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1.
PLoS One ; 19(7): e0304769, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38991012

RESUMO

Nesting colonial seabirds are prime examples of central-place foragers, animals that must return to a central location (e.g., a breeding colony) after each bout of foraging. They must balance the costs and benefits of foraging with the need to return to their colonies frequently to form pair bonds during courtship, incubate, provision mates and offspring, and protect and rear young. For some populations, the loss and degradation of suitable breeding habitat due to human activities have necessitated the construction of new breeding sites and/or the restoration of previously occupied sites. South Island, which is part of the Hampton Roads Bridge-Tunnel (HRBT) complex in the Commonwealth of Virginia, U.S.A., is a human-created island that supported Virginia's largest mixed species seabird colony until 2020, when the expansion of the HRBT began and when all nesting seabirds were permanently excluded from the site. We studied the movement patterns of foraging common terns (Sterna hirundo) to determine how travel to and around foraging sites related to their colony location and to inform the siting and construction of a new breeding island. We tracked 18 individual common terns from 07 June to 29 June 2018, and we used a hidden Markov model to assign behavioral states and investigate common tern movements around the HRBT. Common terns spent more than half their time in the colony (58%), followed by time devoted to foraging (22%), and the remainder of their time was spent on outbound (15%) and inbound (5%) transit. Terns traveled as far as 98km from the colony, but on average foraged relatively close to South Island (13.6 ± 0.3km, mean ± 1 SD). Individuals tended to forage in the same locations, but there was variation among individuals. Flying to foraging sites uses energy during the already energetically costly breeding season, thus managers should prioritize placing a new colony site in a location that minimizes the distance traveled to the foraging locations frequented by the South Island birds while accounting for other life-history characteristics. These findings could help in the design and construction of new breeding sites or the restoration of current sites for other, related species, particularly for which these data do not exist.


Assuntos
Charadriiformes , Animais , Virginia , Charadriiformes/fisiologia , Comportamento de Nidação/fisiologia , Ecossistema , Cruzamento , Feminino , Masculino , Comportamento Alimentar/fisiologia , Reprodução/fisiologia , Migração Animal/fisiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-38929023

RESUMO

We evaluated the impact of Medicaid policies in Virginia (VA), namely the Addiction and Recovery Treatment Services (ARTS) program and Medicaid expansion, on the number of behavioral health acute inpatient admissions from 2016 to 2019. We used Poisson fixed-effect event study regression and compared average proportional differences in admissions over three time periods: (1) prior to ARTS; (2) following ARTS but before Medicaid expansion; (3) post-Medicaid expansion. The number of behavioral health acute inpatient admissions decreased by 2.6% (95% CI [-5.1, -0.2]) in the first quarter of 2018 and this decrease gradually intensified by 4.9% (95% CI [-7.5, -2.4]) in the fourth quarter of 2018 compared to the second quarter of 2017 (beginning of ARTS) in VA relative to North Carolina (NC). Following the first quarter of 2019 (beginning of Medicaid expansion), decreases in VA admissions became larger relative to NC. The average proportional difference in admissions estimated a decrease of 2.7% (95% CI, [-4.1, -0.8]) after ARTS but before Medicaid expansion and a decrease of 2.9% (95% CI, [-6.1, 0.4]) post-Medicaid expansion compared to pre-ARTS in VA compared to NC. Behavioral health acute inpatient admissions in VA decreased following ARTS implementation, and the decrease became larger after Medicaid expansion.


Assuntos
Medicaid , Transtornos Relacionados ao Uso de Substâncias , Medicaid/estatística & dados numéricos , Virginia , Humanos , Transtornos Relacionados ao Uso de Substâncias/terapia , Estados Unidos , Hospitalização/estatística & dados numéricos , Masculino , Adulto , Feminino , Pacientes Internados/estatística & dados numéricos , Pessoa de Meia-Idade
3.
J Water Health ; 22(6): 1064-1074, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38935457

RESUMO

We characterized concentrations of trihalomethanes (THMs), a measure of disinfection byproducts (DBPs), in tap water samples collected from households with utility-supplied water in two rural counties in Appalachian Virginia, and assessed associations with pH, free chlorine, and metal ions which can impact THM formation. Free chlorine concentrations in all samples (n = 27 homes) complied with EPA drinking water guidelines, though 7% (n = 2) of first draw samples and 11% (n = 3) of 5-min flushed-tap water samples exceeded the US Safe Drinking Water Act (SDWA) maximum contaminant level (MCL) for THM (80 ppb). Regression analyses showed that free chlorine and pH were positively associated with the formation of THM levels above SDWA MCLs (OR = 1.04, p = 0.97 and OR = 1.74, p = 0.79, respectively), while temperature was negatively associated (OR = 0.78, p = 0.38). Of the eight utilities serving study households, samples from water served by three different utilities exceeded the EPA MCL for THM. Overall, these findings do not indicate substantial exposures to DBPs for rural households with utility-supplied water in this region of southwest Virginia. However, given the observed variability in THM concentrations between and across utilities, and established adverse health impacts associated with chronic and acute DBP exposure, more research on DBPs in rural Central Appalachia is warranted.


Assuntos
Cloro , Água Potável , População Rural , Trialometanos , Poluentes Químicos da Água , Abastecimento de Água , Virginia , Cloro/análise , Água Potável/química , Água Potável/análise , Poluentes Químicos da Água/análise , Trialometanos/análise , Purificação da Água/métodos , Desinfecção , Humanos , Desinfetantes/análise , Região dos Apalaches , Características da Família
4.
Harmful Algae ; 135: 102634, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38830711

RESUMO

Previous research on phytoplankton blooms has often focused on the initiation of blooms, while studies on the mechanisms underlying bloom decline and termination have been more limited. This study aimed to explore the extent of which Acartia tonsa (copepod) grazing does or does not contribute to Margalefidinium polykrikoides (dinoflagellate) bloom decline. M. polykrikoides is a prominent harmful algal bloom (HAB) species that forms dense blooms in coastal and estuarine systems around the world with known ichthyotoxic effects. Sampling occurred in the lower York River Estuary, Virginia, USA in 2021 and 2022 during two M. polykrikoides blooms. Prey removal experiments were conducted using organisms collected from the field to estimate A. tonsa ingestion rates on M. polykrikoides. While A. tonsa was capable of ingesting M. polykrikoides at low abundance, when M. polykrikoides abundance exceeded 2000 cells mL-1, A. tonsa experienced nearly 100% mortality in the 24-hour prey removal experiments. This suggests that A. tonsa likely cannot exert any top-down control on M. polykrikoides blooms, rather, at high concentrations, M. polykrikoides may act as its own grazing deterrent. Extensive M. polykrikoides blooms could therefore continue to persist due to a reduction in grazing pressure, rather than an increase. This would suggest that the decline of M. polykrikoides blooms is likely caused by another factor. As the frequency, duration, and magnitude of HABs are expected to increase in the future, these findings provide key insights to the trophic interactions that may be influencing the duration of M. polykrikoides blooms.


Assuntos
Copépodes , Dinoflagellida , Proliferação Nociva de Algas , Dinoflagellida/fisiologia , Dinoflagellida/crescimento & desenvolvimento , Animais , Proliferação Nociva de Algas/fisiologia , Copépodes/fisiologia , Virginia , Cadeia Alimentar , Estuários
5.
J Christ Nurs ; 41(3): E47-E55, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38853327

RESUMO

ABSTRACT: The professional nurse cares for an increasingly diverse population, varying in ethnicity, culture, and faith beliefs that influence health and wellness. The moral obligation of the nurse to provide individualized, holistic care of clients includes spiritual care. Supported by the Agape Model of Nursing, nurses should understand their personal religiosity and its impact on the care they provide. The purpose of this study was to better understand the self-reported religiosity and spirituality of registered nurses licensed to practice in the Commonwealth of Virginia.


