This article presents results of a research carried out with the objective of analyzing the participation of Social Control in the sphere of Public Health Policy of a small municipality, located in ...the Extreme West of Santa Catarina. This is a qualitative study, carried out with the participation of twelve directors, six representatives of non-governmental entities and six of governmental entities. Data were collected between August and December 2019, through interviews with open and closed questions. The research was approved by the Ethics and Research Committee. All requirements contained in the Resolution of the National Health Council - CNS 466/2012 were observed and respected. The limits for the participation of members in the Council, time and lack of knowledge in the health area were found as limits, and with regard to the possibilities, a broader view of the health services offered, and within this, the prioritization of actions and actions. It is observed that Social Control is very important and necessarily needs to be maintained and strengthened. The Federal Constitution of 1988 consolidated and predicted in its devices the participation of citizens in the formulation and implementation of Social Control, public health policies. It is hoped that the result of the research can boost proposals that are configured as responses to the strengthening of participation in Social Control, recognizing the Health Councils are deliberative and permanent collegiate organs of the SUS, existing in each sphere of government and members of the basic structure of the health system.
In December 2019, a new coronavirus was sparked in China, which was named the following year by the World Health Organization as Coronavirus Disease (COVID-19). The pandemic installed because to ...Covid-19 brought interference from social and governmental aspects, such as social isolation and the closing of borders, as strategies to reduce exposures of populations to the virus. In contrast, health professionals live a time of exposure and vulnerability, facing challenges on a daily basis. This paper aims to discuss the scenario of Covid-19 in Brazil and the challenges experienced by health professionals. This is a bibliographic review of complete scientific articles, published in the Scielo, BVS and WHO virtual libraries, between 2019 and 2020, in English or Portuguese languages, being articles in the Health Sciences area. Search for the keywords “coronavirus infections and healthcare personnel”, “coronavirus infections and Brazil”, and “coronavirus infections”. Were found 696 articles and 21 of relevant content were selected for the present review. Complementary official government data were also used. It is concluded that frontline health professionals in Brazil and other countries in the world face personal and professional challenges, related to degrading feelings, insufficient guidance on handling contaminated materials and practices with transitory truths and little scientific basis. It is observed the importance of professional valorization in typical days, bigger operational investments and care with the physical and mental health of the health professionals.
This study aimed to know the profile of the hypertensive population, using drug therapy, not responsive to antihypertensive treatment. We interviewed 37 people diagnosed with systemic arterial ...hypertension even when they were treated. Patient data were collected through a questionnaire to assess the profile of people who have high blood pressure, even using antihypertensive. The results showed that the most common causes were sedentary lifestyle (35.1%), alcohol use, smoking and forgetfulness of medication use (29.7%). When analyzing the questionnaire, the participants' low schooling was diagnosed, since 56.7% were literate, 41.5% had elementary education, and 51.3% received less than a minimum wage. In conclusion, this study suggests the main influencing factors for the non-control of systemic arterial pressure, allowing to elaborate better strategies to combat systemic arterial hypertension
This study aimed to perform a subjective evaluation of the sleep quality of truck drivers in the extreme western region of Santa Catarina. For this purpose, a questionnaire was used to evaluate the ...participants' profile and two other questionnaires to measure the degree of sleepiness (Epworth Scale) and Pittsburgh sleep quality index. The sample consisted of 179 truck drivers, all of them male, aged between 21 and 65 years; 77.65% married and 22.34% single; 72.6% have children, with an average of two children per participant. As for the professional profile, 75.9% of the interviewees work as wage earners and 24.1% as freelancers. The type of route covered, in most cases, is long distance, representing 66%, and 34% being short distance routes. Regarding the educational level, 53.5% of the participants have elementary education; 42.4% high school and 3.9% were graduates. Overweight or obesity was identified in 59.80% of the interviewees. About sleep quality, 22.5% reported sleeping less than 5 hours daily; 35.1% from 5h to 6h; 29.0% from 6h to 7h; 12.8% sleep more than 7 hours. On the Epworth Sleepiness Scale, 67.0% presented no sleepiness; 27.3% presented mild degree of somnolence; 5.5% had moderate degree of somnolence. Regarding the Pittsburgh Sleep Quality Index, it was verified that 55.8% presented subjective poor sleep quality. The results suggested that lifestyle and poor habits can negatively influence the health of these professionals.
