Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 18.966
Filtrar
1.
MMWR Morb Mortal Wkly Rep ; 69(41): 1492-1493, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33056952

RESUMO

On June 16, 2020, a recreational ice hockey game was played at an ice rink in the Tampa Bay, Florida, metropolitan area. Teams A and B, each consisting of 11 players (typically six on the ice and five on the bench at any given time), included men aged 19-53 years. During the 5 days after the game, 15 persons (14 of the 22 players and a rink staff member) experienced signs and symptoms compatible with coronavirus disease 2019 (COVID-19)*; 13 of the 15 ill persons had positive laboratory test results indicating infection with SARS-CoV-2, the virus that causes COVID-19. Widespread transmission of SARS-CoV-2 has been documented at a choir practice (1) and at meat processing plants (2,3); however, apart from an outbreak involving 57 infected dancers that has been linked to high-intensity fitness dance classes in South Korea (4) and a cluster of five infected persons at a squash facility in Slovenia (5), few published reports are available regarding transmission associated with specific sports games or practices. In addition, outbreaks of COVID-19 infections among amateur hockey players in the United States have recently been reported in the news.†.


Assuntos
Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Hóquei , Pneumonia Viral/epidemiologia , Recreação , Adulto , Florida/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Adulto Jovem
2.
PLoS One ; 15(10): e0240009, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33002052

RESUMO

OBJECTIVE: Brighter Bites is a school-based health promotion program that delivers fresh produce and nutrition education to low-income children and families. Due to COVID-19-related school closures, states were under "shelter in place" orders, and Brighter Bites administered a rapid assessment survey to identify social needs among their families. The purpose of this study is to demonstrate the methodology used to identify those with greatest social needs during this time ("high risk"), and to describe the response of Brighter Bites to these "high risk" families. METHODS: The rapid assessment survey was collected in April 2020 across Houston, Dallas, Washington DC, and Southwest Florida. The survey consisted of items on disruption of employment status, financial hardship, food insecurity, perceived health status and sociodemographics. The open-ended question "Please share your greatest concern at this time, or any other thoughts you would like to share with us." was asked at the end of each survey to triage "high risk" families. Responses were then used to articulate a response to meet the needs of these high risk families. RESULTS: A total of 1048 families completed the COVID-19 rapid response survey, of which 71 families were triaged and classified as "high risk" (6.8% of survey respondents). During this time, 100% of the "high risk" participants reported being food insecure, 85% were concerned about their financial stability, 82% concerned about the availability of food, and 65% concerned about the affordability of food. A qualitative analysis of the high-risk group revealed four major themes: fear of contracting COVID19, disruption of employment status, financial hardship, and exacerbated food insecurity. In response, Brighter Bites pivoted, created, and deployed a framework to immediately address a variety of social needs among those in the "high risk" category. Administering a rapid response survey to identify the immediate needs of their families can help social service providers tailor their services to meet the needs of the most vulnerable.


Assuntos
Infecções por Coronavirus/epidemiologia , Características da Família , Determinação de Necessidades de Cuidados de Saúde , Pneumonia Viral/epidemiologia , Pobreza , Betacoronavirus , Criança , District of Columbia , Emprego , Florida , Alimentos/economia , Abastecimento de Alimentos , Promoção da Saúde , Humanos , Renda , Pandemias , Serviço Social , Inquéritos e Questionários , Texas
3.
Oecologia ; 194(1-2): 283-298, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33006076

RESUMO

Information on ecological systems often comes from diverse sources with varied levels of complexity, bias, and uncertainty. Accordingly, analytical techniques continue to evolve that address these challenges to reveal the characteristics of ecological systems and inform conservation actions. We applied multiple statistical learning algorithms (i.e., machine learning) with a range of information sources including fish tracking data, environmental data, and visual surveys to identify potential spawning aggregation sites for a marine fish species, permit (Trachinotus falcatus), in the Florida Keys. Recognizing the potential complementarity and some level of uncertainty in each information source, we applied supervised (classic and conditional random forests; RF) and unsupervised (fuzzy k-means; FKM) algorithms. The two RF models had similar predictive performance, but generated different predictor variable importance structures and spawning site predictions. Unsupervised clustering using FKM identified unique site groupings that were similar to the likely spawning sites identified with RF. The conservation of aggregate spawning fish species depends heavily on the protection of key spawning sites; many of these potential sites were identified here for permit in the Florida Keys, which consisted of relatively deep-water natural and artificial reefs with high mean permit residency periods. The application of multiple machine learning algorithms enabled the integration of diverse information sources to develop models of an ecological system. Faced with increasingly complex and diverse data sources, ecologists, and conservation practitioners should find increasing value in machine learning algorithms, which we discuss here and provide resources to increase accessibility.


