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1.
Plant Dis ; 105(1): 114-126, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33197383

RESUMO

Gibberella ear rot (GER) severity (percent area of the ear diseased) and associated grain contamination with mycotoxins were quantified in plots of 15 to 16 maize hybrids planted at 10 Ohio locations from 2015 to 2018. Deoxynivalenol (DON) was quantified in grain samples in all 4 years, whereas nivalenol, 3-acetyldeoxynivalenol, and 15-acetyldeoxynivalenol (15ADON) were quantified only in the last 2 years. Only DON and 15ADON were detected. The highest levels of GER and DON contamination were observed for 2018, followed by 2016 and 2017. No GER symptoms or DON were detected in 2015. Approximately 41% of the samples from asymptomatic ears had detectable levels of DON, and 7% of these samples from 2016 had DON > 5 ppm. Associations between DON contamination and 43 variables representing summaries of temperature (T), relative humidity (RH), rainfall (R), surface wetness, and T-RH combinations for different window lengths and positions relative to R1 growth stage were quantified with Spearman correlation coefficients (r). Fifteen-day window lengths tended to show the highest correlations. Most of the variables based on T, R, RH, and T-RH were significantly correlated with DON for the 15-day window, as well as other windows. For moisture-related variables, there generally was a negative correlation before R1, changing to a positive correlation after R1. Results showed that GER and DON can be frequently found in Ohio maize fields, with the risk of DON being associated with multiple weather variables, particularly those representing combinations of T between 15 and 30°C and RH > 80 summarized during the 3 weeks after R1.


Assuntos
Gibberella , Micotoxinas , Contaminação de Alimentos/análise , Ohio , Tempo (Meteorologia) , Zea mays
2.
J Environ Manage ; 279: 111708, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33370707

RESUMO

This research examines public acceptability of regulations to reduce agricultural nutrient runoff and curb Harmful Algal Blooms (HABs). We tested the effects of two novel policy specific beliefs including support for farmers' autonomy and support for external accountability. We also simultaneously tested the direct and indirect effects of political orientation and environmental worldview through a Direct Effect Model and a Mediation Model using structural equation modelling. Survey data were collected from 729 Ohio residents collected in November 2018. The specific regulatory policy measure we targeted is fines on excessive agricultural runoff. As hypothesized, autonomy beliefs negatively affect, and accountability positively affect support for fines. Both models revealed good fits. the direct effects of environmental worldviews political orientation were not supported. Instead, environmental worldviews indirectly increased support for fines through increased accountability beliefs and diminished autonomy beliefs. From the results, we suggest that when proposing suitable regulations for specific sites, policy makers and interest groups should be aware of differences in public support for farmer autonomy and external accountability, and that such differences are likely rooted in environmental worldviews. The study also suggests a need for coupled ecological and social studies that assess the likelihood of regional agricultural producers voluntarily adopting conservation practices and forecast the effectiveness of potential accountability measures.


Assuntos
Agricultura , Fazendeiros , Humanos , Nutrientes , Ohio , Políticas
3.
Water Res ; 189: 116656, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33249307

RESUMO

Opportunistic pathogens such as Legionella are of significant public health concern in hospitals. Microbiological and water chemistry parameters in hot water throughout an Ohio hospital were monitored monthly before and after the installation of a monochloramine disinfection system over 16 months. Water samples from fifteen hot water sampling sites as well as the municipal water supply entering the hospital were analyzed using both culture and qPCR assays for specific microbial pathogens including Legionella, Pseudomonas spp., nontuberculous Mycobacteria [NTM], as well as for heterotrophic bacteria. Legionella culture assays decreased from 68% of all sites being positive prior to monochloramine addition to 6% positive after monochloramine addition, and these trends were parallel to qPCR results. Considering all samples, NTMs by culture were significantly reduced from 61% to 14% positivity (p<0.001) after monochloramine treatment. Mycobacterium genus-specific qPCR positivity was reduced from 92% to 65%, but the change was not significant. Heterotrophic bacteria (heterotrophic bacteria plate counts [HPCs]) exhibited large variability which skewed statistical results on a per room basis. However, when all samples were considered, a significant decrease in HPCs was observed after monochloramine addition. Lastly, Pseudomonas aeruginosa and Vermamoeba vermiformis demonstrated large and significant decrease of qPCR signals post-chloramination. General water chemistry parameters including monochloramine residual, nitrate, nitrite, pH, temperature, metals and total trihalomethanes (TTHMs) were also measured. Significant monochloramine residuals were consistently observed at all sampling sites with very little free ammonia present and no water quality indications of nitrification (e.g., pH decrease, elevated nitrite or nitrate). The addition of monochloramine had no obvious impact on metals (lead, copper and iron) and disinfection by-products.


