Evaluating the association of state regulation of community health workers on adoption of standard roles, skills, and qualities by employers in select states: a mixed methods study.

BACKGROUND: The occupation of community health worker (CHW) has evolved to support community member navigation of complex health and social systems. The U.S. Bureau of Labor Statistics formally recognized the occupation of community health worker (CHW) in 2009. Since then, various national and state efforts to professionalize the occupation have been undertaken. The Community Health Workers Core Consensus (C3) project released a set of CHW roles and competency recommendations meant to provide evidence-based standards for CHW roles across work settings. Some states have adopted the recommendations; however, there are a variety of approaches regarding the regulation of the occupation. As of 2020, 19 U.S. states have implemented voluntary statewide CHW certification programs. The purpose of this study was to explore the relationship between state regulation of CHWs and adoption of standard roles, skills, and qualities by employers in select states. METHODS: This mixed methods study used purposive sampling of job ads for CHWs posted by employers from 2017 to 2020 in select states. Natural language processing was used to extract content from job ads and preprocess the data for statistical analysis. ANOVA, chi-square analysis, and MANOVA was used to test hypotheses related to the relationship between state regulation of CHWs and differences in skills, roles, and qualities employers seek based on seniority of state regulatory processes and employer types. RESULTS: The mean job ads with nationally identified roles, skills, and qualities varies significantly by state policy type (F(2, 4801) = 26.21) and by employer type (F(4, 4799) = 69.08, p = 0.000). CONCLUSIONS: Employment of CHWs is increasing to provide culturally competent care, address the social determinants of health, and improve access to health and social services for members of traditionally underserved communities. Employers in states with CHW certification programs were associated with greater adoption of occupational standards set by state and professional organizations. Wide adoption of such standards may improve recognition of the CHW workforce as a valuable resource in addressing the needs of high-need and marginalized groups.

Cone-beam Computed Tomography Evaluation of Root Canal Preparation using Various Rotary Instruments: An in vitro Study.

AIM: To evaluate the remaining dentin thickness of teeth after cleaning and shaping the root canal using three rotary instrumentation technique using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This in vitro study is being done with 30 premolar samples with 20' curvature. The study is divided into three groups a CBCT was taken to measure the shortest distance from the root canal outline to the closest adjacent root surface was measured at each level from the cementoenamel junction (CEJ) (1,3, 5 and 7 mm) before and after root canal instrumentation. The purpose of this study was to compare the effects of different instruments used to prepare curved root canals on the remaining cervical dentin thickness and total amount of dentin removed from root canals during instrumentation by using multi-slice CBCT. The remaining dentin thickness is very much necessary for the success rate of root canal treatment. However, this study helps to prove that a conservative preparation with a sound remaining dentin thickness is much more advisable. RESULT: It was observed that there was a significant difference at 1 and 3 mm (p < 0.05) and at 5 and 7 mm there was no significant difference ( p > 0.05). Mtwo has removed less amount dentin when compared to ProTaper Universal and ProTaper Next system at 1 and 3 mm. CONCLUSION: Under the conditions of the study, we concluded that ProTaper Universal and ProTaper Next should be used judiciously, as it causes higher thinning of root dentin of the root when compared with Mtwo.

Tumor associated macrophage: a review on the phenotypes, traits and functions.

The macrophages role within the tumor microenvironment has amended by a variety of factors, thus serves a vital role in tissue morphogenesis. The role of macrophages in health and disease differs enormously as the macrophage has shown dual functions. Macrophage has a basic role in antigen presentation serving as the first line of defense in diseases. However the presence of cytokines and growth factors, both together have regulated the macrophage to become negative effectors promoting tumor activity. Hence macrophages are a double edged weapon, and any imbalance in the regulatory mechanisms caused a shift from tumoricidal to tumorigenic activities. TAMs would be the main reason of the invasion in tumor microenvironment enhancing as well as tumor invasion, angiogenesis and metastasis promoting tumor genesis. Macrophages are the multifunctional cells which have conducted by the tumor cells to produce tumor promoting factors that enable the stimulation of angiogenesis, and tumor cell invasion. This fact has resulted initiation or promotion of tumor genesis, where the tumor has progressed to an upper malignant stage. The present review has focused on the tumor associated macrophages and their roles in tumor genesis.