Salmonella enterica can survive in surface waters (SuWa), and the role of nonhost environments in its transmission has acquired increasing relevance. In this study, we conducted comparative genomic ...analyses of 172 S. enterica isolates collected from SuWa across 3 months in six states of central Mexico during 2019. S. enterica transmission dynamics were assessed using 87 experimental and 112 public isolates from Mexico collected during 2002 through 2019. We also studied genetic relatedness between SuWa isolates and human clinical strains collected in North America during 2005 through 2020. Among experimental isolates, we identified 41 S. enterica serovars and 56 multilocus sequence types (STs). Predominant serovars were Senftenberg (
= 13), Meleagridis, Agona, and Newport (
= 12 each), Give (
= 10), Anatum (
= 8), Adelaide (
= 7), and Infantis, Mbandaka, Ohio, and Typhimurium (
= 6 each). We observed a high genetic diversity in the sample under study, as well as clonal dissemination of strains across distant regions. Some of these strains are epidemiologically important (ST14, ST45, ST118, ST132, ST198, and ST213) and were genotypically close to those involved in clinical cases in North America. Transmission network analysis suggests that SuWa are a relevant source of S. enterica (0.7 source/hub ratio) and contribute to its dissemination as isolates from varied sources and clinical cases have SuWa isolates as common ancestors. Overall, the study shows that SuWa act as reservoirs of various S. enterica serovars of public health significance. Further research is needed to better understand the mechanisms involved in SuWa contamination by S. enterica, as well as to develop interventions to contain its dissemination in food production settings.
Surface waters are heavily used in food production worldwide. Several human pathogens can survive in these waters for long periods and disseminate to food production environments, contaminating our food supply. One of these pathogens is Salmonella enterica, a leading cause of foodborne infections, hospitalizations, and deaths in many countries. This research demonstrates the role of surface waters as a vehicle for the transmission of Salmonella along food production chains. It also shows that some strains circulating in surface waters are very similar to those implicated in human infections and harbor genes that confer resistance to multiple antibiotics, posing a risk to public health. This study contributes to expand our current knowledge on the ecology and epidemiology of Salmonella in surface waters.
ABSTRACT
Three-body interactions can eject stars from the core of a globular cluster, causing them to enter the Galactic halo as extra-tidal stars. While finding extra-tidal stars is imperative for ...understanding cluster evolution, connecting isolated extra-tidal field stars back to their birth cluster is extremely difficult. In this work, we present a new methodology consisting of high-dimensional data analysis and a particle spray code to identify extra-tidal stars of any Galactic globular cluster using M3 as a case study. Using the t-Stochastic Neighbour Embedding and Uniform Manifold Approximation and Projection machine learning dimensionality reduction algorithms, we first identify a set of 103 extra-tidal candidates in the APOGEE DR17 data catalogue with chemical abundances similar to M3 stars. To confirm each candidate’s extra-tidal nature, we introduce corespray – a new python-based three-body particle spray code that simulates extra-tidal stars for any Galactic globular cluster. Using Gaia EDR3 proper motions and APOGEE DR17 radial velocities, we apply multivariate Gaussian modelling and an extreme deconvolution to identify the extra-tidal candidates that are more likely to be associated with a distribution of corespray-simulated M3 extra-tidal stars than the field. Through these methods, we identify 10 new high-probability extra-tidal stars produced via three-body interactions in M3. We also explore whether any of our extra-tidal candidates are consistent with being ejected from M3 through different dynamical processes. Future applications of corespray will yield better understandings of core dynamics, star formation histories, and binary fractions in globular clusters.
Abstract
Background
Despite the elevated prevalence of smoking among gender minority adults, little is known about the factors that influence their tobacco use and cessation.
Purpose
We identified ...and examined factors that influence tobacco use and cessation for gender minority adults, using a conceptual framework based on the Model of Gender Affirmation and Gender Minority Stress Model.
Methods
Nineteen qualitative, semi-structured in-depth interviews were conducted with gender minority adults who smoke or no longer smoke and were recruited from the Portland, OR metropolitan area. Interviews were audio-recorded, professionally transcribed, and analyzed utilizing thematic analysis.
Results
Four main themes were generated. Gender minority adults smoke to cope with general and gender minority-specific stressors. Smoking was described as a social behavior that was influenced and sustained by community and interpersonal relationships. Smoking cessation was motivated by health concerns (both general and gender minority-specific) and moderated by conducive life circumstances. Recommendations for tobacco cessation interventions highlighted the importance and role of social support. Participants expressed a strong desire for gender minority-specific tobacco cessation programs. There are unique and complex factors that contribute to the higher prevalence of smoking observed among gender minority adults.
Conclusions
Tobacco cessation interventions are urgently needed for this population and should be tailored to address the unique factors that impact tobacco use and cessation among gender minority people to increase the likelihood of success.
Interviews with gender minority adults revealed both gender minority-specific motivations for smoking behavior and gender minority-specific ways to tailor successful smoking cessation programs.
Lay Summary
Tobacco use is the leading cause of preventable death in the U.S. Smoking rates among gender minority people (people whose gender identity and/or gender expression do not align with the cultural expectations of their sex assigned at birth) are higher than in the general population. As a result, for developing smoking cessation interventions, it is important to understand what influences tobacco use and cessation among gender minority adults; however, little is known about these specific influencing factors. By conducting 19 interviews with gender minority adults who smoke or no longer smoke, we found gender minority adults smoke to cope with general and gender minority-specific stressors. In addition, smoking was described as a social behavior that was influenced and sustained by community and interpersonal relationships. Furthermore, smoking cessation was motivated by health concerns (both general and gender minority-specific) and moderated by conducive life circumstances. In sum, to encourage tobacco cessation, these findings suggest interventions across multiple contexts. Gender-affirming smoking cessation programs may prove more acceptable, satisfactory, and successful when (a) tailored to gender minority persons’ needs, motivators, and experienced barriers and (b) aligned with significant and meaningful life changes, such as gender-affirming hormone therapy and surgery.
