Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.391
Filtrar
1.
2.
Science ; 377(6604): 373-375, 2022 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-35862535

RESUMO

A continuation of the current 23-year-long drought will require difficult decisions to prevent further decline.


Assuntos
Secas , Rios , Abastecimento de Água , Colorado
4.
Prev Med ; 161: 107146, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35810935

RESUMO

Adolescent violence, including sexual violence, homophobic name-calling, and teen dating violence, are public health problems that cause harm to many adolescents in the United States. Although research on the perpetration of these forms of adolescent violence has increased in recent years, little is known about perpetration rates across gender, race/ethnicity, and sexual orientation. To address this gap, the current study descriptively examined perpetration rates between and across different identities, including self-identified race/ethnicity, sexual identity, and gender identity. In Fall 2017, 9th - 11th grade students (N = 4782) at 20 high schools in Colorado (United States) completed a survey that assessed demographics (e.g., race/ethnicity, sexual identity, and gender identity) and various forms of violence perpetration. Compared to female adolescents, male adolescents reported significantly higher perpetration rates for: any sexual violence (27% vs. 17%); sexual harassment (26% vs. 15%); unwanted sexual contact (8% vs. 4%); and homophobic name-calling (61% vs. 38%). Differences in perpetration rates were also observed among various racial/ethnic, sexual, and gender minority students compared to non-minority students. This emphasizes a need for more research on how minority stress that results from the dynamics of intersecting identities and societal systems of power-including racism, sexism, homophobia, and transphobia-contributes to violence perpetration. Evidence-based violence prevention approaches, particularly strategies targeted at changing social norms about violence, gender, and sexuality, need to be tailored and evaluated for students with diverse cultural and social identities to ensure safe school climates for all students.


Assuntos
Comportamento do Adolescente , Vítimas de Crime , Violência por Parceiro Íntimo , Adolescente , Colorado/epidemiologia , Etnicidade , Feminino , Identidade de Gênero , Humanos , Masculino , Prevalência , Estudantes , Estados Unidos/epidemiologia , Violência
5.
Sci Rep ; 12(1): 12235, 2022 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-35851284

RESUMO

Joint species distribution models have become ubiquitous for studying species-environment relationships and dependence among species. Accounting for community structure often improves predictive power, but can also affect inference on species-environment relationships. Specifically, some parameterizations of joint species distribution models allow interspecies dependence and environmental effects to explain the same sources of variability in species distributions, a phenomenon we call community confounding. We present a method for measuring community confounding and show how to orthogonalize the environmental and random species effects in suite of joint species distribution models. In a simulation study, we show that community confounding can lead to computational difficulties and that orthogonalizing the environmental and random species effects can alleviate these difficulties. We also discuss the inferential implications of community confounding and orthogonalizing the environmental and random species effects in a case study of mammalian responses to the Colorado bark beetle epidemic in the subalpine forest by comparing the outputs from occupancy models that treat species independently or account for interspecies dependence. We illustrate how joint species distribution models that restrict the random species effects to be orthogonal to the fixed effects can have computational benefits and still recover the inference provided by an unrestricted joint species distribution model.


Assuntos
Besouros , Florestas , Animais , Colorado , Simulação por Computador , Mamíferos
6.
Med Care ; 60(8): 596-601, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35797458

RESUMO

BACKGROUND: During the coronavirus disease-2019 (COVID-19) pandemic cumulative United States COVID-19 deaths per capita were higher than all other large, high-income nations, but with substantial variation across the country. OBJECTIVE: The aim was to detail the public health response during the pandemic in Eagle County, Colorado. RESEARCH DESIGN AND MEASURES: Observational study using pre-COVID-19 county public health metrics. Pandemic actions were recorded from a narrative summary of daily phone consultations by a county-wide taskforce and interviews. Outcomes obtained from local, state, and nationally reported databases. METHODS: Eagle County began with a life expectancy of 85.9, low all-cause age-adjusted death rates equal for both White and Latinx populations, a high household median income, and other prepandemic advantages. It also launched an innovative, independent county-wide taskforce lead by experienced mid-level managers. The taskforce implemented rapid communication of decision consequences, made immediate course corrections without traditional organizational approvals or contradictory political pressures. RESULTS: Eagle County was first in Colorado to obtain Personal Protective Equipment and to establish a drive-through testing facility. The COVID-19 case fatality rate was 0.34%. The sole intensive care unit never reached maximum capacity. By March 2022, Eagle County had administered at least 1 vaccine dose to 100% of the population and 83% were fully vaccinated. CONCLUSIONS: It is not possible to directly attribute superior outcomes to either the baseline characteristics of Eagle County or its innovative taskforce design and deployment. Rather this report highlights the potential impact that improving the baseline health status of US citizens and permitting novel problem-solving approaches by local public health officials might have for the next pandemic.


Assuntos
COVID-19 , Coronavirus , Águias , Animais , COVID-19/epidemiologia , Colorado , Humanos , Pandemias/prevenção & controle , Saúde Pública , Estados Unidos/epidemiologia
7.
J Environ Radioact ; 250: 106910, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35653873

RESUMO

Radon is a naturally occurring radioactive gas that enters homes through cracks in the foundation where accumulated levels can cause lung cancer. Within the United States (U.S.), state level radon reduction strategies rely on education and outreach to motivate people to test and mitigate their home. Only about 5% of the housing units in Colorado, U.S. have been tested for radon. This study looks at the 2012 Behavioral Risk Factors Surveillance System (BRFSS) in Colorado to identify distinct groups of people using Latent Class Analysis, and compares radon awareness, testing, and mitigation to understand underlying differences of radon reduction behaviors using path models. Five classes were identified: 1) Wealthy Young Families, 2) Older Singles, 3) Empty Nesters, 4) Smokers, and 5) Struggling Young Families. Significant differences in responses to radon survey questions existed across groups in which Struggling Young Families were the least likely to be aware of radon, have tested their home for radon, and have their home mitigated. Average radon awareness, testing, and mitigation appeared to be influenced by financial stress. Results from this study can be used to tailor future radon interventions and policy initiatives to enhance equity of radon reduction behaviors including legal framework to ensure radon mitigation takes place in rental properties.


Assuntos
Poluição do Ar em Ambientes Fechados , Neoplasias Pulmonares , Monitoramento de Radiação , Radônio , Poluição do Ar em Ambientes Fechados/análise , Colorado , Habitação , Humanos , Análise de Classes Latentes , Radônio/análise , Estados Unidos
8.
Dis Aquat Organ ; 149: 109-120, 2022 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-35678356

RESUMO

Detections of Renibacterium salmoninarum in Colorado USA fish hatcheries have become more frequent in recent years, including one disease outbreak that originated with a wild broodstock. Our objectives were to document the prevalence and distribution of R. salmoninarum in Colorado's wild trout fisheries, investigate variables that influence that distribution, and evaluate the effectiveness of common testing methods on non-anadromous trout. We sampled wild trout across Colorado and tested kidney tissue with enzyme-linked immunosorbent assay (ELISA), quantitative polymerase chain reaction (qPCR), nested polymerase chain reaction (nPCR), and direct fluorescent antibody test (DFAT). Screening with ELISA showed high prevalence of R. salmoninarum among fish populations, but antigen levels were low. No clinical disease was observed in any of the fish sampled despite the antigen of R. salmoninarum being common. Antigen levels measured by ELISA increased in smaller streams with lower historic fish stocking rates. Brook trout Salvelinus fontinalis had the highest prevalence of the bacterium among fish species and highest ELISA antigen levels. The distribution of brook trout in the smallest streams may help explain the patterns of R. salmoninarum across the landscape. The most effective assays for screening wild trout were qPCR and ELISA; DFAT was inconsistent for bacterial levels encountered in wild trout and generally uninformative. Additionally, qPCR and ELISA can provide quantitative information about bacteria levels. The bacterium R. salmoninarum is ubiquitous in Colorado trout fisheries but is generally found at low levels. Active infections are rare and overt bacterial kidney disease appears more common in Colorado hatcheries than in wild fish.


Assuntos
Infecções Bacterianas , Doenças dos Peixes , Nefropatias , Micrococcaceae , Animais , Infecções Bacterianas/veterinária , Colorado/epidemiologia , Doenças dos Peixes/microbiologia , Pesqueiros , Rim , Nefropatias/epidemiologia , Nefropatias/veterinária , Micrococcaceae/genética , Prevalência , Renibacterium , Truta
9.
Alcohol Clin Exp Res ; 46(6): 1094-1102, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35723682

