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1.
J Dent Child (Chic) ; 88(2): 101-107, 2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-34321141

RESUMO

Purpose: To describe the geographic distribution of pediatric dentists (PDs) in Florida and the sociodemographic characteristics of communities in which they are located compared with communities without a PD.
Methods: The ratio of PDs to children for each county in Florida and the distribution of PDs in Florida counties at the census tract (CT) level were calculated. Each CT was categorized as having or not having PDs to examine the geographic distribution of PDs, and the sociodemographic differences between CTs with and without a PD were tested by using t-tests. PDs' participation in Medicaid and acceptance of new patients were also investigated.
Results: Of the 67 counties in Florida, 31 had no PD. There were 4,181,677 children younger than 18 years served by 388 PDs, for a statewide ratio of 9.2 PDs per 100,000 population (range 0 to 34.9). Median household income, family income, and education were higher in CTs with PDs, and poverty level, unemployment rate, and percentage of African American population were higher in CTs with fewer PDs. Although 49 percent of PDs accepted Medicaid, only 32 percent accepted new patients.
Conclusion: There are regional and sociodemographic disparities in the distribution of PDs in Florida.


Assuntos
Odontólogos , Medicaid , Criança , Escolaridade , Florida/epidemiologia , Humanos , Pobreza , Estados Unidos
2.
BMC Public Health ; 21(1): 1314, 2021 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-34225674

RESUMO

BACKGROUND: COVID-19 has accelerated interest in and need for online delivery of healthcare. We examined the reach, engagement and effectiveness of online delivery of lifestyle change programs (LCP) modelled after the Diabetes Prevention Program (DPP) in a multistate, real-world setting. METHODS: Longitudinal, non-randomized study comparing online and in-person LCP in a large multistate sample delivered over 1 year. Sample included at-risk adults (n = 26,743) referred to online (n = 9) and in-person (n = 11) CDC-recognized LCP from a multi-state registry (California, Florida and Colorado) between 2015 and 2018. The main outcome was effectiveness (proportion achieving > 5% weight loss) at one-year. Our secondary outcomes included reach (proportion enrolled among referred) and engagement (proportion ≥ 9 sessions by week 26). We used logistic regression modelling to assess the association between participant- and setting -level characteristics with meaningful weight loss. RESULTS: Online LCP effectiveness was lower, with 23% of online participants achieving > 5% weight loss, compared with 35% of in-person participants (p < 0.001). More adults referred to online programs enrolled (56% vs 51%, p < 0.001), but fewer engaged at 6-months (attendance at ≥9 sessions 46% vs 66%, p < 0.001) compared to in-person participants. CONCLUSIONS: Compared to adults referred to in-person LCP, those referred to online LCP were more likely to enroll and less likely to engage. Online participants achieved modest meaningful weight loss. Online delivery of LCP is an attractive strategy to deliver and scale DPP, particularly with social distancing measures currently in place. However, it is unclear how to optimize delivery models for maximal impact given trade-offs in reach and effectiveness.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 2 , Programas de Redução de Peso , Adulto , Colorado , Florida , Humanos , Estilo de Vida , SARS-CoV-2
3.
Sensors (Basel) ; 21(13)2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34201965

RESUMO

Operational coarse-resolution satellite thermal sensors designed for global oceans are often insufficient for evaluating surface temperature of small water bodies. Here, the quality of the thermal data, collected by the ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS), over several South Florida estuaries, Chesapeake Bay, and Lake Okeechobee is evaluated using both in situ and Moderate Resolution Imaging Spectroradiometer (MODIS) Sea Surface Temperature (SST) data. Overall, for SST between ~6 and ~32 °C, ECOSTRESS LST (Land Surface Temperature, used as a surrogate for SST in this study) appears to be slightly underestimated, with the underestimation being more severe at night (-1.13 °C) than during the day (-0.64 °C), in spring and summer (-1.25 ± 1.39 °C) than in autumn and winter (-0.57 ± 0.98 °C), and after May 2019 when two of the five bands failed. The root-mean-square uncertainties of ECOSTRESS SST are generally within 1-2 °C. Spatial analysis further suggests that ECOSTRESS SST covers waters closer to shore and reveals more spatial features than MODIS, with comparable image noise. From these observations, after proper georeferencing and empirical correction of the negative bias, ECOSTRESS SST may be used to evaluate the thermal environments of small water bodies, thus filling gaps in the coarse-resolution satellite data.