ABSTRACT
This work presents the Globular cluster Extra-tidal Mock Star (GEMS) catalogue of extra-tidal stars and binaries created via three-body dynamical encounters in globular cluster cores. Using ...the particle-spray code Corespray, we sample $N=50\, 000$ extra-tidal stars and escaped recoil binaries for 159 Galactic globular clusters. Sky positions, kinematics, stellar properties, and escape information are provided for all simulated stars. Stellar orbits are integrated in seven different static and time-varying Milky Way gravitational potential models where the structure of the disc, perturbations from the Large Magellanic Cloud and the mass and sphericity of the Milky Way’s dark matter halo are all investigated. We find that the action coordinates of the mock extra-tidal stars are largely Galactic model independent, where minor offsets and broadening of the distributions between models are likely due to interactions with substructure. Importantly, we also report the first evidence for stellar stream contamination by globular cluster core stars and binaries for clusters with pericentre radii larger than five kiloparsecs. Finally, we provide a quantitative tool that uses action coordinates to match field stars to host clusters with probabilities. Ultimately, combining data from the GEMS catalogue with information of observed stars will allow for association of extra-tidal field stars with any Galactic globular cluster; a requisite tool for understanding population-level dynamics and evolution of clusters in the Milky Way.
Background
Opioid use disorder (OUD) is a chronic condition that requires regular visits and care continuity. Telehealth implementation has created multiple visit modalities for OUD care. There is ...limited knowledge of patients’ and clinicians’ perceptions and experiences related to multi-modality care and when different modalities might be best employed.
Objective
To identify patients’ and clinicians’ experiences with multiple visit modalities for OUD treatment in primary care.
Design
Comparative case study, using video- and telephone-based semi-structured interviews.
Participants
Patients being treated for OUD (
n
= 19) and clinicians who provided OUD care (
n
= 15) from two primary care clinics within the same healthcare system.
Approach
Using an inductive approach, interviews were analyzed to identify patients’ and clinicians’ experiences with receiving/delivering OUD care via different visit modalities. Clinicians’ and patients’ experiences were compared using a group analytical process.
Key Results
Patients and clinicians valued having multiple modalities available for care, with flexibility identified as a key benefit. Patients highlighted the decreased burden of travel and less social anxiety with telehealth visits. Similarly, clinicians reported that telehealth decreased medical intrusion into the lives of patients stable in recovery. Patients and clinicians saw the value of in-person visits when establishing care and for patients needing additional support. In-person visits allowed the ability to conduct urine drug testing, and to foster relationships and trust building, which were more difficult, but not impossible via a telehealth visit. Patients preferred telephone over video visits, as these were more private and more convenient. Clinicians identified benefits of video, including being able to both hear and see the patient, but often deferred to patient preference.
Conclusions
Considerations for utilization of visit modalities for OUD care were identified based on patients’ needs and preferences, which often changed over the course of treatment. Continued research is needed determine how visit modalities impact patient outcomes.
Atherosclerotic cardiovascular disease (ASCVD) disproportionally affects racial and ethnic minority populations. Statin prescribing guidelines changed in 2013 to improve ASCVD prevention. It is ...unknown whether risk screening for statin eligibility differed across race and ethnicity over this guideline change. We examine racial/ethnic/language differences in screening measure prevalence for period-specific statin consideration using a retrospective cohort design and linked electronic health records from 635 community health centers in 24 U.S. states. Adults 50+ years, without known ASCVD, and ≥ 1 visit in 2009–2013 and/or 2014–2018 were included, grouped as: Asian, Latino, Black, or White further distinguished by language preference. Outcomes included screening measure prevalence for statin consideration, 2009–2013: low-density lipoprotein (LDL), 2014–2018: pooled cohort equation (PCE) components age, sex, race, systolic blood pressure, total cholesterol, high-density lipoprotein, smoking status. Among patients seen both periods, change in period-specific measure prevalence was assessed. Adjusting for sociodemographic and clinical factors, compared to English-preferring White patients, all other groups were more likely to have LDL documented (2009–2013, n = 195,061) and all PCE components documented (2014–2018, n = 344,504). Among patients seen in both periods (n = 128,621), all groups had lower odds of PCE components versus LDL documented in the measures' respective period; English-preferring Black adults experienced a greater decline compared to English-preferring White adults (OR 0.81; 95% CI: 0.72–0.91). Racial/ethnic/language disparities in documented screening measures that guide statin therapy for ASCVD prevention were unaffected by a major guideline change advising this practice. It is important to understand whether the newer guidelines have altered disparate prescribing and morbidity/mortality for this disease.
•Race, ethnicity, language associated with statin screening measures documentation.•Electronic health record data for cardiovascular screening best for minority groups.•Black adults' cardiovascular screening data less robust after 2013 guideline change.
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