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1.
Artigo em Inglês | MEDLINE | ID: mdl-34639356

RESUMO

Stormwater control measures (SCMs) (i.e., green infrastructure) are advantageous methods of stormwater management. However, studies suggest that urban greening may be associated with gentrification, displacing racially/ethnically minoritized groups due to increased housing costs and loss of feelings of belonging. We studied displacement of racially/ethnically minoritized groups after SCM installation in Washington, DC. We compared the change in percentage of persons in racial/ethnic groups at the Census block group level with varying levels of SCM installation (i.e., area-weighted SCM count at 300 m buffer). We stratified findings by SCM type, pre-installation income, and SCM size. DC installed a higher density of SCMs in areas with a higher percentage of Black and/or Hispanic/Latino residents. Nonetheless, findings suggest SCM installation is associated with displacement of Black residents. The percentage of residents who are Black decreased by 2.2% [95% Confidence Interval: 1.7, 2.7] and 4.1% [95% Confidence Interval: 3.4, 4.8] after low and high levels of SCM installation, respectively. In turn, the change in percentage of residents who are White increased with increasing levels of SCM installation. Compared to ecological studies on SCMs, studies about social impacts are scarce. This research intends to help optimize SCM installations so more residents can enjoy their health, economic, and ecological benefits.


Assuntos
Grupos de Populações Continentais , Hispano-Americanos , District of Columbia , Grupos Étnicos , Humanos , Renda
2.
Am J Prev Med ; 61(5 Suppl 1): S16-S25, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34686285

RESUMO

INTRODUCTION: In 2019, the District of Columbia recorded a 20-year low rate in new HIV infections but also had near-record numbers of gonorrhea and chlamydia infections. District of Columbia Department of Health has supported numerous forms of community-based in-person screening but not direct at-home testing. METHODS: In summer 2020, the District of Columbia Department of Health launched GetCheckedDC.org for District of Columbia residents to order home-based oral HIV antibody test and urogenital, pharyngeal, and rectal chlamydia and gonorrhea tests. Initial and follow-up surveys were completed by individuals for both test modalities. RESULTS: A retrospective analysis was conducted for the first 5 months of the program. During that period, 1,089 HIV and 1,262 gonorrhea and chlamydia tests (535 urogenital, 520 pharyngeal, 207 rectal) were ordered by 1,245 District of Columbia residents. The average age was 33.1 (median=31, range=14-78) years; 51.6% of requestors identified as Black; 39.3% identified as men who have sex with men; 16.2% reported no form of insurance; and 8.1% and 10.4% reported never being testing for HIV and sexually transmitted infections, respectively. More than half of people requesting tests reported convenience and COVID-19 as the reasons. In total, 39.5% of sexually transmitted infection tests were returned; 7.22% of people testing for sexually transmitted infections received a positive result, and 10.35% of rectal tests were positive. No individuals reported a positive HIV self-test that was confirmed; 98.5% of respondents said that they would recommend the HIV self-test kit. CONCLUSIONS: Mail-out HIV and sexually transmitted infection testing was readily taken up among high-priority demographics within a diverse, urban, high-morbidity jurisdiction during the COVID-19 pandemic. Extragenital testing for gonorrhea and chlamydia should be included in all at-home screening tests given the high positivity rate.


Assuntos
COVID-19 , Infecções por Chlamydia , Gonorreia , Infecções por HIV , Minorias Sexuais e de Gênero , Doenças Sexualmente Transmissíveis , Adulto , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/epidemiologia , District of Columbia/epidemiologia , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Programas de Rastreamento , Pandemias , Serviços Postais , Estudos Retrospectivos , SARS-CoV-2 , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/epidemiologia , Washington/epidemiologia
3.
Nutrients ; 13(9)2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34578813

