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Breast cancer is the most common cancer in women in the United States (U.S.) and the leading cause of cancer related death among U.S. Hispanics/Latinas (H/Ls). H/Ls have lower rates of screening and longer time to follow up after an abnormal mammogram. We developed a comprehensive community health educator (promotores)-led education and risk identification program for Spanish-speaking H/Ls in California to increase mammography screening, genetic testing, and the understanding of the impact of family history on cancer risk. Due to COVID-19, we adapted the program to a virtual platform. The experience of transforming the program to a virtual platform provided unique opportunities for collaboration between researchers, community partners, and participants. Promotores are major partners in community based participatory research and in the provision of health care services, but their voices are often excluded from scientific reports. This commentary is an effort to provide a platform for promotores to share their experiences and for the readers to understand their approach in bridging the gap between health care services and communities.

Community Health Workers, promotores, and navigators (henceforth, CHWs) emerged as critical members of the public health workforce addressing social, economic, and health inequities worsened by the COVID-19 pandemic. While there is increased appreciation for and utilization of CHW models, and recognition of the importance of tailoring and innovating these models during the pandemic, few studies have examined the processes of change by which CHW models operated during the COVID-19 pandemic and factors that facilitated or constrained CHW health equity efforts. This protocol paper describes and reflects on the research methodology used in our qualitative study focused on CHWs. The CATALYST study aims to examine the roles that CHWs served during the COVID-19 pandemic and facilitators and barriers related to CHW health equity strategies. This qualitative study incorporates the lived experiences of CHWs, low-income communities of color whom CHWs engaged, and institutional representatives and policymakers familiar with locally implemented CHW models during the pandemic. Through a community-based participatory research process, this study involves an abductive qualitative approach to data collection and analysis. We integrate community member expertise alongside CHW and health equity frameworks in designing the research questions and data collection process. Additionally, we use an analytic approach that combines inductive (drawn from qualitative data) and deductive codes (drawn from theoretical frameworks and practice-based evidence integrated through a participatory research process) and nimbly leverages flexible coding to address inductive themes and practice-based questions. Our collaborative process offers concrete strategies to develop qualitative research protocols with community partners, with evidence used to inform policy, programmatic, and relational changes to support and amplify CHW models to promote community health and health equity. [ABSTRACT FROM AUTHOR]

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.

Royal Decree-Law 8/2023 adopts measures to address the economic and social consequences derived from conflicts in Ukraine and the Middle East, as well as to alleviate the effects of drought. Title III of the decree is dedicated to energy, establishing measures for the incorporation of renewable energy facilities into the electrical system. Access and connection to electricity transportation and distribution networks are also regulated, as well as self-consumption and decarbonization of the industry. Modifications are introduced to prevent speculative hoarding of network access permits, and guarantees and expiration periods are established for access and connection permits. Additionally, measures to flexibilize electricity supply contracts are maintained, and the support mechanism for electro-intensive industries is extended. The possibility of modifying the list of Just Transition Nodes is also contemplated, and the La Pereda 220 kV transportation network node is granted the status of Just Transition Node. An urgent review of legislation affecting the hydrocarbon sector is foreseen due to the transformation of the market in recent years. Royal Decree-Law 8/2023 establishes measures to address fraudulent practices in the liquid hydrocarbon sector and to comply with the renewable energy objectives established by the European Union Directive. Support measures to mitigate the effects of drought in sectors such as agriculture are also included. Modifications are introduced in the legislation of the electricity and water sectors to promote energy storage and ensure water supply to nuclear power plants. These measures will come into effect on different dates starting from December 29, 2023. [Extracted from the article]

El estudio de la fábrica de San Cosme y San Damián de Covarrubias demuestra la dificultad que durante el tardogótico castellano tuvieron algunas instituciones religiosas para renovar sus edificios. A partir de la documentación conservada y el análisis artístico, este trabajo examina la actuación de promotores, sus intereses, el trabajo de los canteros encargados de las obras, los problemas de financiación a los que hubo que hacer frente y, en definitiva, el complejo proceso constructivo de la iglesia en el siglo XV. El conocimiento detallado de estas circunstancias nos permite establecer criterios de emulación con respecto de obras de referencia en la época y comportamientos comunes a otros centros artísticos coetáneos para proponer, como objetivo final, una reflexión sobre el concepto de élite periférica aplicado a todas las facetas de la creación artística de la época: fábricas, promotores y canteros.

