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Litt JS, Coll-Planas L, Sachs AL, Masó Aguado M, Howarth M. Current Trends and Future Directions in Urban Social Prescribing. Curr Environ Health Rep 2023; 10:383-393. [PMID: 38087048 DOI: 10.1007/s40572-023-00419-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE OF REVIEW Social prescribing (SP) is defined as a non-medical community referral program to support well-being and health. This review explores the current evidence about the effectiveness of SP. RECENT FINDINGS This review examined existing SP models that have been or are being tested to connect people to these opportunities through direct and indirect referral schemes. The review identified a fifth model that facilitates a group-based approach used to mental well-being and resilience. While the development of SP largely originates from the UK, the global interest in SP has increased, with over 31 nations reporting elements of SP. The main goal of SP is to better integrate care between the traditional medical setting and resources available in the community and voluntary sectors. Although this review found widespread optimism around SP, there remain concerns about its effectiveness and demands for high-quality evaluations to strengthen the evidence base for SP.
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Affiliation(s)
- J S Litt
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88 08003, Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
- University of Colorado Boulder, Boulder, CO, USA.
| | - L Coll-Planas
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Carrer de La Sagrada Família, 7 Vic, 08500, Barcelona, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - A L Sachs
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88 08003, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - M Masó Aguado
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Carrer de La Sagrada Família, 7 Vic, 08500, Barcelona, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - M Howarth
- Edgehill University, St Helens Road, Ormskirk, L39 4QP, Lancashire, UK
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Carter JE, Amani H, Carter D, Foster KN, Griswold JA, Hickerson WL, Holmes JH, Jones S, Khandelwal A, Kopari N, Litt JS, Savetamal A, Schupp JW, Sood R, Ferrufino CP, Vadagam P, Kowal S, Walsh T, Sparks J. Evaluating real-world national and regional trends in definitive closure in US burn care: A survey of US Burn Centers. J Burn Care Res 2021; 43:141-148. [PMID: 34329478 PMCID: PMC8737084 DOI: 10.1093/jbcr/irab151] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To better understand trends in burn treatment patterns related to definitive closure, this study sought to benchmark real-world survey data with national data contained within the National Burn Repository version 8.0 (NBR v8.0) across key burn center practice patterns, resource utilization, and clinical outcomes. A survey, administered to a representative sample of U.S. burn surgeons, collected information across several domains: burn center characteristics, patient characteristics including number of patients and burn size and depth, aggregate number of procedures, resource use such as autograft procedure time and dressing changes, and costs. Survey findings were aggregated by key outcomes (number of procedures, costs) nationally and regionally. Aggregated burn center data were also compared to the NBR to identify trends relative to current treatment patterns. Benchmarking survey results against the NBR v8.0 demonstrated shifts in burn center patient mix, with more severe cases being seen in the inpatient setting and less severe burns moving to the outpatient setting. An overall reduction in the number of autograft procedures was observed compared to NBR v8.0, and time efficiencies improved as the intervention time per TBSA decreases as TBSA increases. Both nationally and regionally, an increase in costs was observed. The results suggest resource use estimates from NBR v8.0 may be higher than current practices, thus highlighting the importance of improved and timely NBR reporting and further research on burn center standard of care practices. This study demonstrates significant variations in burn center characteristics, practice patterns, and resource utilization, thus increasing our understanding of burn center operations and behavior.