Assuntos
Ecossistema , Estuários , Monitoramento Ambiental , Florida , Oceanos e Mares
4.
BMC Health Serv Res ; 21(1): 653, 2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34225719

RESUMO

BACKGROUND: Patients with serious mental illness (SMI) are vulnerable to medical-surgical readmissions and emergency department visits. METHODS: We studied 1,914,619 patients with SMI discharged after medical-surgical admissions in Florida and New York between 2012 and 2015 and their revisits to the hospital within 30 days of discharge. RESULTS: Patients with SMI from the most disadvantaged communities had greater adjusted 30-day revisit rates than patients from less disadvantaged communities. Among those that experienced a revisit, patients from the most disadvantaged communities had 7.3 % greater 30-day observation stay revisits. CONCLUSIONS: These results suggest that additional investments are needed to ensure that patients with SMI from the most disadvantaged communities are receiving appropriate post-discharge care.


Assuntos
Assistência ao Convalescente , Transtornos Mentais , Serviço Hospitalar de Emergência , Florida/epidemiologia , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , New York/epidemiologia , Alta do Paciente , Readmissão do Paciente , Estudos Retrospectivos , Fatores Socioeconômicos
5.
MMWR Morb Mortal Wkly Rep ; 70(26): 937-941, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34197364

RESUMO

Disasters can adversely affect population health, resulting in increased need for health services. Hurricane Irma made landfall in the Florida Keys (Monroe County) as a Category 4 hurricane on September 10, 2017. The hurricane caused substantial damage to 65% of homes and resulted in 40 persons injured and 17 deaths from hurricane-related causes.* During 2018, the county suicide rate increased to 34.9 per 100,000 population from the 5-year (2013-2017) average of 25.2 per 100,000 population (1). In May 2019, 20 months after the hurricane, the Florida Department of Health (FDOH) conducted a modified Community Assessment for Public Health Emergency Response (CASPER) to assess the community's mental, physical, and economic health and develop public health interventions to decrease the suicide rate. A consenting adult member from 231 households was interviewed, and a weighted cluster analysis was conducted to estimate the number and percentage of households throughout the Florida Keys with a particular response, as well as the number and percentage of persons at risk for suicide. During the 20 months since Hurricane Irma, 17% of households reported a need for a mental health care provider; 37.9% of these did not receive those services. A modified CASPER was used to calculate population estimates of suicide risk in an area of high landfall for hurricanes; estimated population suicide risk was 7.3%. Respondents reported worsening of respiratory conditions (17.7%), anxiety (17.0%), and depression (11.3%). Emergency preparedness plans should consider strengthening mental health service delivery after a hurricane, particularly during the long-term recovery phase.


Assuntos
Tempestades Ciclônicas , Desastres , Determinação de Necessidades de Cuidados de Saúde , Saúde Pública , Adulto , Idoso , Ansiedade/epidemiologia , Serviços Comunitários de Saúde Mental , Depressão/epidemiologia , Florida/epidemiologia , Humanos , Pessoa de Meia-Idade , Medição de Risco , Suicídio
6.
Medicine (Baltimore) ; 100(28): e26631, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34260554

RESUMO

ABSTRACT: Antiretroviral therapy (ART) has improved survival of patients living with HIV (PLWH); however, this has been accompanied by an increase in cardiovascular disease (CVD). Although preventative measures for CVD among the general population are well described, information is limited about CVD prevention among PLWH. The goal of this study was to characterize the prevalence of CVD in our population and to assess the use of primary and secondary prevention.We performed a retrospective review of PLWH receiving primary care at a large academic center in Miami, Florida. We characterized the prevalence of CVD, CVD risk, and the use of aspirin and statins for primary and secondary CVD prevention.A total of 985 charts were reviewed (45% women, 55% men). Average age was 52.2 years. Average CD4 count was 568 cells/microL. 92.9% were receiving ART, and 71% were virologically suppressed. The median 10-year ASCVD risk was 7.3%. The prevalence of CVD was 10.4% (N = 102). The odds of having CVD was lower in patients on ART (OR 0.47, 95% CI: 0.25-0.90, P = .02). The use of medications for primary and secondary prevention of CVD based on current guidelines was low: 15% and 37% for aspirin respectively, and 25% and 44% for statins.CVD risk and rates of CVD are high among PLWH and receiving ART could protect against CVD. However, the use of medications for primary and secondary prevention is low. Increased awareness of CVD risk-reduction strategies is needed among providers of PLWH to decrease the burden of CVD.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Infecções por HIV/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Aspirina/administração & dosagem , Feminino , Florida/epidemiologia , Fatores de Risco de Doenças Cardíacas , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
7.
BMJ Open ; 11(7): e047340, 2021 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-34272219

