scholarly journals The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ying Han ◽  
Wei Yan ◽  
Yongbo Zheng ◽  
Muhammad Zahid Khan ◽  
Kai Yuan ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Severe Pain ◽  
Large Scale ◽  
Social Economic ◽  
The United States ◽  
Therapeutic Strategies ◽  
Public Health Threat ◽  
Reduction Strategies ◽  
Overdose Deaths

Abstract Fentanyl is a powerful opioid anesthetic and analgesic, the use of which has caused an increasing public health threat in the United States and elsewhere. Fentanyl was initially approved and used for the treatment of moderate to severe pain, especially cancer pain. However, recent years have seen a growing concern that fentanyl and its analogs are widely synthesized in laboratories and adulterated with illicit supplies of heroin, cocaine, methamphetamine, and counterfeit pills, contributing to the exponential growth in the number of drug-related overdose deaths. This review summarizes the recent epidemic and evolution of illicit fentanyl use, its pharmacological mechanisms and side effects, and the potential clinical management and prevention of fentanyl-related overdoses. Because social, economic, and health problems that are related to the use of fentanyl and its analogs are growing, there is an urgent need to implement large-scale safe and effective harm reduction strategies to prevent fentanyl-related overdoses.

scholarly journals A New Vision for Europe’s Bioeconomy in a Post-COVID World

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Susan Finston ◽  
Nigel Thompson
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
The United States ◽  
Inclusive Leadership ◽  
Global Pandemic ◽  
Academic Researchers ◽  
Public Health Threat ◽  
New Vision ◽  
The Eu

In response to the COVID-19 global pandemic, the European Commission (EC) provided inclusive leadership, working as a team including EU member (national) officials, biopharmaceutical industry, NGOs, academic researchers and frontline health care personnel – acting with unprecedented collaboration and cohesion.  The emergence in early 2020 of the greatest public health threat in a century required new approaches and new collaborations. While the United States failed to provide leadership, the EU did not disappoint.

A Cost-Benefit Analysis of a Potential Supervised Injection Facility in San Francisco, California, USA

2016 ◽  
Vol 47 (2) ◽  
pp. 164-184 ◽  
Author(s):  
Amos Irwin ◽  
Ehsan Jozaghi ◽  
Ricky N. Bluthenthal ◽  
Alex H. Kral
Keyword(s):  
Public Health ◽  
United States ◽  
San Francisco ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
The United States ◽  
Local Public Health ◽  
Supervised Injection ◽  
Overdose Deaths

Supervised injection facilities (SIFs) have been shown to reduce infection, prevent overdose deaths, and increase treatment uptake. The United States is in the midst of an opioid epidemic, yet no sanctioned SIF currently operates in the United States. We estimate the economic costs and benefits of establishing a potential SIF in San Francisco using mathematical models that combine local public health data with previous research on the effects of existing SIFs. We consider potential savings from five outcomes: averted HIV and hepatitis C virus (HCV) infections, reduced skin and soft tissue infection (SSTI), averted overdose deaths, and increased medication-assisted treatment (MAT) uptake. We find that each dollar spent on a SIF would generate US$2.33 in savings, for total annual net savings of US$3.5 million for a single 13-booth SIF. Our analysis suggests that a SIF in San Francisco would not only be a cost-effective intervention but also a significant boost to the public health system.

Challenge of Hospital Emergency Preparedness: Analysis and Recommendations

2009 ◽  
Vol 3 (S1) ◽  
pp. S74-S82 ◽  
Author(s):  
Joseph A. Barbera ◽  
Dale J. Yeatts ◽  
Anthony G. Macintyre
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Natural Disasters ◽  
Emergency Response ◽  
Emergency Preparedness ◽  
Large Scale ◽  
The United States ◽  
Public Health Care ◽  
Medical Emergency

ABSTRACTIn the United States, recent large-scale emergencies and disasters display some element of organized medical emergency response, and hospitals have played prominent roles in many of these incidents. These and other well-publicized incidents have captured the attention of government authorities, regulators, and the public. Health care has assumed a more prominent role as an integral component of any community emergency response. This has resulted in increased funding for hospital preparedness, along with a plethora of new preparedness guidance.Methods to objectively measure the results of these initiatives are only now being developed. It is clear that hospital readiness remains uneven across the United States. Without significant disaster experience, many hospitals remain unprepared for natural disasters. They may be even less ready to accept and care for patient surge from chemical or biological attacks, conventional or nuclear explosive detonations, unusual natural disasters, or novel infectious disease outbreaks.This article explores potential reasons for inconsistent emergency preparedness across the hospital industry. It identifies and discusses potential motivational factors that encourage effective emergency management and the obstacles that may impede it. Strategies are proposed to promote consistent, reproducible, and objectively measured preparedness across the US health care industry. The article also identifies issues requiring research. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S74–S82)

scholarly journals Compound risks of hurricane evacuation amid the COVID-19 pandemic in the United States

