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Imagining Eco-Wellness: A Scoping Review of Interventions Aimed at Changing Individual Behaviors to Promote Personal Health and Environmental Sustainability. 想象生态健康:旨在改变个人行为以促进个人健康和环境可持续性的干预措施的范围审查。
Q3 Medicine Pub Date : 2023-07-01
Brandon R Kim, Maggie L Grabow, Sarah Walters, Sabrina Rateike, Mary Hitchcock, Bruce Barrett

Introduction: Climate change poses enormous threats to humanity and much of life on earth. Many of the behavioral patterns that drive climate change also contribute to the epidemics of obesity, diabetes, and cardiovascular disease.

Objectives: The primary objective of this study was to compile and categorize the literature on interventions aimed at modifying individual behaviors to promote both personal health and environmental sustainability. Secondary objectives were to help define the emerging field of behavioral eco-wellness and to discuss future directions, including the need for assessment tools and analytic strategies.

Methods: A scoping review was conducted to locate, categorize, and interpret current scientific studies of interventions aimed at changing individual behaviors to promote both personal health and environmental sustainability.

Results: Other than a pilot study that this team previously conducted, nothing was found that strictly fit the inclusion criteria. However, we did find 16 relevant studies that fit neatly within 4 broad topical areas: active transportation, dietary intake, indoor air quality, and green space immersion.

Discussion: While this systematic scoping review found little meeting original criteria, we did find that 4 separate fields of study are converging on a scientific area that we are calling behavioral eco-wellness, defined as the simultaneous pursuit of both personal health and environmental sustainability. The emerging field could provide a conceptual framework and methodological toolkit for those seeking to enhance sustainability while supporting health behaviors, including dietary intake. This, in turn, could help to inform and motivate the urgent action needed to confront both climate change and the epidemics of obesity, diabetes, and cardiovascular disease.

气候变化对人类和地球上的大部分生命构成了巨大的威胁。许多导致气候变化的行为模式也会导致肥胖、糖尿病和心血管疾病的流行。目的:本研究的主要目的是对旨在改变个人行为以促进个人健康和环境可持续性的干预措施的文献进行汇编和分类。次要目标是帮助确定行为生态健康的新兴领域,并讨论未来的方向,包括对评估工具和分析战略的需求。方法:对旨在改变个体行为以促进个人健康和环境可持续性的干预措施的现有科学研究进行了范围综述、分类和解释。结果:除了该小组先前进行的一项试点研究外,没有发现严格符合纳入标准的研究。然而,我们确实找到了16项相关研究,它们完全符合4个广泛的主题领域:主动交通、饮食摄入、室内空气质量和绿色空间沉浸。讨论:虽然这个系统的范围审查发现很少符合最初的标准,但我们确实发现4个独立的研究领域正在汇聚到一个科学领域,我们称之为行为生态健康,定义为同时追求个人健康和环境可持续性。这个新兴领域可以为那些寻求在支持健康行为(包括饮食摄入)的同时加强可持续性的人提供一个概念框架和方法工具包。反过来,这可能有助于告知和激励应对气候变化和肥胖、糖尿病和心血管疾病流行所需的紧急行动。
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引用次数: 0
Ocular Findings Aid in Diagnosis of West Nile Virus. 眼部表现有助于西尼罗病毒的诊断。
Q3 Medicine Pub Date : 2023-07-01
Brandon K Winward, Justin L Gottlieb, Jonathan S Chang, Luke Bradbury, Nenita Maganti, Chintan Pathak, Benjamin J Fowler

Introduction: West Nile virus disease, which is endemic to the United States, is a rarely reported systemic infection that can be difficult to diagnose. Chorioretinitis is an uncommon manifestation of West Nile virus but has pathognomonic ocular findings that can aid in diagnosis.

Case presentation: A 66-year-old man presented with acute onset fever, chills, and dyspnea. He underwent an extensive but nondiagnostic workup during hospitalization. New visual complaints prompted ophthalmology consultation. Funduscopic examination showed macular hemorrhages and midperipheral chorioretinal lesions. Fluorescein angiography revealed target-like lesions in a radial distribution, which is pathognomonic for West Nile virus chorioretinitis. Serology confirmed the diagnosis of West Nile virus disease. Systemic and ocular symptoms improved with supportive care.

Discussion: West Nile virus disease has many nonspecific manifestations. History of recent mosquito exposure is not always readily elicited. In patients with visual symptoms, eye examination can help in its diagnosis.

Conclusions: West Nile virus should be considered in patients with acute febrile or neurological illness during mosquito season.

