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1.
Talanta ; 236: 122824, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34635214

RESUMO

Ultra-sensitive detection of 2,4,6-trinitrotoluene (TNT) plays an important role in society security and human health. The Raman probe molecule p-aminothiophenol (PATP) can interact with TNT in three ways to form a TNT-PATP complex. In this paper, a 'sandwich' structure was developed to detect TNT with high sensitivity. Au nano-pillar arrays (AuNPAs) substrates modified by low-concentration PATP through Au-S bonds were acted as capture probe for TNT. Meanwhile, Ag nano-particles (AgNPs) modified by PATP at higher concentration were employed as tags for surface-enhanced Raman scattering (SERS). The formation of the TNT-PATP complex is not only the means by which AuNPAs substrates recognize and capture TNT, but also links the SERS tags to TNT, forming an AuNPAs-TNT-AgNPs 'sandwich' structure. The Raman signal of PATP was greatly enhanced mainly because novel 'hot spots' formed between the AuNPAs and AgNPs of the 'sandwich' structure. The Raman signal of PATP was further amplified by the chemical enhancement effect induced by the TNT-PATP complex formation. Based on this mechanism, the limit of detection (LOD) of TNT was determined from the Raman signal of PATP. The LOD reached 10-9 mg/mL (4.4 × 10-12 M), much lower than that suggested by the US Environmental Protection Agency (88 nM). Moreover, TNT was selectively detected over several TNT analogues 2,4-dinitrotoluene (DNT), p-nitrotoluene (NT) and hexogen (RDX). Finally, the 'sandwich' structure was successfully applied to TNT detection in environmental water and sand.


Assuntos
Análise Espectral Raman , Trinitrotolueno , Humanos , Limite de Detecção , Prata , Trinitrotolueno/análise , Estados Unidos
2.
J Exp Child Psychol ; 213: 105210, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34450462

RESUMO

Understanding fractions and decimals requires not only understanding each notation separately, or within-notation knowledge, but also understanding relations between notations, or cross-notation knowledge. Multiple notations pose a challenge for learners but could also present an opportunity, in that cross-notation knowledge could help learners to achieve a better understanding of rational numbers than could easily be achieved from within-notation knowledge alone. This hypothesis was tested by reanalyzing three published datasets involving fourth- to eighth-grade children from the United States and Finland. All datasets included measures of rational number arithmetic, within-notation magnitude knowledge (e.g., accuracy in comparing fractions vs. fractions and decimals vs. decimals), and cross-notation magnitude knowledge (e.g., accuracy in comparing fractions vs. decimals). Consistent with the hypothesis, cross-notation magnitude knowledge predicted fraction and decimal arithmetic when controlling for within-notation magnitude knowledge. Furthermore, relations between within-notation magnitude knowledge and arithmetic were not notation specific; fraction magnitude knowledge did not predict fraction arithmetic more than decimal arithmetic, and decimal magnitude knowledge did not predict decimal arithmetic more than fraction arithmetic. Implications of the findings for assessing rational number knowledge and learning and teaching about rational numbers are discussed.


Assuntos
Idioma , Aprendizagem , Criança , Finlândia , Humanos , Matemática , Estados Unidos
3.
J Environ Manage ; 301: 113751, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34628283

RESUMO

Heat-related mortality is one of the leading causes of weather-related deaths in the United States. With changing climates and an aging population, effective adaptive strategies to address public health and environmental justice issues associated with extreme heat will be increasingly important. One effective adaptive strategy for reducing heat-related mortality is increasing tree cover. Designing such a strategy requires decision-support tools that provide spatial and temporal information about impacts. We apply such a tool to estimate spatially and temporally explicit reductions in temperature and mortality associated with a 10% increase in tree cover in 10 U.S. cities with varying climatic, demographic, and land cover conditions. Two heat metrics were applied to represent tree impacts on moderately and extremely hot days (relative to historical conditions). Increasing tree cover by 10% reduced estimated heat-related mortality in cities significantly, with total impacts generally greatest in the most populated cities. Mortality reductions vary widely across cities, ranging from approximately 50 fewer deaths in Salt Lake City to about 3800 fewer deaths in New York City. This variation is due to differences in demographics, land cover, and local climatic conditions. In terms of per capita estimated impacts, hotter and drier cities experience higher percentage reductions in mortality due to increased tree cover across the season. Phoenix potentially benefits the most from increased tree cover, with an estimated 22% reduction in mortality from baseline levels. In cooler cities such as Minneapolis, trees can reduce mortality significantly on days that are extremely hot relative to historical conditions and therefore help mitigate impacts during heat wave conditions. Recent studies project highest increases in heat-related mortality in the cooler cities, so our findings have important implications for adaptation planning. Our estimated spatial and temporal distributions of mortality reductions for each city provide crucial information needed for promoting environmental justice and equity. More broadly, the methods and model can be applied by both urban planners and the public health community for designing targeted, effective policies to reduce heat-related mortality. Additionally, land use managers can use this information to optimize tree plantings. Public stakeholders can also use these impact estimates for advocacy.


