The increase in global water insecurity is one of the first perceivable effects of climate change. Two billion people are now without access to safe drinking water, and four billion experience water stress at least once a year, primarily in low per-capita emission countries. This nexus between climate change and water insecurity has significant implications for the global economy, with the water sector contributing 10% of global emissions.
View Article and Find Full Text PDFBackground: Thoracic endovascular aortic repair (TEVAR) is a well-established therapy for descending aortic aneurysms (DTA). There is a paucity of large series reporting the mid- and long-term outcomes from this era. The main aim of this study was to evaluate the outcomes of TEVAR with regards to the effect of aortic morphology and procedure-related variables on survival, reintervention and freedom from endoleaks.
View Article and Find Full Text PDFBackground: Nursing curricula are in a constant state of evolution to meet stakeholder and population needs. Although general guidelines are available from accrediting organizations, particular curricular features are not mandated. Curricula from top-ranked nursing programs may provide some insight on best practices in curricular design.
View Article and Find Full Text PDFObjective: To develop and validate prediction models for inference of Latino nativity to advance health equity research.
Data Sources/study Setting: This study used electronic health records (EHRs) from 19,985 Latino children with self-reported country of birth seeking care from January 1, 2012 to December 31, 2018 at 456 community health centers (CHCs) across 15 states along with census-tract geocoded neighborhood composition and surname data.
Study Design: We constructed and evaluated the performance of prediction models within a broad machine learning framework (Super Learner) for the estimation of Latino nativity.
We designed and validated a sensitive, continuous, in-situ, remotely reporting tryptophan-like fluorescence sensor and coupled it with a machine learning model to predict high-risk fecal contamination in water (>10 colony forming units (CFU)/100mL E. coli). We characterized the sensor's response to multiple fluorescence interferents with benchtop analysis.
View Article and Find Full Text PDFGroundwater is an important source of water for people, livestock, and agriculture during drought in the Horn of Africa. In this work, areas of high groundwater use and demand in drought-prone Kenya were identified and forecasted prior to the dry season. Estimates of groundwater use were extended from a sentinel network of 69 in-situ sensored mechanical boreholes to the region with satellite data and a machine learning model.
View Article and Find Full Text PDFObjective: Asthma care is negatively impacted by neighbourhood social and environmental factors, and moving is associated with undesirable asthma outcomes. However, little is known about how movement into and living in areas of high deprivation relate to primary care use. We examined associations between neighbourhood characteristics, mobility and primary care utilisation of children with asthma to explore the relevance of these social factors in a primary care setting.
View Article and Find Full Text PDFObjective: Social deprivation is associated with worse asthma outcomes. The Social Deprivation Index is a composite measure of social determinants of health used to identify neighbourhood-level disadvantage in healthcare. Our objective was to determine if higher neighbourhood-level social deprivation is associated with documented asthma care quality measures among children treated at community health centres (CHCs).
View Article and Find Full Text PDFThe coronavirus disease 19 (COVID-19) pandemic continues to impose a significant burden on global health infrastructure. While identification and containment of new cases remain important, laboratories must now pivot and consider an assessment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunity in the setting of the recent availability of multiple COVID-19 vaccines. Here, we have utilized the latest Abbott Alinity semiquantitative IgM and quantitative IgG spike protein (SP) serology assays (IgM and IgG) in combination with Abbott Alinity IgG nucleocapsid (NC) antibody test (IgG) to assess antibody responses in a cohort of 1,236 unique participants comprised of naive, SARS-CoV-2-infected, and vaccinated (including both naive and recovered) individuals.
View Article and Find Full Text PDFWarning coloration deters predators from attacking unpalatable prey, and is often characterized by long-wavelength colors, such as orange and red. However, warning colors in nature are more diverse and include short-wavelength colors, like blue. Blue has evolved as a primary defense in some animals but is not common.
View Article and Find Full Text PDFObjectives: To understand if neighborhood-level social deprivation moderates the association between gaining health insurance and improved hypertension control.
Methods: We used electronic health record (EHR) data from the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) clinical data research network from five states that expanded Medicaid eligibility (CA, OH, OR, WA, WI). We include patients with hypertension aged 19-64.
