Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.222
Filtrar
1.
Int J Health Geogr ; 21(1): 17, 2022 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-36344996

RESUMO

BACKGROUND: Food is not equitably available. Deficiencies and generalizations limit national datasets, food security assessments, and interventions. Additional neighborhood level studies are needed to develop a scalable and transferable process to complement national and internationally comparative data sets with timely, granular, nuanced data. Participatory geographic information systems (PGIS) offer a means to address these issues by digitizing local knowledge. METHODS: The objectives of this study were two-fold: (i) identify granular locations missing from food source and risk datasets and (ii) examine the relation between the spatial, socio-economic, and agency contributors to food security. Twenty-nine subject matter experts from three cities in Southeastern Virginia with backgrounds in food distribution, nutrition management, human services, and associated research engaged in a participatory mapping process. RESULTS: Results show that publicly available and other national datasets are not inclusive of non-traditional food sources or updated frequently enough to reflect changes associated with closures, expansion, or new programs. Almost 6 percent of food sources were missing from publicly available and national datasets. Food pantries, community gardens and fridges, farmers markets, child and adult care programs, and meals served in community centers and homeless shelters were not well represented. Over 24 km2 of participant identified need was outside United States Department of Agriculture low income, low access areas. Economic, physical, and social barriers to food security were interconnected with transportation limitations. Recommendations address an international call from development agencies, countries, and world regions for intervention methods that include systemic and generational issues with poverty, incorporate non-traditional spaces into food distribution systems, incentivize or regulate healthy food options in stores, improve educational opportunities, increase data sharing. CONCLUSIONS: Leveraging city and regional agency as appropriate to capitalize upon synergistic activities was seen as critical to achieve these goals, particularly for non-traditional partnership building. To address neighborhood scale food security needs in Southeastern Virginia, data collection and assessment should address both environment and utilization issues from consumer and producer perspectives including availability, proximity, accessibility, awareness, affordability, cooking capacity, and preference. The PGIS process utilized to facilitate information sharing about neighborhood level contributors to food insecurity and translate those contributors to intervention strategies through discussion with local subject matter experts and contextualization within larger scale food systems dynamics is transferable.


Assuntos
Abastecimento de Alimentos , Características de Residência , Adulto , Criança , Estados Unidos , Humanos , Virginia/epidemiologia , Pobreza , Segurança Alimentar
2.
J Am Board Fam Med ; 35(5): 979-989, 2022 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-36257695

RESUMO

PURPOSE: HHS' Million Hearts campaign focused the delivery system on ABCS clinical quality measures (appropriate Aspirin use, Blood pressure control, Cholesterol control, and Smoking cessation counseling). AHRQ's Evidence Now project funded 7 collaboratives to test different ways to improve performance and outcomes on ABCS within small primary care practices. The Heart of Virginia Health care (HVH) collaborative designed 1 of the approaches in Evidence Now. METHODS: Two hundred sixty-four eligible practices were recruited to participate and randomized to 3 cohorts in a stepped wedge design, and 173, employing 16 different EHRs, remained for the duration of the initiative. The practice support curriculum was delivered by trained practice coaches to enhance overall practice function and improve performance on the ABCS metrics. The intervention consisted of a kickoff meeting, 3 months of intensive support, 9 months of ongoing support, and access to online learning materials and expert faculty. The mean practice contact time with coaches was 428 minutes, but the standard deviation was 426 minutes. RESULTS: Overall, the short HVH intervention had a small but statistically significant positive average effects on appropriate use of aspirin and other antithrombotics, small negative effects on blood pressure control, except for those practices which did not attend the kickoff, and small negative effects on smoking cessation counseling. CONCLUSIONS: The intervention phase was truncated due to difficulty in recruiting a sufficient number of practices. This undoubtedly contributed to the lack of substantial improvements in the ABCS. Other likely contributing factors were our inability to provide real time feedback on metrics and the frequency with which major practice disruptions occurred. Future efforts to improve primary care practice function should allow adequate time for both practice recruitment and external support.