Assuntos
Temperatura Alta , Árvores , Cidades , Mortalidade , Saúde Pública , Estações do Ano , Estados Unidos
4.
Chemosphere ; 287(Pt 3): 132323, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34563776

RESUMO

This study investigated the concentration of radon (222Rn) in hot springs water. For this purpose, 222Rn concentration was measured using the RAD7 (Durridge Company, USA) in the water of hot springs located in Tata Pani, Gilgit (n = 4), and Garam Chashma, Chitral (n = 6), northern Pakistan. Water samples from the springs (background, n = 3) were also collected and analyzed for 222Rn concentration 40-50 km away from the hot springs in Gilgit and Chitral, northern Pakistan, to be used as background/reference concentration. The determined 222Rn in hot springs water surpassed the threshold of maximum contamination level (MCL, 11.1 Bq/L) set by the United States Environmental Protection Agency (US-EPA) in 100% samples collected from Tata Pani, Gilgit, and Garam Chashma, Chitral sites. Soil 222Rn along with the hot springs exhibited a decreasing trend with increasing distance. 222Rn concentration in hot springs water was used to calculate the exposure doses of human health through ingestion and inhalation pathways. The total effective dose for human (EWT) of 222Rn contaminated water consumption was 626 µSv/a in the Tata Pani, Gilgit and 34.7 µSv/a in the Garam Chashma, Chitral. Results revealed that hot springs water in the Tata Pani, Gilgit had surpassed the threshold limit (100 µSv/a) set by the World Health Organization (WHO). This study concluded that hot springs water should be avoided for drinking and other domestic uses.


Assuntos
Água Potável , Fontes Termais , Monitoramento de Radiação , Radônio , Poluentes Radioativos da Água , Ingestão de Líquidos , Água Potável/análise , Humanos , Paquistão , Radônio/análise , Estados Unidos , Poluentes Radioativos da Água/análise
5.
Med Educ Online ; 27(1): 1981803, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34813390

RESUMO

Coronavirus Disease 2019 (COVID-19) and the social justice movement in early 2020 awakened many Americans to the health disparities and health care inequities affecting Black communities. This heightened awareness has strengthened the call to address social determinants of health, like racism. Physicians can play an important role in dismantling racism through knowledge of implicit biases and understanding of historical trauma resulting in medical distrust as a crucial step to help advance the health of minority communities. The purpose of this project was to develop an anti-racism workshop for Graduate Medical Education. Two discussants led 1.5-hour interactive workshops. Content covered microagressions, colorblindness, tokenism, stereotypes, levels of racism, the impact of racism on health, and anti-racism concepts. Facilitated breakout sessions allowed participants to provide examples of witnessed racism and discuss application of anti-racism tools in those settings. Following the workshops, participants were asked to complete a 16-item survey to evaluate workshop effectiveness. Between July and August 2020, four workshops were delivered to 131 attendees. Fifty-nine completed post workshop surveys. Most respondents were White (75%), female (63%), and aged 31-40 (29%). Over half were faculty; 24% were residents, 8% fellows. The majority agreed they could apply knowledge to their work (95%) and found the workshop useful (95%). Over two-thirds reported being able to better identify disparities and better identify and communicate about racism. In open-ended questions, many participants requested an interactive longitudinal curriculum. Developing an antiracism workshop for an academic medical center located in the Deep South provided more insight into tangible next steps to foster an institutional culture centered on antiracism.


