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1.
J Law Health ; 37(2): 52-104, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38833597

RESUMO

Over half the states have enacted laws diminishing or curtailing the rights of the executive branch (legislatures or governors) to enact laws to preserve, protect, or safeguard public health in the wake of the COVID-19 emergency. Governor DeSantis, of Florida, for example, effectively banned mask mandates in schools during the high point of the epidemic--based on flawed science and erroneous data--and now wants to make that response permanent. The rules effectuating this Executive Order were enacted under an emergency order finding a threat to public health. Nevertheless, the response promulgated by the Florida Department of Health was to prevent public health measures, favoring individual liberties, parental rights (which have previously been held not to apply in the context of the spread of contagious disease epidemics) at the expense of public health and safety. This article explores alternative means to compel state governments, heretofore vested with the police power to protect public health, to comply with this obligation, using the Florida situation as a case study.


Assuntos
COVID-19 , Responsabilidade Legal , Saúde Pública , Governo Estadual , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Florida , Saúde Pública/legislação & jurisprudência , Liberdade , SARS-CoV-2 , Estados Unidos
2.
BMC Pulm Med ; 24(1): 267, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840112

RESUMO

BACKGROUND: Telemedicine use increased with the Covid-19 pandemic. The impact of telemedicine on resource use in pulmonary clinics is unknown. METHODS: This retrospective cohort study identified adults with pulmonary clinic visits at the University of Miami Hospital and Clinics (January 2018-December 2021). The primary exposure was telemedicine versus in-person visits. Standard statistics were used to describe the cohort and compare patients stratified by visit type. Multivariable logistic regression models evaluated the association of telemedicine with resource use (primarily, computed tomography [CT] orders placed within 7 days of visit). RESULTS: 21,744 clinic visits were included: 5,480 (25.2%) telemedicine and 16,264 (74.8%) in-person. In both, the majority were < 65-years-old, female, and identified as Hispanic white. Patients seen with telemedicine had increased odds of having CT scans ordered within 7 days (adjusted odds ratio [aOR] 1.34, [95% confidence interval 1.04-1.74]); and decreased odds of chest x-rays (aOR 0.37 [0.23-0.57]). Telemedicine increased odds of contact of any kind with our healthcare system within 30-days (aOR 1.56 [1.29-1.88]) and 90-days (aOR 1.39 [1.17-1.64]). Specifically, telemedicine visits had decreased odds of emergency department visits and hospitalizations (30 days: aOR 0.54 [0.38-0.76]; 90 days: aOR 0.68 [0.52-0.89]), but increased odds of phone calls and electronic health record inbox messages (30 days: aOR 3.44 [2.73-4.35]; 90 days: aOR 3.58 [2.95-4.35]). CONCLUSIONS: Telemedicine was associated with an increased odds of chest CT order with a concomitant decreased odds of chest x-ray order. Increased contact with the healthcare system with telemedicine may represent a larger time burden for outpatient clinicians.


Assuntos
COVID-19 , Telemedicina , Humanos , Feminino , Telemedicina/estatística & dados numéricos , Masculino , Estudos Retrospectivos , COVID-19/epidemiologia , Idoso , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/estatística & dados numéricos , SARS-CoV-2 , Florida , Adulto
3.
Lancet Planet Health ; 8(6): e378-e390, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38849180

