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1.
Addict Sci Clin Pract ; 16(1): 13, 2021 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-33627183

RESUMO

BACKGROUND: We describe addiction consult services (ACS) adaptations implemented during the Novel Coronavirus Disease 2019 (COVID-19) pandemic across four different North American sites: St. Paul's Hospital in Vancouver, British Columbia; Oregon Health & Sciences University in Portland, Oregon; Boston Medical Center in Boston, Massachusetts; and Yale New Haven Hospital in New Haven, Connecticut. EXPERIENCES: ACS made system, treatment, harm reduction, and discharge planning adaptations. System changes included patient visits shifting to primarily telephone-based consultations and ACS leading regional COVID-19 emergency response efforts such as substance use treatment care coordination for people experiencing homelessness in COVID-19 isolation units and regional substance use treatment initiatives. Treatment adaptations included providing longer buprenorphine bridge prescriptions at discharge with telemedicine follow-up appointments and completing benzodiazepine tapers or benzodiazepine alternatives for people with alcohol use disorder who could safely detoxify in outpatient settings. We believe that regulatory changes to buprenorphine, and in Vancouver other medications for opioid use disorder, helped increase engagement for hospitalized patients, as many of the barriers preventing them from accessing care on an ongoing basis were reduced. COVID-19 specific harm reductions recommendations were adopted and disseminated to inpatients. Discharge planning changes included peer mentors and social workers increasing hospital in-reach and discharge outreach for high-risk patients, in some cases providing prepaid cell phones for patients without phones. RECOMMENDATIONS FOR THE FUTURE: We believe that ACS were essential to hospitals' readiness to support patients that have been systematically marginilized during the pandemic. We suggest that hospitals invest in telehealth infrastructure within the hospital, and consider cellphone donations for people without cellphones, to help maintain access to care for vulnerable patients. In addition, we recommend hospital systems evaluate the impact of such interventions. As the economic strain on the healthcare system from COVID-19 threatens the very existence of ACS, overdose deaths continue rising across North America, highlighting the essential nature of these services. We believe it is imperative that health care systems continue investing in hospital-based ACS during public health crises.


Assuntos
/epidemiologia , Assistência à Saúde/tendências , Admissão do Paciente/tendências , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Telemedicina/tendências , Colúmbia Britânica , Buprenorfina/uso terapêutico , Connecticut , Comparação Transcultural , Previsões , Implementação de Plano de Saúde/tendências , Acesso aos Serviços de Saúde/tendências , Humanos , Massachusetts , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/reabilitação , Oregon , Equipe de Assistência ao Paciente/tendências , Alta do Paciente/tendências , Consulta Remota/tendências
2.
J Am Board Fam Med ; 34(Suppl): S170-S178, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33622833

RESUMO

To respond to the COVID-19 pandemic and recover from its aftermath, primary care teams will face waves of overwhelming demand for information and the need to significantly transform care delivery. INNOVATION: Oregon Health & Science University's primary care team envisioned and implemented the COVID-19 Connected Care Center, a statewide telephone "hotline" service. RESULTS: The hotline has taken more than 5825 calls from patients in 33 of Oregon's 36 counties in less than 3 months. In preliminary survey data, 86% of patients said their questions were answered during the call, 90% would recommend this service, and 70% reported a reduction in stress levels about coronavirus. In qualitative interviews, patients reported their questions answered, short wait times, nurses spent time as needed, and appropriate follow-up was arranged. CONCLUSION: Academic health centers may have the capacity to leverage their extensive resources to rapidly launch a multiphased pandemic response that meets peoples' need for information and access to primary care, while minimizing risk of infection and emergency department use and rapidly supporting primary care teams to make the necessary operational changes to do the same in their communities. Such efforts require external funding in a fee-for-service payment model.


