RESUMO
Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are two common disorders that affect the anterior compartment of the pelvic floor in women. These can be treated conservatively or surgically. Among patients treated surgically, a substantial number present with pain, recurrent POP or SUI, or other conditions that warrant additional interventions. In many of these cases, imaging is key to identifying and characterizing the type of procedure performed, locating synthetic materials that may have been placed, and characterizing complications. Imaging may be particularly helpful when prior surgical records are not available or a comprehensive physical examination is not possible. US and MRI are the most commonly used modalities for such patients, although radiopaque surgical materials may be visible at voiding cystourethrography and CT. The authors summarize commonly used surgical treatment options for patients with SUI and POP, review imaging techniques for evaluation of such patients, and describe the normal imaging appearance and complications of pelvic floor surgical repair procedures in the anterior compartment of the pelvis. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Prolapso de Órgão Pélvico , Procedimentos de Cirurgia Plástica , Incontinência Urinária por Estresse , Humanos , Feminino , Diafragma da Pelve/diagnóstico por imagem , Diafragma da Pelve/cirurgia , Prolapso de Órgão Pélvico/diagnóstico por imagem , Prolapso de Órgão Pélvico/cirurgia , Incontinência Urinária por Estresse/diagnóstico por imagem , Incontinência Urinária por Estresse/cirurgia , Incontinência Urinária por Estresse/complicações , Imagem MultimodalRESUMO
BACKGROUND: Mandatory examination requirements for US coal miners newly entering the workforce have been in place since the 1969 Coal Act mandated chest radiographs and were updated to include spirometry with promulgation of the 2014 Mine Safety and Health Administration Dust Rule. Compliance with the mandatory respiratory screening series is described using data from the National Institute for Occupational Safety and Health Coal Workers' Health Surveillance Program (CWHSP). METHODS: Among all radiographic and spirometry submissions to the CWHSP during 30 June 1971-15 March 2022, new underground coal miners who began work in the industry after 30 June 1971, and new underground, surface miners and contractors who began work after new regulations were implemented 1 August 2014, were identified and included in analysis. RESULTS: Of the 115 093 unique miners who participated in the CWHSP and whose estimated entry into mining occurred during 30 June 1971-15 March 2019, 50 487 (43.9%) received their initial mandatory radiograph, and 15 452 (13.4%) submitted their initial and 3-year mandatory radiographs. Since new regulations were implemented, compliance with initial radiographs appeared to improve (80%) but compliance with 3-year radiographs remained low (11.6%). Compliance with spirometry testing was also low for initial (17.1%) and follow-up screenings (2.7%). CONCLUSIONS: The majority of new coal miners eligible for health surveillance did not receive a baseline radiograph or spirometry test through the CWHSP even though coal mine operators are required by law to provide these. Ensuring coal miners' regular participation in health surveillance from early in their careers is an important way to monitor and protect their respiratory health.
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Minas de Carvão , Mineradores , Pneumoconiose , Estados Unidos , Humanos , Poeira , Programas de Rastreamento , Espirometria , Carvão Mineral , Pneumoconiose/epidemiologiaRESUMO
Despite the importance of acoustic signaling in fishes, the prevalence of the behavioral contexts associated with their active (i.e., intentional) sound production remains unclear. A systematized review was conducted to explore documented acoustic behaviors in marine, subtropical fishes and potential influences affecting their relative pervasiveness. Data were collected on 186 actively soniferous fish species studied across 194 publications, identified based on existing FishSounds and FishBase datasets. Disturbance was the most common behavioral context associated with active sound production-reported for 140 species or 75% of the species studied-and then aggression (n = 46 species, 25%) and reproduction (n = 34 species, 18%). This trend, however, somewhat differed when examined by research effort, study environment, and fish family, such as reproductive sounds being more commonly reported by studies conducted in the wild. The synthesis of fish sound production behaviors was in some ways stymied by the fact that many species' sound production did not have discernible associated behavioral contexts and that some investigations did not clearly identify the study environments in which active sound production was observed. These findings emphasize the importance of context-behavioral or otherwise-when studying acoustic behaviors in fishes.
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Acústica , Som , Animais , Peixes , AgressãoRESUMO
INTRODUCTION: The Hall technique is a biological caries management approach commonly used within the field of paediatric dentistry. The technique involves the placement of a preformed metal crown (PMC) without local anaesthetic, caries removal or tooth preparation. Despite being widely taught across dental schools in the United Kingdom, evidence from the literature suggests that PMCs are seldom used in general dental practice, even by newly qualified dentists. This study aimed to evaluate the experience and self-reported confidence of Foundation Dentists (FDs) in the North West of England in the placement of preformed metal crowns using the Hall technique. MATERIALS AND METHODS: An anonymous questionnaire was distributed to 117 Foundation Dentists in the North West of England. RESULTS: Forty-six questionnaires were returned, giving a response rate of 39%. The results revealed that 80.4% of FDs felt "somewhat," "quite" or "extremely" confident with the Hall technique at the point of graduation. This increased to 85.3% upon completion of Dental Foundation Training. CONCLUSION: Foundation Dentists' self-reported confidence in the Hall technique was reasonably high both at the point of qualification and upon completing Dental Foundation Training. Nevertheless, many of the Foundation Dentists felt that they would benefit from further postgraduate training on the technique.
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Cárie Dentária , Dente Decíduo , Criança , Humanos , Educação em Odontologia , Inglaterra , Cárie Dentária/terapia , Inquéritos e Questionários , Coroas , Metais , Odontólogos , Padrões de Prática OdontológicaRESUMO
OBJECTIVE: To identify potential strategies to mitigate COVID-19 transmission in a Utah meat-processing facility and surrounding community. DESIGN/SETTING: During March-June 2020, 502 workers at a Utah meat-processing facility (facility A) tested positive for SARS-CoV-2. Using merged data from the state disease surveillance system and facility A, we analyzed the relationship between SARS-CoV-2 positivity and worker demographics, work section, and geospatial data on worker residence. We analyzed worker survey responses to questions regarding COVID-19 knowledge, beliefs, and behaviors at work and home. PARTICIPANTS: (1) Facility A workers (n = 1373) with specimen collection dates and SARS-CoV-2 RT-PCR test results; (2) residential addresses of all persons (workers and nonworkers) with a SARS-CoV-2 diagnostic test (n = 1036), living within the 3 counties included in the health department catchment area; and (3) facility A workers (n = 64) who agreed to participate in the knowledge, attitudes, and practices survey. MAIN OUTCOME MEASURES: New cases over time, COVID-19 attack rates, worker characteristics by SARS-CoV-2 test results, geospatially clustered cases, space-time proximity of cases among workers and nonworkers; frequency of quantitative responses, crude prevalence ratios, and counts and frequency of coded responses to open-ended questions from the COVID-19 knowledge, attitudes, and practices survey. RESULTS: Statistically significant differences in race (P = .01), linguistic group (P < .001), and work section (P < .001) were found between workers with positive and negative SARS-CoV-2 test results. Geographically, only 6% of cases were within statistically significant spatiotemporal case clusters. Workers reported using handwashing (57%) and social distancing (21%) as mitigation strategies outside work but reported apprehension with taking COVID-19-associated sick leave. CONCLUSIONS: Mitigating COVID-19 outbreaks among workers in congregate settings requires a multifaceted public health response that is tailored to the workforce. IMPLICATIONS FOR POLICY AND PRACTICE: Tailored, multifaceted mitigation strategies are crucial for reducing COVID-19-associated health disparities among disproportionately affected populations.
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COVID-19 , Surtos de Doenças , Humanos , Carne , Saúde Pública , SARS-CoV-2 , Utah/epidemiologiaRESUMO
The U.S. COVID-19 vaccination program began in December 2020, and ensuring equitable COVID-19 vaccine access remains a national priority.* COVID-19 has disproportionately affected racial/ethnic minority groups and those who are economically and socially disadvantaged (1,2). Thus, achieving not just vaccine equality (i.e., similar allocation of vaccine supply proportional to its population across jurisdictions) but equity (i.e., preferential access and administra-tion to those who have been most affected by COVID-19 disease) is an important goal. The CDC social vulnerability index (SVI) uses 15 indicators grouped into four themes that comprise an overall SVI measure, resulting in 20 metrics, each of which has national and state-specific county rankings. The 20 metric-specific rankings were each divided into lowest to highest tertiles to categorize counties as low, moderate, or high social vulnerability counties. These tertiles were combined with vaccine administration data for 49,264,338 U.S. residents in 49 states and the District of Columbia (DC) who received at least one COVID-19 vaccine dose during December 14, 2020-March 1, 2021. Nationally, for the overall SVI measure, vaccination coverage was higher (15.8%) in low social vulnerability counties than in high social vulnerability counties (13.9%), with the largest coverage disparity in the socioeconomic status theme (2.5 percentage points higher coverage in low than in high vulnerability counties). Wide state variations in equity across SVI metrics were found. Whereas in the majority of states, vaccination coverage was higher in low vulnerability counties, some states had equitable coverage at the county level. CDC, state, and local jurisdictions should continue to monitor vaccination coverage by SVI metrics to focus public health interventions to achieve equitable coverage with COVID-19 vaccine.