RESUMO

BACKGROUND: Exposure to climate change-related threats (eg, hurricanes) has been associated with mental health symptoms, including post-traumatic stress symptoms. Yet it is unclear whether climate change anxiety, which is understudied in representative samples, is a specific mental health threat, action motivator, or both, particularly in populations exposed to climate-change related disasters. We sought to examine the associations between exposure to hurricanes, climate change anxiety, and climate change actions and attitudes in a representative sample of US Gulf Coast residents. METHODS: This study used data from a 5-year, representative, prospectively assessed, probability-based, longitudinal cohort sample of residents in Texas and Florida (USA) exposed to exogenous catastrophic hurricanes rated category 3 or greater. Participants were adults aged 18 years and older and were initially recruited from the Ipsos KnowledgePanel in the 60 h before Hurricane Irma (Sept 8-11, 2017). Relationships between climate change anxiety, hurricane exposure, hurricane-related post-traumatic stress symptoms, general functional impairment, and climate change-related individual-level actions (eg, eating a plant-based diet and driving more fuel efficient cars) and collective-level actions (eg, petition signing and donating money) and climate change action attitudes were evaluated using structural equation modelling. FINDINGS: The final survey was completed by 1479 individuals (787 [53·2%] women and 692 [46·8%] men). Two climate change anxiety subscales (cognitive-emotional impairment and perceived experience of climate change) were confirmed using confirmatory factor analysis. Mean values were low for both climate change anxiety subscales: cognitive-emotional impairment (mean 1·31 [SD 0·63], range 1-5) and perceived climate change experience (mean 1·67 [SD 0·89], range 1-5); these subscales differentially predicted outcomes. The cognitive-emotional impairment subscale did not significantly correlate with actions or attitudes; its relationship with general functional impairment was attenuated by co-occurring hurricane-related post-traumatic stress symptoms, which were highly correlated with general functional impairment in all three models (all p<0·0001). The perceived climate change experience subscale correlated with climate change attitudes (b=0·57, 95% CI 0·47-0·66; p<0·0001), individual-level actions (b=0·34, 0·21-0·47; p<0·0001), and collective-level actions (b=0·22, 0·10-0·33; p=0·0002), but was not significantly associated with general functional impairment in any of the final models. Hurricane exposure correlated with climate change-related individual-level (b=0·26, 0·10-0·42; p=0·0011) and collective-level (b=0·41, 0·26-0·56; p<0·0001) actions. INTERPRETATION: Expanded treatment for post-traumatic stress symptoms after disasters could help address climate change-related psychological distress; experiences with climate change and natural hazards could be inflection points to motivate action. FUNDING: National Science Foundation and the National Center for Atmospheric Research.


Assuntos
Ansiedade , Mudança Climática , Tempestades Ciclônicas , Humanos , Ansiedade/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Texas , Florida , Estudos Longitudinais , Idoso , Atitude , Inquéritos e Questionários , Estudos Prospectivos , Adulto Jovem , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
4.
Front Public Health ; 12: 1366161, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38859894

RESUMO

Introduction: Globally, overdose deaths increased near the beginning of the COVID-19 pandemic, which created availability and access barriers to addiction and social services. Especially in times of a crisis like a pandemic, local exposures, service availability and access, and system responses have major influence on people who use drugs. For policy makers to be effective, an understanding at the local level is needed. Methods: This retrospective epidemiologic study from 2019 through 2021 compares immediate and 20-months changes in overdose deaths from the pandemic start to 16 months before its arrival in Pinellas County, FL We examine toxicologic death records of 1,701 overdoses to identify relations with interdiction, and service delivery. Results: There was an immediate 49% increase (95% CI 23-82%, p < 0.0001) in overdose deaths in the first month following the first COVID deaths. Immediate increases were found for deaths involving alcohol (171%), heroin (108%), fentanyl (78%), amphetamines (55%), and cocaine (45%). Overdose deaths remained 27% higher (CI 4-55%, p = 0.015) than before the pandemic through 2021.Abrupt service reductions occurred when the pandemic began: in-clinic methadone treatment dropped by two-thirds, counseling by 38%, opioid seizures by 29%, and drug arrests by 56%. Emergency transport for overdose and naloxone distributions increased at the pandemic onset (12%, 93%, respectively) and remained higher through 2021 (15%, 377%,). Regression results indicate that lower drug seizures predicted higher overdoses, and increased 911 transports predicted higher overdoses. The proportion of excess overdose deaths to excess non-COVID deaths after the pandemic relative to the year before was 0.28 in Pinellas County, larger than 75% of other US counties. Conclusions: Service and interdiction interruptions likely contributed to overdose death increases during the pandemic. Relaxing restrictions on medical treatment for opioid addiction and public health interventions could have immediate and long-lasting effects when a major disruption, such as a pandemic, occurs. County level data dashboards comprised of overdose toxicology, and interdiction and service data, can help explain changes in overdose deaths. As a next step in predicting which policies and practices will best reduce local overdoses, we propose using simulation modeling with agent-based models to examine complex interacting systems.


Assuntos
COVID-19 , Overdose de Drogas , Humanos , COVID-19/mortalidade , COVID-19/epidemiologia , Overdose de Drogas/mortalidade , Overdose de Drogas/epidemiologia , Estudos Retrospectivos , Adulto , Masculino , Florida/epidemiologia , Feminino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2
5.
Sci Rep ; 14(1): 13184, 2024 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851774

