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1.
Am Psychol ; 76(5): 812-814, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34780222

RESUMO

This award recognizes a distinguished career and enduring contribution to the practice of psychology. Samuel Knapp's long, distinguished career has resulted in demonstrable effects and significant contributions to best practices in professionalism, ethics education, positive ethics, and legislative advocacy as Director of Professional Affairs for the Pennsylvania Psychological Association and as an ethics educator extraordinaire. Dr. Knapp's work has modified the way psychologists think about professional ethics through education, from avoiding disciplinary consequences to promoting overarching ethical principles to achieve the highest standards of ethical behavior. His focus on respectful collaboration among psychologists promotes honesty through nonjudgmental conversations. His Ethics Educators Workshop and other continuing education programs have brought together psychology practitioners and faculty to focus deeply on ethics and resulted in the development of the APA Ethics Educators Award. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Distinções e Prêmios , Comunicação , Ética Profissional , História do Século XX , História do Século XXI , Princípios Morais , Pennsylvania , Psicologia
4.
Pract Radiat Oncol ; 11(5): 310-312, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34479658

RESUMO

I am a radiation oncologist with a busy clinical practice in Pennsylvania. I am credentialed to certify patients for medical marijuana and recommend that my patients try medical marijuana when symptom control with other options is suboptimal. This invited contribution is a brief summary of information that may help radiation oncologists understand their potential role in getting patients access to medical marijuana and my perspective on its potential value in the care of our patients.


Assuntos
Maconha Medicinal , Neoplasias , Humanos , Maconha Medicinal/uso terapêutico , Neoplasias/tratamento farmacológico , Pennsylvania , Radio-Oncologistas
5.
J Med Microbiol ; 70(9)2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34542396

RESUMO

To the best of our knowledge to date there are no scientific studies specifically investigating whether the SARS-CoV-2 virus is present in the air or on the various surfaces in the school environment. The aim of this study was to determine if SARS-CoV-2 is present on various high touch surfaces and in the air across the elementary, middle and high schools in the Chester County of Pennsylvania, USA. One hundred and fifty surface swab samples and 45 air samples were analysed for the presence of the virus. All the samples tested were negative for the presence of SARS-CoV-2. The results indicate that the spread of the virus through contact and through air in the school buildings across the USA is highly unlikely.


Assuntos
Microbiologia do Ar , COVID-19 , Pandemias/prevenção & controle , SARS-CoV-2/isolamento & purificação , Instituições Acadêmicas , COVID-19/transmissão , COVID-19/virologia , Humanos , Pennsylvania/epidemiologia
6.
Nutrients ; 13(9)2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34579014

RESUMO

Early care and education (ECE) settings are important avenues for reaching young children and their families with food and nutrition resources, including through the U.S. federally funded Child and Adult Care Food Program (CACFP). Researchers conducted a cross-sectional survey of ECE providers in two U.S. states in November 2020 to identify approaches used to connect families with food and nutrition resources amid the COVID-19 pandemic. Logistic regression models were used to estimate odds of sites reporting no approaches and adjusted Poisson models were used to estimate the incidence rate ratio of the mean number of approaches, comparing sites that participate in CACFP to those that did not. A total of 589 ECE sites provided responses. Of those, 43% (n = 255) participated in CACFP. CACFP participating sites were more likely to report using any approaches to connecting families to food resources and significantly more likely to report offering "grab and go" meals, providing meal delivery, distributing food boxes to families, and recommending community food resources than non-CACFP sites. This study suggests that CACFP sites may have greater capacity to connect families to food resources amid emergencies than non-CACFP participating sites.


Assuntos
COVID-19 , Creches/estatística & dados numéricos , Assistência Alimentar/estatística & dados numéricos , Serviços de Alimentação/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Adulto , Arizona , Pré-Escolar , Estudos Transversais , Fast Foods , Feminino , Abastecimento de Alimentos/métodos , Humanos , Modelos Logísticos , Masculino , Pennsylvania , Distribuição de Poisson , SARS-CoV-2
7.
J Invertebr Pathol ; 185: 107667, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34560106

