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1.
Nurs Sci Q ; 37(2): 181-182, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38491892

RESUMO

This article uses storytelling and poetry to emphasize the core concepts of taking a risk while highlighting the mystique of the Grand Canyon in Arizona.


Assuntos
Comunicação , Humanos , Arizona
2.
Sex Transm Dis ; 51(3): 192-198, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38412466

RESUMO

BACKGROUND: As the incidence of syphilis continues to increase, examining benzathine penicillin G (BPG) treatment data provides valuable insight for public health strategies. This study analyzed the trends of where BPG is administered relative to the initial clinical site of syphilis diagnosis. Our findings are timely in the context of recent national BPG shortages. METHODS: The analysis included persons diagnosed with any syphilis stage in Maricopa County, Arizona, from January 1, 2021, to December 31, 2021. The Arizona surveillance database (PRISM) was the source of demographic, testing, and treatment data. RESULTS: Of a total of 4028 persons with syphilis, 3038 (75.4%) received at least 1 injection of BPG. Among persons who received an initial BPG injection, only 1719 (56.6%) were diagnosed and treated at the same clinical site type. The Maricopa County Sexually Transmitted Disease Clinic administered BPG to 48.8% (n = 1483) of persons with syphilis who received an initial injection. CONCLUSIONS: Our findings analyze trends in BPG administration that are likely due to treatment referral practices and medication cost. Administration of BPG is not guaranteed at the clinical site of diagnosis, highlighting concerns regarding access to BPG. A burden is placed on patients who are required to leave their diagnosing provider to seek syphilis treatment at other health facilities that administer BPG.


Assuntos
Penicilina G Benzatina , Sífilis , Humanos , Penicilina G Benzatina/uso terapêutico , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Sífilis/epidemiologia , Arizona/epidemiologia , Saúde Pública , Instalações de Saúde , Antibacterianos/uso terapêutico
3.
BMC Public Health ; 24(1): 648, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38424548

RESUMO

BACKGROUND: Widespread transmission of COVID-19 continues to threaten public health, particularly of rural, American Indian communities. Although COVID-19 risk factors for severe disease and clinical characteristics are well described in the general population, there has been little shared on hospitalized American Indian populations. METHODS: In this observational study, we performed chart extractions on all persons hospitalized with COVID-19 from April 1 through July 31, 2020 among an exclusively American Indian population living on or near Tribal lands in eastern Arizona. We provide descriptive statistics for the cohort stratified by presentation, comparing those who self-presented or were referred by an outreach program. Exploratory analyses were performed to identify risk factors for morbidity and mortality. RESULTS: During the observation period, 2262 persons were diagnosed with COVID-19 and 490 (22%) were hospitalized. Hospitalized persons had a median age of 54 years; 92% had at least one comorbidity, 72% had greater than one comorbidity, and 60% had a BMI of > 30. Most persons required supplemental oxygen (83%), but the majority (62%) only required nasal cannula and only 11% were intubated. The case fatality rates were 1.7% for the population, 7.1% among hospitalizations, and 9.3% among hospitalized patients 50 years and older. All rates that are significantly lower than those reported nationally during the same period. CONCLUSIONS: We observed a cohort of American Indian patients hospitalized secondary to COVID-19 with greater number of comorbidities compared to the general population but with lower mortality rates. We posit that the primary driver of mortality reduction for this population and the hospitalized cohort was a community-based referral program that led to disproportionately lower fatality rates among the oldest persons.


Assuntos
COVID-19 , Hospitalização , Humanos , Pessoa de Meia-Idade , Indígena Americano ou Nativo do Alasca , Arizona/epidemiologia , Comorbidade , COVID-19/epidemiologia , COVID-19/mortalidade , Fatores de Risco
4.
Sci Total Environ ; 920: 170781, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38360322

