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1.
Zootaxa ; 4808(1): zootaxa.4808.1.1, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33055987

RESUMO

The Mexican Pacific has been the focus of several research expeditions, with 90 species of hydromedusae and more than 200 species of hydroids recorded for the region. However, only a few of these reports include taxonomic descriptions, hindering inferences of the phylogenetic relationships, species boundaries, and diversity of Hydrozoa in Mexican waters. In this study, we present detailed and illustrated descriptions of new records of hydromedusae and hydroids for La Paz Bay, Gulf of California. We found a total of 16 species comprising 15 genera, with three new records for the Gulf of California (polyps of Antennella secundaria, Bimeria vestita, and Ventromma halecioides), two new records for the Mexican Pacific (medusa of Clytia linearis, polyp of Halopteris violae), and we redescribe Obelia tenuis. We show that the diversity of Hydrozoa in the Mexican Pacific is likely underestimated, and we emphasize the importance of taxonomic and systematic studies of hydroids and hydromedusae in Mexico.


Assuntos
Hidrozoários , Animais , Baías , California , Filogenia
2.
Nat Commun ; 11(1): 4933, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004787

RESUMO

The influence of seasons on biological processes is poorly understood. In order to identify biological seasonal patterns based on diverse molecular data, rather than calendar dates, we performed a deep longitudinal multiomics profiling of 105 individuals over 4 years. Here, we report more than 1000 seasonal variations in omics analytes and clinical measures. The different molecules group into two major seasonal patterns which correlate with peaks in late spring and late fall/early winter in California. The two patterns are enriched for molecules involved in human biological processes such as inflammation, immunity, cardiovascular health, as well as neurological and psychiatric conditions. Lastly, we identify molecules and microbes that demonstrate different seasonal patterns in insulin sensitive and insulin resistant individuals. The results of our study have important implications in healthcare and highlight the value of considering seasonality when assessing population wide health risk and management.


Assuntos
Exposição Ambiental , Resistência à Insulina/fisiologia , Redes e Vias Metabólicas/fisiologia , Microbiota/fisiologia , Estações do Ano , Adulto , Idoso , Glicemia/análise , Glicemia/metabolismo , California , Análise por Conglomerados , Feminino , Nível de Saúde , Humanos , Insulina/metabolismo , Estudos Longitudinais , Masculino , Metabolômica , Pessoa de Meia-Idade , RNA-Seq
3.
Zootaxa ; 4803(2): zootaxa.4803.2.5, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-33056020

RESUMO

Only a few previous surveys of the deep-water planktonic fauna have been accomplished off western Mexico, in particular in the Gulf of California. Samples of pelagic amphipods were obtained between surface and as deep as 2394 m using different gear during an extensive survey in this area. Among these samples, nine species of the genus Scina were recognized, including 78 specimens: 27 males and 51 females. The genus Scina inhabits mesopelagic waters at depths over 200 m, a community that remains largely unknown. The material examined includes a new species, the first reported from the Gulf of California, which is described and compared with its closest congeners, S. setigera Wagler, 1926 and S. parasetigera Zeidler, 1990. These three species share the presence of a long bristle on the base of the dactylus of pereopods 5 and 6. Scina sp. nov. differs from these other two species mainly by: 1) the shape and proportions of pereiopods 1-7; 2) the presence of three inner spiniform elements on uropod 1; 3) the insertion of the exopod on distal 1/3 of uropods. Of the remaining species collected during the survey S. borealis was by far the most abundant and widely distributed, followed by S. wolterecki and S. marginata. The other five species, S. curvidactyla, S. nana, S. pacifica, S. setigera, and S. submarginata, were represented by one or two specimens only. Co-occurence of species of Scina in samples was low with a maximum of four species in a single sample, all associated with S. borealis, the most common species. The distribution of Scina species collected during this survey is briefly discussed.


Assuntos
Anfípodes , Animais , California , Feminino , Masculino , México , Plâncton , Inquéritos e Questionários
4.
Zootaxa ; 4786(2): zootaxa.4786.2.8, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-33056488

RESUMO

Specimens of an ambrosia beetle, Xyleborus monographus (Fabricius), were found infesting oak trees in California. This is the first record of this species established in North America. Based on collection information, this species most likely has been established in the Napa County area for several years. A modified key to Xyleborus in North America, and diagnosis of the species is provided.


