasks. The implementation of the multispectral approach has brought further advantages and motivated the design and validation of a hyperspectral elastic light-scatter phenotyping instrument (HESPI). The newly developed instrument consists of a supercontinuum (SC) laser and an acousto-optic tunable filter (AOTF). The use of these two components provided a broad spectrum of excitation light and a rapid selection of the wavelength of interest, which enables the collection of multiple spectral patterns for each colony instead of relying on single band analysis. The performance was validated by classifying microflora of green-leafed vegetables using the hyperspectral ELS patterns of the bacterial colonies. The accuracy ranged from 88.7% to 93.2% when the classification was performed with the scattering pattern created at a wavelength within the 473-709 nm region. When all of the hyperspectral ELS patterns were used, owing to the vastly increased size of the data, feature reduction and selection algorithms were utilized to enhance the robustness and ultimately lessen the complexity of the data collection. A new classification model with the feature reduction process improved the overall classification rate to 95.9%.

La experiencia vivida de la emergencia obstétrica: un estudio fenomenológico con mujeres mexicanas / The lived experience of the obstetric emergency: a phenomenological study with Mexican women

Resumen Este estudio pretende profundizar en la experiencia vivida por mujeres mexicanas en la emergencia obstétrica. Para ello, se realizó un estudio cualitativo-fenomenológico por medio de entrevistas en profundidad a 15 mujeres sobrevivientes de esta experiencia que se realizaron en el periodo de enero a septiembre de 2017. La información se procesó mediante análisis fenomenológico del discurso, y para su interpretación se organizó en las cuatro dimensiones de la fenomenología de la percepción: cuerpo, tiempo, espacio y relacionabilidad. Las informantes percibieron la complicación de forma temprana, sin embargo, postergaron la atención institucional hasta que se hicieron presentes signos objetivos de complicación; la llegada puntual a los servicios de salud no implicó, desde su percepción, la certeza de manejo oportuno y adecuado, además se reportó un insuficiente apoyo de las redes formales e informales para el traslado y la atención especializada. Es necesario que sociedad y gobierno articulen estrategias que empoderen a las mujeres para la atención a las situaciones de emergencia obstétrica, acciones que promuevan su autocuidado pero garanticen también el apoyo pronto y expedito de sus redes y una atención profesional de calidad.

Abstract This article aims to explore the experience of Mexican women in the obstetric emergency. This qualitative-phenomenological study was conducted with data collected by means of in-depth interviews with 15 women survivors of this experience, performed from January to September 2017. Obtained data were processed through discourse analysis and interpreted based on the four dimensions of the phenomenology of perception, namely: body, time, space, and relationality. Despite perceiving the complications at early stages, interviewees waited for objective symptoms before seeking for healthcare. According to them, timely treatment seeking did not imply an adequate management. Moreover, these women also reported insufficient support from both formal and informal networks in the provision of specialized treatment. Society and government must articulate strategies that empower women for the attention to obstetric emergencies, besides implementing actions that promote their self-care while guaranteeing timely and specialized care.

Ética del trabajo en Ecuador: un análisis de las diferencias en cuatro cohortes generacionales / Work Ethic: analysis of differences between four generational cohorts

Las organizaciones enfrentan el reto de gestionar una fuerza laboral multigeneracional con características propias que difieren en el valor que le otorgan al trabajo. La incorporación al mercado laboral de las generaciones más jóvenes hace imprescindible el estudio de sus diferentes actitudes hacia el trabajo en comparación con las generaciones antecesoras. El propósito de esta investigación fue analizar a través del constructo de la Ética Protestante las diferencias existentes en las actitudes hacia el trabajo de cuatro generaciones (Baby Boomers, Generación X, Generación Y, y Generación Z). La muestra de 624 participantes ecuatorianos (BB 11.2%; GX 11.2%, GY 58.5% y GZ 19.1%) se agrupó por cohortes. Se aplicó el Cuestionario Multidimensional Ética del Trabajo (MWEP). Los resultados mostraron que los BB y la GX tiene una mayor creencia sobre la importancia del trabajo y más tolerancia a la utilización improductiva del tiempo de trabajo que las generaciones Y y Z. En el aplazamiento de las recompensas la GZ muestra puntuaciones superiores a las obtenidas por los BB, GX y GY. No se encuentran diferencias significativas en las dimensiones de autoconfianza, ocio y moralidad-ética