西尼罗河病毒病是美国的一种地方性疾病,是一种罕见的系统性感染,很难诊断。绒毛膜视网膜炎是西尼罗病毒的一种不常见的表现,但有病变的眼部发现,可以帮助诊断。病例介绍:一名66岁男性,表现为急性发热、寒战和呼吸困难。他在住院期间接受了广泛但非诊断性的检查。新的视力问题促使眼科咨询。眼底检查显示黄斑出血和中周绒毛膜视网膜病变。荧光素血管造影显示靶样病变呈放射状分布,这是西尼罗病毒脉络膜视网膜炎的典型病理特征。血清学确诊为西尼罗病毒病。系统和眼部症状在支持治疗后得到改善。讨论:西尼罗病毒病有许多非特异性表现。最近与蚊子接触的历史并不总是容易得到。对于有视觉症状的患者,眼部检查有助于诊断。结论:蚊虫季节急性发热或神经系统疾病患者应考虑西尼罗病毒感染。
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引用次数: 0
An Unlikely Guest With an Overstayed Welcome: Cyclospora-Induced Postinfectious Irritable Bowel Syndrome. 一个不太可能的客人,欢迎久留:环孢子虫引起的感染后肠易激综合征。
Q3 Medicine Pub Date : 2023-07-01
Matthew Aiken, Trisha Jethwa, Muhammad Bilal Abid

Introduction: Postinfectious irritable bowel syndrome is a phenomenon that can occur following bouts of acute gastroenteritis. While bacterial pathogens are typically implicated in the development of postinfectious irritable bowel syndrome, viral and parasitic infections should also be considered as inciting pathogens.

Case presentation: An immunocompetent, 65-year-old woman presented with several weeks of watery diarrhea, which polymerase chain reaction testing confirmed to be a Cyclospora infection. Resolution of diarrhea was achieved with antibiotic treatment, however, months later she presented to the gastroenterology service with persistence of loose stools and abdominal cramping consistent with a diagnosis of postinfectious irritable bowel syndrome.

Discussion: Postinfectious irritable bowel syndrome has a similar presentation to sporadic irritable bowel syndrome, with diagnosis aided by the identification of an inciting pathogen. To our knowledge, this is the first documented case of Cyclospora-induced postinfectious irritable bowel syndrome. While parasitic infections typically aren't implicated in cases of postinfectious irritable bowel syndrome, this case highlights the value of considering this condition as a cause of protracted diarrhea in patients previously diagnosed with Cyclospora.

简介:感染后肠易激综合征是急性肠胃炎发作后可能发生的一种现象。虽然细菌病原体通常与感染后肠易激综合征的发展有关,但病毒和寄生虫感染也应被视为煽动性病原体。病例介绍:一名具有免疫功能的65岁妇女,出现数周水样腹泻,聚合酶链反应试验证实为环孢子虫感染。通过抗生素治疗,腹泻得到了缓解,然而,几个月后,她出现了持续的稀便和腹部痉挛,这与感染后肠易激综合征的诊断一致。讨论:感染后肠易激综合征与散发性肠易激综合征有相似的表现,诊断时需借助煽动性病原体的鉴定。据我们所知,这是第一例环孢子虫引起的感染后肠易激综合征。虽然寄生虫感染通常与感染后肠易激综合征病例无关,但本病例强调了将这种情况视为先前诊断为环孢子虫的患者持续性腹泻的原因的价值。
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引用次数: 0
Pediatric Acute Q Fever in Rural Wisconsin: A Case Report. 威斯康星州农村儿童急性Q热:一个病例报告。
Q3 Medicine Pub Date : 2023-07-01
Taylor Boland Rigby, Tyler Grunow, Jillian Landeck, Kathryn M Scmitt, Jennifer Lochner

Introduction: Q fever is a zoonotic disease with a variable clinical presentation and potentially fatal complications. While rare, it is more common in rural areas due to its transmission from animals, including cattle.

Case presentation: A 3-year-old boy presented in December 2020 with intermittent fevers, headache, rash, and lymphadenopathy. After several months of symptoms, he was diagnosed with acute Q fever.

Discussion: This case demonstrates the importance of considering Q fever in the differential diagnosis when a patient presents with nonspecific infectious symptoms and an epidemiological link that places them at risk.

Conclusions: While rare, Q fever is a potentially serious infection that can affect people living in Wisconsin's rural farming communities.

