A PRECIPITATION ORGANIZATION CLIMATOLOGY FOR NORTH CAROLINA : DEVELOPMENT AND GIS-BASED ANALYSIS

A climatology of precipitation organization is developed for the Southeast United States and is analyzed in a GIS framework. This climatology is created using four years (2009-2012) of daily-averaged data from the NOAA high-resolution multi-sensor precipitation estimation (MPE) dataset, specifically the radar-based quantitative precipitation estimation (QPE) product and the mosaic reflectivity. The analysis associates precipitation at each pixel with the spatial scale of precipitation organization, either a mesoscale precipitation feature (MPF) or isolated storm. While the long-term averaged precipitation totals of these systems may be similar, their hydrological and climatological impacts are very different, especially at a local scale. The classification of these modes of precipitation organization in the current precipitation climatology provides information beyond standard precipitation climatologies that will benefit a range of hydrological and climatological applications.  This study focuses on North Carolina and takes advantage of a GIS framework to examine hydrological responses to different modes of precipitation organization. Specifically, the following questions are addressed: First, what are the discharge response characteristics to precipitation events in different watersheds across the state, from the mountains to the coastal plain? Second, what are the different impacts on watershed discharge between MPF precipitation and isolated precipitation? We first present seasonal and annual composites of precipitation and duration of MPF and isolated storms across three regions of North Carolina: the western mountains, the central Piedmont, and the eastern coastal plain. Further analysis in a GIS framework provides information about the impacts this seasonal and geographic variability in precipitation has on watershed discharge. This analysis defines five watersheds in North Carolina based on five North Carolina river basins using ArcGIS watershed delineation techniques. The amount of precipitation that comes from MPF and isolated convection in each watershed is estimated using ArcGIS and QPE data from a climatology of precipitation organization. Comparing these estimates to USGS streamflow data provides information about the impact different modes of precipitation organization have on watershed discharge in North Carolina.   It was found that precipitation from MPF and isolated events had substantial spatial and temporal variability. While MPF average daily precipitation was greatest in the winter, isolated average daily precipitation was greatest in the summer. This resulted in seasonal and spatial variations in precipitation-discharge correlations. Precipitation originating from MPF events produced stronger precipitation-discharge correlations in the winter and fall than in the summer and spring, while most isolated precipitation-discharge correlations were relatively weak. Additionally, the watersheds in the western mountains experienced stronger correlations with a shorter time lag than coastal watersheds. It was determined that much of this spatial variability in precipitation-discharge correlations could be explained by watershed characteristics. Overall, it was found that MPF precipitation is the main mode of precipitation organization that drives daily watershed discharge, and differences in watershed precipitation-discharge lag times can be best explained by the watershed characteristics.  M.A

Association between Binge Drinking, Type of Friends and Gender: A Cross-sectional Study among Brazilian Adolescents

Background: Hazardous drinking among adolescents is a major public health concern. The purpose of this study was to examine the prevalence of binge drinking/alcohol consumption and its association with different types of friendship networks, gender and socioeconomic status among students in Belo Horizonte, Minas Gerais, Brazil. Methods We conducted a cross-sectional study on a representative random sample of 891 adolescents (41% male, aged 15–19 years) from public and private schools in 2009–2010. Information on friendship networks and binge drinking was collected using two validated self-administered questionnaires: the Integrated Questionnaire for the Measurement of Social Capital and the first 3 items in the Alcohol Use Disorders Identification Test (AUDIT C). We used the area-based Social Vulnerability Index (SVI), mother and father’s educational background, and the type of school to assess socioeconomic status. The chi-squared test was used to examine the associations between sample characteristics or the type of friends and binge drinking (p-values <0.05 were considered statistically significant). Ordinal logistic regression was used to estimate the association between binge drinking and the independent variables. Results: A total of 321 (36%) adolescents reported binge drinking (5 or more drinks in one occasion), and among them, 233 (26.2%) adolescents reported binge drinking less than monthly to monthly, and 88 (9.9%) weekly to daily. Binge drinking was associated with being male (OR = 1.52, 95% CI 1.01–2.28) and with living in a low vulnerability area (having the best housing conditions, schooling, income, jobs, legal assistance and health) (OR = 1.66, 95% CI 1.05–2.62). Students who reported that their closest friends were from school (as opposed to friends from church) had an increased risk of binge drinking (OR = 3.55, 95% CI 1.91–5.87). In analyses stratified by gender, the association was significant only among the female students. Conclusions: The prevalence of binge drinking was high in this sample of Brazilian adolescents, and gender, low social vulnerability and friendship network were associated with binge drinking

Cross-cultural adaptation of the Child Perceptions Questionnaire 11–14 (CPQ11–14) for the Brazilian Portuguese language

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Strategies Utilized to Prevent and Control SARS-CoV-2 Transmission in Two Congregate, Psychiatric Healthcare Settings During the Pandemic

BACKGROUND: The COVID-19 pandemic has had a substantial effect on the delivery of psychiatric healthcare. Inpatient psychiatric healthcare facilities have experienced outbreaks of COVID-19, making these areas particularly vulnerable. METHODS: Our facility used a multidisciplinary approach to implement enhanced infection prevention and control (IPC) interventions in our psychiatric healthcare areas. RESULTS: In a sixteen-month period during the COVID-19 pandemic, our two facilities provided >29,000 patient days of care to 1,807 patients and identified only forty-seven COVID-19 positive psychiatric health inpatients (47/1,807, or 2.6%). We identified the majority of these cases by testing all patients at admission, preventing subsequent outbreaks. Twenty-one psychiatric healthcare personnel were identified as COVID+ during the same period, with 90% linked to an exposure other than a known positive case at work. DISCUSSION: The IPC interventions we implemented provided multiple layers of safety for our patients and our staff. Ultimately, this resulted in low SARS-CoV-2 infection rates within our facilities. CONCLUSIONS: Psychiatric healthcare facilities are uniquely vulnerable to COVID-19 outbreaks because they are congregate units that promote therapeutic interactions in shared spaces. IPC interventions used in acute medical care settings can also work effectively in psychiatric healthcare, but often require modifications to ensure staff and patient safety

30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data

Background: There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. Materials and methods: This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien–Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. Results: In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). Conclusions: This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts

30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study

Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n = 122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7 ± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 146; 85.9%), only 42.4% (n = 72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n = 9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients