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At least 19 recordsLinked to original sources
PubMed2005

Effects of contaminant exposure on reproductive success of ospreys (Pandion haliaetus) nesting in Delaware River and Bay, USA.

Despite serious water-quality problems and pollutant loading and retention, Delaware River and Bay (USA) provide important wildlife habitat. In 2002, we conducted a comprehensive evaluation of contaminant exposure and reproduction of ospreys (Pandion haliaetus) breeding in Delaware River and Bay. Sample eggs were collected from 39 nests and analyzed for organochlorine pesticides, polychlorinated biphenyls (PCBs), and mercury; a subset of 15 eggs was analyzed for perfluorinated compounds and polybrominated diphenyl ethers (PBDEs). The fate of each nest was monitored weekly. Concentrations of 10 organochlorine pesticides or metabolites, total PCBs, and several toxic PCB congeners were greater (p < 0.05) in eggs collected between the Chesapeake and Delaware Canal (C and D Canal) and Trenton (Delaware River and northern Bay) compared to other sites. Concentrations of p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE; 0.785-3.84 microg/g wet wt) and total PCBs (5.50-14.5 microg/g wet wt) in eggs collected between the C and D Canal and Trenton were similar to levels recently found in the Chesapeake Bay. In all study segments, at least one young fledged from 66 to 75% of nests. Productivity for Delaware Inland Bays (reference area) and southern Delaware Bay was 1.17 and 1.42 fledglings/active nest, respectively; north of the C and D Canal, productivity was 1.00 fledgling/active nest, which is marginally adequate to maintain the population. Using these data, a logistic regression model found that contaminant concentrations (p,p'-DDE, heptachlor epoxide, chlordane and metabolites, and total PCBs) were predictive of hatching success. Several perfluorinated compounds and PBDEs were detected in eggs at concentrations approaching 1 microg/g wet weight. These findings provide evidence that contaminants continue to be a significant stressor on osprey productivity in the northern Delaware River and Bay.

Animals↗
PubMed2003

Increasing infant mortality among very low birthweight infants--Delaware, 1994-2000.

One of the national health objectives for 2010 is to reduce the U.S. infant mortality rate (IMR) to </=4.5 deaths per 1,000 live births (objective no. 16-1c). Historically, Delaware's IMR exceeded the national average; however, during the early 1990s, Delaware's IMR decreased, reaching the U.S. average in 1993. During 1995--2000, the overall U.S. IMR decreased from 7.6 to 6.9; since 1996, Delaware's IMR has increased, and the state now has the seventh highest IMR nationally. To understand the cause of this increase, the Delaware Division of Public Health and CDC analyzed Delaware birth and death data. This report summarizes the results of the investigation, which attributed the Delaware IMR increase primarily to increased mortality among very low birthweight (VLBW) infants born to older, married, suburban mothers who were insured privately and who received early prenatal care. Further study, including collection of data on method of conception, is required to determine the etiology of the increased mortality in this subpopulation.

Delaware↗
PubMed1994

The epidemiology of Lyme disease in Delaware 1989-1992.

OBJECTIVES: The study was conducted to describe the temporal, geographic, demographic and treatment characteristics of Lyme disease in Delaware and to assist health planners in developing and implementing control strategies. METHODS: All physician-submitted Centers for Disease Control and Prevention (CDC) follow-up Lyme disease report forms from 1989 through 1992 were reviewed for completeness. Data were gathered from completed forms only. All cases were classified according to the 1990 CDC surveillance case definition. Cases were further subdivided into two groups. Antibiotic usage patterns were then identified for each group. Data on the percentage of infected ticks by county were obtained from a 1988 study conducted by the University of Delaware; Delaware Health and Social Services, Division of Public Health; and the Department of Natural Resources and Environmental Control. RESULTS: Reported cases of Lyme disease increased 246 percent between 1989 and 1992. The 1992 statewide incidence rate was 12.6 cases per 100,000 population. Whites were four times more likely to contract Lyme disease than were blacks. The majority of cases were reported between June and October. The number of patients being treated with oral antibiotics for localized disease for three weeks or longer increased from 52 percent in 1991 to 94 percent in 1992. Ixodid ticks infected with Borrelia burgdorferi were found in all three counties. CONCLUSION: The Delaware State Board of Health made Lyme disease reportable in September 1989. This requirement increased the quality of Lyme disease surveillance; however, the disease is probably under-reported since Delaware does not actively solicit Lyme disease reports. Delaware's case data reflect national data which indicate an increase in reported cases. A trend toward longer duration of treatment for localized Lyme disease is evident.

Adolescent↗
PubMed1998

Statewide assessment of school-age children with asthma in Delaware.

In Delaware, asthma affects almost 14,000 children. The American Lung Association of Delaware and the University of Delaware surveyed school nurses to identify the needs of children with asthma and the services and accommodations available for these children. Researchers developed a survey instrument that was mailed to all Delaware schools (N = 324). The response rate was 38.6% (n = 125). According to respondents, a variety of protocols were in place regarding the administration of asthma medications. Respondents also reported that several measures had been taken to modify the school environment to improve air quality and reduce asthma triggers. Most respondents (77%) indicated they did not have asthma education programs in their schools. Findings from this study sparked development of a multidisciplinary Delaware Asthma Committee, an Asthma Education Center, and a statewide system for communicating with the parents of children with asthma.

