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1.
PLoS One ; 16(10): e0258213, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34606507

RESUMO

Our objective was to describe how residents of Philadelphia, Pennsylvania, coped psychologically with the first wave of COVID-19 pandemic. In a cross-sectional design, we aimed to estimate the rates and correlates of anxiety and depression, examine how specific worries correlated with general anxiety and depression, and synthesize themes of "the most difficult experiences" shared by the respondents. We collected data through an on-line survey in a convenience sample of 1,293 adult residents of Philadelphia, PA between April 17 and July 3, 2020, inquiring about symptoms of anxiety and depression (via the Hospital Anxiety and Depression Scale), specific worries, open-ended narratives of "the most difficult experiences" (coded into themes), demographics, perceived sources of support, and general health. Anxiety was evident among 30 to 40% of participants and depression-about 10%. Factor analysis revealed two distinct, yet inter-related clusters of specific worries related to mood disorders: concern about "hardships" and "fear of infection". Regression analyses revealed that anxiety, depression, and fear of infection, but not concern about hardships, worsened over the course of the epidemic. "The most difficult experiences" characterized by loss of income, poor health of self or others, uncertainty, death of a relative or a friend, and struggle accessing food were each associated with some of the measures of worries and mood disorders. Respondents who believed they could rely on support of close personal network fared better psychologically than those who reported relying primarily on government and social services organizations. Thematic analysis revealed complex perceptions of the pandemic by the participants, giving clues to both positive and negative experiences that may have affected how they coped. Despite concerns about external validity, our observations are concordant with emerging evidence of psychological toll of the COVID-19 pandemic and measures employed to mitigate risk of infection.


Assuntos
Adaptação Psicológica , COVID-19/epidemiologia , Transtornos do Humor/diagnóstico , Adulto , Ansiedade/patologia , COVID-19/patologia , COVID-19/virologia , Estudos Transversais , Depressão/patologia , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Pandemias , Philadelphia/epidemiologia , Análise de Regressão , SARS-CoV-2/isolamento & purificação , Inquéritos e Questionários
2.
Artigo em Inglês | MEDLINE | ID: mdl-34682673

RESUMO

In February 2020, the paper "Sugar-Sweetened and Diet Beverage Consumption in Philadelphia One Year after the Beverage Tax" was published in the International Journal of Environmental Research and Public Health [...].


Assuntos
Bebidas Adoçadas Artificialmente , Açúcares , Bebidas , Philadelphia , Saúde Pública , Impostos
3.
Artigo em Inglês | MEDLINE | ID: mdl-34682675

RESUMO

Thank you for the opportunity to respond to the recent letter to the editor regarding our paper "Sugar-Sweetened and Diet Beverage Consumption in Philadelphia One Year after the Beverage Tax" [...].


Assuntos
Bebidas Adoçadas Artificialmente , Açúcares , Bebidas , Philadelphia , Saúde Pública , Impostos
4.
BMC Cancer ; 21(1): 1094, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635061

RESUMO

BACKGROUND: To ensure safe delivery of oncologic care during the COVID-19 pandemic, telemedicine has been rapidly adopted. However, little data exist on the impact of telemedicine on quality and accessibility of oncologic care. This study assessed whether conducting an office visit for thoracic oncology patients via telemedicine affected time to treatment initiation and accessibility. METHODS: This was a retrospective cohort study of patients with thoracic malignancies seen by a multidisciplinary team during the first surge of COVID-19 cases in Philadelphia (March 1 to June 30, 2020). Patients with an index visit for a new phase of care, defined as a new diagnosis, local recurrence, or newly discovered metastatic disease, were included. RESULTS: 240 distinct patients with thoracic malignancies were seen: 132 patients (55.0%) were seen initially in-person vs 108 (45.0%) via telemedicine. The majority of visits were for a diagnosis of a new thoracic cancer (87.5%). Among newly diagnosed patients referred to the thoracic oncology team, the median time from referral to initial visit was significantly shorter amongst the patients seen via telemedicine vs. in-person (median 5.0 vs. 6.5 days, p < 0.001). Patients received surgery (32.5%), radiation (24.2%), or systemic therapy (30.4%). Time from initial visit to treatment initiation by modality did not differ by telemedicine vs in-person: surgery (22 vs 16 days, p = 0.47), radiation (27.5 vs 27.5 days, p = 0.86, systemic therapy (15 vs 13 days, p = 0.45). CONCLUSIONS: Rapid adoption of telemedicine allowed timely delivery of oncologic care during the initial surge of the COVID19 pandemic by a thoracic oncology multi-disciplinary clinic.