RESUMO

Understanding human mobility patterns amid natural hazards is crucial for enhancing urban emergency responses and rescue operations. Existing research on human mobility has delineated two primary types of individuals: returners, who exhibit a tendency to frequent a limited number of locations, and explorers, characterized by a more diverse range of movement across various places. Yet, whether this mobility dichotomy endures in the context of natural hazards remains underexplored. This study addresses this gap by examining anonymized high-resolution mobile phone location data from Lee County, Florida residents, aiming to unravel the dynamics of these distinct mobility groups throughout different phases of Hurricane Ian. The results indicate that returners and explorers maintained their distinct mobility characteristics even during the hurricane, showing increased separability. Before the hurricane, returners favored shorter trips, while explorers embarked on longer journeys, a trend that continued during the hurricane. However, the hurricane heightened people's inclination to explore, leading to a notable increase in longer-distance travel for both groups, likely influenced by evacuation considerations. Spatially, both groups exhibited an uptick in trips towards the southern regions, away from the hurricane's path, particularly converging on major destinations such as Miami, Fort Lauderdale, Naples, and West Palm Beach during the hurricane.


Assuntos
Tempestades Ciclônicas , Humanos , Florida , Masculino , Feminino , Viagem , Adulto , Telefone Celular , Pessoa de Meia-Idade
6.
Am J Case Rep ; 25: e943306, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38863182

RESUMO

BACKGROUND Histoplasma capsulatum is prevalent in the mid-eastern United States and is an environmental fungus that causes human infection by the inhalation of its spores. It is commonly associated with areas containing large amounts of bird excrement and can survive for years in the soil. Only 1% of infected individuals develop disseminated histoplasmosis or Histoplasma endocarditis. CASE REPORT A 61-year-old man with atrial fibrillation had 8 months of fatigue, low-grade fevers, night sweats, and unexplained weight loss presented to the Emergency Department. He worked and lived in Central Florida and although he raised cattle, he denied exposure to birds or bats with regularity. A transesophageal echocardiogram confirmed a sessile echo density on the atrial surface of the mitral valve. His microbial Karius cell-free DNA test from his blood sample was positive for Histoplasma capsulatum, and he was immediately given intravenous liposomal amphotericin for 2 weeks. A tissue valve was used to successfully replace his mitral valve along with a coronary artery bypass and a maze procedure for his persistent atrial fibrillation and atrial flutter. The diagnosis of mitral valve endocarditis from disseminated histoplasmosis was confirmed by pathological analysis, and he was sent home on long-term itraconazole maintenance treatment. CONCLUSIONS Surgical intervention in combination with anti-fungal medication can be a lifesaving intervention for disseminated histoplasmosis. A thorough history is particularly important when evaluating a patient with an unknown infectious source, especially assessing for risk factors, including exposure to environmental factors, workplace, and animals.


Assuntos
Endocardite , Histoplasmose , Valva Mitral , Humanos , Histoplasmose/diagnóstico , Masculino , Pessoa de Meia-Idade , Endocardite/microbiologia , Endocardite/diagnóstico , Florida , Antifúngicos/uso terapêutico , Ecocardiografia Transesofagiana , Doenças das Valvas Cardíacas/microbiologia , Histoplasma/isolamento & purificação
7.
PLoS One ; 19(6): e0298182, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38833434

RESUMO

BACKGROUND: Hospitalizations due to diabetes complications are potentially preventable with effective management of the condition in the outpatient setting. Diabetes-related hospitalization (DRH) rates can provide valuable information about access, utilization, and efficacy of healthcare services. However, little is known about the local geographic distribution of DRH rates in Florida. Therefore, the objectives of this study were to investigate the geographic distribution of DRH rates at the ZIP code tabulation area (ZCTA) level in Florida, identify significant local clusters of high hospitalization rates, and describe characteristics of ZCTAs within the observed spatial clusters. METHODS: Hospital discharge data from 2016 to 2019 were obtained from the Florida Agency for Health Care Administration through a Data Use Agreement with the Florida Department of Health. Raw and spatial empirical Bayes smoothed DRH rates were computed at the ZCTA level. High-rate DRH clusters were identified using Tango's flexible spatial scan statistic. Choropleth maps were used to display smoothed DRH rates and significant high-rate spatial clusters. Demographic, socioeconomic, and healthcare-related characteristics of cluster and non-cluster ZCTAs were compared using the Wilcoxon rank sum test for continuous variables and Chi-square test for categorical variables. RESULTS: There was a total of 554,133 diabetes-related hospitalizations during the study period. The statewide DRH rate was 8.5 per 1,000 person-years, but smoothed rates at the ZCTA level ranged from 0 to 101.9. A total of 24 significant high-rate spatial clusters were identified. High-rate clusters had a higher percentage of rural ZCTAs (60.9%) than non-cluster ZCTAs (41.8%). The median percent of non-Hispanic Black residents was significantly (p < 0.0001) higher in cluster ZCTAs than in non-cluster ZCTAs. Populations of cluster ZCTAs also had significantly (p < 0.0001) lower median income and educational attainment, and higher levels of unemployment and poverty compared to the rest of the state. In addition, median percent of the population with health insurance coverage and number of primary care physicians per capita were significantly (p < 0.0001) lower in cluster ZCTAs than in non-cluster ZCTAs. CONCLUSIONS: This study identified geographic disparities of DRH rates at the ZCTA level in Florida. The identification of high-rate DRH clusters provides useful information to guide resource allocation such that communities with the highest burdens are prioritized to reduce the observed disparities. Future research will investigate determinants of hospitalization rates to inform public health planning, resource allocation and interventions.