Assuntos
COVID-19 , Racismo , Educação de Pós-Graduação em Medicina , Feminino , Humanos , SARS-CoV-2 , Estados Unidos , Universidades
6.
Thorac Surg Clin ; 32(1): 1-11, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34801189

RESUMO

Civil Rights legislation and court decisions influenced health care policy, which attempted to provide health care to elderly and low-income populations. Passing Medicaid and Medicare was monumental in increasing access to health insurance. The Affordable Care Act aimed to increase access to and affordability of health care to alleviate some disparities in health care. The Affordable Care Act established the National Institute of Minority and Health Disparity and Offices of Minority Health. However, disparities of access, care, morbidity, and mortality among marginalized populations persist. We in the thoracic community must leverage all means to mitigate the injustice of health disparities.


Assuntos
Medicare , Patient Protection and Affordable Care Act , Idoso , Política de Saúde , Acesso aos Serviços de Saúde , Humanos , Medicaid , Estados Unidos/epidemiologia
7.
Thorac Surg Clin ; 32(1): 13-21, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34801191

RESUMO

Racial disparities in health care systems exist in all phases of health care delivery. The Affordable Care Act has been unable to completely mitigate disparities in health care as the root cause (ie, socioeconomic inequality) remains unaddressed. Uninsured status, lack of transportation, high costs, health literacy, provider unavailability, lack of trust in the health system, and implicit bias block minority populations from obtaining deserved quality care. With the COVID-19 crisis, increased sensitivity and development of innovative approaches to provide accessibly and quality health care are necessary.


Assuntos
COVID-19 , Patient Protection and Affordable Care Act , Atenção à Saúde , Humanos , Qualidade da Assistência à Saúde , SARS-CoV-2 , Estados Unidos
8.
Thorac Surg Clin ; 32(1): 43-49, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34801194

RESUMO

The many socioeconomic disparities in the myriad of diagnoses that make up benign lung diseases are unfortunately a global issue that was most recently highlighted by the COVID-19 pandemic of 2020. In this chapter, we will be reviewing the socioeconomic disparities in benign lung disease from both a United States perspective as well as a global perspective. We will cover the spectrum of infectious, obstructive, and restrictive lung disease and review the evidence on how social disparities affect these populations and their access to medical care.


Assuntos
COVID-19 , Pneumopatias , Doença Pulmonar Obstrutiva Crônica , Humanos , Pneumopatias/epidemiologia , Pandemias , SARS-CoV-2 , Estados Unidos/epidemiologia
9.
Thorac Surg Clin ; 32(1): 91-102, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34801200

RESUMO

Despite an ever-diversifying US population, women, and underrepresented minorities lack proportionate membership in the CT surgery workforce. CT surgery is the surgical specialty practiced by the oldest surgeons as a group. This highlights a deficit within our specialty and foreshadows a shrinking of the CT surgery workforce that will be compounded by a lack of diversity as the workforce ages. If CT surgery is to continue to advance forward and attract the brightest, most skilled, and innovative people, we must invite, encourage, and guide qualified individuals from all races, cultures, genders, sexual orientations, and experiences to join us.


Assuntos
Cirurgiões , Cirurgia Torácica , Procedimentos Cirúrgicos Torácicos , Feminino , Humanos , Masculino , Grupos Minoritários , Estados Unidos , Recursos Humanos
10.
J Palliat Care ; 37(1): 34-40, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34410180

RESUMO

Objectives: Centers for Medicare and Medicaid Services requirements for Emergency Preparedness Planning (EPP) by hospice organizations significantly increased in 2017. This study seeks to assess the involvement of various hospice personnel in EPP before and since the onset of the novel coronavirus disease COVID-19 pandemic. Methods: A link to an anonymous online survey was sent to members of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association, targeting members involved in hospice care in the United States. A descriptive analysis of the data was performed. Results: Prior to the pandemic, 39.8% of respondents were "moderately" or "very" involved with the development and revisions of the Emergency Preparedness Plan. Since the beginning of the pandemic, this increased to 59%, which largely occurred among physicians. Clinical Nurse and Nurse Practitioner involvement in development/revisions remained low. Approximately 30% of respondents desired more involvement across the areas of EPP. Conclusion: The involvement of personnel of various disciplines is varied and the involvement of physicians appears to have increased with the onset of the COVID-19 pandemic. A notable portion of personnel desired more involvement across all aspects of EPP. More research is needed in this important but little-understood area.