RESUMO

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population. METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential design, including a multisite, prospective cohort study in three southern states-North Carolina, Florida and Kentucky-and subsequent qualitative interviews. HIV-negative adults clinically indicated for PrEP with CJ-involvement in the past year (n=660; 220 per site)-will be recruited for four quantitative interviews separated by 6 months, with 18 months of follow-up. Interviews will measure CJ involvement, substance use, sexual behaviours, PrEP acceptability and use, healthcare access and utilisation, support systems and psychological and emotional well-being. We will estimate probabilities of PrEP acceptability and use in a CJ-involved population using descriptive and multivariable analyses. After the follow-up, a subsample that never initiated PrEP, initiated but did not sustain PrEP or sustained PrEP will be asked to participate in a qualitative interview to contextualise their experiences and decisions around PrEP. An inductive approach will guide qualitative analyses. ETHICS AND DISSEMINATION: PrEP initiation and sustained use rates are unknown among CJ-involved adults. This research will identify individual, social and structural factors that predict PrEP initiation and use. Data generated from the study have the potential to guide research and the development and tailoring of PrEP interventions to CJ-involved populations and provide context to HIV-related outcomes for those with CJ experiences.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Adulto , Fármacos Anti-HIV/uso terapêutico , Estudos de Coortes , Direito Penal , Florida , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Humanos , Kentucky , North Carolina , Estudos Prospectivos , Estados Unidos
8.
Sci Total Environ ; 792: 148321, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34153761

RESUMO

We present results of a multiyear study of the Everglades (Florida, USA) detailing how differences in environmental variables can alter mercury concentrations in the food web. About 1000 random locations throughout the freshwater Everglades marsh have been sampled for the United States Environmental Protection Agency's Everglades Regional Environmental Monitoring and Assessment Program ("REMAP") since 1995. REMAP sampling is synoptic and multimedia, including an abundant prey fish (eastern mosquitofish, Gambusia holbrooki) as an indicator of mercury bioaccumulation. Amplifying an approach we reported to Everglades National Park, we used Generalized Boosted Models on the REMAP data to estimate how much of the mercury concentration in mosquitofish could be explained by water quality constituents or indicators of ecological health (covariates). The resulting model accounts for 60% of the environmental influence on variation in mosquitofish mercury, a robust outcome for a large, disturbed ecosystem such as the Everglades, given its seasonal, annual, and spatial differences. Of the eight most influential covariates, two were methyl mercury in periphyton and water, two can be indicators of trophic state (alkaline phosphatase and chlorophyll-a), one can be a marker of stormwater transport (conductivity), and two can be enablers of mercury methylation (sulfate in soil and water). While these covariates had an average individual influence ranging from 4.0% to 10.1%, together they accounted for 52.2% of the total relative influence. Water with low phosphorus, but with sulfur and carbon above background, moved into the less disturbed parts of the Everglades via modifications to the existing water management system, could increase mercury bioaccumulation in those parts of the marsh.


Assuntos
Mercúrio , Poluentes Químicos da Água , Animais , Ecossistema , Monitoramento Ambiental , Florida , Mercúrio/análise , Poluentes Químicos da Água/análise , Qualidade da Água , Áreas Alagadas
9.
J Subst Abuse Treat ; 127: 108344, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34134863