Community-initiated health interventions fill important gaps in access to health services. This study examines the effectiveness of a community-initiated health intervention to improve diabetes management in an underserved community of color using a retrospective observational study, comparing a study intervention, the Latino Health Access Diabetes Self-Management Program (LHA-DSMP), with usual care. The LHA-DSMP is a 12-session community health worker (promotor/a) intervention developed and implemented by a community-based organization in a medically underserved area. Usual care was delivered at a federally qualified health center in the same geographic area. Participants were 688 predominantly Spanish-speaking Latinx adults with type 2 diabetes. The main outcome was change in glycemic control (glycosylated hemoglobin [HbA1c]) from baseline to follow-up. At 14-week follow-up, mean (95% CI) HbA1c decrease was -1.1 (-1.3 to -0.9; P < .001) in the LHA-DSMP cohort compared with -0.3 (-0.4 to -0.2; P < .001) in the comparison cohort. Controlling for baseline differences between cohorts, the adjusted difference-in-differences value in HbA1c was -0.6 (-0.8 to -0.3; P < .001) favoring the LHA-DSMP. A community-initiated promotor/a-led educational program for diabetes self-management is associated with clinically significant improvement in blood sugar control, superior to what was observed with usual medical care.

Abstract 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.

Unhealthy alcohol use (UAU) affects nearly 1 in 4 Latinx/o/a individuals in the United States (US). Compared with White individuals, Latinx/o/a individuals with UAU face increased morbidity, decreased access to addiction treatment, and higher rates of incarceration. Community health workers (CHWs), also known as promotores, provide culturally and linguistically informed services while augmenting social and health care interventions. Although there is extensive literature evaluating the role of CHWinterventions for chronic conditions including hypertension and diabetes, less is known about CHWinterventions for UAU in the US. To better understand how CHWs can address UAU in the Latinx/o/a community in the US, we performed a scoping reviewof the literature for CHWinterventions for UAU in the Latinx/o/a population. We reviewed publications up toMarch 8, 2022, which described CHWinterventions for UAU in Latinx/o/a individuals in the US and identified 6 publications thatmet inclusion criteria after full-text review. These publications included 3 randomized controlled trials, 2 follow-up feasibility and acceptability assessments within the randomized controlled trial intervention group, and a pre-post noncontrolled feasibility study. All interventions were brief, with low-intensity touchpoints between CHWs and patients. None included medications for alcohol use disorder. We found few publications related to CHW-delivered interventions for UAU within the Latinx/o/a population. Given the acceptance and success of CHW-delivered interventions other conditions, as well as the increasing use of CHWs in the US, we need to invest in research that examines the efficacy of the CHWs in UAU. [ABSTRACT FROM AUTHOR]

Purpose: Although psychological distress is common among Latinos in the United States, they underutilize mental health services. We describe a community-based program to manage stress and reduce depressive symptoms among low-income Spanish-speaking Latinos. Methods: Mentes Positivas en Acción (MPA) (Positive Minds in Action) is an 8-week group program, delivered by trained promotores in community settings and evaluated through a randomized feasibility study. Participants were randomly assigned to an immediate MPA treatment group or a delayed-intervention control group. Outcomes assessed at baseline and 8 weeks included stress (Perceived Stress Scale [PSS]) and depressive symptoms (PHQ-9); higher scores indicate worse health. Repeated-measures analysis of variance examined group×time interaction effects for group differences in change from baseline to 8 weeks. The control group offered the program after the 8-week assessment, completed an additional assessment at the end of the program (16 weeks); t-tests assessed within-group changes. Results: Most participants were female, born in Mexico, and spoke only Spanish. Group×time interaction effects were significant for both outcomes. Mean PSS scores improved in the treatment group but not the control group (-0.80 vs. +0.10; p

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. [ABSTRACT FROM AUTHOR]

Copyright of Ciencia y Educación (2707-3378) is the property of Duanys Miguel Pena Lopez and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Low-income Latino immigrants lack access to mental health providers. We explored the feasibility of training promotores to deliver a stress management program in community settings. Methods: We trained promotores to deliver an 8-week intervention program comprising evidence-based cognitive-behavioral stress management techniques. Trained promotores then delivered the program to Spanish-speaking Latino immigrants. Results: Promotores (n=10) improved their knowledge significantly after the training (p

