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Wetlands provide numerous ecosystem services to the environment, such as nutrient removal and storage. The aim of this work is to evaluate the nutrient dynamics in different sectors within wetland systems in the south of the Samborombón Bay (Argentina) based on hydrological and/or anthropogenic variations. For this purpose, the hydrological features of the wetland were defined through the analysis of satellite images, precipitation and tidal data, and field surveys. Three sectors were identified in the wetland: one with tidal influence, another which is dependent on rainfall, and another that receives inputs from rainfall and from a sewage effluent treatment plant. In order to analyze the nutrient dynamics, samples of surface water, groundwater, and sediments were collected from these sectors. Measurements of pH and electrical conductivity were determined in situ in water samples, while the concentration of inorganic forms of phosphorus and nitrogen, soluble reactive silica, and organic carbon were determined through laboratory analysis. Also, bioavailable phosphorus, organic matter, pH, and electrical conductivity were determined in the sediment samples collected. Statistical analysis of the data reveals differences between the sectors and allows the interpretation of the dynamics of the studied components in the wetland. Electrical conductivity distinguishes the intertidal sectors of the wetland while components associated with P and N discriminate the sectors with inputs from the sewage effluent treatment plant. On the other hand, soluble reactive silica, organic carbon, and organic matter do not seem to be influenced by the tide or effluent discharge. This study demonstrates that the studied wetland works as a nutrient retention area, providing ecosystem services to local inhabitants. Although these services can be utilized, they require a continuous monitoring over time to provide an early warning in case the variations in P and N cycles could lead to eutrophication or wetland degradation.
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OBJECTIVE: We sought to test whether a 2-week Total Worker Health (TWH) training mapped to TWH education competencies could be administered to a Mexican audience of occupational safety and health professionals and could lead to positive changes to knowledge and behaviors. METHODS: This study used robust program evaluation methods collected before and after each of the nine training days and at the end of the course. RESULTS: Overall course quality received a mean score of 4.6 (SD = 0.6) and 98.8% of participants agreed that their TWH knowledge increased. All participants intended to make at least one change to their professional practice, most frequently helping companies assess their organizational culture to support health, safety, and well-being. CONCLUSIONS: This TWH training was well received and led to positive self-reported increase in knowledge and abilities to influence workers' health, safety, and well-being.
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Saúde Ocupacional , Humanos , México , Saúde Ocupacional/educação , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Promoção da Saúde/métodos , Avaliação de Programas e Projetos de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Cultura OrganizacionalRESUMO
Estuarine coastal water and sediments collected from multiple locations within the middle Río de la Plata (RDLP) estuary were analyzed in order to identify the presence of microplastics (MPs, <5 mm) and mesoplastics (MePs, 5-25 mm) in one of the most significant estuaries in the Southwestern Atlantic. The present study represents one of the first researches to survey MPs and MePs contamination in key stations at RDLP estuary. Average concentrations of 14.17 ± 5.50 MPs/L and 10.00 MePs/L were detected in water samples, while 547.83 ± 620.06 MPs/kg (dry weight) and 74.23 ± 47.29 MePs/kg d.w. were recorded in sediments. The greatest abundances were observed in the more anthropized areas, near urban settlements. Fibers were the most conspicuous plastic items in water and sediments, followed by fragments. On the other hand, surface sediments, and 50 cm and 100 cm-depth sediments also presented MPs and MePs indicating they could serve as a stratigraphic indicator for recently formed sediments. The main polymer type identified were acrylic fibers, followed by polypropylene (PP) and polyethylene terephthalate (PET). Besides, SEM-EDX detected the presence of Si, Fe, Ti, Al and Cl onto the plastics' surface. These elements may serve as additives to enhance the plastics' properties, such as in the case of Ti, or they could originate from the environment, like biogenic Si or Fe, and Al possibly as a component of the suspended particles or sediments adhered to the micro or meso plastics. Finally, the results of the present study showed that MPs and MePs are commonly found in waters and also tend to be trapped in sediments of the RDLP estuary supporting the assertion that these areas play a substantial role in influencing the transport, dispersion, and buildup of MPs in estuarine regions.
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Native WYSE CHOICES adapted an Alcohol Exposed Pregnancy (AEP) prevention curriculum for mobile health delivery for young urban American Indian and Alaska Native (AIAN) women. This qualitative study explored the relevance of culture in adapting a health intervention with a national sample of urban AIAN youth. In total, the team conducted 29 interviews across three iterative rounds. Participants expressed interest in receiving culturally informed health interventions, were open to cultural elements from other AIAN tribes, and highlighted the importance of culture in their lives. The study underscores why community voices are central in tailoring health interventions for this population.