Assuntos
COVID-19/epidemiologia , Acesso aos Serviços de Saúde , Pandemias , Telemedicina/organização & administração , Neoplasias Torácicas/terapia , Tempo para o Tratamento , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Equipe de Assistência ao Paciente , Philadelphia/epidemiologia , Qualidade da Assistência à Saúde , Encaminhamento e Consulta , Estudos Retrospectivos , Telemedicina/normas , Telemedicina/estatística & dados numéricos , Neoplasias Torácicas/epidemiologia , Neoplasias Torácicas/patologia , Fatores de Tempo
5.
Health Aff (Millwood) ; 40(10): 1566-1574, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34606353

RESUMO

Acute stress during pregnancy can have adverse effects on maternal health and increase the risk for postpartum depression and impaired mother-infant bonding. The COVID-19 pandemic represents an acute environmental stressor during which it is possible to explore risk and resilience factors that contribute to postpartum outcomes. To investigate prenatal risk and resilience factors as predictors of postpartum depression and impaired mother-infant bonding, this study recruited a diverse cohort of 833 pregnant women from an urban medical center in Philadelphia, Pennsylvania, and assessed them once during pregnancy in the early phase of the COVID-19 pandemic (April-July 2020) and again at approximately twelve weeks postpartum. Adverse childhood experiences, prenatal depression and anxiety, and COVID-19-related distress predicted a greater likelihood of postpartum depression. Prenatal depression was the only unique predictor of impaired maternal-infant bonding after postpartum depression was controlled for. Women reporting greater emotion regulation, self-reliance, and nonhostile relationships had healthier postpartum outcomes. Policies to increase the number of nonspecialty providers providing perinatal mental health services as well as reimbursement for integrated care and access to mental health screening and care are needed to improve lifelong outcomes for women and their children.


Assuntos
COVID-19 , Depressão Pós-Parto , Criança , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Lactente , Mães , Pandemias , Philadelphia/epidemiologia , Gravidez , SARS-CoV-2
6.
Am J Prev Med ; 61(5 Suppl 1): S151-S159, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34686284

RESUMO

INTRODUCTION: The Ending the HIV Epidemic in the U.S. initiative considers cluster and outbreak response essential. This article describes the design, implementation, and early findings of a Philadelphia-based project to systematically assess sentinel cases among priority populations for improving public health infrastructure and preventing future outbreaks. METHODS: Sentinel HIV cases (i.e., early-stage or acute infection or molecular cluster cases) were identified among priority populations (Black and Hispanic/Latino men who have sex with men, youth aged 18-24 years, and transgender people who have sex with men). Chart abstraction and structured interview data were reviewed to determine themes and service gaps and to identify, prioritize, and implement recommendations. Interdisciplinary review teams included individuals with lived experience, frontline staff, and local agency leadership. RESULTS: Data were collected during July 2019-December 2020 and analyzed for 53 of 126 sentinel cases of HIV diagnosed since July 1, 2018. The majority were men who have sex with men (79.3%), those aged 18-24 years (67.9%), and non-Hispanic Black (67.9%). More than half received sexually transmitted infection and HIV testing ≤3 years preceding HIV diagnosis (56.6% and 54.7%, respectively), had a healthcare visit within 12 months before diagnosis (64.2%), and had no evidence of pre-exposure prophylaxis awareness (58.5%). Project recommendations effectuated actions to improve pre-exposure prophylaxis provision, integrate sexually transmitted infection and HIV testing, and educate primary care providers. CONCLUSIONS: HIV sentinel case review is a model for health departments to rapidly respond to recent transmission, identify missed HIV prevention opportunities, strengthen community partnerships, and implement programmatic and policy changes. Such efforts may prevent outbreaks and inform longer-term strategies.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Adolescente , Surtos de Doenças/prevenção & controle , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Philadelphia/epidemiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-34501644

