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1.
Ambio ; 51(4): 926-942, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34523080

RESUMEN

Climate change, overfishing, and other anthropogenic drivers are forcing marine resource users and decision makers to adapt-often rapidly. In this article we introduce the concept of pathways to rapid adaptation to crisis events to bring attention to the double-edged role that institutions play in simultaneously enabling and constraining swift responses to emerging crises. To develop this concept, we draw on empirical evidence from a case study of the iconic Maine lobster (Homarus americanus) industry. In the Gulf of Maine, the availability of Atlantic herring (Clupea harengus) stock, a key source of bait in the Maine lobster industry, declined sharply. We investigate the patterns of bait use in the fishery over an 18-year period (2002-2019) and how the lobster industry was able to abruptly adapt to the decline of locally-sourced herring in 2019 that came to be called the bait crisis. We found that adaptation strategies to the crisis were diverse, largely uncoordinated, and imperfectly aligned, but ultimately led to a system-level shift towards a more diverse and globalized bait supply. This shift was enabled by existing institutions and hastened an evolution in the bait system that was already underway, as opposed to leading to system transformation. We suggest that further attention to raceways may be useful in understanding how and, in particular, why marine resource users and coastal communities adapt in particular ways in the face of shocks and crises.


Asunto(s)
Explotaciones Pesqueras , Nephropidae , Animales , Cambio Climático , Conservación de los Recursos Naturales , Maine
2.
Environ Entomol ; 50(6): 1358-1369, 2021 12 17.
Artículo en Inglés | MEDLINE | ID: mdl-34532731

RESUMEN

As part of a quantitative survey of Maine's bumble bee fauna (Butler et al. 2021), we compared and contrasted genetic diversity, parasite and pathogen burdens, and pesticide exposure of the relatively common Bombus ternarius Say, 1937 and the spatially rare Bombus terricola Kirby, 1837. We recorded 11 Bombus species at 40 survey sites across three Maine ecoregions, and B. ternarius was the most common species, while B. terricola was spatially rare. Nonmetric multidimensional scaling indicated that B. terricola was associated with higher elevation sites in Maine, while B. ternarius was more broadly distributed in the state. Pollinator networks constructed for each bee indicated B. ternarius foraged on more plant species than B. terricola, but that there was considerable overlap (73%) in plant species visited. Genetic diversity was greater in the spatially restricted B. terricola, whereas the widely distributed B. ternarius was characterized by greater genetic differentiation among regions. Bombus terricola had higher molecular marker levels of the microsporidian fungi Nosema spp. and the trypanosome Crithidia spp., and both species had high levels of Trypanosoma spp. exposure. No Western Honey Bee (Apis mellifera, Linnaeus, 1758) viruses were detected in either species. Pesticides were not detected in pollen samples collected from workers of either species, and B. ternarius worker tissue samples exhibited only trace levels of diflubenzuron.


Asunto(s)
Himenópteros , Plaguicidas , Animales , Abejas/genética , Crithidia , Maine , Polen
3.
Pharmacol Biochem Behav ; 207: 173222, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34197845

RESUMEN

RATIONALE: Despite a long history of use in synaptic physiology, the lobster has been a neglected model for behavioral pharmacology. A restaurateur proposed that exposing lobster to cannabis smoke reduces anxiety and pain during the cooking process. It is unknown if lobster gill respiration in air would result in significant Δ9-tetrahydrocannabinol (THC) uptake and whether this would have any detectable behavioral effects. OBJECTIVE: The primary goal was to determine tissue THC levels in the lobster after exposure to THC vapor. Secondary goals were to determine if THC vapor altered locomotor behavior or nociception. METHODS: Tissue samples were collected (including muscle, brain and hemolymph) from Homarus americanus (N = 3 per group) following 30 or 60 min of exposure to vapor generated by an e-cigarette device using THC (100 mg/mL in a propylene glycol vehicle). Separate experiments assessed locomotor behavior and hot water nociceptive responses following THC vapor exposure. RESULTS: THC vapor produced duration-related THC levels in all tissues examined. Locomotor activity was decreased (distance, speed, time-mobile) by 30 min inhalation of THC. Lobsters exhibit a temperature-dependent withdrawal response to immersion of tail, antennae or claws in warm water; this is novel evidence of thermal nociception for this species. THC exposure for 60 min had only marginal effect on nociception under the conditions assessed. CONCLUSIONS: Vapor exposure of lobsters, using an e-cigarette based model, produces dose-dependent THC levels in all tissues and reduces locomotor activity. Hot water nociception was temperature dependent, but only minimal anti-nociceptive effect of THC exposure was confirmed.