Assuntos
Diabetes Mellitus , Hospitalização , Humanos , Florida/epidemiologia , Hospitalização/estatística & dados numéricos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Idoso , Adolescente , Disparidades em Assistência à Saúde/estatística & dados numéricos , Adulto Jovem , Teorema de Bayes , Análise Espacial , Complicações do Diabetes/epidemiologia , Pré-Escolar , Criança , Fatores Socioeconômicos , Lactente
8.
J Environ Manage ; 362: 121284, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38838538

RESUMO

Future changes in land use/land cover (LULC) and climate (CC) affect watershed hydrology. Despite past research on estimating such changes, studies on the impacts of both these nonstationary stressors on urban watersheds have been limited. Urban watersheds have several important details such as hydraulic infrastructure that call for fine-scale models to predict the impacts of LULC and CC on watershed hydrology. In this paper, a fine-scale hydrologic model-Personal Computer Storm Water Management Model (PCSWMM)-was applied to predict the individual and joint impacts of LULC changes and CC on surface runoff attributes (peak and volume) in 3800 urban subwatersheds in Midwest Florida. The subwatersheds a range of characteristics in terms of drainage area, surface imperviousness, ground slope and LULC distribution. The PCSWMM also represented several hydraulic structures (e.g., ponds and pipes) across the subwatersheds. We analyzed changes in the runoff attributes to determine which stressor is most responsible for the changes and what subwatersheds are mostly sensitive to such changes. Six 24-h design rainfall events (5- to 200-year recurrence intervals) were studied under historical (2010) and future (year 2070) climate and LULC. We evaluated the response of the subwatersheds in terms of runoff peak and volume to the design rainfall events using the PCSWMM. The results indicated that, overall, CC has a greater impact on the runoff attributes than LULC change. We also found that LULC and climate induced changes in runoff are generally more pronounced in greater recurrence intervals and subwatersheds with smaller drainage areas and milder slopes. However, no relationship was found between the changes in runoff and original subwatershed imperviousness; this can be due to the small increase in urban land cover projected for the study area. This research helps urban planners and floodplain managers identify the required strategies to protect urban watersheds against future LULC change and CC.


Assuntos
Hidrologia , Florida , Mudança Climática , Modelos Teóricos , Movimentos da Água , Clima , Chuva
9.
PLoS One ; 19(6): e0282451, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38843159

RESUMO

IMPORTANCE: The frequency and characteristics of post-acute sequelae of SARS-CoV-2 infection (PASC) may vary by SARS-CoV-2 variant. OBJECTIVE: To characterize PASC-related conditions among individuals likely infected by the ancestral strain in 2020 and individuals likely infected by the Delta variant in 2021. DESIGN: Retrospective cohort study of electronic medical record data for approximately 27 million patients from March 1, 2020-November 30, 2021. SETTING: Healthcare facilities in New York and Florida. PARTICIPANTS: Patients who were at least 20 years old and had diagnosis codes that included at least one SARS-CoV-2 viral test during the study period. EXPOSURE: Laboratory-confirmed COVID-19 infection, classified by the most common variant prevalent in those regions at the time. MAIN OUTCOME(S) AND MEASURE(S): Relative risk (estimated by adjusted hazard ratio [aHR]) and absolute risk difference (estimated by adjusted excess burden) of new conditions, defined as new documentation of symptoms or diagnoses, in persons between 31-180 days after a positive COVID-19 test compared to persons without a COVID-19 test or diagnosis during the 31-180 days after the last negative test. RESULTS: We analyzed data from 560,752 patients. The median age was 57 years; 60.3% were female, 20.0% non-Hispanic Black, and 19.6% Hispanic. During the study period, 57,616 patients had a positive SARS-CoV-2 test; 503,136 did not. For infections during the ancestral strain period, pulmonary fibrosis, edema (excess fluid), and inflammation had the largest aHR, comparing those with a positive test to those without a COVID-19 test or diagnosis (aHR 2.32 [95% CI 2.09 2.57]), and dyspnea (shortness of breath) carried the largest excess burden (47.6 more cases per 1,000 persons). For infections during the Delta period, pulmonary embolism had the largest aHR comparing those with a positive test to a negative test (aHR 2.18 [95% CI 1.57, 3.01]), and abdominal pain carried the largest excess burden (85.3 more cases per 1,000 persons). CONCLUSIONS AND RELEVANCE: We documented a substantial relative risk of pulmonary embolism and a large absolute risk difference of abdomen-related symptoms after SARS-CoV-2 infection during the Delta variant period. As new SARS-CoV-2 variants emerge, researchers and clinicians should monitor patients for changing symptoms and conditions that develop after infection.


Assuntos
COVID-19 , Registros Eletrônicos de Saúde , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/diagnóstico , Feminino , Masculino , Pessoa de Meia-Idade , SARS-CoV-2/isolamento & purificação , Estudos Retrospectivos , Adulto , Idoso , Estados Unidos/epidemiologia , Síndrome de COVID-19 Pós-Aguda , Florida/epidemiologia , Estudos de Coortes
10.
Environ Monit Assess ; 196(7): 599, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38844615

RESUMO

This research was carried out in order to assess a baseline occurrence in Biscayne National Park, Florida, of four organic contaminants: the UV filters oxybenzone, dioxybenzone, and benzophenone, as well as the topical pain reliever benzocaine. A total of 35 samples were taken from five locations within the park, four near barrier islands, and one at a coral reef. Analyses were carried out using liquid chromatography coupled to high-resolution mass spectrometry. Oxybenzone was detected in 26% of samples from the park at concentrations up to 31 ng/L. Benzophenone was detected in 49% of samples from the park at concentrations up to 131 ng/L. Benzocaine and dioxybenzone were not detected in any of the samples.


Assuntos
Benzofenonas , Monitoramento Ambiental , Parques Recreativos , Protetores Solares , Poluentes Químicos da Água , Florida , Benzofenonas/análise , Poluentes Químicos da Água/análise , Protetores Solares/análise , Benzocaína/análise
11.
PLoS One ; 19(6): e0302433, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38865356

RESUMO

The timing of American horseshoe crab (Limulus polyphemus) spawning behavior along the coast of Florida (United States) is generally associated with the highest tides during the spring and fall lunar cycles. All Florida estuaries support horseshoe crab populations, but tidal characteristics vary markedly among locations, which may influence the timing of horseshoe crab spawning behavior. The Indian River Lagoon is a large microtidal estuary on Florida's east coast. Given the microtidal nature of the lagoon, it is unclear which environmental factors affect horseshoe spawning. In 2019, volunteers of Florida Horseshoe Crab Watch conducted daily surveys at two sites in the northern Indian River Lagoon during peak spawning months (February-April). During each survey, volunteers counted all spawning horseshoe crabs and recorded environmental variables, including water temperature, air temperature, wind speed, wind direction, salinity, and tide height. We developed a suite of negative-binomial regression models to quantify relationships between the number of spawning horseshoe crabs and environmental factors. Modeling results indicated a positive relationship between onshore wind speed and number of spawning horseshoe crabs. Our study suggests that in the absence of tidal cues, onshore wind speed may be an important driver of horseshoe crab spawning activity in microtidal estuarine systems.


Assuntos
Caranguejos Ferradura , Animais , Florida , Caranguejos Ferradura/fisiologia , Temperatura , Estações do Ano , Estuários , Reprodução/fisiologia , Vento , Ondas de Maré , Salinidade , Rios
12.
Viruses ; 16(5)2024 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-38793601

RESUMO

West Nile virus (WNV) is an arbovirus spread primarily by Culex mosquitoes, with humans being a dead-end host. WNV was introduced to Florida in 2001, with 467 confirmed cases since. It is estimated that 80 percent of cases are asymptomatic, with mild cases presenting as a non-specific flu-like illness. Currently, detection of WNV in humans occurs primarily in healthcare settings via RT-PCR or CSF IgM when patients present with severe manifestations of disease including fever, meningitis, encephalitis, or acute flaccid paralysis. Given the short window of detectable viremia and requirement for CSF sampling, most WNV infections never receive an official diagnosis. This study utilized enzyme-linked immunosorbent assay (ELISA) to detect WNV IgG antibodies in 250 patient serum and plasma samples collected at Tampa General Hospital during 2020 and 2021. Plaque reduction neutralization tests were used to confirm ELISA results. Out of the 250 patients included in this study, 18.8% of them were IgG positive, consistent with previous WNV exposure. There was no relationship between WNV exposure and age or sex.