RESUMO

INTRODUCTION: Syringe services programs (SSPs) are evidence-based HIV prevention programs for people who inject drugs. However, not all SSPs operate evidence-based syringe distribution models, such as needs-based distribution. This study aims to provide preliminary evidence from the IDEA SSP on changes in injection risk behaviors over time, and to examine factors, including syringe coverage, associated with injection risk behavior trajectories over time under a one-for-one syringe distribution model. METHODS: We used a prospective observational study design to generate a cohort of SSP clients who completed three behavioral assessments at SSP service visits between December 2016 and January 2020 (N = 115). The study used generalized estimating equations (GEE) to examine the relationship between covariate measures and the primary outcomes. The primary outcomes were 1) sharing of any injection equipment (e.g. syringes, needles, cookers, cottons) in the previous 30 days (yes/no) and 2) reusing of needles/syringes in the previous 30 days (yes/no). RESULTS: Men were more likely to report reusing syringes (aRR = 1.15, 95% CI: 1.01-1.37) and those who reported injecting in public were less likely to report reusing syringes (aRR = 0.90, 95% CI: 0.82-0.99). HCV-positive clients had a 62% reduction in sharing injection equipment and those who reported public injection had a 62% increase in sharing injection equipment over time. Most importantly, increasing syringe coverage was associated with a decrease in both sharing injection equipment (aRR = 0.42, 95% CI: 0.25-0.72) and reusing syringes (aRR = 0.79, 95% CI: 0.66-0.95). CONCLUSION: This study provides preliminary evidence of reductions in injection-related risk behaviors from the IDEA SSP and highlights potential high priority groups, such as people experiencing homelessness, that may need additional intervention. In addition, improving syringe coverage among SSP clients may be an important factor in reducing behaviors that place individuals at risk for contracting HIV and HCV.


Assuntos
Infecções por HIV , Abuso de Substâncias por Via Intravenosa , Feminino , Florida , Infecções por HIV/prevenção & controle , Humanos , Masculino , Uso Comum de Agulhas e Seringas , Programas de Troca de Agulhas , Assunção de Riscos , Seringas
10.
Nat Commun ; 12(1): 4003, 2021 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-34183663

RESUMO

Mangroves buffer inland ecosystems from hurricane winds and storm surge. However, their ability to withstand harsh cyclone conditions depends on plant resilience traits and geomorphology. Using airborne lidar and satellite imagery collected before and after Hurricane Irma, we estimated that 62% of mangroves in southwest Florida suffered canopy damage, with largest impacts in tall forests (>10 m). Mangroves on well-drained sites (83%) resprouted new leaves within one year after the storm. By contrast, in poorly-drained inland sites, we detected one of the largest mangrove diebacks on record (10,760 ha), triggered by Irma. We found evidence that the combination of low elevation (median = 9.4 cm asl), storm surge water levels (>1.4 m above the ground surface), and hydrologic isolation drove coastal forest vulnerability and were independent of tree height or wind exposure. Our results indicated that storm surge and ponding caused dieback, not wind. Tidal restoration and hydrologic management in these vulnerable, low-lying coastal areas can reduce mangrove mortality and improve resilience to future cyclones.


Assuntos
Avicennia/crescimento & desenvolvimento , Tempestades Ciclônicas , Ciclo Hidrológico/fisiologia , Conservação dos Recursos Naturais , Florida , Hidrologia , Lagoas , Imagens de Satélites , Áreas Alagadas
11.
Zootaxa ; 4991(1): 185-191, 2021 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-34186727

RESUMO

The bark beetle, Ernoporus parvulus (Eggers, 1943) was collected from Pinellas County, Florida, USA representing the first North American record of the genus. Two species previously described from the Caribbean were examined and are synonymous: Ernoporus minutus (Bright Torres, 2006) syn. nov. and E. exquisitus (Bright, 2019) syn. nov. This beetle is likely an overlooked exotic from Africa, known only from sea hibiscus, Talipariti tiliaceum (L.) Fryxell (Malvaceae). There is no evidence that this is a threat to commercial or ornamental Hibiscus and related species.


Assuntos
Besouros , Animais , Animais Exóticos , Besouros/anatomia & histologia , Besouros/classificação , Florida , Casca de Planta/parasitologia , Especificidade da Espécie
12.
Zootaxa ; 4980(3): 490520, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34186968

RESUMO

Three new species of the genus Heteromysis S.I. Smith, 1873 (tribus Heteromysini), are described from a rich stock of mysids obtained on request from the international community of professional aquarium keepers. The 18S rDNA and COI sequences of the three species were distinct from each other and also from other sequences published in DNA databases. Heteromysis (Olivemysis) schoenbrunnensis sp. nov. is morphologically characterized within the subgenus Olivemysis based on the structure of the first and second antennae, male pleopods, uropods, and telson. Heteromysis (Heteromysis) gulfarii sp. nov. is outstanding within the subgenus Heteromysis by sexually dimorphic modified setae on the antennular trunk. These setae are non-dimorphic in the very similar Heteromysis (Heteromysis) korntalensis sp. nov. Both species H. gulfarii and to a lesser degree also H. korntalensis show modified eyes, subquadrate in dorsal view, eyestalks anteriorly tapering in lateral view; small, well-developed cornea implanted laterally on modified eyestalk. Apart from eye structure H. gulfarii and H. korntalensis clearly fall morphologically within the nominotypical subgenus Heteromysis.