Assuntos
Cristianismo , Autorrelato , Espiritualidade , Humanos , Virginia , Feminino , Adulto , Masculino , Pessoa de Meia-Idade
6.
JAMA Health Forum ; 5(6): e241383, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38848088

RESUMO

Importance: Dual Eligible Special Needs Plans (D-SNPs) are private managed care plans designed to promote Medicare and Medicaid integration for full-benefit, dually eligible beneficiaries. Currently, the highest level of D-SNP integration occurs in plans with exclusively aligned enrollment (EAE). Objective: To compare patient experience of care, out-of-pocket spending, and satisfaction among dually enrolled Medicaid beneficiaries in D-SNPs with EAE, those in D-SNPs without EAE, and those with traditional Medicare. Design, Setting, and Participants: This cross-sectional study included respondents to a mail survey fielded to a stratified random sample of full-benefit, community-dwelling, dual-eligible Medicaid beneficiaries who qualified for receipt of home and community-based services in the Virginia Medicaid Commonwealth Coordinated Care Plus program between March and October 2022. Exposure: Enrollment in a D-SNP with EAE or a D-SNP without EAE vs traditional Medicare. Main Outcomes and Measures: The main outcomes were self-reported measures of access and delays in receiving plan approvals, out-of-pocket spending, and satisfaction with health plans' customer service and choice of primary care and specialist physicians. Results: Of 7200 surveys sent, 2226 were completed (response rate, 30.9%). The analytic sample consisted of 1913 Medicaid beneficiaries with nonmissing data on covariates (mean [SD] age, 70.8 [15.6] years; 1367 [71.5%] female). Of these, 583 (30.5%) were enrolled in D-SNPs with EAE, 757 (39.6%) in D-SNPs without EAE, and 573 (30.0%) in traditional Medicare. Compared with respondents enrolled in D-SNPs without EAE, those in D-SNPs with the highest level of integration (EAE) were 6.77 percentage points (95% CI, 8.81-12.66 percentage points) more likely to report being treated with courtesy and respect and 5.83 percentage points (95% CI, 0.21-11.46 percentage points) more likely to know who to call when they had a health problem. No statistically significant differences were found between members in either type of D-SNP and between those in D-SNPs and traditional Medicare in terms of their difficulty accessing care, delays in care, and satisfaction with care coordination and physician choice. Conclusions and Relevance: This cross-sectional study found some benefits of integrating administrative processes under Medicare and Medicaid but suggests that care coordination and access improvements under full integration require additional time and/or efforts to achieve.


Assuntos
Medicaid , Medicare , Humanos , Estados Unidos , Estudos Transversais , Feminino , Masculino , Medicaid/estatística & dados numéricos , Idoso , Pessoa de Meia-Idade , Satisfação do Paciente , Virginia , Definição da Elegibilidade , Programas de Assistência Gerenciada/organização & administração , Inquéritos e Questionários , Gastos em Saúde/estatística & dados numéricos , Adulto , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos
7.
PLoS One ; 19(6): e0304165, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38913675