Underprivileged urban communities often have less parks than wealthier communities. Even when new parks are built and are physically accessible to such communities, park design and programming is often undertaken without community input and may result in psychologically inaccessible parks. To address this problem, the California Department of Parks and Recreation piloted a community outreach intervention in a newly created Los Angeles park. It employed the promotores model, which uses community members as outreach ambassadors. Using participant observations, interviews, and a survey, we evaluated the intervention's success in recruiting and training promotores, organizing community outreach, and making the park more accessible to underprivileged communities. We found that the promotores helped increase community involvement in park programming, thus enhancing procedural justice, and also helped enhance park use by previously underrepresented groups. We conclude with recommendations about how the promotores model can be improved and used more effectively in park planning. [ABSTRACT FROM AUTHOR]

The Museum of Mexican Medicine is a place dedicated to the divulgation of the history of medicine especially Mexico's history. The museum is located in the Palace of the School of Medicine in Mexico City. In this work we present the background of the Museum of Mexican Medicine, a key element of UNAM's Department of History and Philosophy of Medicine (DHyFM) for teaching and divulgating the history of medicine. Therefore, we will indicate the background, information of its promoters, works for the museum, the origin of the museographic collection and the first exhibitions. [ABSTRACT FROM AUTHOR]

Background: The rate of Type 2 diabetes mellitus (T2DM) among Mexican American individuals is 16.3%, about twice that of non-Hispanic White individuals. While a number of education approaches have been developed and shown to improve diabetes self-management behaviors and glycemic control for Spanish-speaking Latinx patients with T2DM, there is little research to guide health practitioners regarding which interventions to apply and when so that resources are used efficiently, and treatment outcomes are maximized. Objective: This study aimed to describe an adaptive intervention that integrates community mental health workers, diabetes nurse educators, family members, and patients as partners in care while promoting diabetes self-management for Mexican American individuals with T2DM. The project incorporates four evidence-based, culturally tailored treatments to determine what sequence of intervention strategies work most efficiently and for whom. Given the increasing prevalence of T2DM, achieving better control of diabetes and lowering the associated medical complications experienced disproportionally by Mexican American individuals is a public health priority. Methods: Funded by the National Institute of Nursing Research (National Institutes of Health grant R01 NR015809), this project used a sequential multiple assignment randomized trial and included 330 Spanish-speaking Latinx patients with T2DM. In the first phase of the study, subjects were randomly assigned to an evidence-based diabetes self-management educational program called Tomando Control delivered in a group format for 6, biweekly 1.5-hour sessions, led either by a community health worker or a diabetes nurse educator. In the second phase of the study, those subjects who did not improve their diabetes self-management behaviors were rerandomized to receive either an augmented version of Tomando Control or a multifamily group treatment focused on problem-solving. The primary outcome measure was the "Summary of Diabetes Self-Care Activities." Evaluations were made at baseline and at 3, 6, and 12 months. Results: This study was funded in June 2016 for a period of 5 years. Institutional review board approval was obtained in November 2016. Between March 2017 and September 2020, a total of 330 patients were recruited from the outpatient primary care clinics of Olive View-UCLA Medical Center, with a brief hiatus between May 2020 and July 2020 due to COVID-19 restrictions. The study interventions were completed in December 2020. Data collection began in March 2017 and was completed in December 2021. Data analysis is expected to be completed in Spring 2023, and results will be published in Fall 2023. Conclusions: The results of this trial should help practitioners in selecting the optimal approach for improving diabetes self-management in Spanish-speaking, Latinx patients with T2DM. [ABSTRACT FROM AUTHOR]

Rapid proliferation of smartphone ownership and use among Latinos offers a unique opportunity to employ innovative visually enhanced low-text (VELT) mobile health applications (mHealth app) to promote health behavior change for Latinos at risk for lifestyle-related diseases. Using focus groups and in-depth interviews with 16 promotores and 5 health care providers recruited from California clinics, this qualitative study explored perceptions of visuals for a VELT mHealth app promoting physical activity (PA) and limiting sedentary behavior (SB) for Latinos. In this Phase 1 study, participants endorsed visuals portraying PA guidelines and recommended visuals depicting family and socially oriented PA. Overall, participants supported a VELT mHealth app as an alternative to text-based education. Findings will inform the future Phase 2 study development of a culturally appropriate VELT mHealth app to promote PA for Latinos, improve health literacy, and provide an alternative to traditional clinic text-based health education materials.

