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1.
MMWR Morb Mortal Wkly Rep ; 73(19): 430-434, 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38753544

RESUMO

Measles is a highly infectious, vaccine-preventable disease that can cause severe illness, hospitalization, and death. A measles outbreak associated with a migrant shelter in Chicago occurred during February-April 2024, in which a total of 57 confirmed cases were identified, including 52 among shelter residents, three among staff members, and two among community members with a known link to the shelter. CDC simulated a measles outbreak among shelter residents using a dynamic disease model, updated in real time as additional cases were identified, to produce outbreak forecasts and assess the impact of public health interventions. As of April 8, the model forecasted a median final outbreak size of 58 cases (IQR = 56-60 cases); model fit and prediction range improved as more case data became available. Counterfactual analysis of different intervention scenarios demonstrated the importance of early deployment of public health interventions in Chicago, with a 69% chance of an outbreak of 100 or more cases had there been no mass vaccination or active case-finding compared with only a 1% chance when those interventions were deployed. This analysis highlights the value of using real-time, dynamic models to aid public health response, set expectations about outbreak size and duration, and quantify the impact of interventions. The model shows that prompt mass vaccination and active case-finding likely substantially reduced the chance of a large (100 or more cases) outbreak in Chicago.


Assuntos
Surtos de Doenças , Sarampo , Humanos , Surtos de Doenças/prevenção & controle , Chicago/epidemiologia , Sarampo/epidemiologia , Sarampo/prevenção & controle , Modelos Epidemiológicos , Saúde Pública , Fatores de Tempo , Previsões , Adolescente , Criança , Pré-Escolar , Vacinação em Massa , Adulto
2.
MMWR Morb Mortal Wkly Rep ; 73(19): 424-429, 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38753539

RESUMO

Measles, a highly contagious respiratory virus with the potential to cause severe complications, hospitalization, and death, was declared eliminated from the United States in 2000; however, with ongoing global transmission, infections in the United States still occur. On March 7, 2024, the Chicago Department of Public Health (CDPH) confirmed a case of measles in a male aged 1 year residing in a temporary shelter for migrants in Chicago. Given the congregate nature of the setting, high transmissibility of measles, and low measles vaccination coverage among shelter residents, measles virus had the potential to spread rapidly among approximately 2,100 presumed exposed shelter residents. CDPH immediately instituted outbreak investigation and response activities in collaboration with state and local health departments, health care facilities, city agencies, and shelters. On March 8, CDPH implemented active case-finding and coordinated a mass vaccination campaign at the affected shelter (shelter A), including vaccinating 882 residents and verifying previous vaccination for 784 residents over 3 days. These activities resulted in 93% measles vaccination coverage (defined as receipt of ≥1 recorded measles vaccine dose) by March 11. By May 13, a total of 57 confirmed measles cases associated with residing in or having contact with persons from shelter A had been reported. Most cases (41; 72%) were among persons who did not have documentation of measles vaccination and were considered unvaccinated. In addition, 16 cases of measles occurred among persons who had received ≥1 measles vaccine dose ≥21 days before first known exposure. This outbreak underscores the need to ensure high vaccination coverage among communities residing in congregate settings.


Assuntos
Surtos de Doenças , Vacina contra Sarampo , Sarampo , Migrantes , Humanos , Sarampo/epidemiologia , Sarampo/prevenção & controle , Chicago/epidemiologia , Masculino , Lactente , Adulto , Adulto Jovem , Pré-Escolar , Adolescente , Criança , Vacina contra Sarampo/administração & dosagem , Migrantes/estatística & dados numéricos , Feminino , Pessoa de Meia-Idade , Vacinação em Massa/estatística & dados numéricos
3.
Environ Health ; 23(1): 47, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38715087

RESUMO

OBJECTIVES: To examine whether long-term air pollution exposure is associated with central hemodynamic and brachial artery stiffness parameters. METHODS: We assessed central hemodynamic parameters including central blood pressure, cardiac parameters, systemic vascular compliance and resistance, and brachial artery stiffness measures [including brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR)] using waveform analysis of the arterial pressure signals obtained from a standard cuff sphygmomanometer (DynaPulse2000A, San Diego, CA). The long-term exposures to particles with an aerodynamic diameter < 2.5 µm (PM2.5) and nitrogen dioxide (NO2) for the 3-year periods prior to enrollment were estimated at residential addresses using fine-scale intra-urban spatiotemporal models. Linear mixed models adjusted for potential confounders were used to examine associations between air pollution exposures and health outcomes. RESULTS: The cross-sectional study included 2,387 Chicago residents (76% African Americans) enrolled in the ChicagO Multiethnic Prevention And Surveillance Study (COMPASS) during 2013-2018 with validated address information, PM2.5 or NO2, key covariates, and hemodynamics measurements. We observed long-term concentrations of PM2.5 and NO2 to be positively associated with central systolic, pulse pressure and BAR, and negatively associated with BAD, and BAC after adjusting for relevant covariates. A 1-µg/m3 increment in preceding 3-year exposures to PM2.5 was associated with 1.8 mmHg higher central systolic (95% CI: 0.98, 4.16), 1.0 mmHg higher central pulse pressure (95% CI: 0.42, 2.87), a 0.56%mmHg lower BAD (95% CI: -0.81, -0.30), and a 0.009 mL/mmHg lower BAC (95% CI: -0.01, -0.01). CONCLUSION: This population-based study provides evidence that long-term exposures to PM2.5 and NO2 is related to central BP and arterial stiffness parameters, especially among African Americans.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Exposição Ambiental , Material Particulado , Rigidez Vascular , Humanos , Rigidez Vascular/efeitos dos fármacos , Masculino , Feminino , Chicago/epidemiologia , Pessoa de Meia-Idade , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/efeitos adversos , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Idoso , Material Particulado/análise , Material Particulado/efeitos adversos , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Estudos Transversais , Hemodinâmica , Adulto , Dióxido de Nitrogênio/análise , Dióxido de Nitrogênio/efeitos adversos , Pressão Sanguínea , Etnicidade/estatística & dados numéricos , Negro ou Afro-Americano
4.
JAMA Netw Open ; 7(5): e248886, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38709536

RESUMO

Importance: Lesbian, gay, and bisexual populations face barriers accessing health care in Chicago, Illinois. Objective: To describe the prevalence of up-to-date cervical cancer screening among lesbian, gay, and bisexual vs heterosexual cisgender women in Chicago. Design, Setting, and Participants: This retrospective, cross-sectional, population-based study of cisgender women residing in Chicago was completed from 2020 to 2022 using data from the Healthy Chicago Survey, which is conducted annually by the Chicago Department of Public Health. Participants included cisgender women aged 25 to 64 years with no history of hysterectomy. Respondents who self-identified as lesbian, gay, or bisexual or other than straight, lesbian, or bisexual were coded as lesbian, gay, or bisexual (LGB). Respondents who self-identified as straight were coded as heterosexual. Those who reported having a Papanicolaou test within the past 3 years were considered up-to-date with cervical cancer screening. Data analysis was performed from June to October 2023. Exposures: The primary exposure was sexual orientation. Covariates included age, income level, race, ethnicity, having a primary care practitioner (PCP), and insurance coverage. Main Outcomes and Measures: Prevalence ratios (PRs), log-based regression models, and interaction analysis were used to describe the association of sexual orientation with up-to-date screening. Results: The sample included 5167 cisgender women (447 LGB and 4720 heterosexual), aged 25 to 64 years, with no history of hysterectomy. Among LGB cisgender women, 318 (71.14%) reported previous cervical cancer screening compared with 3632 (76.95%) heterosexual cisgender women. The prevalence of up-to-date screening was 10% lower in the LGB group compared with the heterosexual group (PR, 0.90; 95% CI, 0.82-1.00). In regression analysis, having a PCP (PR, 1.43; 95% CI, 1.29-1.59) was associated with up-to-date screening. In interaction analysis, LGB cisgender women with a PCP were 93% more likely to be up-to-date compared with those without a PCP (PR, 1.93; 95% CI, 1.37-2.72). Conclusions and Relevance: In this cross-sectional study of cervical cancer screening rates between the heterosexual and LGB populations in Chicago, up-to-date cervical cancer screening was associated with having a PCP, regardless of sexual orientation, but this association was greater for LGB individuals. Although LGB populations were less likely to be screened, this disparity may be reduced with more consistent health care access and established care with PCPs.


Assuntos
Detecção Precoce de Câncer , Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Pessoa de Meia-Idade , Adulto , Estudos Transversais , Detecção Precoce de Câncer/estatística & dados numéricos , Estudos Retrospectivos , Chicago/epidemiologia , Teste de Papanicolaou/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos
5.
Geospat Health ; 19(1)2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38752862

RESUMO

Black sexually minoritized men (BSMM) are the most likely to acquire HIV in Chicago- a racially segregated city where their daily travel may confer different HIV-related risks. From survey and GPS data among participants of the Neighbourhoods and Networks Cohort Study, we examined spatial (proportion of total activity space away from home), temporal (proportion of total GPS points away from home), and motivation-specific (discordance between residential and frequented sex or socializing neighbourhoods) dimensions of mobility. To identify potential drivers of BSMM's risk, we then examined associations between mobility and sexual behaviours known to cause HIV transmission: condomless anal sex, condomless anal sex with a casual partner, transactional sex, group sex, and sex-drug use. Multivariable logistic regression models assessed associations. Of 269 cisgender BSMM, most were 20-29 years old, identified as gay, and lowincome. On average, 96.9% (Standard Deviation: 3.7%) of participants' activity space and 53.9% (Standard Deviation: 38.1%) of participants' GPS points occurred outside their 800m home network buffer. After covariate adjustment, those who reported sex away from home were twice as likely to report condomless sex (Odds Ratio: 2.02, [95% Confidence Interval (CI): 1.08, 3.78]). Those who reported socializing away from home were four times more likely to have condomless sex with a casual partner (Odds Ratio: 4.16 [CI: 0.99, 29.0]). BSMM are on the move in Chicago, but only motivation-specific mobility may increase HIV transmission risk. Multidimensional investigations of mobility can inform place-based strategies for HIV service delivery.


Assuntos
Infecções por HIV , Comportamento Sexual , Humanos , Masculino , Chicago/epidemiologia , Adulto , Infecções por HIV/epidemiologia , Adulto Jovem , Negro ou Afro-Americano/estatística & dados numéricos , Sistemas de Informação Geográfica , Características de Residência , Minorias Sexuais e de Gênero/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Assunção de Riscos , Viagem
6.
PLoS One ; 19(5): e0303499, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38743699

RESUMO

BACKGROUND: Older adults with HIV are at increased risk of developing certain chronic health conditions including type 2 diabetes mellitus (T2DM). As the number and complexity of conditions increases, so do treatment and health care needs. We explored patient and clinician preferences for HIV+T2DM care and perceived solutions to improving care. METHODS: We conducted an exploratory qualitative study comprised of individual in-depth interviews. Participants included English-speaking patients aged 50 and older living with HIV and T2DM and infectious disease (ID) and primary care (PC) clinicians from a large academic health center in Chicago. Thematic analysis drew from the Framework Method. RESULTS: A total of 19 patient and 10 clinician participants were interviewed. Many patients reported seeking HIV and T2DM care from the same clinician; they valued rapport and a 'one-stop-shop'. Others reported having separate clinicians; they valued perceived expertise and specialty care. Nearly all clinicians reported comfort screening for T2DM and initiating first line oral therapy; ID clinicians reported placing referrals for newer, complex therapies. Patients would like educational support for T2DM management; clinicians would like to learn more about newer therapies and easier referral processes. CONCLUSIONS: Patient-centered care includes managing T2DM from a variety of clinical settings for individuals with HIV, yet strategies are needed to better support clinicians. Future research should examine how best to implement these strategies.


Assuntos
Diabetes Mellitus Tipo 2 , Infecções por HIV , Preferência do Paciente , Pesquisa Qualitativa , Humanos , Infecções por HIV/psicologia , Infecções por HIV/epidemiologia , Infecções por HIV/terapia , Infecções por HIV/complicações , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Preferência do Paciente/psicologia , Comorbidade , Gerenciamento Clínico , Chicago/epidemiologia
7.
Accid Anal Prev ; 200: 107566, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38574604

RESUMO

In this paper, a framework is outlined to generate realistic artificial data (RAD) as a tool for comparing different models developed for safety analysis. The primary focus of transportation safety analysis is on identifying and quantifying the influence of factors contributing to traffic crash occurrence and its consequences. The current framework of comparing model structures using only observed data has limitations. With observed data, it is not possible to know how well the models mimic the true relationship between the dependent and independent variables. Further, real datasets do not allow researchers to evaluate the model performance for different levels of complexity of the dataset. RAD offers an innovative framework to address these limitations. Hence, we propose a RAD generation framework embedded with heterogeneous causal structures that generates crash data by considering crash occurrence as a trip level event impacted by trip level factors, demographics, roadway and vehicle attributes. Within our RAD generator we employ three specific modules: (a) disaggregate trip information generation, (b) crash data generation and (c) crash data aggregation. For disaggregate trip information generation, we employ a daily activity-travel realization for an urban region generated from an established activity-based model for the Chicago region. We use this data of more than 2 million daily trips to generate a subset of trips with crash data. For trips with crashes crash location, crash type, driver/vehicle characteristics, and crash severity. The daily RAD generation process is repeated for generating crash records at yearly or multi-year resolution. The crash databases generated can be employed to compare frequency models, severity models, crash type and various other dimensions by facility type - possibly establishing a universal benchmarking system for alternative model frameworks in safety literature.


Assuntos
Acidentes de Trânsito , Meios de Transporte , Humanos , Acidentes de Trânsito/prevenção & controle , Viagem , Bases de Dados Factuais , Chicago
8.
Int J Equity Health ; 23(1): 74, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38622612

RESUMO

BACKGROUND: Adverse childhood experiences (ACE) are important predictors of mental health outcomes in adulthood. However, commonly used ACE measures such as the Behavioural Risk Factor Surveillance System (BRFSS) have not been validated among Black sexually minoritized men (SMM) nor transgender women (TW), whom are known to have higher rates of ACE and poorer mental health outcomes. Assessing the psychometric properties of the measure is important for health equity research, as measurements that are not valid for some populations will render uninterpretable results. METHODS: Data are drawn from the Neighborhoods and Networks (N2) study, a longitudinal cohort of Black SMM and TW living in Southern Chicago. We conducted confirmatory factor analysis, correlation analysis and a two-parameter Item Response Theory (IRT) on the BRFSS ACE measure, an 11-item measure with 8 domains of ACE. RESULTS: One hundred forty seven participants (85% cisgender male) completed the BRFSS ACE measurement in the N2 study with age ranges from 16-34. The cohort were from a low socioeconomic background: about 40% of the cohort were housing insecure and made than $10,000 or less annually. They also have a high number of ACEs; 34% had endorsed 4 or more ACE domains. The three-factor structure fit the BRFSS ACE measure best; the measurement consisted of three subscales: of "Household Dysfunction", "Emotional / Physical", and "Sexual Abuse" (CFI = 0.975, TLI = 0.967, and RMSEA = 0.051). When the 8 domains of ACE were summed to one score, the total score was is correlated with depressive symptoms and anxiety scores, establishing concurrent validity. Item Response Theory model indicated that the "parental separation" domain had a low discrimination (slope) parameter, suggesting that this domain does not distinguish well between those with and without high ACE. CONCLUSIONS: The BRFFS ACE measure had adequate reliability, a well-replicated structure and some moderate evidence of concurrent validity among Black SMM and TW. The parental separation domain does not discriminate between those with high and low ACE experiences in this population. With changing population demographics and trends in marriage, further examination of this item beyond the current study is warranted to improve health equity research for all.


Assuntos
Experiências Adversas da Infância , Pessoas Transgênero , Humanos , Masculino , Feminino , Reprodutibilidade dos Testes , Chicago , Fatores de Risco
9.
PLoS One ; 19(4): e0295293, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38598554

RESUMO

RiSE study aims to evaluate a race-based stress-reduction intervention as an effective strategy to improve coping and decrease stress-related symptoms, inflammatory burden, and modify DNA methylation of stress response-related genes in older AA women. This article will describe genomic analytic methods to be utilized in this longitudinal, randomized clinical trial of older adult AA women in Chicago and NYC that examines the effect of the RiSE intervention on DNAm pre- and post-intervention, and its overall influence on inflammatory burden. Salivary DNAm will be measured at baseline and 6 months following the intervention, using the Oragene-DNA kit. Measures of perceived stress, depressive symptoms, fatigue, sleep, inflammatory burden, and coping strategies will be assessed at 4 time points including at baseline, 4 weeks, 8 weeks, and 6 months. Genomic data analysis will include the use of pre-processed and quality-controlled methylation data expressed as beta (ß) values. Association analyses will be performed to detect differentially methylated sites on the targeted candidate genes between the intervention and non-intervention groups using the Δß (changes in methylation) with adjustment for age, health behaviors, early life adversity, hybridization batch, and top principal components of the probes as covariates. To account for multiple testing, we will use FDR adjustment with a corrected p-value of <0.05 regarded as statistically significant. To assess the relationship between inflammatory burden and Δß among the study samples, we will repeat association analyses with the inclusion of individual inflammation protein measures. ANCOVA will be used because it is more statistically powerful to detect differences.


Assuntos
Negro ou Afro-Americano , Metilação de DNA , Humanos , Feminino , Idoso , Negro ou Afro-Americano/genética , Chicago , Inflamação/genética , Genômica
10.
PLoS One ; 19(4): e0296486, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38630687

RESUMO

Crime remains a crucial concern regarding ensuring a safe and secure environment for the public. Numerous efforts have been made to predict crime, emphasizing the importance of employing deep learning approaches for precise predictions. However, sufficient crime data and resources for training state-of-the-art deep learning-based crime prediction systems pose a challenge. To address this issue, this study adopts the transfer learning paradigm. Moreover, this study fine-tunes state-of-the-art statistical and deep learning methods, including Simple Moving Averages (SMA), Weighted Moving Averages (WMA), Exponential Moving Averages (EMA), Long Short Term Memory (LSTM), Bi-directional Long Short Term Memory (BiLSTMs), and Convolutional Neural Networks and Long Short Term Memory (CNN-LSTM) for crime prediction. Primarily, this study proposed a BiLSTM based transfer learning architecture due to its high accuracy in predicting weekly and monthly crime trends. The transfer learning paradigm leverages the fine-tuned BiLSTM model to transfer crime knowledge from one neighbourhood to another. The proposed method is evaluated on Chicago, New York, and Lahore crime datasets. Experimental results demonstrate the superiority of transfer learning with BiLSTM, achieving low error values and reduced execution time. These prediction results can significantly enhance the efficiency of law enforcement agencies in controlling and preventing crime.


Assuntos
Aprendizado Profundo , Chicago , Crime , Conhecimento , Memória de Longo Prazo
11.
J Occup Environ Hyg ; 21(5): 365-377, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38560920

RESUMO

The COVID-19 pandemic led to widespread consequences for economic, social, and general wellbeing with rates of anxiety and depression increasing across the population and disproportionately for some workers. This study explored which factors were the most salient contributors to mental health through a cross-sectional 68-item questionnaire that addressed topics related to the pandemic. Data were collected through an address-based sampling frame over the two months from April 2022 to June 2022. A total of 2,049 completed surveys were collected throughout Chicago's 77 Community Areas. Descriptive statistics including frequency and percentages were generated to describe workplace characteristics, work-related stress, and sample demographics and their relationship to psychological distress. Independent participant and workplace factors associated with the outcomes were identified using multivariable logistic regression. The weighted prevalence of persons experiencing some form of psychological distress from mild to serious was 32%. After adjusting for potential confounding factors, certain marginalized communities experienced psychological distress more than others including females, adults over the age of 25 years of age, and people with higher income levels. Those who had been laid off, lost pay, or had reduced hours had increased odds of psychological distress (aOR = 1.71, CI95% 1.14-2.56; p = 0.009) as did people that reported that their work-related stress was somewhat or much worse as compared to before the COVID-19 pandemic (aOR = 2.22, CI95% 1.02-4.82; p = 0.04, aOR = 11.0, CI95% 4.65-26.1; p < 0.001, respectively). These results warrant further investigation and consideration in developing workplace and mental health interventions.


Assuntos
COVID-19 , Saúde Mental , SARS-CoV-2 , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Chicago/epidemiologia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Inquéritos e Questionários , Local de Trabalho/psicologia , Adulto Jovem , Idoso , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/psicologia , Pandemias , Adolescente , Depressão/epidemiologia , Estresse Psicológico/epidemiologia , Ansiedade/epidemiologia , Angústia Psicológica
12.
J Am Heart Assoc ; 13(9): e031619, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38656121

RESUMO

BACKGROUND: Cognitive decline may progress for decades before dementia onset. Better cardiovascular health (CVH) has been related to less cognitive decline, but it is unclear whether this begins early, for all racial subgroups, and all domains of cognitive function. The purpose of this study was to determine the impact of CVH on decline in the 2 domains of cognition that decline first in White and Black women at midlife. METHODS AND RESULTS: Subjects were 363 Black and 402 White women, similar in baseline age (mean±SD, 46.6±3.0 years) and education (15.7±2.0 years), from the Chicago site of the Study of Women's Health Across the Nation. Cognition, measured as processing speed and working memory, was assessed annually or biennially over a maximum of 20 years (mean±SD, 9.8±6.7 years). CVH was measured as Life's Essential 8 (blood pressure, body mass index, glucose, non-high-density lipoprotein cholesterol, smoking, physical activity, diet, sleep). Hierarchical linear mixed models identified predictors of cognitive decline with progressive levels of adjustment. There was a decline in processing speed that was explained by race, age, and the 3-way interaction of race, CVH, and time (F1,4308=8.8, P=0.003). CVH was unrelated to decline in White women but in Black women poorer CVH was associated with greater decline. Working memory did not decline in the total cohort, by race, or by CVH. CONCLUSIONS: In midlife Black women, CVH promotion may be a target for preventing the beginnings of cognitive decline, thereby enhancing independent living with aging.


Assuntos
Negro ou Afro-Americano , Cognição , Disfunção Cognitiva , Memória de Curto Prazo , População Branca , Saúde da Mulher , Humanos , Feminino , Pessoa de Meia-Idade , Saúde da Mulher/etnologia , Negro ou Afro-Americano/psicologia , Cognição/fisiologia , População Branca/estatística & dados numéricos , Memória de Curto Prazo/fisiologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etnologia , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/diagnóstico , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/psicologia , Fatores de Risco , Chicago/epidemiologia , Estados Unidos/epidemiologia , Adulto , Fatores Etários , Envelhecimento Cognitivo/psicologia , Fatores de Risco de Doenças Cardíacas
13.
Sensors (Basel) ; 24(8)2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38676110

RESUMO

In urban areas like Chicago, daily life extends above ground level due to the prevalence of high-rise buildings where residents and commuters live and work. This study examines the variation in fine particulate matter (PM2.5) concentrations across building stories. PM2.5 levels were measured using PurpleAir sensors, installed between 8 April and 7 May 2023, on floors one, four, six, and nine of an office building in Chicago. Additionally, data were collected from a public outdoor PurpleAir sensor on the fourteenth floor of a condominium located 800 m away. The results show that outdoor PM2.5 concentrations peak at 14 m height, and then decline by 0.11 µg/m3 per meter elevation, especially noticeable from midnight to 8 a.m. under stable atmospheric conditions. Indoor PM2.5 concentrations increase steadily by 0.02 µg/m3 per meter elevation, particularly during peak work hours, likely caused by greater infiltration rates at higher floors. Both outdoor and indoor concentrations peak around noon. We find that indoor and outdoor PM2.5 are positively correlated, with indoor levels consistently remaining lower than outside levels. These findings align with previous research suggesting decreasing outdoor air pollution concentrations with increasing height. The study informs decision-making by community members and policymakers regarding air pollution exposure in urban settings.


Assuntos
Poluição do Ar em Ambientes Fechados , Monitoramento Ambiental , Material Particulado , Material Particulado/análise , Chicago , Poluição do Ar em Ambientes Fechados/análise , Monitoramento Ambiental/métodos , Humanos , Poluentes Atmosféricos/análise , Poluição do Ar/análise
14.
Artigo em Inglês | MEDLINE | ID: mdl-38673296

RESUMO

This study analyzes the prevalence of elevated blood lead levels (BLLs) in children across Chicagoland zip codes from 2019 to 2021, linking them to socioeconomic, environmental, and racial factors. Wilcoxon tests and generalized additive model (GAM) regressions identified economic hardship, reflected in per capita income and unemployment rates, as a significant contributor to increased lead poisoning (LP) rates. Additionally, LP rates correlate with the average age of buildings, particularly post the 1978 lead paint ban, illustrating policy impacts on health outcomes. The study further explores the novel area of land surface temperature (LST) effects on LP, finding that higher nighttime LST, indicative of urban heat island effects, correlates with increased LP. This finding gains additional significance in the context of anthropogenic climate change. When these factors are combined with the ongoing expansion of urban territories, a significant risk exists of escalating LP rates on a global scale. Racial disparity analysis revealed that Black and Hispanic/Latino populations face higher LP rates, primarily due to unemployment and older housing. The study underscores the necessity for targeted public health strategies to address these disparities, emphasizing the need for interventions that cater to the unique challenges of these at-risk communities.


Assuntos
Intoxicação por Chumbo , Chumbo , Fatores Socioeconômicos , Humanos , Chumbo/sangue , Intoxicação por Chumbo/sangue , Intoxicação por Chumbo/epidemiologia , Pré-Escolar , Chicago , Lactente , Masculino , Exposição Ambiental/estatística & dados numéricos , Feminino , Criança
15.
Artigo em Inglês | MEDLINE | ID: mdl-38673406

RESUMO

Medical advocacy has continued to significantly impact quality of life and survivorship outcomes among Latina breast cancer survivors in the United States. However, little is known about the unique experiences of Latina survivors, including the perceived value, process, and context in which they practice medical advocacy. To help address this gap, we conducted a qualitative, secondary analysis of semi-structured focus groups with 18 Latina breast cancer survivors from Chicago, Illinois. Eligible women had to self-identify as (1) female, (2) Latina, (3) 18 years or older, and (4) having a breast cancer diagnosis 5 years ago or more. In total, 61% of participants were 50-59 years old, 83% were born in Mexico, and 100% spoke Spanish. The three emergent themes from the focus groups were (1) the cultural need for Latina advocates and support groups; (2) the process and experiences of becoming a community advocate within Latine culture; and (3) the cultural contexts for advocacy by Latina breast cancer survivors. Latina survivor advocates share strengths of receiving ongoing health education, peer support, and access to resources when being linked to a support group furthering their exposure to role models, increasing their awareness of opportunities in medical advocacy, and providing an entry to participate in medical advocacy.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Grupos Focais , Hispânico ou Latino , Humanos , Neoplasias da Mama/psicologia , Neoplasias da Mama/etnologia , Feminino , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Pessoa de Meia-Idade , Sobreviventes de Câncer/psicologia , Sobreviventes de Câncer/estatística & dados numéricos , Defesa do Paciente , Chicago , Adulto , Idoso , Qualidade de Vida
16.
J Urban Health ; 101(2): 318-326, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38565779

RESUMO

Rats are an understudied stressor for people in urban environments around the world but the effects may not be distributed equally among residents. In this study, we examined associations between residential rat sightings and mental health in Chicago, where rat complaints are the highest of any American city. We examined how this relationship varied by frequency of rat sightings, race, ethnicity, income, home ownership, and gender and explored potential psychosocial pathways (e.g., feelings about the home) between rat sightings and mental distress. We conducted a randomized household survey along an income gradient in 2021 and asked about depressive symptoms in the past week (i.e., Center for Epidemiologic Studies Depression scale), frequency of rat sightings in/around the home, perceptions of rats, neighborhood conditions, and socio-demographic characteristics. We used logistic regression to assess relationships among these variables for our entire sample and for specific demographics using stratified models. Respondents (n = 589; 409 complete cases) who saw rats in/around the home daily/almost daily had 5.5 times higher odds of reporting high depressive symptoms relative to respondents who saw rats less frequently after accounting for socio-demographics and neighborhood conditions. This relationship was significant for men and respondents with lower incomes or race or ethnicity other than white. Our results show that rat infestations should be considered a threat to mental health among urban residents. Increased mental health support for residents living in rat-infested housing may improve public health in cities.


Assuntos
Depressão , Saúde Mental , Animais , Chicago/epidemiologia , Masculino , Humanos , Feminino , Ratos , Depressão/epidemiologia , Adulto , Pessoa de Meia-Idade , Fatores Sexuais , Renda/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Fatores Socioeconômicos , Grupos Raciais/estatística & dados numéricos , Adulto Jovem , Fatores Sociodemográficos
17.
JMIR Mhealth Uhealth ; 12: e51637, 2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38686560

RESUMO

Background: The COVID-19 pandemic accelerated telemedicine and mobile app use, potentially changing our historic model of maternity care. MyChart is a widely adopted mobile app used in health care settings specifically for its role in facilitating communication between health care providers and patients with its messaging function in a secure patient portal. However, previous studies analyzing portal use in obstetric populations have demonstrated significant sociodemographic disparities in portal enrollment and messaging, specifically showing that patients who have a low income and are non-Hispanic Black, Hispanic, and uninsured are less likely to use patient portals. Objective: The study aimed to estimate changes in patient portal use and intensity in prenatal care before and during the pandemic period and to identify sociodemographic and clinical disparities that continued during the pandemic. Methods: This retrospective cohort study used electronic medical record (EMR) and administrative data from our health system's Enterprise Data Warehouse. Records were obtained for the first pregnancy episode of all patients who received antenatal care at 8 academically affiliated practices and delivered at a large urban academic medical center from January 1, 2018, to July 22, 2021, in Chicago, Illinois. All patients were aged 18 years or older and attended ≥3 clinical encounters during pregnancy at the practices that used the EMR portal. Patients were categorized by the number of secure messages sent during pregnancy as nonusers or as infrequent (≤5 messages), moderate (6-14 messages), or frequent (≥15 messages) users. Monthly portal use and intensity rates were computed over 43 months from 2018 to 2021 before, during, and after the COVID-19 pandemic shutdown. A logistic regression model was estimated to identify patient sociodemographic and clinical subgroups with the highest portal nonuse. Results: Among 12,380 patients, 2681 (21.7%) never used the portal, and 2680 (21.6%), 3754 (30.3%), and 3265 (26.4%) were infrequent, moderate, and frequent users, respectively. Portal use and intensity increased significantly over the study period, particularly after the pandemic. The number of nonusing patients decreased between 2018 and 2021, from 996 of 3522 (28.3%) in 2018 to only 227 of 1743 (13%) in the first 7 months of 2021. Conversely, the number of patients with 15 or more messages doubled, from 642 of 3522 (18.2%) in 2018 to 654 of 1743 (37.5%) in 2021. The youngest patients, non-Hispanic Black and Hispanic patients, and, particularly, non-English-speaking patients had significantly higher odds of continued nonuse. Patients with preexisting comorbidities, hypertensive disorders of pregnancy, diabetes, and a history of mental health conditions were all significantly associated with higher portal use and intensity. Conclusions: Reducing disparities in messaging use will require outreach and assistance to low-use patient groups, including education addressing health literacy and encouraging appropriate and effective use of messaging.


Assuntos
COVID-19 , Portais do Paciente , Cuidado Pré-Natal , Humanos , Feminino , Estudos Retrospectivos , Gravidez , Adulto , Cuidado Pré-Natal/estatística & dados numéricos , Cuidado Pré-Natal/psicologia , COVID-19/epidemiologia , Estudos de Coortes , Portais do Paciente/estatística & dados numéricos , Chicago , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Telemedicina/métodos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Gestantes/psicologia , Gestantes/etnologia , Pandemias
18.
JAMA Pediatr ; 178(5): 473-479, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38497944

RESUMO

Importance: There is no level of lead in drinking water considered to be safe, yet lead service lines are still commonly used in water systems across the US. Objective: To identify the extent of lead-contaminated drinking water in Chicago, Illinois, and model its impact on children younger than 6 years. Design, Setting, and Participants: For this cross-sectional study, a retrospective assessment was performed of lead exposure based on household tests collected from January 2016 to September 2023. Tests were obtained from households in Chicago that registered for a free self-administered testing service for lead exposure. Machine learning and microsimulation were used to estimate citywide childhood lead exposure. Exposure: Lead-contaminated drinking water, measured in parts per billion. Main Outcomes and Measures: Number of children younger than 6 years exposed to lead-contaminated water. Results: A total of 38 385 household lead tests were collected. An estimated 68% (95% uncertainty interval, 66%-69%) of children younger than 6 years were exposed to lead-contaminated water, corresponding to 129 000 children (95% uncertainty interval, 128 000-131 000 children). Ten-percentage-point increases in block-level Black and Hispanic populations were associated with 3% (95% CI, 2%-3%) and 6% (95% CI, 5%-7%) decreases in odds of being tested for lead and 4% (95% CI, 3%-6%) and 11% (95% CI, 10%-13%) increases in having lead-contaminated drinking water, respectively. Conclusions and Relevance: These findings indicate that childhood lead exposure is widespread in Chicago, and racial inequities are present in both testing rates and exposure levels. Machine learning may assist in preliminary screening for lead exposure, and efforts to remediate the effects of environmental racism should involve improving outreach for and access to lead testing services.


Assuntos
Água Potável , Exposição Ambiental , Intoxicação por Chumbo , Chumbo , Humanos , Chicago , Estudos Retrospectivos , Estudos Transversais , Exposição Ambiental/efeitos adversos , Pré-Escolar , Chumbo/sangue , Lactente , Intoxicação por Chumbo/epidemiologia , Intoxicação por Chumbo/diagnóstico , Intoxicação por Chumbo/etiologia , Masculino , Feminino , Poluentes Químicos da Água/análise , Criança
19.
J Am Mosq Control Assoc ; 40(1): 78-80, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38427587

RESUMO

Over the course of three years, 200 ft to 0.75 mi (60 m to 1.2 km) sections of 3 larger (>6 ft [1.8 m] diam) belowground storm sewer conveyance pipes in the northwestern Chicago suburbs were inspected for the presence of adult mosquitoes. Culex mosquitoes were by far the most common (555 of 556 [99.8%] total mosquitoes) collected within pipes during all four meteorological seasons (i.e. during months of October, January, May, August). These observations support prior work elsewhere, suggesting storm sewer pipes are consistent sites of refuge for adult Culex mosquitoes.


Assuntos
Culex , Culicidae , Animais , Chicago , Estações do Ano
20.
MMWR Morb Mortal Wkly Rep ; 73(9): 199-203, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38451858

RESUMO

Approximately 1,000 out-of-hospital cardiac arrests (OHCAs) are assessed by emergency medical services in the United States every day, and approximately 90% of patients do not survive, leading to substantial years of potential life lost (YPLL). Chicago emergency medical services data were used to assess changes in mean age and YPLL from nontraumatic OHCA in adults in biennial cycles during 2014-2021. Among 21,070 reported nontraumatic OHCAs during 2014-2021, approximately 60% occurred among men and 57% among non-Hispanic Black or African American (Black) persons. YPLL increased from 52,044 during 2014-2015 to 88,788 during 2020-2021 (p = 0.002) and mean age decreased from 64.7 years during 2014-2015, to 62.7 years during 2020-2021. Decrease in mean age occurred among both men (p<0.001) and women (p = 0.002) and was largest among Black men. Mean age decreased among patients without presumed cardiac etiology from 56.3 to 52.5 years (p<0.001) and among patients with nonshockable rhythm from 65.5 to 62.7 years (p<0.001). Further study is needed to assess whether similar trends are occurring elsewhere, and to understand the mechanisms that underlie these trends in Chicago because these mechanisms could help guide prevention efforts. Increased public awareness of the risk of cardiac arrest and knowledge of how to intervene as a bystander could help decrease associated mortality.


Assuntos
Reanimação Cardiopulmonar , Serviços Médicos de Emergência , Parada Cardíaca Extra-Hospitalar , Masculino , Adulto , Humanos , Feminino , Estados Unidos , Pessoa de Meia-Idade , Parada Cardíaca Extra-Hospitalar/epidemiologia , Parada Cardíaca Extra-Hospitalar/terapia , Chicago/epidemiologia , Expectativa de Vida
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