Assuntos
Ecossistema , Aprendizado de Máquina , Algoritmos , Animais , Florida , Reprodução
4.
Am Surg ; 86(8): 1005-1009, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32997953

RESUMO

INTRODUCTION: Interteam performance and Clavien-Dindo (C-D) complications in renal cell carcinoma with inferior vena cava thrombectomy (RCC-IVCT) have not been reported. We aimed to describe complications by the degree of complexity and surgical teams in a collaborative effort between a National Cancer Institute-designated Comprehensive Cancer Center and a Quaternary Care Teaching Hospital. METHODS: Between January 2011 and May 2019, 73 consecutive RCC-IVCT were included. C-D grades III or higher were captured. Teams involved were urologic-oncology, vascular, hepatobiliary/transplant, and cardiothoracic. The Mayo Clinic tumor thrombus classification was used. RESULTS: Overall complication rate was 42% (n = 31). Nineteen percent had grade III, 18% had grade IV, and 6% had grade V complications. Patients with level IV thrombus had the highest in-hospital mortality rate (75%). Thrombus level did not show a correlation to complication rates (14% level I, 45% level II, 32% level III, 42% level IV). A positive correlation found between the number of teams involved and complication rates (35% with 2-team, 59% with 3-team, P = .059). Thromboembolic events (6% vs 24%, P = .02) and disposition other than home (22% vs 48%, P = .01) were statistically lower for the 2-team groups. Two-team in-hospital mortality was 1/51 (2%) versus 3-team (3/22,14%, (P = .07). No statistical differences were found in infections, thromboembolic events, and grades of complications between surgical teams. CONCLUSIONS: Despite similar interteam performance, the consistency of surgeons in high complexity cases could improve outcomes further. Complexity was higher for hepatobiliary/transplant and cardiothoracic teams. A combination of intraoperative events and patient selection (comorbidities and age) contributed to death. Overall, in-hospital mortality was lower than in most reported series.


Assuntos
Carcinoma de Células Renais/complicações , Neoplasias Renais/complicações , Equipe de Assistência ao Paciente , Trombectomia , Veia Cava Inferior/cirurgia , Trombose Venosa/cirurgia , Adulto , Idoso , Institutos de Câncer , Florida , Mortalidade Hospitalar , Hospitais de Ensino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Resultado do Tratamento , Trombose Venosa/etiologia
5.
J Stroke Cerebrovasc Dis ; 29(10): 105077, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32912524

RESUMO

BACKGROUND: As Covid-19 evolved into a world-wide pandemic, hospitals reported marked declines in strokes, only to be followed by reports of increased numbers of young people presenting with large-vessel occlusions. We reviewed our patient data-base to determine if similar or other novel trends were present. RESULTS: Our Thrombectomy Stroke Center experienced marked declines in ED visits from 2,349 in early March to 1,178 in late April, stroke alerts dropped from 34 to 14 during the same period. Average monthly stroke admissions dropped from 34 in 2019 to 23 in 2020. Nonetheless, in March, we had 12 patients eligible for tPA, which is twice the typical caseload and was unexpected given the low overall stroke presentations. Although the neurointervention caseload was low, the patients were significantly younger. Of the acute intervention patients in March, 5 of the 12 patients were ≤ 60 years old, and two were in their 30's. These trends are similar to those reported elsewhere but were highly unusual for our center as our catchment area is predominantly Caucasian with 34 % of the population > 65 years of age. CONCLUSIONS: Even in low risk centers Covid-19 will likely impart unique stroke presentations. It will be imperative to determine the mechanisms responsible for these changes so we can institute effective strategies for optimal stroke prevention as well as maintain timely acute interventions.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Idoso , Betacoronavirus/patogenicidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Feminino , Florida/epidemiologia , Interações entre Hospedeiro e Microrganismos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Acidente Vascular Cerebral/virologia , Trombectomia , Terapia Trombolítica , Fatores de Tempo
6.
Sci Adv ; 6(37)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32917709

