scholarly journals Predicting the impact of placing an overdose prevention site in Philadelphia: a mathematical modeling approach

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Joanna R. Wares ◽  
Jing Dong ◽  
Jana L. Gevertz ◽  
Ami Radunskaya ◽  
Kendra Vine ◽  
...  
Keyword(s):  
Public Health ◽  
Mathematical Modeling ◽  
Population Distribution ◽  
Health Impact ◽  
Opioid Use ◽  
Overdose Prevention ◽  
User Behaviors ◽  
Substance Disorders ◽  
The Usa ◽  
The Impact

Abstract Background Fatal overdoses from opioid use and substance disorders are increasing at an alarming rate. One proposed harm reduction strategy for reducing overdose fatalities is to place overdose prevention sites—commonly known as safe injection facilities—in proximity of locations with the highest rates of overdose. As urban centers in the USA are tackling legal hurdles and community skepticism around the introduction and location of these sites, it becomes increasingly important to assess the magnitude of the effect that these services might have on public health. Methods We developed a mathematical model to describe the movement of people who used opioids to an overdose prevention site in order to understand the impact that the facility would have on overdoses, fatalities, and user education and treatment/recovery. The discrete-time, stochastic model is able to describe a range of user behaviors, including the effects from how far they need to travel to the site. We calibrated the model to overdose data from Philadelphia and ran simulations to describe the effect of placing a site in the Kensington neighborhood. Results In Philadelphia, which has a non-uniform racial population distribution, choice of site placement can determine which demographic groups are most helped. In our simulations, placement of the site in the Kensington neighborhood resulted in White opioid users being more likely to benefit from the site’s services. Overdoses that occur onsite can be reversed. Our results predict that for every 30 stations in the overdose prevention site, 6 per year of these would have resulted in fatalities if they had occurred outside of the overdose prevention site. Additionally, we estimate that fatalities will decrease further when referrals from the OPS to treatment are considered. Conclusions Mathematical modeling was used to predict the impact of placing an overdose prevention site in the Kensington neighborhood of Philadelphia. To fully understand the impact of site placement, both direct and indirect effects must be included in the analysis. Introducing more than one site and distributing sites equally across neighborhoods with different racial and demographic characteristics would have the broadest public health impact. Cities and locales can use mathematical modeling to help quantify the predicted impact of placing an overdose prevention site in a particular location.

scholarly journals Predicting the Impact of Placing an Overdose Prevention Site in Philadelphia: A Mathematical Modeling Approach

2021 ◽  
Author(s):  
Joanna R. Wares ◽  
Jing Dong ◽  
Jana L. Gevertz ◽  
Ami Radunskaya ◽  
Kendra Viner ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Indirect Effects ◽  
Population Distribution ◽  
Health Impact ◽  
The United States ◽  
Opioid Use ◽  
Overdose Prevention ◽  
User Behaviors ◽  
Substance Disorders ◽  
The Impact

Abstract Background: Fatal overdoses from opioid use and substance disorders are increasing at an alarming rate. One proposed harm reduction strategy for reducing overdose fatalities is to place overdose prevention sites - commonly known as safe injection facilities - in proximity of locations with the highest rates of overdose. As urban centers in the United States are tackling legal hurdles and community skepticism around the introduction and location of these sites, it becomes increasingly important to present compelling evidence of impact and safety. Methods: We developed a mathematical model to describe the movement of opioid users to an overdose prevention site in order to understand the impact that the facility would have on overdoses, fatalities, and user education and recovery. The discrete-time, stochastic model is able to describe a range of user behaviors, including the effects from how far they need to travel to the site. We calibrated the model to overdose data from Philadelphia, and ran simulations to describe the effect of placing a site in the Kensington neighborhood.Results: In Philadelphia, which has a non-uniform racial population distribution, choice of site placement can determine which demographic groups are most helped. In our simulations, placement of the site in the Kensington neighborhood resulted in disproportionate benefits for white users. Simulations also predict that direct effects from overdose reversal in the overdose prevention site are small (about 6 fewer fatalities per year per 30 spots at the overdose prevention site without other effects). However, fatalities and nonfatal overdoses are predicted to decrease substantially when indirect effects from site safety and education of users are considered. Conclusions: Cities and locales can use mathematical modeling to help quantify the predicted impact of placing an opioid prevention site in a particular location. To fully understand the impact of site placement, it is recommended to include both direct and indirect effects in analysis. Introducing more than one site and distributing sites equally across neighborhoods with different racial and demographic characteristics would have the broadest public health impact.

