Digital Storytelling Intervention for Hemoglobin A1c Control Among Hispanic Adults With Type 2 Diabetes: A Randomized Clinical Trial.

Importance: Hispanic adults with type 2 diabetes (T2D) are more likely to develop complications and die from the disease than the US general population. Digital storytelling interventions are narrative-based videos elicited through a community-based participatory research approach to surface the authentic voices of participants overcoming obstacles to health-promoting behaviors that perpetuate health inequities; research on the effect of digital storytelling on T2D outcomes among Hispanic adults is lacking. Objective: To assess the impact of a digital storytelling intervention on glycemic control and its acceptability among Hispanic patients with poorly controlled T2D. Design, Setting, and Participants: This was a multicenter, randomized clinical trial conducted within 2 primary care networks in Minnesota and Arizona among Hispanic adults with poorly controlled T2D (hemoglobin A1c level ≥8%). Enrollment and follow-up were conducted between February 14, 2019, and November 1, 2023. Intervention: The intervention group viewed a 12-minute digital storytelling video. The video included 4 Spanish-language stories that reinforced 4 diabetes self-management behavioral goals (healthful diet for diabetes, physical activity, medication adherence, and glucose self-monitoring). The control group received printed, culturally tailored T2D education materials. Main Outcomes and Measures: The primary outcome was the mean change from baseline to 3 months for hemoglobin A1c levels, adjusting for baseline hemoglobin A1c, age, gender, education, and income. Acceptability and narrative quality of the intervention were assessed through questionnaires. Results: There were 451 study participants, with 227 (mean [SD] age, 54.3 [9.3] years; 158 [69.3%] women) randomized to the intervention group and 224 (mean [SD] age, 54.5 [9.1] years; 156 [69.3%] women) to the control group. Of these, 390 completed 3-month follow-up of the primary outcome (86% retention). There was a small improvement in the mean (SD) hemoglobin A1c level in the intervention group compared with the control group in the adjusted model (9.1% [1.7] to 8.4% [1.6] vs 9.4% [1.8] to 8.8% [2.0]; P = .04] but not in the unadjusted model. Acceptability and narrative quality of the intervention were high. Conclusions and Relevance: In this randomized clinical trial, a digital storytelling intervention developed with and for Hispanic adults with T2D was highly acceptable and feasibly implemented within primary care settings and resulted in a modest improvement of glycemic control. This was a highly scalable intervention that may be integrated into clinical practice as part of a longitudinal diabetes self-management program for Hispanic adults. Trial Registration: ClinicalTrials.gov Identifier: NCT03766438.

Breast Cancer Risk Perceptions Among Underserved, Hispanic Women: Implications for Risk-Based Approaches to Screening.

BACKGROUND: Understanding factors that shape breast cancer risk perceptions is essential for implementing risk-based approaches to breast cancer detection and prevention. This study aimed to assess multilevel factors, including prior screening behavior, shaping underserved, Hispanic women's perceived risk for breast cancer. METHODS: Secondary analysis of survey data from Hispanic women (N = 1325, 92% Spanish speaking, 64% < 50) enrolled in a large randomized controlled trial. Analyses were performed in two cohorts to account for the role of age on screening guideline recommendations (< 50 and 50 +). For each cohort, we examined differences in three common measures of perceived risk of breast cancer (percent lifetime, ordinal lifetime, comparative) by participant factors with chi-square or Kruskal-Wallis tests, as appropriate. Multivariate analyses examined the association between mammography history with percent perceived lifetime risk (outcome > 10 vs ≤ 10%). RESULTS: Overall, 75% reported a lifetime risk between 0 and 10%, 96% rated their ordinal risk as "not high," and 50% rated their comparative risk as "much lower." Women < 50 with a family history of breast cancer reported significantly higher levels of perceived risk across all three measures. Among women 50 + , those reporting lower levels of perceived risk were significantly more likely to be Spanish speaking. No significant association was observed between mammography history and percent lifetime risk of breast cancer. CONCLUSION: Factors shaping breast cancer risk perceptions differ by age. Prior screening may play less of role in constructing risk perceptions. Research is needed to develop culturally and linguistically appropriate strategies to improve implementation of risk-based screening.

Comparative metatranscriptomics reveals effect of host plant on microbiota gene expression of Anastrepha obliqua (Diptera: Tephritidae) larvae.

The microbiota associated with phytophagous insects perform several functions that help insects exploit plant resources. Thus, microorganisms contribute to the dispersal of phytophagous species to new host plants, thereby promoting diversification. In this study, metatranscriptomic analysis was used to compare the gene expression of the microbiome of Anastrepha obliqua Macquart larvae feeding on 3 of its host plants: Spondias purpurea L (red mombin), Mangifera indica L (mango), and Averrhoa carambola L (starfruit). To identify differential gene expression in relation to the host plant, transcript abundance was compared. The results of the taxonomic and functional beta-diversity analysis showed that there were significant differences in the structures and activities of the microbial communities depending on the infested plant. Among the microorganisms, bacteria and fungi were active components of the microbiota. Differential expression analyses showed that the different active genes in each of the plants analyzed were mainly grouped into categories related to carbohydrate and amino acid metabolism, with some of these genes coding for cytochrome o ubiquinol oxidase, cytochrome c, and the enzyme isocitrate dehydrogenase. The microbiota of A. carambola larvae differed more at the level of community structure and gene function, possibly due to the different nutritional composition of the A. carambola and the presence of a set of secondary metabolites specific to the family Oxalidaceae. In conclusion, the transcriptional activity of the microbiota of A. obliqua larvae is influenced by diet, which is important because it could influence the performance of the insect on each of its different host plants.