Adolescent↗
PubMed2003

Diversity and abundance of uncultured cytophaga-like bacteria in the Delaware estuary.

The Cytophaga-Flavobacterium group is known to be abundant in aquatic ecosystems and to have a potentially unique role in the utilization of organic material. However, relatively little is known about the diversity and abundance of uncultured members of this bacterial group, in part because they are underrepresented in clone libraries of 16S rRNA genes. To circumvent a suspected bias in PCR, a primer set was designed to amplify 16S rRNA genes from the Cytophaga-Flavobacterium group and was used to construct a library of these genes from the Delaware Estuary. This library had several novel Cytophaga-like 16S rRNA genes, of which about 40% could be grouped together into two clusters (DE clusters 1 and 2) defined by sequences initially observed only in the Delaware library; the other 16S rRNA genes were classified into an additional four clades containing sequences from other environments. An oligonucleotide probe was designed for the cluster with the most clones (DE cluster 2) and was used in fluorescence in situ hybridization assays. Bacteria in DE cluster 2 accounted for about 10% of the total prokaryotic abundance in the Delaware Estuary and in a depth profile of the Chukchi Sea (Arctic Ocean). The presence of DE cluster 2 in the Arctic Ocean was confirmed by results from 16S rRNA clone libraries. The contribution of this cluster to the total bacterial biomass is probably larger than is indicated by the abundance of its members, because the average cell volume of bacteria in DE cluster 2 was larger than those of other bacteria and prokaryotes in the Delaware Estuary and Chukchi Sea. DE cluster 2 may be one of the more abundant bacterial groups in the Delaware Estuary and possibly other marine environments.

Cytophaga↗
PubMed2002

Distribution of cytochrome P4501A1-inducing chemicals in sediments of the Delaware River-Bay system, USA.

The Delaware River-Bay system, USA, was the subject of a study by the National Oceanic and Atmospheric Administration that involved chemical and biological analyses, including the use of the biomarker P450 human reporter gene system (HRGS) to document the occurrence and distribution of cytochrome P450 (CYP) 1A1-inducing compounds. Sediment extracts from 81 locations along the Delaware River, Delaware Bay and immediate coastline were tested by utilizing HRGS as an inexpensive screening test, and were also analyzed for polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls, with selected stations analyzed for dioxins and furans. Benthic community degradation has been observed when benzo[a]pyrene equivalents (BaPEq) exceeded 60 microg/g. The average levels of BaPEq for the largely industrialized upper, middle, and lower regions of the Delaware River were 107, 62, and 5 microg/g, respectively, excluding outliers. Tributaries leading into river averaged 21 microg/g BaPEq, whereas the central Bay and open coast had relatively low values (2.0 and 0.5 microg/g BaPEq, respectively). The HRGS values were highly correlated with total PAHs measured in the same sediment samples (r2 = 0.81). Overall, contamination levels consistently decreased from the upper and middle river sites as collection locations progressed down through the lower river and bay to the coast. Thus, despite the relatively high contaminant load in the river system, Delaware Bay and the immediate coastline seem to have relatively low levels of contaminants, and, therefore, impacts on the benthic organisms in the bay and coast would not be expected from these findings.

Animals↗
PubMed2003

A snapshot of tobacco-related messages relayed in pediatric offices in Delaware.

OBJECTIVE: Much research exists demonstrating that pediatricians should counsel patients and families about tobacco. However, few data are available about tobacco-related messages relayed in pediatric offices. Since an anti-tobacco office environment can be a strong component of an active tobacco prevention program, we evaluated pediatric offices in Delaware to characterize tobacco-related messages. METHODS: A convenience sample of 32 of 63 (51%) pediatric offices in Delaware was directly evaluated for the presence of tobacco-related messages. Fifty-five of 63 (87%) pediatric practices in Delaware were contacted by telephone to inquire about the presence of a tobacco coordinator. RESULTS: The 32 practices represented 71 physicians, were located in all three counties throughout the state, and were urban and non-urban in setting. The same investigator evaluated practices in a single site visit. All were located in smoke-free buildings. At one office, people were seen smoking outside; however, the presence of discarded cigarettes was much more common. Thirteen practices (41%) employed smokers, most of whom smoked outside during work hours. Twenty-one of 28 practices (75%) had waiting room magazines containing tobacco advertisements. Fifteen practices (47%) offered anti-tobacco literature while six practices (19%) displayed visual media, none exclusively addressing tobacco. Nine practices (28%) use chart flags to identify smokers. None of 55 pediatric practices in Delaware contacted by telephone identified an office tobacco prevention coordinator. CONCLUSIONS: Our data indicate that, in Delaware, the pediatric offices we visited overall convey a limited message about tobacco and could strengthen tobacco prevention strategies. Research measuring the impact of office-based anti-tobacco messages is needed. If these messages are effective in preventing tobacco use, practitioners can supplement active counseling with indirect interventions that require minimal maintenance once established and that place no additional demands on their time.