RESUMO

Childhood obesity prevalence trends involve complex societal and environmental factors as well as individual behaviors. The Healthy Schoolhouse 2.0 program seeks to improve nutrition literacy among elementary school students through an equity-focused intervention that supports the health of students, teachers, and the community. This five-year quasi-experimental study follows a baseline-post-test design. Research activities examine the feasibility and effectiveness of a professional development series in the first program year to improve teachers' self-efficacy and students' nutrition literacy. Four elementary schools in Washington, DC (two intervention, two comparison) enrolled in the program (N = 1302 students). Demographic and baseline assessments were similar between schools. Teacher participation in professional development sessions was positively correlated with implementing nutrition lessons (r = 0.6, p < 0.001, n = 55). Post-test student nutrition knowledge scores (W = 39985, p < 0.010, n = 659) and knowledge score changes (W = 17064, p < 0.010, n = 448) were higher among students in the intervention schools. Students who received three nutrition lessons had higher post knowledge scores than students who received fewer lessons (H(2) =22.75, p < 0.001, n = 659). Engaging teachers to implement nutrition curricula may support sustainable obesity prevention efforts in the elementary school environment.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Obesidade Pediátrica/terapia , Avaliação de Programas e Projetos de Saúde/métodos , Professores Escolares/estatística & dados numéricos , Adulto , Criança , Currículo , District of Columbia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Obesidade Pediátrica/prevenção & controle
4.
Cardiol Young ; 31(8): 1220-1227, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34493356

RESUMO

Cardiac surgery for CHD was pioneered in Washington, DC by Charles Hufnagel and Edgar Davis working at Georgetown University and Children's Hospital of the District of Columbia. Children's Hospital, now Children's National Hospital, had been established just 5 years after the end of the Civil War. In the 1950s, Davis and Hufnagel undertook many open-heart operations using the technique of surface cooling, hypothermia, and circulatory arrest. Hufnagel and Lewis Scott, who founded the cardiology department at Children's, were trained in Boston by Gross and Nadas. Judson Randolph, also a trainee of Gross, introduced cardiac surgery using cardiopulmonary bypass and established the General Pediatric Surgery department at Children's in the 1960s. The transition of hospital staffing from community-based private physicians to full-time hospital employees was often controversial but was complete by the turn of the millennium. The 21st century has seen continuing growth of the new Children's National Heart Institute and consolidation of several congenital cardiac programmes in Washington, DC.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Cardiopatias Congênitas , Cirurgia Torácica , Criança , District of Columbia , Cardiopatias Congênitas/cirurgia , Hospitais Pediátricos , Humanos
5.
Am J Cardiol ; 157: 42-47, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34384590

RESUMO

Cardiac involvement in coronavirus disease 2019 (COVID-19) has been established. This is manifested by troponin elevation and associated with worse patient prognosis. We evaluated whether patient outcomes improved as experience accumulated during the pandemic. We analyzed COVID-19-positive patients with myocardial injury (defined as troponin elevation) who presented to the MedStar Health system (11 hospitals in Washington, DC, and Maryland) during the "Early Phase" of the pandemic (March 1 - June 30, 2020) and compared their characteristics and outcomes to the COVID-19-positive patients with the presence of troponin elevation in the "Later Phase" of the pandemic (October 1, 2020 - January 31, 2021). The cohort included 788 COVID-19-positive admitted patients for whom troponin was elevated, 167 during the "Early Phase" and 621 during the "Later Phase." Maximum troponin-I in the "Early Phase" was 13.46±34.72 ng/mL versus 11.21±20.57 ng/mL in the "Later Phase" (p = 0.553). In-hospital mortality was significantly higher in the "Later Phase" (50.3% vs. 24.6%; p<0.001), as were incidence of intensive-care-unit admission (77.8% vs. 46.1%; p<0.001) and need for mechanical ventilation (61.7% versus 28%; p<0.001). In addition, more "Early Phase" patients underwent coronary angiography (6% vs. 2.3%; p=0.013). Finally, 3% of "Early Phase" and 0.8% of "Later Phase" patients underwent percutaneous coronary intervention (p=0.025). In conclusion, treatment outcomes have significantly improved since the beginning of the pandemic in COVID-19-positive patients with troponin elevation. This may be attributed to awareness, severity of the disease, improvements in therapies, and provider experience.


