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1.
Nursing ; 51(10): 42-48, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34580263

RESUMO

ABSTRACT: Patient safety attendants (PSAs) provide constant direct observation to patients who have cognitive impairments or thoughts. Some estimates report that an acute care hospital in the United States may spend more than $1 million annually on PSAs, an expenditure often not reimbursed. With no national defined standards to regulate or monitor PSA use, this study sought to determine the impact of COVID-19 on a PSA reduction program in a large Midwestern healthcare system.


Assuntos
Pessoal Técnico de Saúde/estatística & dados numéricos , COVID-19/epidemiologia , Segurança do Paciente , Pessoal Técnico de Saúde/economia , Disfunção Cognitiva/enfermagem , Humanos , Meio-Oeste dos Estados Unidos/epidemiologia , Avaliação de Programas e Projetos de Saúde
2.
Med Care ; 59(10): 888-892, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34334737

RESUMO

BACKGROUND: Despite many studies reporting disparities in coronavirus disease-2019 (COVID-19) incidence and outcomes in Black and Hispanic/Latino populations, mechanisms are not fully understood to inform mitigation strategies. OBJECTIVE: The aim was to test whether neighborhood factors beyond individual patient-level factors are associated with in-hospital mortality from COVID-19. We hypothesized that the Area Deprivation Index (ADI), a neighborhood census-block-level composite measure, was associated with COVID-19 mortality independently of race, ethnicity, and other patient factors. RESEARCH DESIGN: Multicenter retrospective cohort study examining COVID-19 in-hospital mortality. SUBJECTS: Inclusion required hospitalization with positive SARS-CoV-2 test or COVID-19 diagnosis at three large Midwestern academic centers. MEASURES: The primary study outcome was COVID-19 in-hospital mortality. Patient-level predictors included age, sex, race, insurance, body mass index, comorbidities, and ventilation. Neighborhoods were examined through the national ADI neighborhood deprivation rank comparing in-hospital mortality across ADI quintiles. Analyses used multivariable logistic regression with fixed site effects. RESULTS: Among 5999 COVID-19 patients median age was 61 (interquartile range: 44-73), 48% were male, 30% Black, and 10.8% died. Among patients who died, 32% lived in the most disadvantaged quintile while 11% lived in the least disadvantaged quintile; 52% of Black, 24% of Hispanic/Latino, and 8.5% of White patients lived in the most disadvantaged neighborhoods.Living in the most disadvantaged neighborhood quintile predicted higher mortality (adjusted odds ratio: 1.74; 95% confidence interval: 1.13-2.67) independent of race. Age, male sex, Medicare coverage, and ventilation also predicted mortality. CONCLUSIONS: Neighborhood disadvantage independently predicted in-hospital COVID-19 mortality. Findings support calls to consider neighborhood measures for vaccine distribution and policies to mitigate disparities.


Assuntos
COVID-19/epidemiologia , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Mortalidade Hospitalar/tendências , Características de Residência/estatística & dados numéricos , Fatores Etários , Teste para COVID-19 , Comorbidade , Humanos , Seguro Saúde/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , Pobreza/estatística & dados numéricos , Estudos Retrospectivos , Fatores Sexuais
4.
PLoS One ; 16(6): e0243676, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34111144

RESUMO

Since March 2020, the United States has lost over 580,000 lives to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. A growing body of literature describes population-level SARS-CoV-2 exposure, but studies of antibody seroprevalence within school systems are critically lacking, hampering evidence-based discussions on school reopenings. The Lake Central School Corporation (LCSC), a public school system in suburban Indiana, USA, assessed SARS-CoV-2 seroprevalence in its staff and identified correlations between seropositivity and subjective histories and demographics. This study is a cross-sectional, population-based analysis of the seroprevalence of SARS-CoV-2 in LCSC staff measured in July 2020. We tested for seroprevalence with the Abbott Alinity™ SARS-CoV-2 IgG antibody test. The primary outcome was the total seroprevalence of SARS-CoV-2, and secondary outcomes included trends of antibody presence in relation to baseline attributes. 753 participants representative of the staff at large were enrolled. 22 participants (2.9%, 95% CI: 1.8% - 4.4%) tested positive for SARS-CoV-2 antibodies. Correcting for test performance parameters, the seroprevalence is estimated at 1.7% (90% Credible Interval: 0.27% - 3.3%). Multivariable logistic regression including mask wearing, travel history, symptom history, and contact history revealed a 48-fold increase in the odds of seropositivity if an individual previously tested positive for COVID-19 (OR: 48, 95% CI: 4-600). Amongst individuals with no previous positive test, exposure to a person diagnosed with COVID-19 increased the odds of seropositivity by 7-fold (OR: 7.2, 95% CI: 2.6-19). Assuming the presence of antibodies is associated with immunity against SARS-CoV-2 infection, these results demonstrate a broad lack of herd immunity amongst the school corporation's staff irrespective of employment role or location. Protective measures like contact tracing, face coverings, and social distancing are therefore vital to maintaining the safety of both students and staff as the school year progresses.