RESUMO

Lead (Pb) soil contamination in urban environments represents a considerable health risk for exposed populations, which often include environmental justice communities. In Philadelphia, Pennsylvania (PA), Pb pollution is a major concern primarily due to extensive historical Pb-smelting/processing activity and legacy use of Pb-based paints and leaded gasoline. The U.S. Environmental Protection Agency (USEPA) organized and/or compiled community-driven soil sampling campaigns to investigate Pb content in surface soils across Philadelphia. Using these data (n = 1277), combined with our own dataset (n = 1388), we explored the spatial distribution of Pb content in soils across the city using ArcGIS. While assessing Zone Improvement Plan (ZIP)-code level data, we found strong correlations between factors, such as the percentage of children with elevated blood lead levels (% EBLL) and % minority population as well as between % EBLL and % children in poverty. We developed a "Lead Index" that took demographics, median measured Pb-in-soil content, and % EBLLs into account to identify ZIP codes in need of further assessment. Our results will be used to help lower the Pb-exposure risk for vulnerable children living in disproportionately burdened communities.


Assuntos
Chumbo , Poluentes do Solo , Criança , Demografia , Saúde Ambiental , Humanos , Chumbo/análise , Philadelphia , Poluentes do Solo/análise
9.
AMIA Jt Summits Transl Sci Proc ; 2021: 545-554, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34457170

RESUMO

As of August 2020, there were ~6 million COVID-19 cases in the United States of America, resulting in ~200,000 deaths. Informatics approaches are needed to better understand the role of individual and community risk factors for COVID-19. We developed an informatics method to integrate SARS-CoV-2 data with multiple neighborhood-level factors from the American Community Survey and opendataphilly.org. We assessed the spatial association between neighborhood-level factors and the frequency of SARS-CoV-2 positivity, separately across all patients and across asymptomatic patients. We found that neighborhoods with higher proportions of individuals with a high-school degree and/or who were identified as Hispanic/Latinx were more likely to have higher SARS-CoV-2 positivity rates, after adjusting for other neighborhood covariates. Patients from neighborhoods with higher proportions of individuals receiving public assistance and/or identified as White were less likely to test positive for SARS-CoV-2. Our approach and its findings could inform future public health efforts.


Assuntos
COVID-19 , Humanos , Philadelphia/epidemiologia , Características de Residência , SARS-CoV-2 , Regressão Espacial , Estados Unidos/epidemiologia
10.
Environ Manage ; 68(4): 566-579, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34383110

RESUMO

Green infrastructure (GI) initiatives, including programs to plant trees and install bioswales, have been adopted by a growing number of local government and non-governmental organizations. While the details of these programs vary, a common characteristic of most Canadian and US GI initiatives is a distributed approach that includes both public and private land. To date, little research has explored residents' knowledge of GI or their engagement with related initiatives even though residents' installation of GI is often key to creating distributed GI networks. In this study, we (1) assess residents' knowledge of the term GI, (2) identify residents' level of engagement with GI initiatives, and (3) examine whether factors like level of concern about local environmental issues can predict GI knowledge or level of engagement with GI initiatives. We explored these objectives through a survey of residents in Toronto (Ontario, Canada) and Philadelphia (Pennsylvania, US). We found that about a quarter of survey respondents in both cities had previously heard the term "green infrastructure". Neither knowledge of GI nor level of engagement with GI initiatives could be predicted by the level of concern about local environmental issues, but residents' interest in using their outdoor space for nature activities (e.g., gardening) predicted GI knowledge in both cities and level of initiative engagement in Philadelphia. Our results suggest the need for widespread education campaigns that clearly define GI so that residents can be participants in policy discussions, link it with their needs, and identify ways to manage GI to create desired benefits.