RESUMO

BACKGROUND: There is limited understanding of how social determinants of health (SDOH) impact family decision-making when seeking surgical care for children. Our objectives of this study are to identify key family experiences that contribute to decision-making when accessing surgical care for children, to confirm if family experiences impact delays in care, and to describe differences in family experiences across populations (race, ethnicity, socioeconomic status, rurality). METHODS: We will use a prospective, cross-sectional, mixed methods design to examine family experiences during access to care for children with appendicitis. Participants will include 242 parents of consecutive children (0-17 years) with acute appendicitis over a 15-month period at two academic health systems in North Carolina and Virginia. We will collect demographic and clinical data. Parents will be administered the Adult Responses to Children's Symptoms survey (ARCS), the child and parental forms of the Adverse Childhood Experiences (ACE) survey, the Accountable Health Communities Health-Related Social Needs Screening Tool, and Single Item Literacy Screener. Parallel ARCS data will be collected from child participants (8-17 years). We will use nested concurrent, purposive sampling to select a subset of families for semi-structured interviews. Qualitative data will be analyzed using thematic analysis and integrated with quantitative data to identify emerging themes that inform a conceptual model of family-level decision-making during access to surgical care. Multivariate linear regression will be used to determine association between the appendicitis perforation rate and ARCS responses (primary outcome). Secondary outcomes include comparison of health literacy, ACEs, and SDOH, clinical outcomes, and family experiences across populations. DISCUSSION: We expect to identify key family experiences when accessing care for appendicitis which may impact outcomes and differ across populations. Increased understanding of how SDOH and family experiences influence family decision-making may inform novel strategies to mitigate surgical disparities in children.


Assuntos
Apendicite , Tomada de Decisões , Acessibilidade aos Serviços de Saúde , Humanos , Criança , Estudos Transversais , Adolescente , Pré-Escolar , Masculino , Feminino , Apendicite/cirurgia , Lactente , Estudos Prospectivos , Pais/psicologia , Recém-Nascido , Família/psicologia , North Carolina , Virginia
8.
Nutrients ; 16(10)2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38794760

RESUMO

Household food insecurity is not necessarily equally experienced by all household members, with mothers often changing their intake first when food resources are limited. The purpose of this study was to understand the association between maternal mental health and intrahousehold differences in food security statuses. A cross-sectional survey was administered to Virginia mothers with low income (August-October 2021), assessing validated measures of food security, mental and physical health and related factors. Participants (n = 570) were grouped according to the food security status of adults and children within the household. Linear regression was used to assess the outcomes of interest by group and controlled for key demographic variables. Mothers in households with any food insecurity reported worse overall mental health and used 3-4 more food coping strategies than households experiencing food security (p < 0.05). Only mothers in households where adults experienced food insecurity reported significantly greater anxiety and depressive symptoms (61.5 and 58.1, respectively) compared to households experiencing food security (55.7 and 52.4, p < 0.001). While any experience of household food insecurity is associated with worse maternal mental health, there were differences by the within-household food security status. Future research should explore screening measures that capture specific household members' food security to connect households with available resources.


Assuntos
Características da Família , Insegurança Alimentar , Segurança Alimentar , Saúde Mental , Mães , Humanos , Feminino , Adulto , Saúde Mental/estatística & dados numéricos , Estudos Transversais , Segurança Alimentar/estatística & dados numéricos , Mães/psicologia , Pobreza/estatística & dados numéricos , Depressão/epidemiologia , Ansiedade/epidemiologia , Virginia/epidemiologia , Saúde Materna/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Adulto Jovem
9.
Sci Rep ; 14(1): 11958, 2024 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-38796489

RESUMO

Freshwater mussels (Mollusca: Unionidae) play a crucial role in freshwater river environments where they live in multi-species aggregations and often serve as long-lived benthic ecosystem engineers. Many of these species are imperiled and it is imperative that we understand their basic needs to aid in the reestablishment and maintenance of mussel beds in rivers. In an effort to expand our knowledge of the diet of these organisms, five species of mussel were introduced into enclosed systems in two experiments. In the first, mussels were incubated in water from the Clinch River (Virginia, USA) and in the second, water from a manmade pond at the Commonwealth of Virginia's Aquatic Wildlife Conservation Center in Marion, VA. Quantitative PCR and eDNA metabarcoding were used to determine which planktonic microbes were present before and after the introduction of mussels into each experimental system. It was found that all five species preferentially consumed microeukaryotes over bacteria. Most microeukaryotic taxa, including Stramenopiles and Chlorophytes were quickly consumed by all five mussel species. We also found that they consumed fungi but not as quickly as the microalgae, and that one species of mussel, Ortmanniana pectorosa, consumed bacteria but only after preferred food sources were depleted. Our results provide evidence that siphon feeding Unionid mussels can select preferred microbes from mixed plankton, and mussel species exhibit dietary niche differentiation.