DAMPAK PENGELOLAAN SAMPAH PADA KESEHATAN MASYARAKAT DI TPA

2019 ◽  
Vol 5 (2) ◽  
Author(s):  
Emilda Emilda
Keyword(s):  
Public Health ◽  
Hand Hygiene ◽  
Waste Management ◽  
Qualitative Data ◽  
Water Storage ◽  
Health Impact ◽  
Clean Water ◽  
The People ◽  
Clean Environment ◽  
The Impact

The limitations of waste management in the Cipayung Landfill (TPA) causing a buildup of garbage up to more than 30 meters. This condition has a health impact on people in Cipayung Village. This study aims to analyze the impact of waste management at Cipayung Landfill on public health in Cipayung Village, Depok City. The research is descriptive qualitative. Data obtained by purposive sampling. Data was collected by interviews, observation and documentation. Based on interviews with 30 respondents, it was found that the most common diseases were diarrhea, then other types of stomach ailments, subsequent itching on the skin and coughing. This is presumably because the environmental conditions in the form of unhealthy air and water and clean and healthy living behaviors (PHBS) have not become the habit of the people. The results indicated that there were no respondents who had implemented all of these criteria. In general respondents have implemented  3 criteria, namely maintaining hair hygiene, maintaining skin cleanliness, and maintaining hand hygiene. While maintaining clean water storage is the most often overlooked behavior. To minimize this health impact, improvements in waste management in Cipayung landfill are needed along with continuous socialization and education to develop PHBS habits and the importance of maintaining a clean environment.

scholarly journals Impact of the Affordable Care Act’s Dependent Coverage Expansion on the Health Care and Health Status of Young Adults: What Do We Know So Far?

2017 ◽  
Vol 75 (2) ◽  
pp. 131-152 ◽  
Author(s):  
Joshua Breslau ◽  
Bradley D. Stein ◽  
Bing Han ◽  
Shoshanna Shelton ◽  
Hao Yu
Keyword(s):  
Public Health ◽  
Health Status ◽  
Insurance Coverage ◽  
Health Impact ◽  
Care Utilization ◽  
The Public ◽  
Behavioral Health Treatment ◽  
Coverage Expansion ◽  
Dependent Coverage ◽  
The Impact

The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders’ children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent. There is evidence that the DCE reduced high out-of-pocket expenditures and frequent emergency room visits and increased behavioral health treatment. Evidence regarding the impact of the DCE on health is sparse but suggestive of positive impacts on self-rated health and health behavior. Inferences regarding the public health impact of the DCE await studies with greater methodological diversity and longer follow-up periods.

scholarly journals Using RE-AIM to examine the potential public health impact of an integrated collaborative care intervention for weight and depression management in primary care: Results from the RAINBOW trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248339
Author(s):  
Megan A. Lewis ◽  
Laura K. Wagner ◽  
Lisa G. Rosas ◽  
Nan Lv ◽  
Elizabeth M. Venditti ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Collaborative Care ◽  
Health Impact ◽  
Public Health Impact ◽  
Integrative Approach ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Care Intervention ◽  
The Impact

Background An integrated collaborative care intervention was used to treat primary care patients with comorbid obesity and depression in a randomized clinical trial. To increase wider uptake and dissemination, information is needed on translational potential. Methods The trial collected longitudinal, qualitative data at baseline, 6 months (end of intensive treatment), 12 months (end of maintenance treatment), and 24 months (end of follow-up). Semi-structured interviews (n = 142) were conducted with 54 out of 409 randomly selected trial participants and 37 other stakeholders, such as recruitment staff, intervention staff, and clinicians. Using a Framework Analysis approach, we examined themes across time and stakeholder groups according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Results At baseline, participants and other stakeholders reported being skeptical of the collaborative care approach related to some RE-AIM dimensions. However, over time they indicated greater confidence regarding the potential for future public health impact. They also provided information on barriers and actionable information to enhance program reach, effectiveness, adoption, implementation, and maintenance. Conclusions RE-AIM provided a useful framework for understanding how to increase the impact of a collaborative and integrative approach for treating comorbid obesity and depression. It also demonstrates the utility of using the framework as a planning tool early in the evidence-generation pipeline.