RESUMO

Synthetic opioids, particularly the nitazene analogues class, have become a public health concern due to their high potency. Wastewater-based epidemiology can detect community use of these compounds. The objective of this work was to detect nitazene analogues in wastewater from samples collected from eight sites in the United States. Influent wastewater samples were collected from eight sites in seven states (Arizona, Oregon, New Mexico, Illinois, New Jersey, Washington and Georgia) in the United States. Samples were collected from each site on three days between 27 December 2022 and 4 January 2023, acidified on collection, stored frozen and shipped to Arizona State University (Tempe, AZ) for sample processing. Samples were then shipped to The University of Queensland (Brisbane, Australia) for sample analysis. Protonitazene was found in samples collected from two sites in Washington and Illinois. The concentration was estimated up to 0.5 ng/L, with estimated excreted mass loads up to 0.3 mg/day/1000 people. This work has shown that it is possible to detect nitazene analogues in wastewater using a combination of sample pre-concentration and sensitive instrumentation, thereby further expanding the utility of wastewater-based epidemiology.


Assuntos
Drogas Ilícitas , Poluentes Químicos da Água , Humanos , Drogas Ilícitas/análise , Águas Residuárias , Vigilância Epidemiológica Baseada em Águas Residuárias , Austrália , Arizona , Poluentes Químicos da Água/análise
5.
Cancer Med ; 13(3): e7007, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38400688

RESUMO

BACKGROUND: Hispanics and American Indians (AI) have high kidney cancer incidence and mortality rates in Arizona. This study assessed: (1) whether racial and ethnic minority patients and patients from neighborhoods with high social vulnerability index (SVI) experience a longer time to surgery after clinical diagnosis, and (2) whether time to surgery, race and ethnicity, and SVI are associated with upstaging to pT3/pT4, disease-free survival (DFS), and overall survival (OS). METHODS: Arizona Cancer Registry (2009-2018) kidney and renal pelvis cases (n = 4592) were analyzed using logistic regression models to assess longer time to surgery and upstaging. Cox-regression hazard models were used to test DFS and OS. RESULTS: Hispanic and AI patients with T1 tumors had a longer time to surgery than non-Hispanic White patients (median time of 56, 55, and 45 days, respectively). Living in neighborhoods with high (≥75) overall SVI increased odds of a longer time to surgery for cT1a (OR 1.54, 95% CI: 1.02-2.31) and cT2 (OR 2.32, 95% CI: 1.13-4.73). Race and ethnicity were not associated with time to surgery. Among cT1a patients, a longer time to surgery increased odds of upstaging to pT3/pT4 (OR 1.95, 95% CI: 0.99-3.84). A longer time to surgery was associated with PFS (HR 1.52, 95% CI: 1.17-1.99) and OS (HR 1.63, 95% CI: 1.26-2.11). Among patients with cT2 tumor, living in high SVI neighborhoods was associated with worse OS (HR 1.66, 95% CI: 1.07-2.57). CONCLUSIONS: High social vulnerability was associated with increased time to surgery and poor survival after surgery.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Humanos , Etnicidade , Arizona/epidemiologia , Vulnerabilidade Social , Grupos Minoritários , Neoplasias Renais/cirurgia , Rim
6.
Harm Reduct J ; 21(1): 49, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38388463

RESUMO

BACKGROUND: Pharmacies are critical healthcare partners in community efforts to eliminate bloodborne illnesses. Pharmacy sale of sterile syringes is central to this effort. METHODS: A mixed methods "secret shopper" syringe purchase study was conducted in the fall of 2022 with 38 community pharmacies in Maricopa and Pima Counties, Arizona. Pharmacies were geomapped to within 2 miles of areas identified as having a potentially high volume of illicit drug commerce. Daytime venue sampling was used whereby separate investigators with lived/living drug use experience attempted to purchase syringes without a prescription. Investigator response when prompted for purchase rationale was "to protect myself from HIV and hepatitis C." A 24-item instrument measured sales outcome, pharmacy staff interaction (hostile/neutral/friendly), and the buyer's subjective experience. RESULTS: Only 24.6% (n = 28) of 114 purchase attempts across the 38 pharmacies resulted in syringe sale. Less than one quarter (21.1%) of pharmacies always sold, while 44.7% never sold. Independent and food store pharmacies tended not to sell syringes. There emerged distinct pharmacy staff interactions characterized by body language, customer query, normalization or othering response, response to purchase request and closure. Pharmacy discretion and pharmacy policy not to sell syringes without a prescription limited sterile syringe access. Investigators reported frequent and adverse emotional impact due to pharmacy staff negative and stigmatizing interactions. CONCLUSIONS: Pharmacies miss opportunities to advance efforts to eliminate bloodborne infections by stringent no-sale policy and discretion about syringe sale. State regulatory policy facilitating pharmacy syringe sales, limiting pharmacist discretion for syringe sales, and targeting pharmacy-staff level education may help advance the achievement of public health goals to eliminate bloodborne infections in Arizona.


