Community-engaged optimization of COVID-19 rapid evaluation and testing experiences: roll-out implementation optimization trial.

BACKGROUND: There continues to be a need for COVID-19 testing that is pragmatic, community-centered, and sustainable. This study will refine and test implementation strategies prioritized by community partners: (1) walk-up no-cost testing, (2) community health worker (promotores)-facilitated testing and preventive care counseling, (3) vending machines that dispense no-cost, self-testing kits. METHODS: A co-designed Theory of Change from an earlier study phase and the Practical, Robust Implementation and Sustainment Model (PRISM) will guide the study design, measures selection, and evaluation. The first aim is to refine and operationalize a multi-component implementation strategy bundle and outcome measures for COVID-19 testing. A Community and Scientific Advisory Board (CSAB) will be established and include community members, clinical providers/staff from the partnering Federally Qualified Health Center (FQHC), public health researchers, policymakers, and a county health department ambassador. Engagement of CSAB members will be assessed through structured ethnography and a survey about the quality and quantity of engagement practices. The second aim is to implement and evaluate the impact of the implementation strategy bundle to optimize COVID-19 testing in communities using a roll-out implementation optimization (ROIO) design. Seven thousand and five hundred community members will be enrolled across four FQHC clinics over 18 months. Participants will be invited to complete an electronic survey about their demographics, health, and COVID-19 testing results and experiences. CSAB members and clinic partners will participate in PRISM fit and determinant assessments prior to each clinic rollout and post-trial. Interviews will be conducted with 60 community participants and 12 providers/staff following a 3-month rollout period at each clinic, inquiring about their experiences with the implementation strategies. Quantitative data will be analyzed using hierarchical multilevel models to determine the impact of implementation strategies. Qualitative data will be analyzed using rapid qualitative approaches to summarize implementation experiences and identify necessary changes prior to subsequent rollouts. A matrix approach will be used to triangulate data from quantitative and qualitative sources based on PRISM domains. DISCUSSION: This is one of the first pragmatic implementation trials to use a ROIO design and aims to co-create a sustainable and equitable COVID-19 testing program. Findings are likely to generalize to other public health prevention efforts. TRIAL REGISTRATION: NCT05894655 March 2, 2023.

The COVID-19 Pandemic: Identifying Adaptive Solutions for Colorectal Cancer Screening in Underserved Communities.

The 2019 novel coronavirus disease (COVID-19) pandemic has dramatically impacted numerous health and economic fronts. Because of the stay-at-home mandate and practice of physical distancing, nearly all preventive care measures have been halted, including colorectal cancer (CRC) screening. The health consequences of this temporary suspension are of great concern, particularly for underserved populations, who experience substantial CRC-related disparities. In this commentary, we describe challenges and opportunities to deliver COVID-19-adapted CRC screening to medically underserved populations receiving care in community health centers (CHC). This perspective is based on key informant interviews with CHC medical directors, teleconference discussions, and strategic planning assessments. To address the unprecedented challenges created by the COVID-19 pandemic, we identify 2 broad calls to action: invest in CHCs now and support equitable and adaptable telehealth solutions now and in the future. We also recommend 4 CRC-specific calls to action: establish COVID-19-adapted best practices to implement mailed fecal immunochemical test programs, implement grassroots advocacy to identify community gastroenterologists who commit to performing colonoscopies for CHC patients, assess cancer prevention priorities among individuals in underserved communities, and assess regional CRC screening and follow-up barriers and solutions. The COVID-19 pandemic may further exacerbate existing CRC screening disparities in underserved individuals. This will likely lead to delayed diagnosis, a shift to later-stage disease, and increased CRC deaths. To prevent this from happening, we call for timely action and a commitment to address the current extraordinary CRC screening challenges for vulnerable populations.

Antioxidant effect and chemical composition of Ananas comosus [L.] Merr. peels from Peruvian northern / Efecto antioxidante y composición química de las cascaras de Ananas comosus [L.] Merr. del norte peruano

Pineapple peels has several beneficial properties including antioxidant activity. We investigated the antioxidant effect of five different peels of pineapple lyophilized extracts, not adsorbed and adsorbed onto Amberlite. They were examined using total phenolic contents (TPC), antioxidant effect by 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging and ferric reducing antioxidant power (FRAP). In addition, we analyzed the chemical composition by HPLC-ESI-QTOF-MS/MS. The main constituents of pineapple peels were tentatively identified as quercetin glycosides and N,N'-diferuloylspermidine. We conclude that the antioxidant activity in pineapple peels from District of Poroto, Province of Trujillo, Region of La Libertad, can be associated with the presence of flavonoid and spermidines.

Las cáscaras de piña tienen varias propiedades beneficiosas, incluida la actividad antioxidante. Investigamos el efecto antioxidante de cinco exfoliaciones diferentes de extracto liofilizado de piña, no adsorbidas y adsorbidas en Amberlita. Se examinaron utilizando los contenidos fenólicos totales (TPC), el efecto antioxidante mediante la eliminación del radical 1,1-difenil-2-picril-hidrazilo (DPPH) y el poder férrico antioxidante reductor (FRAP). Además, analizamos la composición química por HPLC-ESI-QTOF-MS/MS. Los principales constituyentes de las cáscaras de piña se identificaron tentativamente como glucósidos de quercetina y N,N'- diferuloylspermidina. Concluimos que la actividad antioxidante en las cáscaras de piña del Distrito de Poroto, Provincia de Trujillo, Región de La Libertad, puede estar asociada con la presencia de flavonoides y espermidinas.

Burnout Syndrome in Middle and Senior Management in the Industrial Manufacturing Sector of Mexico.

Due to globalization and the accelerated growth of technology, ever more employees of companies are affected by burnout syndrome, the psychological nature of which requires a prolonged response to chronic interpersonal stressors in work environments. The present research aims to validate the operability of the Maslach Burnout Inventory-General Survey (MBI-GS) using a sample of 378 professionals belonging to middle and senior management working in companies within the IMMEX sector (comprising the industrial-manufacturing, maquiladora and export services) located in the state of Baja California, Mexico. Firstly, an exploratory factor analysis using the principal components method and Varimax rotation was performed and the results revealed the existence of three factors representing more than 67 percent of the total variance. Secondly, a confirmatory factorial analysis was carried out performing appropriate results for the indices Chi-square goodness-of-fit model, Root Mean Square Error of Approximation (RMSEA), Normed Fit Index (NFI), Comparative Fit Index (CFI), Relative Fit Index (RFI), Parsimony Ratio (PRATIO) and Parsimony Normed Fit Index (PNFI), which are highly recommended by literature in these types of studies. Additionally, construct validity was satisfactorily verified. The factorial solution coincided with the Maslach Burnout Inventory original proposal so that this instrument can be considered a valid and reliable option to analyze the burnout levels in people pertaining to middle and senior management in these types of industries.