Assuntos
Linhas Diretas/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Telemedicina/organização & administração , Centros Médicos Acadêmicos , /epidemiologia , Planos de Pagamento por Serviço Prestado , Linhas Diretas/organização & administração , Humanos , Oregon/epidemiologia , Pandemias , Atenção Primária à Saúde/economia , Pesquisa Qualitativa , Telemedicina/economia , Triagem/métodos
3.
BMC Oral Health ; 21(1): 35, 2021 01 20.
Artigo em Inglês | MEDLINE | ID: mdl-33472613

RESUMO

BACKGROUND: Silver diamine fluoride (SDF) is a minimally-invasive preventive service used in the U.S. to avert and arrest caries since 2014. No studies document survival outcomes based in real world delivery. We analyzed 12-month survival outcomes of SDF applied independently or concurrently with other restorative procedures among a population receiving community dental care. METHODS: We analyzed data on SDF applications from de-identified dental claims on Oregon Health Plan patients served by Advantage Dental in 2016, who had been seen in 2015 (patient n = 2269; teeth n = 7787). We compared survival rates of SDF alone, SDF applied with a sedative filling, and SDF with a same-day restoration. Failure was defined as a restoration or extraction of the tooth 7 to 365 days after initial application. Survival was defined as a patient returning 180 or more days after application whose tooth did not have a restoration or extraction. Differences were assessed through Wilcoxon equality of survivor function tests and log-rank equality of survivor tests to compare failure rates, Cox Proportional Hazards models to assess factors associated with survival of SDF, and Kaplan-Meier survival estimate to calculate the probability of survival over time. RESULTS: SDF alone had an overall survival rate of 76%. SDF placed with sedative filling and with a same-day restoration had survival rates of 50% and 84% respectively, likely reflecting treatment intent. SDF alone survived exceptionally well on primary cuspids, permanent molars, and permanent bicuspids and among patients aged 10 to 20 years, with modest variation across caries risk assessment categories. A single annual application of SDF was successful in 75% of cases. Among SDF failures on permanent dentition, more than two-thirds of teeth received a minor restoration. CONCLUSION: SDF is a minimally invasive non-aerosolizing option that prevented non-cavitated lesions and arrested early decay among community dentistry patients when applied independently or concurrently with restorative procedures. Professional organizations, policy makers, providers, and payors should broaden optional SDF use by informing clinical guidelines, reimbursement policies, and treatment decisions. Future research should address clinical, social, service delivery, workforce, and economic outcomes using diverse population-based samples, and the mechanisms underlying single application success and caries prevention potential.


Assuntos
Cárie Dentária , Clínicas Odontológicas , Adolescente , Adulto , Cariostáticos/uso terapêutico , Criança , Cárie Dentária/tratamento farmacológico , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Humanos , Oregon , Compostos de Amônio Quaternário , Compostos de Prata/uso terapêutico , Adulto Jovem
4.
J Environ Manage ; 282: 111962, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33461091

RESUMO

While many different watershed management strategies have been implemented to improve water quality, relatively few studies empirically tested the combined effects of different strategies on water quality in relation to land cover changes using long-term empirical data at the sub-basin scale. Using 10 years of total suspended solids (TSS) data, we examined how the conversion of wetland, wetland fragmentation, beaver dams, and Best Management Practices (BMPs) affect wet season TSS concentrations for the 25 monitoring stations in the Tualatin River basin, USA. Geographic information systems, FRAGSTATS, and correlation analysis were used to identify the direction of land cover change, degree of wetland fragmentation, and the strength of the relationship between TSS change and explanatory variables. Improvement in TSS concentrations was tightly coupled with the aggregation of wetlands, presence of beaver dams, particularly during the mid-wet season when flows were highest. Other BMPs effectively reduced TSS concentrations for the early and late-wet seasons when flows were not as high as in the middle wet-season. Aggregated wetlands were more effective for improving water quality than smaller disaggregated wetlands of similar total area when combined with the presence of beaver dams and BMPs. These findings offer important scientific and practical implications for management of urbanizing watersheds that seek to achieve the dual goals of improving environmental quality and land development.