Asunto(s)
Dronabinol/farmacología , Cigarrillo Electrónico a Vapor/farmacología , Locomoción/efectos de los fármacos , Nephropidae , Nocicepción/efectos de los fármacos , Administración por Inhalación , Animales , Culinaria/métodos , Dronabinol/administración & dosificación , Dronabinol/análisis , Cigarrillo Electrónico a Vapor/administración & dosificación , Sistemas Electrónicos de Liberación de Nicotina , Femenino , Calor , Maine , Masculino , Fumar Marihuana/metabolismo , Dolor/tratamiento farmacológico , Ratas
4.
J Osteopath Med ; 121(1): 85-96, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33512388

RESUMEN

CONTEXT: Osteopathic manipulative medicine (OMM) has been shown to successfully alleviate some pregnancy-related pain. However, most of the published data focuses on the third trimester and postpartum period or musculoskeletal indications. OBJECTIVE: To explore OMM use among obstetrical providers and determine the frequency of use by trimester and by clinical indications across multiple types of women's healthcare practices in Southern and Central Maine. METHODS: An anonymous, 43-item survey, presented in English, was emailed to 172 eligible providers (physicians, nurse practitioners, and certified nurse midwives with obstetrics privileges at one of two main delivery centers in southern and central Maine) via an encrypted database system in January 2018. Follow-up email reminders were sent weekly for three weeks. Questions addressed use of OMM for specific indications, knowledge of OMM, and perceived barriers use of OMM. RESULTS: The survey response rate was 73 of 172 (42%); 95% of respondents were physicians (n=69). Due to the low response rate of non-physicians, only data from physicians was included in the study. Data were summarized descriptively as frequencies (n [%]). The highest rates of OMM utilization were during the third trimester (35 [51.5%]) and postpartum (41 [60.3%]) periods, while the lowest rates of utilization were in the intrapartum (eight [11.9%]) and first trimester periods (26 [38.3%]). Osteopathic physicians (n=19) used OMM more frequently in the first, second, and third trimesters, as well as the intrapartum period (10 [52.6%]; 11 [57.9%]; 14 [73.7%]; and six [31.6%], respectively) compared with their allopathic physician (n=50) counterparts (nine [8%]; 15 [30%]; 21 [42%]; and two [4%], respectively). While osteopathic physicians reported higher frequencies of OMM use and referral for non-musculoskeletal indications such as constipation, edema, and nasal congestion (13 [68.4%]; 11 [57.9%]; 10 [52.6%], respectively), musculoskeletal complaints were the most frequently cited indication for OMM use among both osteopathic and allopathic physicians (low back, 67 [97.1%]; pelvis, 65 [94.2%]; coccyx, 50 [72.5%]; and head, 49 [71%]). CONCLUSION: These results suggest that more education is needed about OMM use in the obstetric population, particularly during early trimesters and the intrapartum period, as well as for visceral and lymphatic complaints of pregnancy.


Asunto(s)
Osteopatía , Medicina Osteopática , Médicos Osteopáticos , Femenino , Humanos , Maine , Encuestas y Cuestionarios
5.
J Vasc Access ; 22(1): 81-89, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32484002

RESUMEN

Peripheral intravenous catheters are frequently used devices in emergency departments. Many patients now present with difficult anatomy and are labeled as difficult intravenous access patients. A common technology to address this challenge is ultrasound. While studies have examined the ability to train emergency staff, few have addressed how this should be done and the outcomes associated with such training. No studies were found with dedicated vascular access specialist teams in emergency departments. An emergency department vascular access specialist team was formed at a hospital in Bangor, Maine, United States to train, validate, and proctor clinicians with ultrasound-guided peripheral intravenous devices. A quality review of this process was compiled and determined that appropriate clinicians with dedicated training and guidance can achieve higher levels of procedural success. Furthermore, evidence substantiates that frequent practice is linked to a higher quality of care and that a significant need for such teams is present. This review examines how a team was implemented and its impact both department- and facility-wide. It is possible that hospitals benefit from the services of vascular access specialists to provide higher quality care. Successful implementation of such specialist teams requires foundational knowledge and skills in vascular access with ongoing quality measures to ensure competency and compliance with evidence-based practices.