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OBJECTIVES: To assess the psychosocial effects of a methicillin-resistant Staphylococcus aureus (MRSA) diagnosis on the households of children with MRSA skin and soft tissue infection (SSTI). STUDY DESIGN: We constructed and administered an interview to the primary caregiver within the home of a child with a history of MRSA SSTI. RESULTS: Seventy-six households were enrolled. Survey responses were analyzed and grouped into 4 themes: health behavior changes, disclosure, social interactions, and knowledge/awareness. The most common theme was disclosure; 91% of participants reported sharing their child's MRSA diagnosis with someone outside of the household. Forty-two percent of respondents reported a change in the manner in which household contacts interacted as a result of the index patient's MRSA diagnosis, including isolating the index patient from other children in the household. Many households reported adopting enhanced personal hygiene behaviors and environmental cleaning routines. Thirty-eight percent of participating households reported altering how they interact with people outside of their home, largely to avoid spreading MRSA to vulnerable individuals. In addition, many participants perceived that others regarded them with caution, especially at daycare, whereas other affected households were excluded from family gatherings. CONCLUSION: Primary caregivers of children with MRSA SSTI reported changing their health behaviors, altering their interactions with people outside of their home, and feeling isolated by others in response to their child's MRSA diagnosis. The findings of our study highlight a need for community interventions and education to prevent the negative psychosocial repercussions associated with MRSA.
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Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Relações Interpessoais , Staphylococcus aureus Resistente à Meticilina , Comportamento Social , Infecções dos Tecidos Moles/psicologia , Infecções Cutâneas Estafilocócicas/psicologia , Adolescente , Adulto , Cuidadores/psicologia , Criança , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Infecções dos Tecidos Moles/prevenção & controle , Infecções dos Tecidos Moles/transmissão , Infecções Cutâneas Estafilocócicas/prevenção & controle , Infecções Cutâneas Estafilocócicas/transmissãoRESUMO
The coastal plain of the middle estuary of the Río de la Plata is a highly industrialized area and is densely populated by sectors. The main human activity in the sector encompassed between the cities of Ensenada and Berisso is associated with the petrochemical industry. In this work, hydrogeochemical and isotopic characteristics of surface and groundwater in the impacted area are analyzed and the results are contrasted with those obtained in an undisturbed protected area. Major and trace elements were determined using standardized methods while the stable isotopes δ18O y δ2H were analyzed by mass spectroscopy. Human impact is evidenced by the occurrence of large variations in the major chemical composition of water, and also by the elevated concentrations of some trace elements that are not contributed from natural sources. These results may contribute to the understanding of chemical processes and pollutants distribution in highly industrialized coastal plain areas.
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Água Subterrânea , Isótopos/análise , Argentina , Cidades , Monitoramento Ambiental , Humanos , Poluentes Químicos da ÁguaAssuntos
Fator Neurotrófico Derivado do Encéfalo/metabolismo , Condicionamento Psicológico/fisiologia , Ciclo Estral/fisiologia , Medo/fisiologia , Hormônios/metabolismo , Caracteres Sexuais , Tonsila do Cerebelo/metabolismo , Análise de Variância , Animais , Feminino , Reação de Congelamento Cataléptica/fisiologia , Expressão Gênica/fisiologia , Hipocampo/metabolismo , Masculino , Rememoração Mental/fisiologia , Córtex Pré-Frontal/metabolismo , Ratos WistarRESUMO
Landscape fragmentation is often a major cause of species extinction as it can affect a wide variety of ecological processes. The impact of fragmentation varies among species depending on many factors, including their life-history traits and dispersal abilities. Felids are one of the groups most threatened by fragmented landscapes because of their large home ranges, territorial behavior, and low population densities. Here, we model the impacts of habitat fragmentation on patterns of genetic diversity in the guigna (Leopardus guigna), a small felid that is closely associated with the heavily human-impacted temperate rainforests of southern South America. We assessed genetic variation in 1798 base pairs of mitochondrial DNA sequences, 15 microsatellite loci, and 2 sex chromosome genes and estimated genetic diversity, kinship, inbreeding, and dispersal in 38 individuals from landscapes with differing degrees of fragmentation on Chiloé Island in southern Chile. Increased fragmentation was associated with reduced genetic diversity, but not with increased kinship or inbreeding. However, in fragmented landscapes, there was a weaker negative correlation between pairwise kinship and geographic distance, suggesting increased dispersal distances. These results highlight the importance of biological corridors to maximize connectivity in fragmented landscapes and contribute to our understanding of the broader genetic consequences of habitat fragmentation, especially for forest-specialist carnivores.