简介:Q热是一种具有多种临床表现和潜在致命并发症的人畜共患疾病。虽然罕见,但由于其通过包括牛在内的动物传播,在农村地区更为常见。病例介绍:一名3岁男孩于2020年12月出现间歇性发烧、头痛、皮疹和淋巴结病。经过几个月的症状,他被诊断为急性Q热。讨论:本病例表明,当患者出现非特异性感染症状时,在鉴别诊断中考虑Q热的重要性,以及将其置于危险中的流行病学联系。结论:虽然罕见,但Q热是一种潜在的严重感染,可以影响生活在威斯康星州农村农业社区的人们。
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引用次数: 0
Database Tracking in Gender-Affirming Surgery: Are Patients Falling Through the Cracks? 性别确认手术中的数据库跟踪:患者是否被忽视了?
Q3 Medicine Pub Date : 2023-07-01
Ton C Doan, Kasey Leigh Wood Matabele, Peter J Nicksic, Katherine M Gast, Samuel O Poore

Background: This study sought to examine risk factors for venous thromboembolism in transfeminine vaginoplasty. Secondarily, the authors outline reasons why patients are not adequately classified for research purposes despite using relevant queried codes.

Methods: Transgender patients undergoing vaginoplasty were identified with diagnostic and procedure-specific codes using a national surgical database from 2010 through 2019.

Results: There were 457 transgender vaginoplasties performed, with 24 wound dehiscences, 17 unplanned reoperations, and 12 surgical site infections. With zero cases of venous thromboembolism, risk factor analysis was deferred.

Conclusions: Heterogeneity in coding practices for gender-affirming surgery led to an uncharacteristically small cohort of transfeminine vaginoplasty patients captured in the database. Current diagnostic and procedure-specific codes are nonspecific and unbundled, hindering accurate assessment of the incidence of standard surgical complications.

背景:本研究旨在探讨经女性阴道成形术中静脉血栓栓塞的危险因素。其次,作者概述了尽管使用了相关的查询代码,但患者没有被充分分类用于研究目的的原因。方法:使用2010年至2019年国家外科数据库,通过诊断和手术特定代码识别接受阴道成形术的跨性别患者。结果:变性阴道成形术457例,伤口裂开24例,意外再手术17例,手术部位感染12例。由于没有静脉血栓栓塞病例,风险因素分析被推迟。结论:性别确认手术编码实践的异质性导致数据库中捕获的跨女性阴道成形术患者异常少。目前的诊断和程序特异性代码是非特异性和非捆绑的,妨碍了对标准手术并发症发生率的准确评估。
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引用次数: 0
Do Internal Medicine Advanced Practice Providers Perceive a Benefit in Mentorship? 内科高级执业医师认为师徒关系有益吗?
Q3 Medicine Pub Date : 2023-07-01
Andrea Bequest, Paige Gioia, Sanjay Bhandari, Pinky Jha
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引用次数: 0
Join the Conversation: Talking About the Health Consequences of Global Heating/Climate Destabilization. 加入对话:谈论全球变暖/气候不稳定对健康的影响。
Q3 Medicine Pub Date : 2023-07-01
Bruce Krawisz

Global heating/climate destabilization is likely to be the most serious public health problem in this century. This article encourages health care workers to discuss climate change and provides a short summary of climate change/health information. There are talking points with references that may be of practical use. Although climate change is a global crisis that requires global solutions, by conversing with others, an individual may be able to take effective climate action.

全球变暖/气候不稳定可能是本世纪最严重的公共卫生问题。本文鼓励卫生保健工作者讨论气候变化,并提供了气候变化/健康信息的简短摘要。有一些谈话要点和参考资料可能有实际用途。虽然气候变化是一个需要全球解决方案的全球危机,但通过与他人交谈,个人可能能够采取有效的气候行动。
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引用次数: 0
Inpatient Pediatric Care and Clinician Workforce in Wisconsin: The State of the State. 住院儿科护理和临床医生队伍在威斯康星州:国家的状态。
Q3 Medicine Pub Date : 2023-07-01
Samantha Busch, Ann Allen, Jen Birstler, Andrea Ildiko Martonffy

Introduction: Availability of inpatient pediatric services declined across the United States from 2008 through 2018, with rural areas experiencing steepest declines. Despite the movement of pediatric care to children's centers, most children are still cared for in community hospitals nationally. Assessing the availability and providers of inpatient pediatric care in Wisconsin is an important step in ensuring the health care needs of children in the state continue to be met.

Methods: A cross-sectional survey was distributed to Wisconsin hospitals to determine pediatric services and physician workforce. The response rate was 130/138 (94%), including 56/58 (97%) critical access hospitals. Results of specific inpatient pediatric subdivisions were analyzed by descriptive statistics.