Enterprises face the challenge of managing a multigenerational workforce which has its characteristics that differ in the value they grant to work. Incorporation of younger generations into the labour market requires to study all their attitudes towards work, contrasting them with previous generations. The purpose of this research was to analyse, through the Protestant Ethic construct, the differences of four age groups in attitudes towards work (Baby Boomers, Generation X, Generation Y, and Generation Z). Cohorts grouped the sample of 624 Ecuadorians (BB 11.2%; Gen X 11.2%, Gen Y 58.5% and Gen Z 19.1%). The Multidimensional Work Ethic Profile (MWEP) was applied. The results showed that BB and Gen X believe more in the importance of work than generations Y and Z. At the same time, BB and Gen X are more tolerant to the unproductive use of time than generations Y and Z. Gen Z has higher scores than BB, Gen X and Gen Y in the postponement of rewards dimension. Besides, there are no meaningful differences in self-reliance, leisure and morality/ethics dimensions

Generalized spectral light scatter models of diverse bacterial colony morphologies.

An optical forward-scatter model was generalized to encompass the diverse nature of bacterial colony morphologies and the spectral information. According to the model, the colony shape and the wavelength of incident light significantly affect the characteristics of a forward elastic-light-scattering pattern. To study the relationship between the colony morphology and the scattering pattern, three-dimensional colony models were generated in various morphologies. The propagation of light passing through the colony model was then simulated. In validation of the theoretical modeling, the scattering patterns of three bacterial genera, Staphylococcus, Exiguobacterium and Bacillus, which grow into colonies having convex, crateriform and flat elevations, respectively, were qualitatively compared to the simulated scattering patterns. The strong correlations observed between simulated and experimental patterns validated the scatter model. In addition, spectral effect on the scattering pattern was studied using the scatter model, and experimentally investigated using Staphylococcus, whose colony has circular form and convex elevation. Both simulation and experiment showed that changes in wavelength affected the overall pattern size and the number of rings.

Narrativas sobre morbilidad materna extrema en sobrevivientes a esta experiencia en México / Narratives of obstetric risk in survivors to extreme maternal morbidity

Objetivo: analizar las narrativas que sobre morbilidad materna extrema han desarrollado mujeres sobrevivientes a esta experiencia en san luis potosí, méxico. Metodología: estudio biográfico-narrativo en el que mediante muestreo intencional inicial y teórico posteriormente, fueron seleccionadas 20 mujeres para recuperar sus relatos sobre la experiencia. Las narrativas compartidas fueron sometidas a análisis paradigmático de contenido. Resultados principales: con marco en la antropología del riesgo, se identificó que las narrativas que prevalecen sobre morbilidad materna extrema son: a) como sinónimo de muerte, b) como evento fortuito y efímero, y c) como una situación ilegítima o inventada. Conclusión: las narrativas que las mujeres han construido sobre su experiencia de morbilidad materna extrema son diversas, sostenidas en emociones que van desde el miedo, hasta la aceptación e incredulidad; sin embargo, ninguna de estas narrativas aporta al desarrollo de una agencia real para prevenir un riesgo obstétrico futuro

Objective: to analyze the narratives about extreme maternal morbidity developed by women survivors of this experience in san luis potosí, mexico. Methods: biographicalnarrative study in which, through initial intentional sampling and theoretical sampling, 20 women were selected to recover their report son her experiences. The shared narratives were transcribed and later subjected to a paradigmatic analysis of content. Results: with a framework in the anthropology of risk it was identified that the narratives that prevail over extreme maternal morbidity are: a) as a synonym of death, b) as a fortuitous and ephemeral event, and c) as an illegitimate or invented situation. Conclusions: the narratives that women have built on their experience of extreme maternal morbidity are diverse, sustained in emotions ranging from fear to acceptance and disbelief; however, none of these narratives contributes to the development of a real agency to prevent a future obstetric risk