Assuntos
COVID-19 , Cuidados Paliativos na Terminalidade da Vida , Hospitais para Doentes Terminais , Idoso , Humanos , Medicare , Pandemias , SARS-CoV-2 , Estados Unidos
11.
Int J Health Serv ; 52(1): 168-173, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34668424

RESUMO

The COVID-19 pandemic has wrought fundamental changes in the US workplace, placing employer-sponsored health insurance (ESI) in disarray. Before the pandemic, ESI was the single largest share of private health insurance in the country, including some 150 million Americans. Even before the pandemic, however, ESI had become increasingly volatile and more unaffordable for both employers and employees. During the pandemic, many workers found that they could work at home remotely. Job losses during the pandemic left many millions uninsured, with many jobs lost indefinitely. Today, many Americans are rethinking how and where they want to be involved in the workplace, while many businesses are considering a future when more people are working from home or being replaced by robots, placing ESI in further jeopardy. This article brings historical perspective to these problems, showing how the private health insurance industry has failed the public interest by being too fragmented and unreliable to be afforded or depended upon. Three major reform alternatives are described, only 1 of which-single-payer improved Medicare for All-can provide stable universal coverage that meets the needs of all Americans while being affordable for patients, families, and taxpayers.


Assuntos
COVID-19 , Planos de Assistência de Saúde para Empregados , Humanos , Cobertura do Seguro , Seguro Saúde , Medicare , Pandemias , SARS-CoV-2 , Medicina Estatal , Estados Unidos , Cobertura Universal do Seguro de Saúde
12.
Sci Total Environ ; 803: 150061, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34525705

RESUMO

Downed woody material (DWM) is a unique part of the forest carbon cycle serving as a pool between living biomass and subsequent atmospheric emission or transference to other forest pools. Thus, DWM is an individually defined pool in national greenhouse gas inventories. The diversity of DWM carbon drivers (e.g., decay, tree mortality, or wildfire) and associated high spatial variability make this a difficult-to-predict component of forest ecosystems. Using the now fully established nationwide inventory of DWM across the United States (US), we developed models, which substantially improved predictions of stand-level DWM carbon density relative to the current national-reporting model ('previous' model, here). The previous model was developed from published DWM carbon densities prior to the NFI DWM inventory. Those predictions were tested using NFI DWM carbon densities resulting in a poor fit to the data (coefficient of determination, or R2 = 0.03). We present new random forest (RF) and stochastic gradient boosted (SGB) regression models to prediction DWM carbon density on all NFI plots and spatially on all forest land pixels. We evaluated various biotic and abiotic regression predictors, and the most important were standing dead trees, long-term annual precipitation, and long-term maximum summer temperature. A RF model scored best for expanding predictions to NFI plots (R2 = 0.31), while an SGB model was identified for DWM carbon predictions based on purely spatial data (i.e., NFI-plot-independent, with R2 = 0.23). The new RF model predicts conterminous US DWM carbon stocks to be 15% lower than the previous model and 2% higher than NFI data expanded according to inventory design-based inference. The new NFI data-driven models not only improve the predictions of DWM carbon density on all plots, they also provide flexibility in extending these predictions beyond the NFI to make spatially explicit and spatially continuous estimates of DWM carbon on all forest land in the US.


Assuntos
Carbono , Ecossistema , Biomassa , Carbono/análise , Ciclo do Carbono , Estados Unidos , Madeira/química
13.
J Public Health Manag Pract ; 28(1): 50-59, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34797241

RESUMO

CONTEXT: Coronavirus disease 2019 (COVID-19) incidence rates are 2- to 5-fold higher among persons incarcerated in the United States than in the general population. PROGRAM OR POLICY: We describe an outbreak investigation of COVID-19 at a jail (jail A) in Alameda County during March 2020-March 2021. IMPLEMENTATION: To prevent COVID-19 cases among incarcerated persons and employees, staff at jail A and the county public health department worked to develop and recommend infection control measures implemented by jail A including, but not limited to, face covering use among incarcerated persons and staff; cohorting incarcerated persons at a higher risk of severe COVID-19 in dedicated housing units; quarantining all newly detained individuals for 14 days; and offering testing for all symptomatic incarcerated persons, newly incarcerated persons at day 2 and day 10, and all persons who resided in a housing unit where a COVID-19 case was detected. EVALUATION: A total of 571 COVID-19 cases were detected among incarcerated persons at jail A during March 2020-March 2021, which represented a total incidence of 280 per 1000 population, 5 times higher than the rate in Alameda County. Of the 571 cases among incarcerated persons, 557 (98%) were male; 415 (73%) were aged 18 to 40 years; 249 (44%) were Latino; and 180 (32%) were African American; 354 (62%) were not symptomatic; and 220 (39%) had no comorbidities. Less than 2% of infected incarcerated persons were hospitalized, and no deaths were reported. DISCUSSION: COVID-19 disproportionately impacted persons incarcerated at jail A, with higher numbers among Latinos and African Americans. Implementation of COVID-19 infection control and testing measures, and collaboration between public health, law enforcement, and health care providers may have, in part, led to reductions in morbidity and mortality associated with COVID-19 at jail A.


