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1.
Data Brief ; 34: 106723, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33521176

RESUMEN

Oxygen-18 and deuterium were measured in streamflow samples collected from 331 gauging stations across Canada during 2013 to 2019. This dataset includes 9206 isotopic analyses made on 4603 individual water samples, and an additional 1259 analysis repeats for quality assurance/quality control. We also include arithmetic and flow-weighted averages, and other basic statistics for stations where adequate data were available. Station data are provided including station code, name, province, latitude, longitude and drainage area. Flow data were extracted from the historical database of the Water Survey of Canada. Details on the preliminary application of these data are provided in "18O and 2H in streamflow across Canada" [1]. Overall, these data are expected to be useful when combined with precipitation datasets and analytical or numerical models for water resource management and planning, including tracing streamflow source, water balance, evapotranspiration partitioning, residence time analysis, and early detection of climate and land use changes in Canada.

2.
Data Brief ; 29: 105308, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32154345

RESUMEN

Watershed data, climate and stable data collected over a 16-year period from a network of 50 lakes in northeastern Alberta, are provided to allow for broader incorporation into regional assessments of environmental impacts, particularly hydrologic and geochemical processes under changing climate and land use development. Oxygen-18 and deuterium analyses of water samples are provided from late summer surveys of 50 lakes with varying land cover and permafrost conditions. Six sub-groups of lakes are represented, including Stony Mountains, West Fort McMurray, Northeast Fort McMurray, Birch Mountains, Caribou Mountains and Shield. This dataset includes 1582 isotopic analyses made on 791 water samples and 3164 isotope mass balance model outputs, as well as 800 lake/watershed parameters, 5600 climate parameters, and 800 modelled values for isotopic composition of precipitation used in the computations. Model data are provided to facilitate evaluation of transferability of the model for other applications, and to permit more sophisticated spatial analysis and intercomparison with geochemical and biological datasets. Details and further discussion on the isotope mass balance approach are provided in "Regional trends in water balance and runoff to fifty boreal lakes: a 16-year isotope mass balance assessment including evaluation of hydrologic drivers" [1]. Overall, the data are expected to be useful, in comparison with local and regional datasets, for water resource management and planning, including design of monitoring networks and environmental impact assessments for oil sands projects.

3.
Sci Total Environ ; 689: 1276-1292, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31466165

RESUMEN

A spatially distributed network of thermokarst lakes undergoing significant environmental changes was sampled in 2014 and 2016 to develop a comprehensive understanding of lake water balances in lakes across a gradient of frozen ground conditions. Frozen ground ranges from seasonally frozen ground (SFG) to sporadic discontinuous permafrost (SDP) to extensive discontinuous permafrost (EDP), and is representative of complex conditions in the Source Area of the Yellow River, northeastern part of Qinghai-Tibet Plateau. Radioactive and stable water isotopes in reference lakes (non-thaw lakes), thermokarst lakes, precipitation, wetlands, ground ice and supra-permafrost groundwater are analyzed to characterize systematic variations and to assess lake water balances using stable isotope mass balance (IMB). IMB, paired with analysis of tritium decay gradients, is shown to be a valid approach for detecting short-term shifts in lake water balance, which allows evaluation of the proportion of precipitation-derived versus permafrost-derived water inputs to lakes. All lakes except EDP thaw lakes are evaporation-dominated (E/I > 0.5). Negative water balances occurred most frequently in reference lakes due to hydrological connectivity with rivers. Precipitation-derived water inputs result in positive water balances in SFG and SDP thermokarst lakes, but negative-trending water balances are found in SDP thermokarst lakes due to substantial reduction in water yield. Increasing contributions from thawing permafrost in EDP thermokarst lakes result in strong positive water balance. Permafrost degradation may also lead to the changes in hydrological connectivity between precipitation and wetlands or thermokarst lakes. Based on these findings, a conceptual model of the hydrological evolution of thermokarst lakes under the influence of permafrost degradation is proposed.

4.
Data Brief ; 22: 781-786, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30766899

RESUMEN

Oxygen-18 and deuterium analyses of water samples are provided from a regional survey of lakes, wetlands, soil waters, groundwaters, and snowpack samples collected in the Southern Athabasca Oil Sands (SAOS) region, Alberta, Canada, mainly during 2007-2009. Lake, wetland, and river sampling were conducted by helicopter during late summer, capturing conditions close to peak evaporative enrichment. Shallow soil water from the unsaturated zone was also collected in late summer, whereas deeper groundwaters from Quaternary aquifers, Quaternary channels, and uppermost Cretaceous strata, were collected primarily as part of winter drilling programs by industrial partners. Snowpack samples were collected in late March/early April, prior to significant spring melt. This dataset includes 1576 isotopic analyses made on 788 water samples as well as selected isotope mass balance model outputs (lake evaporation/inflow and water yield to lakes). These basic model data are provided to facilitate evaluation of the method as a tool for spatial mapping of water yield and its interannual variability. Details and further discussion on the isotope mass balance approach are provided in "Mapping water yield distribution across the southern Athabasca Oil Sands area: baseline surveys applying isotope mass balance of lakes" (Gibson et al., 2019). Overall, the data are expected to be useful, in comparison with local and regional datasets, for water resource management and planning, including design of monitoring networks and environmental impact assessments for oil sands projects.

5.
Sci Total Environ ; 603-604: 570-583, 2017 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-28646776

RESUMEN

The composition of polycyclic aromatic hydrocarbons present in snow and surface waters in the Athabasca Oil Sands Region (AOSR) was characterized in order to identify major contributors to the organics detected in rivers and lakes in the region. PAH concentrations, measured by three monitoring programs in 2011, were used to compare the PAH compositions of snow and surface waters across the AOSR. The 2011 dataset includes total (dissolved+particulate) concentrations of thirty-four parent and alkylated PAH compounds in 105 snow, 272 river, and 3 lake samples. The concentration of PAHs in rivers varies seasonally, with the highest values observed in July. The timing of increases in PAH concentrations in rivers coincides with the high river discharge during the spring freshet, indicating that this major hydrological event may play an important role in delivering PAHs to rivers. However, the composition of PAHs present in rivers during this period differs from the composition of PAHs present in snow, suggesting that direct runoff and release of PAHs accumulated on snow may not be the major source of PAHs to the Athabasca River and its tributaries. Instead, snowmelt may contribute indirectly to increases in PAHs due to hydrological processes such as erosion of stream channels, remobilization of PAH-containing sediments, increased catchment runoff, and snowmelt-induced groundwater inputs during this dynamic hydrologic period. Better understanding of transformations of PAH profiles during transport along surface and subsurface flow paths in wetland-dominated boreal catchments would improve identification of potential sources and pathways in the region. The compositional differences highlight the challenges in identifying the origins of PAHs in a region with multiple potential natural and anthropogenic sources particularly when the potential transport pathways include air, soil and water.


Asunto(s)
Monitoreo del Ambiente , Yacimiento de Petróleo y Gas , Hidrocarburos Policíclicos Aromáticos/análisis , Ríos/química , Nieve/química , Contaminantes Químicos del Agua/análisis , Alberta , Atmósfera , Sedimentos Geológicos/química
6.
Rapid Commun Mass Spectrom ; 29(13): 1215-26, 2015 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-26395605

RESUMEN

RATIONALE: Storage trials were conducted for 2 to 3 months using a hydrocarbon and carbon dioxide gas mixture with known carbon isotopic composition to simulate typical hold times for gas samples prior to isotopic analysis. A range of containers (both pierced and unpierced) was periodically sampled to test for δ(13)C isotopic fractionation. METHODS: Seventeen containers were tested for free-gas storage (20°C, 1 atm pressure) and 7 containers were tested for dissolved-gas storage, the latter prepared by bubbling free gas through tap water until saturated (20°C, 1 atm) and then preserved to avoid biological activity by acidifying to pH 2 with phosphoric acid and stored in the dark at 5°C. Samples were extracted using valves or by piercing septa, and then introduced into an isotope ratio mass spectrometer for compound-specific δ(13)C measurements. RESULTS: For free gas, stainless steel canisters and crimp-top glass serum bottles with butyl septa were most effective at preventing isotopic fractionation (pierced and unpierced), whereas silicone and PTFE-butyl septa allowed significant isotopic fractionation. FlexFoil and Tedlar bags were found to be effective only for storage of up to 1 month. For dissolved gas, crimp-top glass serum bottles with butyl septa were again effective, whereas silicone and PTFE-butyl were not. FlexFoil bags were reliable for up to 2 months. CONCLUSIONS: Our results suggest a range of preferred containers as well as several that did not perform very well for isotopic analysis. Overall, the results help establish better QA/QC procedures to avoid isotopic fractionation when storing environmental gas samples. Recommended containers for air transportation include steel canisters and glass serum bottles with butyl septa (pierced and unpierced).

7.
Sci Total Environ ; 518-519: 148-58, 2015 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-25747374

RESUMEN

This study was conducted to characterize the composition of dissolved organic compounds present in snow and surface waters in the Athabasca Oil Sands Region (AOSR) with the goal of identifying whether atmospherically-derived organic compounds present in snow are a significant contributor to the compounds detected in surface waters (i.e., rivers and lakes). We used electrospray ionization Fourier transform ion cyclotron resonance mass spectrometry (ESI-FTICR MS) to characterize the dissolved organic compound compositions of snow and surface water samples. The organic profiles obtained for the snow samples show compositional differences between samples from near-field sites (<5 km from oil sands activities) and those from more distant locations (i.e., far-field sites). There are also significant compositional differences between samples collected in near-field sites and surface water samples in the AOSR. The composition of dissolved organic compounds at the upstream Athabasca River site (i.e., Athabasca River at Athabasca) is found to be different from samples obtained from downstream sites in the vicinity of oil sands operations (i.e., Athabasca River at Fort McMurray and Athabasca River at Firebag confluence). The upstream Athabasca River sites tended to share some compositional similarities with far-field snow deposition, while the downstream Athabasca River sites are more similar to local lakes and tributaries. This contrast likely indicates the relative role of regional snowmelt contributions to the Athabasca River vs inputs from local catchments in the reach downstream of Fort McMurray.


Asunto(s)
Monitoreo del Ambiente/métodos , Yacimiento de Petróleo y Gas , Ríos/química , Nieve/química , Contaminantes Químicos del Agua/análisis , Alberta , Análisis de Fourier , Espectrometría de Masas
8.
Int J Obes (Lond) ; 31(4): 644-51, 2007 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16969360

RESUMEN

OBJECTIVE: We examined having a TV in the bedroom as a risk factor for child overweight. DESIGN: Cross-sectional study. SETTING: School- and telephone-based surveys in New Hampshire and Vermont between 2002 and 2004. PARTICIPANTS: Two thousand three hundred and forty-three children enrolled in public schools, aged 9-12 years, and one of their parents. MAIN EXPOSURES: The child having a TV in the bedroom. MAIN OUTCOME MEASURES: Age- and gender-standardized child body mass index (zBMI). Overweight was defined as equal to or above the 95th percentile for zBMI. RESULTS: Overall, 22.3% (N=523) of the children were overweight, and almost half of all children (48.2%, N=1130) had a TV in their bedroom. Children with a TV in their bedroom had a higher zBMI and were significantly more likely to be overweight compared to those without a TV in their bedroom (27.3 versus 17.7%, respectively; P<0.05). After controlling for sociodemographics, physical activity, frequency of TV or movie watching and internet use, children with a TV in their bedroom who watched at least one session of TV or movies per day were more likely to be overweight compared to those without a TV in their bedroom (odds ratio=1.32, 95% confidence interval: 1.03, 1.70). CONCLUSIONS: Having a TV in the bedroom is a risk factor for child overweight, independent of reported physical activity, participation in team sports, TV or movie watching time and internet use at home. Further study is needed to fully understand the mechanism by which having a TV in the bedroom increases children's risk for overweight.


