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1.
Water Res ; 168: 115161, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31654960

RESUMO

The San Joaquin River (SJR) in California is purported to receive high nitrate loadings from surrounding agricultural lands through both surface and groundwater inputs. To investigate the potential removal of nitrate (NO3-) from surface and ground water sources, the spatial variations in dinitrogen (N2) gas concentrations and direct measurements of sediment denitrification potential (DNP), with amended NO3- and carbon (C) treatments, were investigated in the summer along a 95-km reach of the San Joaquin River. Excess N2 in hyporheic porewaters ranged from <0.1 to 8.65 mg L-1 and was significantly higher in porewaters from the 1.3 m (ground water source) versus 0.3 m (mixed surface and ground water) depths. In deep groundwater wells (3-7 m), median excess N2 concentration was 5.39 mg L-1 (range = <0.1-14.6 mg L-1). Excess N2 concentrations were inversely correlated with dissolved oxygen and NO3- concentrations suggesting denitrification as an important process in the dominantly anaerobic sediments. Hyporheic porewater NO3- concentrations exceeded the detection limit of 0.01 mg L-1 in only 20% of the hyporheic porewaters, in spite of high NO3- concentrations measured in both surface waters (mean = 2.25 mg N L-1) and surrounding groundwaters. Sediment DNP rates averaged 253 and 297 µg N kg-1 hr-1 for NO3- amended, and NO3- + C amended sediments, respectively, supporting the prevalence of denitrification in hyporheic sediments. Our results indicate that the hyporheic/riparian zones act as an anoxic barrier to nitrate transport from regional groundwater and as a location to remove NO3- from surface waters exchanging with the hyporheic zone.


Assuntos
Água Subterrânea , Poluentes Químicos da Água , California , Desnitrificação , Nitratos , Rios
2.
Bone Joint J ; 101-B(10): 1186-1191, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564149

RESUMO

AIMS: In previous studies, we identified multiple factors influencing the survivorship of hip resurfacing arthroplasties (HRAs), such as initial anatomical conditions and surgical technique. In addition, the University of California, Los Angeles (UCLA) activity score presents a ceiling effect, so a better quantification of activity is important to determine which activities may be advisable or detrimental to the recovered patient. We aimed to determine the effect of specific groups of sporting activities on the survivorship free of aseptic failure of a large series of HRA. PATIENTS AND METHODS: A total of 661 patients (806 hips) representing 77% of a consecutive series of patients treated with metal-on-metal hybrid HRA answered a survey to determine the types and amounts of sporting activities they regularly participated in. There were 462 male patients (70%) and 199 female patients (30%). Their mean age at the time of surgery was 51.9 years (14 to 78). Their mean body mass index (BMI) was 26.5 kg/m2 (16.7 to 46.5). Activities were regrouped into 17 categories based on general analogies between these activities. Scores for typical frequency and duration of the sessions were used to quantify the patients' overall time spent engaging in sporting activities. Impact and cycle scores were computed. Multivariable models were used. RESULTS: We found no association between any category of activity and a decrease in survivorship. Impact and hip cycle scores also failed to show any association with revision for aseptic failure or wear. CONCLUSION: Return to sporting activities after surgery is safe for patients treated with well-designed and well-implanted HRA. Cite this article: Bone Joint J 2019;101-B:1186-1191.


Assuntos
Artroplastia de Quadril/métodos , Exercício/fisiologia , Próteses Articulares Metal-Metal , Segurança do Paciente/estatística & dados numéricos , Volta ao Esporte/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Artroplastia de Quadril/reabilitação , California , Estudos Transversais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Falha de Prótese , Qualidade de Vida , Medição de Risco , Fatores Sexuais , Inquéritos e Questionários , Sobrevivência , Fatores de Tempo
3.
Am Surg ; 85(10): 1094-1098, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657301

RESUMO

On January 9, 2018, a catastrophic debris flow devastated Montecito, California. A 30-foot wall of boulders, mud, and debris ran down the hillsides at 15 miles per hour injuring dozens and causing 21 prehospital deaths. A retrospective review was conducted of the victims from the debris flow presenting to Cottage Health. Injury patterns, procedures performed, complications, length of stay, and outcomes were analyzed. Twenty-four patients were evaluated; 15 were admitted. Of the patients admitted, the most common presenting symptoms were soft tissue injuries (100%), hypothermia (67%), craniofacial injuries (67%), corneal abrasions (53%), and orthopedic injuries (47%), as well as loss of an immediate family member during the incident (73%). Procedures included skin irrigation (93%), operative soft tissue debridement (47%), body orifice irrigation due to mud impaction (40%), and orthopedic repair of fractures and ligaments (40%). All survived to discharge. "Debris flow syndrome" can be defined as a pattern of injuries, including soft tissue injuries, hypothermia, craniofacial trauma, corneal abrasions, orthopedic injuries, and mud impaction. Managing the debris flow syndrome requires co-ordinated and specialized care.


Assuntos
Osso e Ossos/lesões , Lesões da Córnea/epidemiologia , Desastres/estatística & dados numéricos , Traumatismos Faciais/epidemiologia , Inundações/estatística & dados numéricos , Hipotermia/epidemiologia , Deslizamentos de Terra/estatística & dados numéricos , Lesões dos Tecidos Moles/epidemiologia , Adolescente , Adulto , Idoso , California/epidemiologia , Criança , Pré-Escolar , Lesões da Córnea/etiologia , Lesões da Córnea/cirurgia , Traumatismos Faciais/etiologia , Traumatismos Faciais/cirurgia , Feminino , Humanos , Hipotermia/etiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Lesões dos Tecidos Moles/etiologia , Lesões dos Tecidos Moles/cirurgia , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Síndrome , Adulto Jovem
4.
Am Surg ; 85(10): 1099-1103, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657302

RESUMO

Foley catheters (FCs) are often used during inguinal hernia operations; however, the impact of intraoperative FC use on postoperative urinary retention (POUR) is not well understood. We reviewed unplanned returns to the urgent care or ED for 27,012 inguinal hernia operations across 15 Southern California Kaiser Permanente medical centers over 6.5 years. In total, 239 (0.88%) patients returned to urgent care/ED with POUR [235 (98%) men versus 4 (2%) women]. Overall, POUR increased with age (P < 0.00001). POUR was higher in open repairs using general anesthesia versus local with monitored anesthesia care (0.7% vs 0.3%, P < 0.0001). Of 5,017 laparoscopic operations, 28 per cent had FC use. Although POUR was greater for laparoscopic versus open operations (2.21 vs 0.58%, P < 0.00001), there was no difference in POUR for intraoperative FC versus no FC use in the laparoscopic approach (2.36% vs 2.15%, P = 0.33). For all laparoscopic operations, there was no difference in urinary tract infection within 7 or 30 days when comparing intraoperative FC versus no FC use (P = 0.28). POUR can be minimized by avoiding general anesthesia for open inguinal hernia repairs, but intraoperative FC use does not affect POUR or urinary tract infection rates for laparoscopic inguinal hernia repair.


Assuntos
Hérnia Inguinal/cirurgia , Herniorrafia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Cateteres Urinários/efeitos adversos , Retenção Urinária/etiologia , Distribuição por Idade , Fatores Etários , Idoso , Anestesia Geral/efeitos adversos , Anestesia Geral/estatística & dados numéricos , California/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Herniorrafia/métodos , Herniorrafia/estatística & dados numéricos , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Cateteres Urinários/estatística & dados numéricos , Retenção Urinária/epidemiologia , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologia
5.
Am Surg ; 85(10): 1142-1145, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657311

RESUMO

The ACS Committee on Trauma specifies prehospital criteria that trigger trauma team activation (TTA). The study aims to define the relationship between TTA and time of day, mechanism of injury, and need for operative intervention. All trauma patients presenting to LAC+USC (January 2008-July 2018) after triggering TTA were screened. Patients were excluded if time of ED arrival was undocumented. Demographics, injury data, and outcomes were analyzed. After exclusions (<1%), 54,826 patients were enrolled. The median age was 35 [IQR 23-53]. The median Injury Severity Score was 4 [1-10]. The most common mechanisms of injury were falls (n = 14,166; 31%), auto versus pedestrian collisions (n = 11,921; 26%), and motor vehicle collisions (n = 11,024; 24%). Penetrating trauma comprised 16 per cent (n = 8,686). The busiest hour for TTAs was 19:00 to 20:00, although penetrating trauma was most common between 23:00 and 01:00. Emergent surgical intervention in absolute numbers was most frequent between 20:00 and 01:00. As a proportion of the number of TTAs per hour, emergent operative intervention was most frequent between 23:00 and 06:00. In conclusion, the volume of TTAs and the triggering mechanism of injury vary significantly by time of day. The need for operative intervention is highest overnight. This information can be used to help increase hospital preparedness and allocate resources accordingly.


Assuntos
Serviços Médicos de Emergência/estatística & dados numéricos , Fatores de Tempo , Centros de Traumatologia/estatística & dados numéricos , Ferimentos não Penetrantes/etiologia , Ferimentos Penetrantes/etiologia , Escala Resumida de Ferimentos , Adulto , California/epidemiologia , Tratamento de Emergência/estatística & dados numéricos , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Triagem , Ferimentos não Penetrantes/epidemiologia , Ferimentos não Penetrantes/mortalidade , Ferimentos não Penetrantes/cirurgia , Ferimentos Penetrantes/epidemiologia , Ferimentos Penetrantes/mortalidade , Ferimentos Penetrantes/cirurgia , Adulto Jovem
6.
Am Surg ; 85(10): 1150-1154, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657313

RESUMO

Bile duct injury represents a complication after laparoscopic cholecystectomy, impairing quality of life and resulting in subsequent litigations. A five-year experience of bile duct injury repairs in 52 patients at a community hospital was reviewed. Twenty-nine were female, and the median age was 51 years (range, 20-83 years). Strasberg classification identified injuries as Type A (23), B (1), C (1), D (5), E1 (5), E2 (6), E3 (4), E4 (6), and E5 (1). Resolution of the bile duct injury and clinical improvement represent main postoperative outcome measures in our study. The referral time for treatment was within 4 to 14 days of the injury. Type A injury was treated with endobiliary stent placement. The remaining patients required T-tube placement (5), hepaticojejunostomy (20), and primary anastomosis (4). Two patients experienced bile leak after hepaticojejunostomy and were treated and resolved with percutaneous transhepatic drainage. At a median follow-up of 36 months, two patients (Class E4) required percutaneous balloon dilation and endobiliary stent placement for anastomotic stricture. The success of biliary reconstruction after complicated laparoscopic cholecystectomy can be achieved by experienced biliary surgeons with a team approach in a community hospital setting.


Assuntos
Ductos Biliares/lesões , Colecistectomia Laparoscópica/efeitos adversos , Complicações Pós-Operatórias/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica/estatística & dados numéricos , Ductos Biliares/diagnóstico por imagem , Ductos Biliares Extra-Hepáticos/lesões , California , Colecistectomia Laparoscópica/estatística & dados numéricos , Feminino , Hospitais Comunitários , Humanos , Jejunostomia/métodos , Jejunostomia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados (Cuidados de Saúde) , Complicações Pós-Operatórias/classificação , Estudos Retrospectivos , Stents/estatística & dados numéricos , Fatores de Tempo , Tempo para o Tratamento , Ferimentos e Lesões/classificação , Adulto Jovem
7.
Am Surg ; 85(10): 1159-1161, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657315

RESUMO

There are conflicting views regarding techniques for repair of small umbilical hernias (UHs). Here, we compare the recurrence rate in primary repair with that reported for mesh repair by examining a single surgeon's practice at a large medical center with a comprehensive electronic medical record. A six-year retrospective review of primary UH repairs between January 2012 and December 2017 at Kaiser Permanente Los Angeles Medical Center was undertaken. Patients were identified through a database search of the electronic medical record. The primary endpoint of UH recurrence was examined; median follow-up was 3.4 years. Primary, elective UH repair was performed in 244 patients; 71 per cent of hernias were small (<2 cm). The total number of recurrences was seven (3%). The t test analysis showed significant differences in the average size of hernia defects between those with recurrences (2 cm) and those without (1.4 cm), P < 0.05. Primary repair affords low infection and recurrence rates, comparable to those reported for mesh repair. Our single-surgeon/large-volume study contributes to the evidence that primary UH repair is a safe and durable method, with low risk of recurrence. The use of absorbable monofilament suture, and selection for lower BMI and smaller hernia sizes proved to be effective.


Assuntos
Hérnia Umbilical/cirurgia , Herniorrafia/estatística & dados numéricos , Telas Cirúrgicas/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , California , Feminino , Hérnia Umbilical/patologia , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Hospitais com Alto Volume de Atendimentos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Fumantes/estatística & dados numéricos , Telas Cirúrgicas/efeitos adversos , Suturas , Técnicas de Fechamento de Ferimentos
9.
J Environ Manage ; 252: 109343, 2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31604182

RESUMO

The Ocean Climate Indicators Project, developed for the Greater Farallones National Marine Sanctuary (GFNMS), yielded the first set of physical and biological ocean climate indicators specifically developed for the north-central California coast and ocean region, which extends from Point Arena to Point Año Nuevo and includes the ocean shorelines of the San Francisco metropolitan area. This case study produced a series of physical and biological indicator categories through a best professional judgment (BPJ) process with an interdisciplinary group of over 50 regional research scientists and marine resource managers from a wide range of state and federal agencies, NGOs, and universities. A working group of research scientists and marine resource managers used this set of ocean climate indicators to develop the Ocean Climate Indicators Monitoring Inventory and Plan. The Plan includes monitoring goals and objectives common for eight physical and four biological indicators; specific goals for each indicator; monitoring strategies and activities; an inventory of available monitoring data; opportunities for expanding or improving existing or new monitoring approaches; and case studies with specific examples of the indicators' utility for natural resource management and basic scientific research. Beyond developing indicators that support effective science-based management decisions, this scalable process established and strengthened mutually beneficial connections between scientists and managers, resulting in indicators that had broad support of project participants, were quickly adopted by the GFNMS, and could be used by managers and scientists from this region and beyond.


Assuntos
Mudança Climática , Ecossistema , California , Oceanos e Mares
10.
MMWR Morb Mortal Wkly Rep ; 68(42): 943-946, 2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31647789

RESUMO

Vaccinia virus (VACV) is an orthopoxvirus used in smallpox vaccines, as a vector for novel cancer treatments, and for experimental vaccine research (1). The Advisory Committee on Immunization Practices (ACIP) recommends smallpox vaccination for laboratory workers who handle replication-competent VACV (1). For bioterrorism preparedness, the U.S. government stockpiles tecovirimat, the first Food and Drug Administration-approved antiviral for treatment of smallpox (caused by variola virus and globally eradicated in 1980*,†) (2). Tecovirimat has activity against other orthopoxviruses and can be administered under a CDC investigational new drug protocol. CDC was notified about an unvaccinated laboratory worker with a needlestick exposure to VACV, who developed a lesion on her left index finger. CDC and partners performed laboratory confirmation, contacted the study sponsor to identify the VACV strain, and provided oversight for the first case of laboratory-acquired VACV treated with tecovirimat plus intravenous vaccinia immunoglobulin (VIGIV). This investigation highlights 1) the misconception among laboratory workers about the virulence of VACV strains; 2) the importance of providing laboratorians with pathogen information and postexposure procedures; and 3) that although tecovirimat can be used to treat VACV infections, its therapeutic benefit remains unclear.


Assuntos
Pessoal de Laboratório , Ferimentos Penetrantes Produzidos por Agulha/virologia , Doenças Profissionais/terapia , Traumatismos Ocupacionais/virologia , Vaccinia/terapia , Adulto , California , Feminino , Humanos
11.
J Nurs Adm ; 49(10): 473-479, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31490796

RESUMO

OBJECTIVE: To describe strategies to recruit and support members from hard-to-reach groups on research-focused Patient and Family Advisory Councils (PFACs). BACKGROUND: Ensuring diverse representation of members of research PFACs is challenging, and few studies have given attention to addressing this problem. METHODS: A qualitative study was conducted using 8 focus groups and 19 interviews with 80 PFAC members and leaders, hospital leaders, and researchers. RESULTS: Recruitment recommendations were: 1) utilizing existing networks; 2) going out to the community; 3) accessing outpatient clinics; and 4) using social media. Strategies to support inclusion were: 1) culturally appropriate communication methods; 2) building a sense of community between PFAC members; 3) equalizing roles between community members/leaders; 4) having a diverse PFAC leadership team; and 5) setting transparent expectations for PFAC membership. CONCLUSION: Increasing the diversity of research PFACs is a priority, and it is important to determine how best to engage groups that have been traditionally underrepresented.


Assuntos
Comitês Consultivos/organização & administração , Pesquisa em Enfermagem/organização & administração , Seleção de Pacientes , Adulto , California , Cuidadores , Família , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Projetos de Pesquisa
13.
BMC Evol Biol ; 19(1): 178, 2019 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492110

RESUMO

BACKGROUND: Fossil evidence suggests that extant North American lizard genera (north of Mexico) evolved during the Miocene. Although fossils of the clade Phrynosomatidae (spiny lizards and sand lizards) have been reported, there have been no previously described fossils of the fringe-toed sand lizards (Uma). In the extant biota, Uma inhabit arid deserts, and members of the western clade of Uma are restricted to sand dunes or other habitats containing fine-grained sand. RESULTS: I describe the first known fossil of Uma and refer the fossil to the total clade of Uma with an apomorphy-based diagnosis. The fossil is a partial premaxilla that was found in the Miocene strata of the Dove Spring Formation of southern California, dating to 8.77 Ma. The paleoenvironment of the Dove Spring Formation was semiarid and contained ephemeral streams that facilitated deposition, and there is no evidence of sand dune deposits in the strata containing the locality from which the Uma fossil was found. Divergence time analyses of a concatenated molecular dataset with four fossil calibrations support a Neogene origin of the total clade of Uma and of the crown clade of Uma. Those analyses also estimated a Neogene divergence between Uma scoparia and the Uma notata complex. Multispecies coalescent analyses with one fossil calibration inferred a Paleogene origin for the total clade of Uma and a Pliocene or Pleistocene divergence between Uma scoparia and the Uma notata complex. The fossil and the total and crown clades of Uma precede the evolution of modern desert ecosystems in the southwestern United States and northern Mexico by millions of years. CONCLUSIONS: The total clade and the crown clade of Uma were not restricted to arid deserts throughout their evolutionary histories. I demonstrate that an apomorphy-based diagnosis can be used to identify fossils of isolated skeletal elements for at least one clade of phrynosomatid lizard, and suggest exercising caution when using environmental tolerances of extant taxa to hypothesize paleoecological reconstructions.


Assuntos
Fósseis , Lagartos/classificação , Lagartos/genética , Animais , Evolução Biológica , California , Ecologia , Ecossistema , Lagartos/anatomia & histologia , México , Filogenia
14.
J Environ Manage ; 250: 109520, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31518796

RESUMO

In recent years, with the continual urbanization of China, regional atmospheric environmental problems have become increasingly prominent. Although local emissions are an important cause of local pollution, the cross-boundary transmission of pollutants between cities also has an inevitable impact on regional pollution. In this study, the Weather Research and Forecasting (WRF) model coupled with the California Puff (CALPUFF) air quality model was used to study the transmission characteristics of four major air pollutants (SO2, NOx, PM2.5 and PM10) in the Beijing-Tianjin-Hebei urban agglomeration in China in winter, which is the season characterized by the highest levels of pollution. This urban agglomeration is the most polluted area in China. We compared the emission and transmission of pollutants at the city level based on data for January 2012 and 2016. We found that the emissions of most cities had declined since the implementation, in 2013, of the "Action Plan for the Prevention and Control of Air Pollution". However, the emissions of three cities, Zhangjiakou, Chengde and Baoding, had significantly increased. Furthermore, the "receptor cities" and "source cities" also showed some changes. For example, in 2016, Chengde and Zhangjiakou changed from receptor to source cities, while Tangshan and Tianjin showed the opposite change in status. The likely reason for these changes was that some industries in heavily polluted cities had moved due to stringent atmospheric pollution policies. Moreover, the transmission range of source cities (e.g., Shijiazhuang) in 2016 was significantly smaller than that in 2012, and the transmission intensity also decreased. This case study aids our understanding of how inter-city air pollution transmission has been affected by environmental policy.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Pequim , California , China , Cidades , Monitoramento Ambiental , Material Particulado , Estações do Ano
15.
MMWR Morb Mortal Wkly Rep ; 68(38): 813-818, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31557149

RESUMO

Silicosis is an incurable occupational lung disease caused by inhaling particles of respirable crystalline silica. These particles trigger inflammation and fibrosis in the lungs, leading to progressive, irreversible, and potentially disabling disease. Silica exposure is also associated with increased risk for lung infection (notably, tuberculosis), lung cancer, emphysema, autoimmune diseases, and kidney disease (1). Because quartz, a type of crystalline silica, is commonly found in stone, workers who cut, polish, or grind stone materials can be exposed to silica dust. Recently, silicosis outbreaks have been reported in several countries among workers who cut and finish stone slabs for countertops, a process known as stone fabrication (2-5). Most worked with engineered stone, a manufactured, quartz-based composite material that can contain >90% crystalline silica (6). This report describes 18 cases of silicosis, including the first two fatalities reported in the United States, among workers in the stone fabrication industry in California, Colorado, Texas, and Washington. Several patients had severe progressive disease, and some had associated autoimmune diseases and latent tuberculosis infection. Cases were identified through independent investigations in each state and confirmed based on computed tomography (CT) scan of the chest or lung biopsy findings. Silica dust exposure reduction and effective regulatory enforcement, along with enhanced workplace medical and public health surveillance, are urgently needed to address the emerging public health threat of silicosis in the stone fabrication industry.


Assuntos
Manufaturas/efeitos adversos , Indústria Manufatureira , Exposição Ocupacional/efeitos adversos , Silicose/diagnóstico , Adulto , California/epidemiologia , Colorado/epidemiologia , Evolução Fatal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Silicose/epidemiologia , Texas/epidemiologia , Washington/epidemiologia
16.
Am J Occup Ther ; 73(5): 7305205030p1-7305205030p18, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31484027

RESUMO

IMPORTANCE: Developed in California to enable community-dwelling older adults to maintain healthy and meaningful activities, Lifestyle Redesign® is a well-known cost-effective preventive occupational therapy intervention. The impact of a newly adapted French version on older French-Canadians was, however, unknown. OBJECTIVE: To explore the influence of Lifestyle Redesign on older French-Canadians' health, social participation, leisure, and mobility. DESIGN: A mixed-methods design included a preexperimental component (questionnaires administered before and after the intervention and 3 and 6 mo postintervention) and an exploratory descriptive qualitative clinical study. Individual semidirected interviews were digitally audiotaped and transcribed, then underwent thematic content analysis using mix extraction grids. SETTING: Community. PARTICIPANTS: Sixteen volunteers (10 women) aged 65-90 yr (mean = 76.4, standard deviation = 7.6), 10 without and 6 with disabilities. Inclusion criteria were age ≥65 yr, normal cognitive functions, residence in a conventional or senior home, and French speaking. INTERVENTION: French-Canadian 6-mo version of Lifestyle Redesign. OUTCOMES AND MEASURES: Health, social participation, leisure, and mobility were measured using the 36-item Short Form Health Survey, Social Participation Scale, Leisure Profile, and Life-Space Assessment, as well as a semistructured interview guide. RESULTS: The French-Canadian Lifestyle Redesign had a beneficial effect on participants' mental health (p = .02) and interest in leisure (p = .02) and, in those with disabilities, social participation (p = .03) and attitudes toward leisure (p = .04). Participants reported positive effects on their mental health, leisure, mobility, and social participation, including frequency and quality of social interactions, and indicated that having an occupational routine fostered better health. None of the participants reported no effect. CONCLUSION AND RELEVANCE: The translated and culturally adapted Lifestyle Redesign is a promising occupational therapy intervention for community-dwelling older French-Canadians. WHAT THIS ARTICLE ADDS: This study sheds light on the influence of the French-Canadian version of the intervention not only on older adults' health and social participation but also on their leisure activities and life-space mobility, two important outcomes not addressed in previous Lifestyle Redesign studies. Moreover, this study provides an in-depth understanding of the Lifestyle Redesign experience of French-Canadian older adults with and without disabilities, including participants with significant communication and mobility disabilities.


Assuntos
Atividades de Lazer , Participação Social , Idoso , Idoso de 80 Anos ou mais , California , Canadá , Feminino , Humanos , Estilo de Vida
17.
J Environ Manage ; 248: 109337, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31386989

RESUMO

This is the first study to assess the current status of solar photovoltaic (PV) adoption across a range of wastewater treatment plant sizes, and to identify the opportunities for solar PV in the wastewater sector. It quantifies solar PV contributions to the energy demand of the wastewater treatment plants and improves knowledge of sector-specific factors influencing PV uptake. California was used as a case study due to its high commitment to solar power and the high data availability. The study compiled and examined data on multiple wastewater treatment plant attributes from 105 Californian plants, representing 78% of total state flows. The analysis focused on the effect of three sector-specific influencing factors: size of wastewater treatment plant, presence/absence of anaerobic digestion and geographical location (urban vs rural). Solar PV adoption was observed to vary significantly with the size of the wastewater treatment plants. Of the 105 plants analysed, 41 installed a solar PV system. Of these 41, 39 were installed in wastewater treatment plants with a flow rate below 50 mega gallons day-1 (MGD). Only two plants with flow above 50 MGD had solar PV installed. In wastewater treatment plants with a flow rate above 5 MGD, solar PV was primarily installed in hybrid configurations with anaerobic digestion. In these plants, biogas contributed 25-65% to the overall energy demand, while solar provided 8-30%. In wastewater treatment plants with a flow rates below 5 MGD, solar PV often represented the only source of renewable energy, producing 30-100% of the energy demand of these plants. Across all the plants analysed, 1 MW was the most adopted solar installation size and solar PV installations were mostly found in wastewater treatment plants in rural settings. While acknowledging multiple other factors of potential influence, these results demonstrate the role of solar PV in wastewater treatment plants under three sector-specific influencing factors. The results will support the sector in making informed decisions over solar PV investments, helping wastewater utilities to transition towards sustainable management practices.


Assuntos
Energia Solar , Águas Residuárias , Biocombustíveis , California
19.
Oecologia ; 190(4): 769-781, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31273518

RESUMO

Increased drought frequency and intensity and agricultural intensification have been key stressors to ecological systems over the past century. Biological proxies (e.g., pollen, tree rings) have been used to track this environmental change; however, linking these changes to the ecology of organisms remains challenging. Here, we link historical drought records to conditions of high water-stress in grassland habitats through the stable isotope analysis of California vole museum specimens (Microtus californicus). Using museum collections spanning 118-years (1891-2009), isotope values of dated hair tissues were associated with statewide drought metrics on the Palmer Drought Severity Index. We observed a positive correlation between δ15N and δ18O values and drought severity. The range in δ15N values (~ 18‰) is greater than what would be expected as a result of dietary shifts across the landscape (~ 3‰), and is likely attributed to the combined effects of physiological responses of M. californicus and isotopic shifts in plant resources with increased water-stress. Geospatial patterns in δ34S values of hair tissues reflect higher baseline isotope values in coastal habitats. However, comparably high δ34S values in the southern-most inland localities suggest sulfur fertilization of croplands and subsequent transfer to surrounding grassland habitats in 34S enriched forms. A broad δ13C range (- 28.7 to - 14.3‰) further suggests the consumption of C3 and C4 plant-based dietary proteins. As shown here, stable isotope analysis of museum collections can provide a climate and land use record based on the physiological performance and ecology of a study species in a region affected intensely by anthropogenic activities.


Assuntos
Secas , Cabelo , Animais , Arvicolinae , California , Isótopos de Carbono
20.
Behav Sci Law ; 37(4): 452-467, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31355480

RESUMO

Mental health courts (MHCs) use a collaborative justice approach to provide a therapeutic alternative to the traditional justice process for defendants with mental illnesses directly relevant to their alleged criminal offenses. MHCs have proliferated in recent years, in light of early research reports documenting their successes. The aim of this paper is to provide further evaluation of the effects of MHCs by evaluating the impact of the Sacramento County MHC in California. We analyzed quantitative data and conducted interviews with stakeholders and MHC participants to understand how the MHC influenced individual participants' recidivism rates, mental health, and quality of life. Results from the quantitative data analysis indicate that defendants had a lower rate of recidivism after the MHC program than before it. Moreover, graduates were less likely to be rearrested and rehospitalized than non-graduates. Qualitative analyses revealed several core themes regarding participants' views on facilitators and barriers related to the MHC's success. These findings provide further insights into the effectiveness of MHCs.


Assuntos
Criminosos , Transtornos Mentais , Serviços de Saúde Mental , Saúde Mental , Reincidência , California , Criminosos/psicologia , Humanos , Transtornos Mentais/psicologia , Saúde Mental/legislação & jurisprudência , Qualidade de Vida , Comportamento Social , Justiça Social
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