SWOT Analysis and Recommendations for Community Health Workers and Stakeholders Responding to COVID-19 Health Inequities.

Background. By 2023, 1,080,000 cases of COVID-19 have been reported in Harris County. Systemic inequity and vaccine hesitancy have contributed to COVID-19 disparities. Community Health Workers provide health education and instrumental support to alleviate health disparities among vulnerable communities. We conducted an analysis of Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis in June 2022 among a broad coalition of Community Health Work stakeholders to better understand the local landscape in the context of the COVID-19 pandemic. Methods. We recruited 33 community health workers and industry stakeholders in Harris County, Texas, to participate in the SWOT analysis. Participants were asked to describe their opinions on the SWOT facing the Community Health Work landscape and then rank the outcomes of the analysis to prioritize action. Results. A total of 19 themes were identified. Weaknesses included lack of respect and resources for Community Health Workers and poor coordination and capacity among the workforce infrastructure. Limited funding and lack of appreciation for Community Health Workers were deemed important threats. Diversity and community connection were critical strengths, and strong education, training, and raising awareness for community health work were considered opportunities to overcome identified weaknesses and threats. Discussion. Increased funding, greater coordination, greater respect, and amplified training can improve capacity for Community Health Workers and, therefore, improve public health outcomes for respiratory illness and viral infections such as COVID-19. This analysis helps fill an important research gap on the topic Community Health Workers responding to public health crises with racially disparate outcomes.

Association between Prescribers' Perceptions of the Utilization of Medication for Opioid Use Disorder and Opioid Dependence Treatability.

BACKGROUND: Medication for opioid use disorder (MOUD) has been proven to be effective, yet the perceptions or beliefs of prescribers of MOUD may have a substantial impact on their prescribing and dispensing of MOUD and their patients' accessibility and utilization of MOUD services. We examined the associations of the perceptions of medical and pharmacy professionals regarding MOUD with sociodemographic characteristics, personal experiences with substance use disorders, and perceptions of opioid treatment. METHOD: Data were collected via telephone or online survey from March to August 2021, in Texas, to assess medical and pharmacy professionals' perceptions of MOUD. Our sample included 542 participants who completed the survey. A multinomial logistic regression analysis was conducted to assess perceptions of MOUD, its use, and their correlates. RESULTS: The participants had a mean age of 35 years (SD = 7.13) and had worked, on average, 6.90 years (SD = 5.37) in their current positions. The majority of the participants were males (50.93%) and medical professionals (82.01%). More than one third of the participants believed MOUD did not lead to abstinence or recovery (36.16%). Those who had personal experiences with a substance use disorder were more likely to believe that MOUD could be a replacement drug for previously misused substance(s) (RRR = 2.06, 95% CI = 1.19, 3.59) and that MOUD did not lead to abstinence or recovery (RRR = 2.34, 95% CI = 1.40, 3.91). However, the risk ratio values were lower for those who believed that a stigma against MOUD was a barrier for patients initiating and adhering to MOUD (MOUD is a replacement drug for previously misused substances (initiation RRR = 0.43, 95% CI = 0.19, 0.93 and adhering RRR = 0.30, 95% CI = 0.13, 0.71) or MOUD does not lead to abstinence or recovery (initiation RRR = 0.26, 95% CI = 0.13, 0.54 and adhering RRR = 0.36, 95% CI = 0.17, 0.78)). The various perceptions of the utilization of MOUD were not statistically different between medical and pharmacy professionals. CONCLUSION: Perceptions, experience with substance use disorder, and stigma against the utilization of MOUD influenced negative perceptions about MOUD. An innovative strategy is needed to improve medical and pharmacy professionals' perceptions of MOUD, while efforts are being made to promote the use of MOUD for patients with opioid use disorders.

Cross-sectional survey for assessing cancer care providers' characteristics and attitudes on smoking cessation in Colombia and Mexico.

OBJECTIVE: Cancer care providers' (CCPs) attitudes towards smoking cessation are influenced by many factors, including their smoking status and knowledge. Our objective was to assess CCPs' characteristics, tobacco use and smoking cessation practices in two Latin American cancer centres. DESIGN: Cross-sectional survey. SETTINGS: Two urban cancer centres located in Colombia and Mexico. PARTICIPANTS: A total of 238 CCPs. MEASURES: Online survey consisted of 28 close-ended questions adapted from the 2012 International Association for the Study of Lung Cancer survey and the Global Adult Tobacco Survey developed by the WHO. Means, frequencies and proportions were reported for each country. Factors associated to providing of smoking cessation treatment or referral at initial visit were evaluated using logistic regression. RESULTS: Current smoking prevalence was 10.5% and 12.3% among Colombian and Mexican CCPs, respectively. Around three quarters of the Colombian (86.4%) and Mexican CCPs (66.1%) considered to have inadequate training in smoking cessation. Approximately two-thirds of Colombian (67.5%) and Mexican CCPs (63.9%) reported always or most of the time asking patients about tobacco use during the initial visit. In Colombia and Mexico, the most relevant barriers for providing cessation services were (1) difficulties for motivating patients with cancer, (2) patient resistance in quitting smoking, (3) lack of local resources or referral centres for smoking cessation and (4) lack of training in smoking cessation. CCPs appointed at Instituto Nacional de Cancerología were less likely to provide cessation treatment or referral to their patients if they had less than 50% of their time devoted to patient care and were former or current smokers. The regression model for Instituto de Cancerología did not retain statistically significant variables. CONCLUSION: Our findings highlight an urgent need for assisting Latin American CCPs in their quitting efforts as well as expanding formal smoking cessation training specifically tailored to these professionals for improving patients' cancer prognosis and quality of life.

Effect of plateletpheresis on total platelet count and mean platelet volume: A meta-analysis.

OBJECTIVE: Currently, there are discrepancies in the reports on the extent of the reduction in platelet count after platelet donation by apheresis, and its impact on mean platelet volume (MPV). This study was conducted to meta-analyze the effect of plateletpheresis on platelet count and on mean platelet volume, based on studies published between 1980 and 2018. METHODS: Medline-Pubmed, Scielo, ScienceDirect, and Scopus databases were searched from inception to December 31 2019. The PRISMA guidelines, reproducibility, and evaluation of the methodological quality were guaranteed. Heterogeneity was evaluated with DerSimonian-Laird's, publication bias with a Begg's test. Sensitivity analysis and cumulative meta-analysis were also conducted, as well as a forest plot. RESULTS: Twenty-five studies with 3769 donors were systematized to analyze platelet count, and seven studies with 1176 donors to observe MPV. Most studies were published in India and the United States. There was a postprocedure reduction in both variables. The reduction in platelet count was 14.3 × 103 /µL (95% CI 11.4 to 17.1 × 103 /µL). The reduction in MPV was 1.43 fL (95% CI 0.3 to 2.5 fL). The analysis of subgroups showed that, in the case of platelet count, the reduction is not statistically significant two weeks after donation. CONCLUSION: Platelet donation by apheresis reduces platelet count and MPV in donors, which is detrimental to the purposes of the procedure; although the decrease is not clinically significant for the donor or the recipient. This demonstrates the need for subsequent studies to evaluate variables, such as donation frequency and donation intervals, should be considered to evaluate if the reported decrease is easily compensated, without adverse consequences for donors, or if modifications in donor selection criteria are required.

Cambios en el EEG en reposo de exparticipantes en el conflicto armado colombiano con trastorno de personalidad antisocial / Changes in Resting EEG in Colombian Ex-combatants ith Antisocial Personality Disorder

RESUMEN Introducción: El conflicto armado colombiano, además de secuelas sociales y económicas en la población civil, ha implicado otras consecuencias. Los excombatientes, como la otra cara del conflicto, han sido objeto de interrogación sobre su estructura de personalidad y predisposición a conductas violentas. Se ha encontrado en parte de la población asociada al conflicto armado rasgos característicos del trastorno de personalidad antisocial (TPA) que se relacionarían con los comportamientos en contra de las convenciones sociales. Métodos: Mediante registros electrocardiográficos cuantitativos (qEEG), se evaluaron las diferencias en los patrones de actividad cortical entre un grupo de excombatientes, algunos de ellos con diagnóstico de TPA, y un grupo de control ajeno al conflicto armado y sin alteraciones psiquiátricas. Se empleó la Lista de Chequeo de Psicopatía Revisada (PCL-R) para determinar la presencia de criterios diagnósticos de TPA, así como la entrevista diagnóstica para estudios genéticos (DIGS) para clasificar la presencia de otros trastornos mentales incluidos en el CIE-10. Resultados: Se encontraron diferencias significativas en los niveles de psicopatía evaluados mediante la PCL-R. Con respecto al análisis de la potencia espectral, se observaron diferencias entre grupos en las ondas alfa-2 y beta, en regiones frontal y temporal izquierda y temporocentral izquierda respectivamente. Conclusiones: La técnica de qEEG permite evidenciarlas diferencias entre grupos en el potencial espectral en reposo, las cuales se relacionan con comportamientos desadaptativos característicos del TPA.

ABSTRACT Introduction: Although the social and economic consequences of Colombian internal conflicts mainly affected the civilian population, they also had other implications. The ex-combatants, the other side of the conflict, have been the subject of many studies that question their personality structures and antisocial features. Results suggest that ex-combatants usually have characteristics of an antisocial personality disorder (ASPD) that is related with their behavior. Methods: Quantitative EEG (qEEG) was used to evaluate differences in cortical activity patterns between an ex-combatants group and a control group. The Psychopathy Checklist-Revised (PCL-R) was used to assess the presence of ASPD in the ex-combatants group, as well as the Diagnostic Interview for Genetic Studies (DIGS) for other mental disorders classified in the DCI-10. Results: There are significant differences in psychopathy levels between groups, as well as in alpha-2 and beta waves, especially in left temporal and frontal areas for alpha-2 waves and left temporal-central regions for beta waves. Conclusions: qEEG measurements allow spectral resting potential to be differentiated between groups that are related with features typically involved in antisocial personality disorder, and to correlate them with patterns in the questionnaires and clinical interview.

Changes in Resting EEG in Colombian Ex-combatants ith Antisocial Personality Disorder. / Cambios en el EEG en reposo de exparticipantes en el conflicto armado colombiano con trastorno de personalidad antisocial.

INTRODUCTION: Although the social and economic consequences of Colombian internal conflicts mainly affected the civilian population, they also had other implications. The ex-combatants, the other side of the conflict, have been the subject of many studies that question their personality structures and antisocial features. Results suggest that ex-combatants usually have characteristics of an antisocial personality disorder (ASPD) that is related with their behaviour. METHODS: Quantitative EEG (qEEG) was used to evaluate differences in cortical activity patterns between an ex-combatants group and a control group. The Psychopathy Checklist-Revised (PCL-R) was used to assess the presence of ASPD in the ex-combatants group, as well as the Diagnostic Interview for Genetic Studies (DIGS) for other mental disorders classified in the DCI-10. RESULTS: There are significant differences in psychopathy levels between groups, as well as in alpha-2 and beta waves, especially in left temporal and frontal areas for alpha-2 waves and left temporal-central regions for beta waves. CONCLUSIONS: qEEG measurements allow spectral resting potential to be differentiated between groups that are related with features typically involved in antisocial personality disorder, and to correlate them with patterns in the questionnaires and clinical interview.