Assuntos
Infecções por HIV , Farmácias , Farmácia , Abuso de Substâncias por Via Intravenosa , Humanos , Infecções por HIV/prevenção & controle , Seringas , Arizona
7.
Sci Rep ; 14(1): 1311, 2024 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-38225347

RESUMO

Coccidioides is the fungal causative agent of Valley fever, a primarily pulmonary disease caused by inhalation of fungal arthroconidia, or spores. Although Coccidioides has been an established pathogen for 120 years and is responsible for hundreds of thousands of infections per year, little is known about when and where infectious Coccidioides arthroconidia are present within the ambient air in endemic regions. Long-term air sampling programs provide a means to investigate these characteristics across space and time. Here we present data from > 18 months of collections from 11 air sampling sites across the Phoenix, Arizona, metropolitan area. Overall, prevalence was highly variable across space and time with no obvious spatial or temporal correlations. Several high prevalence periods were identified at select sites, with no obvious spatial or temporal associations. Comparing these data with weather and environmental factor data, wind gusts and temperature were positively associated with Coccidioides detection, while soil moisture was negatively associated with Coccidioides detection. These results provide critical insights into the frequency and distribution of airborne arthroconidia and the associated risk of inhalation and potential disease that is present across space and time in a highly endemic locale.


Assuntos
Coccidioidomicose , Coccidioidomicose/epidemiologia , Coccidioidomicose/microbiologia , Coccidioides , Arizona/epidemiologia , Tempo (Meteorologia) , Temperatura , Esporos Fúngicos
8.
Public Health Rep ; 139(2): 241-251, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38240272

RESUMO

OBJECTIVES: In May 2021, the Health Resources and Services Administration Health Center COVID-19 Vaccine Program (HCCVP) began supporting the national adolescent vaccination rollout for a safe return to in-person learning for children and adolescents from medically underserved communities. To understand the initial implementation of adolescent vaccinations, we estimated the number of vaccines administered through the HCCVP at the national and state level to adolescents aged 12-17 years, and we examined challenges and solutions in vaccine deployment. METHODS: We analyzed data on vaccine administration, challenges, and solutions from the Health Center COVID-19 Survey during May 14-August 27, 2021, and we analyzed data on patients served from the 2019 Uniform Data System. National adolescent COVID-19 vaccination and population data came from CDC's COVID Data Tracker and the US Census Bureau's 2019 Current Population Survey. RESULTS: HCCVP health centers administered >485 000 COVID-19 vaccine doses to adolescents during the study period, with variations across states. Health centers in 13 states and territories (Arizona, California, Colorado, Connecticut, Delaware, Maine, Massachusetts, Missouri, Nebraska, Nevada, Oregon, Virginia, and Puerto Rico) vaccinated more adolescents than their share of prepandemic adolescent patients. The most frequently reported challenges in vaccine administration were vaccine confidence and staffing availability. CONCLUSIONS: This assessment of the initial months of COVID-19 vaccine administration among adolescent health center patients suggests rapid response by health centers in several states, reaching beyond their adolescent patient population to support state-level pandemic response. Future research could examine processes to optimize strategic activation of health centers in public health emergency responses.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Adolescente , Criança , Estados Unidos/epidemiologia , Área Carente de Assistência Médica , COVID-19/epidemiologia , COVID-19/prevenção & controle , Arizona , Vacinação , Inquéritos Epidemiológicos
9.
BMC Public Health ; 24(1): 225, 2024 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-38238751

RESUMO

BACKGROUND: In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not. METHODS: PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess. RESULTS: Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one. CONCLUSIONS: Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.