Assuntos
COVID-19/epidemiologia , Infarto do Miocárdio/terapia , Troponina I/sangue , Idoso , Idoso de 80 Anos ou mais , Competência Clínica , Estudos de Coortes , Angiografia Coronária/estatística & dados numéricos , District of Columbia/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Masculino , Maryland/epidemiologia , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Pandemias , Admissão do Paciente/estatística & dados numéricos , Intervenção Coronária Percutânea/estatística & dados numéricos , Respiração Artificial/estatística & dados numéricos
6.
J Health Care Poor Underserved ; 32(3): 1166-1172, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34421021

RESUMO

During academic clinical suspensions related to the COVID-19 pandemic, a group of medical students in Washington, D.C. collaborated with a local federally qualified health center to launch a free COVID-19 testing site to increase access to testing in the community. The patients who accessed the testing site were predominantly Black/African American and Hispanic/Latino, some of whom were uninsured or without access to testing or a timely physician's referral. In this article, medical students reflect on their experiences at this testing site and provide commentary on how existing racial and socioeconomic health disparities have been exacerbated by the COVID-19 pandemic. While under the extremely unusual circumstance of a suspension from their clinical rotations, medical students elaborate on the lessons learned from this experience and the continued work required to engage deeply in the issues of equality and racial justice now and in the future.


Assuntos
Teste para COVID-19 , Serviços de Saúde Comunitária , Estudantes de Medicina , Afro-Americanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , District of Columbia/epidemiologia , Disparidades em Assistência à Saúde , Hispano-Americanos , Humanos , Pandemias , Voluntários
7.
MMWR Morb Mortal Wkly Rep ; 70(34): 1136-1141, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34437522

RESUMO

Nonfatal and fatal drug overdoses increased overall from 2019 to 2020 (1).* Illicit benzodiazepines (e.g., etizolam, flualprazolam, and flubromazolam)† were increasingly detected among postmortem and clinical samples in 2020, often with opioids,§ and might have contributed to overall increases in drug overdoses. Availability of recent multistate trend data on nonfatal benzodiazepine-involved overdoses and involvement of illicit benzodiazepines in overdoses is limited. This data gap was addressed by analyzing annual and quarterly trends in suspected benzodiazepine-involved nonfatal overdoses¶ treated in emergency departments (EDs) (benzodiazepine overdose ED visits) during January 2019-December 2020 (32 states and the District of Columbia [DC]) and benzodiazepine-involved overdose deaths (benzodiazepine deaths), which include both illicit and prescription benzodiazepines, during January 2019-June 2020 (23 states) from CDC's Overdose Data to Action (OD2A) program. From 2019 to 2020, benzodiazepine overdose ED visits per 100,000 ED visits increased (23.7%), both with opioid involvement (34.4%) and without (21.0%). From April-June 2019 to April-June 2020, overall benzodiazepine deaths increased 42.9% (from 1,004 to 1,435), prescription benzodiazepine deaths increased 21.8% (from 921 to 1,122), and illicit benzodiazepine deaths increased 519.6% (from 51 to 316). During January-June 2020, most (92.7%) benzodiazepine deaths also involved opioids, mainly illicitly manufactured fentanyls (IMFs) (66.7%). Improving naloxone availability and enhancing treatment access for persons using benzodiazepines and opioids and calling emergency services for overdoses involving benzodiazepines and opioids, coupled with primary prevention of drug use and misuse, could reduce morbidity and mortality.


Assuntos
Benzodiazepinas/envenenamento , Overdose de Drogas/mortalidade , Adolescente , Adulto , Idoso , District of Columbia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
8.
J Health Econ ; 78: 102480, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34218042

RESUMO

Recent increases in vaccine-preventable diseases have led policymakers to reconsider the scope of vaccine requirement exemptions. Yet eliminating these provisions is politically difficult. Beginning in 2009, sixth grade girls in Washington, DC were required to receive the HPV vaccine or submit a one-time opt-out form. In 2014, the requirement was expanded to all students grades 6-12, and those not vaccinating were required to opt-out annually. I show that the movement from a one-time opt-out provision to an annual requirement increased the probability that teen girls in Washington, DC initiated HPV vaccination by 11 percentage points. Teen boys were 20 percentage points more likely to be vaccinated. Back-of-the-envelope calculations suggest 7 fewer cases of cervical cancer and 41 fewer cases of oropharyngeal cancer for the 33,000 enrolled during the 2017/2018 year. Using the initial value of cancer care and the value of a statistical life year, my estimates imply nearly $36 million in savings compared to $1.5 million spent on vaccination. In generalizing these results to other states, effect sizes even one-tenth the size of my most conservative estimate would imply meaningful reductions in the nationwide incidence of HPV-related cancers.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Adolescente , District of Columbia , Feminino , Humanos , Masculino , Infecções por Papillomavirus/prevenção & controle , Instituições Acadêmicas , Vacinação
10.
Med Intensiva (Engl Ed) ; 45(6): 325-331, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34294231