Assuntos
Anticorpos Antivirais , Imunoglobulina G , Febre do Nilo Ocidental , Vírus do Nilo Ocidental , Humanos , Vírus do Nilo Ocidental/imunologia , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/virologia , Florida/epidemiologia , Masculino , Feminino , Anticorpos Antivirais/sangue , Anticorpos Antivirais/líquido cefalorraquidiano , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Imunoglobulina G/sangue , Imunoglobulina G/líquido cefalorraquidiano , Adulto , Idoso , Adulto Jovem , Adolescente , Idoso de 80 Anos ou mais , Ensaio de Imunoadsorção Enzimática , Hospitalização , Imunoglobulina M/sangue , Imunoglobulina M/líquido cefalorraquidiano
13.
J Gerontol Nurs ; 50(6): 25-33, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38815224

RESUMO

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic impacted life for older adults living in residential settings, affecting their psychosocial well-being. Risk for COVID-19 is associated with increasing age and pre-existing health conditions. The current study aimed to describe the challenges of COVID-19 and post-traumatic growth (PTG) for residents of a continuing care retirement community (CCRC) in South Florida. METHOD: A parallel mixed methods approach was used to explore the experience of older adults with PTG. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using content analysis to identify emergent themes. RESULTS: Ninety-eight older adults living in a single CCRC completed a survey. Age ranged from 67 to 99 years (mean age = 86 years), with >90% identifying as non-Hispanic White and female (78%). Using the PTG theoretical framework, experiences were categorized into five dimensions: new possibilities, relating to others, personal strength, spiritual growth, and appreciation for life. CONCLUSION: The current study focused on the challenges and growth experienced by older adults, as framed by PTG theory. Findings shed light on the capacity of this demographic, with an average age of 86 years, to overcome obstacles and achieve PTG. [Journal of Gerontological Nursing, 50(6), 25-33.].


Assuntos
COVID-19 , Crescimento Psicológico Pós-Traumático , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Idoso , Feminino , Masculino , Idoso de 80 Anos ou mais , Florida/epidemiologia , SARS-CoV-2 , Pandemias
14.
J Environ Manage ; 360: 121010, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38749135

RESUMO

Numerous unique flora and fauna inhabit the Lower Florida Keys, including the endangered Florida Key deer, found nowhere else. In this vulnerable habitat of flat islands with low elevation, accelerated sea level rise poses a threat. Predicting the impact of sea level rise on vegetation and wildlife is crucial. This study used 5 Intergovernmental Panel on Climate Change (IPCC) sea level rise scenarios to assess their effects on No Name Key, Florida. The goal was to estimate changes in the Florida Key deer population relative to sea level rise using a lidar-derived elevation data and a vegetation map. The method used 2 cases to model the sea level rise impact. In Case 1, total non-submerged area at current sea level was determined. Using 5 IPCC scenarios, a new total non-submerged land area was estimated, and deer numbers were predicted for each scenario. In Case 2, upward migration of coastal vegetation combined with the coastal squeeze process was modeled. A distinct elevation range for each vegetation type at the current sea level was determined. Vegetation ranges were redistributed based on respective elevation ranges in the sea level rise scenarios. Areas for each vegetation type were recalculated, and Key deer numbers were estimated for each sea level rise scenario. Results under the worst emission scenario showed the following: (1) for case 1, the land area was reduced to 30 % of the current land area, corresponding to having about 27 deer, and (2) for case 2, the land area was reduced to 70 % of the current land area, having about 54 deer on No Name Key. The results indicated reduced non-submerged land area and less upland vegetation, particularly hardwoods/hammocks, by the year 2100. As less land area is available, a decline in Key deer population is expected as sea levels rise. Since Key deer favor upland vegetation, habitat affected by sea level rise will likely support a smaller deer population. The findings emphasize the need for precise, timely predictions of sea level rise impacts and long-term conservation strategies. Specifically designed measures are required to protect and maintain endangered wildlife, such as the Florida Key deer, residing on these vulnerable islands.