Asunto(s)
Cateterismo Periférico , Competencia Clínica , Prestación Integrada de Atención de Salud/organización & administración , Servicio de Urgencia en Hospital/organización & administración , Evaluación de Procesos y Resultados en Atención de Salud/organización & administración , Grupo de Atención al Paciente/organización & administración , Ultrasonografía Intervencional , Humanos , Maine , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Mejoramiento de la Calidad/organización & administración , Indicadores de Calidad de la Atención de Salud/organización & administración
6.
J Econ Entomol ; 114(1): 320-325, 2021 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-33367828

RESUMEN

Eastern New York State is frequently the site of Colorado potato beetle (Leptinotarsa decemlineata, Say) populations with the highest observed levels of insecticide resistance to a range of active ingredients. The dominance of a resistant phenotype will affect its rate of increase and the potential for management. On organic farms on Long Island, L. decemlineata evolved high levels of resistance to spinosad in a short period of time and that resistance has spread across the eastern part of the Island. Resistance has also emerged in other parts of the country as well. To clarify the level of dominance or recessiveness of spinosad resistance in different parts of the United States and how resistance differs in separate beetle populations, we sampled in 2010 beetle populations from Maine, Michigan, and Long Island. In addition, a highly resistant Long Island population was assessed in 2012. All populations were hybridized with a laboratory-susceptible strain to determine dominance. None of the populations sampled in 2010 were significantly different from additive resistance, but the Long Island population sampled in 2012 was not significantly different from fully recessive. Recessive inheritance of high-level resistance may help manage its increase.


Asunto(s)
Escarabajos , Insecticidas , Solanum tuberosum , Animales , Escarabajos/genética , Colorado , Combinación de Medicamentos , Macrólidos , Maine , Michigan , New York
7.
J Am Osteopath Assoc ; 120(8): 540-542, 2020 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-32717089

RESUMEN

The University of New England College of Osteopathic Medicine (UNE COM) was founded by a group of osteopathic physicians who wanted to ensure that the practice of Osteopathic Medicine would endure in northern New England and that patients in the region would continue to receive the best health care possible. UNECOM merged with St. Francis College in 1978 to form the University of New England (UNE). 1 UNE has grown and developed over the years, building on the shared Franciscan and osteopathic traditions of integrating philosophy and intellect. Following the 1996 merger with Westbrook College in Portland, Maine, UNE now comprises 3 campuses, 13 additional health profession programs, 6 Centers of Excellence in Research, and strong undergraduate programs that link the environment, people, and community in a "One Health" concept.


Asunto(s)
Medicina Osteopática , Médicos Osteopáticos , Becas , Humanos , Maine , New England
8.
Ambio ; 49(1): 144-155, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30852777

RESUMEN

The ability of resource-dependent communities to adapt to climate change depends in part on their perceptions and prioritization of specific climate-related threats. In the Maine lobster fishery, which is highly vulnerable to warming water associated with climate change, we found a strong majority (84%) of fishers viewed warming water as a threat, but rank its impacts lower than other drivers of change (e.g., pollution). Two-thirds believed they will be personally affected by warming waters, but only half had plans to adapt. Those with adaptation plans demonstrated fundamentally different views of human agency in this system, observing greater anthropogenic threats, but also a greater ability to control the fishery through their own actions on the water and fisheries management processes. Lack of adaptation planning was linked to the view that warming waters result from natural cycles, and the expectation that technological advancements will help buffer the industry from warming waters.