Delaware↗
PubMed2004

The Medical Society of Delaware's Uniform Clinical Guidelines for diabetes: did they have a positive impact on quality of diabetes care?

BACKGROUND: In 2001, the Diabetes Physician Committee of the Medical Society of Delaware developed Uniform Clinical Guidelines (UCGs) for diabetes mellitus. These guidelines were intended to provide a standard for the diabetes quality indicators that could be used by all providers and all major insurers in Delaware. The guidelines were sent to Delaware physicians in December 2001. This study examines whether implementation of the diabetes UCG had a positive impact on the quality of diabetes care in primary care offices. METHODS: A chart review was conducted for 258 diabetic patients of 28 primary care physicians in all three counties in Delaware. Quality of care was compared from the year prior to guideline implementation (2001) to the year after implementation (2002). Quality was determined by process measures, including receipt of recommended monitoring tests (glycosylated hemoglobin, blood pressure, lipids, microalbumin, foot exams, eye exams) and immunizations (influenza and pneumococcal), as well as by outcome measures, including adequate glycemic control, blood pressure control, and lipid control. RESULTS: There was no significant change in most quality indicators from the year before to the year after implementation of the UCG. The only improvements seen were in influenza immunizations and, to some extent, lipid and blood pressure control. However, none of these reached optimal levels, and for some process measures (microalbumin testing and eye exams) there was a decrease in adherence to guidelines. In a second analysis, physicians who used diabetes flow sheets had better quality of care for most measures, although these differences were relatively small and not consistent across all measures. CONCLUSIONS: The Medical Society of Delaware's Uniform Clinical Guidelines are intended to standardize care for diabetes and other conditions. While the guidelines may help to reduce unnecessary duplication and confusion caused by multiple guidelines, this study showed that they have not yet resulted in substantial improvements in quality of care for diabetes. Since the study does suggest that using flow sheets is associated with somewhat better care, it could be that quality will improve as more physicians incorporate these tools into their practices.

Adult↗
PubMed2004

Do physicians in Delaware follow national guidelines for tobacco counseling?

BACKGROUND: Despite national guidelines, studies across the country have shown that many physicians do not regularly engage in tobacco cessation behaviors such as assisting their patients with quitting. This survey study examined tobacco cessation behaviors among physicians in Delaware as part of the state's tobacco control program called Plan for a Tobacco-Free Delaware. METHODS: A self-administered questionnaire was mailed to all Delaware physicians in primary care and specialties that manage tobacco-related illnesses (cardiology, pulmonology, and allergy) in May of 2002 (n=890). RESULTS: Of the 156 survey respondents, most physicians reported regularly asking their adolescent patients (57.3%) and their adult patients (65.4%) about smoking and advising their smoking patients to quit (84%). Most physicians do not regularly assist patients in quitting (17.6%) or arrange follow-up (28.1%). Also, most physicians do not regularly prescribe nicotine replacement (12.9%) or bupropion (10.7%), nor do they regularly give written materials to help in quitting (16.3%) or refer patients to smoking cessation programs (14.7%). CONCLUSIONS: While most physicians in Delaware ask their patients about smoking and advise them to quit, most physicians do not adequately assist their smoking patients in accordance with national guidelines. Reasons include lack of time, lack of quick and easy tools to help patients quit, and inadequate reimbursement for physicians' tobacco cessation activities and medications. This article suggests ways that the state can assist physicians with tobacco cessation that can be incorporated into the Plan for a Tobacco-Free Delaware. In particular, ensuring adequate and universal reimbursement for physician visits related to tobacco cessation, for tobacco cessation programs, and for tobacco cessation medications is essential to increasing physician involvement in tobacco cessation activities.

Adult↗
PubMed1997

What is being done about Delaware's high cancer death rate? (1988 through June 1997).

After more than ten years of studies of Delaware's high cancer death rates by Delaware's Division of Public Health, few of the recommendations to reduce the excessive number of cancer deaths have been understood or adopted. Although rural Sussex County's cancer death rate is higher than the other two counties (except for lung cancer), and Delaware has only a few more cancers per population than the national average, industrial toxins commonly continue to be blamed for the State's high cancer mortality rate. People are still not persuaded that over the long run, cancer deaths would be cut by adopting healthy life styles to: 1. Reduce exposures to tobacco (by far the most significant intervention), 2. Stick to low fat, high fiber diets, 3. Have regular screening for cancers with appropriate tests 4. Seek medical attention for early symptoms of cancer. This review is seeking to emphasize the importance of implementing the repeated recommendations to reduce cancer mortality in Delaware without asking for another study, and to stress that health behavior education at home and in the schools is a cost effective way to initiate the adoption of healthy life styles to reduce the risk of getting cancer and dying from it. Efforts in the schools should be continued by extending health promotion activities to workplaces, doctors' offices, and to the general public with a focus on senior citizens. Universal access to health care will be needed especially for the poorly educated with limited fiscal resources who are most at risk. Delaware needs action, not more studies, to reduce its high cancer death rate.

Delaware↗