RESUMO

OBJECTIVE: To describe outcomes of critically ill patients with COVID-19, particularly the association of renal replacement therapy to mortality. DESIGN: A single-center prospective observational study was carried out. SETTING: ICU of a tertiary care center. PATIENTS: Consecutive adults with COVID-19 admitted to the ICU. INTERVENTION: Renal replacement therapy. MAIN VARIABLES OF INTEREST: Demographic data, medical history, illness severity, type of oxygen therapy, laboratory data and use of renal replacement therapy to generate a logistic regression model describing independent risk factors for mortality. RESULTS: Of the total of 166 patients, 51% were mechanically ventilated and 26% required renal replacement therapy. The overall hospital mortality rate was 36%, versus 56% for those requiring renal replacement therapy, and 68% for those with both mechanical ventilation and renal replacement therapy. The logistic regression model identified four independent risk factors for mortality: age (adjusted OR 2.8 [95% CI 1.8-4.4] for every 10-year increase), mechanical ventilation (4.2 [1.7-10.6]), need for continuous venovenous hemofiltration (2.3 [1.3-4.0]) and C-reactive protein (1.1 [1.0-1.2] for every 10mg/L increase). CONCLUSIONS: In our cohort, acute kidney injury requiring renal replacement therapy was associated to a high mortality rate similar to that associated to the need for mechanical ventilation, while multiorgan failure necessitating both techniques implied an extremely high mortality risk.


Assuntos
Injúria Renal Aguda/terapia , COVID-19/complicações , Estado Terminal/terapia , Terapia de Substituição Renal , SARS-CoV-2 , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/mortalidade , Corticosteroides/uso terapêutico , Adulto , Fatores Etários , Idoso , Proteína C-Reativa/análise , COVID-19/sangue , Comorbidade , Terapia de Substituição Renal Contínua , Estado Terminal/mortalidade , District of Columbia/epidemiologia , Feminino , Mortalidade Hospitalar , Hospitais Universitários/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/mortalidade , Oxigenoterapia/estatística & dados numéricos , Utilização de Procedimentos e Técnicas/estatística & dados numéricos , Estudos Prospectivos , Terapia de Substituição Renal/estatística & dados numéricos , Respiração Artificial/estatística & dados numéricos , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/mortalidade , Síndrome do Desconforto Respiratório/terapia , Fatores de Risco , Centros de Atenção Terciária/estatística & dados numéricos , Resultado do Tratamento
12.
Artigo em Inglês | MEDLINE | ID: mdl-34281057

RESUMO

About 8% of the Americans contract influenza during an average season according to the Centers for Disease Control and Prevention in the United States. It is necessary to strengthen the early warning for influenza and the prediction of public health. In this study, Spatial autocorrelation analysis and spatial scanning analysis were used to identify the spatiotemporal patterns of influenza-like illness (ILI) prevalence in the United States, during the 2011-2020 transmission seasons. A seasonal autoregressive integrated moving average (SARIMA) model was constructed to predict the influenza incidence of high-risk states. We found the highest incidence of ILI was mainly concentrated in the states of Louisiana, District of Columbia and Virginia. Mississippi was a high-risk state with a higher influenza incidence, and exhibited a high-high cluster with neighboring states. A SARIMA (1, 0, 0) (1, 1, 0)52 model was suitable for forecasting the ILI incidence of Mississippi. The relative errors between actual values and predicted values indicated that the predicted values matched the actual values well. Influenza is still an important health problem in the United States. The spread of ILI varies by season and geographical region. The peak season of influenza was the winter and spring, and the states with higher influenza rates are concentrated in the southeast. Increased surveillance in high-risk states could help control the spread of the influenza.