Assuntos
Ecossistema , Modelos Teóricos , Elevação do Nível do Mar , Elevação do Nível do Mar/estatística & dados numéricos , Florida , Dinâmica Populacional/estatística & dados numéricos , Distribuição Animal , Simulação por Computador , Dispersão Vegetal
16.
Environ Sci Technol ; 58(21): 9061-9070, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38743562

RESUMO

Bottlenose dolphins (Tursiops truncatus) are keystone and sentinel species in the world's oceans. We studied correlations between per- and polyfluoroalkyl substances (PFAS) and their stress axis. We investigated associations between plasma biomarkers of 12 different PFAS variants and three cortisol pools (total, bound, and free) in wild T. truncatus from estuarine waters of Charleston, South Carolina (n = 115) and Indian River Lagoon, Florida (n = 178) from 2003 to 2006, 2010-2013, and 2015. All PFAS and total cortisol levels for these dolphins were previously reported; bound cortisol levels and free cortisol calculations have not been previously reported. We tested null hypotheses that levels of each PFAS were not correlated with those of each cortisol pool. Free cortisol levels were lower when PFOS, PFOA, and PFHxS biomarker levels were higher, but free cortisol levels were higher when PFTriA was higher. Bound cortisol levels were higher when there were higher PFDA, PFDoDA, PFDS, PFTeA, and PFUnDA biomarkers. Total cortisol was higher when PFOA was lower, but total cortisol was higher when PFDA, PFDoDA, PFTeA, and PFTriA were higher. Additional analyses indicated sex and age trends, as well as heterogeneity of effects from the covariates carbon chain length and PFAS class. Although this is a cross-sectional observational study and, therefore, could reflect cortisol impacts on PFAS toxicokinetics, these correlations are suggestive that PFAS impacts the stress axis in T. truncatus. However, if PFAS do impact the stress axis of dolphins, it is specific to the chemical structure, and could affect the individual pools of cortisol differently. It is critical to conduct long-term studies on these dolphins and to compare them to populations that have no or little expose to PFAS.


Assuntos
Biomarcadores , Golfinho Nariz-de-Garrafa , Hidrocortisona , Poluentes Químicos da Água , Animais , Golfinho Nariz-de-Garrafa/metabolismo , Hidrocortisona/sangue , Hidrocortisona/metabolismo , Monitoramento Ambiental , Fluorocarbonos , Estresse Fisiológico , Feminino , Masculino , South Carolina , Florida
17.
Toxins (Basel) ; 16(5)2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38787058

RESUMO

Cyanobacterial harmful algal blooms (cyanoHABs) occur in fresh water globally. These can degrade water quality and produce toxins, resulting in ecological and economic damages. Thus, short-term management methods (i.e., algaecides) are necessary to rapidly mitigate the negative impacts of cyanoHABs. In this study, we assess the efficacy of a hydrogen peroxide-based algaecide (PAK® 27) on a Microcystis dominated bloom which occurred within the Pahokee Marina on Lake Okeechobee, Florida, USA. We observed a significant reduction in chlorophyll a (96.81%), phycocyanin (93.17%), and Microcystis cell counts (99.92%), and a substantial reduction in microcystins (86.7%) 48 h after treatment (HAT). Additionally, there was a significant shift in bacterial community structure 48 HAT, which coincided with an increase in the relative abundance of photosynthetic protists. These results indicate that hydrogen peroxide-based algaecides are an effective treatment method for cyanoHAB control and highlight their effects on non-target microorganisms (i.e., bacteria and protists).


Assuntos
Proliferação Nociva de Algas , Peróxido de Hidrogênio , Lagos , Florida , Peróxido de Hidrogênio/farmacologia , Lagos/microbiologia , Microcystis/efeitos dos fármacos , Microcystis/crescimento & desenvolvimento , Cianobactérias/efeitos dos fármacos , Microbiota/efeitos dos fármacos , Microcistinas , Ficocianina/farmacologia , Clorofila A/metabolismo
18.
Hum Vaccin Immunother ; 20(1): 2342622, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38771122