Assuntos
Conhecimento , Parques Recreativos , Árvores , Cidades , Humanos , Ontário , Philadelphia
11.
Invest Ophthalmol Vis Sci ; 62(9): 16, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34241624

RESUMO

Purpose: The purpose of this study was to perform genetic linkage analysis and association analysis on exome genotyping from highly aggregated African American families with nonpathogenic myopia. African Americans are a particularly understudied population with respect to myopia. Methods: One hundred six African American families from the Philadelphia area with a family history of myopia were genotyped using an Illumina ExomePlus array and merged with previous microsatellite data. Myopia was initially measured in mean spherical equivalent (MSE) and converted to a binary phenotype where individuals were identified as affected, unaffected, or unknown. Parametric linkage analysis was performed on both individual variants (single-nucleotide polymorphisms [SNPs] and microsatellites) as well as gene-based markers. Family-based association analysis and transmission disequilibrium test (TDT) analysis modified for rare variants was also performed. Results: Genetic linkage analysis identified 2 genomewide significant variants at 7p15.2 and 7p14.2 (in the intergenic region between MIR148A and NFE2L3 and in the noncoding RNA LOC401324) and 2 genomewide significant genes (CRHR2 and AVL9) both at 7p14.3. No genomewide results were found in the association analyses. Conclusions: This study identified a significant linkage peak in African American families for myopia at 7p15.2 to 7p14.2, the first potential risk locus for myopia in African Americans. Interesting candidate genes are located in the region, including PDE1C, which is highly expressed in the eyes, and known to be involved in retinal development. Further identification of the causal variants at this linkage peak will help elucidate the genetics of myopia in this understudied population.


Assuntos
Afro-Americanos , Cromossomos Humanos Par 7/genética , Miopia/etnologia , Adulto , Mapeamento Cromossômico , Feminino , Ligação Genética , Predisposição Genética para Doença , Genoma Humano , Genótipo , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Miopia/genética , Miopia/fisiopatologia , Linhagem , Philadelphia/epidemiologia , Refração Ocular
12.
Clin Chim Acta ; 521: 151-154, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34265257

RESUMO

BACKGROUND: Xylazine is an α-2 adrenoreceptor agonist used as a sedative/analgesic in veterinary medicine. Xylazine is known to be present within the street supply of opiates in urban Philadelphia. Medical staff at our hospital asked if we could test for xylazine in fentanyl screen-positive urine samples. We developed an LC-MS/MS assay for this purpose, and determined prevalence of xylazine among fentanyl screen-positive urine samples at our hospital. METHODS: The LC-MS/MS assay utilized d5-norfentanyl as internal standard (IS). One hundred microliter samples were extracted with 200 µl of MeOH/IS. LC was performed using a Phenomenex Kinetix C18 column (100 A, 5 µm, 50 × 4.6 mm) at 40 °C. Time-variable mobile phases (A = H2O, 0.1% formic acid; B = MeOH, 0.1% formic acid) were used at a fixed flow rate of 0.5 ml/min. MS/MS used positive electrospray ionization, monitoring m/z transitions of 221 > 164 for xylazine (primary), 221 > 90 for xylazine (qualifier), and 238 > 84 for d5-norfentanyl (IS). Retention time was 3.9 min for both xylazine and IS. RESULTS: Calibration curve was linear (0-500 ng/ml; r > 0.99). Inter-assay CVs (n = 20) were 5.2% (18 ng/ml) and 6.6% (95 ng/ml). Lower limit of detection was set at 10 ng/ml (CV = 15%). Among 81 urine samples that were screen-positive for fentanyl (Ark Diagnostics immunoassay), 63 (78%) were positive for xylazine (>10 ng/ml). CONCLUSIONS: By LC-MS/MS, there was high prevalence (78%) of xylazine in fentanyl screen-positive urine samples submitted to the laboratory. Because α-2 adrenoreceptor agonists may be used in treatment of opioid addiction, knowledge of xylazine exposure may be clinically useful to guide patient management.