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Affiliation(s)
| | - H Amani
- Lehigh Valley Health Network Regional Burn Center, Allentown PA
| | | | - Kevin N Foster
- Arizona Burn Center at Valleywise Health Medical Center, Phoenix AZ
| | | | - William L Hickerson
- University of Tennessee Health Science Center: Firefighters Regional Burn Center, Memphis TN
| | | | | | | | - Nicole Kopari
- . University of California San Francisco Fresno, Fresno CA
| | | | - Alisa Savetamal
- Connecticut Burn Center at Bridgeport Hospital, Bridgeport CT
| | | | - Rajiv Sood
- Richard M. Fairbanks Burn Center at Eskenazi Health, Indianapolis IN
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Stroder M, Litt JS, Litofsky NS. Complex Multidisciplinary Cranial and Scalp Reconstruction for Patient Salvage. World Neurosurg 2021; 152:e549-e557. [PMID: 34144172 DOI: 10.1016/j.wneu.2021.06.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE/BACKGROUND Patients can develop scalp and cranial defects as a result of neoplasm, trauma, or infection. Reconstruction of these defects can be difficult in some patients and may require a multidisciplinary approach using creative solutions usually used for disease processes in other areas of the body, such as severe burns. METHODS A series of 9 patients were treated using multidisciplinary techniques for reconstruction of complex cranial and scalp defects. Data on patient characteristics, initial treatment, and preparatory and definitive reconstructive treatment were retrospectively collected. Outcomes were measured as full solution, partial solution, or failure. RESULTS Three patients had a full solution/wound closure, 5 had a partial solution, and 1 failed reconstructive attempt. Full solution patients tended to be younger, received reconstruction treatment modalities for longer periods of time, and had more definitive surgeries. Initial and preparatory surgeries did not tend to promote a full solution, though having fewer preparatory surgeries that were not related to wound vacuum-assisted closure use tended to be associated with a better outcome. Infection of the scalp or cranium did not tend to change the result. CONCLUSIONS Reconstructive salvage of complex cranial and scalp defects takes time, so patience and earlier recognition of need for atypical reconstruction is beneficial. Patient characteristics may influence outcomes, but judicious choice of materials and techniques is more critical to patient success. Use of a multidisciplinary approach to complex cranial and scalp reconstruction is a beneficial option for many patients for whom standard reconstruction methods are not viable.
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Affiliation(s)
- Madelyn Stroder
- Division of Neurological Surgery, University of Missouri School of Medicine, One Hospital Drive, Columbia, Missouri, USA
| | - Jeffrey S Litt
- Division of Acute Care Surgery, University of Missouri School of Medicine, One Hospital Drive, Columbia, Missouri, USA
| | - N Scott Litofsky
- Division of Neurological Surgery, University of Missouri School of Medicine, One Hospital Drive, Columbia, Missouri, USA.
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Courtney JB, Nuss K, Lyden K, Harrall KK, Glueck DH, Villalobos A, Hamman RF, Hebert JR, Hurley TG, Leiferman J, Li K, Alaimo K, Litt JS. Comparing the activPAL software's Primary Time in Bed Algorithm against Self-Report and van der Berg's Algorithm. Meas Phys Educ Exerc Sci 2020; 25:212-226. [PMID: 34326627 PMCID: PMC8315620 DOI: 10.1080/1091367x.2020.1867146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The purpose of this study was to compare activPAL algorithm-estimated values for time in bed (TIB), wake time (WT) and bedtime (BT) against self-report and an algorithm developed by van der Berg and colleagues. Secondary analyses of baseline data from the Community Activity for Prevention Study (CAPS) were used in which adults ≥ 18 years wore the activPAL for seven days. Mixed-effects models compared differences between TIB, WT, and BT for all three methods. Bland-Altman plots examined agreement and the two-one-sided test examined equivalence. activPAL was not equivalent to self-report or van der Berg in estimating TIB, but was equivalent to self-report for estimating BT, and was equivalent to van der Berg for estimating WT. The activPAL algorithm requires adjustments before researchers can use it to estimate TIB. However, researchers can use activPAL's option to manually enter self-reported BT and WT to estimate TIB and better understand 24-hour movement patterns.
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Affiliation(s)
- J B Courtney
- Colorado State University, Fort Collins, Colorado
| | - K Nuss
- Colorado State University, Fort Collins, Colorado
| | - K Lyden
- University of Massachusetts, Amherst, Massachusetts
| | - K K Harrall
- University of Colorado School of Medicine, Aurora, Colorado
| | - D H Glueck
- University of Colorado School of Medicine, Aurora, Colorado
| | - A Villalobos
- Colorado School of Public Health, Aurora, Colorado
| | - R F Hamman
- Colorado School of Public Health, Aurora, Colorado
| | - J R Hebert
- University of South Carolina, Columbia, South Carolina
| | - T G Hurley
- University of South Carolina, Columbia, South Carolina
| | - J Leiferman
- Colorado School of Public Health, Aurora, Colorado
| | - K Li
- Colorado State University, Fort Collins, Colorado
| | - K Alaimo
- Michigan State University, East Lansing, Michigan
| | - J S Litt
- University of Colorado Boulder, Boulder, Colorado
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Tabatabaie S, Litt JS, Crane LA. The experience of outdoor physical activity for skin cancer survivors: understanding the importance of the built and natural environments. J Cancer Surviv 2020; 14:739-756. [PMID: 32506221 DOI: 10.1007/s11764-020-00889-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 04/28/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Cancer patients are encouraged to do more physical activity (PA). Exercising in outdoor settings, however, may expose people to UV radiation, which is the main risk factor of melanoma. This study aimed to understand how melanoma diagnoses affect people's perception of the outdoor environment for PA. METHOD In-depth interviews were conducted among 19 individuals (20-85 years) with a history of melanoma at a skin cancer clinic in the Denver metropolitan area. Transcribed interviews were coded for emergent themes. The coding framework included topics related to PA behavior, sun protection, and perceptions of outdoor environment. RESULTS Respondents reported no change in their level of outdoor activity after the melanoma diagnosis; they tried to reduce the risk of sun exposure by using sunscreen and sun-protective clothing. They also reported seeking shade, trees, and groundcover along urban corridors, in order to avoid sun exposure, reflective surfaces, and heat while being active outdoors. CONCLUSION Given the public health significance of UV exposure and extreme heat, further investments should be made to craft streetscape design guidelines and implement sun-proof spaces across public facilities, including parks, schools, and sport fields in order to ameliorate environmental risks for skin cancer survivors, to prevent future cancers among those that are vulnerable to the hazards of excessive UV exposure and extreme heat, and to promote outdoor PA. IMPLICATIONS FOR CANCER SURVIVORS Skin cancer survivors and other vulnerable population subgroups will benefit from discussions around neighborhood-based design interventions that promote PA while accounting for sun safety.
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Affiliation(s)
- S Tabatabaie
- The Program in Environmental Design, University of Colorado Boulder, Boulder, CO, USA.
| | - J S Litt
- The Environmental Studies Program, University of Colorado Boulder, Boulder, CO, USA
| | - L A Crane
- Colorado School of Public Health, Boulder, CO, USA
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Litt JS. Evaluation and Management of the Burn Patient: A Case Study and Review. Mo Med 2018; 115:443-446. [PMID: 30385993 PMCID: PMC6205272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Advances in the management of burn patients have contributed to significant improvements in morbidity and mortality over the last century. The physiologic insult from this injury pattern, however, still requires extensive surgical intervention, resuscitation and multidisciplinary care. This paper will review the standard of care of these patients in the context of a recent case study from our institution.
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Affiliation(s)
- Jeffrey S Litt
- Jeffrey S. Litt, DO, FACS, is Assistant Professor of Surgery, Burn Director, Division of Acute Care Surgery, Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri
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Litt JS, Alaimo K, Buchenau M, Villalobos A, Glueck DH, Crume T, Fahnestock L, Hamman RF, Hebert JR, Hurley TG, Leiferman J, Li K. Rationale and design for the community activation for prevention study (CAPs): A randomized controlled trial of community gardening. Contemp Clin Trials 2018; 68:72-78. [PMID: 29563043 PMCID: PMC5963280 DOI: 10.1016/j.cct.2018.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/02/2018] [Accepted: 03/12/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Engaging in health-promoting behaviors (e.g., healthy fruit- and vegetable-rich diet, physical activity) and living in supportive social and built environments are consistently and significantly associated with reductions in cancer, heart disease, diabetes, and other chronic diseases. Interventions to change diet and physical activity behaviors should aim to educate individuals, change the environments in which people live, work and recreate, improve access, availability, and affordability of healthy foods, and create safe places the facilitate active lifestyles. This trial will assess whether community gardening increases fruit and vegetable consumption and physical activity, improves social support and mental health, and reduces age-associated weight gain and sedentary time among a multi-ethnic, mixed-income population. METHODS/DESIGN A randomized controlled trial of community gardening began in Denver, Colorado in January 2017. Over 3 years, we will recruit 312 consenting participants on Denver Urban Gardens' waitlists and randomize them to garden or remain on the waitlist. At baseline (pre-gardening), harvest time, and post-intervention, study participants will complete three 24-hour dietary recalls, a 7-day activity monitoring period using accelerometry, a health interview and physical anthropometry. DISCUSSION This project addresses health-promoting behaviors among a multi-ethnic, mixed-income adult population in a large metropolitan area. If successful, this trial will provide evidence that community gardening supports and sustains healthy and active lifestyles, which can reduce risk of cancer and other chronic diseases. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03089177: Registered on 03/17/17.
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Affiliation(s)
- J S Litt
- Environmental Studies, University of Colorado Boulder, Boulder, CO, United States.
| | - K Alaimo
- Michigan State University, Lansing, MI, United States
| | - M Buchenau
- Denver Urban Gardens, Boulder, CO, United States
| | - A Villalobos
- University of Colorado Boulder, Boulder, CO, United States
| | - D H Glueck
- University of Colorado School of Medicine, Denver, CO, United States
| | - T Crume
- Colorado School of Public Health, Denver, CO, United States
| | - L Fahnestock
- Denver Urban Gardens, Boulder, CO, United States
| | - R F Hamman
- Colorado School of Public Health, Denver, CO, United States
| | - J R Hebert
- University of South Carolina, Charleston, SC, United States
| | - T G Hurley
- University of South Carolina, Charleston, SC, United States
| | - J Leiferman
- Colorado School of Public Health, Denver, CO, United States
| | - K Li
- Environmental Studies, University of Colorado Boulder, Boulder, CO, United States
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Lambiris B, Linneman P, Litt JS. 456 Iatrogenic Burns to the Skin and Lower Genital Tract Following Hydrothermal Endometrial Ablation: A Case Report and Review of the Literature. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | | | - J S Litt
- University of Missouri, Columbia, MO
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Affiliation(s)
| | - J S Litt
- University of Missouri, Columbia, MO
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Makler V, Litt JS, Litofsky NS. Palliative Coverage of Cranial Defect following Failed Cranial Flap for Advanced Squamous Cell Carcinoma: Case Report. J Palliat Med 2018; 21:109-113. [DOI: 10.1089/jpm.2017.0258] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Vyacheslav Makler
- Division of Neurological Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Jeffrey S. Litt
- Division of Acute Care Surgery, University of Missouri School of Medicine, Columbia, Missouri
| | - N. Scott Litofsky
- Division of Neurological Surgery, University of Missouri School of Medicine, Columbia, Missouri
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Litt JS, Schmiege SJ, Hale JW, Buchenau M, Sancar F. Exploring ecological, emotional and social levers of self-rated health for urban gardeners and non-gardeners: A path analysis. Soc Sci Med 2015; 144:1-8. [PMID: 26372933 PMCID: PMC4609634 DOI: 10.1016/j.socscimed.2015.09.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 08/30/2015] [Accepted: 09/02/2015] [Indexed: 11/29/2022]
Abstract
RATIONALE The social, emotional, and mental health benefits associated with gardening have been well documented. However, the processes underlying the relationship between garden participation and improvements in health status have not been sufficiently studied. METHODS Using population-based survey data (n = 469 urban residents), objective street environment data, and area-level measures, this research used a path analytic framework to examine several theoretically based constructs as mediators between gardening history and self-reported health. RESULTS The results showed that garden participation influenced health status indirectly through social involvement with one's community, perceived aesthetic appeal of the neighborhood, and perceived collective efficacy. Gardeners, compared to non-gardeners, reported higher ratings of neighborhood aesthetics and more involvement in social activities, whereas aesthetics and involvement were associated with higher ratings of collective efficacy and neighborhood attachment. Collective efficacy, but not neighborhood attachment, predicted self-rated health. Gardening also directly influenced improved fruit and vegetable intake. The physical and social qualities of garden participation may therefore stimulate a range of interpersonal and social responses that are supportive of positive ratings of health. CONCLUSION This research suggests that community planners and health professionals should aim to strengthen the social and aesthetic relationships while designing environments and policies as a way to ignite intermediate processes that may lead to improved health status.