Assuntos
Desinfetantes , Legionella , Cloraminas , Desinfecção , Hospitais , Ohio , Microbiologia da Água , Qualidade da Água
4.
Surg Obes Relat Dis ; 17(1): 208-214, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33243670

RESUMO

BACKGROUND: Obesity is a risk factor for poor clinical outcomes in patients with coronavirus disease 2019 (COVID-19). OBJECTIVES: To investigate the relationship between prior metabolic surgery and the severity of COVID-19 in patients with severe obesity. SETTING: Cleveland Clinic Health System in the United States. METHODS: Among 4365 patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between March 8, 2020 and July 22, 2020 in the Cleveland Clinic Health System, 33 patients were identified who had a prior history of metabolic surgery. The surgical patients were propensity matched 1:10 to nonsurgical patients to assemble a cohort of control patients (n = 330) with a body mass index (BMI) ≥ 40 kg/m2 at the time of SARS-CoV-2 testing. The primary endpoint was the rate of hospital admission. The exploratory endpoints included admission to the intensive care unit (ICU), need for mechanical ventilation and dialysis during index hospitalization, and mortality. After propensity score matching, outcomes were compared in univariate and multivariate regression models. RESULTS: The average BMI of the surgical group was 49.1 ± 8.8 kg/m2 before metabolic surgery and was down to 37.2 ± 7.1 at the time of SARS-CoV-2 testing, compared with the control group's BMI of 46.7 ± 6.4 kg/m2. In the univariate analysis, 6 (18.2%) patients in the metabolic surgery group and 139 (42.1%) patients in the control group were admitted to the hospital (P = .013). In the multivariate analysis, a prior history of metabolic surgery was associated with a lower hospital admission rate compared with control patients with obesity (odds ratio, 0.31; 95% confidence interval, 0.11-0.88; P = .028). While none of the 4 exploratory outcomes occurred in the metabolic surgery group, 43 (13.0%) patients in the control group required ICU admission (P = .021), 22 (6.7%) required mechanical ventilation, 5 (1.5%) required dialysis, and 8 (2.4%) patients died. CONCLUSION: Prior metabolic surgery with subsequent weight loss and improvement of metabolic abnormalities was associated with lower rates of hospital and ICU admission in patients with obesity who became infected with SARS-CoV-2. Confirmation of these findings will require larger studies.


Assuntos
Cirurgia Bariátrica/métodos , Índice de Massa Corporal , Unidades de Terapia Intensiva , Obesidade/cirurgia , Pandemias , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Ohio/epidemiologia , Estudos Prospectivos
5.
J Dent Educ ; 85(1): 37-43, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32920870

RESUMO

BACKGROUND: The Ohio Department of Health identified dental care as the number one unmet health need for Ohio's children. The Dental Health Outreach Mobile Experience (HOME) Coach is a pediatric mobile dental unit that seeks to meet the dental needs of underserved children in the Columbus City Schools. PURPOSE: The purpose was to conduct an outcome evaluation of the Dental HOME Coach Program and to compare the outcomes before (2010-2014) and after (2015-2019) the incorporation of the new Dental HOME Coach. METHODS: Using a longitudinal outcome evaluation research design, the data were analyzed from 10 years of the Dental HOME Coach Program at the Ohio State University (OSU) College of Dentistry during the academic years ending in 2010-2019. RESULTS: A total of 1063 dental students provided dental care to 26469 children in the Columbus City Schools. The top 3 performed procedures were sealants, prophylaxis, and resin composite fillings. Despite significant increases in the number of dental students providing oral health care, there were significant decreases in the number of amalgam fillings and stainless-steel crowns from before to after the incorporation of the new Dental HOME Coach. CONCLUSION: The outcome evaluation revealed the Dental HOME Coach Program has been providing underserved children with oral health care that offers them a dental "home," giving dental students an array of hands-on learning experiences that include pediatric dentistry treatments performed under the supervision of OSU faculty members, and positively impacting the problems of access to oral health care for Ohio's families.


Assuntos
Resinas Compostas , Materiais Dentários , Criança , Humanos , Unidades Móveis de Saúde , Ohio
6.
Am J Health Promot ; 35(1): 77-83, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32551916

RESUMO

PURPOSE: To evaluate the feasibility, utility, and limitations of a rapid community behavioral diagnosis (RCBD) for social distancing behaviors to prevent coronavirus transmission during a global coronavirus pandemic. DESIGN: Using social media for recruitment, we partnered with a local community task force to administer a brief online survey. SETTING: Residential urban community. SAMPLE: Eighty-four community members, the majority of whom were white, female, college educated completed the survey. MEASURES: Theory of planned behavior constructs: behavioral intentions, attitudes, perceived norms, and perceived behavioral control for 3 social distancing behaviors: maintaining a 6-foot distance, avoiding places people congregate, and staying home as much as possible. ANALYSIS: Path analyses were conducted to understand significant determinants of intentions for each behavior to guide the development of locally tailored health promotion messages. RESULTS: The RCBD was implemented, and results were communicated to the community within 1 week. Intentions were high across the 3 behaviors but lowest for staying home as much as possible. Younger participants had lower intentions of maintaining a 6-foot distance than older participants. For each behavior, specific recommendations for health promotion messaging emerged based on how attitudes, norms, and perceived behavioral control related to intentions. CONCLUSION: In a situation where local community action is paramount for reducing coronavirus transmission, this RCBD process is feasible and useful for informing local health promotion.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Fidelidade a Diretrizes , Promoção da Saúde/organização & administração , Pandemias/prevenção & controle , Isolamento Social/psicologia , /epidemiologia , /psicologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Ohio/epidemiologia , Inquéritos e Questionários
7.
Ann Vasc Surg ; 70: 393-400, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32599105

RESUMO

BACKGROUND: Human immunodeficiency virus (HIV) is a multisystem disease and is associated with vascular complications including aneurysm formation. HIV-associated aneurysms are well documented and may present in unusual locations with concerning features. However, the literature regarding aneurysms in HIV-positive patients is limited to case series with limited data regarding aneurysm patterns. Furthermore, several small series have documented poor outcomes with surgical repair. Thus, our aim was to investigate the characteristics, patterns, and repair of aneurysms in HIV-positive patients in a multicenter study. METHODS: All patients with a diagnosis of aneurysms and HIV were retrospectively identified from 2013 to 2018 across 2 institutions. Comorbidities, HIV-related characteristics, aneurysm characteristics, and repair were reviewed. RESULTS: There were a total of 104 HIV-positive patients with 129 aneurysms. The mean age at the time of diagnosis was 57.7 ± 10.3 years, 80.8% of patients were male, and 32.0% had a history of acquired immunodeficiency syndrome. The average time from HIV diagnosis to aneurysm diagnosis was 14.1 ± 10.1 years. There were 53 (41.1%) ascending aortic, 25 (19.4%) abdominal aortic, 14 (10.9%) cerebral artery aneurysms, 13 (10.1%) descending thoracic, 9 (7.0%) iliac, 6 (4.7%) femoropopliteal, 4 (3.1%) visceral, 3 (2.9%) axillosubclavian, 1 (0.8%) carotid, and 1 (0.8%) coronary artery aneurysms. There were 23 (22.1%) patients with aneurysms in multiple vascular beds, 10 (9.6%) saccular aneurysms, and 1 (0.8%) inflammatory aneurysm. There were 7 ruptures (cerebral, descending thoracic, and iliac), 3 type A dissections (ascending aorta), and 1 thrombosis (popliteal). There were 26 (25.0%) patients who underwent surgical repair. This included 8 endovascular aneurysm repairs for abdominal aortic aneurysms, 6 endovascular coiling, clipping, and stent procedures for cerebral aneurysms, 4 open ascending aorta repairs, 2 bypasses for popliteal artery aneurysms, 2 endovascular stents for axillosubclavian artery aneurysms, 1 open descending aortic aneurysm repair, 1 endovascular aneurysm repair for an iliac aneurysm, 1 endovascular coiling for a renal artery aneurysm, and 1 open repair of a femoral artery aneurysm. Perioperative complications were common at 46.2%, although mortality was low at 3.8%. CONCLUSIONS: Although aneurysms were widespread, most HIV-positive patients had large vessel aneurysms in this study. There was a high prevalence of saccular and multiple aneurysms, and repair was associated with low rates of mortality despite high rates of complications. Additional studies are necessary to characterize this rare entity.


Assuntos
Aneurisma/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Infecções por HIV , Idoso , Aneurisma/diagnóstico por imagem , Aneurisma/mortalidade , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/mortalidade , Connecticut/epidemiologia , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/mortalidade , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Ohio/epidemiologia , Complicações Pós-Operatórias/mortalidade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
8.
Sci Total Environ ; 754: 141970, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32920387

RESUMO

Integrating a network perspective into multiple-stressor research can reveal indirect stressor effects and simultaneously estimate both taxonomic and functional community characteristics, thus representing a novel approach to stressor paradigms in rivers. Using six years of data from twelve streams of Columbus, Ohio, USA, the effects of nutrients (N:P), impervious surface (%IS), and sedimentation on network properties were quantified. Variability in the strength and distribution of trophic interactions was assessed by incorporating biomass into networks. All stressors impacted some properties of network topology - linkage density (average number of links per species), connectance (fraction of all possible links realized in a network), and compartmentalization (degree to which networks contain discrete sub-webs), including synergistic interactive effects between sedimentation and stream size. We also found support for antagonistic effects between (1) sedimentation and %IS and between %IS and N:P on the weighted index mean link weight, which represents the magnitude of trophic interactions among species in a network, and (2) %IS and stream size on strength standard deviation, a measure of the distribution of total magnitude of all trophic interactions per species in a network. Overall, our results point to the potential for urban stressors such as impervious surfaces and sedimentation - alone and as interactions - to decrease network complexity, compartmentalization, and stability, likely through homogenizing habitat and limiting food resources. The observation that larger streams often buffered the negative effects of these stressors suggests that restoration and other management approaches might be most beneficial in smaller headwater streams of urban catchments.


Assuntos
Peixes , Rios , Animais , Ecossistema , Ohio
9.
Medicine (Baltimore) ; 99(47): e21834, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33217786

RESUMO

Cataract surgery is the most common ambulatory surgery at our outpatient surgery center. Several studies have shown that patients with bilateral cataracts may experience different levels of anxiety, pain, and awareness during the first and second cataract extraction.A prospective observational cohort study was conducted at The Ohio State University Wexner Medical Center Eye and Ear Institute in order to compare anxiety, general comfort, awareness, and pain levels in patients undergoing sequential cataract surgeries. Likert and numerical rating scale were used to assess the outcomes. Patients receiving monitored anesthesia care and topical anesthesia were included.A total of 198 patients were enrolled in this study, 116 patients (59%) were female and 157 patients (78%) were Caucasians with a median age of 67 years among participants. Patients with rating "no anxiety" or feeling "somewhat anxious" were significantly higher during surgery 2 (P =< .001). Most of the patients felt "extremely comfortable" during surgery 1 when compared to surgery 2 (54% vs 42.9%; P = .08). No significant differences were found between surgeries regarding intraoperative awareness (P = .16). Overall, patients experienced mild pain during both procedures (92.4% in surgery 1 compared to 90.4% in surgery 2; P = .55). During the postoperative visit, 54% of the patients associated surgery 2 with less anxiety levels, 53% with no differences in general comfort, 60% felt more aware, and 59% had no differences in pain levels.Previous exposure to surgery could have been associated with a significant reduction in anxiety levels reported during surgery 2. Non-pharmacological strategies aiming to reduce perioperative anxiety may be considered an alternative or additional approach to premedication in patients undergoing consecutive cataract surgeries.


Assuntos
Anestesia Local/métodos , Anestésicos Locais/administração & dosagem , Ansiolíticos/administração & dosagem , Ansiedade/prevenção & controle , Extração de Catarata , Midazolam/administração & dosagem , Medidas de Resultados Relatados pelo Paciente , Idoso , Ansiedade/etiologia , Conscientização , Feminino , Humanos , Masculino , Ohio , Medição da Dor , Pré-Medicação , Estudos Prospectivos
10.
PLoS One ; 15(11): e0242457, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33232335

RESUMO

The availability of breastfeeding support resources, including those provided by Baby-Friendly Hospitals, International Board Certified Lactation Consultants, breastfeeding counselors and educators, and volunteer-based mother-to-mother support organizations, such as La Leche League, are critically important for influencing breastfeeding initiation and continuation for the mother-child dyad. In addition, the emergence of community support options via information and communication technologies such as Skype and Facetime, social media (e.g., Facebook), and telelactation providers are providing mothers with a new range of support options that can help bridge geographic barriers to traditional community support. However, telelactation services that use information and communication technologies to connect breastfeeding mothers to remotely located breastfeeding experts require reliable, affordable, high-quality broadband connections to facilitate interaction between mothers and their support resources. The purpose of this paper is to explore the complex spatial landscape of virtual and face-to-face breastfeeding support options for mothers in the state of Ohio (U.S.), identifying barriers to support. Using a range of spatial and network analytics, the results suggest that a divide is emerging. While urban areas in Ohio benefit from both a density of face-to-face breastfeeding support resources and robust broadband options for engaging in telelactation, many rural areas of the state are lacking access to both. Policy implications and several potential strategies for mitigating these inequities are discussed.


Assuntos
Aleitamento Materno/métodos , Redes Comunitárias/organização & administração , Educação a Distância/métodos , Acesso aos Serviços de Saúde , Internet , Mães/educação , Grupos de Autoajuda/organização & administração , Adulto , Aconselhamento , Feminino , Humanos , Lactente , Recém-Nascido , Lactação , Ohio , Densidade Demográfica , Sistemas de Apoio Psicossocial , População Rural , Mídias Sociais , Fatores Socioeconômicos , Estados Unidos
11.
Nat Commun ; 11(1): 5864, 2020 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-33203846

RESUMO

Global soil organic carbon (SOC) stocks may decline with a warmer climate. However, model projections of changes in SOC due to climate warming depend on microbially-driven processes that are usually parameterized based on laboratory incubations. To assess how lab-scale incubation datasets inform model projections over decades, we optimized five microbially-relevant parameters in the Microbial-ENzyme Decomposition (MEND) model using 16 short-term glucose (6-day), 16 short-term cellulose (30-day) and 16 long-term cellulose (729-day) incubation datasets with soils from forests and grasslands across contrasting soil types. Our analysis identified consistently higher parameter estimates given the short-term versus long-term datasets. Implementing the short-term and long-term parameters, respectively, resulted in SOC loss (-8.2 ± 5.1% or -3.9 ± 2.8%), and minor SOC gain (1.8 ± 1.0%) in response to 5 °C warming, while only the latter is consistent with a meta-analysis of 149 field warming observations (1.6 ± 4.0%). Comparing multiple subsets of cellulose incubations (i.e., 6, 30, 90, 180, 360, 480 and 729-day) revealed comparable projections to the observed long-term SOC changes under warming only on 480- and 729-day. Integrating multi-year datasets of soil incubations (e.g., > 1.5 years) with microbial models can thus achieve more reasonable parameterization of key microbial processes and subsequently boost the accuracy and confidence of long-term SOC projections.


Assuntos
Sequestro de Carbono , Carbono , Modelos Biológicos , Solo/química , Carbono/metabolismo , Florestas , Iowa , Ohio , Microbiologia do Solo , Tennessee
12.
MMWR Morb Mortal Wkly Rep ; 69(45): 1671-1674, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33180753

RESUMO

In the United States, outbreaks of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), were initially reported in densely populated urban areas (1); however, outbreaks have since been reported in rural communities (2,3). Rural residents might be at higher risk for severe COVID-19-associated illness because, on average, they are older, have higher prevalences of underlying medical conditions, and have more limited access to health care services.* In May, after a cluster of seven COVID-19 cases was identified in a rural Ohio Amish community, access to testing was increased. Among 30 additional residents tested by real-time reverse transcription-polymerase chain reaction (RT-PCR; TaqPath COVID-19 Combo Kit),† 23 (77%) received positive test results for SARS-CoV-2. Rapid and sustained transmission of SARS-CoV-2 was associated with multiple social gatherings. Informant interviews revealed that community members were concerned about having to follow critical mitigation strategies, including social distancing§ and mask wearing.¶ To help reduce the ongoing transmission risk in a community, state and county health department staff members and community leaders need to work together to develop, deliver, and promote culturally responsive health education messages to prevent SARS-CoV-2 transmission and ensure that access to testing services is timely and convenient. Understanding the dynamics of close-knit communities is crucial to reducing SARS-CoV-2 transmission.


Assuntos
Amish/psicologia , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Pneumonia Viral/epidemiologia , População Rural , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amish/estatística & dados numéricos , Criança , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ohio/epidemiologia , Pandemias , Pneumonia Viral/transmissão , População Rural/estatística & dados numéricos , Comportamento Social , Adulto Jovem
13.
J Nurs Educ ; 59(12): 692-696, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33253398

RESUMO

BACKGROUND: The The Neonatal Nurse Practitioner program at The Ohio State University transitioned from a traditional face-to-face program to a distance-enhanced hybrid model providing course content online with campus visits for procedural skills and simulation in 2017. Although the 2020 COVID-19 pandemic necessitated cancellation of all in-person events across the university, the neonatal nurse practitioner students' learning needs remained the same. METHOD: The onsite experience was redesigned for virtual delivery. Procedural content was accomplished through student-led small-group collaborative critical thinking activities surrounding procedural complications, and other faculty-led scenario discussions. RESULTS: Students collaborated for a Complications Rounds activity (1-day) that promoted learning about procedural skills from a global perspective including safe techniques, monitoring, risks, and troubleshooting complications. CONCLUSION: Procedural content can be achieved when in-person learning is not possible. The Complications Rounds approach can mitigate delays or gaps in practical experiences. Examining complications in-depth increases preparedness, promoting greater awareness of harm prevention when these present in future practice. [J Nurs Educ. 2020;59(12):692-696.].


Assuntos
Educação a Distância/organização & administração , Educação de Pós-Graduação em Enfermagem/organização & administração , Enfermagem Neonatal/educação , Profissionais de Enfermagem/educação , /epidemiologia , Docentes de Enfermagem , Humanos , Ohio/epidemiologia , Pandemias , Escolas de Enfermagem
15.
J Nurs Adm ; 50(11): 605-611, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33105337

RESUMO

Bed flow decisions should be based on current information about capacity. The purpose of this project was to develop a real-time, enterprise-wide, capacity management dashboard. The dashboard successfully used information from the electronic medical record to create a comprehensive standardized data source, which was used to drive patient flow decisions optimizing bed space, allocating resources and maintaining safety.


Assuntos
Eficiência Organizacional , Registros Eletrônicos de Saúde , Hospitais Pediátricos/organização & administração , Criança , Humanos , Ohio
16.
Health Aff (Millwood) ; 39(10): 1792-1798, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33017232

RESUMO

Motor vehicle crashes remain the leading cause of adolescent mortality and injury in the United States. For young drivers, crash risk peaks immediately after licensure and declines during the next two years, making the point of licensure an important safety intervention opportunity. Legislation in Ohio established a unique health-transportation partnership among the State of Ohio, Children's Hospital of Philadelphia, and Diagnostic Driving, Inc., to identify underprepared driver license applicants through a virtual driving assessment system. The system, a computer-based virtual driving test, exposes drivers to common serious crash scenarios to identify critical skill deficits and is delivered in testing centers immediately before the on-road examination. A pilot study of license applicants who completed it showed that the virtual driving assessment system accurately predicted which drivers would fail the on-road examination and provided automated feedback that informed drivers on their skill deficits. At this time, the partnership's work is informing policy changes around integrating the virtual driving assessment system into licensing and driver training with the aim of reducing crashes in the first months of independent driving. The system can be developed to identify deficits in safety-critical skills that lead to crashes in new drivers and to address challenges that the coronavirus disease 2019 pandemic has introduced to driver testing and training.


Assuntos
Condução de Veículo/legislação & jurisprudência , Infecções por Coronavirus/prevenção & controle , Licenciamento/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Gestão da Segurança/organização & administração , Interface Usuário-Computador , Adolescente , Infecções por Coronavirus/epidemiologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Veículos Automotores/estatística & dados numéricos , Ohio , Pandemias/estatística & dados numéricos , Philadelphia , Projetos Piloto , Pneumonia Viral/epidemiologia , Transportes/métodos , Adulto Jovem
17.
J Environ Qual ; 49(3): 675-687, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-33016383

RESUMO

Legacy phosphorus (P) in agricultural soils can be transported to surface waters via runoff and tile drainage, where it contributes to the development of harmful and nuisance algal blooms and hypoxia. However, a limited understanding of legacy P loss dynamics impedes the identification of mitigation strategies. Edge-of-field data from 41 agricultural fields in northwestern Ohio, USA, were used to develop regressions between legacy P concentrations (C) and discharge (Q) for two P fractions: total P (TP) and dissolved reactive P (DRP). Tile drainage TP concentration (CTP ) and DRP concentration (CDRP ) both increased as Q increased, and CTP tended to increase at a greater rate than CDRP . Surface runoff showed greater variation in C-Q regressions, indicating that the response of TP and DRP to elevated Q was field specific. The relative variability of C and Q was explored using a ratio of CVs (CVC /CVQ ), which indicated that tile drainage TP and DRP losses were chemodynamic, whereas losses via surface runoff demonstrated both chemodynamic and chemostatic behavior. The chemodynamic behavior indicated that legacy P losses were strongly influenced by variation in P source availability and transport pathways. In addition, legacy P source size influenced C, as demonstrated by a positive relationship between soil-test P and the CTP and CDRP in both tile drainage and surface runoff. Progress towards legacy P mitigation will require further characterization of the drivers of variability in CTP and CDRP , including weather-, soil-, and management-related factors.


Assuntos
Fósforo/análise , Movimentos da Água , Agricultura , Ohio , Solo
18.
J Environ Qual ; 49(4): 933-944, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33016483