Assuntos
Rios , Áreas Alagadas , Monitoramento Ambiental , Sistemas de Informação Geográfica , Oregon , Qualidade da Água
5.
Environ Monit Assess ; 193(2): 58, 2021 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-33439357

RESUMO

Land use alteration such as livestock grazing can affect water quality in habitats of at-risk wildlife species. Data from managed wetlands are needed to understand levels of exposure for aquatic life stages and monitor grazing-related changes afield. We quantified spatial and temporal variation in water quality in wetlands occupied by threatened Oregon spotted frog (Rana pretiosa) at Klamath Marsh National Wildlife Refuge in Oregon, United States (US). We used analyses for censored data to evaluate the importance of habitat type and grazing history in predicting concentrations of nutrients, turbidity, fecal indicator bacteria (FIB; total coliforms, Escherichia coli (E. coli), and enterococci), and estrogenicity, an indicator of estrogenic activity. Nutrients (orthophosphate and ammonia) and enterococci varied over time and space, while E. coli, total coliforms, turbidity, and estrogenicity were more strongly associated with local livestock grazing metrics. Turbidity was correlated with several grazing-related constituents and may be particularly useful for monitoring water quality in landscapes with livestock use. Concentrations of orthophosphate and estrogenicity were elevated at several sites relative to published health benchmarks, and their potential effects on Rana pretiosa warrant further investigation. Our data provided an initial assessment of potential exposure of amphibians to grazing-related constituents in western US wetlands. Increased monitoring of surface water quality and amphibian population status in combination with controlled laboratory toxicity studies could help inform future research and targeted management strategies for wetlands with both grazing and amphibians of conservation concern.


Assuntos
Qualidade da Água , Áreas Alagadas , Anfíbios , Animais , Ecossistema , Monitoramento Ambiental , Escherichia coli , Gado , Oregon
6.
JACC Clin Electrophysiol ; 7(1): 6-11, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33478713

RESUMO

OBJECTIVES: The purpose of this study was to evaluate the potential impact of the coronavirus disease-2019 (COVID-19) pandemic on out-of-hospital cardiac arrest (OHCA) responses and outcomes in 2 U.S. communities with relatively low infection rates. BACKGROUND: Studies in areas with high COVID-19 infection rates indicate that the pandemic has had direct and indirect effects on community responses to OHCA and negative impacts on survival. Data from areas with lower infection rates are lacking. METHODS: Cases of OHCA in Multnomah County, Oregon, and Ventura County, California, with attempted resuscitation by emergency medical services (EMS) from March 1 to May 31, 2020, and from March 1 to May 31, 2019, were evaluated. RESULTS: In a comparison of 231 OHCA in 2019 to 278 in 2020, the proportion of cases receiving bystander cardiopulmonary resuscitation (CPR) was lower in 2020 (61% to 51%, respectively; p = 0.02), and bystander use of automated external defibrillators (AEDs) declined (5% to 1%, respectively; p = 0.02). EMS response time increased (6.6 ± 2.0 min to 7.6 ± 3.0 min, respectively; p < 0.001), and fewer OHCA cases survived to hospital discharge (14.7% to 7.9%, respectively; p = 0.02). Incidence rates did not change significantly (p > 0.07), and coronavirus infection rates were low (Multnomah County, 143/100,000; Ventura County, 127/100,000 as of May 31) compared to rates of ∼1,600 to 3,000/100,000 in the New York City region at that time. CONCLUSIONS: The community response to OHCA was altered from March to May 2020, with less bystander CPR, delays in EMS response time, and reduced survival from OHCA. These results highlight the pandemic's indirect negative impact on OHCA, even in communities with relatively low incidence of COVID-19 infection, and point to potential opportunities for countering the impact.


Assuntos
Reanimação Cardiopulmonar/tendências , Serviços Médicos de Emergência/tendências , Parada Cardíaca Extra-Hospitalar/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , California/epidemiologia , Desfibriladores , Cardioversão Elétrica/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oregon/epidemiologia , Parada Cardíaca Extra-Hospitalar/epidemiologia , Parada Cardíaca Extra-Hospitalar/mortalidade , Taxa de Sobrevida/tendências , Fatores de Tempo , Estados Unidos/epidemiologia
7.
Pest Manag Sci ; 77(1): 104-112, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32841491

RESUMO

BACKGOUND: Biological invasions are a global concern in agriculture, food production and biodiversity. Among the invasive species, some hornets are known to have serious effects on honey bees, as found during the invasion of Vespa velutina in Europe. The recent findings of Vespa mandarinia individuals in Washington state in the west coast of the USA have raised alarm in the whole country. Here we estimate the potential spread of V. mandarinia in the USA, analyzing its potential impacts on honey bee colonies, economic losses in the honey bee industry and bee-pollinated croplands. RESULTS: We found that V. mandarinia could colonize Washington and Oregon states in the west coast and a significant proportion of the east coast. If this species spread across the country, it could threaten 95 216 ± 5551 honey bee colonies, threatening an estimated income of US$11.9 and 101.8 million for hive derived products and bee-pollinated crops production, respectively, while colonizing 60 837.8 km2 of bee-pollinated croplands. CONCLUSION: Our results suggest that V. mandarinia will have serious effects in the USA, raising the need for prompt monitoring actions and planning at different administrative levels to avoid its potential spread.


Assuntos
Vespas , Animais , Abelhas , Europa (Continente) , Espécies Introduzidas , Oregon , Estados Unidos , Washington
8.
J Med Libr Assoc ; 108(4): 645-646, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33013224

RESUMO

While institutional repositories are common in medical schools and academic health centers, they have been used by only a small number of health systems to track and promote their research and scholarly activity. This article describes how Providence System Library Services leveraged their existing institutional repository platform to substitute a virtual showcase for an annual in-person event.


Assuntos
Pesquisa Biomédica , Curadoria de Dados , Internato e Residência , Bibliotecas Médicas , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Oregon , Pandemias , Pneumonia Viral/epidemiologia
9.
BMC Public Health ; 20(1): 1337, 2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32878612

RESUMO

BACKGROUND: People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community. METHODS: Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that serve people who are houseless in Portland, Oregon. Medical students approach guests at both locations to ascertain interest in participating in the study. Qualitative data were analyzed using thematic analysis rooted in an inductive process. RESULTS: We enrolled 38 participants in this study. Most participants were male (73.7%), white (78.9%), and had been houseless for over a year at the time of interview (65.8%). Qualitative themes describe care experiences among people with mental health and substance use disorders, and roles for medical students and health-care institutions. Specifically, people who are houseless want medical students to 1) listen to and believe them, 2) work to destigmatize houselessness, 3) engage in diverse clinical experiences, and 4) advocate for change at the institutional level. Participants asked healthcare institutions to use their power to change laws that criminalize substance use and houselessness, and build healthcare systems that take better care of people with addiction and mental health conditions. CONCLUSIONS: Medical students, and the institutions they are a part of, should seek to reduce stigma against people who are houseless in medical systems. Additionally, institutions should change their approaches to healthcare delivery and advocacy to better support the health of people who are houseless.


Assuntos
Assistência à Saúde , Pessoas em Situação de Rua , Transtornos Mentais , Defesa do Paciente , Relações Profissional-Paciente , Estigma Social , Estudantes de Medicina , Adulto , Atitude Frente a Saúde , Comportamento Aditivo , Feminino , Necessidades e Demandas de Serviços de Saúde , Pessoas em Situação de Rua/psicologia , Habitação , Humanos , Masculino , Transtornos Mentais/complicações , Saúde Mental , Pessoa de Meia-Idade , Oregon , Saúde da População , Pesquisa Qualitativa , Mudança Social , Apoio Social , Transtornos Relacionados ao Uso de Substâncias/complicações , Inquéritos e Questionários
10.
PLoS One ; 15(9): e0238886, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32997674

RESUMO

In 2015, the Pacific marine heat wave, low river flows, and record high water temperatures in the Columbia River Basin contributed to a near-complete failure of the adult migration of endangered Snake River sockeye salmon (Oncorhynchus nerka, NOAA Fisheries 2016). These extreme weather events may become the new normal due to anthropogenic climate change, with catastrophic consequences for endangered species. Existing anthropogenic pressures may amplify vulnerability to climate change, but these potential synergies have rarely been quantified. We examined factors affecting survival of endangered sockeye (Oncorhynchus nerka) and threatened Chinook salmon (O. tshawytscha) as they migrated upstream through eight dams and reservoirs to spawning areas in the Snake River Basin. Our extensive database included histories of 17,279 individual fish that migrated since 2004. A comparison between conditions in 2015 and daily temperatures and flows in a regulated basin forced by output from global climate models showed that 2015 did have many characteristics of projected future mean conditions. To evaluate potential salmon responses, we modeled migration timing and apparent survival under historical and future climate scenarios (2040s). For Chinook salmon, adult survival from the first dam encountered to spawning grounds dropped by 4-15%, depending on the climate scenario. For sockeye, survival dropped by ~80% from their already low levels. Through sensitivity analyses, we observed that the adult sockeye migration would need to shift more than 2 weeks earlier than predicted to maintain survival rates typical of those seen during 2008-2017. Overall, the greater impacts of climate change on adult sockeye compared with adult Chinook salmon reflected differences in life history and environmental sensitivities, which were compounded for sockeye by larger effect sizes from other anthropogenic factors. Compared with Chinook, sockeye was more negatively affected by a history of juvenile transportation and by similar temperatures and flows. The largest changes in temperature and flow were projected to be upstream from the hydrosystem, where direct mitigation through hydrosystem management is not an option. Unfortunately, Snake River sockeye have likely lost much of their adaptive capacity with the loss of the wild population. Further work exploring habitat restoration or additional mitigation actions is urgently needed.


Assuntos
Migração Animal/fisiologia , Oncorhynchus/classificação , Migração Animal/classificação , Animais , Mudança Climática , Conservação dos Recursos Naturais , Espécies em Perigo de Extinção , Idaho , Oncorhynchus/crescimento & desenvolvimento , Oncorhynchus/fisiologia , Oregon , Rios , Washington
11.
Artigo em Inglês | MEDLINE | ID: mdl-32887328

RESUMO

The Supplemental Nutrition Assistance Program (SNAP) is a critical program that helps reduce the risk of food insecurity, yet little is known about how SNAP addresses the needs of rural, food-insecure residents in the United States (U.S.). This study examines how rural, food-insecure residents perceive SNAP. Semi-structured interviews were conducted with 153 individuals living in six diverse rural regions of Arkansas, Montana, North Carolina, Oregon, Texas, and West Virginia. SNAP was described as a crucial stop-gap program, keeping families from experiencing persistent food insecurity, making food dollars stretch when the family budget is tight, and helping them purchase healthier foods. For many rural residents interviewed, SNAP was viewed in a largely positive light. In efforts to continue improving SNAP, particularly in light of its relevance during and post-coronavirus (COVID-19) pandemic, policymakers must be aware of rural families' perceptions of SNAP. Specific improvements may include increased transparency regarding funding formulas, budgeting and nutrition education for recipients, effective training to improve customer service, connections among social service agencies within a community, and increased availability of automation to streamline application processes.