Assuntos
Espectrometria de Massas em Tandem , Xilazina , Cromatografia Líquida , Fentanila , Humanos , Philadelphia , Prevalência , Reprodutibilidade dos Testes
13.
Harm Reduct J ; 18(1): 75, 2021 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-34301246

RESUMO

BACKGROUND: The incidence of opioid-related overdose deaths has been rising for 30 years and has been further exacerbated amidst the COVID-19 pandemic. Naloxone can reverse opioid overdose, lower death rates, and enable a transition to medication for opioid use disorder. Though current formulations for community use of naloxone have been shown to be safe and effective public health interventions, they rely on bystander presence. We sought to understand the preferences and minimum necessary conditions for wearing a device capable of sensing and reversing opioid overdose among people who regularly use opioids. METHODS: We conducted a combined cross-sectional survey and semi-structured interview at a respite center, shelter, and syringe exchange drop-in program in Philadelphia, Pennsylvania, USA, during the COVID-19 pandemic in August and September 2020. The primary aim was to explore the proportion of participants who would use a wearable device to detect and reverse overdose. Preferences regarding designs and functionalities were collected via a questionnaire with items having Likert-based response options and a semi-structured interview intended to elicit feedback on prototype designs. Independent variables included demographics, opioid use habits, and previous experience with overdose. RESULTS: A total of 97 adults with an opioid use history of at least 3 months were interviewed. A majority of survey participants (76%) reported a willingness to use a device capable of detecting an overdose and automatically administering a reversal agent upon initial survey. When reflecting on the prototype, most respondents (75.5%) reported that they would wear the device always or most of the time. Respondents indicated discreetness and comfort as important factors that increased their chance of uptake. Respondents suggested that people experiencing homelessness and those with low tolerance for opioids would be in greatest need of the device. CONCLUSIONS: The majority of people sampled with a history of opioid use in an urban setting were interested in having access to a device capable of detecting and reversing an opioid overdose. Participants emphasized privacy and comfort as the most important factors influencing their willingness to use such a device. TRIAL REGISTRATION: NCT04530591.


Assuntos
Naloxona/administração & dosagem , Antagonistas de Entorpecentes/administração & dosagem , Overdose de Opiáceos/diagnóstico , Overdose de Opiáceos/tratamento farmacológico , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Masculino , Naloxona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Overdose de Opiáceos/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Philadelphia , Dispositivos Eletrônicos Vestíveis/psicologia , Adulto Jovem
14.
Am J Public Health ; 111(7): 1352-1357, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34111937

RESUMO

Objectives. To estimate excess all-cause mortality in Philadelphia, Pennsylvania, during the COVID-19 pandemic and understand the distribution of excess mortality in the population. Methods. With a Poisson model trained on recent historical data from the Pennsylvania vital registration system, we estimated expected weekly mortality in 2020. We compared these estimates with observed mortality to estimate excess mortality. We further examined the distribution of excess mortality by age, sex, and race/ethnicity. Results. There were an estimated 3550 excess deaths between March 22, 2020, and January 2, 2021, a 32% increase above expectations. Only 77% of excess deaths (n = 2725) were attributed to COVID-19 on the death certificate. Excess mortality was disproportionately high among older adults and people of color. Sex differences varied by race/ethnicity. Conclusions. Excess deaths during the pandemic were not fully explained by COVID-19 mortality; official counts significantly undercount the true death toll. Far from being a great equalizer, the COVID-19 pandemic has exacerbated preexisting disparities in mortality by race/ethnicity. Public Health Implications. Mortality data must be disaggregated by age, sex, and race/ethnicity to accurately understand disparities among groups.