scholarly journals Exploring Ethnicity in Hospital Patients with COVID-19 in South London

The Physician ◽  
2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Anna Zatorska ◽  
Niladri Konar ◽  
Pratyasha Saha ◽  
Alice Moseley ◽  
Jessica Denman ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Population Distribution ◽  
Local Population ◽  
Case Series ◽  
Risk Of Death ◽  
Hospitalised Patients ◽  
Hospital Patients ◽  
The Usa ◽  
The Uk ◽  
The Impact

Ethnicity was found to be an independent risk factor in COVID-19 outcomes in the UK and the USA during the pandemic surge. London, being in the epicentre and having one of the most ethnically diverse population in the UK, was likely to have experienced a much higher intensity of this phenomenon. Black Asian and Minority ethnic groups were more likely to be admitted, more likely to require admission to intensive care, and more likely to die from COVID-19. We undertook an analysis of a case series to explore the impact of ethnicity in hospitalised patients with confirmed COVID-19 during the 3 months of the pandemic. Our results demonstrated that although the proportion of Asian and Black patients were representative of the local population distribution, they were much younger. The prevalence of comorbidities was similar but logistic regression analysis showed that male sex (OR 1.4, 95% CI 1.1-1.9; p=0.02), age (OR 1.03, 95% CI 1.02 - 1.04, p<0.001), those in the ‘Other’ [Odds ratio 1.7 (1.1-2.6) p = 0.01] and ‘Asian’[Odds ratio 1.8 (1.1-2.7) p=0.01], category were at higher risk of death in this cohort. Our results, therefore, are consistent with the overall data from the UK and USA indicating that ethnicity remains a significant additional risk and hence our clinical services must ensure that adequate provision is made to cater to this risk and research must be designed to understand the causes.   

scholarly journals The Impact of Human Genetic Polymorphisms on Rotavirus Susceptibility, Epidemiology, and Vaccine Take

Viruses ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 324 ◽  
Author(s):  
Sumit Sharma ◽  
Marie Hagbom ◽  
Lennart Svensson ◽  
Johan Nordgren
Keyword(s):  
Public Health ◽  
Genetic Diversity ◽  
Immune Response ◽  
Viral Infections ◽  
Phenotypic Diversity ◽  
Health Impact ◽  
Human Populations ◽  
Blood Group Antigens ◽  
Receptor Ligand ◽  
The Impact

Innate resistance to viral infections can be attributed to mutations in genes involved in the immune response, or to the receptor/ligand. A remarkable example of the latter is the recently described Mendelian trait resistance to clinically important and globally predominating genotypes of rotavirus, the most common agent of severe dehydrating gastroenteritis in children worldwide. This resistance appears to be rotavirus genotype-dependent and is mainly mediated by histo-blood group antigens (HBGAs), which function as a receptor or attachment factors on gut epithelial surfaces. HBGA synthesis is mediated by fucosyltransferases and glycosyltransferases under the genetic control of the FUT2 (secretor), FUT3 (Lewis), and ABO (H) genes on chromosome 19. Significant genotypic and phenotypic diversity of HBGA expression exists between different human populations. This genetic diversity has an effect on genotype-specific susceptibility, molecular epidemiology, and vaccine take. Here, we will discuss studies on genetic susceptibility to rotavirus infection and place them in the context of population susceptibility, rotavirus epidemiology, vaccine take, and public health impact.

scholarly journals Using informatics to guide public health policy during the COVID-19 pandemic in the USA

2020 ◽  
Vol 42 (4) ◽  
pp. 660-664
Author(s):  
Jay G Ronquillo ◽  
William T Lester ◽  
Diana M Zuckerman
Keyword(s):  
Public Health ◽  
Cross Sectional Study ◽  
Washington Dc ◽  
Cross Sectional ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Health Decision ◽  
The Usa ◽  
The Impact ◽  
At Home