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Vacinas contra COVID-19/administração & dosagem , Disparidades em Assistência à Saúde/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Populações Vulneráveis , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Programas de Imunização , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
In December 2020, two COVID-19 vaccines (Pfizer-BioNTech and Moderna) received Emergency Use Authorization from the Food and Drug Administration.*, Both vaccines require 2 doses for a completed series. The recommended interval between doses is 21 days for Pfizer-BioNTech and 28 days for Moderna; however, up to 42 days between doses is permissible when a delay is unavoidable.§ Two analyses of COVID-19 vaccine administration data were conducted among persons who initiated the vaccination series during December 14, 2020-February 14, 2021, and whose doses were reported to CDC through February 20, 2021. The first analysis was conducted to determine whether persons who received a first dose and had sufficient time to receive the second dose (i.e., as of February 14, 2021, >25 days from receipt of Pfizer-BioNTech vaccine or >32 days from receipt of Moderna vaccine had elapsed) had received the second dose. A second analysis was conducted among persons who received a second COVID-19 dose by February 14, 2021, to determine whether the dose was received during the recommended dosing interval, which in this study was defined as 17-25 days (Pfizer-BioNTech) and 24-32 days (Moderna) after the first dose. Analyses were stratified by jurisdiction and by demographic characteristics. In the first analysis, among 12,496,258 persons who received the first vaccine dose and for whom sufficient time had elapsed to receive the second dose, 88.0% had completed the series, 8.6% had not received the second dose but remained within the allowable interval (≤42 days since the first dose), and 3.4% had missed the second dose (outside the allowable interval, >42 days since the first dose). The percentage of persons who missed the second dose varied by jurisdiction (range = 0.0%-9.1%) and among demographic groups was highest among non-Hispanic American Indian/Alaska Native (AI/AN) persons (5.1%) and persons aged 16-44 years (4.0%). In the second analysis, among 14,205,768 persons who received a second dose, 95.6% received the dose within the recommended interval, although percentages varied by jurisdiction (range = 79.0%-99.9%). Public health officials should identify and address possible barriers to completing the COVID-19 vaccination series to ensure equitable coverage across communities and maximum health benefits for recipients. Strategies to ensure series completion could include scheduling second-dose appointments at the first-dose administration and sending reminders for second-dose visits.
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Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Esquemas de Imunização , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Compared with other age groups, older adults (defined here as persons aged ≥65 years) are at higher risk for COVID-19-associated morbidity and mortality and have therefore been prioritized for COVID-19 vaccination (1,2). Ensuring access to vaccines for older adults has been a focus of federal, state, and local response efforts, and CDC has been monitoring vaccination coverage to identify and address disparities among subpopulations of older adults (2). Vaccine administration data submitted to CDC were analyzed to determine the prevalence of COVID-19 vaccination initiation among adults aged ≥65 years by demographic characteristics and overall. Characteristics of counties with low vaccination initiation rates were quantified using indicators of social vulnerability data from the 2019 American Community Survey.* During December 14, 2020-April 10, 2021, nationwide, a total of 42,736,710 (79.1%) older adults had initiated vaccination. The initiation rate was higher among men than among women and varied by state. On average, counties with low vaccination initiation rates (<50% of older adults having received at least 1 vaccine dose), compared with those with high rates (≥75%), had higher percentages of older adults without a computer, living in poverty, without Internet access, and living alone. CDC, state, and local jurisdictions in partnerships with communities should continue to identify and implement strategies to improve access to COVID-19 vaccination for older adults, such as assistance with scheduling vaccination appointments and transportation to vaccination sites, or vaccination at home if needed for persons who are homebound. Monitoring demographic and social factors affecting COVID-19 vaccine access for older adults and prioritizing efforts to ensure equitable access to COVID-19 vaccine are needed to ensure high coverage among this group.
