scholarly journals Combatting the opioid epidemic: Baltimore’s experience and lessons learned

2017 ◽  
Vol 40 (2) ◽  
pp. e107-e111 ◽  
Author(s):  
Leana S Wen ◽  
Katherine E Warren
Keyword(s):  
Critical Role ◽  
Health Department ◽  
Lessons Learned ◽  
Federal State ◽  
Opioid Epidemic ◽  
Baltimore City ◽  
Overdose Prevention ◽  
Opioid Crisis ◽  
Drug And Alcohol ◽  
The City

Abstract In the midst of a national opioid crisis, Baltimore City witnessed 393 deaths from drug and alcohol overdose in 2015. With an estimated 25 000 residents who are addicted to heroin or other opioids, Baltimore has been profoundly affected by the opioid epidemic. Other resources have commented on federal, state-based, and provider responses to the opioid crisis. This article examines what may be done at the city level based on the experiences of the Baltimore City Health Department. Local jurisdictions must play a critical role in addressing the U.S. opioid crisis through public health coalitions, overdose prevention, treatment expansion, and anti-stigma education.

scholarly journals Children morbidity as indicator of ecological situation in Sevastopol

2020 ◽  
Vol 26 (3) ◽  
pp. 62-77
Author(s):  
Irina Yaseneva ◽  
Elena Yaseneva
Keyword(s):  
Respiratory Diseases ◽  
Health Knowledge ◽  
Negative Impact ◽  
Health Department ◽  
International Classification Of Diseases ◽  
Federal State ◽  
Additional Tool ◽  
Industrial Enterprises ◽  
Child Population ◽  
The City

The aim of this study was to define the factors that have a negative impact on public health. Knowledge in this field is an additional tool for the environmental quality management in the context of preserving and strengthening of the child population health. The geoformation material of the children’s morbidity has an important information about the health of the population and the environmental impact on it. Industrial enterprises influence air pollution: Sevgorvodokanal DKP Balaklava State Mining Administration, Sevtets DP, Sevteploenergo KP, Yugtorsan LLC. Pollutants such as inorganic dust, carbon monoxide, sulfur dioxide, nitric oxide, which increase the incidence of respiratory diseases, increase mortality from diseases of the respiratory system and the cardiovascular system, are present in the air basin. The results of the study are based on statistical data collected by the author in the Territorial Bodies of the Federal State Statistics Service for cities and districts, regional health organizations (Sevastopol Health Department), and city polyclinics in the study area. The dataset included information on the demographic situation, as well as medical statistics (morbidity and mortality according to the international classification of diseases). Analysis of the medical and environmental status of the city of Sevastopol was carried out taking into account the criteria of the environmentally dependent diseases of the child population (age group from 0 to 17 years). Assessment of the incidence of children in the city of Sevastopol, showed that respiratory diseases occupy a leading place in the structure of the general incidence rate, digestive apparatus diseases take the 2nd place and the nervous system disease takes the third one.

Practical Lessons Learned from Baltimore’s B’FRIEND Initiative

2019 ◽  
pp. 219-228
Author(s):  
Darcy F. Phelan-Emrick ◽  
Michael Fried ◽  
Heang Tan ◽  
Molly Martin ◽  
Leana S. Wen
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Information Exchange ◽  
Surveillance System ◽  
Health Information Exchange ◽  
Health Department ◽  
Lessons Learned ◽  
Emergency Department Visits ◽  
Baltimore City

This chapter presents a case study from the Baltimore City Health Department called the Baltimore Falls Reduction Initiative Engaging Neighborhoods and Data (B'FRIEND). The initiative aimed at improving the issue of falls among older adults (65 years and over). B'FRIEND seeks to reduce falls-related emergency department visits and hospitalizations among older adults in Baltimore City. It does this by implementing a falls surveillance system with data from the state's health information exchange (HIE) and then using those data to target interventions. The chapter looks at how this initiative came about, the key groups involved, and the lessons learned.

Characterising and quantifying links between water, energy, and food consumption in a water-poor, energy-rich city; Adelaide, Australia

2020 ◽  
Author(s):  
Margaret Shanafield ◽  
Okke Batelaan ◽  
Sundar Subramani
Keyword(s):  
Critical Role ◽  
River System ◽  
Lessons Learned ◽  
Data Availability ◽  
Groundwater Depletion ◽  
Water Supplies ◽  
Murray River ◽  
The World ◽  
Production Areas ◽  
The City

<p>More than half of the world’s population are urban dwellers, and this percentage is on the rise. Therefore, understanding the links between water, energy, and food requirements of cities plays a critical role in determining global resource consumption. Adelaide is a mid-size, coastal Australian city in Australia with a population of almost 1.3 million inhabitants. With its plentiful access to wind and solar energy, the Adelaide region has one of the highest rates of renewable energy production in the world, and access to additional, conventional energies supplies from other parts of the Australian network. However, the water supplies in this region are theoretically limited, as groundwater depletion is already occurring in the food production areas surrounding the city, and municipal water supplies rely heavily on the fully allocated Murray River system. Therefore, optimization of the food, energy and water requirements of the city provides an opportunity for optimal use of valuable resources. Quantification of these industries was not trivial and provided data availability and comparison challenges.  Lessons learned on a quantitative example of the water-energy-food nexus at city scale are presented.</p>

scholarly journals Disaster Surveillance: Perspectives from Federal, State, and Local levels

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Eric Bakota ◽  
David Atrubin ◽  
Michael Coletta ◽  
Aaron Kite-Powell
Keyword(s):  
Syndromic Surveillance ◽  
Florida Keys ◽  
Health Department ◽  
Federal State ◽  
Poison Control ◽  
Local Response ◽  
Syndromic Surveillance System ◽  
Federal Level ◽  
The City ◽  
Hurricane Irma

ObjectiveIn this panel, attendees will learn about how disaster surveillance was conducted in response to Hurricanes Irma and Harvey, as well as the role of CDC at the federal level in supporting local response efforts. By hearing and discussing the challenges faced and solutions identified, attendees will be better able to respond in the event of a low-frequency/high-consequence disaster occurring within their jurisdiction.IntroductionIn this panel, the presenters will discuss their perspective in responding to Hurricanes Harvey and Irma. Hurricane Harvey made landfall on August 25th and over the course of 4 days dropped approximately 27 trillion gallons of water on Texas and Louisiana.1 The flooding that ensued was unprecedented and forced over 13,000 people into shelters.2 These individuals needed to have their basic needs -food, shelter, clothing, sanitation- met as well as their physical and mental health needs. The George R Brown Conference Center (GRB) and NRG Stadium Center were set up as mega-shelters to house shelterees. Hurricane Irma made landfall on September 10th in the Florida Keys as a Category 4 Hurricane. The Hurricane caused 72 deaths3 and forced thousands of people into shelters.4 These weather events created novel challenges for local response efforts. Decision makers needed timely and actionable data, including surveillance data.DescriptionAt the federal level, Aaron Kite-Powell will discuss his experiences in supporting local efforts to acquire timely and actionable data collected by on-site federally deployed disaster medical assistance teams (DMAT). DMAT provided clinical services to residents who were staying in a mega-shelter. Data collected from DMAT was electronically sent to CDC through the National Syndromic Surveillance Program (NSSP) where it could be accessed in CDC's instance of ESSENCE. Additionally, in Houston, 3 area hospitals submitted their data to NSSP. The City of Houston Health Department (HHD) was given access to DMAT and hospital syndromic data through ESSENCE. Once access was established, just in time training was conducted for HHD.David Atrubin will discuss how Florida’s syndromic surveillance system was utilized during Hurricane Irma in September 2017. ESSENCE-FL provided critical near real-time surveillance data before, during, and after the storm. Multiple data sources, within the ESSENCE-FL, were utilized including emergency department, poison control, death record, and DMAT data. In addition to the anticipated increases in animal bites, injuries, medication refills, dialysis visits, and carbon monoxide exposures, some unexpected increases were observed as well.Eric Bakota will describe his experience in coordinating the remote shelter surveillance team for the City of Houston Health Department. In the immediate aftermath of the flooding, several organizations opened shelters for people who were forced to leave their homes. Many of these facilities were not officially connected to the City. An ad hoc process was used to identify and connect with these facilities. Once identified as a shelter, a team of 6 epidemiologists conducted daily check-ins to determine the census and status of shelterees. Several tools to coordinate activities and record the data collected were used, including Dropbox, Googlesheets, and MAVEN. Each tool had its own strengths and limitations that will be discussed.How the Moderator Intends to Engage the Audience in Discussions on the TopicThe moderator should engage the panelists by asking questions the following questions:● How did each panelist work with their Federal/State/Local partners● How did each panelist integrate into the larger response framework (e.g., ICS)● How did each panelist use technology to address any novel surveillance barriers during the disasterReferences1. Sanchez R, Yan H, Simon D. Harvey aftermath: Houston 'open for business'; other cities suffering. CNN. 2017 Sep 1.2. Sullivan K, Hernandez A, Fahrenthold D. Harvey leaving record rainfall, at least 22 deaths behind in Houston. Chicago Tribune. 2017 Aug 29.3. Impact of Hurricane Irma. Boston Globe. Accessed 2017 Oct 10. https://www.bostonglobe.com/news/bigpicture/2017/09/11/impact-hurricane-irma/W6WBN9K2lXd4gPmtu26auN/story.html4. Smith A. After Hurricane Irma, Many Ask: How Safe Are Shelters? Tampa Bay Times. 2017 September 21. 