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Ecossistema , Felidae/genética , Variação Genética , Genética Populacional , Animais , Chile , Conservação dos Recursos Naturais , DNA Mitocondrial/genética , Repetições de Microssatélites , Filogeografia , Densidade Demográfica , Floresta Úmida , Análise de Sequência de DNARESUMO
BACKGROUND: The effect of volunteer lay leaders on availability and sustainability of strength-training programs for older adults has not been well explored. We describe implementation of the StrongWomen strength training program by the Arkansas Cooperative Extension Service, and report on the relationship between delivery approach (agent-led, lay-led, or combination of agent- and lay-led) and program access and sustainability. METHODS: All state Extension agents (n = 66) were surveyed on program implementation, continuance, and use of lay leaders. Program records were used to identify the number of trained lay leaders. Regression models were used to examine the relationship between delivery approach and group availability. RESULTS: Counties using lay leaders had twice as many groups as counties using only agents. There was a significant, positive relationship between the number of lay leaders and the number of groups. Counties using lay leaders were 8.3 times more likely to have continuing groups compared with counties not using lay leaders. CONCLUSIONS: Program continuance was significantly and positively associated with lay leader use. Lay delivery expanded access to strength training programs and increased the likelihood that programs would continue. This approach can be used to increase access to and sustainability of strength training programs, particularly in resource-constrained areas.
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Comunicação em Saúde/métodos , Liderança , Treinamento Resistido/métodos , Saúde da População Rural/educação , Adulto , Idoso , Arkansas , Feminino , Recursos em Saúde , Humanos , Masculino , População Rural , VoluntáriosRESUMO
OBJECTIVES: To determine whether previously reported high mortality rates associated with bilateral femoral fractures have decreased over time. DESIGN: Retrospective review. SETTING: Urban academic trauma center. STUDY GROUP: 54 adults with bilateral femoral fractures treated at our center from 2000 to 2006. The 108 fractures were initially treated with external fixation (11%), reamed antegrade nailing (23%), and reamed retrograde nailing (67%). Unilateral control group: 461 patients with unilateral femoral fractures treated at our center from 2002 to 2005. INTERVENTION: Univariate analysis compared our results with those of a published historical control group from the same center approximately 15 years ago (study period, 1984-1990). MAIN OUTCOME MEASUREMENTS: Mortality rates. RESULTS: We noted marked differences between the current mortality rate associated with bilateral femoral fractures and that of the historical control group. The mortality rate decreased over time at our center for both bilateral (26%-7%, P = 0.002) and unilateral (12%-2%, P = 0.0001) fractures. Mortality rates were still significantly higher (P = 0.037) for bilateral (7%) than for unilateral (2%) fractures. CONCLUSIONS: Mortality rates and Injury Severity Scores were reduced for bilateral and unilateral femoral fractures compared with data reported 15 years ago from the same center. The improved outcome might be related in part to changes in resuscitation, triage, intensive care, and orthopaedic management of the patients. However, considering that the Injury Severity Score also significantly decreased, the improvement might have occurred because of changes in injury patterns, perhaps secondary to improved safety features in motor vehicles. LEVEL OF EVIDENCE: Prognostic level III. See instructions for authors for a complete description of levels of evidence.
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Fraturas do Fêmur/mortalidade , Centros Médicos Acadêmicos , Adulto , Feminino , Fraturas do Fêmur/cirurgia , Humanos , Escala de Gravidade do Ferimento , Masculino , Prognóstico , Estudos Retrospectivos , Centros de Traumatologia , População UrbanaRESUMO
OBJECTIVE: To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. METHODS: Data were collected from a sample of facilities that participated in five demonstration projects for hpv vaccine delivery: school-based delivery was used in Peru, Uganda and Viet Nam; health-centre-based delivery was also used in Viet Nam; and integrated delivery, which involved existing health services, was also used in Uganda. Microcosting methods were used to guide data collection on the use of resources (i.e. staff, supplies and equipment) and data were obtained from government, demonstration project and health centre administrative records. Delivery costs were expressed in 2009 United States dollars (US$). Exclusively project-related expenses and the cost of the vaccine were excluded. FINDINGS: The economic delivery cost per vaccine dose ranged from US$ 1.44 for integrated outreach in Uganda to US$ 3.88 for school-based delivery in Peru. In Viet Nam, the lowest cost per dose was US$ 1.92 for health-centre-based delivery. Cost profiles revealed that, in general, the largest contributing factors were project start-up costs and recurrent personnel costs. The delivery cost of HPV vaccine was higher than published costs for traditional vaccines recommended by the Expanded Programme on Immunization (EPI). CONCLUSION: The cost of delivering HPV vaccine to young adolescent girls in Peru, Uganda and Viet Nam was higher than that for vaccines currently in the EPI schedule. The cost per vaccine dose was lower when delivery was integrated into existing health services.
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Programas de Imunização/economia , Vacinas contra Papillomavirus/economia , Adolescente , Orçamentos , Custos e Análise de Custo , Custos de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Vacinas contra Papillomavirus/administração & dosagem , Peru , Projetos Piloto , Uganda , VietnãRESUMO
OBJECTIVE: To characterize the clinical course, therapies, and outcomes of children with fatal and near-fatal asthma admitted to pediatric intensive care units (PICUs). STUDY DESIGN: This was a retrospective chart abstraction across the 8 tertiary care PICUs of the Collaborative Pediatric Critical Care Research Network (CPCCRN). Inclusion criteria were children (aged 1-18 years) admitted between 2005 and 2009 (inclusive) for asthma who received ventilation (near-fatal) or died (fatal). Data collected included medications, ventilator strategies, concomitant therapies, demographic information, and risk variables. RESULTS: Of the 261 eligible children, 33 (13%) had no previous history of asthma, 218 (84%) survived with no known complications, and 32 (12%) had complications. Eleven (4%) died, 10 of whom had experienced cardiac arrest before admission. Patients intubated outside the PICU had a shorter duration of ventilation (median, 25 hours vs 84 hours; P < .001). African-Americans were disproportionately represented among the intubated children and had a shorter duration of intubation. Barotrauma occurred in 15 children (6%) before admission. Pharmacologic therapy was highly variable, with similar outcomes. CONCLUSION: Of the children ventilated in the CPCCRN PICUs, 96% survived to hospital discharge. Most of the children who died experienced cardiac arrest before admission. Intubation outside the PICU was correlated with shorter duration of ventilation. Complications of barotrauma and neuromyopathy were uncommon. Practice patterns varied widely among the CPCCRN sites.
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Asma/mortalidade , Unidades de Terapia Intensiva Pediátrica , Adolescente , Anestesia por Inalação , Asma/fisiopatologia , Asma/terapia , Gasometria , Criança , Pré-Escolar , Cuidados Críticos , Oxigenação por Membrana Extracorpórea , Feminino , Hospitalização , Humanos , Lactente , Intubação Intratraqueal , Masculino , Readmissão do Paciente , Respiração com Pressão Positiva , Respiração Artificial , Fenômenos Fisiológicos Respiratórios , Estado Asmático/mortalidade , Estado Asmático/fisiopatologia , Estado Asmático/terapia , Taxa de SobrevidaRESUMO
In previous studies, chronic low-dose methylphenidate (MPH) administration during early development has been shown to increase emotional responding in adulthood. However, most studies employed male subjects, which generally show enhanced fear relative to females in laboratory tests of anxious behaviors. The present study examined the sex-dependent effects of MPH treatment on innate and learned fear behaviors. Rats were treated for 4 weeks from periadolescence through early adulthood with oral MPH. In open field testing, females showed greater levels of activity than males, and MPH (5mg/kg) decreased locomotion relative to control and 2mg/kg treatment in both sexes. In contextual fear conditioning, females exhibited less freezing than males at all retention intervals. Both sexes treated with 5mg/kg MPH showed increased fear to the shock context, although MPH treatment did not interfere with contextual discrimination in either sex. Upon reexposure to the shock context at 24h, only females treated with 5mg/kg MPH exhibited increases in freezing. MPH treatment did not disrupt extinction of contextual fear (48 h post-conditioning) in either sex. These findings illustrate subtle sex differences in the effects of prolonged MPH exposure on fear behaviors, and highlight the need to examine further the underlying mechanisms in both sexes.