Asunto(s)
Sobrepeso , Televisión , Índice de Masa Corporal , Niño , Conducta Infantil/fisiología , Conducta Infantil/psicología , Estudios Transversales , Ejercicio Físico/fisiología , Femenino , Humanos , Estilo de Vida , Masculino , New Hampshire/epidemiología , Sobrepeso/fisiología , Vigilancia de la Población , Recreación , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Vermont/epidemiología
9.
Undersea Hyperb Med ; 33(1): 17-25, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16602253

RESUMEN

Hyperbaric oxygen (HBO2) increases wound oxygen delivery, but few data quantify wound oxygen levels over the course of healing. We characterized these changes during and after HBO2 treatment in a rat wound model. The treatment group (n=7) received 2.0 ATA HBO2, 90 minutes BID for 15 days. Control rats (n=5) were only exposed to HBO2 during measurement. On days 5, 10, and 15, wound pO2 was measured before, during, and for an hour after HBO2 treatment. Both the peak pO2 and the pO2 one hour after HBO2 treatment were significantly greater than baseline on all days in both the treatment (p < .01) and control group (p < .05). The peak pO2 during HBO2 exposure and one hour after decreased significantly in the treatment group on day 15 compared to day 5 (p <.01, p <.05 respectively). No significant differences were found in pO2 values between days within the control group. These results demonstrate that both the peak wound oxygen levels and duration of elevation change significantly throughout the course of HBO2 treatment.


Asunto(s)
Oxigenoterapia Hiperbárica , Oxígeno/metabolismo , Cicatrización de Heridas , Heridas y Lesiones/metabolismo , Animales , Área Bajo la Curva , Femenino , Presión Parcial , Ratas , Ratas Sprague-Dawley
10.
Environ Monit Assess ; 113(1-3): 167-97, 2006 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-16520874

RESUMEN

The Northern Rivers Ecosystem Initiative (NREI) was established in the late 1990s to address important science questions resulting from previous studies undertaken by the Northern Rivers Basin Study (NRBS). This manuscript summarizes the results from a number of reports on hydrologic research conducted on the Peace-Athabasca-Slave river and lake systems. Specific concerns expressed by the NRBS and subsequent NREI focused on how these systems were being affected by climate change, flow regulation and land-use changes. Issues addressed in this report include: the fate of aquatic perched basins within the Peace-Athabasca Delta under historical and future climate trends; the sources of major floods that replenish these basins and how the frequency, magnitude and source areas of such events have changed over time; the synoptic weather patterns and atmospheric teleconnections that are responsible for the generation of major snowmelt runoff that drive major floods; the potential effect that climate and land-use changes might have on basin runoff and delta lake levels; the specific hydro-climatic conditions required to produce major ice-jam floods on the Peace River and how these may be altered by climate change; remote-sensing methods to document delta flooding and vegetation change; and the dual effect of climate and flow regulation on the water levels of Great Slave Lake and how these may affect other nearshore processes, particularly wind seiches, that influence flooding of the Slave River Delta. A review of the major findings and recommendations for future research concludes the report.


Asunto(s)
Clima Frío , Conservación de los Recursos Naturales , Ecosistema , Monitoreo del Ambiente/métodos , Ríos , Movimientos del Agua , Canadá
11.
Isotopes Environ Health Stud ; 41(1): 49-68, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15823857

RESUMEN

Monitoring of stable water isotopes (18O and 2H) in precipitation and surface waters in the Mackenzie River basin of northern Canada has created new opportunities for researchers to study the complex hydrology and hydroclimatology of this remote region. A number of prior studies have used stable isotope data to investigate aspects of the hydrological regime of the wetland-dominated terrain near Fort Simpson, Northwest Territories, Canada. The present paper compares estimates of groundwater contributions to streamflow derived using the WATFLOOD distributed hydrological model, equipped with a new water isotope tracer module, with the results of conventional isotope hydrograph separation for five wetland-dominated catchments along the lower Liard River. The comparison reveals highly promising agreement, verifying that the hydrological model is simulating groundwater flow contributions to total streamflow with reasonable fidelity, especially during the crucial snowmelt period. Sensitivity analysis of the WATFLOOD simulations also reveals intriguing features about runoff generation from channelized fens, which may contribute less to streamflow than previously thought.


Asunto(s)
Isótopos de Oxígeno/análisis , Ríos , Movimientos del Agua , Contaminantes del Agua/análisis , Abastecimiento de Agua , Canadá , Ecosistema , Modelos Químicos , Nieve , Factores de Tiempo
12.
Sex Transm Dis ; 28(9): 497-503, 2001 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11518865

RESUMEN

BACKGROUND AND GOAL: In areas with persistent syphilis, to characterize persons at higher risk for transmitting syphilis. STUDY DESIGN: Cohort study. Structured interviews of persons with early syphilis from four research centers were linked to outcomes of partner tracing. RESULTS: Of 743 persons with syphilis, 229 (31%) reported two or more partners in the previous month, and 57 (8%) received money or drugs for sex in the previous three months. Persons with at least one partner at an earlier stage of syphilis than themselves were defined as transmitters; 63 (8.5%) of persons with early syphilis met this definition. Having concurrent partners (two or more in one week in the last month) was independently associated with being a transmitter. CONCLUSION: Sexual network/behavioral characteristics of syphilis patients and their partners, such as concurrency, can help identify persons at higher risk for transmitting syphilis who should receive emphasis in disease prevention activities.


Asunto(s)
Conducta Sexual/estadística & datos numéricos , Parejas Sexuales , Sífilis/transmisión , Adulto , Negro o Afroamericano/estadística & datos numéricos , Asiático/estadística & datos numéricos , Estudios de Cohortes , Transmisión de Enfermedad Infecciosa , Femenino , Programas de Gobierno , Humanos , Modelos Logísticos , Louisiana/epidemiología , Masculino , Persona de Mediana Edad , Mississippi/epidemiología , Medición de Riesgo , Factores de Riesgo , South Carolina/epidemiología , Sífilis/epidemiología , Sífilis/prevención & control , Texas/epidemiología , Población Blanca/estadística & datos numéricos
13.
Arch Surg ; 135(11): 1293-7, 2000 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11074883

RESUMEN

HYPOTHESIS: Hyperbaric oxygen (HBO) therapy increases vascular endothelial growth factor (VEGF) levels in wounds. DESIGN: Wounds were monitored for oxygen delivery during HBO treatment, and wound fluids were analyzed for VEGF and lactate on days 2, 5, and 10 following wounding. SETTING: Experimental animal model. INTERVENTIONS: Rats were randomized to HBO therapy and control groups. The HBO therapy was administered for 90 minutes, twice daily with 100% oxygen at 2.1 atmospheres absolute. Treatment was administered for 7 days following wounding. MAIN OUTCOME MEASURES: Vascular endothelial growth factor, PO(2), and lactate levels in wound fluid were measured on days 2, 5, and 10. RESULTS: Wound oxygen rises with HBO from nearly 0 mm Hg to as high as 600 mm Hg. The peak level occurs at the end of the 90-minute treatment, and hyperoxia of lessening degree persists for approximately 1 hour. The VEGF levels significantly increase with HBO by approximately 40% 5 days following wounding and decrease to control levels 3 days after exposures are stopped. Wound lactate levels remain unchanged with HBO treatment (range, 2.0-10.5 mmol/L). CONCLUSIONS: Increased VEGF production seems to explain in part the angiogenic action of HBO. This supports other data that hypoxia is not necessarily a requirement for wound VEGF production.


Asunto(s)
Factores de Crecimiento Endotelial/metabolismo , Oxigenoterapia Hiperbárica , Linfocinas/metabolismo , Cicatrización de Heridas , Animales , Hiperoxia/metabolismo , Ácido Láctico/metabolismo , Masculino , Neovascularización Fisiológica , Oxígeno/análisis , Isoformas de Proteínas , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Factores de Tiempo , Factor A de Crecimiento Endotelial Vascular , Factores de Crecimiento Endotelial Vascular
15.
Infect Control Hosp Epidemiol ; 19(3): 162-7, 1998 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-9552183

RESUMEN

OBJECTIVE: To identify the etiologic agent and risk factors associated with a hospital ward outbreak of gastroenteritis. SETTING: A regional referral hospital in upstate South Carolina. METHODS: We reviewed patient charts, surveyed staff, and tested stool from acutely ill persons. A case was defined as diarrhea and vomiting in a staff member or patient from January 5 to 13, 1996. RESULTS: The initial case occurred on January 5 in a staff nurse who subsequently was hospitalized on the ward and visited by many staff colleagues. The staff were at a significantly greater risk for gastroenteritis than were patients (28/89 [31%] vs 10/91 [11%]; relative risk [RR], 2.9; 95% confidence interval [CI95], 1.5-5.5). All 10 case-patients had been exposed to case-nurses (assigned nurses who were primary caretakers), and eight had documented exposure to case-nurses 1 to 2 days before their illness. Patients exposed to case-nurses had a significantly increased risk of illness (8/57 [14%] vs 0/32; RR, >4.5; CI95, undefined). Neither staff nor patients had significantly increased risk from food, water, ice, or exposure to case-patients. Electron microscopy identified small round-structured viruses (SRSVs) in nine of nine stool samples. CONCLUSION: This nosocomial outbreak of gastroenteritis was likely caused by SRSVs introduced by a staff member and spread via person-to-person transmission from and among staff. The potential for spread of SRSV-associated gastroenteritis from and among staff should be considered in developing strategies to prevent similar outbreaks in hospital settings.


Asunto(s)
Infecciones por Caliciviridae/epidemiología , Infecciones por Caliciviridae/transmisión , Infección Hospitalaria/epidemiología , Infección Hospitalaria/virología , Brotes de Enfermedades , Gastroenteritis/epidemiología , Gastroenteritis/virología , Transmisión de Enfermedad Infecciosa de Profesional a Paciente , Virus Norwalk , Personal de Enfermería en Hospital , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , South Carolina/epidemiología
16.
Br Dent J ; 183(8): 297-8, 1997 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-9375444

RESUMEN

A patient presented with recurrent facial dermatitis associated with dental work. Dermatology referral identified the cause as allergic contact dermatitis to the epoxy acrylate BIS-GMA. Occupationally-induced allergic contact dermatitis to epoxy resin was also demonstrated. A structurally distinct aliphatic acrylate was successfully substituted. Contact sensitivity to BIS-GMA is reviewed and the potential for epoxy sensitive patients to cross-react to BIS-GMA is discussed.


Asunto(s)
Bisfenol A Glicidil Metacrilato/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Resinas Epoxi/efectos adversos , Dermatosis Facial/inducido químicamente , Enfermedad Crónica , Reacciones Cruzadas , Dermatitis Alérgica por Contacto/diagnóstico , Dermatosis Facial/diagnóstico , Femenino , Humanos , Persona de Mediana Edad , Pruebas del Parche , Recurrencia
18.
Sex Transm Dis ; 23(1): 40-4, 1996.
Artículo en Inglés | MEDLINE | ID: mdl-8801641

RESUMEN

BACKGROUND AND OBJECTIVES: The nadir in syphilis incidence in the 1950s provided evidence that current control methods could eliminate the transmission of syphilis. Planning such an effort will require information on the current state of the public and private infrastructure for the control of sexually transmitted disease (STD). GOAL OF THIS STUDY: To evaluate the accessibility, acceptability, and quality of delivery of clinical and preventive outreach services for syphilis control in the southern United States. STUDY DESIGN: A telephone-and-questionnaire survey of the 7 largest southern city, 10 state, and 9 nonsouthern comparison state STD control programs. RESULTS: The gender-race composition of public-sector STD providers is very different from their clients. Median ratio of STD clinicians per 1994 infectious syphilis patient was 0.08 (0.01-0.25) in southern states and 0.50(0.07-1.00) in comparison states. The proportion of clients treated within one day of care-seeking in southern states was 58% to 100%; regions with inadequate access were common. A median of 45% to 50% of patients with presumptive congenital syphilis underwent recommended diagnostic procedures. CONCLUSIONS: Serious deficiencies exist in the accessibility of STD care in the south that make the elimination of syphilis transmission difficult using current clinic-based diagnosis and treatment. A more community-based program of case finding and presumptive treatment may be indicated.


Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Servicios de Salud/estadística & datos numéricos , Sífilis/prevención & control , Femenino , Humanos , Masculino , Calidad de la Atención de Salud , Sudeste de Estados Unidos , Tennessee
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