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BACKGROUND: The COVID-19 pandemic affects population groups differently, worsening existing social, economic, and health inequities. PURPOSE: This study examined 159 counties within Georgia to identify community characteristics associated with county-level COVID-19 case, hospitalization, and death rates. METHODS: Data from the 2020 County Health Rankings, the 2010 US Census, and the Georgia Department of Public Health COVID-19 Daily Status Report were linked using county Federal Information Processing Standard codes and evaluated through multivariable linear regression models. RESULTS: The percentages of children in poverty, severe housing problems, and people not proficient in the English language were significant predictors associated with increases in case, hospitalization, and death rates. Diabetic prevalence was significantly associated with increases in the hospitalization and death rates; in contrast, the percentages of people with excessive drinking and female were inversely associated with hospitalization and death rates. Other independent variables showing an association with death rate included the percentages of people reporting fair or poor health and American Indian/Alaska Native. IMPLICATION: Local authorities' proper allocation of resources and plans to address community social determinants of health are essential to mitigate disease transmission and reduce hospitalizations and deaths associated with COVID-19, especially among vulnerable groups.
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COVID-19/epidemiologia , COVID-19/mortalidade , COVID-19/terapia , Causas de Morte , Pandemias/estatística & dados numéricos , População Rural/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Georgia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Fatores Socioeconômicos , Resultado do TratamentoRESUMO
AIMS: To examine the extent to which local health departments (LHDs) conduct activities to address opioid use and abuse. To test the hypothesis that (i) LHDs' access to data from an electronic syndromic surveillance system is associated with conducting activities to address opioid use and abuse, and (ii) among those LHDs with access to syndromic surveillance data, the use of syndromic and other surveillance data on opioid-related events is associated with LHDs' report of conducting activities to address opioid use and abuse. METHODS: Logistic regression was used to analyze data from the 2018 Forces of Change Survey of a statistically representative sample of 966 LHDs, of which 591 participated in the survey. RESULTS: The LHDs' access to a syndromic surveillance system was significantly associated with their report of conducting activities to address opioid use and abuse. Compared with LHDs that had no surveillance systems, odds of participating in activities to address the opioid use or abuse were higher for LHDs that managed their own surveillance systems (adjusted odds ratio, AOR = 3.022, P = .03) and those who had but did not manage their own surveillance systems (AOR = 1.920, P < .01). The LHDs' use of syndromic surveillance systems (AOR = 2.98, P = .01) or other surveillance systems (AOR = 2.21, P = .03) was also associated with higher odds to participate in activities to address the opioid use or abuse (vs no such use). CONCLUSION: The LHDs are strategically well positioned to play their role in addressing this multifaceted epidemic. Access to data or information from electronic syndromic surveillance systems that use hospital emergency department data might significantly improve LHDs' engagement in conducting activities to address opioid use and abuse within their communities while building their capacity to face the next epidemic.
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Analgésicos Opioides , Governo Local , Humanos , Saúde Pública , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The continuous improvement function, 1 of the 6 public health governance functions, can be usefully applied in the context of local boards of health (LBoHs) operations to target self-improvements. PURPOSE: The purpose of this study was to determine the engagement level of LBoHs in continuous improvement efforts and to identify factors associated with this function. METHODS: Negative binomial regression was performed to analyze data from the 2015 Local Board of Health National Profile. The LBoH taxonomy was used as the guiding model. The taxonomy includes 6 governance functions as structural domains and LBoHs' characteristics and strengths as the central or seventh domain. RESULTS: For the 17 items that comprise the continuous improvement domain, the mean of the dichotomous responses was 4.97 (SD = 3.41). The negative binomial regression analysis showed that the overall summary scale for the other 5 governance domains and the LBoHs' other strengths domain had a significant positive association with the governance domain continuous improvement domain (incidence rate ratio [IRR] = 1.05, P < .001). The 5 individual scales for the governance domains also had significant positive associations with the continuous improvement domain, which included the governance functions of policy development (IRR = 1.13, P < .001), resource stewardship (IRR = 1.18, P < .001), legal authorization (IRR = 1.09, P < .001, partnership engagement (IRR = 1.12, P < .001), and oversight (IRR = 1.29, P < .001). The scale for other characteristics and strengths also showed positive association with continuous improvement (IRR = 1.14, P < .001). CONCLUSION: The findings of this study revealed that there was room for improvement in LBoHs' engagement in the continuous improvement governance function. The results also identified other governance functions and LBoHs' characteristics as factors associated with their continuous improvement.