Assuntos
Exercício Físico , Instituições Acadêmicas , Criança , Humanos , Arizona , Atividades de Lazer , Acelerometria
10.
Nutrients ; 16(2)2024 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-38257106

RESUMO

To support families during the COVID-19 pandemic, the USDA allowed all US schools to offer meals at no cost regardless of family income, a policy referred to as Universal Free Meals or Healthy School Meals for All (HSM4A). Despite the recognized benefits and popularity of HSM4A during the pandemic, the policy expired in June 2022. The goal of this study was to gather perceptions of parents in Arizona about school meals, the HSM4A program, and the discontinuation of HSM4A. In collaboration with a local anti-hunger group, using an online survey distributed in September and October 2022, we collected data from a diverse sample of over 2000 parents living in Arizona. Parents unequivocally supported HSM4A during the pandemic (97%) and expressed support for continuing to offer HSM4A (95%). High levels of support were seen across all groups in the study, including from individuals who identified as politically conservative. We also analyzed 750 responses to an open-ended question asking respondents to share their thoughts about offering meals to all Arizona students regardless of family income. The majority of emergent themes related to perceived benefits of HSM4A, including reducing financial burden and stress for families. Our findings will be useful for advocates and policy makers considering HSM4A legislation.


Assuntos
COVID-19 , Pandemias , Humanos , Arizona , Refeições , Pais
11.
J Econ Entomol ; 117(1): 280-292, 2024 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-38007391

RESUMO

The alfalfa weevil (Hypera postica Gyllenhal (Coleoptera: Curculionidae)), a key pest of alfalfa (Medicago sativa L. (Fabales: Fabacae)) across the US, has developed resistance to pyrethroids lambda-cyhalothrin and zeta-cypermethrin in at least 6 western US states. Unfortunately, 6 pyrethroid active ingredients represent most commercial insecticides registered for alfalfa weevil control in forage alfalfa systems. Thus, the loss of efficacy of this mode of action group due to multiple resistance represents a significant agricultural challenge because of a limited registered alternative mode of actions. To evaluate the extent and severity of resistance among pyrethroids around the United States, laboratory bioassays using larvae from Arizona, California, Montana, Oregon, Washington, and Wyoming, including both the Egyptian and western strains, were conducted. Results indicated that similar degrees of resistance among type II pyrethroids as determined by both laboratory bioassays and field trials exist. The LC50 values of alpha-cypermethrin, beta-cyfluthrin and zeta-cypermethrin produced significant correlations with the LC50 values of lambda-cyhalothrin. In contrast, resistance did not include type I pyrethroid, bifenthrin (registered for seed alfalfa production), whose LC50 values yielded a slope not significantly different from zero when correlated with lambda-cyhalothrin. Field trials conducted in Arizona, Montana, and Washington corroborated laboratory results, as commercial formulations with type II pyrethroid active ingredients failed to adequately control alfalfa weevils resistant to lambda-cyhalothrin. Integrated resistance management recommendations are discussed.


Assuntos
Besouros , Inseticidas , Nitrilas , Piretrinas , Gorgulhos , Animais , Inseticidas/farmacologia , Medicago sativa , Arizona , Resistência a Inseticidas
12.
Am J Prev Med ; 66(1): 138-145, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37739192

RESUMO

INTRODUCTION: Coprescribing naloxone with opioids could reduce the risk of overdose. By the end of 2020, 8 U.S. states implemented coprescribing laws requiring the prescription of naloxone alongside certain opioid prescriptions. This study examined the impacts of state laws that require coprescribing opioids and naloxone on codispensing practices. METHODS: Data included opioid prescriptions for commercially insured adults between 2014 and 2020. Augmented synthetic control analyses were used to examine the impacts of 8 coprescribing requirement laws implemented between 2017 and 2020 on the proportion of opioid prescription fills with a naloxone coprescription fill. Analyses were completed in spring 2023. RESULTS: Changes in the proportion of opioid prescription fills with a naloxone coprescription fill attributable to the laws varied across states. In 4 states (New Jersey, New Mexico, Rhodes Island, and Virginia), laws were associated with 0.8 (95% CI=0.3, 1.3) to 4.4 (95% CI=3.4, 5.4) percentage point increases in the proportion of opioid prescriptions with a naloxone coprescription fill (p<0.05). There were no statistically significant changes attributable to the other state laws (Arizona, Florida, Vermont, Washington). CONCLUSIONS: Laws requiring coprescribing naloxone with certain opioid prescriptions are associated with small-in-magnitude increases in codispensing in some states. Broadening the categories of opioid prescriptions covered in naloxone coprescribing requirement laws and implementing health system strategies to encourage providers to coprescribe naloxone could help to magnify the impacts of these laws.