Assuntos
Doenças Cardiovasculares , Atenção Primária à Saúde , Humanos , Melhoria de Qualidade , Virginia , Fibrinolíticos , Atenção à Saúde , Aspirina , Colesterol
3.
Ann Fam Med ; 20(5): 446-451, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36228075

RESUMO

PURPOSE: Primary care is the foundation of the health care workforce and the only part that extends life and improves health equity. Previous research on the geographic and specialty distribution of physicians has relied on the American Medical Association's Masterfile, but these data have limitations that overestimate the workforce. METHODS: We present a pragmatic, systematic, and more accurate method for identifying primary care physicians using the National Plan and Provider Enumeration System (NPPES) and the Virginia All-Payer Claims Database (VA-APCD). Between 2015 and 2019, we identified all Virginia physicians and their specialty through the NPPES. Active physicians were defined by at least 1 claim in the VA-APCD. Specialty was determined hierarchically by the NPPES. Wellness visits were used to identify non-family medicine physicians who were providing primary care. RESULTS: In 2019, there were 20,976 active physicians in Virginia, of whom 5,899 (28.1%) were classified as providing primary care. Of this primary care physician workforce, 52.4% were family medicine physicians; the remaining were internal medicine physicians (18.5%), pediatricians (16.8%), obstetricians and gynecologists (11.8%), and other specialists (0.5%). Over 5 years, the counts and relative percentages of the workforce made up by primary care physicians remained relatively stable. CONCLUSIONS: Our novel method of identifying active physicians with a primary care scope provides a realistic size of the primary care workforce in Virginia, smaller than some previous estimates. Although the method should be expanded to include advanced practice clinicians and to further delineate the scope of practice, this simple approach can be used by policy makers, payers, and planners to ensure adequate primary care capacity.


Assuntos
Medicina , Especialização , Humanos , Atenção Primária à Saúde , Estados Unidos , Virginia , Recursos Humanos
4.
Eur J Med Res ; 27(1): 213, 2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36307887

RESUMO

Sepsis is an inflammation caused by the body's systemic response to an infection. The infection could be a result of many diseases, such as pneumonia, urinary tract infection, and other illnesses. Some of its symptoms are fever, tachycardia, tachypnea, etc. Unfortunately, sepsis remains a critical problem at the hospitals and leads to many issues, such as increasing mortality rate, health care costs, and health care utilization. Early detection of sepsis in patients can help respond quickly, take preventive actions, and prevent major issues. The main aim of this study is to predict the risk of sepsis by utilizing the patient's demographic and clinical information, i.e., patient's gender, age, severity level, mortality risk, admit type along with hospital length of stay. Six machine learning approaches, Logistic Regression (LR), Naïve Bayes, Support Vector Machine (SVM), Boosted Tree, Classification and Regression Tree (CART), and Bootstrap Forest are used to predict the risk of sepsis. The results showed that different machine learning methods have other performances in terms of various measures. For instance, the Bootstrap Forest machine learning method exhibited the highest performance in AUC and R-square or SVM and Boosted Tree showed the highest performance in terms of misclassification rate. The Bootstrap Forest can be considered the best machine learning method in predicting sepsis regarding applied features in this research, mainly because it showed superior performance and efficiency in two performance measures: AUC and R-square.


Assuntos
Aprendizado de Máquina , Sepse , Humanos , Teorema de Bayes , Virginia , Sepse/diagnóstico , Hospitais
5.
Nanoscale Horiz ; 7(10): 1119-1120, 2022 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-36106837

RESUMO

Our Emerging Investigator Series highlights exceptional work by early-career nanoscience and nanotechnology researchers. Read Huiyuan Zhu's Emerging Investigator Series article 'Heterostructured Bi-Cu2S nanocrystals for efficient CO2 electroreduction to formate' (https://doi.org/10.1039/D1NH00661D) and read more about her in the interview below.