Assuntos
Crustáceos , Animais , Animais de Zoológico , Recifes de Corais , Crustáceos/anatomia & histologia , Crustáceos/classificação , Crustáceos/genética , DNA Ribossômico , Complexo IV da Cadeia de Transporte de Elétrons/genética , Europa (Continente) , Florida , Masculino , RNA Ribossômico 18S/genética , Especificidade da Espécie
13.
Emerg Infect Dis ; 27(7): 1886-1892, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34152960

RESUMO

Eastern equine encephalitis virus (EEEV) is an arbovirus in the family Togaviridae, genus Alphavirus, found in North America and associated with freshwater/hardwood swamps in the Atlantic, Gulf Coast, and Great Lakes regions. EEEV disease in humans is rare but causes substantial illness and death. To investigate the molecular epidemiology and microevolution of EEEV from a fatal case in Alabama, USA, in 2019, we used next-generation sequencing of serum and cerebrospinal fluid (CSF). Phylogenetic inference indicated that the infecting strain may be closely related to isolates from Florida detected during 2010-2014, suggesting potential seeding from Florida. EEEV detected in serum displayed a higher degree of variability with more single-nucleotide variants than that detected in the CSF. These data refine our knowledge of EEEV molecular epidemiologic dynamics in the Gulf Coast region and demonstrate potential quasispecies bottlenecking within the central nervous system of a human host.


Assuntos
Vírus da Encefalite Equina do Leste , Alabama , Animais , Florida , Cavalos , Humanos , América do Norte , Filogenia
14.
J Health Care Poor Underserved ; 32(2): 598-606, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34120960

RESUMO

In response to the COVID-19 pandemic, the Herbert Wertheim College of Medicine's Neighborhood Health Education Learning Program (NeighborhoodHELP) initiated a longitudinal assessment and mitigation of social and health care challenges for a population of approximately 850 underserved households. Here, we describe the needs assessment, ensuing interventions, and lessons learned during this pandemic.


Assuntos
COVID-19/epidemiologia , Determinação de Necessidades de Cuidados de Saúde , Populações Vulneráveis , Adolescente , Adulto , Idoso , Criança , Serviços de Saúde Comunitária , Informação de Saúde ao Consumidor , Feminino , Florida/epidemiologia , Assistência Alimentar , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Área Carente de Assistência Médica , Pessoa de Meia-Idade , Pandemias , Determinantes Sociais da Saúde , Adulto Jovem
16.
Child Abuse Negl ; 118: 105136, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34098378

RESUMO

BACKGROUND: COVID-19 has had a major impact on child abuse and neglect (CAN) in the U.S. leading to a change in the number of reported screened-in CAN investigations, missed prevention cases, and missed CAN cases. OBJECTIVES: To estimate the deficit number of CAN investigations and resultant estimated number of missed prevention and CAN cases due to the COVID-19 pandemic in the U.S. from March 2020 to December 2020. METHODS: Secondary data analyses of administrative child welfare data from January 2013 to December 2020 from New York City, Florida, New Jersey and Wisconsin were conducted. Spline regression modeling controlling for autocorrelation was utilized to explore any significant changes once the pandemic began in March 2020 in the number of screened-in CAN investigations. The seven-year monthly average of screen-in CAN investigations for March through December from 2013 to 2019 was calculated and compared to the numbers of CAN investigations for March 2020 to December 2020. The resultant number of missed prevention cases and CAN cases was estimated for the four jurisdictions and used to approximate the number of missed prevention cases and CAN cases in the U.S., as well as the projected estimation of national lifetime economic costs. RESULTS: Prior to the pandemic, there were insignificant monthly increases of 0.7 CAN investigations in NYC and 6.2 CAN investigations in Florida, a significant monthly increase 4.2 CAN investigations in New Jersey and an insignificant monthly decrease in 0.6 CAN investigations in Wisconsin. Once the pandemic began, there were significant monthly decreases (p < .001) in each of the four jurisdictions, including 1425.6 fewer CAN investigations in NYC, 3548.0 fewer CAN investigations in Florida, 963.0 fewer CAN investigations in New Jersey and 529.1 fewer CAN investigations in Wisconsin. There were an estimated 60,791 fewer CAN investigations in these four jurisdictions from March 2020 to December 2020 of which there were approximately 18,540 missed prevention and CAN cases suggesting up to $4.2 billion in lifetime economic costs. It was estimated that were 623,137 children not investigated for CAN in the U.S. during the same 10-month period. This suggests that there were an estimated 85,993 children were missed for prevention services and about 104,040 children were missed for CAN with a potential lifetime economic impact of up to $48.1 billion in the U.S. CONCLUSIONS: The COVID-19 pandemic has led to a precipitous drop in CAN investigations where almost 200,000 children are estimated to have been missed for prevention services and CAN in a 10-month period. There are opportunities for the child welfare jurisdictions to work with partner education, public health, social service and other providers to strategically approach this very grave issue in order to mitigate its impact on this very vulnerable population.