Assuntos
Overdose de Drogas , Naloxona , Adulto , Humanos , Estados Unidos , Analgésicos Opioides/uso terapêutico , Prescrições , Overdose de Drogas/tratamento farmacológico , Overdose de Drogas/prevenção & controle , Arizona , Antagonistas de Entorpecentes
13.
Eur J Clin Nutr ; 78(1): 27-33, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37833567

RESUMO

OBJECTIVE: The existence of seasonal changes in energy metabolism is uncertain. We investigated the relationship between the seasons and spontaneous physical activity (SPA), energy expenditure (EE), and other components measured in a respiratory chamber. METHODS: Between 1985-2005, 671 healthy adults (aged 28.8 ± 7.1 years; 403 men) in Phoenix, Arizona had a 24-hour stay in the respiratory chamber equipped with radar sensors; SPA (expressed as a percentage over the time interval), the energy cost of SPA, EE, and respiratory exchange ratio (RER) were measured. RESULTS: In models adjusted for known covariates, SPA (%) was lower during summer (7.2 ± 2.9, p = 0.0002), spring (7.5 ± 2.9, p = 0.025), and fall (7.6 ± 3, p = 0.038) compared to winter (8.3 ± 3.5, reference). Conversely, energy cost of SPA (kcal/h/%) was higher during summer (2.18 ± 0.83, p = 0.0008), spring (2.186 ± 0.83, p = 0.017), and fall (2.146 ± 0.75, p = 0.038) compared to winter (2.006 ± 0.76). Protein (292 ± 117 kcal/day, ß = -21.2, p = 0.08) oxidation rates was lower in the summer compared to winter. Carbohydrate and lipid oxidation rates (kcal/day) did not differ across seasons. RER and 24-h EE did not differ by season. CONCLUSION: SPA, representing fidgeting-like behavior in the chamber, demonstrated a winter peak and summer nadir in humans living in a desert climate. These findings indicate that the physiological propensity for movement may be affected by seasonal factors. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifiers: NCT00340132, NCT00342732.


Assuntos
Metabolismo Energético , Exercício Físico , Adulto , Masculino , Humanos , Arizona , Metabolismo Energético/fisiologia , Exercício Físico/fisiologia , Oxirredução , Estações do Ano
14.
Psychiatr Serv ; 75(2): 148-154, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-37554005

RESUMO

OBJECTIVE: In July 2022, the 988 Suicide and Crisis Lifeline went live. The Lifeline is part of larger federal and state efforts to build comprehensive behavioral health crisis response systems that include mobile crisis units and crisis diversion and stabilization centers. Comprehensive response systems are anticipated to reduce hospitalizations for suicide and other behavioral health crises; however, research testing this assumption has been limited. The authors used Arizona-a state known for its comprehensive crisis system-to determine the association between state implementation of a comprehensive behavioral health crisis response system and suicide-related hospitalizations. METHODS: A comparative interrupted time-series (CITS) design was used to compare changes in suicide-related hospitalizations after the 2015 implementation of Arizona's crisis response system (N=215,063). Data were from the 2010-2019 Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID). Nevada (N=84,091 hospitalizations) was used as a comparison state because it is a western state that had not yet implemented a comprehensive crisis system and had available HCUP SID data. The CITS model included controls for time-varying differences in state demographic composition. RESULTS: From 2010 to 2014 to 2019, annual suicide-related hospitalizations in Arizona increased from 122.0 to 324.2 to 584.5, respectively, per 100,000 people, and in Nevada, hospitalizations increased from 94.7 to 263.2 to 595.5, respectively, per 100,000 people. Arizona's crisis response system was associated with a significant relative decrease in the quarterly trend of 2.57 suicide-related hospitalizations per 100,000 people (p=0.033). CONCLUSIONS: More research is needed to understand how the implementation of a comprehensive crisis response system may affect suicide-related hospitalizations.