Results: Hospitals that provide inpatient newborn care are mostly staffed by pediatricians and family physicians, while critical access hospitals are staffed by family physicians. Hospitals with neonatal intensive care units are staffed by neonatologists, with telemedicine utilized in critical access hospitals. Hospitals with general pediatric admissions are staffed by pediatricians or family physicians, while critical access hospitals are staffed by family physicians. Hospitals with pediatric intensive care units are staffed by pediatric intensivists.

Conclusions: Despite workforce disparities and shortages, hospitals across Wisconsin, including many critical access hospitals, continue to provide inpatient pediatric services. Family physicians play a major role in the pediatric health care delivery in Wisconsin hospitals. Robust inpatient pediatric training of family physicians may enable rural health authorities to continue addressing the gaps that persist in inpatient pediatric care accessibility.

导读:从2008年到2018年,美国儿科住院服务的可用性下降,农村地区下降幅度最大。尽管儿科护理向儿童中心转移,但大多数儿童仍然在全国社区医院接受治疗。评估威斯康星州儿科住院护理的可得性和提供者是确保该州儿童保健需求继续得到满足的重要一步。方法:对威斯康辛州各医院进行横断面调查,以确定儿科服务和医生队伍。应答率为130/138(94%),其中56/58(97%)为危重医院。具体住院儿童细分的结果用描述性统计进行分析。结果:提供新生儿住院护理的医院大多由儿科医生和家庭医生组成,而关键医院则由家庭医生组成。设有新生儿重症监护室的医院配备了新生儿专家,在关键通道医院使用远程医疗。一般儿科医院的工作人员是儿科医生或家庭医生,而关键医院的工作人员是家庭医生。设有儿科重症监护室的医院配备儿科重症医师。结论:尽管劳动力存在差异和短缺,但威斯康星州的医院,包括许多关键医院,仍在继续提供儿科住院服务。家庭医生在威斯康辛州医院的儿科保健服务中发挥着重要作用。对家庭医生进行强有力的儿科住院培训,可能使农村卫生当局能够继续解决儿科住院护理可及性方面存在的差距。
{"title":"Inpatient Pediatric Care and Clinician Workforce in Wisconsin: The State of the State.","authors":"Samantha Busch,&nbsp;Ann Allen,&nbsp;Jen Birstler,&nbsp;Andrea Ildiko Martonffy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Availability of inpatient pediatric services declined across the United States from 2008 through 2018, with rural areas experiencing steepest declines. Despite the movement of pediatric care to children's centers, most children are still cared for in community hospitals nationally. Assessing the availability and providers of inpatient pediatric care in Wisconsin is an important step in ensuring the health care needs of children in the state continue to be met.</p><p><strong>Methods: </strong>A cross-sectional survey was distributed to Wisconsin hospitals to determine pediatric services and physician workforce. The response rate was 130/138 (94%), including 56/58 (97%) critical access hospitals. Results of specific inpatient pediatric subdivisions were analyzed by descriptive statistics.</p><p><strong>Results: </strong>Hospitals that provide inpatient newborn care are mostly staffed by pediatricians and family physicians, while critical access hospitals are staffed by family physicians. Hospitals with neonatal intensive care units are staffed by neonatologists, with telemedicine utilized in critical access hospitals. Hospitals with general pediatric admissions are staffed by pediatricians or family physicians, while critical access hospitals are staffed by family physicians. Hospitals with pediatric intensive care units are staffed by pediatric intensivists.</p><p><strong>Conclusions: </strong>Despite workforce disparities and shortages, hospitals across Wisconsin, including many critical access hospitals, continue to provide inpatient pediatric services. Family physicians play a major role in the pediatric health care delivery in Wisconsin hospitals. Robust inpatient pediatric training of family physicians may enable rural health authorities to continue addressing the gaps that persist in inpatient pediatric care accessibility.</p>","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 3","pages":"164-170"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving Health Equity Through the Integration of Mental Health Services Within Primary Care. 通过将精神卫生服务纳入初级保健,改善卫生公平。
Q3 Medicine Pub Date : 2023-07-01
Jeffrey D Shahidullah, Rachel A Petts
{"title":"Improving Health Equity Through the Integration of Mental Health Services Within Primary Care.","authors":"Jeffrey D Shahidullah,&nbsp;Rachel A Petts","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 3","pages":"162-163"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9872624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Continuing to Address the Shortage of Family Medicine Physicians. 继续解决家庭医生短缺问题。
Q3 Medicine Pub Date : 2023-07-01
Joseph E Kerschner
{"title":"Continuing to Address the Shortage of Family Medicine Physicians.","authors":"Joseph E Kerschner","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38747,"journal":{"name":"Wisconsin Medical Journal","volume":"122 3","pages":"233-234"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Wisconsin Medical Journal
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