Assuntos
Bactérias , Bivalves , Fungos , Animais , Fungos/genética , Fungos/classificação , Fungos/isolamento & purificação , Bactérias/genética , Bactérias/classificação , Bactérias/isolamento & purificação , Bivalves/microbiologia , Água Doce/microbiologia , Dieta , Rios/microbiologia , Ecossistema , Virginia
10.
J Hazard Mater ; 472: 134463, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38723486

RESUMO

Per- and polyfluoroalkyl substances (PFAS) are a class of toxic manufactured chemicals in commercial and consumer products. They are resistant to environmental degradation and mobile in soil, air, and water. This study used the introduced bivalve Corbicula fluminea as a passive biomonitor at sampling locations in a primary drinking water source in Virginia, USA. Many potential PFAS sources were identified in the region. Perfluorohexane sulfonate (PFHxS) and 6:2 fluorotelomer sulfonic acid (6:2 FTS) levels were highest downstream of an airport. The highest levels of short-chain carboxylic acids were in locations downstream of a wastewater treatment plant. Measured PFAS concentrations varied by location in C. fluminea, sediment, and surface water samples. Two compounds were detected across all three mediums. Calculated partitioning coefficients confirm bioaccumulation of PFAS in C. fluminea and sorption to sediment. C. fluminea bioaccumulated two PFAS not found in the other mediums. Perfluoroalkyl carboxylic acids and short-chain compounds dominated in clam tissue, which contrasts with findings of accumulation of longer-chain and perfluorosulfonic acids in fish. These findings suggest the potential for using bivalves to complement other organisms to better understand the bioaccumulation of PFAS and their fate and transport in a freshwater ecosystem.


Assuntos
Corbicula , Fluorocarbonos , Poluentes Químicos da Água , Animais , Poluentes Químicos da Água/análise , Fluorocarbonos/análise , Corbicula/metabolismo , Corbicula/química , Monitoramento Ambiental/métodos , Sedimentos Geológicos/química , Sedimentos Geológicos/análise , Monitoramento Biológico , Virginia
11.
Sci Rep ; 14(1): 11021, 2024 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-38744972

RESUMO

For the past 15 years, the proportion of honey bee hives that fail to survive winter has averaged ~ 30% in the United States. Winter hive loss has significant negative impacts on agriculture, the economy, and ecosystems. Compared to other factors, the role of honey bee gut microbial communities in driving winter hive loss has received little attention. We investigate the relationship between winter survival and honey bee gut microbiome composition of 168 honey bees from 23 hives, nine of which failed to survive through winter 2022. We found that there was a substantial difference in the abundance and community composition of honey bee gut microbiomes based on hive condition, i.e., winter survival or failure. The overall microbial abundance, as assessed using Quantitative Microbiome Profiling (QMP), was significantly greater in hives that survived winter 2022 than in those that failed, and the average overall abundance of each of ten bacterial genera was also greater in surviving hives. There were no significant differences in alpha diversity based on hive condition, but there was a highly significant difference in beta diversity. The bacterial genera Commensalibacter and Snodgrassella were positively associated with winter hive survival. Logistic regression and random forest machine learning models on pooled ASV counts for the genus data were highly predictive of winter outcome, although model performance decreased when samples from the location with no hive failures were excluded from analysis. As a whole, our results show that the abundance and community composition of honey bee gut microbiota is associated with winter hive loss, and can potentially be used as a diagnostic tool in evaluating hive health prior to the onset of winter. Future work on the functional characterization of the honey bee gut microbiome's role in winter survival is warranted.


Assuntos
Microbioma Gastrointestinal , Estações do Ano , Animais , Abelhas/microbiologia , Microbioma Gastrointestinal/genética , Virginia , Bactérias/genética , Bactérias/classificação , Bactérias/isolamento & purificação
12.
Int J Hyg Environ Health ; 260: 114390, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38772087

RESUMO

OBJECTIVES: In the US, violations of drinking water regulations are highest in lower-income rural areas overall, and particularly in Central Appalachia. However, data on drinking water use, quality, and associated health outcomes in rural Appalachia are limited. We sought to assess public and private drinking water sources and associated risk factors for waterborne pathogen exposures for individuals living in rural regions of Appalachian Virginia. METHODS: We administered surveys and collected tap water, bottled water, and saliva samples in lower-income households in two adjacent rural counties in southwest Virginia (bordering Kentucky and Tennessee). Water samples were tested for pH, temperature, conductivity, total coliforms, E. coli, free chlorine, nitrate, fluoride, heavy metals, and specific pathogen targets. Saliva samples were analyzed for antibody responses to potentially waterborne infections. We also shared water analysis results with households. RESULTS: We enrolled 33 households (83 individuals), 82% (n = 27) with utility-supplied water and 18% with private wells (n = 3) or springs (n = 3). 58% (n = 19) reported household incomes of <$20,000/year. Total coliforms were detected in water samples from 33% (n = 11) of homes, E. coli in 12%, all with wells or springs (n = 4), and Aeromonas, Campylobacter, and Enterobacter in 9%, all spring water (n = 3). Diarrhea was reported for 10% of individuals (n = 8), but was not associated with E. coli detection. 34% (n = 15) of saliva samples had detectable antibody responses for Cryptosporidium spp., C. jejuni, and Hepatitis E. After controlling for covariates and clustering, individuals in households with septic systems and straight pipes had significantly higher likelihoods of antibody detection (risk ratios = 3.28, 95%CI = 1.01-10.65). CONCLUSIONS: To our knowledge, this is the first study to collect and analyze drinking water samples, saliva samples, and reported health outcome data from low-income households in Central Appalachia. Our findings indicate that utility-supplied water in this region was generally safe, and individuals in low-income households without utility-supplied water or sewerage have higher exposures to waterborne pathogens.


Assuntos
Água Potável , Humanos , Água Potável/microbiologia , Virginia/epidemiologia , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Saliva/microbiologia , Microbiologia da Água , Qualidade da Água , Abastecimento de Água , Adulto Jovem , Adolescente , População Rural/estatística & dados numéricos , Idoso , Região dos Apalaches/epidemiologia , Criança , Pobreza
14.
J Public Health Manag Pract ; 30(3): E94-E101, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38603759

RESUMO

CONTEXT: Home-based asthma interventions have a significant evidence base as an effective means to address moderate and severe breathing concerns triggered by home conditions. However, the literature lacks logistical and staffing considerations necessary to successfully implement such a program at a governmental level. This practice report and process evaluation outlines practical details and lessons learned during a healthy homes pilot, and how they were addressed in the design of a permanent program. OBJECTIVE: To inform the creation of a permanent home-based asthma intervention at the Alexandria Health Department (AHD) (City of Alexandria, Virginia) and understand the tools and resources necessary for success. INTERVENTION: Participating households received a health and environmental assessment, followed by cleaning supplies, relevant education, and referrals to partners for services. AHD staff tracked challenges and insights at each step of the intervention. At the end of the pilot, staff worked with the community to identify solutions and design a permanent program. CONCLUSIONS: Although the pilot model was constructed based on existing case studies, technical assistance from national experts, and guidance documents, the team still experienced challenges around recruitment, staff support, home visit implementation, and impact evaluation. While pilots and existing literature can be instructive for identifying issues, work with residents and partners to develop a uniquely tailored community program was essential for practical success. IMPLICATIONS ON POLICY AND PRACTICE: Health departments developing new initiatives should consider both the staff and participant experience throughout the creation of administrative and programmatic processes. Testing out draft versions of these processes and materials using internal and external focus groups can identify potential bottlenecks and solutions upfront.