Assuntos
Suicídio , Humanos , Arizona/epidemiologia , Custos de Cuidados de Saúde , Hospitalização , Demografia
15.
J Public Health Manag Pract ; 30(1): 79-88, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37966952

RESUMO

OBJECTIVE: To identify skills, organizational practices, and infrastructure needed to address health equity. DESIGN, SETTING, AND PARTICIPANTS: We developed an anonymous online staff survey to assess how to address health equity and policy implications and develop a baseline for future initiatives. We distributed invitations to all Arizona Department of Health Services (ADHS) Division of Prevention Services (DPS) state- and non-state-designated employees in February 2021. MAIN OUTCOME MEASURES: Employee self-reported perceptions of how agency, division, and programs address health inequities; information about (1) organizational and individual traits needed to support our ability to implement effective health equity-focused work and (2) processes to enable improved organizational and workforce capacities; and implications for strategic planning. RESULTS: Seventy-eight percent (N = 123) of eligible staff participated. Overall, we identified 21 of 28 organizational and 17 of 31 workforce capacities needing significant improvement. Organizational capacities were "Institutional commitment to address health inequities" (described using 6 elements), "Hiring to address health inequities" (2 elements), "Structure that supports true community partnerships" (3 elements), "Support staff to address health inequities" (4 elements), "Transparent and inclusive communication" (4 elements), "Community accessible data and planning" (1 element), and "Streamlined administrative process" (1 element). Workforce capacities were "Knowledge of public health framework" (4 elements), "Understand the social, environmental, and structural determinants of health" (1 element), "Community knowledge" (1 element), "Leadership" (4 elements), "Collaboration skills" (3 elements), "Community organizing" (3 elements), and "Problem-solving ability" (1 element). Using survey results, groups of staff identified change needed, specific actions, and training and communication to increase employee understanding. Proposed activities focused on data/evaluation, program planning/contracts, communications, personnel development, and community engagement. CONCLUSIONS: This survey allowed ADHS to establish a baseline of staff knowledge of the ADHS and DPS organizational commitment to address health inequities; results show us what areas to focus on to strengthen our capacity to achieve better outcomes; and improve health and wellness for all Arizonans.


Assuntos
Equidade em Saúde , Cultura Organizacional , Humanos , Arizona , Saúde Pública , Serviços Preventivos de Saúde
16.
Sex Transm Dis ; 51(3): 156-161, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38100793

RESUMO

BACKGROUND: The United States has seen a significant rise in syphilis over the past 20 years with a disparate impact on American Indian communities. We conducted a thorough review of the local epidemiology that guided an innovative response to curb the epidemic. METHODS: We analyzed syphilis data from a hospital in rural Arizona that serves an American Indian population of more than 18,000. Testing data were extracted from 2017 to 2023 with detailed chart reviews of all reactive results since January 2022. Descriptive and comparative statistics were computed using parametric and nonparametric methods where appropriate. RESULTS: Among 5888 tested persons, 555 (9.4%) had reactive results and 277 (4.7%) represented new infections. Among new cases, 151 (54.5%) were female and 55 (19.9%) were reinfections. The annualized incidence rate was 10.0 cases per 1000 persons with peak annualized incidence among women aged 30 to 34 years of 22.6 infections per 1000 persons. During the observation period and after the implementation of programmatic changes in June 2022, there were statistically significant reductions in median time to treatment (-80%), test positivity (-70%), infections (-60%), and no congenital syphilis cases during the observation period. CONCLUSIONS: We observed significantly elevated syphilis rates in American Indian/Alaska Native persons compared with the general population. Strategic implementation of new policies and practices led to a measurable and meaningful improvement in several epidemic variables, and our experience may serve as a model to other communities.


Assuntos
Índios Norte-Americanos , Sífilis , Feminino , Humanos , Masculino , Arizona/epidemiologia , Sífilis/epidemiologia , Sífilis/prevenção & controle , Adulto
17.
Arch Virol ; 169(1): 12, 2023 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-38151635

RESUMO

Coyotes (Canis latrans) have a broad geographic distribution across North and Central America. Despite their widespread presence in urban environments in the USA, there is limited information regarding viruses associated with coyotes in the USA and in particular the state of Arizona. To explore viruses associated with coyotes, particularly small DNA viruses, 44 scat samples were collected (April-June 2021 and November 2021-January 2022) along the Salt River near Phoenix, Arizona (USA), along 43 transects (500 m). From these samples, we identified 11 viral genomes: two novel circoviruses, six unclassified cressdnaviruses, and two anelloviruses. One of the circoviruses is most closely related to a circovirus sequence identified from an aerosolized dust sample in Arizona, USA. The second circovirus is most closely related to a rodent-associated circovirus and canine circovirus. Of the unclassified cressdnaviruses, three encode replication-associated proteins that are similar to those found in protists (Histomonas meleagridis and Monocercomonoides exilis), implying an evolutionary relationship with or a connection to similar unidentified protist hosts. The two anelloviruses are most closely related to those found in rodents, and this suggests a diet-related identification.


Assuntos
Coiotes , DNA Circular , Animais , Cães , Arizona , Vírus de DNA/genética
18.
Igaku Butsuri ; 43(3): 88-104, 2023.
Artigo em Japonês | MEDLINE | ID: mdl-37967969
19.
Environ Monit Assess ; 195(12): 1496, 2023 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-37982889

RESUMO

This investigation examines the transport of metal- and pesticide-polluted dust emitted by one of the most relevant agricultural areas of Northwestern Mexico. In the contaminated area, an excessive water extraction of the aquifer and seawater intrusion caused the abandonment of fields, which are pollutant-loaded dust emitters. We used air mass forward trajectories (HYSPLIT) model to obtain particle trajectories in the wind and the use of banned pesticides as geochemical tracers for dust transported by wind. Fifty dust samples from 10 agriculture fields and 26 roof dust of a city close to the agricultural area were analyzed for their contents of zirconium, lead, arsenic, zinc, copper, iron, manganese, vanadium, and titanium, by portable X-ray fluorescence. Nine pesticides were analyzed in the roof dust and agricultural soil samples by gas chromatography. Results show that the distribution of metals was significantly different between active and abandoned fields. Arsenic-lead-copper was mainly concentrated in abandoned fields, while zinc-iron-manganese-titanium was dominant in active fields. Two potential sources of metal contamination were found by principal component analysis (PCA): (I) a mixture of traffic and agricultural sources and (II) a group related to agricultural activities. The occurrence of banned pesticides in dust deposited on roofs collected at nearby cities confirms the atmospheric transport from the agricultural area. The HYSPLIT results indicated that the dust emitted from agricultural fields can reach up to the neighboring states of Sonora, Mexico, and the USA. The impacts that these emissions can have on human health should be studied in future research.


Assuntos
Arsênio , Praguicidas , Humanos , Cobre , Manganês , Titânio , Arizona , Monitoramento Ambiental , Agricultura , Metais , Zinco , Ferro , Poeira
20.
PLoS One ; 18(11): e0289060, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38011106

RESUMO

Fall armyworm (FAW) is a global agricultural pest, causing substantial economic losses in corn and many other crops. Complicating efforts to control this pest is its capacity for long distance flights, which has been described in greatest detail for the central and eastern sections of the United States. FAW infestations are also routinely found in agricultural areas in southern Arizona, which lie beyond the western limits of the mapped migratory pathways. Climate suitability analysis found that the affected Arizona locations cannot support permanent FAW populations, indicating that these FAW most likely arise from annual migrations. A better understanding of this migration would provide insights into how large moth populations can move across desert habitats as well as the degree of gene flow occurring between FAW populations across the North American continent. In this study the Arizona populations were genetically characterized and compared to a selection of permanent and migratory FAW from multiple sites in the United States and Mexico. The results are consistent with migratory contributions from permanent populations in the states of Texas (United States) and Sinaloa (Mexico), while also providing evidence of significant barriers to gene flow between populations within Mexico. An unexpected finding was that two genetically distinct FAW subpopulations known as "host strains" have a differential distribution in the southwest that may indicate significant differences in their migration behavior in this region. These findings indicate that the combination of mitochondrial and Z-linked markers have advantages in comparing FAW populations that can complement and extend the findings from other methods.


Assuntos
Migração Animal , Zea mays , Animais , Texas , México , Spodoptera/genética , Arizona
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