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Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Vacinação/estatística & dados numéricos , Idoso , COVID-19/epidemiologia , Demografia , Feminino , Humanos , Masculino , Fatores Sociais , Estados Unidos/epidemiologiaRESUMO
Approximately 60 million persons in the United States live in rural counties, representing almost one fifth (19.3%) of the population.* In September 2020, COVID-19 incidence (cases per 100,000 population) in rural counties surpassed that in urban counties (1). Rural communities often have a higher proportion of residents who lack health insurance, live with comorbidities or disabilities, are aged ≥65 years, and have limited access to health care facilities with intensive care capabilities, which places these residents at increased risk for COVID-19-associated morbidity and mortality (2,3). To better understand COVID-19 vaccination disparities across the urban-rural continuum, CDC analyzed county-level vaccine administration data among adults aged ≥18 years who received their first dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine, or a single dose of the Janssen COVID-19 vaccine (Johnson & Johnson) during December 14, 2020-April 10, 2021 in 50 U.S. jurisdictions (49 states and the District of Columbia [DC]). Adult COVID-19 vaccination coverage was lower in rural counties (38.9%) than in urban counties (45.7%) overall and among adults aged 18-64 years (29.1% rural, 37.7% urban), those aged ≥65 years (67.6% rural, 76.1% urban), women (41.7% rural, 48.4% urban), and men (35.3% rural, 41.9% urban). Vaccination coverage varied among jurisdictions: 36 jurisdictions had higher coverage in urban counties, five had higher coverage in rural counties, and five had similar coverage (i.e., within 1%) in urban and rural counties; in four jurisdictions with no rural counties, the urban-rural comparison could not be assessed. A larger proportion of persons in the most rural counties (14.6%) traveled for vaccination to nonadjacent counties (i.e., farther from their county of residence) compared with persons in the most urban counties (10.3%). As availability of COVID-19 vaccines expands, public health practitioners should continue collaborating with health care providers, pharmacies, employers, faith leaders, and other community partners to identify and address barriers to COVID-19 vaccination in rural areas (2).
Assuntos
Vacinas contra COVID-19/administração & dosagem , Disparidades em Assistência à Saúde/estatística & dados numéricos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Submerged aquatic vegetation (SAV) improves environmental conditions by acting as a sediment stabilizer and nutrient retention tool; therefore, reintroduction of SAV is a common freshwater restoration goal. Initial plant establishment is often difficult in suboptimal conditions, and planting material with specific traits may increase establishment rates. Here we evaluate the variability in plant traits based on collection location. We find consistent differences in traits of plants collected from different natural water bodies, and those differences persist in plants grown from seeds under common garden greenhouse conditions-presumably because of genetic differentiation. In three separate mesocosm experiments, we tested the interactive impacts of collection location and environmental condition (control conditions, reduced light, elevated nutrients, or a combination of reduced light and elevated nutrients) on plant reproduction and on traits that might indicate future restoration success (plant height, number of leaves, and rhizome diameter). In most cases, plant traits at the end of the experiments varied by collection location, environmental condition, and an interaction between the two. The best performing plants also depended on response variable (e.g., plant height or number of new shoots produced). Together these results suggest that unpredictable environmental conditions at restoration sites will make selection of a single high-performing plant source difficult, so we suggest incorporating a diverse set of collection locations to increase the probability of incorporating desirable traits.
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Ecossistema , Plantas , Água DoceRESUMO
BACKGROUND: Recent NIOSH publications have focused on the respiratory health of coal miners in central Appalachia, yet 57% of U.S. coal miners work in other regions. We characterized respiratory morbidity in coal miners from these regions. METHODS: Active coal miners working outside of central Appalachia who received chest radiographs and/or spirometry during 2005-2015 were included. Chest radiographs were classified according to International Labour Office standards and spirometry was interpreted using the American Thoracic Society guidelines. Prevalence of coal workers' pneumoconiosis (CWP) and abnormal spirometry were compared by region. RESULTS: A total of 103 (2.1%) miners had CWP. The eastern region had the highest prevalence (3.4%), followed by the western (1.7%), and interior (0.8%) regions. A total of 524 (9.3%) miners had abnormal spirometry. CONCLUSIONS: CWP occurs in all U.S. coal mining regions. Prevalence of CWP was higher in the eastern region, but lower than levels reported in central Appalachia.
