Usefulness of ultrasound in clinical decision-making in rheumatology clinical practice: A single-center longitudinal study.

OBJECTIVE: The purpose of the present study is to identify the extent to which it affects clinical decisions in a single-centre observational retrospective study. METHOD: The results of 801 requests and 1174 consecutive individual ultrasound examinations performed over 10 months were analysed. RESULTS: The most frequent indication was diagnostic assistance (39%) followed by assessment of inflammatory activity (34%). By topography, the hand was the most frequently studied region (51%), followed by the foot (18.1%). Of all requests, 67% had an impact on decision-making. The impact on clinical decision-making was associated with a shorter waiting time for the evaluation of the results, being the greatest in those ultrasound scans performed on demand on the same day of the request. In 73% of bilateral ultrasound studies, findings in one of the joints exemplified the overall result reported. CONCLUSIONS: Rheumatological musculoskeletal ultrasound has proven to be a useful decision-making technique, the greater the impact of which is seen the shorter the waiting time before it is performed.

Utilidad de la ecografía reumatológica en la toma de decisiones en la práctica clínica: Estudio unicéntrico longitudinal / Usefulness of ultrasound in clinical decision-making in rheumatology clinical practice: A single-center longitudinal study

Objetivo: El propósito del presente estudio es identificar en qué medida la ecografía reumatológica afecta a las decisiones clínicas mediante un estudio unicéntrico observacional retrospectivo. Método: Se analizaron los resultados de 801 solicitudes y 1174 ecografías individuales consecutivas realizadas a lo largo de 10 meses. Resultados: La indicación más frecuente fue la asistencia diagnóstica (39%) seguida de la evaluación de actividad inflamatoria (34%). Por topografía, la mano fue la región más estudiada (51%), seguida del pie (18,1%). De todas las solicitudes, en el 67% se constató un impacto en la toma de decisiones. El impacto en la decisión clínica se asoció a un menor tiempo de espera hasta la evaluación de los resultados, siendo el mayor en aquellas ecografías realizadas a demanda el mismo día de su petición. En el 73% de los estudios ecográficos bilaterales, los hallazgos en una de las articulaciones ejemplificaban el resultado global emitido. Conclusiones: La ecografía reumatológica demuestra ser una técnica útil en la toma de decisiones, cuyo mayor impacto se constata cuanto menor es el tiempo de espera hasta la evaluación de los resultados.(AU)

Objective: The purpose of the present study is to identify the extent to which rheumatological musculoskeletal ultrasound affects clinical decisions in a single-centre observational retrospective study. Method: The results of 801 requests and 1174 consecutive individual ultrasound examinations performed over 10 months were analysed. Results: The most frequent indication was diagnostic assistance (39%) followed by assessment of inflammatory activity (34%). By topography, the hand was the most frequently studied region (51%), followed by the foot (18.1%). Of all requests, 67% had an impact on decision-making. The impact on clinical decision-making was associated with a shorter waiting time for the evaluation of the results, being the greatest in those ultrasound scans performed on demand on the same day of the request. In 73% of bilateral ultrasound studies, findings in one of the joints exemplified the overall result reported. Conclusions: Rheumatological musculoskeletal ultrasound has proven to be a useful decision-making technique, the greater the impact of which is seen the shorter the waiting time before it is performed.(AU)

A Community-driven Research Framework: Integrating Promotores as Co-Researchers.

BACKGROUND: Integration of community health workers/promotores in community-based participatory research is an efficient strategy to advance research and health initiatives. We build on the principles of the interactive and contextual model of community-university collaboration for research and action, the public health critical race framework, and the situated learning theory to propose the community-driven research framework for the development of culturally appropriate research methods training and integration of promotores as co-researchers. OBJECTIVES: To present the community-driven research framework as a model that trains and integrates promotores in research methodologies.Application of the Community-Driven Research Framework: By showcasing three case studies (March 2019 to December 2021) we describe the promotores' levels of involvement through the various research stages highlighting the effectiveness of the community-driven research framework. CONCLUSIONS: The community-driven research framework fills a gap in the literature by providing a process through which researchers can engage in a culturally relevant learning process that allows entry to the community, fostering trust, and initiating a mutual collaboration that is embedded within the local context and needs of the community. The implementation of the community-driven research framework has implications for the development of culturally sensitive community partnerships as well as for designing research that is centered around the cultural and social context of the community.

Hydrolats from Humulus lupulus and Their Potential Activity as an Organic Control for Varroa destructor.

Varroa destructor is a parasitic mite, which is considered a severe pest for honey bees causing serious losses to beekeeping. Residual hydrolats from steam extraction of hop essential oils, generally considered as a waste product, were tested for their potential use as acaricides on V. destructor. Four hop varieties, namely Cascade, Spalt, Victoria, and Mapuche, showed an interesting performance as feasible products to be used in the beekeeping industry. Some volatile oxidized terpenoids were found in the hydrolats, mainly ß-caryophyllene oxide, ß-linalool, and isogeraniol. These compounds, together with the presence of polyphenols, flavonoids, and saponins, were probably responsible for the promissory LC50 values obtained for mites after hydrolat exposition. Victoria hydrolat was the most toxic for mites (LC50: 16.1 µL/mL), followed by Mapuche (LC50 value equal to 30.1 µL/mL), Spalt (LC50 value equal to 114.3 µL/mL), and finally Cascade (LC50: 117.9 µL/mL). Likewise, Spalt had the highest larval survival, followed by Victoria and Mapuche. Cascade was the variety with the highest larval mortality. In addition, none of the extracts showed mortality higher than 20% in adult bees. The Victoria hydrolat presented the best results, which makes it a good compound with the prospect of an acaricide treatment against V. destructor.

Beliefs about marijuana use during pregnancy and breastfeeding held by residents of a Latino-majority, rural region of California.

Marijuana use among pregnant and breastfeeding women is on the rise and carries risks for infant health and well-being. Decisions to use marijuana while pregnant and breastfeeding are motivated by beliefs that use poses minimal risk to infants and offers benefits to maternal users. Misperceptions and usage trend higher among disadvantaged populations. This study surveyed 401 community residents on beliefs about risks and benefits of marijuana use by pregnant and breastfeeding women. The study utilized techniques to enhance recruitment of Latino and disadvantaged residents of rural communities in California, a state where recreational marijuana use is legal. Analyses revealed substantial endorsement of beliefs about benefits and low risks of marijuana use while pregnant and breastfeeding, many of which run counter to current evidence. Misperceptions were particularly prevalent for cannabis users and male respondents. Trends in valid beliefs, while modest, were higher for Latinos and parents.

Medical mentorship deconstructed: an analysis and structural recommendation for high value mentorship.

Background: Mentorship is an important component for young students interested in pursuing a career in medicine. In medically underserved areas, such as rural areas, mentorship can be sparse due to the lack of access to healthcare professionals. The purpose of this project was to gain an understanding of the mentorship received by practicing medical students. Methods: The authors conducted structured, one-on-one interviews with 10 current medical students about their perceptions and experiences with mentorship. Interviews were transcribed, coded, and analyzed for themes and subthemes. Results: Our findings revolve around three time periods of mentorship: 1) Before Obtaining a Mentor; 2) During the Mentorship; and 3) After the Mentorship.  In our findings we describe key characteristics such as professional development, personal qualities of the mentor, and professional and personal guidance as important components in guiding the mentee starting from the undergraduate level and continuing to their current level of education.  Conclusion: Interviewees' experiences with and perspectives on the mentorship they received were generally positive, though it was evident there are some aspects of the mentee-mentor relationship that can be improved. Building on the results obtained, setting expectations, providing mentor training, and pairing mentors/mentees from similar backgrounds are what we propose to create fulfilling and meaningful relationships between a mentee and mentor.

Community-responsive scholar-activist research: conceptualizing capacity building and sustainability in a Northern California community-university partnership.

We critically examine the ongoing development of a collaborative, responsive, activist research process between academics and farmworkers. Drawing upon in-depth interviews with community-based researchers and scholar-activists, we assess our team's understanding of community capacity building and research sustainability as the conceptual and operational definitions of these concepts lack academic consensus. The definitions we present reflect a 12-year effort to respond to community needs through interdisciplinary research, planning, and action. Our community-university team's evolving understanding of community capacity building and research sustainability is contextualized by our community-driven, community-responsive, and collaborative process. We discuss strengths and limitations encountered when conducting community-responsive, scholar-activist research and conclude by offering the lessons learned.

Influence of pre-schooler and parent nutrition education on carotenoid levels of Mexican-heritage children.

OBJECTIVE: To determine the mediating effect of direct preschool and parent nutrition education on changes in skin carotenoids scores over 2 years in children of Mexican heritage. DESIGN: In a quasi-experimental, community-based study, two school districts were randomly assigned to either a comparison group (parent workshops unrelated to nutrition) or a childhood obesity prevention intervention group which included nutrition education at family nights for parents and at school for children. Changes in skin carotenoid intensity scores (diffCAROT, year 2015 minus 2013) were measured in children as a proxy for fruit and vegetable consumption using Resonance Raman Spectroscopy. SETTING: Two rural, low-income, school districts from a county in California's Central Valley. PARTICIPANTS: 316 Mexican heritage families with children aged 3-8 years. RESULTS: Intervention group children improved over 2 years in skin carotenoid scores relative to comparison group children (diffCAROT mean +1419 (sd 9540) v. -3473 (sd 9272), P = 0·0001). Parent attendance at nutrition education classes partially mediated the intervention effect on diffCAROT (P = 0·02). Controlling for child's age and other covariates, participation in preschool during the study had a significant positive effect on diffCAROT among intervention children compared with controls (P < 0·03), whereas no significant difference by group was observed among those not enrolled in preschool or already enrolled in elementary school. CONCLUSIONS: Programmes that combine direct parent and preschool nutrition education may be effective in low-income Mexican heritage families to improve children's intake of fruit and vegetables.

Oribatid mites (Acari: Oribatida) from the Patagonian steppe, Argentina.

Knowledge of the oribatid mite community from Patagonian steppe is scarce compared with other environments, such as the Andean-Patagonian forest. In the present research we identified oribatid mites under different environmental conditions: two Patagonian steppe types (grass and shrub), two soil characteristics (bare and covered soil) and two different seasons (autumn and spring). A total of 42 species/morphospecies were found, 13 were new records for Chubut and one was a new record for Argentina. In view of its ecological role in soil formation, it is fundamental that knowledge about this fauna is enhanced in order to provide baselines for study and to aid further understanding about its ecology.

A Web-Based Application to Improve Data Collection in an Interventional Study Targeting Childhood Obesity: Pre-Post Analysis.

BACKGROUND: Although participatory action research (PAR) studies have proliferated in recent years, the development of technological resources to manage these types of projects has not kept pace. Few studies show how Web-based applications can be used to efficiently manage the data collection process. OBJECTIVE: This study described the development, use, and impact of a Web-based application to facilitate data management in Niños Sanos, Familia Sana (Healthy Children, Healthy Family), an interventional multifaceted PAR field study. METHODS: We described the transformation of the data management process and evaluated the impact of the application in terms of time efficiency of data collection and engagement of community-based data collectors. We defined time efficiency as the total number of days it took to collect 3 main surveys, per year of data collection. The engagement of data collectors was assessed based on qualitative reports. RESULTS: The amount of time it took to perform a round of data collection was reduced after implementation of the field team application (between 382 and 383 days and 198 and 233 days). Secondary data were also collected in a tighter time frame around collection of the primary outcome, and communication among data collectors, the field staff, and the research team was streamlined. In focus groups, community-based data collectors reported feeling more empowered and engaged in the data collection process after implementation of the application. CONCLUSIONS: A Web-based management application was successful in improving data collection time efficiency and engagement among data collectors.

Attitudes and Social Norms Are Related to Attendance at Childhood Obesity Prevention Classes in a Rural Mexican-Heritage Community.

OBJECTIVE: To examine factors related to attendance of Mexican-heritage parents at community-based nutrition classes to prevent childhood obesity. METHODS: Starting in 2011, interviewers collected baseline data from Niños Sanos Familia Sana (Healthy Children, Healthy Families) participants in rural California. Educators maintained attendance logs from 2012 to 2014. Informed by the Theory of Planned Behavior, interviewers administered an exit survey in 2015 to collect data on attitudes, subjective norms, health motivations, and perceived control related to attendance. Multivariable ordinal logistic regression analysis examined the correlates of attendance (n = 194, intervention group only). RESULTS: Controlling for mother's age, marital status, acculturation, and employment, attitudes and subjective norms were significantly related to attendance (odds ratio = 1.27; 95% confidence interval [CI], 1.18-1.37; P < .001). CONCLUSIONS AND IMPLICATIONS: In these Mexican-heritage participants, attitudes and subjective norms were significant correlates of attendance. The Theory of Planned Behavior may shed light on attendance of high-risk groups but further testing of instruments is needed.

A Community Cultural Wealth Model to Train Promotoras as Data Collectors.

The literature has documented the use of community health workers as an effective strategy to work with underserved communities. However, there is scant research on the strategies community health workers use when working in research studies. This qualitative study examines how promotoras (community health workers) implement their community cultural wealth to participate as data collectors in the control site of the Niños Sanos, Familia Sana (Healthy Children, Healthy Family) study. Our findings indicate that promotoras implement their cultural values, knowledge, and practices to recruit study participants and facilitate the data collection process. This study has implications for the recruitment and development of culturally and relevant linguistic training targeting promotoras in Mexican-origin communities.