Beca de nivelación académica: resultados de un programa de intervención en estudiantes de origen vulnerable en la universidad de concepción / Bolsa de nivelamento acadêmico: resultados de um programa de intervenção em estudantes de origem vulnerável na universidade de concepción / Academic leveling program: findings of an intervention program on socially vulnerable students at universidad de concepción

RESUMEN: El artículo presenta los resultados de la evaluación de logros académicos de 120 beneficiarios del programa Beca de Nivelación Académica implementado por la Universidad de Concepción. El propósito del programa es apoyar la retención y mejorar el rendimiento académico de estudiantes universitarios de primer año de origen socioeconómico vulnerable. Se utilizó una metodología cuantitativa y se definió un estudio correlacional, cuyos resultados indican que la retención alcanzó un 87%, mientras que el promedio de notas fue un 5.1, mejorando los resultados anteriores y logrando los indicadores comprometidos. La prueba de hábitos de estudios demostró constituir el mejor predictor del rendimiento académico. Estos resultados fueron complementados con dos focus group, que revelaron la alta valoración de los estudiantes hacia el programa como una instancia facilitadora de su adaptación a las exigencias universitarias. Finalmente, se reflexiona respecto a las políticas públicas que buscan fortalecer la equidad en la educación superior en Chile.

RESUMO: O artigo apresenta os resultados da avaliação do desempenho acadêmico de 120 beneficiários do programa de Bolsa de Nivelação Acadêmica implementado pela Universidade de Concepción. O objetivo do programa é apoiar a permanência e melhorar o rendimento acadêmico de estudantes universitários do primeiro ano de origem socioeconômica vulnerável. Utilizou-se uma metodologia quantitativa e definiu-se um estudo correlacional, cujos resultados indicam que a permanência alcançou 87%, enquanto a média de notas foi de 5,1, melhorando os resultados anteriores e atingindo os indicadores previstos. A prova de hábitos de estudos demonstrou ser o melhor preditor do rendimento acadêmico. Esses resultados foram complementados com dois grupos focais, os quais revelaram a grande valorização do programa pelos estudantes como uma instância facilitadora de sua adaptação às exigências universitárias. Finalmente, reflete-se sobre as políticas públicas que buscam fortalecer a equidade na educação superior no Chile.

ABSTRACT: This paper presents the findings of the assessment of 120 students' academic performance, who benefited from an academic leveling program implemented by the University of Concepción. The purpose of this program is to support the stay and to improve the academic performance of first year university students of socioeconomic vulnerable origin. A quantitative methodology was used and a correlational study was defined; the results show the stay reached 87%, while participants' averaged grade was 5.1 on a scale from 1 to 7. This allows improving participants' past results and accomplishing the expected indicators. The study habits test proved to be the best predictor of academic achievement. These results were complemented by two focus groups that show the students' high value of the program as a facilitating instance of their adaptation to the university demands. Finally, there is a reflection on public policies that seek to strengthen higher education equity in Chile.

Evolución de la teorías de explotación de recursos naturales: hacia la creación de una nueva ética mundial / Evoltion of natuural resources exploitation: towardsthe creation off a new global ethics

¿De dónde provienen los actuales problemas ambientales? Se ha detectado que uno de los principales causantes es la disposición y manejo que se le da a los productos post-uso. El objetivo del presente artículo es explorar la procedencia de la problemática causada por residuos industriales y productos post-uso y analizar las consecuencias sobre el ambiente, la economía y la sociedad, resultando que el problema se ha repetido cada vez con más intensidad desde tiempos presocráticos. Para ello, se recurrió a la consulta exploratoria de libros, artículos, revistas, eventos mundiales y locales en bases de datos de la Universidad Nacional de Colombia y la Universidad de Sao Paulo (Brasil), y que muestren las reacciones de la sociedad y por ende las soluciones que se han querido implementar hasta alcanzar un desarrollo más sustentable. De las soluciones propuestas a estos problemas, surgieron lineamientos de carácter mundial en el ámbito social, técnico, ético y jurídico, los cuales finalmente terminan por afectar profundamente los sistemas industriales, todos en función de prácticas sustentables. Se quiere destacar, aquellos hechos que hicieron que evolucionara la mentalidad de los efectos de los productos post-uso hasta la aparición de una nueva ética mundial, de lo cual hay notables ejemplos en Latinoamérica, concluyéndose que todo este problema tiene un componente ético y social, lo que permitirá aplicar técnicas sustentables en los sistemas productivos, donde la acción de un componente hace evolucionar el otro, finalizando en posturas éticas a favor de la sustentabilidad que son congruentes con aspectos técnicos de sistemas de producción, variable que fue observada a través del artículo.

Where do current environmental problems come from? It has been detected that one of the main causes is the disposition and management given to products post-use. The aim of this article is to explore the origin of the problems caused by industrial waste and post-use products and to analyze the consequences on the environment, the economy and society, with the result that the problem has been repeated with increasing intensity since pre-Socratic times. To do this, the exploratory consultation of books, articles, magazines, world and local events in databases of Universidad Nacional de Colombia and the University of São Paulo (Brazil), were used which show the reactions of society and therefore the solutions that have wanted to be implemented to achieve a more sustainable development. From the solutions proposed for these problems, lines of global nature appeared in the field of social, technical, ethical and legal environments, which eventually end up deeply affecting industrial systems, all based on sustainable practices. Those facts that made the mentality evolve from the effects of the post-use products to the emergence of a new global ethics, of which there are notable examples in Latin America, are highlighted concluding that all this problem has an ethical and social component which would allow the application of sustainable techniques in productive systems, where the action of a component makes evolve the other components ending in ethical positions in favor of sustainability that are consistent with technical aspects of production systems, a variable that was observed through the article.