Assuntos
Dióxido de Carbono , Formiatos , Feminino , Humanos , Virginia
6.
JCO Glob Oncol ; 8: e2200180, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-36049151

RESUMO

PURPOSE: This study aimed to examine the quality of life of tobacco farmers and their desire to stop growing tobacco. METHODS: A cross-sectional home-based survey was conducted between October 2021 and January 2022 among 2,970 Virginia and Burley tobacco farmers in Northern Thailand. Multivariate logistic regression models were used to determine the association between farmers' characteristics and their quality of life and a desire to stop planting tobacco. RESULTS: In total, 58.5% of the participants wanted to stop growing tobacco, and most had a lower quality of life than the mean. Nine independent variables were associated with a desire to stop tobacco farming: having a low level of economic quality of life (adjusted odds ratio [ORAdj], 5.42; 95% CI, 3.8 to 7.8); having a high environmental quality of life (ORAdj, 4.60; 95% CI, 3.3 to 6.5); belonging to the Tobacco Farmers' Association (ORAdj, 3.04; 95% CI, 2.1 to 4.5); growing tobacco on their own land (ORAdj, 2.12; 95% CI, 1.8 to 2.6); having a low social quality of life (ORAdj, 1.69; 95% CI, 1.4 to 2.1); having a low health quality of life (ORAdj, 1.69; 95% CI, 1.4 to 2.1); having a low spiritual quality of life (ORAdj, 1.41; 95% CI, 1.2 to 1.7); being Burley tobacco farmers (ORAdj, 1.33; 95% CI, 1.0 to 1.8); and having a low family quality of life (ORAdj, 0.49; 95% CI, 0.4 to 0.6). CONCLUSION: The majority of the tobacco farmers had a declining quality of life, particularly economic and environmental quality of life, resulting in reducing growing tobacco. National and regional support are needed to help these farmers effectively grow alternative crops, and financial support to make such conversions.


Assuntos
Fazendeiros , Tabaco , Estudos Transversais , Humanos , Qualidade de Vida , Inquéritos e Questionários , Tailândia/epidemiologia , Tabaco/efeitos adversos , Virginia
7.
Ann Plast Surg ; 89(4): 365-372, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-36149976

RESUMO

BACKGROUND: Age, race, socioeconomic status, and proximity to plastic surgeons have been shown to impact receipt of reconstruction after mastectomy in several national studies. Given that targeted outreach efforts and programs to address these discrepancies would occur locoregionally, investigation of these reconstructive trends on a state level is warranted. STUDY DESIGN: Patients diagnosed with breast cancer in Virginia between 2000 and 2018 were identified in the Virginia Department of Health Cancer Registry. Patients who underwent mastectomy breast conservation surgery, and/or breast reconstruction at the time of oncologic surgery were identified. Patient demographics were analyzed, and logistic regression analyses were used to determine the likelihood of receipt of mastectomy, receipt of mastectomy versus breast conservation surgery, receipt of mastectomy with reconstruction versus mastectomy alone, and receipt of mastectomy with reconstruction versus breast conservation surgery with respect to the demographic variables. Geographically weighted regression analyses were also performed to determine impact of geographic location on receipt of mastectomy and reconstruction after mastectomy. RESULTS: A total of 78,682 patients in Virginia underwent surgical treatment for breast cancer between 2000 and 2018. Living outside a metropolitan area, increased age, lower socioeconomic status, non-White race, and lower number of plastic surgeons within 50 miles were associated with decreased rates of postmastectomy reconstruction. Rural setting, lower socioeconomic status, and lower plastic surgeon supply were also associated with decreased rates of breast conservation surgery. Reconstruction after mastectomy was lowest in the northwest, central, and southwest regions of Virginia. CONCLUSIONS: Within the state of Virginia, programs to improve access to breast reconstruction for patients residing in rural regions, as well as non-White patients, older patients, and those in lower socioeconomic groups should be implemented. Future studies would implement and study the efficacy of such outreach programs, which could then be applied and tailored to other states or regions to address sociodemographic disparities in access to breast reconstruction.