scholarly journals Experience in Organizing the Activities of an Infectious Hospital Established on the Basis of a Specialized Scientific Center During the COVID-19 Pandemic (on the example of the National Scientific Center of Traumatology and Orthopаedics named after Academician Batpenov N.D.)

2021 ◽  
pp. 16-21
Author(s):  
Yerzhan Iskakov ◽  
◽  
Galiya Mussina ◽  
Keyword(s):  
Infectious Diseases ◽  
Statistical Data ◽  
Emergency Situation ◽  
Health Department ◽  
Lessons Learned ◽  
Scientific Center ◽  
Long Term Consequences ◽  
The Republic ◽  
The City

Purpose of the message to study the results of the first experiment on the re-profiling of a specialized scientific center in order to organize an infectious hospital for the treatment of patients with COVID-19. Methods. The article analyzes the results of the activity of an infectious hospital organized on the basis of the National Scientific Center of Traumatology and Orthopаedics named after Academician Batpenov N.D. during the COVID-19 pandemic. The analysis includes the activities carried out within the framework of the re-profiling of the hospital, as well as statistical data on patients treated and medical services provided for the period from March 26 to August 26, 2021. Results. The infectious diseases hospital has been receiving patients for more than 5 months, during this time more than 1300 patients with COVID-19 have been treated. The correct and concrete actions of the management of the Center and the city health department made it possible to organize the clinic's activities in an emergency situation in such a way that the work on the main profile was not affected. Conclusion. The lessons learned have long-term consequences for the entire public health of the city and the republic. The accumulated experience in the work of the newly created infectious hospital for the treatment of patients with CОVID-19 can be used in the further medical activities of medical organizations of military and civilian healthcare. Keywords: COVID-19 pandemic, infectious diseases hospital, hospital conversion.

Two mechanisms for accelerated diffusion of COVID-19 outbreaks in regions with high intensity of population and polluting industrialization: the air pollution-to-human and human-to-human transmission dynamics (Preprint)

2020 ◽  
Author(s):  
Mario Coccia
Keyword(s):  
Air Pollution ◽  
Wind Speed ◽  
Critical Role ◽  
Meteorological Condition ◽  
Meteorological Conditions ◽  
Lessons Learned ◽  
Transmission Dynamics ◽  
Critical Threshold ◽  
Viral Infectivity ◽  
Low Wind Speed

BACKGROUND Coronavirus disease 2019 (COVID-19) is viral infection that generates a severe acute respiratory syndrome with serious pneumonia that may result in progressive respiratory failure and death. OBJECTIVE This study has two goals. The first is to explain the main factors determining the diffusion of COVID-19 that is generating a high level of deaths. The second is to suggest a strategy to cope with future epidemic threats with of accelerated viral infectivity in society. METHODS Correlation and regression analyses on on data of N=55 Italian province capitals, and data of infected individuals at as of April 2020. RESULTS The main results are: o The accelerate and vast diffusion of COVID-19 in North Italy has a high association with air pollution. o Hinterland cities have average days of exceeding the limits set for PM10 (particulate matter 10 micrometers or less in diameter) equal to 80 days, and an average number of infected more than 2,000 individuals as of April 1st, 2020, coastal cities have days of exceeding the limits set for PM10 equal to 60 days and have about 700 infected in average. o Cities that average number of 125 days exceeding the limits set for PM10, last year, they have an average number of infected individual higher than 3,200 units, whereas cities having less than 100 days (average number of 48 days) exceeding the limits set for PM10, they have an average number of about 900 infected individuals. o The results reveal that accelerated transmission dynamics of COVID-19 in specific environments is due to two mechanisms given by: air pollution-to-human transmission and human-to-human transmission; in particular, the mechanisms of air pollution-to-human transmission play a critical role rather than human-to-human transmission. o The finding here suggests that to minimize future epidemic similar to COVID-19, the max number of days per year in which cities can exceed the limits set for PM10 or for ozone, considering their meteorological condition, is less than 50 days. After this critical threshold, the analytical output here suggests that environmental inconsistencies because of the combination between air pollution and meteorological conditions (with high moisture%, low wind speed and fog) trigger a take-off of viral infectivity (accelerated epidemic diffusion) with damages for health of population, economy and society. CONCLUSIONS Considering the complex interaction between air pollution, meteorological conditions and biological characteristics of viral infectivity, lessons learned for COVID-19 have to be applied for a proactive socioeconomic strategy to cope with future epidemics, especially an environmental policy based on reduction of air pollution mainly in hinterland zones of countries, having low wind speed, high percentage of moisture and fog that create an environment that can damage immune system of people and foster a fast transmission of viral infectivity similar to the COVID-19. CLINICALTRIAL not applicable

scholarly journals Confronting Two Crises: The COVID-19 Pandemic, the Opioid Epidemic, and the Industrial Hygienist

2021 ◽  
pp. 104829112110295
Author(s):  
Jonathan Rosen ◽  
Peter Harnett
Keyword(s):  
Disease Control ◽  
Drug Overdose ◽  
Industrial Hygiene ◽  
Prevention Programs ◽  
Opioid Epidemic ◽  
Opioid Misuse ◽  
Opioid Crisis ◽  
The Impact ◽  
Overdose Deaths ◽  
Industrial Hygienist

This article was originally written for and published in the January 2021 issue of The Synergist, a monthly publication of the American Industrial Hygiene Association. The article addresses the convergence of the COVID-19 and opioid crises, the impact of the opioid crisis on the workplace and workers, and the role that industrial hygienists can play in developing workplace programs to prevent and respond to opioid misuse. While the article is specifically written for industrial hygienists, the review and recommendations will be useful to others who are developing workplace opioid prevention programs. Note that the data presented in this article were current as of January 2021. Centers for Disease Control and Prevention’s latest available data are for the twelve-month period ending October 2020 and include 88,990 total overdose deaths and 91,862 predicted, when reporting is completed. Source: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm (accessed on 15 June 2021).

scholarly journals Dendritic Cell Tumor Vaccination via Fc Gamma Receptor Targeting: Lessons Learned from Pre-Clinical and Translational Studies

Vaccines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 409
Author(s):  
Enrique Gómez Alcaide ◽  
Sinduya Krishnarajah ◽  
Fabian Junker
Keyword(s):  
T Cell ◽  
T Cell Activation ◽  
Cell Activation ◽  
Tumor Antigens ◽  
Checkpoint Inhibitors ◽  
Critical Role ◽  
Lessons Learned ◽  
Antigen Delivery ◽  
Tumor Vaccination ◽  
Translational Studies

Despite significant recent improvements in the field of immunotherapy, cancer remains a heavy burden on patients and healthcare systems. In recent years, immunotherapies have led to remarkable strides in treating certain cancers. However, despite the success of checkpoint inhibitors and the advent of cellular therapies, novel strategies need to be explored to (1) improve treatment in patients where these approaches fail and (2) make such treatments widely and financially accessible. Vaccines based on tumor antigens (Ag) have emerged as an innovative strategy with the potential to address these areas. Here, we review the fundamental aspects relevant for the development of cancer vaccines and the critical role of dendritic cells (DCs) in this process. We first offer a general overview of DC biology and routes of Ag presentation eliciting effective T cell-mediated immune responses. We then present new therapeutic avenues specifically targeting Fc gamma receptors (FcγR) as a means to deliver antigen selectively to DCs and its effects on T-cell activation. We present an overview of the mechanistic aspects of FcγR-mediated DC targeting, as well as potential tumor vaccination strategies based on preclinical and translational studies. In particular, we highlight recent developments in the field of recombinant immune complex-like large molecules and their potential for DC-mediated tumor vaccination in the clinic. These findings go beyond cancer research and may be of relevance for other disease areas that could benefit from FcγR-targeted antigen delivery, such as autoimmunity and infectious diseases.

scholarly journals Rural Emergency Medical Service Providers Perceptions on the Causes of and Solutions to the Opioid Crisis: A Qualitative Assessment

2021 ◽  
Vol 12 ◽  
pp. 215013272098771
Author(s):  
Heather Blue ◽  
Ashley Dahly ◽  
Susan Chhen ◽  
Julie Lee ◽  
Adam Shadiow ◽  
...  
Keyword(s):  
Pain Management ◽  
Rural Communities ◽  
Social Determinants Of Health ◽  
Emergency Medical Service ◽  
Social Determinants ◽  
Medical Service ◽  
Critical Role ◽  
Access To Treatment ◽  
Opioid Crisis

Introduction: The continuing opioid crisis poses unique challenges to remote and often under-resourced rural communities. Emergency medical service (EMS) providers serve a critical role in responding to opioid overdose for individuals living in rural or remote areas who experience opioid overdoses. They are often first at the scene of an overdose and are sometimes the only health care provider in contact with an overdose patient who either did not survive or refused additional care. As such, EMS providers have valuable perspectives to share on the causes and consequences of the opioid crisis in rural communities. Methods: EMS providers attending a statewide EMS conference serving those from greater Minnesota and surrounding states were invited to take a 2-question survey asking them to reflect upon what they believed to be the causes of the opioid crisis and what they saw as the solutions to the opioid crisis. Results were coded and categorized using a Consensual Qualitative Research approach. Results: EMS providers’ perceptions on causes of the opioid crisis were categorized into 5 main domains: overprescribing, ease of access, socioeconomic vulnerability, mental health concerns, and lack of resources and education. Responses focused on solutions to address the opioid crisis were categorized into 5 main domains: need for increased education, enhanced opioid oversight, increased access to treatment programs, alternative therapies for pain management, and addressing socioeconomic vulnerabilities. Conclusion: Along with the recognition that the opioid crisis was at least partially caused by overprescribing, rural EMS providers who participated in this study recognized the critical role of social determinants of health in perpetuating opioid-related harm. Participants in this study reported that education and increased access to treatment facilities and appropriate pain management, along with recognition of the role of social determinants of health in opioid dependency, were necessary steps to address the opioid crisis.

scholarly journals Practical implications of naloxone knowledge among suburban people who use opioids

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Kristin E. Schneider ◽  
Glenna J. Urquhart ◽  
Saba Rouhani ◽  
Ju Nyeong Park ◽  
Miles Morris ◽  
...  
Keyword(s):  
Public Health ◽  
Health Department ◽  
Washington Dc ◽  
Multiple Sources ◽  
Public Health Response ◽  
Baltimore City ◽  
The Public ◽  
Health Response ◽  
The Usa ◽  
Practical Implications

Abstract Background Naloxone distribution programs have been a cornerstone of the public health response to the overdose crisis in the USA. Yet people who use opioids (PWUO) continue to face a number of barriers accessing naloxone, including not knowing where it is available. Methods We used data from 173 PWUO from Anne Arundel County, Maryland, which is located between Baltimore City and Washington, DC. We assessed the prevalence of recently (past 6 months) receiving naloxone and currently having naloxone, the type(s) of the naloxone kits received, and the perceived ease/difficultly of accessing naloxone. We also assessed participants knowledge of where naloxone was available in the community. Results One third (35.7%) of participants had recently received naloxone. Most who had received naloxone received two doses (72.1%), nasal naloxone (86.9%), and education about naloxone use (72.1%). Most currently had naloxone in their possession (either on their person or at home; 78.7%). One third (34.4%) believed naloxone was difficult to obtain in their community. Only half (56.7%) knew of multiple locations where they could get naloxone. The health department was the most commonly identified naloxone source (58.0%). Identifying multiple sources of naloxone was associated with being more likely to perceive that naloxone is easy to access. Discussion Our results suggest that additional public health efforts are needed to make PWUO aware of the range of sources of naloxone in their communities in order to ensure easy and continued naloxone access to PWUO.

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