Assuntos
COVID-19/diagnóstico , COVID-19/epidemiologia , Professores Escolares , Instituições Acadêmicas , Adolescente , Adulto , Idoso , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , COVID-19/sangue , COVID-19/imunologia , Teste Sorológico para COVID-19 , Estudos Transversais , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , SARS-CoV-2/imunologia , SARS-CoV-2/isolamento & purificação , Estudos Soroepidemiológicos , Adulto Jovem
5.
Mycopathologia ; 186(4): 499-505, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34143393

RESUMO

Pulmonary aspergillosis has been reported at high rates in patients with coronavirus disease 2019 (COVID-19) and is associated with high morbidity and mortality. We retrospectively assessed all patients admitted to an intensive care unit during the early COVID-19 surge (3/17/20-5/10/20) at our medical center in the midwestern USA for the presence of COVID-19-associated pulmonary aspergillosis (CAPA). Patients were not routinely screened for CAPA; diagnostic work-up for fungal infections was pursued when clinically indicated. Among 256 patients admitted to the ICU with severe COVID-19, 188 (73%) were intubated and 62 (24%) ultimately expired within 30 days of admission to the ICU. Only three patients (1%) were found to have CAPA; diagnosis was made by tracheal aspirate cultures in two cases and by bronchoalveolar lavage fluid Aspergillus galactomannan in one case. None of the patients who developed CAPA had classic risk factors for invasive fungal infection. The occurrence of CAPA was much lower than that reported at other centers, likely reflecting the local epidemiology.


Assuntos
COVID-19 , Aspergilose Pulmonar , Centros Médicos Acadêmicos , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/complicações , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , Aspergilose Pulmonar/diagnóstico , Aspergilose Pulmonar/epidemiologia , Estudos Retrospectivos , Adulto Jovem
6.
Psychiatry Res ; 302: 114034, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34098158

RESUMO

Given concerns of increased suicide risk among university students during the COVID-19 pandemic, this study examined rates of lifetime and past-year suicidal ideation (SI) among university students in Fall 2020 (vs. two earlier semesters), overall and across gender, racial/ethnic background, and sexual identity. Participants included 1700 university students enrolled in a general education psychology course in Fall 2020, Fall 2014, or Fall 2013. Rates of SI were not significantly higher in Fall 2020 versus the earlier semesters and did not differ across racial/ethnic background. However, rates of SI in Fall 2020 were significantly higher among sexual minority than heterosexual students.


Assuntos
COVID-19/psicologia , Pandemias , Estudantes/psicologia , Ideação Suicida , Adolescente , COVID-19/epidemiologia , Grupos de Populações Continentais/psicologia , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/psicologia , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Masculino , Meio-Oeste dos Estados Unidos/epidemiologia , Fatores de Risco , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Adulto Jovem
7.
J Prim Care Community Health ; 12: 21501327211010991, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33855875

RESUMO

OBJECTIVE: To describe the process and outcome of creating a patient cohort in the early stages of the COVID-19 pandemic in order to better understand the process of and predict the outcomes of COVID-19. PATIENTS AND METHODS: A total of 1169 adults aged 18 years of age or older who tested positive in Mayo Clinic Rochester or the Mayo Clinic Midwest Health System between January 1 and May 23 of 2020. RESULTS: Patients were on average 43.9 years of age and 50.7% were female. Most patients were white (69.0%), and Blacks (23.4%) and Asians (5.8%) were also represented in larger numbers. Hispanics represented 16.3% of the sample. Just under half of patients were married (48.4%). Common comorbid conditions included: cardiovascular diseases (25.1%), dyslipidemia (16.0%), diabetes mellitus (11.2%), chronic obstructive pulmonary disease (6.6%), asthma (7.5%), and cancer (5.1%). All other comorbid conditions were less the 5% in prevalence. Data on 3 comorbidity indices are also available including the: DHHS multi-morbidity score, Charlson Comorbidity Index, and Mayo Clinic COVID-19 Risk Factor Score. CONCLUSION: In addition to managing the ever raging pandemic and growing death rates, it is equally important that we develop adequate resources for the investigation and understanding of COVID-19-related predictors and outcomes.


Assuntos
COVID-19/epidemiologia , Bases de Dados Factuais , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , Multimorbidade , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-33808131

RESUMO

Research on the complex relationships of variables contributing to farmer suicide is limited. The purpose of the study was to examine factors associated with suicide risk through the use of standardized instruments measuring psychological (depression, anxiety), social (social support), and contextual factors. A questionnaire was completed by 600 farmers in the Midwestern United States. A multiple linear regression model was used to analyze associations with suicide risk (SBQ-R), including depression (PHQ-9), anxiety (GAD-7), Brief COPE subscales (BC), social support (MSPSS), and select demographic and farming characteristics. The only variable that emerged as having a significant relationship with the natural log-transformed suicide risk score was coping through self-blame. While suicidality is often considered the outcome of mental illness, our findings do not suggest that suicide risk among farmers is related to mental illness, and a further examination of self-blame as a coping strategy is warranted.


Assuntos
Fazendeiros , Suicídio , Ansiedade , Depressão , Humanos , Meio-Oeste dos Estados Unidos/epidemiologia , Fatores de Risco , Inquéritos e Questionários
9.
Int J Eat Disord ; 54(7): 1213-1223, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33885180

RESUMO

OBJECTIVE: This study tested the association between food insecurity and eating disorder (ED) pathology, including probable ED diagnosis, among two cohorts of university students before and during the beginning of the COVID-19 pandemic. METHOD: Students (n = 579) from a large Midwestern American university completed self-report questionnaires assessing frequency of ED behaviors, ED-related impairment, and individual food insecurity as measured by the Eating Disorder Diagnostic Scale 5, Clinical Impairment Assessment, and Radimer/Cornell, respectively. Chi-square tests and MANOVA with post-hoc corrections were conducted to compare demographic characteristics, ED pathology, and probable ED diagnosis prevalence between students with and without individual food insecurity. RESULTS: Partially supporting hypotheses, MANOVA indicated significantly greater frequency of objective binge eating, compensatory fasting, and ED-related impairment for students with food insecurity compared with individuals without food insecurity. Chi-squared tests showed higher prevalence of ED diagnoses among individuals with food insecurity compared with those without food security (47.6 vs. 31.1%, respectively, p < .01, NNT = 6.06), specifically bulimia nervosa and other specified feeding and eating disorder. There were no differences in food insecurity before or during the beginning of the COVID-19 pandemic. DISCUSSION: Consistent with prior literature, food insecurity was associated with elevated ED psychopathology in this sample. Findings emphasize the importance of proper ED screening for college students vulnerable to food insecurity and EDs.


Assuntos
COVID-19/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Insegurança Alimentar , Pandemias , Estudantes/psicologia , Adolescente , Adulto , Estudos de Coortes , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Feminino , Humanos , Masculino , Meio-Oeste dos Estados Unidos/epidemiologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Adulto Jovem
10.
Public Health Rep ; 136(3): 361-367, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33673779

RESUMO

OBJECTIVES: Increased exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a result of having an essential job is compounded by factors such as age, race, and ethnicity. We used a cross-sectional study design to describe disparities in the seroprevalence of SARS-CoV-2 immunoglobulin G (IgG) test results by demographic characteristics and clinical roles among a cohort of health care workers employed by the largest Midwestern health care system in the United States. METHODS: We collected 16 233 SARS-CoV-2 IgG serum samples from June 8 through July 10, 2020, from a convenience sample of Illinois- and Wisconsin-based adult health care workers. The research team, in collaboration with ACL Laboratories, used a SARS-CoV-2 IgG assay to detect the presence of SARS-CoV-2 IgG antibodies. Study data included SARS-CoV-2 IgG assay results and demographic characteristics of workers (age, sex, race, ethnicity, clinical role, zip code). We generated crude and adjusted odds ratios (ORs) to describe disparities in seroprevalence distribution among demographic and social factors. RESULTS: Of 16 233 IgG serum samples tested, 622 (3.8%) test results were positive for SARS-CoV-2. We found significant disparities in SARS-CoV-2 positivity by age, race, ethnicity, and clinical role. Participants aged 32-82 had lower adjusted ORs (aORs) of positive IgG than participants aged 18-31 (aOR range, 0.54-0.66). Odds of positivity were higher among Black (aOR = 3.86), Asian (aOR = 1.42), and mixed-race (aOR = 1.99) workers than among White workers; among Hispanic workers (aOR = 1.80) than among non-Hispanic workers; and among coronavirus disease 2019 (COVID-19) clinical workers (aOR = 1.86) than among nonclinical workers. CONCLUSIONS: Public health efforts should focus on increasing COVID-19 safety messaging, testing, vaccination, and other prevention efforts for people who are young, non-White, Hispanic, and working in COVID-19-clinical units.


Assuntos
Teste Sorológico para COVID-19 , COVID-19/diagnóstico , COVID-19/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Imunoglobulina G/sangue , SARS-CoV-2 , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Atenção à Saúde , Grupos Étnicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , Fatores Raciais , Estudos Soroepidemiológicos , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-33562454

RESUMO

(1) The association of the indoor environmental conditions in classrooms with illness-related absenteeism (IRA) was not well investigated. In addition, studying the association between heating and non-heating seasons were very limited; (2) To fill this knowledge gap, a research team collected various indoor air quality (IAQ) and thermal comfort conditions (TC) of 85 elementary classrooms in two school districts from the Midwestern United States throughout an academic year; in total, 255 classroom visits were performed. A negative binomial regression model was implied to associate the classroom's IAQ and TC with IRA, separating for heating and non-heating seasons; (3) During non-heating season, a 3% increase of IRA was estimated with 1,000,000-counts/L increase of particles that had a diameter less than 2.5 µm (PN2.5); during the heating season, a 3% increase of IRA were expected with 100 ppm increase of room averaged CO2 concentration; and (4) These results suggested that the IAQ and TC factors could associated with IRA differently between heating and non-heating seasons.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Absenteísmo , Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Calefação , Humanos , Meio-Oeste dos Estados Unidos/epidemiologia , Projetos Piloto , Instituições Acadêmicas , Estações do Ano , Estudantes , Ventilação
12.
J Occup Environ Med ; 63(5): 374-380, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33395171

RESUMO

OBJECTIVE: Determine the industries with the highest proportion of accepted COVID-19 related workers' compensation (WC) claims. METHODS: Study included 21,336 WC claims (1898 COVID-19 and 19,438 other claims) that were filed between January 1, 2020 and August 31, 2020 from 11 states in the Midwest United States. RESULT: The overwhelming proportion of all COVID-19 related WC claims submitted and accepted were from healthcare workers (83.77%). Healthcare was the only industrial classification that was at significantly higher COVID-19 WC claim submission risk (odds ratio [OR]: 4.00; 95% confidence intervals [CI]: 2.77 to 5.79) controlling for type of employment, sex, age, and presumption of COVID-19 work-relatedness. Within healthcare employment, WC claims submitted by workers in medical laboratories had the highest risk (crude rate ratio of 8.78). CONCLUSION: Healthcare employment is associated with an increased risk of developing COVID-19 infections and submitting a workers' compensation claim.


Assuntos
COVID-19/economia , Pessoal de Saúde/classificação , Indústrias/classificação , Doenças Profissionais/economia , Indenização aos Trabalhadores/estatística & dados numéricos , Adulto , Idoso , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Indústrias/estatística & dados numéricos , Masculino , Pessoal de Laboratório Médico/estatística & dados numéricos , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , Razão de Chances , SARS-CoV-2
13.
Dig Dis Sci ; 66(8): 2585-2594, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-32816217

RESUMO

AIMS: Although colorectal cancer screening (CRC) using stool-based test is well-studied, evidence on fecal immunochemical test (FIT) patterns in a safety-net healthcare system utilizing opportunistic screening is limited. We studied the FIT completion rates and adenoma detection rate (ADR) of positive FIT-colonoscopy (FIT-C) in an urban safety-net system. METHODS: We performed a retrospective cross-sectional chart review on individuals ≥ 50 years who underwent CRC screening using FIT or screening colonoscopy, 09/01/2017-08/30/2018. Demographic differences in FIT completion were studied; ADR of FIT-C was compared to that of screening colonoscopy. RESULTS: Among 13,427 individuals with FIT ordered, 7248 (54%) completed the stool test and 230 (48%) followed up a positive FIT with colonoscopy. Increasing age (OR 1.01, CI 1.01-1.02), non-Hispanic Blacks (OR 0.87, CI 0.80-0.95, p = 0.002), current smokers (OR 0.84, CI 0.77-0.92, p < 0.0001), those with Medicaid (OR 0.86, CI 0.77-0.96, p = 0.006), commercial insurance (OR 0.85, CI 0.78-0.94, p = 0.002), CCI score ≥ 3 (OR 0.82, CI 0.74-0.91, p < 0.0001), orders by family medicine providers (OR 0.87, CI 0.81-0.94, p < 0.0001) were associated with lower completion of stool test. Individuals from low median household income cities had lower follow-up of positive FIT, OR 0.43, CI 0.21-0.86, p = 0.017. ADR of FIT-C was higher than that of screening colonoscopy. CONCLUSION: Adherence to CRC screening is low in safety-net systems employing opportunistic screening. Understanding demographic differences may allow providers to formulate targeted strategies in high-risk vulnerable groups.


Assuntos
Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Idoso , Envelhecimento , Estudos Transversais , Atenção à Saúde , Fezes , Feminino , Humanos , Seguro Saúde , Masculino , Programas de Rastreamento , Medicaid , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , Sangue Oculto , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Estados Unidos
14.
Laryngoscope ; 131(6): E1838-E1846, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33098338

RESUMO

OBJECTIVES/HYPOTHESIS: Investigate the relationship between site and pattern of distant metastasis (DM) and overall survival (OS) in a multi-institutional cohort of patients with DM head and neck cancer (HNC). STUDY DESIGN: Retrospective review. METHODS: 283 patients treated at 4 academic centers in the Midwest HNC Consortium between 2000 and 2015 were retrospectively reviewed. Disease patterns were divided between solitary metastatic versus polymetastatic (≥2 sites) disease. Survival functions for clinically relevant variables were estimated using Kaplan-Meier and Cox proportional hazards models. RESULTS: Median OS for all patients was 9.0 months (95% confidence interval [CI]: 7.4-10.6). Lung (n = 220, 77.7%) was the most common site of DM, followed by bone (n = 90, 31.8%), mediastinal lymph nodes (n = 55, 19.4%), liver (n = 41, 14.5%), and brain (n = 17, 6.0%). Bone metastases were independently associated with the worst prognosis (hazard ratio [HR] = 1.6, 95% CI: 1.3-2.1). On univariate analysis, brain metastases were associated with improved prognosis (HR = 0.5, 95% CI: 0.3-0.9), although this was not statistically significant on the multivariate analysis. Polymetastatic disease was present in the majority of patients (n = 230, 81.3%) and was associated with a worse prognosis compared to solitary metastatic disease (HR = 1.4, 95% CI: 1.0-2.0). CONCLUSION: Our large, multi-institutional review indicates that both the metastatic pattern and site of DM impact OS. Polymetastatic disease and bone metastasis are associated with worse prognosis, independent of treatment received. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E1838-E1846, 2021.


Assuntos
Neoplasias de Cabeça e Pescoço/patologia , Metástase Neoplásica/patologia , Feminino , Neoplasias de Cabeça e Pescoço/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
16.
Clin Infect Dis ; 72(10): e642-e645, 2021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-32845985

RESUMO

Combating disparities is a crucial goal of ongoing efforts to end the human immunodeficiency virus (HIV) epidemic. In a multivariable analysis of a cohort in the Midwestern United States, racial/ethnic disparities in HIV viral suppression were no longer robust after accounting for other sociodemographic factors. Neighborhood deprivation and low income were independently inversely associated with viral suppression.


Assuntos
Infecções por HIV , Disparidades nos Níveis de Saúde , Estudos Transversais , Grupos Étnicos , HIV , Infecções por HIV/epidemiologia , Humanos , Meio-Oeste dos Estados Unidos/epidemiologia , Estados Unidos/epidemiologia
17.
Environ Res ; 193: 110541, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33249041

RESUMO

Wildland firefighters are repeatedly exposed to elevated levels of wildland fire smoke (WFS) while protecting lives and properties from wildland fires. Studies reporting personal exposure concentrations of air pollutants in WFS during fire suppression or prescribed burn activities have been geographically limited to the western and southeastern United States. The objective of this study is to characterize exposure concentrations of air pollutants in WFS emissions among wildland firefighters who conducted prescribed burns in the Midwest. Between 2016 and 2019, a total of 35 firefighters (31 males and 4 females, age of 35.63 ± 9.31 years) were recruited to participate in this study. Personal particulate matter 2.5 (PM2.5) and carbon monoxide (CO) exposure concentrations were measured during prescribed burns. The level of black carbon (BC) in WFS particulates was determined using the light transmission technique, while trace metal composition was analyzed using inductively coupled plasma mass spectrometry (ICP-MS). The results showed geometric means for PM2.5, CO, and BC concentrations were 1.43 ± 0.13 mg/m3, 7.02 ± 0.69 ppm, and 58.79 ± 5.46 µg/m3, respectively. Although no occupational exposure limits (OELs) were exceeded by 8-h time-weighted average (TWA) exposure concentration observed in the firefighters, a total of 28 personal CO exposure concentrations were above the National Institute for Occupational Safety and Health (NIOSH) Recommended Exposure Limit (REL) Ceiling (200 ppm) for CO. PM2.5 and CO concentrations were about 2-7 times higher in the Midwest than the other regions. Firefighters who performed holding had higher CO exposure concentrations compared to firefighters who performed lighting (p < 0.01), while lighters were exposed to higher level of BC in the smoke particulates (p < 0.01), possibly due to the domination of exposure by different combustion sources and stages. The levels of trace metals in WFS particulates were well below the corresponding OELs and no task-related difference was observed except for manganese. Our results suggest that wildland firefighters in the midwestern region have higher WFS exposures while working at prescribed burns compared to those western and southeastern United States.


Assuntos
Poluentes Ocupacionais do Ar , Bombeiros , Incêndios , Exposição Ocupacional , Adulto , Poluentes Ocupacionais do Ar/análise , Feminino , Humanos , Exposição por Inalação/análise , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos/epidemiologia , Exposição Ocupacional/análise , Fumaça/análise , Sudeste dos Estados Unidos/epidemiologia , Estados Unidos
18.
J Child Sex Abus ; 29(8): 924-943, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33170112

RESUMO

Treatment utilization following child sexual abuse (CSA) is essential in combatting the various negative consequences of CSA. Youth may present to treatment for CSA with symptoms that cut across multiple diagnostic presentations that impact their ability to successfully engage in treatment. In particular, children who have difficulties with attention may have unique treatment needs following CSA. The purpose of this study was to examine how attention problems interplay with comorbid symptoms and how these clinical presentations impact treatment outcomes for youth who have been sexually abused. Participants included 323 families presenting to treatment for CSA. Youth were 7 to 19 years old, 78.5% female, and 76.6% identified as Caucasian/White. Results indicated that 22.9% of the youth presented with clinically elevated attention problems as collected through parent-report of the Child Behavior Checklist (CBCL). Results demonstrated that child survivors of CSA who presented with attention problems self-reported more psychological concerns (e.g., symptoms of depression, anxiety, and post-traumatic stress). At post-treatment, attention problems, interpersonal problems, and thought problems were significantly reduced for youth initially presenting with attention problems. Further implications for treatment following CSA and unique needs for youth with attention problems are discussed.