Hasta la última década, los mecanismos de financiamiento para el desarrollo de iniciativas con o sin fines de lucro, se han centralizado en el mercado financiero y mercado de valores. Las restricciones y complejidades que conllevan estas alternativas tradicionales han devenido en el surgimiento de un nuevo mecanismo, denominado crowdfunding, el cual nace como una solución del mercado al problema de la falta de acceso a financiamiento. A través de esta vía, múltiples inversionistas aportan, en conjunto, el capital necesario para llevar a cabo un proyecto a título de donación o a cambio de una contraprestación que dependerá del tipo de crowdfunding. El crecimiento acelerado de este mecanismo ha provocado su regulación en algunas legislaciones, a las cuales se ha sumado Ecuador. Estas regulaciones, acertadas en algunos casos y desacertadas en otros, conllevan una causalidad directa respecto del éxito o fracaso de esta nueva herramienta en cada país en el que se instaura. Por esta razón, a través del presente artículo se pretende analizar la regulación del crowdfunding en Ecuador en comparación con legislaciones extranjeras, para evidenciar si esta favorece, o no, a la existencia de este nuevo instrumento financiero en el país.

Daniel Ebbs,1 Julian H Hirschbaum,2 Amanda Mika,3 Starr C Matsushita,4 Joy H Lewis5 1Resident Physician Valley Children’s Hospital, Madera, CA, USA; 2Resident Physician Los Angeles County USC Medical Center, Los Angeles, CA, USA; 3Resident Physician Saint Joseph Hospital, Denver, CO, USA; 4Resident Physician Samaritan Health Services, Corvalis, OR, USA; 5Still University, Mesa, AZ, USACorrespondence: Daniel EbbsResident Physician Valley Children’s Hospital, 9300 Valley Childrens Place, Madera, CA 93636, USATel +1-559-353-3000Email debbs@valleychildrens.orgPurpose: Community health workers (CHWs) play integral roles in primary health care provision in low- and middle-income countries (LMICs). This is particularly true in underdeveloped areas where there are acute shortages of health workers. In this study, we evaluated the development and community utilization of a CHW training program in the Loreto province of Peru. Additionally, a community-oriented training model was designed to augment access to basic health information in underserved and isolated areas of the Amazon.Methods: Health resource utilization was compared in each community by surveying community members before and after implementation of the CHW training program, which utilized a community participatory program development (CPPD) model.Results: All communities demonstrated significantly increased CHW utilization (p = 0.026) as their initial point of contact for immediate health concerns following CHW training implementation. This increase in CHW utilization was accompanied by trends toward decreased preferences for local shamans or traveling to the closest health post as the initial health resource.Conclusion: The community-focused, technology-oriented model utilized in this study proved an effective way to promote the use of CHWs in the Amazon region of Loreto, and could prove valuable to CHW capacitation efforts within other Peruvian provinces and in other LMICs around the world.Keywords: community health worker, promotores, human resources for health, mobile health technology, expanding access to healthcare, rural health

The aim of this work is to identify the main promoters of the devotion to the Image of Senhor Santo Cristo dos Milagres, in Ponta Delgada, Azores, in the 18th century, as well as to understand the way some of them experienced the devotion to the Passion of Christ and how they promoted it, expressing their personal relationship with God, being, sometimes, mediators between the believers and the Image, through which God expresses his thaumaturgical power. Intentionally and deliberately, the 18th century promoters created the Image space and symbology, allowing to congregate and to disseminate the cult, intensifying the individual, familiar and collective devotion. They established the basis for the consolidation of the greatest demonstration of the Azorean Catholicism faith until the 21st century. [ABSTRACT FROM AUTHOR]

Community-initiated health interventions fill important gaps in access to health services. This study examines the effectiveness of a community-initiated health intervention to improve diabetes management in an underserved community of color using a retrospective observational study, comparing a study intervention, the Latino Health Access Diabetes Self-Management Program (LHA-DSMP), with usual care. The LHA-DSMP is a 12-session community health worker (promotor/a) intervention developed and implemented by a community-based organization in a medically underserved area. Usual care was delivered at a federally qualified health center in the same geographic area. Participants were 688 predominantly Spanish-speaking Latinx adults with type 2 diabetes. The main outcome was change in glycemic control (glycosylated hemoglobin [HbA1c]) from baseline to follow-up. At 14-week follow-up, mean (95% CI) HbA1c decrease was -1.1 (-1.3 to -0.9; P < .001) in the LHA-DSMP cohort compared with -0.3 (-0.4 to -0.2; P < .001) in the comparison cohort. Controlling for baseline differences between cohorts, the adjusted difference-in-differences value in HbA1c was -0.6 (-0.8 to -0.3; P < .001) favoring the LHA-DSMP. A community-initiated promotor/a-led educational program for diabetes self-management is associated with clinically significant improvement in blood sugar control, superior to what was observed with usual medical care. [ABSTRACT FROM AUTHOR]