Assuntos
Assistência Alimentar , Abastecimento de Alimentos , Pobreza , Arkansas , Infecções por Coronavirus/epidemiologia , Humanos , Montana , North Carolina , Oregon , Pandemias , Pneumonia Viral/epidemiologia , Texas , West Virginia
12.
Artigo em Inglês | MEDLINE | ID: mdl-32751378

RESUMO

Personal support workers (PSW) are caregivers for children and adults with intellectual and developmental disabilities (IDDs) or adults experiencing mental illness or other behavioral health conditions. The work can be very meaningful, but many PSWs must prepare for, monitor, and manage challenging behaviors, including aggression. This study was designed to estimate the prevalence of aggression experienced by PSWs in Oregon, and compare it to a previous sample of Oregon home care workers (HCWs). This comparison included an analysis of relationships between exposures to aggression and psychological health factors. PSWs in Oregon (N = 240) were surveyed electronically at a single time point. PSWs generally reported higher rates of exposure to aggression compared to HCWs. Experiences with aggression were positively associated with fatigue and weakly associated with depression, but not stress. PSWs' self-reported lost work time injury rate was elevated compared to the US average, but it was comparable to previous self-reported injury rates from HCWs. Physical demands of work were the most prevalent reported primary safety concern, followed by challenging behaviors (including aggression). Developing tailored training to help PSWs understand, plan for, minimize, and manage challenging behaviors is a social priority.


Assuntos
Agressão , Serviços de Assistência Domiciliar , Visitadores Domiciliares , Adulto , Cuidadores , Criança , Humanos , Oregon
13.
PLoS One ; 15(8): e0233627, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804928

RESUMO

We studied avian development in 49 to 153 species of temperate and tropical New World passerine birds to determine how growth rates, and incubation and nestling periods, varied in relation to other life-history traits. We collected growth data and generated unbiased mass and tarsus growth rate estimates (mass n = 92 species, tarsus n = 49 species), and measured incubation period (n = 151) and nestling period (n = 153), which we analyzed with respect to region, egg mass, adult mass, clutch size, parental care type, nest type, daily nest predation rate (DMR), and nest height. We investigated covariation of life-history and natural-history attributes with the four development traits after controlling for phylogeny. Species in our lowland tropical sample grew 20% (incubation period), 25% (mass growth rate), and 26% (tarsus growth rate) more slowly than in our temperate sample. Nestling period did not vary with respect to latitude, which suggests that tropical songbirds fledge in a less well-developed state than temperate species. Suboscine species typically exhibited slower embryonic and post-embryonic growth than oscine passerines regardless of their breeding region. This pattern of slow development in tropical species could reflect phylogenetic effects based on unknown physiological attributes. Time-dependent nest mortality was unrelated to nestling mass growth rate, tarsus growth rate, and incubation period, but was significantly associated with nestling period. This suggests that nest predation, the predominant cause of nest loss in songbirds, does not exert strong selection on physiologically constrained traits, such as embryonic and post-embryonic growth, among our samples of temperate and lowland tropical songbird species. Nestling period, which is evolutionarily more labile than growth rate, was significantly shorter in birds exposed to higher rates of nest loss and nesting at lower heights, among other traits. Differences in life-history variation across latitudes provide insight into how unique ecological characteristics of each region influence physiological processes of passerines, and thus, how they can shape the evolution of life histories. While development traits clearly vary with respect to latitude, trait distributions overlap broadly. Life-history and natural history associations differ for each development trait, which suggests that unique selective pressures or constraints influence the evolution of each trait.


Assuntos
Aves Canoras/crescimento & desenvolvimento , Animais , Evolução Biológica , Clima , Tamanho da Ninhada , Análise Discriminante , Ecossistema , Feminino , Traços de História de Vida , Modelos Lineares , Masculino , Michigan , Modelos Biológicos , Comportamento de Nidação/fisiologia , Oregon , Panamá , Filogenia , Comportamento Predatório/fisiologia , Reprodução/fisiologia , Seleção Genética , Aves Canoras/classificação , Aves Canoras/fisiologia , Especificidade da Espécie , Tarso Animal/crescimento & desenvolvimento , Clima Tropical
15.
J Intellect Disabil Res ; 64(10): 739-749, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32808424

