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1.
Prev Chronic Dis ; 17: E74, 2020 07 30.
Article in English | MEDLINE | ID: mdl-32730199

ABSTRACT

Medically underserved patients in rural areas are more vulnerable to poor health outcomes, including the risks associated with coronavirus disease 2019 (COVID-19). Pharmacists, student pharmacists, and other health care professionals are working together to implement new, innovative ways to deliver the same standard of care during the COVID-19 pandemic to these vulnerable patients. These services include telehealth with virtual and telephone medication therapy management sessions led by ambulatory care pharmacists and student pharmacists. Pharmacists, student pharmacists, and other health care professionals should continue to adapt to these new technologies to improve health outcomes for their patients during the pandemic.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Medically Underserved Area , Pandemics/prevention & control , Pharmacists/organization & administration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Rural Population , COVID-19 , Chronic Disease , Community Pharmacy Services , Florida , Humans , Medication Therapy Management/organization & administration , Professional Role , SARS-CoV-2 , Telemedicine
2.
Environ Res ; 173: 77-86, 2019 06.
Article in English | MEDLINE | ID: mdl-30901611

ABSTRACT

Identifying animals as sentinels for humans and other animal species is an excellent method for understanding exposure to environmental contamination at different times and places. Shorebirds are useful sentinels because they have a world-wide distribution, eat a range of prey, and are eaten by a range of other species, including humans. We collected blood from semipalmated sandpipers (Calidris pusilla) wintering in northern (Suriname N = 71) and northeastern (Brazil N = 61) South America to examine levels of heavy metals and metalloids (arsenic, selenium), and compare them to blood levels in sandpipers at a heavily used stopover site in New Jersey (N = 30; Delaware Bay, NJ). Since blood represents relatively recent exposure, it can provide information on where and when the birds were exposed. Levels were highest in Brazil for arsenic and particularly selenium; highest in Suriname for cadmium and lead; and highest in New Jersey for chromium. Samples from Brazil and Suriname presented higher levels of mercury than did those from New Jersey. There were no geographic differences for cobalt. Levels of all metals were generally within an order of magnitude. The significant geographic difference for selenium was interesting because it is regulated in the body. Selenium levels in the NJ sample were directly proportional to levels found in their principle food at this migration stopover site (eggs of horseshoe crab, Limulus polyphemus). Mean selenium level was almost an order of magnitude higher in the semipalmated sandpiper blood samples from Brazil (mean of 27,500 µg/L= ppb) compared to the other sampling locations (mean > 5330 µg/L). This is a toxic level and cause for concern and further investigation, alerting us to look for other evidence of excess selenium exposure. Otherwise the levels of other metals are generally not high enough to cause harm to the sandpipers themselves or to predators that eat them. We discuss the implications for these birds and their exposure to contaminants at different stopover sites.


Subject(s)
Birds/blood , Environmental Monitoring , Environmental Pollutants/blood , Metals/blood , Selenium , Animals , Bays , Brazil , Delaware , New Jersey , Suriname
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