Coronavirus disease-2019 (COVID-19) has adversely impacted vulnerable communities. Community health workers (CHWs) are an evidence-based solution for helping communities navigate challenges and barriers. This case study describes the work of CHWs in a large Hispanic Chicago neighborhood who experienced a disproportionate number of COVID-19 cases. Methods included semistructured interviews and conventional qualitative content analysis. Results describe the problem; the situation; CHWs' roles, motivations and actions; outcomes; lessons learned; and recommendations. The case study concludes with a discussion of effective CHW engagement--particularly for underresourced communities--and presents recommendations for CHW workforce development and policies to strengthen the health care and public health systems. [ABSTRACT FROM AUTHOR]

El mercado de financiamiento es uno de los ejes de la promoción del emprendimiento, innovación y la creación de empleo. En ese orden de ideas, el financiamiento participativo (o también denominado crowdfunding) se posiciona como una herramienta de crédito importante que, entre otras características, a través de la innovación tecnológica, crea un ecosistema flexible de intermediación directa que permite conectar de forma masiva a inversores y promotores. A su vez, asegura una competencia efectiva de fuentes de financiamiento en el mercado de créditos. En el presente artículo, el autor expone un marco general sobre el crowdfunding y analiza críticamente su regulación en el régimen jurídico peruano. En esa misma línea, tomando en consideración la experiencia comparada, propone algunas recomendaciones normativas, a fin de potenciar el crecimiento de la figura y garantizar su adecuado funcionamiento en el mercado.

This study tested whether a cancer education intervention affected promotores' self-efficacy to deliver an intervention to Hispanics and which psychosocial determinants of promotores influenced the number of Hispanic residents reached by promotores in the subsequent education intervention. A quasi-experimental, pre/post-design with a treatment group (no control) assessed differences for promotores (n = 136) before and after exposure to the cancer education intervention. The design also included a cross-sectional evaluation of the number of residents promotores reached with the educational intervention. After being trained, the promotores delivered the intervention to Hispanic residents (n = 1,469). Paired t-tests demonstrated increases in promotores' self-efficacy from pre- to post-intervention. Regression models assessed associations between the numbers of residents reached and select psychosocial determinants of promotores. Age and promotores' years of experience influenced their delivery of a cervical cancer education intervention to Hispanics, but not their delivery of breast or colorectal cancer education interventions. This is the first study to examine which psychosocial determinants influence promotores delivery of cancer education interventions. The outcomes potentially have implications for CHW interventions and training by examining this potential connection between CHWs' psychosocial determinants and intervention outcomes.

Purpose: Low-income Latino immigrants lack access to mental health providers. We explored the feasibility of training promotores to deliver a stress management program in community settings. Methods: We trained promotores to deliver an 8-week intervention program comprising evidence-based cognitive-behavioral stress management techniques. Trained promotores then delivered the program to Spanish-speaking Latino immigrants. Results: Promotores (n=10) improved their knowledge significantly after the training (p

Copyright of Themis: Revista de Derecho is the property of Themis Asociacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Several Texas communities along the Mexican border, including the Lower Rio Grande Valley (LRGV), are home to low-income Hispanic populations, many of whom live in underserved communities known as colonias. These areas have high incidences of neurocognitive disorders, dementia, and Alzheimer's disease (AD); health care strategies that are culturally and linguistically appropriate for the area are needed. We aim to build capacity to reduce risk, facilitate treatment, and provide caregiver support for affected individuals. However, gaining trust of communities and presenting information about research studies in a way that is culturally appropriate is critical for engagement of underserved communities. This brief report examines our work with local community health workers.(CHWs), promotores in Spanish, to establish contact with, engage, mobilize, and educate the Hispanic communities of the LGRV. Lessons from the succesful experience of training promotores in autism spectrum disorder in the LRGV highlight the importance of specifically addressing outreach in health fairs, clinic vists and referral as well as adequate selection, training, management, and support of the promotores as critical aspects. To initiate and sustain recruitment of older adults and care partners in research studies of AD and other dementias in the RGV, we have incorporated these aspects as components of the promotores training and engagement model, which has been developed and implemented by researchers and their colleagues at the School of Medicine at the University of Texas Rio Grande Valley. [ABSTRACT FROM AUTHOR]