Assuntos
Neoplasias da Mama , Mamoplastia , Cirurgiões , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Virginia
8.
J Med Entomol ; 59(6): 1993-2005, 2022 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-35996864

RESUMO

To better understand tick ecology in Virginia and the increasing Lyme disease incidence in western Virginia, a comparative phenological study was conducted in which monthly collections were performed at twelve sampling locations in southwestern Virginia (high Lyme disease incidence) and 18 equivalent sampling locations in southeastern Virginia (low Lyme disease incidence) for one year. In western Virginia, we also explored the effect of elevation on collection rates of Ixodes scapularis Say (Acari: Ixodidae) and Amblyomma americanum (L.) (Acari: Ixodidae). In total, 35,438 ticks were collected (33,106 A. americanum; 2,052 I. scapularis; 134 Ixodes affinis Neumann [Acari: Ixodidae]; 84 Dermacentor variabilis [Say] [Acari: Ixodidae]; 49 Dermacentor albipictus [Packard] [Acari: Ixodidae]; 10 Haemaphysalis leporispalustris [Packard] [Acari: Ixodidae]; 2 Ixodes brunneus Koch [Acari: Ixodidae]; 1 Haemaphysalis longicornis Neumann [Acari: Ixodidae]). Within southwestern Virginia, Ixodes scapularis collection rates were not influenced by elevation, unlike A. americanum which were collected more frequently at lower elevations (e.g., below 500 m). Notably, I. scapularis larvae and nymphs were commonly collected in southwestern Virginia (indicating that they were questing on or above the leaf litter) but not in southeastern Virginia. Questing on or above the leaf litter is primarily associated with northern populations of I. scapularis. These findings may support the hypothesis that I. scapularis from the northeastern United States are migrating into western Virginia and contributing to the higher incidence of Lyme disease in this region. This comparative phenological study underscores the value of these types of studies and the need for additional research to further understand the rapidly changing tick-borne disease dynamics in Virginia.


Assuntos
Ixodes , Ixodidae , Doença de Lyme , Doenças Transmitidas por Carrapatos , Animais , Virginia , Doença de Lyme/epidemiologia
9.
Biol Lett ; 18(8): 20220155, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-36043303

RESUMO

Much like human consumers, honeybees adjust their behaviours based on resources' supply and demand. For both, interactions occur in fluctuating conditions. Honeybees weigh the cost of flight against the benefit of nectar and pollen, which are nutritionally distinct resources that serve different purposes: bees collect nectar continuously to build large honey stores for overwintering, but they collect pollen intermittently to build modest stores for brood production periods. Therefore, nectar foraging can be considered a supply-driven process, whereas pollen foraging is demand-driven. Here we compared the foraging distances, communicated by waggle dances and serving as a proxy for cost, for nectar and pollen in three ecologically distinct landscapes in Virginia. We found that honeybees foraged for nectar at distances 14% further than for pollen across all three sites (n = 6224 dances, p < 0.001). Specific temporal dynamics reveal that monthly nectar foraging occurs at greater distances compared with pollen foraging 85% of the time. Our results strongly suggest that honeybee foraging cost dynamics are consistent with nectar supply-driven and pollen demand-driven processes.


Assuntos
Comportamento Alimentar , Néctar de Plantas , Animais , Abelhas , Humanos , Pólen , Virginia
10.
Theor Appl Genet ; 135(10): 3433-3442, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35951034

RESUMO

KEY MESSAGE: Contamination at the FAD2B locus due to inadequate screening protocols is the primary cause of sporadic, insufficient oleic acid content in Virginia-type peanut. The high oleic trait in peanut is conditioned by loss-of-function mutations in a pair of homeologous enzymes and is well known to improve the shelf life of peanut products. As such, the trait is given high priority in current and future cultivars by the North Carolina State University peanut breeding program. For unknown reasons, high oleic cultivars and breeding lines intermittently failed to meet self-imposed thresholds for oleic acid content in internal testing. To determine why, a manual seed chipper, crude DNA isolation protocol, genotyping assays for both mutations, and a web-based SNP calling application were developed. The primary cause was determined to be contamination with normal oleic seeds resulting from inadequate screening protocols. In order to correct the problem, a faster screening method was acquired to accommodate a higher oleic acid threshold. Additionally, results showed the mutation in one homeolog is fixed in the program, dig date had no significant effect on oleic acid content, and minor modifiers segregating within the program explained 6% of the variation in oleic acid content.