2020 ◽  
Author(s):  
Sen Pei ◽  
Kristina A. Dahl ◽  
Teresa K. Yamana ◽  
Rachel Licker ◽  
Jeffrey Shaman
Keyword(s):  
Public Health ◽  
United States ◽  
Large Scale ◽  
The United States ◽  
Hurricane Evacuation ◽  
Storm Activity ◽  
Transmission Rates ◽  
Hurricane Season ◽  
Major Hurricane ◽  
Virus Exposure

Current projections and unprecedented storm activity to date suggest the 2020 Atlantic hurricane season will be extremely active and that a major hurricane could make landfall during the global COVID-19 pandemic. Such an event would necessitate a large-scale evacuation, with implications for the trajectory of the pandemic. Here we model how a hypothetical hurricane evacuation from four counties in southeast Florida would affect COVID-19 case levels. We find that hurricane evacuation increases the total number of COVID-19 cases in both origin and destination locations; however, if transmission rates in destination counties can be kept from rising during evacuation, excess evacuation-induced case numbers can be minimized by directing evacuees to counties experiencing lower COVID-19 transmission rates. Ultimately, the number of excess COVID-19 cases produced by the evacuation depends on the ability of destination counties to meet evacuee needs while minimizing virus exposure through public health directives.

scholarly journals SeqSero2: Rapid and Improved Salmonella Serotype Determination Using Whole-Genome Sequencing Data

2019 ◽  
Vol 85 (23) ◽  
Author(s):  
Shaokang Zhang ◽  
Hendrik C. den Bakker ◽  
Shaoting Li ◽  
Jessica Chen ◽  
Blake A. Dinsmore ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Large Scale ◽  
Draft Genome ◽  
The United States ◽  
Whole Genome Sequencing Data ◽  
Whole Genome ◽  
Link Type

ABSTRACT SeqSero, launched in 2015, is a software tool for Salmonella serotype determination from whole-genome sequencing (WGS) data. Despite its routine use in public health and food safety laboratories in the United States and other countries, the original SeqSero pipeline is relatively slow (minutes per genome using sequencing reads), is not optimized for draft genome assemblies, and may assign multiple serotypes for a strain. Here, we present SeqSero2 (github.com/denglab/SeqSero2; denglab.info/SeqSero2), an algorithmic transformation and functional update of the original SeqSero. Major improvements include (i) additional sequence markers for identification of Salmonella species and subspecies and certain serotypes, (ii) a k-mer based algorithm for rapid serotype prediction from raw reads (seconds per genome) and improved serotype prediction from assemblies, and (iii) a targeted assembly approach for specific retrieval of serotype determinants from WGS for serotype prediction, new allele discovery, and prediction troubleshooting. Evaluated using 5,794 genomes representing 364 common U.S. serotypes, including 2,280 human isolates of 117 serotypes from the National Antimicrobial Resistance Monitoring System, SeqSero2 is up to 50 times faster than the original SeqSero while maintaining equivalent accuracy for raw reads and substantially improving accuracy for assemblies. SeqSero2 further suggested that 3% of the tested genomes contained reads from multiple serotypes, indicating a use for contamination detection. In addition to short reads, SeqSero2 demonstrated potential for accurate and rapid serotype prediction directly from long nanopore reads despite base call errors. Testing of 40 nanopore-sequenced genomes of 17 serotypes yielded a single H antigen misidentification. IMPORTANCE Serotyping is the basis of public health surveillance of Salmonella. It remains a first-line subtyping method even as surveillance continues to be transformed by whole-genome sequencing. SeqSero allows the integration of Salmonella serotyping into a whole-genome-sequencing-based laboratory workflow while maintaining continuity with the classic serotyping scheme. SeqSero2, informed by extensive testing and application of SeqSero in the United States and other countries, incorporates important improvements and updates that further strengthen its application in routine and large-scale surveillance of Salmonella by whole-genome sequencing.

PUBLIC HEALTH, NURSING AND MEDICAL SOCIAL WORK

PEDIATRICS ◽  
1950 ◽  
Vol 5 (2) ◽  
pp. 357-361
Keyword(s):  
Public Health ◽  
United States ◽  
Health Authority ◽  
Large Scale ◽  
Epidemiologic Study ◽  
The United States ◽  
Medical Social Work ◽  
Average Annual Incidence ◽  
Health Nursing ◽  
Specific Diagnostic Test

GEOGRAPHIC variation in the incidence of poliomyelitis is not well understood and many of the factors involved have not been properly evaluated. A large scale study of two important phases of this problem has recently been reported by Alexander G. Gilliam, Fay M. Hemphill and Jean H. Gerende (Pub. Health Rep. 64:1575 and 1584, 1949). These investigators studied the reported incidence of poliomyelitis in all the 3,095 counties in the United States and analyzed the data chiefly from the standpoint of variations in average annual incidence and the frequency with which epidemics recurred in a given locality. The problem is complicated, as in many other diseases, by lack of a generally available specific diagnostic test. There is usually little question about the manifest cases with paralysis. Abortive and nonparalytic cases, however, constitute a large variable. In any large scale epidemiologic study one is forced to rely on reports of cases as received by the health authority. While there is provision for correcting these reports if subsequent events cause a change in diagnosis it is obvious that in any locality interest and awareness will largely determine the number of cases reported when there is no paralysis. "It appears necessary to emphasize that in most States in this country no distinction is made between paralytic and nonparalytic poliomyelitis in cases officially reported.