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Estimulantes do Sistema Nervoso Central/administração & dosagem , Comportamento Exploratório/efeitos dos fármacos , Medo/efeitos dos fármacos , Aprendizagem/efeitos dos fármacos , Metilfenidato/administração & dosagem , Caracteres Sexuais , Administração Oral , Análise de Variância , Animais , Feminino , Masculino , Atividade Motora/efeitos dos fármacos , Ratos , Fatores de TempoRESUMO
BACKGROUND: HIV viral load testing as a component of antiretroviral therapy monitoring is costly. Understanding the full costs and the major sources of inefficiency associated with viral load testing is critical for optimizing the systems and technologies that support the testing process. The objective of our study was to estimate the costs associated with viral load testing performed for antiretroviral therapy monitoring to both patients and the public healthcare system in a low-HIV prevalence, low-resource country. METHODS: A detailed cost analysis was performed to understand the costs involved in each step of performing a viral load test in Nicaragua, from initial specimen collection to communication of the test results to each patient's healthcare provider. Data were compiled and cross referenced from multiple information sources: laboratory records, regional surveillance centre records, and scheduled interviews with the key healthcare providers responsible for HIV patient care in five regions of the country. RESULTS: The total average cost of performing a viral load test in Nicaragua varied by region, ranging from US$99.01 to US$124.58, the majority of which was at the laboratory level: $88.73 to $97.15 per specimen, depending on batch size. The average cost to clinics at which specimens were collected ranged from $3.31 to $20.92, depending on the region. The average cost per patient for transportation, food, lodging and lost income ranged from $3.70 to $14.93. CONCLUSIONS: The quantitative viral load test remains the single most expensive component of the process. For the patient, the distance of his or her residence from the specimen collection site is a large determinant of cost. Importantly, the efficiency of results reporting has a large impact on the cost per result delivered to the clinician and utility of the result for patient monitoring. Detailed cost analysis can identify opportunities for removing barriers to effective antiretroviral therapy monitoring programmes in limited-resource countries with low HIV prevalence.
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Fármacos Anti-HIV/economia , Monitoramento de Medicamentos/economia , Infecções por HIV/economia , Recursos em Saúde/economia , Carga Viral/economia , Fármacos Anti-HIV/uso terapêutico , Efeitos Psicossociais da Doença , Custos e Análise de Custo , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Laboratórios/economia , Nicarágua/epidemiologia , PrevalênciaRESUMO
OBJECTIVES: To examine the relationship between whole grain and fiber consumption and body weight measures in children 6 to 12 (n=3868) and adolescents 13 to 18 (n=4931) years old. STUDY DESIGN: Combined 1999 to 2004 National Health and Nutrition Examination Survey data were analyzed. Mean body mass index (BMI), BMI percentile, BMI z-score, waist circumference, and prevalence of overweight/obesity were compared across categories of whole grain consumption (0 to <0.6, >or=0.6 to <1.5, >or=1.5 to <3, and >or=3 servings) with (1) a sex, ethnicity, and total energy intake-adjusted model and (2) a cereal fiber plus model 1 covariates profile. RESULTS: Mean whole grain intake was 0.59 and 0.63 servings/d among children 6 to 12 years and adolescents 13 to 18 years, respectively. In children, consumption of >or=3 servings of whole grain was not associated with body weight measures; however, consumption of 1.5 to <3 servings was positively associated with all weight measures. In adolescents, BMI z-score was significantly lower in the highest whole grain consumption group compared with the lowest 2 groups; BMI percentile and waist circumference (model 1 only) were also significantly lower in the highest whole grain consumption group. CONCLUSIONS: Overall consumption of whole grain was below current recommendations of at least 3 servings per day. Only in adolescents was this level of whole grain intake associated with lower BMI z-scores.
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Peso Corporal , Fibras na Dieta/metabolismo , Grão Comestível/metabolismo , Comportamento Alimentar , Obesidade/epidemiologia , Adolescente , Antropometria , Índice de Massa Corporal , Criança , Estudos Transversais , Ingestão de Energia , Feminino , Humanos , Incidência , Masculino , Avaliação Nutricional , Obesidade/diagnóstico , Obesidade/metabolismo , Guias de Prática Clínica como Assunto , Prevalência , Circunferência da CinturaRESUMO
The West Indies represent an amalgamation of African, European and in some cases, East Asian sources, but the contributions from each ethnic group remain relatively unexplored from a genetic perspective. In the present study, we report, for the first time, allelic frequency data across the complete set of 15 autosomal STR loci for general collections from Haiti and Jamaica, which were subsequently used to examine the genetic diversity present in each island population. Our results indicate that although both Haiti and Jamaica display genetic affinities with the continental African collections, a stronger African signal is detected in Haiti than in Jamaica. Although only minimal contributions from non-African sources were observed in Haiti, Jamaica displays genetic input from both European and East Asian sources, an admixture profile similar to other New World collections of African descent analyzed in this report. The divergent genetic signatures present in these populations allude to the different migratory events of Africans, Europeans, and East Asians into the New World.