RESUMO

When fertilizer phosphorus (P) is applied to soils, the P can run off fields and cause harmful algal blooms. Due to its chemistry, much of the added P that does not run off can bind to soil particles and become inaccessible to plants. In natural systems, microbial and faunal decomposers can increase soil P accessibility to plants. We tested the hypothesis that this may also be true in agricultural systems, which could increase P application efficiency and reduce runoff potential. We stimulated soil fauna with sodium (Na+ ) and microbes with carbon (C) by adding corn (Zea mays L.) stover and Na+ solution to plots in conventionally managed corn fields in northwestern Ohio. Stover addition increased microbial biomass by 65 ± 12% and respiration by 400-700%. Application of stover with Na+ increased soil detritivore fauna abundance by 51 ± 20% and likely did not affect the other invertebrate guilds. However, soil biological activity was low compared with natural systems in all treatments and was not correlated with instantaneous measures of P accessibility, though cumulative P accessibility over the course of the growing season was correlated with microbial phosphatase activity (slope = 1.01, p < .01) and respiration (slope = 0.42, p = .02). Therefore, in agricultural systems, treatments to stimulate decomposers already in those systems may be ineffective at increasing soil P accessibility in the short term, but in the long term, higher microbial activities can be associated with higher soil P accessibility.


Assuntos
Fósforo/análise , Solo , Biota , Fertilizantes , Ohio
19.
Acad Med ; 95(12S Addressing Harmful Bias and Eliminating Discrimination in Health Professions Learning Environments): S23-S27, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32889928

RESUMO

The purpose of this case study is to outline strategies employed by the University of Cincinnati's College of Nursing (CoN) to increase underrepresented racial and ethnic (URE), and economically and educationally disadvantaged student acceptance, presence, inclusion, and success. The case study method was used to examine strategies used at the CoN to address bias and discrimination, identify student success strategies for URE students, and outline college initiatives to facilitate an inclusive environment. CoN leadership has instituted several programs involving faculty and students in efforts to decrease bias and discrimination and promote inclusion. They continue to engage faculty and others in adding to and improving their efforts. This is a process of culture change and must involve everyone. CoN leadership is committed to both demonstrating by example and holding all accountable for progressively improved continued efforts to create a more inclusive environment.


Assuntos
Viés , Educação em Enfermagem/métodos , Teste de Admissão Acadêmica , Educação em Enfermagem/tendências , Humanos , Liderança , Ohio , Estudos de Casos Organizacionais/métodos , Fatores Raciais , Escolas de Enfermagem/organização & administração , Escolas de Enfermagem/tendências
20.
Environ Int ; 144: 106062, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32871381

RESUMO

BACKGROUND: Lead (Pb) is an environmentally ubiquitous heavy metal associated with a wide range of adverse health effects in children. Both lead exposure and the early life microbiome- which plays a critical role in human development-have been linked to similar health outcomes, but it is unclear if the adverse effects of lead are partially driven by early life gut microbiota dysbiosis. The objective of this study was to examine the association between in utero and postnatal lead levels (measured in deciduous baby teeth) and early life bacterial and fungal gut microbiota in the first year of life. METHODS: Data from the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study (WHEALS) birth cohort were analyzed. Tooth lead levels during the 2nd and 3rd trimesters and postnatally (<1 year of age) were quantified using high-resolution microspatial mapping of dentin growth rings. Early life microbiota were measured in stool samples collected at approximately 1 and 6 months of age, using both 16S rRNA (bacterial) and ITS2 (fungal) sequencing. Of the 1,258 maternal-child pairs in WHEALS, 146 had data on both tooth metals and early life microbiome. RESULTS: In utero tooth lead levels were significantly associated with gut fungal community composition at 1-month of age, where higher levels of 2nd trimester tooth lead was associated with lower abundances of Candida and Aspergillus and higher abundances of Malassezia and Saccharomyces; 3rd trimester lead was also associated with lower abundances of Candida. Though lead did not significantly associate with the overall structure of the infant gut bacterial community, it associated with the abundance of some specific bacterial taxa, including the increased abundance of Collinsella and Bilophila and a decreased abundance of Bacteroides taxa. CONCLUSIONS: The observed associations between lead exposure and infant gut microbiota could play a role in the impact of lead on childhood development. Given the paucity of research examining these associations in humans-particularly for fungal microbiota-further investigation is needed.


Assuntos
Microbioma Gastrointestinal , Criança , Fezes , Humanos , Lactente , Chumbo/toxicidade , Estudos Longitudinais , Michigan , Ohio , RNA Ribossômico 16S/genética
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