Assuntos
COVID-19 , Prisões Locais , California/epidemiologia , Humanos , Masculino , Prisões , Quarentena , SARS-CoV-2 , Estados Unidos
14.
J Public Health Manag Pract ; 28(1): 86-94, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34797242

RESUMO

CONTEXT: The COVID-19 pandemic has resulted in a record number of deaths in the United States and tremendous economic and personal strain. During 2020, in anticipation of a vaccine to slow the spread of disease, local and state governments in the United States developed plans for vaccine prioritization, given a limited initial supply. Recognizing the challenges inherent in prioritization, the New York City (NYC) health department sought guidance from members of the public about the fairest approach to early-stage vaccine distribution. OBJECTIVE: To solicit recommendations from NYC residents on priorities regarding vaccine access for essential worker occupations, considering risk factors and preferred approaches to fairness. IMPLEMENTATION: Five public deliberations were conducted with NYC residents (N = 91). Participants heard presentations on the COVID-19 vaccine, the local distribution of illness and death, and approaches to fairness in the context of deliberating on priorities for 6 essential worker occupations and 4 risk factors. Discussions were transcribed, and transcriptions were coded and analyzed using preidentified and emergent themes. Pre- and post-surveys, focused on factors relevant to prioritization, were administered during each public deliberation. RESULTS: Recommendations for prioritization emphasized risk of severe morbidity and mortality, and work and neighborhood conditions with fewer protections (eg, in-person work, exposure to many people). Participants prioritized elementary schoolteachers, grocery store workers, and bus drivers, underlying health conditions, and neighborhood of residence. Participants focused on equity, recognizing that those at highest risk were largely low-income populations of color and individuals living in low-resourced neighborhoods. CONCLUSIONS: Participants' focus on equity, and acknowledgment of racial and ethnic disparities, revealed a nuanced understanding of the broader determinants of health. Recommendations reinforced the NYC health department's approach to vaccine distribution. PUBLIC HEALTH IMPLICATIONS: Results from these public deliberations confirmed community support for approaches prioritizing health equity, recognizing both societal and personal factors affecting vulnerability to poor health.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Cidade de Nova Iorque , Pandemias , SARS-CoV-2 , Estados Unidos
15.
J Public Health Manag Pract ; 28(1): E1-E8, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34797247

RESUMO

CONTEXT: Pediatric providers across the United States have sought guidance on how to care for the nation's children during the uncertain historic times of the COVID-19 pandemic. The health care community has been challenged by the unprecedented burden of caring for patients when they have evolving guidelines and limited information about the effects of the virus on children. PROGRAM: In response, the American Academy of Pediatrics (AAP) rapidly launched a national initiative to increase child health professionals' knowledge, skills, and self-efficacy. This COVID-19 ECHO (Extension for Community Healthcare Outcomes) program created communities of learners among child health professionals and subject matter expert faculty using didactic and case-based presentations that foster an "all-teach, all-learn" approach. IMPLEMENTATION: The initial AAP COVID-19 ECHO program hosted more than 900 participants in 127 individual virtual sessions, with approximately 25 participants per session. The evolving nature of the pandemic necessitated dynamic and continuous bidirectional flow of concerns and information relevant to participants. Session topics were selected in a "just-in-time" fashion based on participant feedback from the prospective postsession surveys and faculty recommendations; speakers brought data and expert recommendations. EVALUATION: To assess impact, the AAP used a mixed-methods approach to evaluate the program's effectiveness in meeting its educational objectives. The 2-phase evaluation collected quantitative and qualitative data through an integrated feedback structure that utilized prospective postsession and retrospective postprogram surveys, along with postprogram focus groups. DISCUSSION: As the COVID-19 pandemic surges and another influenza season is upon us, the ECHO model is an effective strategy for facilitating bidirectional communication and education to build child health professionals' knowledge, skills, and self-efficacy during an unprecedented and ongoing public health emergency. KEY POINTS: The ECHO model is an effective strategy for health care organizations to facilitate bidirectional communication and education in building health professionals' clinical knowledge, skills, and self-efficacy during the unprecedented and ongoing public health emergency of the COVID-19 pandemic.