Assuntos
Asma , Humanos , Asma/terapia , Virginia
16.
Sci Total Environ ; 929: 172539, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38649039

RESUMO

Per- and polyfluoroalkyl substances (PFAS) are a class of man-made contaminants of human health concern due to their resistance to degradation, widespread environmental occurrence, bioaccumulation in living organisms, and potential negative health impacts. Private drinking water supplies may be uniquely vulnerable to PFAS contamination in impacted areas, as these systems are not protected under federal regulations and often include limited treatment or remediation, if contaminated, prior to use. The goal of this study was to determine the incidence of PFAS contamination in private drinking water supplies in two counties in Southwest Virginia, USA (Floyd and Roanoke) that share similar bedrock geologies, are representative of different state Department of Health risk categories, and to examine the potential for reliance on citizen-science based strategies for sample collection in subsequent efforts. Samples for inorganic ions, bacteria, and PFAS analysis were collected on separate occasions by participants and experts at the home drinking water point of use (POU) for comparison. Experts also collected outside tap samples for analysis of 30 PFAS compounds. At least one PFAS was detectable in 95 % of POU samples collected (n = 60), with a mean total PFAS concentration of 23.5 ± 30.8 ppt. PFOA and PFOS, two PFAS compounds which presently have EPA health advisories, were detectable in 13 % and 22 % of POU samples, respectively. On average, each POU sample contained >3 PFAS compounds, and one sample contained as many as 8 compounds, indicating that exposure to a mixture of PFAS in drinking water may be occurring. Although there were significant differences in total PFAS concentrations between expert and participant collected samples (Wilcoxon, alpha = 0.05), collector bias was inconsistent, and may be due to the time of day of sampling (i.e. morning, afternoon) or specific attributes of a given home. Further research is required to resolve sources of intra-sample variability.


Assuntos
Água Potável , Monitoramento Ambiental , Fluorocarbonos , Poluentes Químicos da Água , Abastecimento de Água , Poluentes Químicos da Água/análise , Água Potável/química , Fluorocarbonos/análise , Virginia , Abastecimento de Água/estatística & dados numéricos
18.
J Phycol ; 60(2): 299-307, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38433431

RESUMO

Gomphonema parvulum is a cosmopolitan freshwater diatom that is used as an indicator in water quality biomonitoring. In this study, we report the culturing of two geographically separated isolates from southeastern North America, their morphology, and the sequencing and assembly of their mitochondrial and chloroplast genomes. Morphologically, both strains fit G. parvulum sensu lato, but the frustules from a protected habitat in South Carolina were smaller than those cited in the historic data of this species from the same location as well as a second culture from Virginia. Phylogenetic analyses using the rbcL gene placed both within a clade with G. parvulum. Genetic markers, including full chloroplast and mitochondrial genomes and the nuclear small subunit rRNA gene region were assembled from each isolate. The organellar genomes of the two strains varied slightly in size due to small differences in intergenic regions with chloroplast genomes of 121,035 bp and 121,482 bp and mitochondrial genomes of 34,639 bp and 34,654 bp. The intraspecific pairwise identities of the chloroplast and mitochondrial genomes of these two isolates were 97.9% and 95.4%, respectively. Multigene phylogenetic analysis demonstrated a close relationship between G. parvulum, Gomphoneis minuta, and Didymosphenia geminata.