Background: After a diagnosis of prostate, breast, or colorectal cancer, Latinos experience higher mortality rates and lower health-related quality of life (HRQOL) in comparison with other ethnic/racial groups. Patient navigation (PN) and lay community health workers or promotores are effective in increasing cancer screening and early-stage diagnosis among Latinos. However, little is known about the effect of PN on HRQOL among Latino cancer survivors.Methods: Latinos previously diagnosed with breast, prostate, or colorectal cancer (n = 288) were randomized to 1 of 2 conditions: 1) the Patient Navigator LIVESTRONG Cancer Navigation Services (PN-LCNS) survivor care program or 2) PN only. HRQOL was measured with the Functional Assessment of Cancer Therapy-General, and cancer-specific HRQOL was measured with the Functional Assessment of Cancer Therapy-Breast, the Functional Assessment of Cancer Therapy-Prostate, and the Functional Assessment of Cancer Therapy-Colorectal for breast, prostate, and colorectal cancer survivors, respectively, at the baseline and at 3 follow-up time points. Generalized estimating equation analyses were conducted to estimate the effect of condition on HRQOL with adjustments for covariates and baseline HRQOL.Results: PN-LCNS demonstrated a significant improvement in HRQOL in comparison with PN only for colorectal cancer survivors but not for breast and prostate cancer survivors.Conclusions: Enhanced PN improves HRQOL among Latino colorectal cancer survivors. Future research should identify the best strategies for engaging Latino survivors in PN programs. PN programs should also be adapted to address HRQOL concerns among Latina breast cancer survivors. [ABSTRACT FROM AUTHOR]

Para determinar si los implantes neonatales (IN) de zeranol producen alteracioneste sticulares al igual que las hormonas estrogénicas se utilizaron 20 terneros machos Aberdeen Angus divididos en dos grupos de igual número. El Grupo Implantado (GI) recibió un IN de 24 mg de zeranol mientras que el Grupo Testigo (GT) no recibió ningún tratamiento. Los animales fueron pesados al nacimiento y a los 8 meses de edad, momento en que fueron castrados. Se comparó la ganancia de peso corporal entre el GI y el GT y se estimó la diferencia del desarrollo testicular entre ambos grupos a través del peso de los testículos. Se encontró una disminución del desarrollo testicular (p0,001) y un aumento de la ganancia de peso corporal (p0,10) en el GI respecto al GT. Se concluye que el IN de zeranol produce sobre los testículos y la ganancia de peso corporal un efecto similar a la aplicaciónn eonatald e las hormonal gonadalese strogénicas

Community health advocates (CHAs), known as Promotores in Spanish-speaking communities, are an important resource for the mobilization, empowerment, and the delivery of health education messages in Hispanic/Latino communities. This article focuses on understanding cultural, didactic, and logistical aspects of preparing CHAs to become competent to perform a Screening Brief Intervention and Referral to Treatment in the emergency room. The CHAs training emphasizes making connections with Mexican-origin young adults aged 18 to 30, and capitalizing on a teachable moment to effect change in alcohol consumption and negative outcomes associated with alcohol use. We outline a CHA recruitment, content/methods training, and the analysis of advantages and challenges presented by the delivery of an intervention by CHAs. [ABSTRACT FROM AUTHOR]

We assessed the fidelity of promotores conducting screening and brief intervention (SBI) to reduce unhealthy alcohol use among Latino immigrant day laborers in the Vida PURA study. We reviewed 32 audio-recorded brief interventions to assess promotor adherence to the intervention protocol and to evaluate their motivational interviewing (MI) technique with the Motivational Interviewing Treatment Integrity (MITI) 4.2.1 tool. Promotores delivered three core intervention steps in 78% of recordings and achieved basic MI competence across all domains and proficiency in 50% of measures. Our results suggest that promotores can be trained to deliver SBI in community settings with fidelity. [ABSTRACT FROM AUTHOR]