RESUMO

RATIONALE: Investigations show that medications for alcohol use disorders (MAUD) reduce heavy drinking and relapses. However, only 1.6% of individuals with alcohol use disorders (AUD) receive MAUD across care settings. The epidemiology of MAUD prescribing in the acute care setting is incompletely described. We hypothesized that MAUD would be under prescribed in inpatient acute care hospital settings compared to the outpatient, emergency department (ED), and inpatient substance use treatment settings. METHODS: We evaluated electronic health record (EHR) data from adult patients with an International Classification of Diseases, 10th revision (ICD-10) alcohol-related diagnosis in the University of Colorado Health (UCHealth) system between January 1, 2016 and 31 December, 2019. Data from patients with an ICD-10 diagnosis code for opioid use disorder and those receiving MAUD prior to their first alcohol-related episode were excluded. The primary outcome was prescribing of MAUD, defined by prescription of naltrexone, acamprosate, and/or disulfiram. We performed bivariate and multivariate analyses to identify independent predictors of MAUD prescribing at UCHealth. RESULTS: We identified 48,421 unique patients with 136,205 alcohol-related encounters at UCHealth. Encounters occurred in the ED (42%), inpatient acute care (17%), inpatient substance use treatment (18%), or outpatient primary care (12%) settings. Only 2270 (5%) patients received MAUD across all settings. Female sex and addiction medicine consults positively predicted MAUD prescribing. In contrast, encounters outside inpatient substance use treatment, Hispanic ethnicity, and black or non-white race were negative predictors of MAUD prescribing. Compared to inpatient substance use treatment, inpatient acute care hospitalizations for AUD was associated with a 93% reduced odds of receiving MAUD. CONCLUSIONS: AUD-related ED and inpatient acute care hospital encounters in our healthcare system were common. Nevertheless, prescriptions for MAUD were infrequent in this population, particularly in inpatient settings. Our findings suggest that the initiation of MAUD for patients with alcohol-related diagnoses in acute care settings deserves additional evaluation.


Assuntos
Alcoolismo , Transtornos Relacionados ao Uso de Opioides , Adulto , Alcoolismo/tratamento farmacológico , Alcoolismo/epidemiologia , Colorado/epidemiologia , Atenção à Saúde , Etanol/uso terapêutico , Feminino , Humanos , Naltrexona/uso terapêutico
10.
Front Public Health ; 10: 856878, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35719684

RESUMO

Health is a human right. In order to exercise their right to health, agricultural workers need to have access to medical, dental, and behavioral health care. Agricultural workers need to have medical, dental, and behavioral health care available at times and locations that are amenable to their work schedules and worksites. Many agricultural workers do not have access to transportation due to the nature of their working conditions, therefore policies to provide transportation will increase access to medical, dental, and behavioral health services.


Assuntos
Fazendeiros , Acesso aos Serviços de Saúde , Colorado , Pessoal de Saúde , Humanos , Políticas
11.
Am J Public Health ; 112(S3): S306-S313, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35679563

RESUMO

Objectives. To examine public health nurse (PHN) intervention tailoring through the Colorado Nurse Support Program (NSP). Our 2 specific aims were to describe the NSP program and its outcomes and to determine the effects of modifying interventions on short- and long-term outcomes among NSP clients. Methods. In our retrospective causal investigation of 150 families in Colorado in 2018-2019, intervention effects were modeled via longitudinal modified treatment policy analyses. Results. Families served by PHNs improved in terms of knowledge, behavior, and status outcomes after receiving multidimensional, tailored home visiting interventions. Case management interventions provided in the first month of PHN home visits had lasting effects on behavior outcomes, and 2 additional case management interventions in the first month were estimated to have even more of an impact. Conclusions. Modern causal inference methods and real-world PHN data revealed a nuanced, fine-grained understanding of the real impact of tailored PHN interventions. Public Health Implications PHN programs such as the NSP and use of the Omaha System should be supported and extended to advance evaluations of intervention effectiveness and knowledge discovery and improve population health. (Am J Public Health. 2022;112(S3):S306-S313. https://doi.org/10.2105/AJPH.2022.306792).


Assuntos
Visita Domiciliar , Enfermeiras de Saúde Pública , Criança , Proteção da Criança , Colorado , Feminino , Humanos , Poder Familiar , Encaminhamento e Consulta , Estudos Retrospectivos
12.
Emerg Infect Dis ; 28(8): 1551-1558, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35705189

RESUMO

A COVID-19 outbreak occurred among Cameron Peak Fire responders in Colorado, USA, during August 2020-January 2021. The Cameron Peak Fire was the largest recorded wildfire in Colorado history, lasting August-December 2020. At least 6,123 responders were involved, including 1,260 firefighters in 63 crews who mobilized to the fire camps. A total of 79 COVID-19 cases were identified among responders, and 273 close contacts were quarantined. State and local public health investigated the outbreak and coordinated with wildfire management teams to prevent disease spread. We performed whole-genome sequencing and applied social network analysis to visualize clusters and transmission dynamics. Phylogenetic analysis identified 8 lineages among sequenced specimens, implying multiple introductions. Social network analysis identified spread between and within crews. Strategies such as implementing symptom screening and testing of arriving responders, educating responders about overlapping symptoms of smoke inhalation and COVID-19, improving physical distancing of crews, and encouraging vaccinations are recommended.


Assuntos
COVID-19 , Bombeiros , Incêndios Florestais , COVID-19/epidemiologia , Colorado/epidemiologia , Surtos de Doenças , Humanos , Filogenia
13.
PLoS One ; 17(6): e0270636, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35771836

RESUMO

Potatoes are the most consumed vegetable worldwide and play an important role in the U.S. economy. Growers make critical decisions each year in choosing which cultivar to grow, based on factors such as yield, resilience to the growing environment, and utility in the food industry. Current research supports the finding that less-common specialty cultivars (SCs) have benefits for human health. However, growers have been slow to adopt SCs into mainstream operations. Here, we identify major factors in the decision-making process that determine whether a population of growers in the San Luis Valley, Colorado, a major potato-growing region, adopt SC potatoes. We used a combination of ethnographic techniques and quantitative methods to examine drivers of adoption. The data demonstrate grower perceptions within potato farming and the complexity of interacting factors in decision-making. An integration of the Theory of Planned Behavior, Rational Expectation Hypothesis, and Diffusion of Innovation models identifies economic and social factors that influence grower decision-making. Growers that were more aware of specialty cultivar innovation and associated consumer demand were more open to SCs adoption. Other influencing factors include a grower's experience selling a SC in the previous year and access to diverse markets. Based on these data, we developed a new model to explain grower decision-making processes in adopting SCs. The model demonstrates that one current barrier to adoption is access to buyers, including warehouses, retailers, and households. Taken together, this research demonstrates how rational expectations stem from economic outcomes, knowledge, and experience in the potato industry. These results are important in helping to consider opportunities for growers to access new, higher value markets, while also improving consumer access to nutritious cultivars.


Assuntos
Solanum tuberosum , Agricultura/métodos , Colorado , Meio Ambiente , Humanos , Verduras
14.
Am J Public Health ; 112(S5): S532-S536, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35767790

RESUMO

The Colorado Initiative to Reduce Unintended Pregnancy, including its largest subproject, the Colorado Family Planning Initiative, had a significant impact on contraceptive access during and after the project period. This coordinated and multilevel initiative improved reproductive health outcomes by driving change in public health systems, advancing statewide policies, building capacity through training and technical assistance, and increasing public awareness and education. Lessons learned from the implementation and outcomes of the Colorado Initiative to Reduce Unintended Pregnancy continue to inform contraceptive access efforts. (Am J Public Health. 2022;112(S5):S532-S536. https://doi.org/10.2105/AJPH.2022.306891).


Assuntos
Anticoncepção , Gravidez não Planejada , Colorado , Serviços de Planejamento Familiar , Feminino , Acesso aos Serviços de Saúde , Humanos , Gravidez , Saúde Reprodutiva
15.
Artigo em Inglês | MEDLINE | ID: mdl-35742316

RESUMO

To objectively grasp the current situation and development trend of resilient cities or communities (RC) research. The articles in Web of Science (WOS) Core Collection databases from 1995 to 2022 were used as a sample, and bibliometrics was used to statistically analyze the year of publication and number of articles, highly cited documents and keyword hotness in this field. VOSviewer was used to explore the knowledge graph of RC research documents. The results show that: the development process is roughly divided into 3 periods: no attention (1995-2004), starting (2005-2014), and rapid growth (2015-2021). The journal "Sustainability" and "International journal of disaster risk reduction" are the key journals publishing RC research. Serre and Shaw are the most productive authors. The USA is still the leading country in this field of RC. Colorado State Univ, Texas a&m Univ, and Delft Univ Technol are the main research institutions. The keyword analysis indicates the hot topics in different periods. Moreover, several limitations and some recommendations for future research on RC are also given based on this.


Assuntos
Bibliometria , Gerenciamento de Dados , Cidades , Colorado , Bases de Dados Factuais , Publicações
16.
Headache ; 62 Suppl 1: 1-170, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35593880
17.
Wilderness Environ Med ; 33(2): 197-203, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35491311

RESUMO

INTRODUCTION: While avalanche fatalities have remained relatively steady per year, data suggest a possible increase in sidecountry use and snowmobile fatalities. Limited information is known regarding the accident details and preparedness among different groups of backcountry users including snowmobiles, sidecountry, and backcountry skiers, and what specific factors could contribute to their fatalities. METHODS: Avalanche fatality reports covering all US states posted by the Colorado Avalanche Information Center available online for 10 seasons (2009-2010 through 2018-2019 seasons) were analyzed for group size, specific equipment carried, burial depth, burial time, and other details. Only reports in the 3 following categories were included in the analysis: backcountry ski/snowboard, sidecountry ski/snowboard, and snowmobile/snowbike. These aspects were compared among the 3 tourer types using statistical analyses (ANOVA). RESULTS: Two hundred and five fatalities were analyzed (n=32 sidecountry, n=91 skier/snowboard, n=82 snowmobile/snowbike). Using 2 preparedness scores, the ski/snowboard group had the greatest distribution of high scores when evaluated by equipment carried and group size, with significant differences per group (P<0.01). Of the fatalities that were buried, burial time was related to the tourer group (P=0.04), with the ski/snowboard group having the highest proportion of burials <15 min. Burial depth was significantly different among the 3 tourer groups, with snowmobiles buried the deepest on average (P<0.01). CONCLUSIONS: Despite limited data available on fatalities, an analysis of preparedness suggests that backcountry skiers and snowboarders are more prepared for avalanche accidents compared to snowmobiles and sidecountry users when evaluated by equipment carried and group size.


Assuntos
Avalanche , Veículos Off-Road , Esqui , Acidentes , Colorado/epidemiologia , Estações do Ano , Estados Unidos/epidemiologia
18.
J Health Care Poor Underserved ; 33(2): 580-589, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35574861

RESUMO

Medical-legal partnerships (MLPs) add legal professionals, trained specifically to tackle health-related social needs (HRSN), to the health care team. We evaluated the impact on health outcomes and health care utilization of a MLP housed in a large federally qualified health center in Colorado (MLP-CO). Clients screened for I-HELP (Income, Housing, Employment, Legal status, Personal stability) needs were surveyed at baseline and six months post-enrollment. Reasons for legal aid were legal immigration status (46.5%), income (30.8%), personal/family stability (14.8%), housing (4.8%), and education (1.2%). Overall, 61.4% attributed great/moderate improvements in their health care experience to the MLP-CO. Statistically significant improvements were noted for days with poor physical/mental health, and feelings of stress/worry. There was a reduction in emergency department visits, hospitalization days, and missed appointments, but only the latter was statistically significant. In conclusion, MLPs are a promising innovation to achieve the Institute for Healthcare Improvement's quadruple aim.


Assuntos
Atenção à Saúde , Habitação , Colorado , Humanos , Avaliação de Resultados em Cuidados de Saúde , Populações Vulneráveis
19.
Viruses ; 14(5)2022 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-35632657

RESUMO

Randall Cohrs established the Colorado Alphaherpesvirus Latency Society (CALS) in 2011 [...].


Assuntos
Alphaherpesvirinae , Colorado , Vírus Oncogênicos
20.
BMC Med Res Methodol ; 22(1): 148, 2022 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-35597908

RESUMO

BACKGROUND: Missing data prove troublesome in data analysis; at best they reduce a study's statistical power and at worst they induce bias in parameter estimates. Multiple imputation via chained equations is a popular technique for dealing with missing data. However, techniques for combining and pooling results from fitted generalized additive models (GAMs) after multiple imputation have not been well explored. METHODS: We simulated missing data under MCAR, MAR, and MNAR frameworks and utilized random forest and predictive mean matching imputation to investigate a variety of rules for combining GAMs after multiple imputation with binary and normally distributed outcomes. We compared multiple pooling procedures including the "D2" method, the Cauchy combination test, and the median p-value (MPV) rule. The MPV rule involves simply computing and reporting the median p-value across all imputations. Other ad hoc methods such as a mean p-value rule and a single imputation method are investigated. The viability of these methods in pooling results from B-splines is also examined for normal outcomes. An application of these various pooling techniques is then performed on two case studies, one which examines the effect of elevation on a six-minute walk distance (a normal outcome) for patients with pulmonary arterial hypertension, and the other which examines risk factors for intubation in hospitalized COVID-19 patients (a dichotomous outcome). RESULTS: In comparison to the results from generalized additive models fit on full datasets, the median p-value rule performs as well as if not better than the other methods examined. In situations where the alternative hypothesis is true, the Cauchy combination test appears overpowered and alternative methods appear underpowered, while the median p-value rule yields results similar to those from analyses of complete data. CONCLUSIONS: For pooling results after fitting GAMs to multiply imputed datasets, the median p-value is a simple yet useful approach which balances both power to detect important associations and control of Type I errors.


Assuntos
COVID-19 , Hipertensão Pulmonar , COVID-19/epidemiologia , Colorado , Hospitalização , Humanos , Hipertensão Pulmonar/diagnóstico , Modelos Estatísticos , Sistema de Registros
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...