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Saúde Pública/métodos , Melhoria de Qualidade/tendências , Estudos Transversais , Georgia , Conselho Diretor , Humanos , Saúde Pública/tendências , Administração em Saúde Pública/métodos , Administração em Saúde Pública/tendênciasRESUMO
This study employed novel extraction methods with natural deep eutectic solvents (NADES) to extract bioactive compounds and proteins from Bacopa monnieri leaves. The conditional influence of ultrasonic-assisted extraction (UAE), microwave-assisted extraction (MAE), and enzymatic-assisted extraction (EAE) on the recovery efficiency of phenolics, proteins, flavonoids, and terpenoids was evaluated. The conditions of UAE were 50 mL/g LSR, 600W of ultrasonic power, and 30% water content with 40°C for 1 min to obtain the highest bioactive compounds and protein contents. The conditions of MAE were 40 mL/g LSR, 400W of microwave power with 30% water content for 3 min to reach the highest contents of biological compounds. The conditions of EAE were 30 mL/g of LSR, 20 U/g of enzyme concentration with L-Gly-Na molar ratio at 2:4:1, and 40% water content for 60 min to acquire the highest bioactive compound contents. Scanning electron microscopy (SEM) is employed to analyze the surface of Bacopa monnieri leaves before and after extraction. Comparing seven extraction methods was conducted to find the most favorable ones. The result showed that the UMEAE method was the most effective way to exploit the compounds. The study suggested that UMEAE effectively extracts phenolics, flavonoids, terpenoids, and protein from DBMP.
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Bacopa , Extratos Vegetais , Solventes Eutéticos Profundos , Solventes , Flavonoides , Água , Fenóis , TerpenosRESUMO
Diabetes, including type 1, type 2, and gestational, is a significant public health issue responsible for various clinical, economic, and societal issues. Most of the consequences, if uncontrolled, can result in serious health problems, such as heart disease, vision loss, and kidney disease. Approximately 37.3 million Americans have diabetes, including 37.1 million adults 18 years or older, with 90-95% type 2 diabetes (T2D). The purpose of this study is (1) to explore the profile of patients with T2D and (2) to identify the associated factors of diabetic status. Examined factors included sociodemographic characteristics, social factors, and comorbidities. The study analyzed a primary dataset from a retrospective chart review of adult patients with T2D who were seen at a large medical center and its satellite clinics in the southeast region of the United States in 2019. Sex, dyslipidemia, and the number of concordant comorbidities were found to be significant associated factors of diabetic status. In the era of intertwined patient-centered approach and public health, the study's findings can guide treatment plans and interventions targeting individuals and communities.
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This study aimed to use oleic acid-based ultrasonic-assisted extraction (UAE) to recover carotenoids from carrot pomace and emulsify the enriched-carotenoid oleic acid using spontaneous and ultrasonic-assisted emulsification. The extraction performance of oleic acid was compared with traditional organic solvents, including hexane, acetone, and ethyl acetate. The one-factor experiments were employed to examine the impact of UAE conditions, including liquid-to-solid ratios, temperature, ultrasonic power, and time, on the extraction yield of carotenoids and to find the conditional ranges for the optimization process. The response surface methodology was employed to optimize the UAE process. The second-order extraction kinetic model was used to find the mechanism of oleic acid-based UAE. After that, the enriched-carotenoid oleic acid obtained at the optimal conditions of UAE was used to fabricate nanoemulsions using spontaneous emulsification (SE), ultrasonic-assisted emulsification (UE), and SE-UE. The effect of SE and UE conditions on the turbidity of nanoemulsion was determined. Then, the physiochemical attributes of the nanoemulsion from SE, UE, and spontaneous ultrasonic-assisted emulsification (SE-UE) were determined using the dynamic light scattering method. The extraction yield of carotenoids from carrot pomace by using sonication was the highest. The adjusted optimal conditions were 39 mL/g of LSR, 50 °C, 12.5 min, and 350 W of ultrasonic power. Under optimal conditions, the carotenoid content attained was approximately 163.43 ± 1.83 µg/g, with the anticipated value (166 µg/g). The particle sizes of nanoemulsion fabricated at the proper conditions of SE, UE, and SE-UE were 31.2 ± 0.83, 33.8 ± 0.52, and 109.7 ± 8.24 nm, respectively. The results showed that SE and UE are suitable methods for fabricating nanoemulsions. The research provided a green approach for extracting and emulsifying carotenoids from carrot pomace.