Asunto(s)
Explotaciones Pesqueras , Nephropidae , Adaptación Fisiológica , Animales , Cambio Climático , Humanos , Maine
9.
Environ Entomol ; 48(6): 1369-1376, 2019 12 02.
Artículo en Inglés | MEDLINE | ID: mdl-31713600

RESUMEN

Common St. John's wort, Hypericum perforatum L. (Malpighiales: Hypericaceae), is a weed in Maine wild blueberry fields. A survey of its presence and relative density in 55 wild blueberry fields was conducted from 2013 to 2016. The objectives of this study were to determine how widespread it is as a weed in wild blueberry and whether it might indirectly contribute to beneficial ecosystem services for wild blueberry. It was found that St. John's wort occurs in about half (45.5%) of all wild blueberry fields surveyed. The crop cycle (prune vs cropping year) affected its relative abundance, significantly less St. John's wort was found in prune fields. St. John's wort relative abundance in wild blueberry fields was not affected by farming system (conventional vs organic) or landscape surrounding blueberry fields. Geographical distribution modeling was performed using the software Maxent. In Maine, the most likely areas predicted to be infested with St. John's wort were the two major blueberry production regions: Mid-coast and Downeast, Maine. Insects associated with St. John's wort were diverse. This weed appears to be under considerable herbivore pressure, especially hemipterans and Chrysolina spp. (Coleoptera: Chrysomelidae) beetles that have been released for biological control. Insect predators and parasitoids were abundant and may not only reduce herbivory on St. John's wort but may also provide a valuable ecosystem service in terms of predator spillover, resulting in reduction of wild blueberry insect pests. Bumble bees (Bombus spp., Hymenoptera, Apidae) are the most efficient pollinator of blueberry and were the predominant bee taxa found foraging on the flowers.


Asunto(s)
Arándanos Azules (Planta) , Clusiaceae , Hypericum , Especies Introducidas , Animales , Abejas , Ecosistema , Maine , Malpighiales
10.
Ecol Appl ; 29(8): e02006, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31541510

RESUMEN

Adding to the challenge of predicting fishery recruitment in a changing environment is downscaling predictions to capture locally divergent trends over a species' range. In recent decades, the American lobster (Homarus americanus) fishery has shifted poleward along the northwest Atlantic coast, one of the most rapidly warming regions of the world's oceans. Building on evidence that early post-settlement life stages predict future fishery recruitment, we describe enhancements to a forecasting model that predict landings using an annual larval settlement index from 62 fixed sites among 10 study areas from Rhode Island, USA to New Brunswick, Canada. The model is novel because it incorporates local bottom temperature and disease prevalence to scale spatial and temporal changes in growth and mortality. For nine of these areas, adding environmental predictors significantly improved model performance, capturing a landings surge in the eastern Gulf of Maine, and collapse in southern New England. On the strength of these analyses, we project landings within the next decade to decline to near historical levels in the Gulf of Maine and no recovery in the south. This approach is timely as downscaled ocean temperature projections enable decision makers to assess their options under future climate scenarios at finer spatial scales.


Asunto(s)
Cambio Climático , Nephropidae , Animales , Canadá , Larva , Maine , New England , Océanos y Mares , Rhode Island , Temperatura
11.
J Agromedicine ; 24(4): 333-340, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31352877

RESUMEN

Objectives: The study objective was to estimate a denominator of exposure to inshore lobstering in Full-Time Equivalents (FTEs), to count incident injury data from a sample cohort of this population, to use this count to calculate rates for incident injuries, and to use official counts of fatalities to estimate a fatality rate.Methods: Captains were randomly selected from those licensed to fish in Maine and Massachusetts. Data on work exposure and injuries that occurred on the boat were collected using a survey that was administered once per season via phone or face-to-face interview with the captain. Data included self-reports of the number of weeks worked during the season, average crew size, number of trips per week, and average trip length in hours. In addition, this survey captured relevant information (body segment affected, type of injury, and whether treatment was received) on all acute injuries occurring during the season. Only data on acute injuries were collected, and defined as having newly occurred within the last 3 months. Counts of fatalities were obtained from an official surveillance database at the National Institute for Occupational Health and Safety.Results: The total occupational exposure reported for the cohort was over 2 million man-hours over 4 years, resulting in an average annual FTE of 5,847. The fatality rate averaged over 4 years was 21/100,000 FTE. The incidence rates for all injuries (51.0/100 FTE) and injuries receiving treatment (17.5/100 FTE) were much higher than those reported in other studies of fishing that used US Coast Guard data. Lobstermen presented with all categories of injuries, sprains being the most frequent (7.8/100 FTE) and amputations the least (0.2/100 FTE). Wrist/hand injuries on the right side occurred most frequently of all body locations (3.6/100 FTE).Conclusion: Non-fatal injuries occur at high rates in lobstering. The impact of interventions aimed at exposure to risk for sprains and cuts has potential to affect the most lobstermen. Fatality rate appears to have been unchanging since the year 2000.


Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Explotaciones Pesqueras/estadística & datos numéricos , Exposición Profesional/estadística & datos numéricos , Accidentes de Trabajo/economía , Accidentes de Trabajo/psicología , Adulto , Animales , Estudios de Cohortes , Empleo , Femenino , Humanos , Entrevistas como Asunto , Maine/epidemiología , Masculino , Massachusetts/epidemiología , Persona de Mediana Edad , Nephropidae/crecimiento & desarrollo , Exposición Profesional/economía , Salud Laboral , Traumatismos Ocupacionales/economía , Traumatismos Ocupacionales/epidemiología , Traumatismos Ocupacionales/psicología , Factores de Tiempo , Adulto Joven
12.
J Agromedicine ; 24(4): 381-390, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31256715

RESUMEN

Background: Falls overboard are the most frequent cause of death in the Northeast lobster fishing industry. National Institute for Occupational Safety and Health (NIOSH) surveillance indicates every victim of a fall overboard who has been found was not wearing a lifejacket. Preliminary research conducted in Maine and Massachusetts indicates lifejacket use is relatively uncommon among lobstermen due to barriers such as comfort, practicality, and social norms.Methods: This study highlights an initiative to: (1) trial various lifejacket designs with lobstermen; (2) identify the most popular designs; and (3) identify other features that could encourage use of lifejackets. In 2017, nine designs were trialed with lobstermen in Maine and Massachusetts during the winter and summer fishing seasons. Participants were recruited dockside, and lifejackets were randomly assigned. Participants completed surveys at 1 week and 4 weeks to assess positive and negative design features and to understand the importance of survival technology that can be used in conjunction with lifejackets.Results: 181 lobstermen in Maine and Massachusetts agreed to participate. Recruitment rates were 90.5%, while the survey completion rate was 88.4%. Survey results identified no clear preference for a specific lifejacket design; however, the ability to choose from many options appeared to be an important factor.Conclusion: Previous studies have indicated that lifejacket preferences are fisheries specific. In the Northeast lobster fishery, however, individual preferences varied. Our research demonstrates that a range of devices covering different buoyancies, wear type, and retrieval systems should be made more available to lobstermen.


Asunto(s)
Accidentes de Trabajo/prevención & control , Salud Laboral/estadística & datos numéricos , Traumatismos Ocupacionales/prevención & control , Equipos de Seguridad/estadística & datos numéricos , Adulto , Animales , Femenino , Explotaciones Pesqueras/estadística & datos numéricos , Humanos , Maine/epidemiología , Masculino , Massachusetts/epidemiología , Persona de Mediana Edad , Nephropidae/crecimiento & desarrollo , Traumatismos Ocupacionales/epidemiología , Adulto Joven
13.
Glob Chang Biol ; 25(11): 3906-3917, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31344307

RESUMEN

Ocean warming can drive poleward shifts of commercially important species with potentially significant economic impacts. Nowhere are those impacts greater than in the Gulf of Maine where North America's most valuable marine species, the American lobster (Homarus americanus Milne Edwards), has thrived for decades. However, there are growing concerns that regional maritime economies will suffer as monitored shallow water young-of-year lobsters decline and landings shift to the northeast. We examine how the interplay of ocean warming, tidal mixing, and larval behavior results in a brighter side of climate change. Since the 1980s lobster stocks have increased fivefold. We suggest that this increase resulted from a complex interplay between lobster larvae settlement behavior, climate change, and local oceanographic conditions. Specifically, postlarval sounding behavior is confined to a thermal envelope above 12°C and below 20°C. Summer thermally stratified surface waters in southwestern regions have historically been well within the settlement thermal envelope. Although surface layers are warming fastest in this region, the steep depth-wise temperature gradient caused thermally suitable areas for larval settlement to expand only modestly. This contrasts with the northeast where strong tidal mixing prevents thermal stratification and recent ocean warming has made an expansive area of seabed more favorable for larval settlement. Recent declines in lobster settlement densities observed at shallow monitoring sites correlate with the expanded area of thermally suitable habitat associated with warmer summers. This leads us to hypothesize that the expanded area of suitable habitat may help explain strong lobster population increases in this region over the last decade and offset potential future declines. It also suggests that the fate of fisheries in a changing climate requires understanding local interaction between life stage-specific biological thresholds and finer scale oceanographic processes.