RESUMO

To probe the understanding of healthcare providers regarding occupational exposure to human papillomavirus and their knowledge about human papillomavirus vaccination in relation to the American Society for Colposcopy and Cervical Pathology (ASCCP) recommendations. In this cross-sectional study, the healthcare providers at Mayo Clinic Arizona, Florida, and Minnesota were delivered an electronic survey. The survey was completed by 349 healthcare providers, with one respondent excluded for inconsistent entry. The mean age of respondents was 42.7 ± 10.9, and of those, 68% were female and 32% were male. Of the unvaccinated respondents, 43.3% were ≤ 45 y of age (eligible for vaccination), while those vaccinated formed 41% of the respondents. Healthcare providers are highly concerned about their cancer safety, as shown by their awareness of occupational human papillomavirus hazards and broad knowledge about vaccine efficacy. The use of personal protective equipment varied widely, including eyewear, double gloving, procedural face mask, N95 face mask, and/or nothing. Human papillomavirus and cancer risk was clearly perceived by healthcare providers. For professions, pairwise comparisons revealed that nurse practitioners, physician assistants, certified registered nurse anesthetists, and allied healthcare providers had lower scores than medical doctors. Despite the high level of understanding among healthcare providers of occupational human papillomavirus exposure, only a few of them knew of the recommendations of the ASCPP for vaccination of healthcare providers treating human papillomavirus-related diseases. In such cases, most of those surveyed embraced vaccination, which was considered 100% safe by medical doctors and allied health professionals.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Exposição Ocupacional , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Feminino , Masculino , Pessoal de Saúde/estatística & dados numéricos , Infecções por Papillomavirus/prevenção & controle , Estudos Transversais , Vacinas contra Papillomavirus/administração & dosagem , Vacinas contra Papillomavirus/efeitos adversos , Adulto , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Pessoa de Meia-Idade , Inquéritos e Questionários , Florida , Vacinação/estatística & dados numéricos , Minnesota , Arizona , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia , Equipamento de Proteção Individual , Papillomavirus Humano
19.
Fungal Biol ; 128(3): 1758-1770, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38796260

RESUMO

Starting in the fall of 2019, mortality, blight symptoms, and signs of white fungal mycelia were observed on external host tissues of non-native landscape trees as well as numerous native trees, understory shrubs, and vines throughout northern and central Florida, USA. We determined that the fungus is an undescribed species of Basidiomycota based on morphological characteristics and DNA sequence analysis. Phylogenetic analyses of the internal transcribed spacer (ITS), large subunit (LSU), and translation elongation factor 1-alpha (tef1) regions revealed that this novel plant pathogen is an undescribed taxon of the genus Parvodontia (Cystostereaceae, Agaricales). We propose the name Parvodontia relampaga sp. nov. which describes its unique morphological features and phylogenetic placement. We confirmed the pathogenicity of P. relampaga in greenhouse inoculations on host plants from which strains of this novel pathogen were isolated, including the non-native gymnosperm Afrocarpus falcatus, the non-native and commercially important Ligustrum japonicum, and the native tree Quercus hemisphaerica. P. relampaga was also detected on a total of 27 different species of woody host plants, including such economically and ecologically important hosts as Fraxinus, Ilex, Magnolia, Persea, Prunus, Salix, Vitis, and Vaccinium. For this new plant disease, we propose the name "relampago blight," which refers to the lightning-like rhizomorph growth (relámpago means 'lightning' in Spanish). This study presents a newly discovered fungal taxon with a wide host range on both angiosperms and gymnosperms that may be an emerging pathogen of concern in Florida and the Gulf Coast region.


Assuntos
DNA Fúngico , Filogenia , Doenças das Plantas , Doenças das Plantas/microbiologia , Florida , DNA Fúngico/genética , Agaricales/genética , Agaricales/classificação , Agaricales/isolamento & purificação , Agaricales/fisiologia , Agaricales/patogenicidade , Análise de Sequência de DNA , DNA Espaçador Ribossômico/genética , DNA Espaçador Ribossômico/química
20.
Glob Public Health ; 19(1): 2350656, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38718289

RESUMO

Throughout the COVID-19 pandemic, public officials in the United States - from the President to governors, mayors, lawmakers, and even school district commissioners - touted unproven treatments for COVID-19 alongside, and sometimes as opposed to, mask and vaccine mandates. Utilising the framework of 'pharmaceutical messianism', our article focuses on three such cures - hydroxychloroquine, ivermectin, and monoclonal antibodies - to explore how pharmaceuticals were mobilised within politicised pandemic discourses. Using the states of Utah, Texas, and Florida as illustrative examples, we make the case for paying attention to pharmaceutical messianism at the subnational and local levels, which can very well determine pandemic responses and outcomes in contexts such as the US where subnational governments have wide autonomy. Moreover, we argue that aside from the affordability of the treatments being studied and the heterodox knowledge claiming their efficacy, the widespread uptake of these cures was also informed by popular medical (including immunological) knowledge, pre-existing attitudes toward 'orthodox' measures like vaccines and masks, and mistrust toward authorities and institutions identified with the 'medical establishment'. Taken together, our case studies affirm the recurrent nature of pharmaceutical messianism in times of health crises - while also refining the concept and exposing its limitations.


Assuntos
COVID-19 , Hidroxicloroquina , Política , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estados Unidos , Hidroxicloroquina/uso terapêutico , Tratamento Farmacológico da COVID-19 , Ivermectina/uso terapêutico , Pandemias , Utah , Florida , Texas
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