Construction is a large employment sector with a high prevalence of small businesses. Despite the high injury rates reported for employees of small construction firms, these firms are under-represented in occupational safety research studies. Such studies are needed to understand barriers experienced by these firms and to examine ways to overcome them. However, challenges accessing and recruiting this hard-to-reach population are frequently reported. Traditional approaches of recruiting through unions or workers' compensation insurers may not be appropriate or effective for small construction businesses. Previous studies have demonstrated the value of academic collaborations with community-based organizations for recruiting participants from hard-to-reach populations for research studies. In accordance with the principles of Community-Based Participatory Research (CBPR), we formed a recruitment team comprised of staff from a local union, a community organization, and a community outreach team to recruit small construction contractors in Lawrence, MA. Media marketing strategies, participation in community events, exploring neighborhoods in search of ongoing residential projects, and partnership with vocational training institutions and building trade associations were some of the strategies implemented during this project. We recruited 118 contractors, supervisors, and foremen from more than 50 construction firms across the Greater Lawrence area to participate in an intervention project to reduce falls and silica exposure. The CBPR approach facilitated the development and implementation of recruitment strategies that resulted in the participation of a significant number of hard-to-reach small construction contractors. [ABSTRACT FROM AUTHOR]

The use of promotores to educate Hispanic communities about different health topics has been proven successful, albeit with limitations in program sustainability. The goal of this study was to develop a sustainable train-the-trainer model to train graduate public health (PH) students to disseminate cancer education among communities in Puerto Rico (PR). Graduate students (n = 32) from Ponce Health Sciences University's (PHSU) PH program participated in a 2-day Cáncer 101 training, where they learned how to deliver nine cancer modules to the community. Cancer knowledge was assessed before and after the training via 54 items measuring discussed concepts. Participants also assessed the training's effectiveness by completing a training evaluation informed by social cognitive theory (SCT) constructs of self-efficacy, outcome expectations, facilitation, and observational learning. Participants were mainly female (78.1 %), 26.7 ± 3.9 years old, and enrolled in a Masters-level program (81.3 %). Participants reported an average 11.38-point increase in cancer knowledge after attending the training [t(31) = 14.88, p < .001]. Participants also evaluated the training favorably upon completion, reporting satisfactory comments in the open-ended responses and high scores on measured SCT constructs. The Cáncer 101 training program effectively prepared students to deliver cancer education to local communities. Training graduate PH students to educate communities about health issues is an innovative, and potentially sustainable, way to reach underserved populations. [ABSTRACT FROM AUTHOR]

Objetivo: Diseñar y evaluar un programa de formación de promotores, con componentes educativos y participativos, que permitan desarrollar procesos locales hacia un mayor control de la tuberculosis en comunidades de alta incidencia de tuberculosis en Chiapas, México. Métodos: Se elaboró un programa basado en un diagnóstico epidemiológico y sociocultural de la tuberculosis en la región; se diseñaron y aplicaron cursos-talleres participativos para una mejor comprensión de la enfermedad y capacitación para la formación de promotores en el diagnóstico y tratamiento de la tuberculosis, con aportes de la biomedicina y de las teorías de participación comunitaria y constructivista. Resultados: Se enfatiza que la participación comunitaria fue esencial en la reflexión y definición del problema de la tuberculosis, así como los posibles caminos a seguir. Se demostró que fue una forma de generar un alto compromiso en la obtención de resultados en el diagnóstico y tratamiento de la enfermedad y en la eficacia de la comunicación con la población. Las localidades incluidas fueron Verapaz, Tres Maravillas y Nuevo México del municipio de Frontera Comalapa, Chiapas. Encontramos que la participación de la población en programas de salud, en especial sobre la tuberculosis, había sido de forma pasiva, pues había tomado el papel de receptora solamente en pláticas informativas, sin confirmar aprendizajes. Estas localidades se ubicaban en los primeros lugares de incidencia por tuberculosis a nivel nacional. El curso fue planificado para capacitar a 15 personas como promotores: 10 de Nuevo México, 4 de Verapaz y uno de Tres Maravillas, quienes trabajaron en beneficio de su comunidad y fueron bien recibidas por los pacientes y familiares. Conclusión: La participación comunitaria para reflexionar y definir el problema de la tuberculosis, así como los posibles caminos a seguir, demostró generar un alto compromiso en la obtención de resultados en el diagnóstico y tratamiento de la enfermedad y en la eficacia de la comunicación con la población. Se evaluaron los aprendizajes, la planificación y resultados del programa y un primer monitoreo en la población, a través de la estructura de contexto insumos-procesos-productos y resultados. Se demostró la eficiencia de la capacitación para promotores y su utilidad en la supervisión del tratamiento de la tuberculosis a nivel comunitario.