Assuntos
COVID-19 , Pediatria , Criança , Humanos , Pandemias , Estudos Prospectivos , Saúde Pública , Estudos Retrospectivos , SARS-CoV-2 , Estados Unidos
16.
J Public Health Manag Pract ; 28(1): E9-E15, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34797248

RESUMO

CONTEXT: Shortly after the first COVID-19 case in the United States was identified in Washington, the Washington State Department of Health (WA DOH) determined that real-time knowledge of scientific findings related to SARS-CoV-2 was critical for an effective response. Epidemiologists at the WA DOH established the Daily Literature Situation Report (Lit Rep), within the agency's incident management team, to support public health and state leaders in evidence-based decision making. However, from January to May, the scale of the pandemic response and daily volume of emerging information grew beyond the capacity of the WA DOH epidemiology team tasked with gathering, reviewing, summarizing, and disseminating it daily. OBJECTIVE: To ensure public health leaders maintained awareness of the rapidly evolving scientific literature during the pandemic to support evidence-based practice. DESIGN: The WA DOH contracted the University of Washington (UW) Alliance for Pandemic Preparedness to assemble a team of faculty and students to continue producing the Lit Rep. MAIN OUTCOME: In addition to the daily Lit Rep, the UW team developed in-depth reports addressing questions from public health leadership and further evolved the methodology for the daily reports to support long-term sustainability and broader accessibility. RESULTS: Throughout its existence, the Lit Rep had summarized more than 4300 articles from more than 150 000 citations and had more than 5600 subscribers from public health practice, academia, and the general public, both domestic and international. CONCLUSIONS: The flexible Lit Rep model sets a standard for responding to emerging public health threats and communicating complex scientific information to government leaders, public health staff, and other interested parties. The WA DOH and the UW have exemplified how a mutually beneficial partnership can be established to support more effective public health practice based on real-time evidence both during a crisis and potentially for future public health challenges.


Assuntos
COVID-19 , Humanos , Pandemias , Saúde Pública , SARS-CoV-2 , Estados Unidos , Washington
17.
J Public Health Manag Pract ; 28(Suppl 1): S54-S57, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34797261

RESUMO

The COVID-19 pandemic has dramatically impacted life across the world and amplified inequities experienced by communities of color within the United States. Washington County was the first jurisdiction in the state of Oregon to have a confirmed COVID-19 case. To center equity within the County Emergency Operations Center (EOC), new positions were created within the EOC including an Equity Officer and an Equity Technical Advisor position, an Equity Team, and a Language Access Coordinator. This team engaged stakeholders and community partners in addition to developing an equity framework to guide decision making within the EOC. Implementation of the framework resulted in better identification of urgent community needs, especially for groups most impacted by inequities. This integration also supports government leaders and communities in creating programs, policies, and procedures to equitably address community needs.


Assuntos
COVID-19 , Equidade em Saúde , Humanos , Governo Local , Pandemias , SARS-CoV-2 , Estados Unidos
18.
Food Chem ; 372: 131232, 2022 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-34634586

RESUMO

Frog farming systems do not take advantage of their byproducts, which represents health risks and environmental pollution. The present study aimed to evaluate the proximate composition, amino acid, and fatty acid profile of American Bullfrog byproducts (whole frogs (WF), legs (LF), and skin (SF)) and their technological functionality. Results showed that WF, LF, and SF protein content was 47.6, 88.4, and 91.1% dry base (d.b.), correspondingly. Fat content resulted in 34.6, 3.2, and 4.2% (d.b.), respectively. Moreover, byproducts contain all the essential amino acids (23.8-46.6%), and the unsaturated fatty acids predominated the saturated fats. Samples showed water and oil absorption capacities of 1.8-2.6% and 1.8-4.0%, respectively, while oil and water emulsion capacities were 76.7-98.3% and 36.1-85.6%, correspondingly. Additionally, SF presented a gelling capacity in a 5% concentration. These results showed that frogs' byproducts have adequate nutritional and functional capacities, compared to other vegetable and animal flours used in the industry.