Asunto(s)
Cambio Climático , Nephropidae , Animales , Maine , América del Norte , Oceanografía
14.
Mar Pollut Bull ; 138: 545-548, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30660305

RESUMEN

This paper provides the first record of ingestion of plastic debris by American lobster, Homarus americanus. Plastics particles, identified as rubber pieces, were found in the stomachs of 3 from 17 individuals of lobsters kept in laboratory conditions. Debris had evidence of cuts, what suggest they were actively consumed.


Asunto(s)
Contenido Digestivo , Nephropidae/efectos de los fármacos , Plásticos/análisis , Contaminantes Químicos del Agua/análisis , Animales , Bahías , Exposición Dietética/efectos adversos , Maine , Plásticos/toxicidad , Contaminantes Químicos del Agua/toxicidad
15.
Environ Entomol ; 47(2): 378-387, 2018 04 05.
Artículo en Inglés | MEDLINE | ID: mdl-29509899

RESUMEN

In 2015, we conducted a statewide assessment of honey bee exposure to pesticides with assistance of volunteer beekeepers. Pollen trapping was conducted at 32 sites in the spring, summer, and early fall. Apiary locations ranged from unmanaged natural landscapes to managed agricultural or urban landscapes. Pollen samples at each site were aggregated over the collection dates and chemical residue analysis was conducted on each pollen sample for 190 pesticides and metabolites using HPLC/MS. Twenty-five different residues were detected for an average of 2.9 detections per site. Detections were dominated by fungicides, but risk, calculated as: ppb residue concentration/LD50, was mostly due to insecticides. Beekeeper perceived land-use in the vicinity of each apiary was associated with significant differences in the number of detections and residue concentrations, agricultural landscapes greater than nonagricultural. However, there was no significant difference in oral or contact risk quotients due to land-use type. The landscape composition surrounding apiaries, derived with GIS, determined pesticide exposure for honey bees when total detections, log pesticide residue concentration, and log contact risk quotients were used as measures. Partial least squares explained 43.9% of the variance in pesticide exposure due to landscape composition. The best predictors describing pesticide exposure were: area (ha) of blueberry, coniferous forest, and urban/developed land cover types. Maine is the most forested state in the United States (as determined by % land area forested, 93%) and a negative exponential decay was observed between land area in conifer forest and the number of pesticide detections per apiary.


Asunto(s)
Abejas , Exposición a Riesgos Ambientales/análisis , Fungicidas Industriales/análisis , Insecticidas/análisis , Residuos de Plaguicidas/análisis , Polen/química , Animales , Apicultura , Arándanos Azules (Planta) , Maine , Medición de Riesgo
16.
Issues Ment Health Nurs ; 39(6): 499-505, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29370560

RESUMEN

Assertive Community Treatment (ACT) is a model of care that provides comprehensive community-based psychiatric care for persons with serious mental illness. This model has been widely documented and has shown to be an evidence-based model of care for reducing hospitalizations for this targeted population. Critical ingredients of the ACT model are the holistic nature of their services, a team based approach to treatment and nurses who assist with illness management, medication monitoring, and provider collaboration. Although the model remains strong there are clear differences between urban and rural teams. This article describes present day practice in two disparate ACT programs in urban and rural Maine. It offers a new perspective on the evolving and innovative program of services that treat those with serious mental illness along with a review of literature pertinent to the ACT model and future recommendations for nursing practice. The success and longevity of these two ACT programs are testament to the quality of care and commitment of staff that work with seriously mentally ill consumers. Integrative care models such as these community-based treatment teams and nursing driven interventions are prime elements of this successful model.