This article explores the promise of infusing the community health worker—Promotores—model within social work. In support of community health and social justice, we encourage a return to the historical legacy of this model and our profession by emphasizing not only access and quality of health and social services, but also indigenous leadership development and community advocacy to engender multisystemic change. In so doing, we highlight a richly successfulPromotoresorganization—PASOs—serving Latino communities throughout South Carolina and conclude by discussing the possibilities of this model as we strive to (re)imagine culturally responsive approaches to social work research and practice. [ABSTRACT FROM PUBLISHER]

Estudio comparativo de promotores de la Chalcón Sintasa en diferentes familias de plantas In the post – genomic era the understanding of gene regulation has become a challenge and a research priority. In this research, we performed a comparative study of the regulator sequences of the chalcone synthase gene across plant families. Twenty-two sequences of chalcone synthase promoters were compared considering three regulator Cis elements: G-Box, H-Box and TATA Box. Our results show that these Cis elements are conserved among species and even at the family level. However, in some species all of the Cis elements were not found, showing that the expression and regulation of these promoters via the Cis elements can be variable. Additionally, a comparison between promoters from a species with a chalcone synthase multigene family showed that the duplicate genes are variable in the composition of the Cis elements, suggesting that these genes could be expressing in different ways. Key Words: Promoter; Chalcone synthase; Cis elements; Floral expression. Resumen En la era post-genómica, el entendimiento de la regulación génica se ha convertido en un reto y una prioridad de investigación. En este trabajo realizamos un estudio comparativo de las secuencias reguladoras del gen de la chalcón sintetasa de varias familias botánicas. Veintidós secuencias de promotores de Chalcone Synthase fueron comparados teniendo en cuenta tres elementos Cis reguladores: Caja-G, Caja-H y Caja-TATA, que podrían estar actuando como una sola unidad cooperativa. Nuestra comparación muestra que estos elementos puede que se conserven en algunas especies e inclusive que se conserven a nivel de familia. Sin embargo, en algunas especies no todos los elementos Cis fueron encontrados, mostrando que no todas las especies se regulan bajo los mismos parámetros. Adicionalmente, una comparación entre promotores de una misma especie con una familia de multigenes Chs, mostró que los genes duplicados son variables en la composición del elemento Cis, sugiriendo que estos genes pueden estarse expresando de maneras diferentes. Palabras claves: Promotores; Chalcón sintetasa; Elementos Cis; Expresión floral.

Digital storytelling is an emergent method in health promotion. It addresses health inequities by combining technology with the voices of members of vulnerable, often underrepresented populations. The overall goal of this pilot project was to explore if digital storytelling could be a culturally relevant health promotion tool for Hispanics/Latinos to share their experiences with cancer, or other diseases. Promotores participated in a train-the-trainer workshop. Community members worked with trained promotores to create digital stories through community workshops. We conducted one-on-one interviews with digital story creators to elicit perspectives and assess their experience. One overarching theme among storytellers was the power of storytelling. Supporting subthemes that emerged in the interviews were (1) connection and communication, (2) lack of opportunities and barriers to telling stories, and (3) potential for disease prevention awareness and education. This study found digital storytelling to be culturally relevant for Hispanics/Latinos of Mexican origin. For these storytellers it was a uniquely valuable tool for sharing personal stories of overcoming or managing health issues. Participants found the digital story experience to be positive and beneficial. It provided a healing outlet to reflect on a difficult experience and find support within one’s own community. [ABSTRACT FROM AUTHOR]

La identificación de segmentos funcionales dentro del DNA es uno de los campos más estudiados en la actualidad, debido a la generación de grandes volúmenes de información a partir de los proyectosgenómicos, las predicciones computacionales han atraído la atención de la comunidad científica en general.En este marco la identificación de secuencias reguladoras se erige como un importante campo del análisis de genomas; sin embargo, dada la enorme complejidad del proceso de regulación de la transcripciónaunque promisorios el problema de la predicción de las zonas reguladoras no se ha solucionado en su totalidad.Este artículo presenta una descripción de algunas aproximaciones desarrolladas para la identificación de promotores y sus elementos cis-reguladores, también se describen las estructuras de señales funcionales y estructurales que son diana de reconocimiento de algunos de estos programas de predicción aplicados al gen que codifica para la subunidad NR1 del receptor de glutamato sensible a N-metil-D-aspartato (iGluR-NMDA) el cual ha sido objeto de estudio desde la década de los noventa.