Assuntos
Ingredientes de Alimentos , Animais , Ácidos Graxos , Rana catesbeiana , Pele , Estados Unidos
19.
J Public Health Manag Pract ; 28(1): 77-85, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34654021

RESUMO

CONTEXT: During the COVID-19 pandemic, demand for telehealth services increased to reduce disease exposure for patients and providers and to meet preexisting demand for physician services in health resource shortage areas. OBJECTIVE: To estimate self-reported telehealth availability, equipment for accessing telehealth, and telehealth usage among Medicare beneficiaries during the COVID-19 pandemic. DESIGN: We used data from the 2020 Medicare Current Beneficiary Survey (MCBS) COVID-19 Fall Supplement Public Use File to estimate the weighted percentages of beneficiaries who had (a) access to telehealth before or during COVID-19; (b) equipment for accessing telehealth; and (c) telehealth visits during COVID-19. We used logistic regression to examine sociodemographic factors associated with telehealth usage. PARTICIPANTS: Beneficiaries who participated in the MCBS COVID-19 Fall Supplements. RESULTS: During October and November 2020, telehealth appointments offered by providers were available to 63.8% (95% confidence interval [CI], 61.8-65.9) of Medicare beneficiaries who had accessed medical care by telephone or video. Among those, only 18.0% (95% CI, 16.1-19.9) had been offered telehealth before the pandemic. The majority of beneficiaries (92.2%; 95% CI, 91.2-93.1) had 1 or more types of equipment available for accessing telehealth, but only 44.9% (95% CI, 43.0-46.9) had had a telehealth visit since July 1, 2020. Older adults, minorities, those with a lower income, and non-English speakers had less availability of telehealth equipment. Patient characteristics were significantly (P < .05) associated with telehealth use, including age, sex, race/ethnicity, and equipment availability. CONCLUSION: Telehealth availability for Medicare beneficiaries increased substantially during the COVID-19 pandemic. Even with the improvement in telehealth offerings and use hastened by the pandemic, gaps in access and use still exist. Effectiveness and implementation research can find ways to close gaps in telehealth services between vulnerable and underrepresented populations and counterparts.


Assuntos
COVID-19 , Telemedicina , Idoso , Humanos , Medicare , Pandemias/prevenção & controle , SARS-CoV-2 , Estados Unidos
20.
J Med Virol ; 94(1): 310-317, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34506640

RESUMO

SARS-CoV-2 is a newly discovered beta coronavirus at the end of 2019, which is highly pathogenic and poses a serious threat to human health. In this paper, 1875 SARS-CoV-2 whole genome sequences and the sequence coding spike protein (S gene) sampled from the United States were used for bioinformatics analysis to study the molecular evolutionary characteristics of its genome and spike protein. The MCMC method was used to calculate the evolution rate of the whole genome sequence and the nucleotide mutation rate of the S gene. The results showed that the nucleotide mutation rate of the whole genome was 6.677 × 10-4 substitution per site per year, and the nucleotide mutation rate of the S gene was 8.066 × 10-4 substitution per site per year, which was at a medium level compared with other RNA viruses. Our findings confirmed the scientific hypothesis that the rate of evolution of the virus gradually decreases over time. We also found 13 statistically significant positive selection sites in the SARS-CoV-2 genome. In addition, the results showed that there were 101 nonsynonymous mutation sites in the amino acid sequence of S protein, including seven putative harmful mutation sites. This paper has preliminarily clarified the evolutionary characteristics of SARS-CoV-2 in the United States, providing a scientific basis for future surveillance and prevention of virus variants.


Assuntos
COVID-19/epidemiologia , Evolução Molecular , Genoma Viral/genética , SARS-CoV-2/genética , Glicoproteína da Espícula de Coronavírus/genética , Sequência de Aminoácidos/genética , COVID-19/patologia , Biologia Computacional , Humanos , Taxa de Mutação , Estados Unidos/epidemiologia , Sequenciamento Completo do Genoma
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