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Affiliation(s)
- J S Litt
- Department of Environmental Health, Colorado School of Public Health, 13001 E. 17th Place, Mail Stop: B119, Aurora, CO 80045, USA.
| | - S J Schmiege
- Department of Biostatistics and Informatics, Colorado School of Public Health, 13001 E. 17th Place, Mail Stop: B119, Aurora, CO 80045, USA
| | - J W Hale
- Department of Sociology, Colorado State University, Fort Collins, CO 80521, USA
| | - M Buchenau
- Denver Urban Gardens, 1031 33rd Street, Suite 100, Denver, CO 80205, USA
| | - F Sancar
- Department of Planning and Design, College of Architecture and Planning, University of Colorado-Boulder, Campus Box 314 Boulder, CO 80309, USA
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Litt JS, Hecht JL. Placental pathology and neonatal thrombocytopenia: lesion type is associated with increased risk. J Perinatol 2014; 34:914-6. [PMID: 24945163 DOI: 10.1038/jp.2014.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 04/16/2014] [Accepted: 05/05/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the association between thrombocytopenia and placental lesions. STUDY DESIGN Cases included singleton infants admitted to the intensive care unit (2005 to 2010) with platelet counts <100 000 μl(-1). We selected a contemporaneous control group matched for gestational age: 49 cases and 63 controls. The frequency of thrombosis in fetal vessels, fetal thrombotic vasculopathy, acute chorioamnionitis, chronic villitis, infarcts, hematomas, cord insertion and increased circulating nucleated red blood cells were identified on retrospective review of placental histology. Logistic regression models were used to test for associations. RESULT Placental lesions associated with poor maternal perfusion (odds ratio (OR) 3.36, 95% confidence interval (CI) 1.38, 8.15) or affecting fetal vasculature (OR 2.75, 95% CI 1.05, 7.23), but not inflammation, were associated with thrombocytopenia. A Pearson Chi-Square Test for Independence for fetal and maternal lesions indicated that the two are independent factors. CONCLUSION Poor maternal perfusion and fetal vascular lesions are independently associated with thrombocytopenia in the newborn.
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Affiliation(s)
- J S Litt
- Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - J L Hecht
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Abstract
The Chesapeake Bay has a profound impact on the lives of all who reside in the 64,000 square miles of its watershed. From crab cakes to sail-boats, drinking water to naval ships, the Bay touches virtually every aspect of life in the region. The Bay has inspired literature, driven the regional economy, and shaped political decision making and development patterns for homes, industry, agriculture, and transportation. As population demands increase and urban boundaries expand into pristine landscapes, the sustainability of the Chesapeake Bay and its resources face unprecedented pressures. Consequently, the public's health also is vulnerable to Bay pollution and other stresses stemming from development activities and widespread growth occurring throughout the Chesapeake Bay watershed. This paper will examine the linkages between the environmental quality of the Bay and the population health status, recommend ways to bridge ecological and human health concerns in the context of the Bay, and finally present a framework for developing a public health report card for the Bay.
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Affiliation(s)
- T A Burke
- Department of Health Policy and Management, The Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA
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