Asunto(s)
Servicios Comunitarios de Salud Mental/organización & administración , Trastornos Mentales/terapia , Grupo de Atención al Paciente/organización & administración , Humanos , Maine
17.
Fam Syst Health ; 35(2): 227-237, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28617023

RESUMEN

INTRODUCTION: The purpose of this study was to assess the degree of behavioral health (BH) integration change in patient-centered medical homes (PCMHs) when using a practice facilitator (PF) specially trained in implementing integrated care and how a quasi-experimental design assists in this process. METHOD: Twelve PCMHs, 8 Federally Qualified Health Centers and 4 private practices, with varying degrees of BH services participated in this study. The degree of BH integration was assessed with a quasi-experimental design using the Maine Health Access Foundation's Site Self Assessment (MeHAF SSA) at baseline and after implementing site-specific BH services. The sites tracked completion of unique objectively measured goals being implemented using the Goal Attainment Scale (GAS) score. RESULTS: At the conclusion of the study, sites saw a statistically significant increase in the level of BH integration from a baseline of 2.73 (SD = 0.44) to a postintervention score of 3.49 (SD = 0.22) with improvements from mild-moderate overall integration to moderate-advanced overall integration (p < .001). In addition, 10 out of the 12 sites achieved successful implementation of unique goals with assistance from the PF. DISCUSSION: This study provides the first quasi-experimental/pretest-posttest evidence utilizing real-world data that the practice facilitation method is an effective solution toward increasing the degree of BH integration. This paper describes the real-world efforts to evaluate the degree of BH integration change in PCMHs when using a PF with content expertise in BH integration within primary care. (PsycINFO Database Record


Asunto(s)
Prestación Integrada de Atención de Salud/métodos , Atención Dirigida al Paciente/métodos , Prestación Integrada de Atención de Salud/normas , Humanos , Maine , Atención Dirigida al Paciente/normas , Atención Primaria de Salud/métodos , Atención Primaria de Salud/normas , Mejoramiento de la Calidad
18.
Mar Pollut Bull ; 121(1-2): 339-351, 2017 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-28633948

RESUMEN

We analyzed surface sediments from 23 northeast USA estuaries, from Maine to Delaware, and nine estuaries from Prince Edward Island (PEI, Canada), to determine how dinoflagellate cyst assemblages varied with nutrient loading. Overall the abundance of cysts of heterotrophic dinoflagellates correlates with modeled nitrogen loading, but there were also regional signals. On PEI cysts of Gymnodinium microreticulatum characterized estuaries with high nitrogen loading while the sediments of eutrophic Boston Harbor were characterized by high abundances of Spiniferites spp. In Delaware Bay and the Delaware Inland Bays Polysphaeridium zoharyi correlated with higher temperatures and nutrient loading. This is the first study to document the dinoflagellate cyst eutrophication signal at such a large geographic scale in estuaries, thus confirming their value as indicators of water quality change and anthropogenic impact.


Asunto(s)
Dinoflagelados , Eutrofización , Animales , Canadá , Quistes , Delaware , Monitoreo del Ambiente , Estuarios , Sedimentos Geológicos , Maine , Nitrógeno , Fósforo , Isla del Principe Eduardo , Contaminantes del Agua/análisis
20.
Philos Trans R Soc Lond B Biol Sci ; 371(1689)2016 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-26880840

RESUMEN

To forecast marine disease outbreaks as oceans warm requires new environmental surveillance tools. We describe an iterative process for developing these tools that combines research, development and deployment for suitable systems. The first step is to identify candidate host-pathogen systems. The 24 candidate systems we identified include sponges, corals, oysters, crustaceans, sea stars, fishes and sea grasses (among others). To illustrate the other steps, we present a case study of epizootic shell disease (ESD) in the American lobster. Increasing prevalence of ESD is a contributing factor to lobster fishery collapse in southern New England (SNE), raising concerns that disease prevalence will increase in the northern Gulf of Maine under climate change. The lowest maximum bottom temperature associated with ESD prevalence in SNE is 12 °C. Our seasonal outlook for 2015 and long-term projections show bottom temperatures greater than or equal to 12 °C may occur in this and coming years in the coastal bays of Maine. The tools presented will allow managers to target efforts to monitor the effects of ESD on fishery sustainability and will be iteratively refined. The approach and case example highlight that temperature-based surveillance tools can inform research, monitoring and management of emerging and continuing marine disease threats.


Asunto(s)
Monitoreo del Ambiente/métodos , Nephropidae/microbiología , Animales , Océano Atlántico , Cambio Climático , Conservación de los Recursos Naturales , Explotaciones Pesqueras , Predicción , Interacciones Huésped-Patógeno , Maine , Estaciones del Año , Temperatura , Factores de Tiempo
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