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Antracose/epidemiologia , Minas de Carvão/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Adulto , Região dos Apalaches/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Radiografia , Espirometria , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: A recent increase in Bordetella pertussis without the pertactin protein, an acellular vaccine immunogen, has been reported in the United States. Determining whether pertactin-deficient (PRN(-)) B. pertussis is evading vaccine-induced immunity or altering the severity of illness is needed. METHODS: We retrospectively assessed for associations between pertactin production and both clinical presentation and vaccine history. Cases with isolates collected between May 2011 and February 2013 from 8 states were included. We calculated unadjusted and adjusted odds ratios (ORs) using multivariable logistic regression analysis. RESULTS: Among 753 isolates, 640 (85%) were PRN(-). The age distribution differed between cases caused by PRN(-) B. pertussis and cases caused by B. pertussis producing pertactin (PRN(+)) (P = .01). The proportion reporting individual pertussis symptoms was similar between the 2 groups, except a higher proportion of PRN(+) case-patients reported apnea (P = .005). Twenty-two case-patients were hospitalized; 6% in the PRN(+) group compared to 3% in the PRN(-) group (P = .11). Case-patients having received at least 1 pertussis vaccine dose had a higher odds of having PRN(-) B. pertussis compared with unvaccinated case-patients (adjusted OR = 2.2; 95% confidence interval [CI], 1.3-4.0). When restricted to case-patients at least 1 year of age and those age-appropriately vaccinated, the adjusted OR increased to 2.7 (95% CI, 1.2-6.1). CONCLUSIONS: The significant association between vaccination and isolate pertactin production suggests that the likelihood of having reported disease caused by PRN(-) compared with PRN(+) strains is greater in vaccinated persons. Additional studies are needed to assess whether vaccine effectiveness is diminished against PRN(-) strains.
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Proteínas da Membrana Bacteriana Externa/análise , Proteínas da Membrana Bacteriana Externa/genética , Bordetella pertussis/genética , Bordetella pertussis/isolamento & purificação , Vacina contra Coqueluche/administração & dosagem , Fatores de Virulência de Bordetella/análise , Fatores de Virulência de Bordetella/genética , Coqueluche/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteínas da Membrana Bacteriana Externa/imunologia , Western Blotting , Bordetella pertussis/imunologia , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Evasão da Resposta Imune , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Estados Unidos/epidemiologia , Fatores de Virulência de Bordetella/imunologia , Coqueluche/imunologia , Coqueluche/patologia , Adulto JovemRESUMO
In July 2014, Multnomah County public health officials investigated a norovirus outbreak among persons visiting Blue Lake Regional Park in Oregon. During the weekend of the reported illnesses (Friday, July 11-Sunday, July 13) approximately 15,400 persons visited the park. The investigation identified 65 probable and five laboratory-confirmed cases of norovirus infection (70 total cases). No hospitalizations or deaths were reported. Analyses from a retrospective cohort study revealed that swimming at Blue Lake during July 12-13 was significantly associated with illness during July 13-14 (adjusted relative risk = 2.3; 95% confidence interval [CI] = 1.1-64.9). Persons who swam were more than twice as likely to become ill compared with those who did not swim in the lake. To control the outbreak, Blue Lake was closed for 10 days to prevent further illness. This investigation underscores the need for guidance for determining when to reopen untreated recreational water venues (e.g., lakes) associated with outbreaks, and communication tools to inform the public about the risks associated with swimming in untreated recreational water venues and measures that can prevent illness.