RESUMO

BACKGROUND: The COVID-19 pandemic introduced challenges to families with young children with developmental delays. Beyond the widespread concerns surrounding illness, loss of employment and social isolation, caregivers are responsible for overseeing their children's educational and therapeutic programmes at home often without the much needed support of professionals. METHOD: The present study sought to examine the impact of COVID-19 in 77 ethnically, linguistically and socioeconomically diverse families with young children with intellectual and developmental disabilities (IDDs) in California and Oregon, who were participating in larger intervention studies. Parents responded to five interview questions about the impact of the pandemic, services for their child, silver linings or positive aspects, coping and their concerns about the long-term impact of the pandemic. RESULTS: Parents reported that their biggest challenge was being at home caring for their children with the loss of many essential services. Parents reported some positive aspects of the pandemic, especially being together as a family. Although there were positive aspects of the situation, many parents expressed concern about long-term impacts of the pandemic on their children's development, given the loss of services, education and social engagement opportunities. CONCLUSION: Results suggest that parents of young children with IDD report significant challenges at home during the pandemic. Professional support, especially during the reopening phases, will be critical to support family well-being and child developmental outcomes.


Assuntos
Infecções por Coronavirus , Deficiências do Desenvolvimento/enfermagem , Família , Acesso aos Serviços de Saúde , Deficiência Intelectual/enfermagem , Pandemias , Pneumonia Viral , Adulto , California/etnologia , Criança , Pré-Escolar , Família/etnologia , Família/psicologia , Feminino , Humanos , Masculino , Oregon/etnologia , Pais
17.
J Dent Hyg ; 94(4): 22-28, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32753521

RESUMO

Purpose: Occupational stress and burn-out among dental hygienists may produce a decrease in overall mental health and well-being. The purpose of this study was to determine prevalence of mental health concerns as well as perceived stressors and self-care strategies among dental hygienists in Oregon.Methods: Dental hygienists belonging to the Oregon Dental Hygienists' Association were invited to participate in an electronic survey. The validated and pilot tested-survey consisted of 28 items that addressed experiences with stress, mental health issues and coping mechanisms. Descriptive and inferential statistics were used to analyze the data.Results: Of the email invitations that were successfully delivered (n=251), 83 dental hygienists volunteered to participate (n=83), for a 33% response rate. Difficulty maintaining work-life balance (35%, n=28), dysfunctional work teams (34%, n=28), and not enough time in the work schedule (65%, n=54) were the most common stressors. Respondents who worked ≥20 hours per week were more likely to attribute their daily stress primarily or entirely to work (p=0.009). Self-care methods included exercise, quiet time, spending time with loved ones, and self-care activities. Only 21% of respondents (n=17) reported that they received information or training on stress management and or burn-out in as part of their dental hygiene education.Conclusion: Symptoms linked to depression and anxiety are common among dental hygienists in Oregon. Stress management education and training should be incorporated in dental hygiene educational programs to prepare graduates to effectively manage the stressors that may lead to burn-out. Additional research should be conducted on a national level to gain a more representative sample.


Assuntos
Higienistas Dentários , Saúde Mental , Atitude do Pessoal de Saúde , Humanos , Oregon , Autocuidado , Inquéritos e Questionários
18.
Plant Dis ; 104(10): 2649-2657, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32749926

RESUMO

No-till or direct seeding can be described as seeding directly into the crop stubble from the previous season without use of tillage. A reduction in tillage can result in many benefits, including increased soil organic matter, increased water holding capacity, and reduced fuel costs. However, the effect of no-till and reduced tillage on crop root disease profiles is poorly understood. To study the effect of tillage on disease dynamics, soil samples were collected from commercial wheat fields representing a wide range of tillage strategies in fall 2016 and fall 2017. Because precipitation might affect soilborne diseases, wheat fields located across a diverse gradient of precipitation zones of the dryland Pacific Northwest were selected. Fusarium spp., Pythium spp., and Rhizoctonia spp. were quantified from soil samples using soil dilution plating and quantitative PCR (qPCR) assays. Results of dilution plating showed that the colony counts of Fusarium, Pythium, and Rhizoctonia at the genus level were negatively associated with tillage. However, the same patterns were not observed when specific causal agents of Fusarium, Pythium, and Rhizoctonia that are known to be pathogenic on wheat were quantified with qPCR. Furthermore, precipitation affected the population density of some fungal pathogens (F. culmorum, P. ultimum, and R. solani AG 8). Within the scope of inference of this study, results of this study indicate that the benefits of adopting reduced tillage likely outweigh potential risk for increased root disease.


Assuntos
Rhizoctonia , Triticum , Noroeste dos Estados Unidos , Oregon , Dinâmica Populacional
19.
PLoS One ; 15(8): e0237178, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32841298

RESUMO

Entanglements affect marine mammal species around the globe, and for some, those impacts are great enough to cause population declines. This study aimed to document rates and causes of entanglement and trends in local haulout abundance for Steller and California sea lions on the north coast of Washington from 2010-2018. We conducted small boat surveys to count sea lions and document entangled individuals. Rates of entanglement and entangling material occurrence were compared with records of stranded individuals on the Washington and Oregon coast and with packing bands recorded during beach debris surveys. The rate of entanglement for California sea lions was 2.13%, almost entirely composed of adult males, with a peak rate during June and July potentially due to some entangled individuals not migrating to their breeding grounds. For Steller sea lions, the rate of entanglement was 0.41%, composed of 77% adults (32.4% male, 63.3% female), 17.1% juveniles, 5.9% unknown age, and no pups. Steller sea lions exhibited a 7.9% ± 3.2 rate of increase in abundance at the study haulouts, which was similar to that seen in California sea lions (7.8% ± 4.2); both increases were greater than the population growth rates observed range-wide despite high rates of entanglement. Most entanglements for both species were classified as packing bands, followed by entanglement scars. Salmon flashers were also prevalent and only occurred from June-September during the local ocean salmon troll fishery. Packing band occurrence in beach debris surveys correlated with packing band entanglements observed on haulouts. However, no packing band entanglements were observed in the stranding record and the rate of stranded animals exhibiting evidence of entanglement was lower than expected, indicating that entanglement survival is higher than previously assumed. Future studies tracking individual entanglement outcomes are needed to develop effective, targeted management strategies.


Assuntos
Comportamento Animal , Cicatriz/etiologia , Leões-Marinhos , Poluição da Água/efeitos adversos , Animais , Feminino , Pesqueiros , Masculino , Oregon , Oceano Pacífico , Washington
20.
Environ Sci Technol ; 54(15): 9305-9314, 2020 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-32667810

RESUMO

The Hells Canyon Complex (HCC) along the Snake River (Idaho-Oregon border, U.S.A.) encompasses three successive reservoirs that seasonally stratify, creating anoxic conditions in the hypolimnion that promote methylmercury (MeHg) production. This study quantified seasonal dynamics and interannual variability in mercury concentrations (inorganic divalent mercury (IHg) and MeHg) and loads at four reservoir inflow and outflow locations through the HCC (2014-2017). We observed (1) that the HCC is a net sink for both IHg and MeHg, (2) interannual variability in IHg and MeHg loads largely reflecting streamflow conditions, and (3) seasonal variability in particulate IHg loading at the inflow (greatest from February to April) and MeHg export from the outflow (greatest from September to December) of the HCC. Seasonal export of MeHg was evidenced by increases in monthly mean concentrations of unfiltered MeHg (approximately 2-fold) and the percentage of total mercury (THg) as MeHg (≥4-fold) coincident with reservoir destratification. Despite evidence of seasonal export of MeHg from the HCC, annual loads indicate a 42% decrease in unfiltered MeHg from HCC inflow to outflow. Results from this study improve the understanding of seasonal variability in mercury transport through and transformation within a reservoir complex.


Assuntos
Mercúrio , Compostos de Metilmercúrio , Poluentes Químicos da Água , Monitoramento Ambiental , Humanos , Idaho , Mercúrio/análise , Oregon , Estações do Ano , Poluentes Químicos da Água/análise
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