Assuntos
Arachis , Ácido Oleico , Arachis/genética , Ácidos Graxos Dessaturases/genética , Humanos , Melhoramento Vegetal , Sementes/genética , Virginia
11.
Front Public Health ; 10: 871864, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35937230

RESUMO

Audience segmentation is necessary in health communications to ensure equitable resource distribution. Peer crowds, which are macro-level teen subcultures, are effective psychographic segments for health communications because each crowd has unique mindsets, values, norms, and health behavior profiles. These mindsets affect behaviors, and can be used to develop targeted health communication campaigns to reach those in greatest need. Though peer crowd research is plentiful, no existing peer crowd measurement tool has been formally validated. As such, we developed and validated Virginia's Mindset Lens Survey (V-MLS), a mindset-based teen peer crowd segmentation survey to support health communication efforts. Using an online convenience sample of teens (N = 1,113), we assessed convergent and discriminant validity by comparing the V-MLS against an existing, widely-used peer crowd survey (I-Base Survey®) utilizing a multi-trait multi-method matrix. We also examined the V-MLS's predictive ability through a series of regressions using peer crowd scores to predict behaviors, experiences, and traits relevant to health communication campaign planning. The V-MLS demonstrated reliability and convergent and discriminant validity. Additionally, the V-MLS effectively distinguished teen peer crowds with unique health behaviors, experiences, and personal traits. When combined with appropriate information processing and campaign development frameworks, this new tool can complement existing instruments to inform message framing, tone, and style for campaigns that target at-risk teens to increase campaign equity and reach.


Assuntos
Comunicação em Saúde , Adolescente , Comportamentos Relacionados com a Saúde , Humanos , Grupo Associado , Reprodutibilidade dos Testes , Virginia
12.
Curr Pharm Teach Learn ; 14(7): 892-899, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35914852

RESUMO

BACKGROUND AND PURPOSE: Prescription verification is a practice-ready expectation for pharmacy graduates. Entrustable professional activities (EPAs) should be applied to practice-ready skills-based assessments. This manuscript describes the technique of two different institutions in assessing prescription verification aligned to the Practice Manager domain of the Core EPAs as defined by the Academic Affairs Standing Committee 2015-2016 report. EDUCATIONAL ACTIVITY AND SETTING: Virginia Commonwealth University School of Pharmacy (VCU) and University of Maryland Eastern Shore (UMES) School of Pharmacy and Health Professions describe their two methods of evaluating prescription verification with the EPA Practice Manager domain. Each program performed the activities in first-year skills-based laboratory courses. FINDINGS: Fulfillment of a medication order was framed into law, medication label, and dispensing accuracy. Both institutions' assessments were high-stakes assessments that included errors. Overall, the majority of both programs' students passed with the institution-specified level of entrustment on their first attempt, with 75.9% to 77.5% of VCU students per each assessment and 74.5% for UMES. The lowest performance, Level 1, assessment scores for the first attempt were 10% for VCU and 2% for UMES, requiring repetition of the assessment for those students. All students achieved a minimum of Level 3 during the reassessments. SUMMARY: Different assessment techniques may arise from program design and institutional resources. However, it is important to ensure EPAs are met for all students in prescription verification. Faculty should consider their own verification activities and level of trust expected for students to meet prior to pharmacy practice experiences.