RESUMO

Mistrust of scientific evidence and government-issued guidelines is increasingly correlated with political affiliation. Survey evidence has documented skepticism in a diverse set of issues including climate change, vaccine hesitancy, and, most recently, COVID-19 risks. Less well understood is whether these beliefs alter high-stakes behavior. Combining GPS data for 2.7 million smartphone users in Florida and Texas with 2016 U.S. presidential election precinct-level results, we examine how conservative-media dismissals of hurricane advisories in 2017 influenced evacuation decisions. Likely Trump-voting Florida residents were 10 to 11 percentage points less likely to evacuate Hurricane Irma than Clinton voters (34% versus 45%), a gap not present in prior hurricanes. Results are robust to fine-grain geographic controls, which compare likely Clinton and Trump voters living within 150 m of each other. The rapid surge in media-led suspicion of hurricane forecasts-and the resulting divide in self-protective measures-illustrates a large behavioral consequence of science denialism.


Assuntos
Negação em Psicologia , Política , Confiança/psicologia , Movimento contra Vacinação , Betacoronavirus , Mudança Climática , Infecções por Coronavirus/psicologia , Florida , Sistemas de Informação Geográfica , Governo , Humanos , Pandemias , Pneumonia Viral/psicologia , Texas , Estados Unidos , Recusa de Vacinação
7.
J Nurs Adm ; 50(10): 515-520, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32889973

RESUMO

OBJECTIVE: The aim of this study was to evaluate the impact of inpatient nursing specialties on the perceptions of workplace violence. BACKGROUND: The association between nursing specialty and the perception of workplace violence has not been identified. METHODS: An evaluation of inpatient nurses' perceptions of workplace violence at a single health system was conducted using a modified Survey of Violence Experienced by Staff instrument. RESULTS: Of the respondents, 87.2% experienced workplace violence, of which 96.3% was patient related. Patient-initiated verbal abuse, threats, and physical assault frequency differed significantly based on specialty. Post hoc comparisons further elucidate the differences in specialty populations. CONCLUSION: Workplace violence is a nursing concern; however, the frequency in which workplace violence occurs differs based on specialty. The frequency of threats and injuries to nursing staff was significantly higher in medical and trauma units.


Assuntos
Atitude do Pessoal de Saúde , Pacientes Internados , Recursos Humanos de Enfermagem no Hospital/psicologia , Especialidades de Enfermagem , Violência no Trabalho , Estudos Transversais , Feminino , Florida , Humanos , Masculino
8.
BMC Public Health ; 20(1): 1226, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787830

RESUMO

BACKGROUND: Diabetes is a leading cause of death and disability in the United States, and its precursor, pre-diabetes, is estimated to occur in one-third of American adults. Understanding the geographic disparities in the distribution of these conditions and identifying high-prevalence areas is critical to guiding control and prevention programs. Therefore, the objective of this study was to investigate clusters of pre-diabetes and diabetes risk in Florida and identify significant predictors of the conditions. METHODS: Data from the 2013 Behavioral Risk Factor Surveillance System were obtained from the Florida Department of Health. Spatial scan statistics were used to identify and locate significant high-prevalence local clusters. The county prevalence proportions of pre-diabetes and diabetes and the identified significant clusters were displayed in maps. Logistic regression was used to identify significant predictors of the two conditions for individuals living within and outside high-prevalence clusters. RESULTS: The study included a total of 34,186 respondents. The overall prevalence of pre-diabetes and diabetes were 8.2 and 11.5%, respectively. Three significant (p < 0.05) local, high-prevalence spatial clusters were detected for pre-diabetes, while five were detected for diabetes. The counties within the high-prevalence clusters had prevalence ratios ranging from 1.29 to 1.85. There were differences in the predictors of the conditions based on whether respondents lived within or outside high-prevalence clusters. Predictors of both pre-diabetes and diabetes regardless of region or place of residence were obesity/overweight, hypertension, and hypercholesterolemia. Income and physical activity level were significant predictors of diabetes but not pre-diabetes. Arthritis, sex, and marital status were significant predictors of diabetes only among residents of high-prevalence clusters, while educational attainment and smoking were significant predictors of diabetes only among residents of non-cluster counties. CONCLUSIONS: Geographic disparities of pre-diabetes and diabetes exist in Florida. Information from this study is useful for guiding resource allocation and targeting of intervention programs focusing on identified modifiable predictors of pre-diabetes and diabetes so as to reduce health disparities and improve the health of all Floridians.


Assuntos
Diabetes Mellitus/epidemiologia , Disparidades nos Níveis de Saúde , Estado Pré-Diabético/epidemiologia , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Feminino , Florida/epidemiologia , Geografia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
9.
J Natl Black Nurses Assoc ; 31(1): 26-31, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32853493

RESUMO

Chronic stress and depressive symptoms in midlife southern rural African-American women were examined because little is known about the intersections among them in this population. The research used Vitaliano's model of chronic stress to guide a secondary analysis of a convenience sample 206 (N = 206) midlife (40-65 years) African-American women from a southern rural community in Florida. Data were obtained from a larger study that focused on menopausal health and well-being among women. It also included brief comments from the women during focus group meetings, indicating that they experienced stress and were feeling "down." Statistical data showed that although the women reported relatively low levels of chronic stress and depressive symptoms, associations with certain personal vulnerabilities and social resources emerged as significant. The results from this secondary analysis will help to inform healthcare professionals about the role of personal vulnerability and social resources.


Assuntos
Afro-Americanos/psicologia , Depressão/etnologia , Estresse Psicológico/etnologia , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Feminino , Florida , Grupos Focais , Humanos , Menopausa , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos
10.
Mar Pollut Bull ; 158: 111437, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32753220

RESUMO

Microplastic pollution is an increasing problem in the marine environment. This study had three objectives: 1) determine if seagrass beds and adjacent sand flats in the Florida Keys differed in microplastics concentration, 2) determine if sea cucumbers from the Florida Keys and sand dollars from the panhandle of Florida contain microplastics, and 3) conduct a laboratory experiment on the sand dollar Mellita tenuis to determine if it will ingest plastic microbeads contained in sediment. Both seagrass beds and sand flats in the Florida Keys contained microplastics. Sediment near Pensacola Beach and in St. Joseph Bay contained microplastics. Sea cucumbers from the Florida Keys and sand dollars from the panhandle of Florida contained microplastics in their gut contents. In the laboratory, M. tenuis ingested microbeads in slightly lower proportions compared to surrounding sediment. Both sea cucumbers and sand dollars may make useful animals for monitoring sandy environments for microplastics pollution.


Assuntos
Pepinos-do-Mar , Poluentes Químicos da Água/análise , Animais , Equinodermos , Monitoramento Ambiental , Florida , Microplásticos , Plásticos , Ouriços-do-Mar
12.
Mar Pollut Bull ; 159: 111521, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32763558

RESUMO

Plastic pollution is a concern in many nearshore ecosystems, and it is critical to understand how microplastics (plastics <5 mm in length) affect nearshore marine biota. Here, we report the presence of microplastics in the benthic, upside-down jellyfish (Cassiopea xamachana) across three estuaries in south Florida. Microplastics were recovered from Cassiopea using an acid digestion, then enumerated via microscopy, and identified using micro Fourier-transform interferometer (µFTIR) analysis. Out of 115 specimens analyzed, 77% contained microplastics. Bell diameter and number of plastics per individual varied significantly across locations with the highest plastic densities and bell diameter observed in individuals from Big Pine Key, followed by Jupiter, and Sarasota. µFTIR analysis confirmed that synthetic microfibers were the dominant microplastic measured at all three locations and may indicate Cassiopea as potential sinks of microplastic. Cassiopea may be used as bioindicators of microplastic contamination in the future, allowing for potential plastic pollution mitigation.


Assuntos
Estuários , Poluentes Químicos da Água/análise , Animais , Ecossistema , Monitoramento Ambiental , Florida , Microplásticos , Plásticos
13.
PLoS One ; 15(8): e0236660, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785239