Assuntos
COVID-19/mortalidade , Surtos de Doenças/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Adulto , Idoso , Causas de Morte/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Philadelphia , Adulto Jovem
16.
J Grad Med Educ ; 13(3): 371-376, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34178262

RESUMO

Background: Team-based decision-making has been shown to reduce diagnostic error, increase clinical certainty, and decrease adverse events. Objective: This study aimed to assess the effect of peer discussion on resident practice intensity (PI) and clinical certainty (CC). Methods: A vignette-based instrument was adapted to measure PI, defined as the likelihood of ordering additional diagnostic tests, consultations or empiric treatment, and CC. Internal medicine residents at 7 programs in the Philadelphia area from April 2018 to June 2019 were eligible for inclusion in the study. Participants formed groups and completed each item of the instrument individually and as a group with time for peer discussion in between individual and group responses. Predicted group PI and CC scores were compared with measured group PI and CC scores, respectively, using paired t testing. Results: Sixty-nine groups participated in the study (response rate 34%, average group size 2.88). The measured group PI score (2.29, SD = 0.23) was significantly lower than the predicted group PI score (2.33, SD = 0.22) with a mean difference of 0.04 (SD = 0.10; 95% CI 0.02-0.07; P = .0002). The measured group CC score (0.493, SD = 0.164) was significantly higher than the predicted group CC score (0.475, SD = 0.136) with a mean difference of 0.018 (SD = 0.073; 95% CI 0.0006-0.0356; P = .022). Conclusions: In this multicenter study of resident PI, peer discussion reduced PI and increased CC more than would be expected from averaging group members' individual scores.


Assuntos
Internato e Residência , Tomada de Decisão Clínica , Humanos , Philadelphia
17.
Law Hum Behav ; 45(2): 165-178, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-34110877

RESUMO

OBJECTIVES: Created to combat the school-to-prison pipeline, the Philadelphia Police School Diversion Program offers voluntary community-based services to eligible youth accused of minor school-based offeses in lieu of arrest. This study evaluated program effectiveness in accomplishing goals related to reductions in school-based arrests, serious behavioral incidents, and recidivism. HYPOTHESES: We expected the annual number of school-based arrests in Philadelphia schools to decrease over the program's first 5 years and predicted that the annual number of serious behavioral incidents would not increase. Further, we expected that diverted youth-compared to youth arrested in schools the year before Diversion Program implementation-would have significantly lower rates of recidivism arrests in the 2 years following their school-based incidents. METHOD: Using a quasi-experimental design, we examined data from 2,302 public school students (67.0% male; 76.1% Black; age range: 10-22 years) who were either diverted from arrest through the Diversion Program or arrested in Philadelphia schools in the year prior to Diversion Program implementation. We compared rate of recidivism arrest, number of arrests, and time to arrest between diverted and arrested youth. We also used district-wide descriptive statistics to examine 5-year trends in school-based arrests and serious behavioral incidents. RESULTS: Since program implementation, the annual number of school-based arrests in Philadelphia has declined by 84% and the number of serious behavioral incidents has declined by 34%. Diverted youth demonstrated less recidivism than arrested youth in the 2 years following their initial incident; however, after propensity score matching, we no longer observed significant differences. CONCLUSIONS: Findings indicate that a prearrest diversion program can safely reduce school-based arrests and suggest a need for future research regarding the role of demographic and incident-related characteristics in recidivism outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Delinquência Juvenil/prevenção & controle , Aplicação da Lei/métodos , Avaliação de Programas e Projetos de Saúde , Reincidência/prevenção & controle , Adolescente , Criança , Feminino , Humanos , Delinquência Juvenil/estatística & dados numéricos , Masculino , Philadelphia , Pontuação de Propensão , Reincidência/estatística & dados numéricos , Instituições Acadêmicas , Adulto Jovem
18.
Environ Monit Assess ; 193(7): 440, 2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34164717

RESUMO

A multi-analytical geochemical investigation of Pb-contaminated collocated road dust and soils, at two size fractions, was performed in Fishtown, Philadelphia, PA, USA. The combinations of methods employed in this case study were chosen to better characterize the contamination, enhance identification of pollution sources, improve understanding of the impact of former Pb smelters, and to study the relationships between two media and between two size fractions. High concentrations of Cu and Sn were observed in both bulk and finer road dust, whereas large concentrations of Zn and Pb were found in both bulk and finer soil samples, implying pollution. There were no obvious associations between Pb soil concentrations and former smelter locations. Therefore, the primary source of the high mean Pb content in bulk (595 ppm) and fine soils (687 ppm) was likely legacy lead paint and/or leaded-gasoline products. Using electron microscopy, we found that Pb particles were mainly 0.1-10 µm in diameter and were ubiquitous in both soil and dust samples. Two-way analysis of variance tests revealed that, for most chemical elements explored here, there were statistically significant differences in concentrations based on media and size fractions, with finer sizes being more polluted than the bulk. The mineralogical composition and the sources of several pollutant elements (Cr, Cu, Zn, Pb), however, were similar for both soil and dust, pointing to material exchange between the two media. We suggest that future investigations of collocated road dust and soils in urban environments use the methodologies applied in this study to obtain detailed insights into sources of roadside pollution and the relationships between neighboring media.


Assuntos
Metais Pesados , Poluentes do Solo , Poeira/análise , Monitoramento Ambiental , Chumbo , Metais Pesados/análise , Philadelphia , Solo , Poluentes do Solo/análise
19.
Front Public Health ; 9: 682112, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34123996

RESUMO

An interdisciplinary group from two higher-education institutions in Philadelphia developed a novel framework for interprofessional education. This framework was applied to two different scenarios disease outbreak and natural disaster, which were used in simulations in 2018 and 2020. By design, these simulations included students from a broad range of disciplines, beyond the typical healthcare fields. Students were first grouped by discipline and were then placed in interdisciplinary teams for the rest of the scenario. Students were administered four surveys throughout which included 10 point-Likert scale and free response items. A statistically significant post-simulation increase in student interest and confidence was found. Survey analysis also revealed higher scores of positive group behaviors among interdisciplinary teams when compared to discipline groups. Importantly, students realized the importance of broad representation of disciplines for disaster preparedness. The PennDemic framework may be helpful for teams looking to develop simulations to build interest and confidence in disaster preparedness/response and interdisciplinary teamwork.


Assuntos
Desastres , Ocupações em Saúde , Humanos , Estudos Interdisciplinares , Philadelphia , Estudantes
20.
Prev Chronic Dis ; 18: E48, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-33988496

RESUMO

INTRODUCTION: Profound geographic disparities in health exist in many US cities. Most reporting on these disparities is based on predetermined administrative districts that may not reflect true neighborhoods. We undertook a ranking project to describe health at the neighborhood level and used Philadelphia, Pennsylvania, as our case study. METHODS: To create neighborhood health rankings, we first divided the city into neighborhoods according to groups of contiguous census tracts. Modeling our ranking methods and indicators on the Robert Wood Johnson Foundation County Health Rankings, we gathered census tract-level data from the Centers for Disease Control and Prevention's 500 Cities Project and local sources and aggregated these data, as needed, to each neighborhood. We assigned composite scores and rankings for both health outcomes and health factors to each neighborhood. RESULTS: Scores for health outcomes and health factors were highly correlated. We found clusters of neighborhoods with low rankings in Philadelphia's northern, lower northeastern, western, and southwestern regions. We disseminated information on rankings throughout the city, including through a comprehensive webpage, public communication, and a museum exhibit. CONCLUSION: The Philadelphia neighborhood health rankings were designed to be accessible to people unfamiliar with public health, facilitating education on drivers of health in communities. Our methods can be used as a model for other cities to create and communicate data on within-city geographic health disparities.


Assuntos
Saúde Pública , Características de Residência , População Urbana , Cidades , Humanos , Philadelphia , Saúde Pública/estatística & dados numéricos , Fatores Socioeconômicos
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