Assuntos
Avaliação Educacional , Assistência Farmacêutica , Competência Clínica , Avaliação Educacional/métodos , Humanos , Prescrições , Virginia
13.
J Emerg Manag ; 20(3): 205-224, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35792811

RESUMO

In the United States, heat kills more people on average than any other weather-related hazard, thus the mitigation of heat-related impacts remains a significant issue within emergency management and public health communities. Research indicates the use of community cooling centers as an effective way to reduce vulnerability and adverse heat impacts. Using the Commonwealth of Virginia as a study location, this research evaluates the placement of cooling centers and assesses emergency managers' understanding of heat-related issues. Surveying local emergency managers and aggregating media reports, a total of 256 cooling centers were identified across 39 localities. Vulnerable populations differed in their proximity to the identified cooling centers. While over 65 percent of Virginians live within a 15-minute drive of a cooling center, this favors wealthier community members; less than 7 percent of Virginia's population below poverty lives within this same 15-minute driveshed. Spatial variability exists with many communities not opening any cooling centers. Within city and county hazard plans, the inclusion of comprehensive heat-related hazard information remains low. The research suggests further cooperation across government and nongovernment agencies is needed to improve the resilience to heat-health concerns across Virginia.


Assuntos
Transtornos de Estresse por Calor , Prática de Saúde Pública , Cidades , Transtornos de Estresse por Calor/prevenção & controle , Temperatura Alta/efeitos adversos , Humanos , Virginia , Populações Vulneráveis
14.
Health Aff (Millwood) ; 41(8): 1078-1087, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35858118

RESUMO

Medicaid is a critical antipoverty program. Since the Affordable Care Act expanded Medicaid eligibility, millions of newly eligible people have enrolled, creating positive financial improvements for low-income families. We examined the association of Virginia's 2019 Medicaid expansion and changes in health care-related and non-health-care-related financial needs among newly eligible Medicaid enrollees. Our unique survey collected responses between December 2018 and April 2019 from newly enrolled members reporting on experiences in the year before enrollment and between July 2020 and May 2021 from members reporting on experiences one year after enrollment. The follow-up period coincided with the COVID-19 pandemic. Medicaid enrollment was associated with decreases in concern about all financial needs assessed: housing, food, monthly bills, credit card and loan payments, and health care costs. These reductions were broadly similar across demographic subgroups and across the months of the pandemic that overlapped with the follow-up period. We add to the evidence that Medicaid expansion is a social safety-net policy that could improve equity among low-income families, potentially encouraging states that have yet to expand to do so.


Assuntos
COVID-19 , Medicaid , Acesso aos Serviços de Saúde , Humanos , Pandemias , Patient Protection and Affordable Care Act , Estados Unidos , Virginia
15.
Perspect Sex Reprod Health ; 54(3): 68-79, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35790127

RESUMO

CONTEXT: Many people wanted to avoid or delay childbearing during the COVID-19 pandemic. This study sought to examine the extent COVID-19 influenced abortion care-seeking in a region that did not enact policy restricting abortion due to the pandemic, has high service availability, and few abortion-restrictive policies. METHODOLOGY: We conducted telephone surveys with adults (n=72) requesting abortion appointments between September 2020 and March 2021 at five clinics in Washington, DC, Maryland, and Virginia. We used χ2 tests to compare sociodemographic, reproductive history, service delivery characteristics, and pandemic-related life changes by whether COVID-19 influenced abortion care-seeking. RESULTS: Most respondents (93%) had an abortion at the time of the survey, 4% were awaiting their scheduled appointment, and 3% did not have an appointment scheduled. Nearly 40% of people reported COVID-19 influenced their decision to have an abortion. These individuals were significantly more likely to report "not financially prepared" (44% vs. 16%) as a reason for termination compared to people reporting no influence of COVID-19. They were also more likely to have lost or changed their health insurance due to pandemic-related employment changes (15% vs. 2%), report substantial money difficulties due to COVID-19 (59% vs. 33%), and report that paying for their abortion was "very difficult" (25% vs. 2%). CONCLUSION: COVID-19 influenced many people to have an abortion, particularly those financially disadvantaged by the pandemic. Expansion of Medicaid abortion coverage in Washington, DC and Virginia could reduce financial barriers to care and help people to better meet their reproductive needs amid future crises.