Assuntos
Influenza Humana , District of Columbia , Humanos , Incidência , Influenza Humana/epidemiologia , Louisiana , Mississippi , Estações do Ano , Análise Espaço-Temporal , Estados Unidos/epidemiologia , Virginia
13.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209989

RESUMO

The purposes of this study were to evaluate the psychometric properties of English and Spanish instruments that measure the nutrition behavior and practices of children and their parents. Orem's self-care deficit nursing theory was used in this methodological study. A convenience sample of 333 children and 262 mothers participated from two schools in Washington, D.C. and two schools in Santiago, Chile. Principal component analysis indicated three component per instrument corresponding to Orem's Theory of operations demonstrating construct validity of the instrument. The study findings showed evidence for validity and reliability of the English and Spanish versions and indicated that the instruments appropriately represented Orem's operations. The results have implications for the development of health behavior measurement instruments that are valid, reliable, designed for children, culturally appropriate, and efficient. Measuring the nutrition behavior of children and parents is critical for determining the effectiveness of nutrition intervention programs. Furthermore, instruments are needed so that researchers can compare corresponding child and parent behaviors or compare behaviors across cultures.


Assuntos
Assistência à Saúde Culturalmente Competente/normas , Comportamento Alimentar/psicologia , Comportamentos Relacionados com a Saúde , Inquéritos Nutricionais/normas , Adolescente , Criança , Chile , District of Columbia , Feminino , Humanos , Idioma , Masculino , Pais/psicologia , Análise de Componente Principal , Psicometria , Reprodutibilidade dos Testes , Autocuidado/psicologia , Traduções
15.
PLoS One ; 16(7): e0253594, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34292969

RESUMO

INTRODUCTION: Social network strategies have been used by health departments to identify undiagnosed cases of HIV. Heterosexual cycle (HET4) of National HIV Behavioral Surveillance (NHBS) is a social network strategy implemented in jurisdictions. The main objectives of this research are to 1) evaluate the utility of the NHBS HET cycle data for network analysis; 2) to apply statistical analysis in support of previous HIV research, as well as to develop new research results focused on demographic variables and prevention/intervention with respect to heterosexual HIV risk; and 3) to employ NHBS data to inform policy with respect to the EHE plan. METHOD: We used data from the 2016 NHBS HET4 (DC). A total of 747 surveys were collected. We used the free social-network analysis package, GEPHI, for all network visualization using adjacency matrix representation. We additionally conducted logistic regression analysis to examine the association of selected variables with HIV status in three models representing 1) demographic and economic effects, 2) behavioral effects, and 3) prevention-intervention effects. RESULTS: The results showed 3% were tested positive. Seed 1 initiated the largest networks with 426 nodes (15 positives); seed 4 with 273 nodes (6 positives). Seed 3 had 35 nodes (2 positives). All 23 HIV diagnoses were recruited from 4 zip-codes across DC. The risk of testing positive was higher among people high-school dropouts (Relative Risk (RR) (25.645); 95 CI% 5.699, 115.987), unemployed ((4.267); 1.295, 14.064), returning citizens ((14.319); 4.593, 44.645). We also found in the final model higher association of pre-exposure prophylaxis (PrEP) awareness among those tested negative ((4.783); 1.042, 21.944) and HIV intervention in the past 12 months with those tested positive ((17.887); 2.350,136.135). CONCLUSION: The network visualization was used to address the primary aim of the analysis-evaluate the success of the implementation of the NHBS as a social network strategy to find new diagnoses. NHBS remains one of the strongest behavioral supplements for DC's HIV planning activities. As part of the evaluation process our analysis helps to understand the impact of demographic, behavioral, and prevention efforts on peoples' HIV status. We strongly recommend other jurisdictions use network visualizations to evaluate the efficacy in reaching hidden populations.


Assuntos
Epidemias/prevenção & controle , Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Comportamentos de Risco à Saúde , Heterossexualidade , Homossexualidade Masculina , Modelos Biológicos , Modelos Psicológicos , Profilaxia Pré-Exposição , Adulto , Sistema de Vigilância de Fator de Risco Comportamental , District of Columbia/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , HIV-1 , Humanos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos
16.
Surgery ; 170(4): 1099-1104, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34127303