Assuntos
Diatomáceas , Genoma de Cloroplastos , Genoma Mitocondrial , Filogenia , Diatomáceas/genética , South Carolina , Virginia , Cloroplastos/genética
19.
Curr Oncol ; 31(3): 1129-1144, 2024 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-38534917

RESUMO

BACKGROUND: Examining lung cancer (LC) cases in Virginia (VA) is essential due to its significant public health implications. By studying demographic, environmental, and socioeconomic variables, this paper aims to provide insights into the underlying drivers of LC prevalence in the state adjusted for spatial associations at the zipcode level. METHODS: We model the available VA zipcode-level LC counts via (spatial) Poisson and negative binomial regression models, taking into account missing covariate data, zipcode-level spatial association and allow for overdispersion. Under latent Gaussian Markov Random Field (GMRF) assumptions, our Bayesian hierarchical model powered by Integrated Nested Laplace Approximation (INLA) considers simultaneous (spatial) imputation of all missing covariates through elegant prediction. The spatial random effect across zip codes follows a Conditional Autoregressive (CAR) prior. RESULTS: Zip codes with elevated smoking indices demonstrated a corresponding increase in LC counts, underscoring the well-established connection between smoking and LC. Additionally, we observed a notable correlation between higher Social Deprivation Index (SDI) scores and increased LC counts, aligning with the prevalent pattern of heightened LC prevalence in regions characterized by lower income and education levels. On the demographic level, our findings indicated higher LC counts in zip codes with larger White and Black populations (with Whites having higher prevalence than Blacks), lower counts in zip codes with higher Hispanic populations (compared to non-Hispanics), and higher prevalence among women compared to men. Furthermore, zip codes with a larger population of elderly people (age ≥ 65 years) exhibited higher LC prevalence, consistent with established national patterns. CONCLUSIONS: This comprehensive analysis contributes to our understanding of the complex interplay of demographic and socioeconomic factors influencing LC disparities in VA at the zip code level, providing valuable information for targeted public health interventions and resource allocation. Implementation code is available at GitHub.


Assuntos
Neoplasias Pulmonares , Masculino , Humanos , Feminino , Idoso , Virginia , Prevalência , Teorema de Bayes , Fatores Socioeconômicos
20.
Contraception ; 135: 110434, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38508407

RESUMO

OBJECTIVES: Health care chaplains are faith providers with theological education, pastoral experience, and clinical training who provide spiritual care to patients, their families, and medical staff. This study sought to characterize chaplains' experiences providing spiritual care for patients experiencing abortion and pregnancy loss and to explore how chaplains gain competency and comfort in providing pastoral care for this patient population. STUDY DESIGN: Researchers conducted in-depth, semistructured, qualitative interviews with currently-practicing chaplains recruited via convenience sampling in the Washington DC, Maryland, and Virginia region. We analyzed interviews using directed content analysis and coded using both inductive and deductive coding. RESULTS: We interviewed 13 chaplains. The majority were Protestant and identified as Democrats. Participants often personally struggled with the acceptability of abortion but emphasized the importance of spiritual care for this patient population. They recognized that religious stigma regarding abortion prevented referrals to chaplaincy. Though desiring to contribute, chaplains reported little formal education in pregnancy support counseling. They relied on foundational pastoral care skills, like holding space, values clarification, connecting with patients' spirituality, words of comfort, ritualistic memorialization, and resource provision. All desired more training specific to abortion and pregnancy loss in chaplaincy education. CONCLUSIONS: Chaplains from varied faith backgrounds have a diverse set of skills to support patients experiencing abortion or pregnancy loss, but feel underutilized and lacking in formal training. Though not all patients require pastoral support, chaplains can be critical members of the care team, particularly for those patients experiencing spiritual distress. IMPLICATIONS: Chaplains have a paucity of training in supporting patients experiencing abortion and pregnancy loss. Chaplains want to be involved with patients experiencing abortion but feel excluded by both patients and practitioners. Standardization of pastoral care training is important to ensure adequate spiritual support for patients who desire such services.


Assuntos
Aborto Induzido , Clero , Assistência Religiosa , Pesquisa Qualitativa , Humanos , Feminino , Virginia , Aborto Induzido/psicologia , Gravidez , Clero/psicologia , Maryland , Adulto , District of Columbia , Masculino , Pessoa de Meia-Idade
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