Assuntos
Aborto Induzido , COVID-19 , Adulto , COVID-19/epidemiologia , District of Columbia/epidemiologia , Feminino , Humanos , Maryland/epidemiologia , Pandemias , Gravidez , Estados Unidos/epidemiologia , Virginia/epidemiologia
16.
PLoS One ; 17(7): e0270224, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35776754

RESUMO

Understanding factors that influence a species' distribution and abundance across the annual cycle is required for range-wide conservation. Thousands of imperiled red knots (Calidris cantus rufa) stop on Virginia's barrier islands each year to replenish fat during spring migration. We investigated the variation in red knot presence and flock size, the effects of prey on this variation, and factors influencing prey abundance on Virginia's barrier islands. We counted red knots and collected potential prey samples at randomly selected sites from 2007-2018 during a two-week period during early and peak migration. Core samples contained crustaceans (Orders Amphipoda and Calanoida), blue mussels (Mytilus edulis), coquina clams (Donax variabilis), and miscellaneous prey (horseshoe crab eggs (Limulus polyphemus), angel wing clams (Cyrtopleura costata), and other organisms (e.g., insect larvae, snails, worms)). Estimated red knot peak counts in Virginia during 21-27 May were highest in 2012 (11,959) and lowest in 2014 (2,857; 12-year peak migration [Formula: see text] = 7,175, SD = 2,869). Red knot and prey numbers varied across sampling periods and substrates (i.e., peat and sand). Red knots generally used sites with more prey. Miscellaneous prey ([Formula: see text] = 2401.00/m2, SE = 169.16) influenced red knot presence at a site early in migration, when we only sampled on peat banks. Coquina clams ([Formula: see text] = 1383.54/m2, SE = 125.32) and blue mussels ([Formula: see text] = 777.91/m2, SE = 259.31) affected red knot presence at a site during peak migration, when we sampled both substrates. Few relationships between prey and red knot flock size existed, suggesting that other unmeasured factors determined red knot numbers at occupied sites. Tide and mean daily water temperature affected prey abundance. Maximizing the diversity, availability, and abundance of prey for red knots on barrier islands requires management that encourages the presence of both sand and peat bank intertidal habitats.


Assuntos
Bivalves , Charadriiformes , Animais , Ecossistema , Areia , Estações do Ano , Virginia
17.
Artigo em Inglês | MEDLINE | ID: mdl-35886462

RESUMO

Consumption of unsafe drinking water is associated with a substantial burden of disease globally. In the US, ~1.8 million people in rural areas lack reliable access to safe drinking water. Our objective was to characterize and assess household-level water sources, water quality, and associated health outcomes in Central Appalachia. We collected survey data and water samples (tap, source, and bottled water) from consenting households in a small rural community without utility-supplied water in southwest Virginia. Water samples were analyzed for physicochemical parameters, total coliforms, E. coli, nitrate, sulfate, metals (e.g., arsenic, cadmium, lead), and 30+ enteric pathogens. Among the 69% (n = 9) of households that participated, all had piped well water, though 67% (n = 6) used bottled water as their primary drinking water source. Total coliforms were detected in water samples from 44.4% (n = 4) of homes, E. coli in one home, and enteric pathogens (Aeromonas, Campylobacter, Enterobacter) in 33% (n = 3) of homes. Tap water samples from 11% (n = 1) of homes exceeded the EPA MCL for nitrate, and 33% (n = 3) exceeded the EPA SMCL for iron. Among the 19 individuals residing in study households, reported diarrhea was 25% more likely in homes with measured E. coli and/or specific pathogens (risk ratio = 1.25, cluster-robust standard error = 1.64, p = 0.865). Although our sample size was small, our findings suggest that a considerable number of lower-income residents without utility-supplied water in rural areas of southwest Virginia may be exposed to microbiological and/or chemical contaminants in their water, and many, if not most, rely on bottled water as their primary source of drinking water.