Assuntos
Ambrosia , Besouros , Quercus , Gorgulhos , Animais , California
5.
MMWR Morb Mortal Wkly Rep ; 69(42): 1512-1516, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33090980

RESUMO

Valley fever (coccidioidomycosis) is endemic in the southwestern United States and caused by inhalation of Coccidioides spp. fungal spores from soil or dust; 97% of U.S. Valley fever cases are reported from Arizona and California (1). In California, Valley fever incidence increased 213% from 2014 to 2018 (2). In 2016, the California Department of Public Health (CDPH) added three questions to the adult California Behavioral Risk Factor Surveillance System (BRFSS) survey to better understand whether Californians had heard of Valley fever, knew the environmental risk where they live, and knew who is at risk for severe disease. A total of 2,893 BRFSS respondents aged ≥18 years answered at least one Valley fever question. Using the weighted California population, 42.4% of respondents reported general awareness of Valley fever; awareness was lowest among adults aged 18-44 years (32.9%) and Hispanic persons (26.4%). In addition, despite higher percentages reporting awareness of Valley fever, only 25.0% of persons living in a high-incidence region and 3.0% of persons living in a moderate-incidence region were aware that they lived in areas where Coccidioides spp. exist. Among persons with one or more risk factors for severe disease, 50.8% reported having heard about Valley fever, but only 3.5% knew they were at increased risk for severe disease. The findings from this survey helped to inform a statewide Valley fever awareness campaign implemented during 2019-2020 and to guide outreach to persons living in high- and moderate-incidence regions in California and potentially other southwestern states or who are at risk for severe disease.


Assuntos
Coccidioidomicose , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , California/epidemiologia , Coccidioidomicose/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Medição de Risco , Adulto Jovem
6.
Zootaxa ; 4845(3): zootaxa.4845.3.8, 2020 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-33056768

RESUMO

Various undescribed Cybaeina Chamberlin Ivie (Araneae: Dictynoidea: Cybaeidae) and Cybaeina-like taxa are known from forested habitats in the west coast of North America. Most have very restricted ranges within the northern portion of the Californian Floristic Province, a well-known biodiversity hotspot. Here we describe Allocybaeina Bennett gen. nov. and its single included species, Allocybaeina littlewalteri Bennett spec. nov. This infrequently collected species is restricted to forested habitat in a small area of the coastal watersheds of southern Humboldt and western Mendocino Counties in northwestern California, U.S.A. In addition to descriptions we provide diagnoses, illustrations, a distribution map, and discuss conservation implications for this distinctive new genus and species.


Assuntos
Aranhas , Animais , Biodiversidade , California , Ecossistema , Florestas
7.
Zootaxa ; 4790(2): zootaxa.4790.2.9, 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-33055846

RESUMO

A new oribatid mite genus, Sculpteremaeus gen. nov. (Oribatida, Cymbaeremaeidae), with Sculpteremaeus olszanowskii sp. nov. as type species, is proposed and described based on adults. It is from sandy soil-litter in chaparral of California, USA, an environment from which no oribatid mites have been recorded previously. Based on an analysis of adults of all genera of Cymbaeremaeidae, the new genus is closely related to Ametroproctus, from which it is most easily distinguished by the morphology of lamellae, size of lamellar cusps, and shape of the tutorium. We expand the Cymbaeremaeidae family diagnosis, and question the inclusion of Scapheremaeus based on extensive molecular evidence showing its closer relationship with Ameronothroidea and Licneremaeoidea.


Assuntos
Ácaros , Distribuição Animal , Animais , California , Areia , Solo
8.
Environ Monit Assess ; 192(11): 704, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33057810

RESUMO

Mercury (Hg) was measured in the muscle, liver, and gonads of Haemulopsis elongatus and Pomadasys macracanthus from Mazatlán (SE Gulf of California) to determine the relationships of the hepatosomatic index (HSI) and gonadosomatic index (GSI) of fish with Hg concentrations in the corresponding tissues. Health risk to consumers was assessed by using the hazard quotient (HQ), considering the average rate of fish consumption in Mexico and Hg concentration in the edible tissue. In H. elongatus, the highest Hg levels were measured in the liver (3.748 µg g-1); in P. macracanthus, the highest Hg concentration was quantified in the muscle (0.574 µg g-1). In P. macracanthus, the HSI was negatively correlated with Hg concentration in the liver; in H. elongatus, there was also a negative relationship between Hg levels in gonads and the GSI. Mean HQ values in Haemulopsis elongatus (0.005) and Pomadasys macracanthus (0.002) were below the value (HQ ≥ 1) of concern. The significant reduction of HSI and GSI with Hg increase in the liver and gonads may suggest that Hg bioaccumulation in these fish shows adverse physiological effects. Though HQ values in both species were below the unit, i.e., the consumption of the muscle from this species does not represent a health risk, it is necessary to carry out surveys of fish consumption rates in coastal areas of Mexico to do a more precise health risk assessment associated to Hg intake.


Assuntos
Mercúrio , Poluentes Químicos da Água , Animais , Bioacumulação , California , Monitoramento Ambiental , Mercúrio/análise , México , Medição de Risco , Poluentes Químicos da Água/análise
9.
JAMA Netw Open ; 3(10): e2024191, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026453

RESUMO

Importance: In late December 2019, an outbreak of a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. Data on the routes of transmission to Los Angeles, California, the US West Coast epicenter for coronavirus disease 2019 (COVID-19), and subsequent community spread are limited. Objective: To determine the transmission routes of SARS-CoV-2 to Southern California and elucidate local community spread within the Los Angeles metropolitan area. Design, Setting, and Participants: This case series included 192 consecutive patients with reverse transcription-polymerase chain reaction (RT-PCR) test results positive for SARS-CoV-2 who were evaluated at Cedars-Sinai Medical Center in Los Angeles, California, from March 22 to April 15, 2020. Data analysis was performed from April to May 2020. Main Outcomes and Measures: SARS-CoV-2 viral genomes were sequenced. Los Angeles isolates were compared with genomes from global subsampling and from New York, New York; Washington state; and China to determine potential sources of viral dissemination. Demographic data and outcomes were collected. Results: The cohort included 192 patients (median [interquartile range] age, 59.5 [43-75] years; 110 [57.3%] men). The genetic characterization of SARS-CoV-2 isolates in the Los Angeles population pinpointed community transmission of 13 patients within a 3.81 km2 radius. Variation landscapes of this case series also revealed a cluster of 10 patients that contained 5 residents at a skilled nursing facility, 1 resident of a nearby skilled nursing facility, 3 health care workers, and a family member of a resident of one of the skilled nursing facilities. Person-to-person transmission was detected in a cluster of 5 patients who shared the same single-nucleotide variation in their SARS-CoV-2 genomes. High viral genomic diversity was identified: 20 Los Angeles isolates (15.0%) resembled SARS-CoV-2 genomes from Asia, while 109 Los Angeles isolates (82.0%) were similar to isolates originating from Europe. Analysis of other common respiratory viral pathogens did not reveal coinfection in the cohort. Conclusions and Relevance: These findings highlight the precision of detecting person-to-person transmission and accurate contact tracing directly through SARS-CoV-2 genome isolation and sequencing. Development and application of phylogenetic analyses from the Los Angeles population established connections between COVID-19 clusters locally and throughout the US.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/transmissão , Genoma Viral/genética , Pneumonia Viral/transmissão , Adulto , Idoso , Ásia , California/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Europa (Continente) , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Los Angeles/epidemiologia , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Pandemias , Filogenia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Análise de Sequência de RNA , Proteínas não Estruturais Virais/genética , Washington
10.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32994177

RESUMO

BACKGROUND: New guidelines support using interferon-γ release assays (IGRAs) in children ≥2 years for diagnosis of latent tuberculosis infection (LTBI). However, lack of experience in young children and concern that IGRAs are less sensitive than tuberculin skin tests (TSTs) limit their use. Our aim was to identify active tuberculosis (TB) cases among high risk children <5 years and tested for LTBI with an IGRA. METHODS: . Retrospective review of domestic TB screening data from California's Refugee Health Electronic Information System for children <5 years old who resettled in California between October, 2013 and December, 2016. Children were crossmatched with the California TB registry to identify cases of TB disease between October 2013 and December 2018. RESULTS: A total of 3371 children <5 years were identified; the majority were born in countries with high TB incidence (>150 cases per 100 000). Half received IGRAs (n = 1878; 56%), a quarter received TSTs (n = 811; 24%); 1.4% of children were IGRA-positive (n = 26) and 13% were TST-positive (n = 106). Twenty-two IGRA results were indeterminate (1.2%). Sixteen children had both tests; 9 were discrepant (positive TST with negative IGRA). No cases of TB disease were identified during 10 797 person-years of follow-up. CONCLUSIONS: IGRA positivity was less than TST positivity in high risk children <5 years old. Despite fewer LTBI diagnoses in the IGRA-tested population, no cases of TB disease among children who tested negative were identified, suggesting IGRA is valuable tool for identifying LTBI in this population.


Assuntos
Testes de Liberação de Interferon-gama/estatística & dados numéricos , Tuberculose Latente/diagnóstico , Refugiados/estatística & dados numéricos , Teste Tuberculínico/estatística & dados numéricos , California/epidemiologia , Pré-Escolar , Feminino , Humanos , Tuberculose Latente/epidemiologia , Masculino , Estudos Retrospectivos
11.
PLoS One ; 15(9): e0238405, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32936809

RESUMO

In the California Current Ecosystem, El Niño acts as a natural phenomenon that is partially representative of climate change impacts on marine bacteria at timescales relevant to microbial communities. Between 2014-2016, the North Pacific warm anomaly (a.k.a., the "blob") and an El Niño event resulted in prolonged ocean warming in the Southern California Bight (SCB). To determine whether this "marine heatwave" resulted in shifts in microbial populations, we sequenced the rpoC1 gene from the biogeochemically important picocyanobacteria Prochlorococcus and Synechococcus at 434 time points from 2009-2018 in the MICRO time series at Newport Beach, CA. Across the time series, we observed an increase in the abundance of Prochlorococcus relative to Synechococcus as well as elevated frequencies of ecotypes commonly associated with low-nutrient and high-temperature conditions. The relationships between environmental and ecotype trends appeared to operate on differing temporal scales. In contrast to ecotype trends, most microdiverse populations were static and possibly reflect local habitat conditions. The only exceptions were microdiversity from Prochlorococcous HLI and Synechococcus Clade II that shifted in response to the 2015 El Niño event. Overall, Prochlorococcus and Synechococcus populations did not return to their pre-heatwave composition by the end of this study. This research demonstrates that extended warming in the SCB can result in persistent changes in key microbial populations.


Assuntos
El Niño Oscilação Sul , Prochlorococcus/isolamento & purificação , Água do Mar/microbiologia , Synechococcus/isolamento & purificação , Organismos Aquáticos/genética , Organismos Aquáticos/crescimento & desenvolvimento , Organismos Aquáticos/isolamento & purificação , Biodiversidade , California , Mudança Climática , Ecossistema , Ecótipo , Genes Bacterianos , Microbiota/genética , Oceano Pacífico , Filogenia , Prochlorococcus/genética , Prochlorococcus/crescimento & desenvolvimento , Estações do Ano , Synechococcus/genética , Synechococcus/crescimento & desenvolvimento , Temperatura
12.
Ther Adv Cardiovasc Dis ; 14: 1753944720948651, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32885724

RESUMO

BACKGROUND: We aimed to investigate the safety of endovascular procedures undertaken in a single outpatient center located in a rural, underserved area. Endovascular procedures for Peripheral Arterial Disease (PAD) have become increasingly common in outpatient settings; their safety is yet to be determined in a rural, underserved area with no stand-by vascular surgeon on site. METHODS: We undertook a retrospective case review of endovascular procedures for the investigation and management of lower extremity PAD between December 2012 and August 2015. Patients were classified by Rutherford score, degree of stenosis and length of lesions. Complications were major (requiring hospitalization) or minor, including perforation, distal embolization, hematoma, and allergic reactions, which could be treated immediately in the catheterization laboratory with no sequelae. Patients were monitored in the facility and followed up using clinical, biochemical and radiological parameters at 24 h and 1 month. RESULTS: A total of 692 patients underwent endovascular procedures for the investigation and/or treatment of PAD, of which 608 were interventional. Of these patients, 10.20% experienced procedural complications, of which 0.66% were classified as major, including wire retention and retroperitoneal hemorrhage. In total, 99.34% were discharged safely on the same day as the procedure. No adverse events were reported at follow up. CONCLUSION: Endovascular procedures for PAD can be performed safely in a rural outpatient setting with low complication rates. Most complications are minor and do not require hospitalization. Outpatient procedures for PAD are safe and may widen access to specialist procedures in areas of socio-economic deprivation.