Proc Natl Acad Sci U S A
November 2020
Tropical forest loss currently exceeds forest gain, leading to a net greenhouse gas emission that exacerbates global climate change. This has sparked scientific debate on how to achieve natural climate solutions. Central to this debate is whether sustainably managing forests and protected areas will deliver global climate mitigation benefits, while ensuring local peoples' health and well-being.
View Article and Find Full Text PDFImportance: Understanding opioid prescribing patterns in community health centers (CHCs) that disproportionately serve low-income patients may help to guide strategies to reduce opioid-related harms.
Objective: To assess opioid prescribing patterns between January 1, 2009, and December 31, 2018, in a network of safety-net clinics serving high-risk patients.
Design, Setting, And Participants: Cross-sectional study of 3 227 459 opioid prescriptions abstracted from the electronic health records of 2 129 097 unique primary care patients treated from 2009 through 2018 at a network of CHCs that included 449 clinic sites in 17 states.
Introduction: Initiating tobacco use in adolescence increases the risk of nicotine dependence and continued use into adulthood. Primary care visits provide opportunities for the assessment and treatment of tobacco use; however, little is known about prevalence and correlates of assessing smoking status and current use among adolescents in these settings.
Aims And Methods: Using electronic health record data from the OCHIN network, we identified adolescents with greater than or equal to one primary care visit to a study clinic (n = 366 clinics from 15 US states) during January 1, 2016 to December 31, 2017.
Background: Racial and ethnic minorities are disproportionately affected by diabetes and at greater risk of experiencing poor diabetes-related outcomes compared with non-Hispanic whites. The Affordable Care Act (ACA) was implemented to increase health insurance coverage and reduce health disparities.
Objective: Assess changes in diabetes-associated biomarkers [hemoglobin A1c (HbA1c) and low-density lipoprotein] 24 months pre-ACA to 24 months post-ACA Medicaid expansion by race/ethnicity and insurance group.
Data from a large network of community health centers connected via a single electronic health record (EHR) system examined associations between psychiatric disorders and documentation of a cannabis-related disorder among patients with reported cannabis use. Participants were adults who had at least one ambulatory visit at a clinic in three states between 1/1/2012 and 12/31/2016 and had either 1) a documented cannabis-related disorder indicated by an ICD-9/10 code on the problem list or encounter list or 2) documentation of cannabis use in the EHR social history section. Clinics included 101,405 patients with either cannabis use recorded in the social history of the EHR (n = 71,660) or a cannabis-related disorder documented in the encounter or problem list (n = 29,745).
View Article and Find Full Text PDFBackground: Biotin interference in streptavidin-based immunoassays is known and may lead to erroneous results and thus to diagnostic error. The recent increase in reports of biotin interference in immunoassay-based testing has been attributed to increased intake of biotin supplements by the public and to the high dose biotin therapy in patients with neurological and inherited disorders. Circulating biotin levels greater than 20 ng/mL are reported to exhibit interference in high sensitivity troponin T (hs-TnT), thyroid stimulating hormone (TSH), and in prostate specific antigen (PSA) among other assays when using our Cobas® 6000 immunoassay analyzer (Roche Diagnostics, IN, USA).
View Article and Find Full Text PDF: Comorbid asthma and obesity leads to poorer asthma outcomes, partially due to decreased response to controller medication. Increased oral steroid prescription, a marker of uncontrolled asthma, may follow. Little is known about this phenomenon among Latino children.
View Article and Find Full Text PDFCadherin cell adhesion molecules play crucial roles in vertebrate development including the development of the retina. Most studies have focused on examining functions of classic cadherins (e.g.
View Article and Find Full Text PDFA three-pronged approach used at the University of Virginia to improve the competency of staff in caring for older adults within the health system is highlighted. The Geriatric Resource Nurse Model was established more than a decade ago. Subsequent initiatives included the development of eight selflearning educational modules that address common concerns in hospitalized elders.
View Article and Find Full Text PDFMaking the transition from an old setting to a new one includes much more than changing the place people report to work. Besides touring the new setting, nursing personnel should decide on locations for stock supply areas, as well as "experiencing" the unit before actual moving of patients. No policy and procedure changes should be made at this time except those directly related to the move.
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