RESUMO

Managed and wild bee populations are in decline around the globe due to several biotic and abiotic stressors. Pathogenic viruses associated with the Western honey bee (Apis mellifera) have been identified as key contributors to losses of managed honey bee colonies, and are known to be transmitted to wild bee populations through shared floral resources. However, little is known about the prevalence and intensity of these viruses in wild bee populations, or how bee visitation to flowers impacts viral transmission in agroecosystems. This study surveyed honey bee, bumble bee (Bombus impatiens) and wild squash bee (Eucera (Peponapis) pruinosa) populations in Cucurbita agroecosystems across Pennsylvania (USA) for the prevalence and intensity of five honey bee viruses: acute bee paralysis virus (ABPV), deformed wing virus (DWV), Israeli acute paralysis virus (IAPV), Kashmir bee virus (KBV), and slow bee paralysis virus (SBPV). We investigated the potential role of bee visitation rate to flowers on DWV intensity among species in the pollinator community, with the expectation that increased bee visitation to flowers would increase the opportunity for transmission events between host species. We found that honey bee viruses are highly prevalent but in lower titers in wild E. pruinosa and B. impatiens than in A. mellifera populations throughout Pennsylvania (USA). DWV was detected in 88% of B. impatiens, 48% of E. pruinosa, and 95% of A. mellifera. IAPV was detected in 5% of B. impatiens and 4% of E. pruinosa, compared to 9% in A. mellifera. KBV was detected in 1% of B. impatiens and 5% of E. pruinosa, compared to 32% in A. mellifera. Our results indicate that DWV titers are not correlated with bee visitation in Cucurbita fields. The potential fitness impacts of these low viral titers detected in E. pruinosa remain to be investigated.


Assuntos
Abelhas/virologia , Vírus de Insetos/fisiologia , Vírus de RNA de Cadeia Positiva/fisiologia , Animais , Produtos Agrícolas , Cucurbita , Dicistroviridae/fisiologia , Pennsylvania , Polinização , Vírus de RNA/fisiologia , Especificidade da Espécie
8.
Influenza Other Respir Viruses ; 15(6): 757-766, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34477304

RESUMO

BACKGROUND: Children are important in community-level influenza transmission. School-based monitoring may inform influenza surveillance. METHODS: We used reported weekly confirmed influenza in Allegheny County during the 2007 and 2010-2015 influenza seasons using Pennsylvania's Allegheny County Health Department all-age influenza cases from health facilities, and all-cause and influenza-like illness (ILI)-specific absences from nine county school districts. Negative binomial regression predicted influenza cases using all-cause and illness-specific absence rates, calendar week, average weekly temperature, and relative humidity, using four cross-validations. RESULTS: School districts reported 2 184 220 all-cause absences (2010-2015). Three one-season studies reported 19 577 all-cause and 3012 ILI-related absences (2007, 2012, 2015). Over seven seasons, 11 946 confirmed influenza cases were reported. Absences improved seasonal model fits and predictions. Multivariate models using elementary school absences outperformed middle and high school models (relative mean absolute error (relMAE) = 0.94, 0.98, 0.99). K-5 grade-specific absence models had lowest mean absolute errors (MAE) in cross-validations. ILI-specific absences performed marginally better than all-cause absences in two years, adjusting for other covariates, but markedly worse one year. CONCLUSIONS: Our findings suggest seasonal models including K-5th grade absences predict all-age-confirmed influenza and may serve as a useful surveillance tool.


Assuntos
Influenza Humana , Criança , Humanos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Pennsylvania/epidemiologia , Instituições Acadêmicas , Estações do Ano , Temperatura
9.
Am J Phys Med Rehabil ; 100(11): 1031-1032, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34483264

RESUMO

ABSTRACT: This brief report summarizes the comparative experience of an inpatient rehabilitation facility dealing with two episodes of COVID-19 infection, one before and one after the availability of vaccination, which was deployed to staff. The experience exemplifies the high rate of infection and potential for asymptomatic presentation of COVID-19 as well as the protective advantage of the vaccine for healthcare workers in this report. With a significant reduction in the rate of infection, from nearly 30% before vaccination to only 2.5% after vaccination. The data presented should serve as an encouragement for vaccination across all populations.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Pessoal de Saúde , Controle de Infecções/normas , Pneumonia Viral/prevenção & controle , Centros de Reabilitação , Adulto , COVID-19/epidemiologia , Surtos de Doenças/prevenção & controle , Feminino , Fidelidade a Diretrizes , Humanos , Pacientes Internados , Masculino , Programas de Rastreamento , Pennsylvania/epidemiologia , Pneumonia Viral/virologia , SARS-CoV-2
10.
Accid Anal Prev ; 161: 106345, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34419653

RESUMO

Individual collision types have different underlying causes and thus the relationships between roadway/traffic characteristics and crash frequency are likely to differ across unique collision types. One way these different influences have been studied is by developing separate statistical models for each collision type. While this is the most straightforward approach, developing collision-specific models can be very tedious and can produce unreliable estimates for collision types that are less frequently observed. Moreover, ignoring correlations between different collision types may result in biased and inefficient parameter estimation. To overcome these limitations, researchers have adopted a multivariate approach that explicitly accounts for the correlation among individual collision types. As an alternative to multivariate approach, two-stage approaches have been proposed in which one model is estimated to predict total crash frequency and its prediction is combined with another model, used to predict the proportions of different collision types. More efficient one-stage joint models, in which both the frequency and proportion models are estimated simultaneously and predictions are provided more directly, have also been proposed for macro-level analysis. This study investigates the performance of this joint model paradigm in analyzing unique collision type frequencies on individual road segments. For this, a joint negative binomial-multinomial fractional split (NB-MFS) model is used. Moreover, this study also proposes the use of a multinomial logit (MNL) model to estimate the proportion of different collision types. As total crash frequency NB model and MNL model utilize different datasets, a two-stage estimation process is required, which leads to the two-stage NB-MNL model proposed here. The performance of proposed model is compared with that of collision-specific NB models, multivariate negative binomial (MVNB) model, and NB-MFS model in predicting crash frequency by collision type on two-way two-lane urban-suburban collector roadway segments in Pennsylvania. The goodness of fit statistics show that the NB-MNL model performs better than collision-specific NB models, MVNB model and joint NB-MFS model and is thus a promising approach in predicting crash frequency by collision type.


Assuntos
Acidentes de Trânsito , Modelos Estatísticos , Planejamento Ambiental , Pennsylvania , Segurança
11.
Obstet Gynecol ; 138(3): 467-471, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34352854

RESUMO

Intrauterine pregnancies of uncertain viability are common, and guidelines for diagnosing early pregnancy loss must balance the risk of interrupting a viable pregnancy with the anxiety and medical complications resulting from delayed diagnosis. Two cases of likely early pregnancy loss presenting as intrauterine pregnancies of uncertain viability are described, with stark differences in care availability related to state reproductive health care regulations. Onerous abortion restrictions, medical and societal stigma, and inherent pronatalism in diagnostic criteria interfere with the exercise of clinical judgment and can damage patients' physical or mental health.


Assuntos
Aborto Induzido/legislação & jurisprudência , Aborto Espontâneo/diagnóstico , Assistência Centrada no Paciente , Políticas , Diagnóstico Pré-Natal , Aborto Espontâneo/terapia , Adulto , Feminino , Humanos , New York , Pennsylvania , Gravidez
12.
Environ Sci Technol ; 55(18): 12153-12161, 2021 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-34463496

RESUMO

The Regional Greenhouse Gas Initiative (RGGI) is a cap-and-trade system targeting CO2 emissions from the electricity sector in the northeastern United States. As a major power producer and carbon emitter, Pennsylvania plans to join RGGI in 2022, which will affect both the carbon market (i.e., RGGI) and the regional electricity market (i.e., PJM). Combining a PJM power system model with a reduced-form model of CO2 emissions abatement from RGGI states that are not in PJM, we find the annual average emissions from power plants in Pennsylvania can be reduced by 40%, 79%, 68%, and 76% for CO2, SO2, NOx, and PM2.5, respectively, during 2022-2030. Then, based on a range of source-specific marginal damage estimates, we find the cumulative monetized health cobenefits to be 17.7 to 40.8 billion USD. However, the reduced emissions and health damages in Pennsylvania are slightly offset by increases in the other states in PJM that do not participate in RGGI. Our study hence highlights the potential cross-state leakage issue that warrants careful consideration in the policy design and implementation process.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Gases de Efeito Estufa , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Poluição do Ar/prevenção & controle , Pennsylvania , Centrais Elétricas
14.
J Hist Dent ; 69(1): 70-72, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34383639

RESUMO

Humphrey Bogart's mother (Fig. 1)1 undoubtedly had a strange sense of humor. How else can one explain Maud Humphrey's bizarre image, on a stock trade card, of a lovely little lass dressed up in her Sunday best lighting the flame under a chafing dish containing two adorable kittens (Figs. 2-5)? Were kitten fondue or kitty feline stew, dishes du jour in Victorian times? Pictured here are three Victorian trade cards, related to dentistry, featuring Maud Humphrey's adorable little kitten chef. Dr. Eli H. Neiman of York, Pennsylvania, and Dr. Charles S. Decker of Binghamton, New York, chose this stock image to advertise their respective dental practices (Figs. 3 & 4), Ramon's Relief pain medication, including toothache relief, and RAMON'S LIVER PILLS AND TONIC PELLETS were available from W.E. JUDAY in West Manchester, Ohio (Figure 4). Note on the reverse of the Dr. Decker card, that for 50 cents "Vitalized Air for Painless Extracting" was offered. "Vitalized Air" was nitrous oxide altered with small amounts of chloroform and alcohol.2-4 Could it be that Maud had sniffed a bit of Vitalized Air before rendering her shocking kitty-cooking image?


Assuntos
Obras Pictóricas como Assunto , Animais , Gatos , Feminino , New York , Ohio , Pennsylvania
16.
Bull Hist Med ; 95(2): 169-197, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34393135

RESUMO

During its first seventy-five years (1850-1925), the Woman's Medical College of Pennsylvania (WMCP) graduated eighteen Black women-more than any other predominantly white medical school. This article examines the lives and careers of these "sisters of a darker race" as they sought a foothold in medicine. Its exclusive focus on WMCP allows historical examination of the experiences of Black medical professionals in a "white space." This perspective helps illuminate the racism that Black women encountered from their white colleagues. WMCP itself maintained a racially exclusionary internship policy that barred Black women and contributed to a racial divide in the female medical world, making plain its educational objective to prepare African Americans for medical careers in Black medical spaces. Nonetheless, WMCP did prepare this pioneering group of Black women physicians with the education and skills to make significant contributions to medicine and Black communities in the United States and Africa.


Assuntos
Afro-Americanos , Racismo , Feminino , Humanos , Pennsylvania , Faculdades de Medicina , Estados Unidos , Universidades
17.
Sci Total Environ ; 795: 148697, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34252768

RESUMO

How weather affects tick development and behavior and human Lyme disease remains poorly understood. We evaluated relations of temperature and humidity during critical periods for the tick lifecycle with human Lyme disease. We used electronic health records from 479,344 primary care patients in 38 Pennsylvania counties in 2006-2014. Lyme disease cases (n = 9657) were frequency-matched (5:1) by year, age, and sex. Using daily weather data at ~4 km2 resolution, we created cumulative metrics hypothesized to promote (warm and humid) or inhibit (hot and dry) tick development or host-seeking during nymph development (March 1-May 31), nymph activity (May 1-July 30), and prior year larva activity (Aug 1-Sept 30). We estimated odds ratios (ORs) of Lyme disease by quartiles of each weather variable, adjusting for demographic, clinical, and other weather variables. Exposure-response patterns were observed for higher cumulative same-year temperature, humidity, and hot and dry days (nymph-relevant), and prior year hot and dry days (larva-relevant), with same-year hot and dry days showing the strongest association (4th vs. 1st quartile OR = 0.40; 95% confidence interval [CI] = 0.36, 0.43). Changing temperature and humidity could increase or decrease human Lyme disease risk.


Assuntos
Ixodes , Doença de Lyme , Animais , Humanos , Umidade , Doença de Lyme/epidemiologia , Pennsylvania/epidemiologia , Temperatura
18.
Obstet Gynecol ; 138(1): 6-15, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34259458

RESUMO

OBJECTIVE: To evaluate differences in short-term perinatal outcomes between the two prominent screening strategies for gestational diabetes mellitus, the International Association of Diabetes and Pregnancy Study Groups (IADPSG) and Carpenter-Coustan. METHODS: In this single-site, blinded, randomized, comparative effectiveness trial, participants received a nonfasting 50-g oral glucose tolerance test and, if less than 200 mg/dL (less than 11.1 mmol/L), were randomized to further screening with either IADPSG or Carpenter-Coustan criteria. Gestational diabetes treatment occurred per routine clinical care. The primary outcome was incidence of large-for-gestational-age (LGA) neonates. Prespecified secondary outcomes included small-for-gestational-age (SGA) neonates, cesarean birth, and neonatal and maternal composites of adverse perinatal outcomes. Assuming a 15% incidence of LGA neonates in the Carpenter-Coustan group, 782 participants provided more than 80% power to detect a 7% absolute risk reduction with the use of IADPSG; planned recruitment was 920 for anticipated attrition. RESULTS: From June 2015 to February 2019, 1,016 participants were enrolled and 921 were randomized to IADPSG (n=461) or Carpenter-Coustan (n=460) groups. Gestational diabetes incidence (14.4% vs 4.5%, P<.001) and diabetes medication use (9.3% vs 2.4%; P<.001) were more common in the IADPSG group; there were no differences in LGA neonates, either overall (risk reduction 0.90, 97.5% CI 0.53-1.52) or among women without gestational diabetes (risk reduction 0.85, 97.5% CI 0.49-1.48). Those screened with IADPSG had higher rates of neonatal morbidity but fewer study-related adverse events. Rates of SGA neonates, cesarean birth, and maternal morbidity composite did not differ significantly between study groups. CONCLUSIONS: The IADPSG screening criteria resulted in more women diagnosed and treated for gestational diabetes than Carpenter-Coustan without reducing the incidence of LGA birth weight or maternal or neonatal morbidity. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02309138.


Assuntos
Diabetes Gestacional/diagnóstico , Programas de Rastreamento/estatística & dados numéricos , Resultado da Gravidez/epidemiologia , Adulto , Diabetes Gestacional/epidemiologia , Feminino , Macrossomia Fetal/epidemiologia , Humanos , Recém-Nascido , Programas de Rastreamento/métodos , Pennsylvania/epidemiologia , Gravidez , Adulto Jovem
19.
Obstet Gynecol ; 138(1): 59-65, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34259464

RESUMO

OBJECTIVE: To explore whether two-layer laparoscopic vaginal cuff closure at the time of laparoscopic hysterectomy is associated with a lower rate of postoperative complications compared with a standard one-layer cuff closure. METHODS: A retrospective cohort study of total laparoscopic hysterectomies performed by fellowship-trained minimally invasive gynecologic surgeons between 2011 and 2017 was performed. Surgeons sutured the vaginal cuff laparoscopically, either in a two- or one-layer closure. The primary outcome was a composite of total postoperative complications, including all medical and surgical complications within 30 days and vaginal cuff complications within 180 days. Factors known to influence laparoscopic vaginal cuff complications including age, postmenopausal status, body mass index, tobacco use, and immunosuppressant medications were examined and controlled for, while surgeon skill, colpotomy technique, and suture material remained standardized. We conducted statistical analyses including χ2, Fisher exact test, logistic regression, and post hoc power calculations. RESULTS: Of the 2,973 women who underwent total laparoscopic hysterectomies, 40.8% (n=1,213) of vaginal cuffs were closed with a two-layer closure and 59.2% (n=1,760) with a one-layer technique. Two-layer vaginal cuff closure was associated with decreased numbers of total postoperative complications (3.5% vs 5.7%; P<.01). The primary difference stemmed from lower vaginal cuff complications within 180 days (0.9% vs 2.6%; P<.01); no differences in 30-day medical and surgical postoperative complications were observed between the two groups (2.6% vs 3.1%; P=.77). No patients in the two-layer vaginal cuff closure cohort experienced a vaginal cuff dehiscence or mucosal separation compared with 1.0% in the one-layer group (P<.01). Compared with a one-layer closure, a two-layer closure was protective from postoperative complications (adjusted odds ratio 0.38, 95% CI 0.19-0.74). CONCLUSION: Although postoperative complications with laparoscopic hysterectomies are rare, two-layer laparoscopic vaginal cuff closure is associated with lower total postoperative complications compared with a one-layer closure. The difference was primary driven by cuff complications.


Assuntos
Histerectomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Técnicas de Sutura/estatística & dados numéricos , Vagina/cirurgia , Adulto , Feminino , Humanos , Histerectomia/métodos , Histerectomia/estatística & dados numéricos , Laparoscopia , Pessoa de Meia-Idade , Pennsylvania/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos
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