RESUMO

Squamate reptiles (snakes and lizards) rely on chemical cues from conspecifics to search the environment for potential mates. How such cues are used by invasive species to facilitate reproduction, especially seasonally, is a key question that can inform management practices. The Argentine black and white tegu (Salvator merianae) is an invasive reptile species in south Florida threatening native fauna in biodiverse regions such as Everglades National Park. While some information exists on the reproductive ecology of this species in its native range in South America, the chemical ecology of S. merianae is unclear especially in its invasive range. By testing both male (n = 7) and female (n = 7) tegus in a Y-maze apparatus, we assessed if either sex follows chemical trails left by conspecifics and if behaviors were sex- or season-specific. We conducted three types of trials where conspecifics created odor trails: Male-only (male scent only in base and one arm of Y), Female-only, and Male vs. female. Males did not preferentially follow scent trails from either sex, but they did differentially investigate conspecific scent from both sexes. Seasonally, males showed increased rates of chemosensory sampling (rates of tongue-flicking) during the spring (breeding season; March-May) compared to fall (non-breeding season; September-November). Males also had reduced turning and pausing behavior while trailing in the spring. Female tegus exhibited stronger conspecific trailing abilities than males, following both male and female scent trails, and they explored the maze less before making an arm choice. Females also investigated the scent trails intensely compared to males (more passes in scented arms, more time with scent trails). Our results demonstrate for the first time that females of an invasive reptile species can follow conspecific scent trails. Given the strong female responses to odor, sex-specific targeting of tegus via application of a conspecific chemical cue in traps could enhance removal rates of females during the breeding season.


Assuntos
Lagartos/fisiologia , Casamento , Comportamento Sexual Animal/fisiologia , Serpentes/fisiologia , Animais , Ecologia , Feminino , Florida , Humanos , Espécies Introduzidas , Masculino , Odorantes/análise , Reprodução/fisiologia , América do Sul
14.
Public Health Rep ; 135(5): 560-564, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32758023

RESUMO

In January 2020, the Florida Department of Health began planning for a potential coronavirus disease 2019 (COVID-19) outbreak. The first 2 cases of COVID-19 in Florida were confirmed on March 1, 2020. The state's multiagency response to the COVID-19 pandemic was based on the Florida STEPS plan: (1) social distancing, (2) testing and contact tracing, (3) elderly and medically vulnerable population protection, (4) preparing hospitals for a patient surge and health care worker protection, and (5) stopping the introduction of COVID-19 into the state. This brief report describes COVID-19 response strategies and outcomes in Florida through May 31, 2020.


Assuntos
Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Técnicas de Laboratório Clínico , Busca de Comunicante , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Florida/epidemiologia , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia
15.
Bull Environ Contam Toxicol ; 105(3): 351-357, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32749513

RESUMO

Sucralose is one of the most popular artificial sweeteners worldwide. Due to its high stability, persistence and low removal efficiency in wastewater treatment plants, sucralose has been used as an indicator of wastewater intrusion into aquatic systems. However, its stability has also been a reason for discussion whether sucralose's presence in surface water could indicate a recent anthropogenic input. Caffeine and acetaminophen have been considered as tracers in human impacted aquatic ecosystems and potentially good indicators of recent anthropogenic inputs into the environment due to their short half-lives in water. Here, a novel, high throughput and sensitive method based on online SPE-LC-HRMS for the determination of caffeine, sucralose and acetaminophen was developed and validated for both fresh and seawater samples and applied to environmental water samples to evaluate the efficiency of these compounds as tracers of aquatic pollution. Caffeine and sucralose were detected in > 70% of samples, while acetaminophen was only detected in 3% of samples above the MDL, demonstrating its limited environmental applicability.


Assuntos
Acetaminofen/análise , Cafeína/análise , Monitoramento Ambiental , Sacarose/análogos & derivados , Poluentes Químicos da Água/análise , Ecossistema , Florida , Humanos , Sacarose/análise , Edulcorantes/análise , Águas Residuárias/análise , Água
16.
Am Surg ; 86(8): 996-1000, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32762467

RESUMO

BACKGROUND: Pulmonary function tests (PFTs) are currently recommended for liver transplant candidates. We hypothesized that PFTs may not provide added clinical value to the evaluation of liver transplant patients. METHODS: We conducted a retrospective cohort study of adult cadaveric liver transplants from 2012 to 2018. Abnormal PFTs were defined as restrictive disease of diffusing capacity of the lungs for carbon monoxide (DLCO) <80% or obstructive disease of ratio of forced expiratory volume in the first 1 second to the first vital capacity of the lungs (FEV1/FVC) <70%. RESULTS: We analyzed data on 415 liver transplant patients (358 abnormal PFT results and 57 normal results). The liver transplant patients with abnormal PFTs had no difference in number of intensive care unit (ICU) days (P = .68), length of stay (P = .24), or intubation days (P = .33). There were no differences in pulmonary complications including pleural effusion (P = .30), hemo/pneumothorax (P = .74), pneumonia (P = .66), acute respiratory distress syndrome (P = .57), or pulmonary edema (P = .73). The significant finding between groups was a higher rate of reintubation in liver transplant patients with normal PFTs (P = .02). There was no difference in graft survival (P = .53) or patient survival (P = .42). DISCUSSION: Abnormal PFTs, found in 86% of liver transplant patients, did not correlate with complications, graft failure, or mortality. PFTs contribute to the high cost of liver transplants but do not help predict which patients are at risk of postoperative complications.


Assuntos
Custos Hospitalares/estatística & dados numéricos , Transplante de Fígado/economia , Cuidados Pré-Operatórios/economia , Testes de Função Respiratória/economia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Feminino , Florida , Sobrevivência de Enxerto , Humanos , Transplante de Fígado/mortalidade , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios/estatística & dados numéricos , Testes de Função Respiratória/estatística & dados numéricos , Estudos Retrospectivos , Adulto Jovem
17.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32848030

RESUMO

BACKGROUND AND OBJECTIVES: The increase in neonatal abstinence syndrome (NAS) has underscored the need for NAS surveillance programs, but many rely on passive surveillance using unverified diagnosis codes. Few studies have evaluated the validity of these codes, and no study has assessed the recently proposed Council of State and Territorial Epidemiologists (CSTE) case definition. The Florida Birth Defects Registry investigated the accuracy of International Classification of Diseases, 10th Revision, Clinical Modification codes related to NAS (P96.1 and P04.49) and assessed the sensitivity of the CSTE case definition. METHODS: We identified a sample of infants born during 2016 coded with P96.1 and/or P04.49. Record review was completed for 128 cases coded with P96.1, 68 with P04.49, and 7 with both codes. Lacking consensus regarding a gold standard definition of NAS, we used clinical data to classify each case using the Florida and CSTE definitions. The code-specific accuracy was measured by using the positive predictive value (PPV). The clinical characteristics indicative of NAS were compared for case classification based on both definitions. RESULTS: By using the Florida definition, the overall PPV was 68% but varied by code: 95.3% for P96.1 and 13.2% for P04.49. The overall (47.8%) and code-specific PPVs were lower by using the CSTE definition. Comparison of clinical characteristics demonstrated that 60.7% of cases classified as no NAS by using the CSTE definition had robust clinical signs of NAS. In our sample, the CSTE case definition underestimated NAS prevalence. CONCLUSIONS: Only the P96.1 International Classification of Diseases, 10th Revision, Clinical Modification code displayed high accuracy. Discordance in NAS case definitions and surveillance methodologies may result in erroneous comparisons and conclusions that negatively impact NAS-related surveillance and research.


Assuntos
Classificação Internacional de Doenças/normas , Síndrome de Abstinência Neonatal/diagnóstico , Confiabilidade dos Dados , Feminino , Florida , Humanos , Recém-Nascido , Síndrome de Abstinência Neonatal/classificação , Valor Preditivo dos Testes , Gravidez , Complicações na Gravidez , Sistema de Registros , Estudos Retrospectivos , Sensibilidade e Especificidade , Transtornos Relacionados ao Uso de Substâncias/complicações
18.
Prev Chronic Dis ; 17: E74, 2020 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-32730199

RESUMO

Medically underserved patients in rural areas are more vulnerable to poor health outcomes, including the risks associated with coronavirus disease 2019 (COVID-19). Pharmacists, student pharmacists, and other health care professionals are working together to implement new, innovative ways to deliver the same standard of care during the COVID-19 pandemic to these vulnerable patients. These services include telehealth with virtual and telephone medication therapy management sessions led by ambulatory care pharmacists and student pharmacists. Pharmacists, student pharmacists, and other health care professionals should continue to adapt to these new technologies to improve health outcomes for their patients during the pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Área Carente de Assistência Médica , Pandemias/prevenção & controle , Farmacêuticos/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , População Rural , Doença Crônica , Serviços Comunitários de Farmácia , Florida , Humanos , Conduta do Tratamento Medicamentoso/organização & administração , Papel Profissional , Telemedicina
19.
Arch Environ Contam Toxicol ; 79(2): 233-245, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32613299

RESUMO

Natural resource managers are concerned about the impacts of aerial ultra-low volume spray (ULV) of insecticides for mosquito control (i.e., mosquito adulticides) and seek science-driven management recommendations that reduce risk but allow vector control for nearby human populations. Managers at the National Key Deer Refuge (Florida Keys, FL) are concerned for ULV effects upon conservation efforts for imperiled butterflies (Florida leafwing [Anaea troglodyta floridalis] and Bartram's hairstreak [Strymon acis bartrami] butterflies). No-spray zones were designated for protection of those butterflies, but their effectiveness for mitigation is unclear. To address this uncertainty, cholinesterase activity (ChE) and mortality were monitored for caged butterflies gulf fritillary [Agraulis vanilla] and great southern white [Ascia monuste]) deployed on the Refuge during three aerial ULV applications of the insecticide naled. Residue samplers also were deployed to estimate butterfly exposure. Spray efficacy against mosquitoes was assessed by deploying caged mosquitoes at the same locations as the butterflies. Average naled residue levels on filter paper samplers in the target area (1882-2898 µg/m2) was significantly greater than in the no-spray zone (9-1562 µg/m2). Differences between the no-spray zone and target area for butterfly mortality and ChE were inconsistent. Average mortality was significantly lower, and average ChE was significantly higher in the no-spray zone for larvae of one species but not for larvae of the other species. Mosquito mortality did not differ significantly between the two areas. Data from the present study reflect the inconsistent effectiveness of no-spray zones on the Refuge using standard methods employed at the time by the vector control agency in the Florida Keys and possibly by other vector control agencies in similar coastal environments. Furthermore, these findings helped to guide the design and to improve the conservation value of future no-spray zone delineations while allowing for treatment in areas where mosquito control is necessary for vector-borne disease reduction.


Assuntos
Borboletas/fisiologia , Inibidores da Colinesterase/toxicidade , Controle de Mosquitos/métodos , Naled/toxicidade , Animais , Borboletas/efeitos dos fármacos , Colinesterases/metabolismo , Cervos , Florida , Humanos , Inseticidas , Larva/efeitos dos fármacos , Medição de Risco
20.
PLoS One ; 15(7): e0234150, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614830

RESUMO

To investigate a Florida manatee (Trichechus manatus latirostris) mortality event following a red tide bloom in Southwest Florida, an RNA sequencing experiment was conducted. Gene expression changes in white blood cells were assessed in manatees rescued from a red tide affected area (n = 4) and a control group (n = 7) using RNA sequencing. The genes with the largest fold changes were compared between the two groups to identify molecular pathways related to cellular and disease processes. In total, 591 genes (false discovery rate <0.05) were differentially expressed in the red tide group. Of these, 158 were upregulated and 433 were downregulated. This suggests major changes in white blood cell composition following an exposure to red tide. The most highly upregulated gene, Osteoclast associated 2C immunoglobulin-like receptor (OSCAR), was upregulated 12-fold. This gene is involved in initiating the immune response and maintaining a role in adaptive and innate immunity. The most highly downregulated gene, Piccolo presynaptic cytomatrix protein (PCLO), was downregulated by a factor of 977-fold. This gene is associated with cognitive functioning and neurotransmitter release. Downregulation of this gene in other studies was associated with neuronal loss and neuron synapse dysfunction. Among the cellular pathways that were most affected, immune response, including inflammation, wounds and injuries, cell proliferation, and apoptosis were the most predominant. The pathway with the most differentially expressed genes was the immune response pathway with 98 genes involved, many of them downregulated. Assessing the changes in gene expression associated with red tide exposure enhances our understanding of manatee immune response to the red tide toxins and will aid in the development of red tide biomarkers.


Assuntos
Perfilação da Expressão Gênica , Proliferação Nociva de Algas , Trichechus manatus/fisiologia , Animais , Buffy Coat/citologia , Florida , Ontologia Genética , Sistema Imunitário , Leucócitos/metabolismo , Toxinas Marinhas/envenenamento , Redes e Vias Metabólicas/genética , Neurotoxinas/envenenamento , Oxocinas/envenenamento , Envenenamento/sangue , Envenenamento/reabilitação , Envenenamento/veterinária , RNA Mensageiro/biossíntese , RNA Mensageiro/sangue , Transcriptoma , Trichechus manatus/sangue , Trichechus manatus/genética , Trichechus manatus/imunologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA