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1.
J Dent Hyg ; 94(3): 37-47, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32554414

RESUMEN

Purpose: The "#MeToo" movement has increased awareness of sexual harassment in the workplace and its detrimental effects on the work environment. The purpose of this study was to determine the prevalence of sexual harassment in a convenience sample of dental hygienists in the state of Virginia (VA).Methods: A cross-sectional research design was used to determine the experiences of VA dental hygienists with sexual harassment in the workplace occurring over the previous twenty-four months. The revised Sexual Experiences Questionnaire (SEQ-W) measured three constructs: gender harassment, unwanted sexual attention, and sexual coercion and was administered electronically to a convenience sample of 238 dental hygienists attending a continuing education conference. Chi-square was used to determine significant associations between survey scores and demographics.Results: A total of 161 dental hygienists completed the survey (n=161) for a response rate of 68%. A little more than one-quarter of the respondents (27%) reported at least one experience of sexual harassment in the previous 24 months. Of the three constructs measured, 27.3% of participants reported gender harassment, 18.6% unwanted sexual attention, and 6.8% sexual coercion. The most commonly reported items were being told offensive sexual jokes or stories (21%) and hearing someone make crude and offensive sexual remarks (18%). A definition of sexual harassment was provided and participants were asked, "During your career as a dental hygienist, have you experienced sexual harassment?" to which 24.2% (n=39) responded yes.Conclusion: Sexual harassment is a contemporary problem in dental hygiene employment settings in the state of Virginia. Effective training and policies in sexual harassment is needed to prevent these behaviors from occurring in the workplace.


Asunto(s)
Acoso Sexual , Estudios Transversales , Higienistas Dentales , Humanos , Encuestas y Cuestionarios , Virginia , Lugar de Trabajo
2.
MMWR Morb Mortal Wkly Rep ; 69(24): 740-743, 2020 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-32555139

RESUMEN

In August 2019, the Virginia Poison Center (VPC) and the Blue Ridge Poison Center (BRPC) were contacted concerning patients experiencing repeated episodes of marked hypoglycemia following ingestion of a male enhancement supplement tablet marketed as "V8" in convenience stores in central Virginia. Over the following 3 months, the Virginia Department of Agriculture and Consumer Services (VDACS) and the Virginia Department of Health (VDH) conducted an investigation and identified 17 patients meeting the case definition (severe hypoglycemia within 48 hours of consuming an over-the-counter male enhancement supplement in a man with no history of use of insulin or other medication used to control blood glucose). Analysis of the V8 tablets revealed that most contained glyburide, a sulfonylurea oral hypoglycemic used in the treatment of diabetes and associated with prolonged hypoglycemia following overdose (1). To stem this outbreak, V8 was removed from stores when found, and public service announcements were released. The public health implications of V8 use include the potential for substantial morbidity from hypoglycemic episodes and the potential for mortality if health care services are not accessed in a timely manner when hypoglycemia occurs. The presence of V8 in the market poses a serious threat to public health because of its potentially life-threatening adverse effects.


Asunto(s)
Suplementos Dietéticos/toxicidad , Brotes de Enfermedades , Hipoglucemia/inducido químicamente , Hipoglucemia/epidemiología , Índice de Severidad de la Enfermedad , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Virginia/epidemiología
3.
Sci Total Environ ; 729: 138736, 2020 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-32361433

RESUMEN

Winter deicing salt application has led to water quality impairment as stormwater carries salt ions (Na+ and Cl-) through watersheds. Green infrastructure (GI) is a promising urban stormwater management practice, but its efficacy in managing salt is unknown. GI is not yet designed to remove salt, but may have potential to mitigate its loading to surface waters. Two roadside infiltration-based GI practices in Northern Virginia (bioretention and bioswale) were monitored year-round over 28 precipitation events to investigate the transport of salt through modern stormwater infrastructure. Stormwater runoff volumes and concentrations of salt ions entering and exiting each GI were monitored to determine reductions of salt ions. Both the bioretention and bioswale significantly reduced effluent surface loads of Cl- and Na+ (76% to 82%), displaying ability to temporarily retain and infiltrate salts and delay their release to surface waters. Changes in bioretention soil chemistry revealed a small percentage of Na+ was stored long-term by ion exchange, but no long-term Cl- storage was observed. Limited soil storage along with groundwater observations suggest the majority of salt removed from stormwater by the bioretention infiltrates into groundwater. Infiltration GI can buffer surface waters from salt, but are also an avenue for groundwater salt loading.


Asunto(s)
Agua Subterránea , Lluvia , Cloruro de Sodio , Suelo , Virginia , Movimientos del Agua , Calidad del Agua
4.
Plant Dis ; 104(5): 1390-1399, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32223639

RESUMEN

Late and early leaf spot, respectively caused by Nothopassalora personata and Passalora arachidicola, are damaging diseases of peanut (Arachis hypogaea) capable of defoliating canopies and reducing yield. Although one of these diseases may be more predominant in a given area, both are important on a global scale. To assist informed management decisions and quantify relationships between end-of-season defoliation and yield loss, meta-analyses were conducted over 140 datasets meeting established criteria. Slopes of proportion yield loss with increasing defoliation were estimated separately for Virginia and runner market type cultivars. Yield loss for Virginia types was described by an exponential function over the range of defoliation levels, with a loss increase of 1.2 to 2.2% relative to current loss levels per additional percent defoliation. Results for runner market type cultivars showed yield loss to linearly increase 2.2 to 2.8% per 10% increase in defoliation for levels up to approximately 95% defoliation, after which the rate of yield loss was exponential. Defoliation thresholds to prevent economic yield loss for Virginia and runner types were estimated at 40 and 50%, respectively. Although numerous factors remain important in mitigating overall yield losses, the integration of these findings should aid recommendations about digging under varying defoliation intensities and peanut maturities to assist in minimizing yield losses.


Asunto(s)
Arachis , Ascomicetos , Virginia
5.
J Environ Manage ; 262: 110262, 2020 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-32250778

RESUMEN

The preservation of salt marshes under rapid sea-level rise (SLR) typically requires the conservation of marsh transgression zones-undeveloped uplands onto which marshes can migrate. Optimal planning for conservation of this type requires information on the expected benefit of marsh conservation and the cost of land suitable for marsh migration in particular areas. While information is available on marsh benefits within the literature, prior research provides little insight on associated land conservation costs. The coastal hedonic pricing literature focuses primarily on developed land, and there are no models designed to predict the cost of conserving land suitable for marsh migration. This paper develops a hedonic property value model to predict cost and explore price patterns associated with purchases of undeveloped land suitable for salt marsh migration under SLR. The model is illustrated using a case study from the Eastern Shore of Virginia, with a dataset consisting of open-market sales of undeveloped land from 2014 to 2017. Particular attention is paid to characteristics that determine marsh migration potential such as coastal distance, elevation and connectivity. Results demonstrate the insight for conservation planning that can be provided by models of this type and the errors associated with the use of simplified proxies to predict conservation costs of land suitable for marsh migration.


Asunto(s)
Conservación de los Recursos Naturales , Humedales , Análisis Costo-Beneficio , Virginia
6.
Parasit Vectors ; 13(1): 188, 2020 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-32276649

RESUMEN

BACKGROUND: Vector-borne diseases are a major public health concern and cause significant morbidity and mortality. Zika virus (ZIKV) is the etiologic agent of a massive outbreak in the Americas that originated in Brazil in 2015 and shows a strong association with congenital ZIKV syndrome in newborns. Cache Valley virus (CVV) is a bunyavirus that causes mild to severe illness in humans and ruminants. In this study, we investigated the vector competence of Virginia mosquitoes for ZIKV and CVV to explore their abilities to contribute to potential outbreaks. METHODS: To determine vector competence, mosquitoes were fed a blood meal comprised of defibrinated sheep blood and virus. The presence of midgut or salivary gland barriers to ZIKV infection were determined by intrathoracic inoculation vs oral infection. After 14-days post-exposure, individual mosquitoes were separated into bodies, legs and wings, and saliva expectorant. Virus presence was detected by plaque assay to determine midgut infection, dissemination, and transmission rates. RESULTS: Transmission rates for Ae. albopictus orally infected (24%) and intrathoracically inoculated (63%) with ZIKV was similar to Ae. aegypti (48% and 71%, respectively). Transmission rates of ZIKV in Ae. japonicus were low, and showed evidence of a midgut infection barrier demonstrated by low midgut infection and dissemination rates from oral infection (3%), but increased transmission rates after intrathoracic inoculation (19%). Aedes triseriatus was unable to transmit ZIKV following oral infection or intrathoracic inoculation. CVV transmission was dose-dependent where mosquitoes fed high titer (ht) virus blood meals developed higher rates of midgut infection, dissemination, and transmission compared to low titer (lt) virus blood meals. CVV was detected in the saliva of Ae. albopictus (ht: 68%, lt: 24%), Ae. triseriatus (ht: 52%, lt: 7%), Ae. japonicus (ht: 22%, lt: 0%) and Ae. aegypti (ht: 10%; lt: 7%). Culex pipiens and Cx. restuans were not competent for ZIKV or CVV. CONCLUSIONS: This laboratory transmission study provided further understanding of potential ZIKV and CVV transmission cycles with Aedes mosquitoes from Virginia. The ability for these mosquitoes to transmit ZIKV and CVV make them a public health concern and suggest targeted control programs by mosquito and vector abatement districts.


Asunto(s)
Virus Bunyamwera/aislamiento & purificación , Mosquitos Vectores/virología , Virus Zika/aislamiento & purificación , Aedes/virología , Animales , Bioensayo , Sangre/virología , Infecciones por Bunyaviridae/transmisión , Culex/virología , Vectores de Enfermedades , Humanos , Intestinos/virología , Saliva/virología , Estados Unidos , Carga Viral , Virginia , Infección por el Virus Zika/transmisión
7.
Mar Pollut Bull ; 154: 111002, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32174483

RESUMEN

In response to the oil spill caused by the collision between the Ro-Ro ship Ulysse and CSL Virginia on 7th October 2018, the Lagrangian oil spill model MEDSLIK-II was utilized to predict spill transport and fate. Oil drift was forced by the high-resolution sea circulation provided by CMEMS and the ECMWF wind. Successive model runs were restarted 5 times with the distinct overflight- and satellite-derived observations provided by REMPEC and the Copernicus Sentinel-1 mission. The results were verified based on the ability to predict the first oil-beaching event that happened near Saint-Tropez (France) in the early afternoon of 16th October. Despite the general consistency among the runs, only the last initialization was able to forecast the oil beaching. Stochastic MEDSLIK-II simulations forced by the historical meteo-oceanographic datasets 2014-2018 revealed that the coastlines between Cap Lardier and the Gulf of Saint-Tropez were among the most impacted areas.


Asunto(s)
Monitoreo del Ambiente , Modelos Teóricos , Contaminación por Petróleo , Francia , Virginia , Viento
8.
Mar Pollut Bull ; 151: 110869, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32056649

RESUMEN

Microplastic particles (<5 mm) constitute a growing pollution problem within coastal environments. This study investigated the microplastic presence of estuarine and barrier island beaches in the states of Virginia and North Carolina, USA. Seventeen sediment cores were collected at four study sites and initially tested for microplastic presence by pyrolysis-gas chromatography-mass spectrometry. For the extraction, microplastic particles were first separated from the sediment using a high-density cesium chloride solution (1.88 g/mL). In a second step, an oil extraction collected the remaining microplastic particles of higher densities. Under the light microscope, the extracted microplastic particles were classified based on their morphologies into fragments and fibers. Raman microspectroscopy chemically identified a subset of microplastic particles as polypropylene, polyethylene terephthalate, poly(4-vinylbiphenyl), polystyrene, polyethylene, and nylon. The results show a concentration of microplastic particles (1410 ± 810 per kg of dry sediment) even in protected and ostensibly unpolluted estuarine and beach sediments of Virginia and North Carolina.


Asunto(s)
Monitoreo del Ambiente , Microplásticos , Contaminantes Químicos del Agua , Sedimentos Geológicos , North Carolina , Plásticos , Virginia
9.
J Am Vet Med Assoc ; 256(2): 195-208, 2020 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-31910075

RESUMEN

OBJECTIVE: To describe rabies and rabies-related events occurring during 2018 in the United States. ANIMALS: All animals submitted for laboratory diagnosis of rabies in the United States during 2018. PROCEDURES: State and territorial public health departments provided data on animals submitted for rabies testing in 2018. Data were analyzed temporally and geographically to assess trends in domestic animal and wildlife rabies cases. RESULTS: During 2018, 54 jurisdictions reported 4,951 rabid animals to the CDC, representing an 11.2% increase from the 4,454 rabid animals reported in 2017. Texas (n = 695 [14.0%]), Virginia (382 [7.7%]), Pennsylvania (356 [7.2%]), North Carolina (332 [6.7%]), Colorado (328 [6.6%]), and New York (320 [6.5%]) together accounted for almost half of all rabid animals reported in 2018. Of the total reported rabies cases, 4,589 (92.7%) involved wildlife, with bats (n = 1,635 [33.0%]), raccoons (1,499 [30.3%]), skunks (1,004 [20.3%]), and foxes (357 [7.2%]) being the major species. Rabid cats (n = 241 [4.9%]) and dogs (63 [1.3%]) accounted for > 80% of rabid domestic animals reported in 2018. There was a 4.6% increase in the number of samples submitted for testing in 2018, compared with the number submitted in 2017. Three human rabies deaths were reported in 2018, compared with 2 in 2017. CONCLUSIONS AND CLINICAL RELEVANCE: The overall number of animal rabies cases increased from 2017 to 2018. Laboratory diagnosis of rabies in animals is critical to ensure that human rabies postexposure prophylaxis is administered judiciously.


Asunto(s)
Enfermedades de los Gatos , Enfermedades de los Bovinos , Quirópteros , Enfermedades de los Perros , Rabia/veterinaria , Animales , Animales Domésticos , Animales Salvajes , Gatos , Bovinos , Perros , Equidae , Humanos , New York , North Carolina , Pennsylvania , Vigilancia de la Población , Salud Pública , Mapaches , Estados Unidos , Virginia
10.
J Zoo Wildl Med ; 50(4): 769-777, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31926506

RESUMEN

Eastern box turtles (Terrapene carolina carolina) are a native North American species with a declining population trend that may be attributable to habitat fragmentation, vehicle collisions, and disease. Adenoviral infections can cause significant morbidity and mortality in captive reptile populations. Adenoviruses have been documented in box turtles, but their occurrence and impact in wild populations are unknown. A disease survey was performed at The Wildlife Center of Virginia, USA, to assess the prevalence of box turtle adenovirus (BTAdV) in wild eastern box turtles and evaluate potential associations with clinical disease. Swabs from the oral cavity, including the choanal slit, and the cloaca were collected from 106 eastern box turtles from July 2015 through June 2016. The quantitative polymerase chain reaction (qPCR) primer detected both ornate box turtle adenovirus 1 and eastern box turtle adenovirus. The resulting qPCR adenovirus prevalence was 55.7% (n = 59). Most animals (99.3%) that tested positive for BTAdV had fewer than 100 viral copies/ng DNA. This study did not find a statistically significant association between cause of admission, age, sex, outcome, and BTAdV qPCR status. However, the probability of BTAdV detection was 1.5 times higher in rehabilitation turtles compared with wild turtles (P = 0.01). Albumin was significantly lower in qPCR BTAdV-positive turtles (P = 0.007). Hypoalbuminemia is not generally associated with adenovirus infections in other species, and no obvious clinical cause for this abnormality was identified. The results of this study suggest that eastern box turtles may harbor BTAdV infections at low levels and that infection is rarely associated with clinical disease, potentially identifying BTAdV as a host-adapted pathogen. Future studies should focus on this pathogen's ability to induce clinical disease and its potential impact on recovery efforts for this species.


Asunto(s)
Infecciones por Adenoviridae/veterinaria , Adenoviridae/clasificación , Adenoviridae/aislamiento & purificación , Tortugas/virología , Infecciones por Adenoviridae/epidemiología , Infecciones por Adenoviridae/virología , Animales , Animales Salvajes , ADN Viral/genética , ADN Viral/aislamiento & purificación , Femenino , Masculino , Reacción en Cadena de la Polimerasa/métodos , Reacción en Cadena de la Polimerasa/veterinaria , Prevalencia , Sensibilidad y Especificidad , Virginia/epidemiología
11.
J Dent Educ ; 84(5): 566-577, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31985083

RESUMEN

OBJECTIVES: Resilience is the ability to bounce back or recover from major life stressors. The aim of this study was to investigate resilience in dental students and how it may or may not vary across demographic characteristics such as gender, socioeconomic status, race/ethnicity, self-reported health, and parental educational level. METHODS: Data were collected from 151 dental students at Virginia Commonwealth University School of Dentistry with an anonymous survey that included the Resilience Scale for Adults (RSA) and various demographic variables. Associations between RSA and variables of interest were assessed using linear models. RESULTS: Dental students demonstrated relatively high levels of resilience. Resilience was significantly associated with gender (with females showing more resilience than males (P = 0.0395)), race (P = 0.0025), overall health (P = 0.0101), and mental health (P < 0.0001). Results from Exploratory Factor Analysis (EFA) supported a 5-factor solution that explained 82.6% of the variability of resilience in the sample of dental students. The 5 factors were nearly identical to the 5 subscales originally described by the RSA demonstrating validity in this population. Overall health ratings were significantly related to resilience, suggesting that perceived resilience in dental students may protect against negative health outcomes. This study can inform internal and external support systems of dental students as well as institutional programmatic development to better support their educational experiences.


Asunto(s)
Resiliencia Psicológica , Estudiantes de Odontología , Adulto , Femenino , Humanos , Masculino , Salud Mental , Encuestas y Cuestionarios , Virginia
12.
Nurse Pract ; 45(2): 33-37, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31977620

RESUMEN

During the 2018 state legislative session, Virginia's General Assembly approved legislation supporting a transitional licensing model for NPs with at least 5 years of full-time work equivalence in their certification area. This article outlines Virginia's case as an example for NP advocates who are planning scope-of-practice legislation in other states.


Asunto(s)
Licencia en Enfermería/legislación & jurisprudencia , Enfermeras Practicantes/legislación & jurisprudencia , Alcance de la Práctica/legislación & jurisprudencia , Certificación/estadística & datos numéricos , Humanos , Virginia
13.
Acad Med ; 95(2): 207-212, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31577587

RESUMEN

Centers and institutes are created to support interdisciplinary collaboration. However, all centers and institutes face the challenge of how best to evaluate their impact since traditional counts of productivity may not fully capture the interdisciplinary nature of this work. The authors applied techniques from social network analysis (SNA) to evaluate the impact of a center for interprofessional education (IPE), a growing area for centers because of the global emphasis on IPE.The authors created networks based on the connections between faculty involved in programs supported by an IPE center at Virginia Commonwealth University from 2014 to 2017. They used mathematical techniques to describe these networks and the change in the networks over time. The results of these analyses demonstrated that, while the number of programs and involved faculty grew, the faculty maintained a similar amount of connection between members. Additional faculty clusters emerged, and certain key faculty were important connectors between clusters. The analysis also confirmed the interprofessional nature of faculty collaboration within the network.SNA added important evaluation data beyond typical metrics such as counts of learners or faculty. This approach demonstrated how a center was evolving and what strategies might be needed to support further growth. With further development of benchmarks, SNA could be used to evaluate the effectiveness of centers and institutes relative to each other. SNA should guide strategic decisions about the future of centers and institutes as they strive to meet their overarching goal of tackling a social challenge through interdisciplinary collaboration.


Asunto(s)
Red Social , Universidades/organización & administración , Conducta Cooperativa , Humanos , Relaciones Interprofesionales , Modelos Teóricos , Virginia
14.
Int J Biometeorol ; 64(3): 397-407, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31720855

RESUMEN

An increasing number of epidemiological studies are finding statistical evidence that diurnal temperature range (DTR) is positively correlated to human morbidity and mortality despite the lack of clear clinical understanding. We examine a 14-year daily time series of emergency department (ED) admissions to the University of Virginia Medical Center in Charlottesville, Virginia, relative to long-term climate records from the Charlottesville/Albemarle County Airport weather station and the Spatial Synoptic Classification. DTR has a consistent strong positive correlation (r ~ 0.5) with maximum temperature in all months but only a weak, negative correlation (r ~- 0.1) with minimum temperature except in late summer (r ~- 0.4). Warm season DTR is highest on dry air mass days with low dew point temperatures. Cool season DTR is unrelated to morning temperature. Using a distributed lag non-linear model with an emphasis on DTR and its seasonal variation, after stratifying the models by season, we find that ED visits are linked to extreme cold events (cold days and nights) and high DTR in the cold season. In the warm season, ED visits are also linked to high DTR, but these are cool, dry, and pleasant days. The existing confusion regarding interpretation of DTR impacts on health might be rectified through a more careful analysis of the underlying physical factors that drive variations in DTR over the course of a year.


Asunto(s)
Frío , Calor , Humanos , Estaciones del Año , Temperatura , Virginia
15.
Am J Surg ; 219(3): 504-507, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31575419

RESUMEN

INTRODUCTION: Obesity is a risk factor for non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC). Bariatric surgery can provide durable weight-loss, but little is known about the later development of NASH and HCC after surgery. METHODS: Bariatric surgery (n = 3,410) and obese controls (n = 46,873) from an institutional data repository were propensity score matched 1:1 by demographics, comorbidities, BMI, and socioeconomic factors. Comparisons were made through paired univariate analysis and conditional logistic regression. RESULTS: Total of 4,112 patients were well matched with no significant baseline differences except initial BMI (49.0 vs 48.2, p = 0.04). Bariatric group demonstrated fewer new-onset NASH (6 0.0% vs 10.3%, p < 0.0001) and HCC (0.05% vs 0.34%, p = 0.03) over a median follow-up of 7.1 years. After risk-adjustment, bariatric surgery was independently associated with reduced development of NASH (OR 0.52, p < 0.0001). CONCLUSIONS: Bariatric surgery is associated with reduced incidence of NASH and HCC in this large propensity matched cohort. This further supports the use of bariatric surgery for morbidly obese patients to ameliorate NASH cirrhosis and development of HCC.


Asunto(s)
Cirugía Bariátrica , Carcinoma Hepatocelular/epidemiología , Neoplasias Hepáticas/epidemiología , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Obesidad Mórbida/cirugía , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Incidencia , Masculino , Puntaje de Propensión , Virginia/epidemiología
17.
Acad Med ; 95(2): 221-225, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31397707

RESUMEN

PROBLEM: Medical students typically perform worse on clinical clerkships that take place early in their training compared with those that occur later. Some institutions have developed transition-to-clerkship courses (TTCCs) to improve students' preparedness for the clinical phase of the curriculum. Yet, the impact of TTCCs on students' performance has not been evaluated. APPROACH: The authors developed and implemented a TTCC at Virginia Commonwealth University School of Medicine and measured its impact on students' clerkship performance. During the 2014-2015 academic year, they introduced a 2-week intersession TTCC. The goal was to improve students' readiness for clerkships by fostering the knowledge, skills, and attitudes required to care for patients throughout a hospitalization. The TTCC included panel discussions, skills development sessions, case-based workshops, and a 4-station standardized patient simulation. The authors assessed the feasibility of designing and implementing the TTCC and students' reactions and clerkship performance. OUTCOMES: The total direct costs were $3,500. Students reacted favorably and reported improved comfort on entering clerkships. Summative performance evaluations across clerkships were higher for those students who received the TTCC with simulation compared with those students who received the standard clerkship orientation (P < .001-.04, Cohen's d range = 0.23-0.62). This finding was particularly apparent in those clerkships that occurred earlier in the academic year. NEXT STEPS: Future plans include evaluating the impact of the TTCC on student well-being and incorporating elements of the TTCC into the preclinical curriculum.


Asunto(s)
Prácticas Clínicas/organización & administración , Facultades de Medicina/organización & administración , Prácticas Clínicas/economía , Competencia Clínica/normas , Estudios de Factibilidad , Femenino , Humanos , Masculino , Entrenamiento Simulado , Virginia
18.
Plast Reconstr Surg ; 145(1): 32-37, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31881600

RESUMEN

Skin adhesives have become standard in wound closure as alternatives to traditional sutures or as sterile occlusive dressings after surgery of all types. The literature is replete with case reports of contact dermatitis following exposure to cyanoacrylate-based adhesives, such as 2-octyl cyanoacrylate. Nonetheless, it has been the impression of the senior author and others that the incidence of allergic and/or contact dermatitis is much higher than commonly considered. The authors prospectively studied 102 consecutive patients who underwent breast surgery performed by the senior author with 2-octyl cyanoacrylate placed over incisions as an occlusive dressing. Two patients with a known glue allergy did not receive cyanoacrylate at surgery but were scratch tested to confirm the diagnosis. All patients were followed postoperatively. Twelve patients went on to develop significant dermatitis postoperatively after glue placement. Cyanoacrylate was confirmed as the cause of all rashes by allergy scratch testing for a total incidence of 14 percent (14 patients). Given the popularity of cyanoacrylate products across emergency rooms, clinics, and operating rooms, awareness of the true incidence of these reactions may caution against their use in the future. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.


Asunto(s)
Cianoacrilatos/efectos adversos , Dermatitis por Contacto/epidemiología , Mamoplastia/métodos , Adhesivos Tisulares/efectos adversos , Técnicas de Cierre de Heridas/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Dermatitis por Contacto/etiología , Femenino , Humanos , Incidencia , Persona de Mediana Edad , Estudios Prospectivos , Virginia/epidemiología , Adulto Joven
19.
Zootaxa ; 4624(2): zootaxa.4624.2.7, 2019 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-31716226

RESUMEN

Alloperla Banks, 1906 (Plecoptera: Chloroperlidae) is a speciose genus of spring- and summer-emergent stoneflies known from the Oriental, eastern Palearctic, and Nearctic realms. Over 50 species are currently recognized. Alloperla clarki sp. nov. is described herein from the adult male stage from a small geographic area in the Appalachian Mountains in Virginia and West Virginia, USA. Diagnostic characters are presented with scanning electron microscope (SEM) photomicrographs. Alloperla clarki sp. nov. most closely resembles A. biserrata Nelson Kondratieff, 1980, A. nanina Banks, 1911, and A. stipitata Surdick, 2004. These four species share similar characteristics of the male epiproct and appear to comprise a species group. The Alloperla nanina Group is formally proposed. Comparative SEM images are also provided for A. biserrata, A. nanina, and A. stipitata to assist with differentiating between these four species.


Asunto(s)
Insectos , Distribución Animal , Animales , Región de los Apalaches , Masculino , Virginia , West Virginia
20.
Zootaxa ; 4658(2): zootaxa.4658.2.4, 2019 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-31716744

RESUMEN

The terrestrial leech Haemopis septagon Sawyer Shelley, 1976, is indigenous to the Great Dismal Swamp and environs of northeastern North Carolina and southeastern Virginia, USA. Ever since its discovery in 1895 at Lake Drummond in the Dismal Swamp, this elusive species has been recognized as taxonomically aberrant. For example, it is the only jawed leech in the United States with seven annuli between gonopores, and the only one with sixteen complete (5-annulate) segments, both highly conserved characters in the Hirudinidae.                The discovery of two populations of H. septagon in the Albemarle Peninsula in the Outer Banks region of North Carolina afforded an opportunity to investigate the taxonomy and biology of this inadequately characterized species. Its description in this study is the first comprehensive account of the external and internal anatomy of this species since its incomplete original description in 1976. This study is also an opportunity to correct errors in the incomplete original description, and to elucidate morphological and developmental variability of taxonomic significance. Evidence is presented for the first time of a possible aquatic or semi-aquatic form of H. septagon.                These Albemarle individuals were compared to the holotype from Durham County, NC, specimens from southeastern Virginia and a terrestrial leech recently reported from southern New Jersey. All of these fall within the variability demonstrated in this study for the Albemarle populations, and are accordingly recognized as the same species, H. septagon.  Consequentially, Haemopis ottorum Wirchansky Shain, 2010, is recognized as a junior synonym of Haemopis septagon.


Asunto(s)
Anélidos , Sanguijuelas , Animales , North Carolina , Estados Unidos , Virginia , Humedales
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