Assuntos
COVID-19/epidemiologia , COVID-19/psicologia , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/tendências , Proteção da Criança/psicologia , Proteção da Criança/tendências , Criança , Família/psicologia , Florida/epidemiologia , Humanos , Masculino , New Jersey/epidemiologia , Cidade de Nova Iorque/epidemiologia , Pandemias/prevenção & controle , Saúde Pública/tendências , SARS-CoV-2 , Estados Unidos/epidemiologia , Wisconsin/epidemiologia
17.
Gene ; 800: 145800, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34175400

RESUMO

Emerging infectious diseases are a major threat to biodiversity in the 21st century. Fibropapillomatosis (FP) is an epithelial tumor disease that affects immature and adult marine turtles worldwide, particularly green turtles (Chelonia mydas). We know little about the host factors contributing to FP susceptibility, in part because transcriptomic studies that compare transcript expression in turtles with and without FP are lacking. Here, we performed RNA-Seq on healthy skin tissue from immature C. mydas in the Indian River Lagoon, Florida, USA, comparing turtles (1) with and without FP and (2) with and without leech parasites, a putative vector of FP. We assembled a de novo C. mydas skin transcriptome to identify transcripts with significant differential expression (DE) across FP and leech categories. Significant DE transcripts were found across FP and leech comparisons, including 10 of the same transcripts with DE across both comparisons. Leech-positive individuals significantly upregulated different immune and viral interaction transcripts than did leech-negative individuals, including viral interaction transcripts associated with herpesvirus interactions. This finding strengthens the role of marine leeches as mechanical vectors of Chelonid herpesvirus 5 (ChHV5) which has been implicated as a causative agent of FP. FP-positive turtles upregulated several tumor progression and suppression transcripts relative to FP-negative turtles, which had no significant DE tumor progression transcripts. FP-positive turtles also upregulated significantly more protein interaction transcripts than FP-negative turtles. DE transcripts across leech comparisons showed no functional enrichment, whereas DE transcripts across FP comparisons showed some GO terms were enriched in FP-positive and FP negative turtles. Notably, only FP-negative turtles were enriched for GO terms involved in acquired and inflammatory immune gene regulation. Overall, our DE transcripts included several candidate genes that may play important roles in C. mydas resistance to or recovery from FP, highlighting that transcriptomics provides a promising venue to understand this impactful disease. Continued investigation of C. mydas responses to FP and leech affliction is imperative for species persistence and the conservation of marine ecosystems worldwide due to the essential role of sea turtles in ecosystem function and stability.


Assuntos
Neoplasias Cutâneas/veterinária , Tartarugas/genética , Tartarugas/parasitologia , Animais , Florida , Infecções por Herpesviridae/veterinária , Infecções por Herpesviridae/virologia , Sanguessugas/virologia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Transcriptoma , Tartarugas/imunologia , Tartarugas/virologia
18.
Environ Pollut ; 285: 117451, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34082371