Assuntos
Água Potável , Qualidade da Água , Escherichia coli , Humanos , Nitratos , Compostos Orgânicos , Avaliação de Resultados em Cuidados de Saúde , População Rural , Virginia/epidemiologia , Abastecimento de Água
18.
Radiol Technol ; 93(6): 509-516, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35790308

RESUMO

PURPOSE: To explore whether patient-reported demographics and hospital classifications were significant factors in the likelihood that a computed tomography (CT) scan of the head would be ordered for nontraumatic headaches. METHODS: Nonexperimental, cross-sectional analysis was performed on a database that included 18 279 patients presenting to emergency departments (EDs) in the Commonwealth of Virginia. Information included in the analysis was diagnosis of a generalized, nontraumatic headache; patient age and sex; the treating hospital's profit status (ie, for-profit vs nonprofit); status of the hospital as a teaching institution; hospital location (ie, rural vs suburban and urban); diagnostic procedures ordered; and patient's insurance coverage (commercial insurance, Medicare, or Medicaid). Descriptive statistics, chi-square, and binary logistic regression analyses were performed. RESULTS: Approximately 10% of patients who presented to EDs with a chief complaint of headache received a diagnostic head CT scan. Patient age proved to be the only significant variable in the analysis (P ≤ .001). Hospital's teaching status, classification as rural or suburban and urban, and profit status were not significant factors in determining the likelihood of a head CT being performed, nor were any other demographic variables studied. DISCUSSION: Radiologic procedure expenditures have increased more than any other physician service in the past 2 decades. The increase in CT use warrants further research. Although the analysis did not demonstrate that hospital characteristics were a significant factor in the ordering of head CT scans for nontraumatic headaches, continued analysis should be performed because resource use in EDs is not static. CONCLUSION: The overall rate of CT usage in EDs in the United States has increased significantly. Understanding CT use rates is important to radiographers and policymakers when considering resource use in dynamic EDs.


Assuntos
Cefaleia , Medicare , Idoso , Estudos Transversais , Serviço Hospitalar de Emergência , Cefaleia/diagnóstico por imagem , Humanos , Tomografia Computadorizada por Raios X , Estados Unidos , Virginia
19.
Hist Cienc Saude Manguinhos ; 29(2): 531-550, 2022.
Artigo em Português | MEDLINE | ID: mdl-35674626

RESUMO

This study investigates the potential of the Virgínia Portocarrero archive, at Casa de Oswaldo Cruz/Fiocruz. It was donated in life by Portocarrero, a Brazilian nurse and Second World War veteran. The documents include records from her education and training and show evidence of a determination to preserve her memories from the frontline and after the war, in a symbolic battle to record an essentially female story in a characteristically male setting. The archive contains a broad variety of types of historical sources, notably a diary on her participation in the conflict, demonstrating everyday and unusual aspects of her work as a health professional at that dramatic time in human history.


Objetivou-se apontar as potencialidades do Fundo Virgínia Portocarrero, da Casa de Oswaldo Cruz/Fiocruz. O acervo foi doado em vida por sua titular, enfermeira brasileira veterana da Segunda Guerra Mundial. Dessa documentação constam registros de sua formação profissional e acadêmica, e é percebida sua determinação em preservar as reminiscências do front de batalha e do período pós-guerra, numa luta simbólica pelo registro de uma história essencialmente feminina em um cenário emblematicamente masculino. Integra o acervo ampla variedade de tipologias de fontes históricas, com destaque para um diário de sua participação no conflito, demonstrando aspectos cotidianos e peculiares de sua atuação profissional na saúde naquele momento dramático da história da humanidade.


Assuntos
Arquivos , II Guerra Mundial , Brasil , Feminino , História do Século XX , Humanos , Masculino , Virginia
20.
Clin Infect Dis ; 75(Supplement_2): S155-S158, 2022 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-35758873

RESUMO

In April 2021, we assessed mRNA vaccine effectiveness (VE) in the context of a COVID-19 outbreak in a skilled nursing facility. Among 28 cases, genomic sequencing was performed on 4 specimens on 4 different patients, and all were classified by sequence analysis as the Beta (B.1.351) variant. Adjusted VE among residents was 65% (95% confidence interval: 25-84%). These findings underscore the importance of vaccination for prevention of COVID-19 in skilled nursing facilities.


Assuntos
COVID-19 , SARS-CoV-2 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Surtos de Doenças/prevenção & controle , Humanos , RNA Mensageiro , SARS-CoV-2/genética , Vacinas Sintéticas , Virginia , Vacinas de mRNA
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...