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Infecções por Caliciviridae/epidemiologia , Surtos de Doenças , Lagos/virologia , Norovirus/isolamento & purificação , Recreação , Microbiologia da Água , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Fezes/virologia , Feminino , Gastroenterite/virologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Oregon/epidemiologia , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Bordetella pertussis causes severe respiratory illness among infants and adolescents. High proportions of breakthrough infection have been observed. To understand the effect of vaccination in the era of acellular pertussis vaccines (DTaP and Tdap), we assessed if vaccination status is associated with disease severity and duration. METHODS: The Multnomah County Health Department conducts enhanced pertussis surveillance for 1.7 million residents in the Portland, Oregon, metropolitan area. Surveillance activities include ascertaining demographics, clinical presentation, cough duration, vaccination history, and other health outcomes. Utilizing Advisory Committee on Immunization Practices (ACIP) routine vaccination recommendations, we analyzed a cohort of persons aged 6 weeks to 18 years with confirmed pertussis to assess illness severity and duration by vaccination status. Analysis was conducted using both logistic regression (disease severity) and survival analysis (cough duration). RESULTS: During 2010-2012, 98.7% (n = 624) of patients with confirmed pertussis in our cohort had vaccination, treatment, demographic, and outcome information. Among these patients, 45% (n = 286) were ACIP up to date with vaccinations. Ever-vaccinated cases were significantly less likely to be hospitalized or develop severe illness (adjusted odds ratio [aOR], 0.2; 95% confidence interval [CI], .1-.8 and aOR, 0.4; 95% CI, .2-.9, respectively). ACIP up-to-date patients stopped coughing significantly more rapidly than unvaccinated patients (adjusted hazard ratio, 1.7; 95% CI, 1.3-2.2). CONCLUSIONS: Patients with pertussis vaccination had decreased morbidity characterized by less severe illness and significantly reduced illness duration. Therefore, vaccination is recommended among at-risk individuals, and research into the nature of the residual vaccine immunity is warranted.
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Vacina contra Coqueluche/administração & dosagem , Índice de Gravidade de Doença , Coqueluche/epidemiologia , Coqueluche/patologia , Adolescente , Criança , Pré-Escolar , Monitoramento Epidemiológico , Feminino , Hospitalização , Humanos , Lactente , Masculino , Oregon/epidemiologia , Fatores de Tempo , Coqueluche/prevenção & controleRESUMO
OBJECTIVE: The aim of the study is to summarize Coal Workers' Health Surveillance Program findings since 2014, focusing on prevalence of radiographic pneumoconiosis and abnormal spirometry by region. METHODS: Analysis included the most recent Coal Workers' Health Surveillance Program encounter for working miners during October 1, 2014-June 30, 2022. Central Appalachia consists of Kentucky, Virginia, and West Virginia. RESULTS: Pneumoconiosis prevalence was highest among underground miners, with 318 (6.2%) having radiographic evidence of disease. Central Appalachian miners were more likely to have evidence of pneumoconiosis (relative risk = 4.1 [3.4-5.0]) and abnormal spirometry (relative risk = 1.4 [1.2-1.6]) compared with all others. CONCLUSIONS: Central Appalachia is a hotspot for pneumoconiosis, as well as for other indicators of respiratory impairment in coal miners. Outreach for occupational respiratory health surveillance should focus on those areas most heavily affected, ensuring that miners are not hindered by perceived or actual barriers to this secondary intervention.
Assuntos
Minas de Carvão , Pneumoconiose , Humanos , Avaliação de Sintomas , Pneumoconiose/diagnóstico por imagem , Radiografia , Espirometria , Prevalência , Carvão MineralRESUMO
Objective: To describe the work experience and respiratory health of women coal miners in the United States using Coal Workers' Health Surveillance Program (CWHSP) data. Methods: Analysis included CWHSP participants with self-reported sex of female between January 1, 1970, and December 31, 2022, and examined radiographic surveillance, demographics, and job history. National Institute for Occupational Safety and Health-certified physicians classified chest radiographs. Results: Among 8,182 women participants, most worked <10 years and a majority reported working in non-dusty jobs. Among 3,392 with ≥1 year of coal mining tenure, 18 (0.5%) had evidence of pneumoconiosis, with no cases of progressive massive fibrosis. Conclusion: Women coal miners participating in the CWSHP had short mining careers and low pneumoconiosis prevalence. Few worked in the most dusty jobs, indicating limited exposure to coal mine dust. This underscores the need to explore women's roles in mining, and for improved gender-specific employment reporting. Such changes can enhance health and work conditions for women in male-dominated industries.
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Minas de Carvão , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Prevalência , Saúde Ocupacional , Pneumoconiose/epidemiologia , Pneumoconiose/diagnóstico por imagem , Vigilância da População , Idoso , Antracose/epidemiologia , Radiografia/estatística & dados numéricos , Doenças Profissionais/epidemiologiaRESUMO
BACKGROUND: Infection precautions (IP) facilitate standardized and safe patient care. Research has demonstrated several barriers to IP adherence among health care personnel (HCP) but potential exposure risk to SARS-CoV-2 and job role has not been considered. METHODS: Researchers used self-reported baseline surveys with 191 HCPs at a university medical center to examine factors that may have affected IP adherence (eg, personal protective equipment [PPE] and hand hygiene errors) over the 2 weeks prior to the survey. Chi-square tests were used to determine if differences existed first, among job role and IP adherence, and second, the potential risk of exposure to SARS-CoV-2 and IP adherence. A binary logistic regression estimated if PPE nonadherence was associated with COVID-19 stress, job role, and potential exposure risk to SARS-CoV-2. RESULTS: PPE nonadherence varied by job role. Those in the Other group (ie, nonphysician/non-nursing HCP) reported significantly fewer errors (9.6%) compared to Physicians (26.5%) and Registered Nurses (33.3%). Hand/glove hygiene errors between COVID-19 patient rooms varied by job role. Respondents who had higher risks of exposure to SARS-CoV-2 were 5.74 times more likely to experience errors. CONCLUSIONS: The results provide implications for adopting systems-level approaches to support worker knowledge and engagement across job roles to improve IP adherence.
Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Equipamento de Proteção Individual , Pessoal de SaúdeRESUMO
Malaria-causing Plasmodium parasites first replicate as liver stages (LS), which then seed symptomatic blood stage (BS) infection. Emerging evidence suggests that these stages impact each other via perturbation of host responses, and this influences the outcome of natural infection. We sought to understand whether the parasite stage interplay would affect live-attenuated whole parasite vaccination, since the efficacy of whole parasite vaccines strongly correlates with their extend of development in the liver. We thus investigated the impact of BS infection on LS development of genetically attenuated and wildtype parasites in female rodent malaria models and observed that for both, LS infection suffered severe suppression during concurrent BS infection. Strikingly and in contrast to previously published studies, we find that the BS-induced iron-regulating hormone hepcidin is not mediating suppression of LS development. Instead, we demonstrate that BS-induced host interferons are the main mediators of LS developmental suppression. The type of interferon involved depended on the BS-causing parasite species. Our study provides important mechanistic insights into the BS-mediated suppression of LS development. This has direct implications for understanding the outcomes of live-attenuated Plasmodium parasite vaccination in malaria-endemic areas and might impact the epidemiology of natural malaria infection.
Assuntos
Hepatopatias , Vacinas Antimaláricas , Malária , Plasmodium , Feminino , Humanos , Hepcidinas , Malária/parasitologia , FígadoRESUMO
Plant microbiomes are known to serve several important functions for their host, and it is therefore important to understand their composition as well as the factors that may influence these microbial communities. The microbiome of Thalassia testudinum has only recently been explored, and studies to-date have primarily focused on characterizing the microbiome of plants in a single region. Here, we present the first characterization of the composition of the microbial communities of T. testudinum across a wide geographical range spanning three distinct regions with varying physicochemical conditions. We collected samples of leaves, roots, sediment, and water from six sites throughout the Atlantic Ocean, Caribbean Sea, and the Gulf of Mexico. We then analyzed these samples using 16S rRNA amplicon sequencing. We found that site and region can influence the microbial communities of T. testudinum, while maintaining a plant-associated core microbiome. A comprehensive comparison of available microbial community data from T. testudinum studies determined a core microbiome composed of 14 ASVs that consisted mostly of the family Rhodobacteraceae. The most abundant genera in the microbial communities included organisms with possible plant-beneficial functions, like plant-growth promoting taxa, disease suppressing taxa, and nitrogen fixers.
RESUMO
Climate change is altering the functioning of foundational ecosystems. While the direct effects of warming are expected to influence individual species, the indirect effects of warming on species interactions remain poorly understood. In marine systems, as tropical herbivores undergo poleward range expansion, they may change food web structure and alter the functioning of key habitats. While this process ('tropicalization') has been documented within declining kelp forests, we have a limited understanding of how this process might unfold across other systems. Here we use a network of sites spanning 23° of latitude to explore the effects of increased herbivory (simulated via leaf clipping) on the structure of a foundational marine plant (turtlegrass). By working across its geographic range, we also show how gradients in light, temperature and nutrients modified plant responses. We found that turtlegrass near its northern boundary was increasingly affected (reduced productivity) by herbivory and that this response was driven by latitudinal gradients in light (low insolation at high latitudes). By contrast, low-latitude meadows tolerated herbivory due to high insolation which enhanced plant carbohydrates. We show that as herbivores undergo range expansion, turtlegrass meadows at their northern limit display reduced resilience and may be under threat of ecological collapse.