Science and Medicine in the United States of America

2012 ◽  
Author(s):  
Edmund Ramsden
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
United States Of America ◽  
Rapid Growth ◽  
Large Scale ◽  
Medical Science ◽  
The United States ◽  
Biomedical Sciences ◽  
Democratic State

This article begins with great optimism expressed by Tocqueville for America's future as the embodiment of the democratic state. It discusses the opportunity to express the liberal political ideals, arguing that its success was based on a community of common sensibility. An understanding of society and politics endowed the historian with the power to help remake health care. This article explores and compares the ways in which medicine is developed and applied in a number of different social, cultural, and physical contexts. It shows rapid growth, from a period in which European ideas, methods, and structures were adapted to the American context, to one in which the United States is at the forefront of large-scale initiatives in public health, disease control, and innovation in the biomedical sciences. Finally, it mentions the contradiction, most notably between profound faith in the technical capacities of medical science and equally profound dissatisfaction with the provision of health care.

scholarly journals Differential Impacts of COVID-19 Lockdowns on PM2.5 across the United States

2021 ◽  
Author(s):  
Kevin L. Chen ◽  
Lucas R.F. Henneman ◽  
Rachel C. Nethery
Keyword(s):  
United States ◽  
Large Scale ◽  
Social Economic ◽  
The United States ◽  
Behavioral Changes ◽  
The Us ◽  
Confounding Adjustment ◽  
Business As Usual ◽  
Relationship Of ◽  
The Relationship

ABSTRACTThe COVID-19 pandemic has induced large-scale social, economic, and behavioral changes, presenting a unique opportunity to study how air pollution is affected by unprecedented societal shifts. At each of 455 PM2.5 monitoring sites across the United States, we conduct a causal inference analysis to determine the impacts of COVID-19 interventions and behavioral changes (“lockdowns”) on PM2.5 concentrations. Our approach allows for rigorous confounding adjustment and provides highly spatio-temporally resolved effect estimates. We find that, with the exception of the Southwest, most of the US experienced increases in PM2.5 during lockdown, compared to the concentrations expected under business-as-usual. To investigate possible drivers of this phenomenon, we use regression to characterize the relationship of many environmental, geographical, meteorological, mobility, and socioeconomic factors with the lockdown-attributable changes in PM2.5. Our findings have immense environmental policy relevance, suggesting that large-scale mobility and economic activity reductions may be insufficient to substantially and uniformly reduce PM2.5.

scholarly journals Effects of Large-Scale Oceanic Phenomena on Non-Cholera Vibriosis Incidence in the United States: Implications for Climate Change

2019 ◽  
Author(s):  
Chloë Logar-Henderson ◽  
Rebecca Ling ◽  
Ashleigh R. Tuite ◽  
David N. Fisman
Keyword(s):  
Public Health ◽  
Climate Change ◽  
United States ◽  
Large Scale ◽  
Disease Incidence ◽  
The United States ◽  
Ocean Warming ◽  
Rate Of Change ◽  
Health Concern ◽  
Increased Risk

AbstractPurposeEpidemics of diarrhea caused by toxigenic strains of Vibrio cholerae are of global public health concern, but non-cholera Vibrio (NCV) species are also important causes of disease. These pathogens are thermophilic, and climate change could increase the risk of NCV infection. The El Niño Southern Oscillation (ENSO) is a “natural experiment” that may presage ocean warming effects on disease incidence.MethodWe obtained vibriosis case counts in the United States by digitizing annual reports from the U.S. Cholera and Other Vibrio Illness Surveillance system. Trends and environmental impacts (of ENSO and the North Atlantic Oscillation) were evaluated using negative binomial and distributed nonlinear lag models. Associations between latitude and changing risk were evaluated with meta-regression.ResultsTrend models demonstrated significant seasonality (P < 0.001) and a 7% annual increase in disease risk from 1999 to 2014 (annual IRR 1.071, 95% CI 1.061-1.081). Distributed lag models demonstrated increased vibriosis risk following ENSO conditions over the subsequent 12 months (integrated RR 1.940, 95% CI 1.298-2.901). The rate of change in vibriosis risk increased with state latitude (RR per 10° increase 1.066, 95% CI 1.027-1.107).ConclusionVibriosis risk in the United States appears to be impacted by irregular large-scale ocean warming and exhibits a north-south gradient in rate of change as would be expected if changing disease incidence is attributable to ocean warming. Vulnerable populations, which include high-income countries with well-developed public health systems, may experience increased risk of this disease as a result of climate change.

Sign in / Sign up

Export Citation Format

Share Document