Assuntos
Assistência Ambulatorial , Procedimentos Endovasculares , Tempo de Internação , Área Carente de Assistência Médica , Alta do Paciente , Doença Arterial Periférica/terapia , Serviços de Saúde Rural , Idoso , Idoso de 80 Anos ou mais , California , Procedimentos Endovasculares/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Doença Arterial Periférica/diagnóstico por imagem , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
13.
PLoS One ; 15(9): e0216019, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32946438

RESUMO

Similar to many large river valleys globally, the Sacramento River Valley has been extensively drained and leveed, hydrologically divorcing river channels from most floodplains. Today, the former floodplain is extensively managed for agriculture. Lack of access to inundated floodplains is recognized as a significant contributing factor in the decline of native Chinook Salmon (Oncorhynchus tshawytscha). We observed differences in salmon growth rate, invertebrate density, and carbon source in food webs from three aquatic habitat types-leveed river channels, perennial drainage canals in the floodplain, and agricultural floodplain wetlands. Over 23 days (17 February to 11 March, 2016) food web structure and juvenile Chinook Salmon growth rates were studied within the three aquatic habitat types. Zooplankton densities on the floodplain wetland were 53x more abundant, on average, than in the river. Juvenile Chinook Salmon raised on the floodplain wetland grew at 0.92 mm/day, 5x faster than fish raised in the adjacent river habitat (0.18 mm/day). Two aquatic-ecosystem modeling methods were used to partition the sources of carbon (detrital or photosynthetic) within the different habitats. Both modeling approaches found that carbon in the floodplain wetland food web was sourced primarily from detrital sources through heterotrophic pathways, while carbon in the river was primarily photosynthetic and sourced from in situ autotrophic production. Hydrologic conditions typifying the ephemerally inundated floodplain-shallower depths, warmer water, longer water residence times and predominantly detrital carbon sources compared to deeper, colder, swifter water and a predominantly algal-based carbon source in the adjacent river channel-appear to facilitate the dramatically higher rates of food web production observed in the floodplain. These results suggest that hydrologic patterns associated with seasonal flooding facilitate river food webs to access floodplain carbon sources that contribute to highly productive heterotrophic energy pathways important to the production of fisheries resources.


Assuntos
Pesqueiros/estatística & dados numéricos , Inundações , Cadeia Alimentar , Oncorhynchus/fisiologia , Zooplâncton/fisiologia , Animais , California , Ciclo do Carbono , Hidrologia , Modelos Biológicos , Dinâmica Populacional/estatística & dados numéricos , Rios , Estações do Ano , Áreas Alagadas
14.
PLoS One ; 15(9): e0234289, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32946456

RESUMO

The livestock industry is one of the main contributors to greenhouse gas emissions and there is an increasing demand for the industry to reduce its carbon footprint. Several studies have shown that feed additives 3-nitroxypropanol and nitrate to be effective in reducing enteric methane emissions. The objective of this study was to estimate the net mitigating effect of using 3-nitroxypropanol and nitrate on total greenhouse gas emissions in California dairy industry. A life cycle assessment approach was used to conduct a cradle-to-farm gate environmental impact analysis based on dairy production system in California. Emissions associated with crop production, feed additive production, enteric methane, farm management, and manure storage were calculated and expressed as kg CO2 equivalents (CO2e) per kg of energy corrected milk. The total greenhouse gas emissions from baseline, 3-nitroxypropanol and nitrate offered during lactation were 1.12, 0.993, and 1.08 kg CO2e/kg energy corrected milk, respectively. The average net reduction rates for 3-nitroxypropanol and nitrate were 11.7% and 3.95%, respectively. In both cases, using the feed additives on the whole herd slightly improved overall carbon footprint reduction compared to limiting its use during lactation phase. Although both 3-nitroxypropanol and nitrate had effects on decreasing the total greenhouse gas emission, the former was much more effective with no known safety issues in reducing the carbon footprint of dairy production in California.


Assuntos
Ração Animal , Indústria de Laticínios/métodos , Aditivos Alimentares/administração & dosagem , Efeito Estufa/prevenção & controle , Gases de Efeito Estufa/metabolismo , Animais , California , Dióxido de Carbono/metabolismo , Pegada de Carbono/estatística & dados numéricos , Bovinos/metabolismo , Indústria de Laticínios/estatística & dados numéricos , Feminino , Aditivos Alimentares/efeitos adversos , Efeito Estufa/estatística & dados numéricos , Gases de Efeito Estufa/efeitos adversos , Lactação/metabolismo , Nitratos/administração & dosagem , Nitratos/efeitos adversos , Propanóis/administração & dosagem , Propanóis/efeitos adversos
15.
West J Emerg Med ; 21(5): 1089-1094, 2020 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-32970559

RESUMO

INTRODUCTION: The correct use of personal protective equipment (PPE) limits transmission of serious communicable diseases to healthcare workers, which is critically important in the era of coronavirus disease 2019 (COVID-19). However, prior studies illustrated that healthcare workers frequently err during application and removal of PPE. The goal of this study was to determine whether a simulation-based, mastery learning intervention with deliberate practice improves correct use of PPE by physicians during a simulated clinical encounter with a COVID-19 patient. METHODS: This was a pretest-posttest study performed in the emergency department at a large, academic tertiary care hospital between March 31-April 8, 2020. A total of 117 subjects participated, including 56 faculty members and 61 resident physicians. Prior to the intervention, all participants received institution-mandated education on PPE use via an online video and supplemental materials. Participants completed a pretest skills assessment using a 21-item checklist of steps to correctly don and doff PPE. Participants were expected to meet a minimum passing score (MPS) of 100%, determined by an expert panel using the Mastery Angoff and Patient Safety standard-setting techniques. Participants that met the MPS on pretest were exempt from the educational intervention. Testing occurred before and after an in-person demonstration of proper donning and doffing techniques and 20 minutes of deliberate practice. The primary outcome was a change in assessment scores of correct PPE use following our educational intervention. Secondary outcomes included differences in performance scores between faculty members and resident physicians, and differences in performance during donning vs doffing sequences. RESULTS: All participants had a mean pretest score of 73.1% (95% confidence interval [CI], 70.9-75.3%). Faculty member and resident pretest scores were similar (75.1% vs 71.3%, p = 0.082). Mean pretest doffing scores were lower than donning scores across all participants (65.8% vs 82.8%, p<0.001). Participant scores increased 26.9% (95% CI of the difference 24.7-29.1%, p<0.001) following our educational intervention resulting in all participants meeting the MPS of 100%. CONCLUSION: A mastery learning intervention with deliberate practice ensured the correct use of PPE by physician subjects in a simulated clinical encounter of a COVID-19 patient. Further study of translational outcomes is needed.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Educação Médica Continuada/métodos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Treinamento por Simulação/métodos , California , Lista de Checagem , Competência Clínica/estatística & dados numéricos , Infecções por Coronavirus/transmissão , Serviço Hospitalar de Emergência , Humanos , Controle de Infecções/instrumentação , Pneumonia Viral/transmissão
16.
West J Emerg Med ; 21(5): 1114-1117, 2020 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-32970563

RESUMO

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has seriously impacted clinical research operations in academic medical centers due to social distancing measures and stay-at-home orders. The purpose of this paper is to describe the implementation of a program to continue clinical research based out of an emergency department (ED) using remote research associates (RA). METHODS: Remote RAs were trained and granted remote access to the electronic health record (EHR) by the health system's core information technology team. Upon gaining access, remote RAs used a dual-authentication process to gain access to a host-based, firewall-protected virtual network where the EHR could be accessed to continue screening and enrollment for ongoing studies. Study training for screening and enrollment was also provided to ensure study continuity. RESULTS: With constant support and guidance available to establish this EHR access pathway, the remote RAs were able to gain access relatively independently and without major technical troubleshooting. Each remote RA was granted access and trained on studies within one week and self-reported a high degree of program satisfaction, EHR access ease, and study protocol comfort through informal evaluation surveys. CONCLUSIONS: In response to the COVID-19 pandemic, we virtualized a clinical research program to continue important ED-based studies.


Assuntos
Betacoronavirus , Pesquisa Biomédica/organização & administração , Infecções por Coronavirus/prevenção & controle , Registros Eletrônicos de Saúde , Serviço Hospitalar de Emergência/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pesquisadores/organização & administração , Centros Médicos Acadêmicos/organização & administração , California , Humanos , Informática Médica , Desenvolvimento de Programas
17.
Matern Child Health J ; 24(Suppl 2): 141-151, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32748287

RESUMO

OBJECTIVES: With funding from the Pregnancy Assistance Fund, the Maternal, Child, and Adolescent Health Division (MCAH) of California redesigned its existing Adolescent Family Life Program (AFLP) for expectant and parenting young women into a more intensive and structured intervention, AFLP with positive youth development (PYD). This paper presents key findings from a federally funded, rigorous implementation study of the two programs. METHODS: This implementation study collected data from 13 agencies from January 2016 through December 2017, including interviews with 69 case managers and 18 supervisors; focus groups with 130 program participants; surveys of 66 case managers and 1330 young women; and observations of 42 visits with program participants. The study combined qualitative and quantitative analysis methods. RESULTS: As designed, PYD was a much more structured and intensive program than AFLP. Case managers and supervisors saw value in the PYD model and new approach but needed more support and guidance than expected in order to deliver it with fidelity. MCAH provided additional trainings and technical assistance to address challenges. In practice, although staff noted differences in approach and content, the youth experience with the two programs was similar. CONCLUSIONS FOR PRACTICE: Integrating the PYD framework into case management systems may foster youth self-sufficiency and resiliency. However, the rigid structure of the program was often challenging to implement in practice. Organizations interested in implementing prescribed case management approaches should consider allowing opportunities for flexibility in implementation and providing more detailed preservice training to prepare staff for real-world implementation.


Assuntos
Mães/educação , Poder Familiar , Gravidez na Adolescência , Avaliação de Programas e Projetos de Saúde/métodos , Adolescente , California , Administração de Caso , Feminino , Humanos , Mães/psicologia , Gravidez
18.
PLoS One ; 15(8): e0235421, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756552

RESUMO

We investigated rock varnish, a thin, manganese- and iron-rich, dark surface crust, on basaltic lava flows and petroglyphs in the Owens and Rose Valleys (California) by portable X-ray fluorescence (pXRF) and femtosecond laser-ablation inductively-coupled-plasma mass spectrometry (fs-LA-ICPMS). The major element composition of the varnish was consistent with a mixture of Mn-Fe oxyhydroxides and clay minerals. As expected, it contained elevated concentrations of elements that are typically enriched in rock varnish, e.g., Mn, Pb, Ba, Ce, and Co, but also showed unusually high enrichments in U, Cu, and Th. The rare earth and yttrium (REY) enrichment pattern revealed a very strong positive cerium (Ce) anomaly and distinct negative europium (Eu) and Y anomalies. The light rare earth elements (REE) were much more strongly enriched than the heavy REY. These enrichment patterns are consistent with a formation mechanism by leaching of Mn and trace elements from aeolian dust, reprecipitation of Mn and Fe as oxyhydroxides, and scavenging of trace elements by these oxyhydroxides. We inferred accumulation rates of Mn and Fe in the varnish from their areal densities measured by pXRF and the known ages of some of the lava flow surfaces. The areal densities of Mn and Fe, as well as their accumulation rates, were comparable to our previous results from the desert of Saudi Arabia. There was a moderate dependence of the Mn areal density on the inclination of the rock surfaces, but no relationship to its cardinal orientation. We attempted to use the degree of varnish regrowth on the rock art surfaces as an estimate of their age. While an absolute dating of the petroglyphs was not possible because of the lack of suitable calibration surfaces and a considerable amount of variability, the measured degree of varnish regrowth on the various petroglyphs was consistent with chronologies based on archeological and other archaeometric techniques. In particular, our results suggest that rock art creation in the study area continued over an extended period of time, possibly starting around the Pleistocene/Holocene transition and extending into the last few centuries.


Assuntos
Argila/química , Hidróxidos/análise , Ferro/análise , Manganês/análise , California , Meio Ambiente , Monitoramento Ambiental , Espectrometria de Massas , Metais Terras Raras/análise , Espectrometria por Raios X , Propriedades de Superfície , Erupções Vulcânicas , Ítrio/análise
19.
J Adolesc Health ; 67(4): 603-605, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32792255

RESUMO

PURPOSE: This study provides information on how the coronavirus disease 2019 (COVID-19) outbreak is affecting emerging adults currently or recently homeless in terms of engagement in protective behaviors, mental health, substance use, and access to services. METHODS: Ninety participants in an ongoing clinical trial of a risk reduction program for homeless, aged 18-25 years, were administered items about COVID-19 between April 10 and July 9, 2020. RESULTS: Most participants reported engaging in COVID-19 protective behaviors. Past week mental health symptoms were reported by 38%-48% of participants, depending on symptoms. Among those who used substances before the outbreak, 16%-28% reported increased use of alcohol, tobacco, and marijuana. More than half of the participants reported increased difficulty meeting basic needs (e.g., food), and approximately 32%-44% reported more difficulty getting behavioral health services since the outbreak. CONCLUSIONS: Innovative strategies are needed to address the increased behavioral health needs of young people experiencing homelessness during events such as the COVID-19 outbreak.


Assuntos
Infecções por Coronavirus , Acesso aos Serviços de Saúde , Pessoas em Situação de Rua , Serviços de Saúde Mental/estatística & dados numéricos , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pneumonia Viral , Adolescente , Adulto , Betacoronavirus , California , Feminino , Pessoas em Situação de Rua/psicologia , Humanos , Masculino , Serviços de Saúde Mental/provisão & distribução , Inquéritos e Questionários , Adulto Jovem
20.
PLoS Med ; 17(8): e1003238, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32810149

RESUMO

BACKGROUND: It is estimated that vaccinating 50%-70% of school-aged children for influenza can produce population-wide indirect effects. We evaluated a city-wide school-located influenza vaccination (SLIV) intervention that aimed to increase influenza vaccination coverage. The intervention was implemented in ≥95 preschools and elementary schools in northern California from 2014 to 2018. Using a matched cohort design, we estimated intervention impacts on student influenza vaccination coverage, school absenteeism, and community-wide indirect effects on laboratory-confirmed influenza hospitalizations. METHODS AND FINDINGS: We used a multivariate matching algorithm to identify a nearby comparison school district with pre-intervention characteristics similar to those of the intervention school district and matched schools in each district. To measure student influenza vaccination, we conducted cross-sectional surveys of student caregivers in 22 school pairs (2017 survey, N = 6,070; 2018 survey, N = 6,507). We estimated the incidence of laboratory-confirmed influenza hospitalization from 2011 to 2018 using surveillance data from school district zip codes. We analyzed student absenteeism data from 2011 to 2018 from each district (N = 42,487,816 student-days). To account for pre-intervention differences between districts, we estimated difference-in-differences (DID) in influenza hospitalization incidence and absenteeism rates using generalized linear and log-linear models with a population offset for incidence outcomes. Prior to the SLIV intervention, the median household income was $51,849 in the intervention site and $61,596 in the comparison site. The population in each site was predominately white (41% in the intervention site, 48% in the comparison site) and/or of Hispanic or Latino ethnicity (26% in the intervention site, 33% in the comparison site). The number of students vaccinated by the SLIV intervention ranged from 7,502 to 10,106 (22%-28% of eligible students) each year. During the intervention, influenza vaccination coverage among elementary students was 53%-66% in the comparison district. Coverage was similar between the intervention and comparison districts in influenza seasons 2014-2015 and 2015-2016 and was significantly higher in the intervention site in seasons 2016-2017 (7%; 95% CI 4, 11; p < 0.001) and 2017-2018 (11%; 95% CI 7, 15; p < 0.001). During seasons when vaccination coverage was higher among intervention schools and the vaccine was moderately effective, there was evidence of statistically significant indirect effects: The DID in the incidence of influenza hospitalization per 100,000 in the intervention versus comparison site was -17 (95% CI -30, -4; p = 0.008) in 2016-2017 and -37 (95% CI -54, -19; p < 0.001) in 2017-2018 among non-elementary-school-aged individuals and -73 (95% CI -147, 1; p = 0.054) in 2016-2017 and -160 (95% CI -267, -53; p = 0.004) in 2017-2018 among adults 65 years or older. The DID in illness-related school absences per 100 school days during the influenza season was -0.63 (95% CI -1.14, -0.13; p = 0.014) in 2016-2017 and -0.80 (95% CI -1.28, -0.31; p = 0.001) in 2017-2018. Limitations of this study include the use of an observational design, which may be subject to unmeasured confounding, and caregiver-reported vaccination status, which is subject to poor recall and low response rates. CONCLUSIONS: A city-wide SLIV intervention in a large, diverse urban population was associated with a decrease in the incidence of laboratory-confirmed influenza hospitalization in all age groups and a decrease in illness-specific school absence rate among students in 2016-2017 and 2017-2018, seasons when the vaccine was moderately effective, suggesting that the intervention produced indirect effects. Our findings suggest that in populations with moderately high background levels of influenza vaccination coverage, SLIV programs are associated with further increases in coverage and reduced influenza across the community.


Assuntos
Absenteísmo , Vacinas contra Influenza/administração & dosagem , Serviços de Saúde Escolar/normas , População Urbana , Cobertura Vacinal/normas , Vacinação/normas , Adolescente , California/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Masculino , Instituições Acadêmicas/normas , Estudantes , Vacinação/métodos , Cobertura Vacinal/métodos
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