RESUMO

Since early 2020, the world has faced an unprecedented pandemic caused by the novel COVID-19 virus. In this study, we characterize the impact of the lockdown associated with the pandemic on air quality in six major cities across the state of Florida, namely: Jacksonville, Tallahassee, Gainesville, Orlando, Tampa, and Miami. Hourly measurements of PM2.5, ozone, NO2, SO2, and CO were provided by the US EPA at thirty sites operated by the Florida Department of Environmental Protection during mid-February to mid-April from 2015 through 2020. To analyze the effect of the pandemic, atmospheric pollutant concentrations in 2020 were compared to historic data at these cities during the same period from 2015 to 2019. Reductions in NO2 and CO levels were observed across the state in most cities and were attributed to restrictions in mobility and the decrease in vehicle usage amid the lockdown. Likewise, decreases in O3 concentrations were observed and were related to the prevailing NOx-limited regime during this time period. Changes in concentrations of SO2 exhibited spatial variations, concentrations decreased in northern cities, however an increase was observed in central and southern cities, likely due to increased power generation at facilities primarily in the central and southern regions of the state. PM2.5 levels varied temporally during the study and were positively correlated with SO2 concentrations during the lockdown. In March, reductions in PM2.5 levels were observed, however elevations in PM2.5 concentrations in April were attributed to long-range transport of pollutants rather than local emissions. This study provides further insight into the impacts of the COVID-19 pandemic on anthropogenic sources from vehicular emissions and power generation in Florida. This work has implications for policies and regulations of vehicular emissions as well as consequences on the use of sustainable energy sources in the state.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Cidades , Controle de Doenças Transmissíveis , Monitoramento Ambiental , Florida , Humanos , Pandemias , Material Particulado/análise , SARS-CoV-2
19.
J Environ Manage ; 295: 113107, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34182337

RESUMO

Collaborative nonregulatory programs can benefit the long-term sustainability of environmental resources. Such programs benefit from extensive planning and assessment relative to ecological systems as well as public participation. While many programs use adaptive management as a guiding programmatic framework, few programs successfully integrate social and human context into their adaptive management frameworks. While this adaptive governance framework can be successful, many potential challenges arise when incorporating public stakeholders into the adaptive management framework. To reduce those challenges, programs need participation from diverse stakeholder groups that represent multiple communities of interest, place, and identity. The participatory process benefits from a diverse group of stakeholders and can result in successful management of environmental resources. We highlight the participatory co-management process of three newly developing nonregulatory programs that are modeled after the United States EPA's National Estuary Program in the Perdido and Pensacola Bay systems, Choctawhatchee Bay, and the St. Andrew and St. Joseph Bay systems (Florida USA). This case study illustrates how collaborative nonregulatory programs can be implemented not only in the United States, but also in other regions of the world.


Assuntos
Ecossistema , Estuários , Participação da Comunidade , Conservação dos Recursos Naturais , Florida , Humanos , Estados Unidos
20.
Am J Manag Care ; 27(6): 234-240, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34156216

RESUMO

OBJECTIVES: To determine (1) factors linked to hospitalizations among managed care patients (MCPs), (2) outcome improvement with use of outpatient off-label treatment, and (3) outcome comparison between MCPs and a mirror group. STUDY DESIGN: Retrospective cohort study comparing MCPs with an age- and gender-matched mirror group in Florida from April 1, 2020, to May 31, 2020. METHODS: A total of 38,193 MCPs in a Florida primary care group were monitored for COVID-19 incidence, hospitalization, and mortality. The highest-risk patients were managed by the medical group's COVID-19 Task Force. As part of a population health program, the COVID-19 Task Force contacted patients, conducted medical encounters, and tracked data including comorbidities and medical outcomes. The MCPs enrolled in the medical group were compared with a mirror group from the state of Florida. RESULTS: The mean (SD) age among the MCPs was 67.9 (15.2) years, and 60% were female. Older age and hypertension were the most important factors in predicting COVID-19. Obesity, chronic kidney disease (CKD), and congestive heart failure (CHF) were linked to higher rates of hospitalizations. Patients prescribed off-label outpatient medications had 73% lower likelihood of hospitalization (P < .05). Compared with the mirror group, MCPs had 60% lower COVID-19 mortality (P < .05). CONCLUSIONS: MCPs have risk factors similar to the general population for COVID-19 incidence and progression, including older age, hypertension, obesity, CHF, and CKD. Outpatient treatment with off-label medicines decreased hospitalizations. A comprehensive population health program decreased COVID-19 mortality.


Assuntos
COVID-19/terapia , Programas de Assistência Gerenciada/organização & administração , Pneumonia Viral/terapia , Idoso , COVID-19/mortalidade , Comorbidade , Feminino , Florida/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Masculino , Uso Off-Label , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
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