RESUMO

BACKGROUND: For patients with differentiated thyroid cancer who will receive postoperative radioactive iodine, thyroid remnant uptake can be calculated and may point to the thoroughness of the surgical resection. In the United States, outcome disparities exist among ethnic/racial minorities with differentiated thyroid cancer. Data about surgical thoroughness and recurrence rates across races/ethnicities do not exist. This study compared the amount of thyroid remnant uptake and cancer recurrence rates across race/ethnicity. METHODS: This was a retrospective analysis of adult patients with differentiated thyroid cancer who had postoperative radioactive iodine in 2017 and 2018 and were followed to 2020. We collected thyroid bed remnant uptake from postoperative radioactive iodine scans and analyzed it as a ratio of percent of uptake to dose of radioactive iodine received to control for varying radioactive iodine doses. Thyroid remnant, uptake to dose of radioactive iodine received, and recurrence were evaluated across race/ethnicity. RESULTS: Of 218 patients: 61% were White, 21% Black, 11% Asian, and 7% Hispanic; 72% were female. Seventy-one percent of patients had their surgery done by a high-volume surgeon, although volume data were not available for all. In White, Black, Asian, and Hispanic patients, median uptake was 0.68%, 0.44%, 1.5%, and 0.8%, respectively (P = .13). We did not observe differences in median uptake to dose of radioactive iodine received across groups (P = .41). Recurrence rate was 17.0% among White patients, 16.7% among Black patients, 17.6% among Asian patients, and 16.7% among Hispanic patients (P = 1.00). CONCLUSION: We did not observe differences across race/ethnicity in surgical thoroughness or rate of recurrence. These findings suggest that disparities may be mitigated when ethnic/racial minorities have similar access to quality surgical care.


Assuntos
Grupos de Populações Continentais , Grupos Étnicos , Recidiva Local de Neoplasia/etnologia , Neoplasias da Glândula Tireoide/etnologia , District of Columbia/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/cirurgia , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/métodos
17.
Pediatr Infect Dis J ; 40(7): e272-e274, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34097664

RESUMO

The estimated severe acute respiratory syndrome coronavirus 2 seroprevalence in children was found to be 9.46% for the Washington Metropolitan area. Hispanic/Latinx individuals were found to have higher odds of seropositivity. While chronic medical conditions were not associated with having antibodies, previous fever and body aches were predictive symptoms.


Assuntos
Anticorpos Antivirais/sangue , Teste Sorológico para COVID-19 , COVID-19/epidemiologia , Adolescente , COVID-19/etnologia , Criança , Pré-Escolar , Doença Crônica/epidemiologia , District of Columbia/epidemiologia , Feminino , Voluntários Saudáveis , Hispano-Americanos , Humanos , Imunoglobulina G/sangue , Lactente , Recém-Nascido , Masculino , Maryland/epidemiologia , Estudos Soroepidemiológicos , Virginia/epidemiologia , West Virginia/epidemiologia , Adulto Jovem
18.
AIDS Res Hum Retroviruses ; 37(9): 706-715, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34157853

RESUMO

Molecular epidemiology (ME) is one tool used to end the HIV epidemic in the United States. We combined clinical and behavioral data with HIV sequence data to identify any overlap in clusters generated from different sequence datasets; to characterize HIV transmission clusters; and to identify correlates of clustering among people living with HIV (PLWH) in Washington, District of Columbia (DC). First, Sanger sequences from DC Cohort participants, a longitudinal HIV study, were combined with next-generation sequences (NGS) from participants in a ME substudy to identify clusters. Next, demographic and self-reported behavioral data from ME substudy participants were used to identify risks of secondary transmission. Finally, we combined NGS from ME substudy participants with Sanger sequences in the DC Molecular HIV Surveillance database to identify clusters. Cluster analyses used HIV-Transmission Cluster Engine to identify linked pairs of sequences (defined as distance ≤1.5%). Twenty-eight clusters of ≥3 sequences (size range: 3-12) representing 108 (3%) participants were identified. None of the five largest clusters (size range: 5-12) included newly diagnosed PLWH. Thirty-four percent of ME substudy participants (n = 213) reported condomless sex during their last sexual encounter and 14% reported a Syphilis diagnosis in the past year. Seven transmission clusters (size range: 2-19) were identified in the final analysis, each containing at least one ME substudy participant. Substudy participants in clusters from the third analysis were present in clusters from the first analysis. Combining HIV sequence, clinical and behavioral data provided insights into HIV transmission that may not be identified using traditional epidemiological methods alone. Specifically, the sexual risk behaviors and STI diagnoses reported in the substudy survey may not have been disclosed during Partner Services activities and the survey data complemented clinical data to fully characterize transmission clusters. These findings can be used to enhance local efforts to interrupt transmission and avert new infections.