Assuntos
Ansiedade/epidemiologia , Atenção , Abuso Sexual na Infância/psicologia , Depressão/epidemiologia , Comportamento Problema , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Criança , Abuso Sexual na Infância/terapia , Terapia Cognitivo-Comportamental , Comorbidade , Feminino , Humanos , Masculino , Meio-Oeste dos Estados Unidos/epidemiologia , Psicoterapia de Grupo , Avaliação de Sintomas , Resultado do Tratamento , Adulto Jovem
19.
Vet Microbiol ; 251: 108914, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33181438

RESUMO

Tracking the genetic diversity and spread of swine influenza viruses (SIVs) in commercial swine farms is central for control and to reduce the potential emergence of SIV reassortants. We analyzed the diversity of SIVs in nasal washes or oral fluids from commercial swine farms in North Carolina using influenza M qRT-PCR and hemagglutinin (HA) and neuraminidase (NA) subtyping. We found a predominance of H1 HAs and N2 NAs in the samples examined. The majority of the H1 HAs could be further classified into gamma and delta subclusters. We also identified HAs of the H1 alpha cluster, and those of human novel pandemic origin. Glycan binding profiles from a representative subset of these viruses revealed broad α2,6 sialylated glycan recognition, though some strains exhibited the ability to bind to α2,3 sialic acid. These data show that SIV surveillance can aid our understanding of viral transmission dynamics and help uncover the diversity at the human-swine interface.


Assuntos
Fazendas/estatística & dados numéricos , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/veterinária , Orthomyxoviridae/genética , Doenças dos Suínos/epidemiologia , Animais , Variação Genética , Hemaglutininas Virais/genética , Humanos , Meio-Oeste dos Estados Unidos/epidemiologia , Neuraminidase/genética , Orthomyxoviridae/classificação , Infecções por Orthomyxoviridae/transmissão , Filogenia , RNA Viral/genética , Vírus Reordenados/genética , Sudeste dos Estados Unidos/epidemiologia , Suínos , Doenças dos Suínos/virologia , Proteínas Virais/genética
20.
Prev Vet Med ; 184: 105158, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33045630

RESUMO

BACKGROUND: Increasing uncertainty and variability in weather due to climate change puts enormous stress on the sustainability of agricultural communities in several parts of the continental United States. Rural agriculture-based communities, such as those in North Carolina, Nebraska, and Illinois are particularly vulnerable to the impacts of flooding. These extreme weather events affect many animal facilities, and flooding can cause long-term impacts on animal health and productivity. OBJECTIVES: This scoping review investigated the potential short- and long-term ramifications of flooding on beef cattle and swine farms with theoretical locations in the Midwestern U.S. The goal of this review is to create a concept map to identify research gaps related to efforts to support those animals and peoples ravaged by floods. This was accomplished by performing a scoping review using search terms "beef OR swine AND flood" to assess direct effects and then "beef OR swine AND direct effect" to evaluate secondary and tertiary effects. RESULTS: Our findings were based on a total of 89 peer-reviewed publications, with 50 publications relating to beef cattle, 24 relating to swine, and 15 containing information applicable to both. On beef farms, the effects of flooding can be broad and long-lasting. The short-term risks of flooding are reasonably well-understood, including the comingling of unfamiliar cattle, nutritional restriction, and disease transmission. However, long-term impacts, including potential effects on reproduction, nutrition, and carcass quality, have been less studied. In particular, further research is needed on mold species that contaminate hay post-flood, the effect of moldy hay ingestion on cattle, and the effects of heavy metal consumption on cattle and consumers. Little research is available regarding the effects of flooding on swine farms, likely due to the highly intensive nature of swine operations. In general, swine farms suffer from acute infectious diseases and biosecurity risks after flooding events. CONCLUSIONS: The potential ramifications of flooding on livestock farms differ among farm operations. Beef farms should prepare for long-term impacts on nutrition and reproduction, while swine farms should prepare for short-term impacts on biosecurity.


Assuntos
Criação de Animais Domésticos , Doenças dos Bovinos/epidemiologia , Bovinos , Inundações , Sus scrofa , Doenças dos Suínos/epidemiologia , Doença Aguda/epidemiologia , Animais , Doenças dos Bovinos/etiologia , Meio-Oeste dos Estados Unidos/epidemiologia , Suínos , Doenças dos Suínos/etiologia
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