Assuntos
Epidemias , Infecções por HIV , District of Columbia/epidemiologia , Infecções por HIV/epidemiologia , Humanos , Epidemiologia Molecular , Assunção de Riscos , Estados Unidos
19.
Prev Chronic Dis ; 18: E51, 2021 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-34014815

RESUMO

INTRODUCTION: Excess sugar consumption is linked to several mental health conditions. Sugar-sweetened beverages (SSBs) and 100% fruit juice contain similar amounts of sugar per serving, yet prior studies examining sugary beverages and mental health are limited to SSBs. Of those, few have assessed potential modifiers such as sex. METHODS: We examined the association between daily consumption of fruit juice and SSBs with poor mental health by using data from the 2017 Behavioral Risk Factor Surveillance System. We used Poisson regression models with clustered-robust standard errors to measure the association between SSB and fruit juice consumption (none, >0 to <1, and ≥1 times per day) and experiencing 14 or more days of poor mental health in the past month, adjusting for sociodemographic characteristics. We used an F test of joint significance to assess effect modification by sex for SSB and fruit juice analyses. RESULTS: Consuming SSBs 1 or more times per day versus consuming none was associated with a 26% greater prevalence of poor mental health (95% CI, 1.11-1.43). Associations for consuming >0 to <1 times per day compared with consuming none were not significant. We found no evidence of an association between fruit juice consumption and mental health, nor evidence of effect modification by sex in the SSB and fruit juice analyses. CONCLUSION: Consuming SSBs 1 or more times per day was significantly associated with poor mental health whereas 100% fruit juice consumption was not. Future studies should examine alternative cut-points of fruit juice by using prospective designs.


Assuntos
Bebidas Adoçadas com Açúcar , Adulto , Bebidas , District of Columbia , Sucos de Frutas e Vegetais , Humanos , Saúde Mental , Estudos Prospectivos
20.
MMWR Morb Mortal Wkly Rep ; 70(20): 744-748, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34014908

RESUMO

The occurrence of cases of COVID-19 reported by child care facilities among children, teachers, and staff members is correlated with the level of community spread (1,2). To describe characteristics of COVID-19 cases at child care facilities and facility adherence to guidance and recommendations, the District of Columbia (DC) Department of Health (DC Health) and CDC reviewed COVID-19 case reports associated with child care facilities submitted to DC Health and publicly available data from the DC Office of the State Superintendent of Education (OSSE) during July 1-December 31, 2020. Among 469 licensed child care facilities, 112 (23.9%) submitted 269 reports documenting 316 laboratory-confirmed cases and three additional cases identified through DC Health's contact tracers. Outbreaks associated with child care facilities,† defined as two or more laboratory-confirmed and epidemiologically linked cases at a facility within a 14-day period (3), occurred in 27 (5.8%) facilities and accounted for nearly one half (156; 48.9%) of total cases. Among the 319 total cases, 180 (56.4%) were among teachers or staff members. The majority (56.4%) of facilities reported cases to DC Health on the same day that they were notified of a positive test result for SARS-CoV-2, the virus that causes COVID-19, by staff members or parents.§ Facilities were at increased risk for an outbreak if they had been operating for <3 years, if symptomatic persons sought testing ≥3 days after symptom onset, or if persons with asymptomatic COVID-19 were at the facility. The number of outbreaks associated with child care facilities was limited. Continued implementation and maintenance of multiple prevention strategies, including vaccination, masking, physical distancing, cohorting, screening, and reporting, are important to reduce transmission of SARS-CoV-2 in child care facilities and to facilitate a timely public health response to prevent outbreaks.¶.


Assuntos
COVID-19/epidemiologia , Creches , Surtos de Doenças , COVID-19/prevenção & controle , COVID-19/transmissão , Teste para COVID-19/estatística & dados numéricos , Criança , Creches/estatística & dados numéricos , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/prevenção & controle , Surtos de Doenças/prevenção & controle , District of Columbia/epidemiologia , Humanos , Medição de Risco , SARS-CoV-2/isolamento & purificação
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