Abstract Background Current and future pandemics will require informatics solutions to assess the risks, resources and policies to guide better public health decision-making. Methods Cross-sectional study of all COVID-19 cases and deaths in the USA on a population- and resource-adjusted basis (as of 24 April 2020) by applying biomedical informatics and data visualization tools to several public and federal government datasets, including analysis of the impact of statewide stay-at-home orders. Results There were 2753.2 cases and 158.0 deaths per million residents, respectively, in the USA with variable distributions throughout divisions, regions and states. Forty-two states and Washington, DC, (84.3%) had statewide stay-at-home orders, with the remaining states having population-adjusted characteristics in the highest risk quartile. Conclusions Effective national preparedness requires clearly understanding states’ ability to predict, manage and balance public health needs through all stages of a pandemic. This will require leveraging data quickly, correctly and responsibly into sound public health policies.

Opioid Use and Chronic Infections: The Value of Addressing the Syndemic in Correctional Settings Via Telemedicine Guidance and Broader Use of Long-Acting Medications

2020 ◽  
Vol 222 (Supplement_5) ◽  
pp. S486-S493
Author(s):  
Martin Krsak ◽  
Brian T Montague ◽  
Paul Trowbridge ◽  
Steven C Johnson ◽  
Ingrid A Binswanger
Keyword(s):  
Public Health ◽  
Health Impact ◽  
The United States ◽  
Cost Of Care ◽  
Advanced Technology ◽  
Unsafe Sex ◽  
Opioid Use ◽  
Chronic Infections ◽  
Correctional Settings ◽  
Long Acting

Abstract In the United States, we are experiencing linked epidemics (a syndemic) of substance use disorders (SUDs) and infections associated with drug use, including unsafe injecting and unsafe sex in exchange for drugs or money. Current drug laws, together with risk-taking behavior among persons with SUDs, contribute to disproportionately high prevalences of these conditions in correctional settings. Detection and treatment of diseases with a high impact on public health are best addressed in the settings where such conditions are most prevalent (ie, jails and prisons for SUDs and chronic infections). The effectiveness, safety, cost of care. and public health impact of these conditions can be improved by means of broader screening and expanded access to specialty consultations through telemedicine/telehealth, along with broader use of long-acting medications for the treatment of human immunodeficiency virus and SUDs. Expanding telemedicine/telehealth, first for specialties which do not require advanced technology (eg, infectious diseases, addictions), can eventually lead to further advancements in correctional healthcare.

scholarly journals The Public Health Implications of Brexit: A Health Impact Assessment Approach

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Green
Keyword(s):  
Public Health ◽  
Impact Assessment ◽  
Health Impact Assessment ◽  
Health Impact ◽  
Complex Nature ◽  
The Public ◽  
Wide Range ◽  
The Impact ◽  
The Eu ◽  
Public Bodies

Abstract On March 29th 2019, the United Kingdom (UK) was due to exit the EU in a process known informally as ’Brexit’. This exit and entry into a 2-year transition is a period of unprecedented political and social upheaval - with many unknowns and much uncertainty attached to the outcomes and future impact. In preparation for Brexit, Public Health Wales commissioned the Wales HIA Support Unit to carry out a health impact assessment of Brexit in Wales to support and inform its and other public bodies planning and future work. This paper examines the unique HIA carried out between July and December 2018 on the impact of the UK withdrawal from the EU in Wales. It discusses the robust, participatory process undertaken, the stakeholders involved and the benefits reaped from this. It highlights the evidence gathered and analysed including the collection methods, the complex nature of the work and disseminates the main findings from the HIA including the potential determinants of health and population groups identified. Finally, it describes the challenges faced, how these were overcome, and the huge benefits, impact and influence it has had to date across a wide range of UK and Welsh organisations and public bodies. This work demonstrates continued leadership in the field of impact assessment and spearheads the requirement for public bodies to carry out HIAs as part of the forthcoming statutory requirements of the Public Health (Wales) Act 2017 an can inform practice at a global level. Key messages HIA can inform and influence action in response to important strategic decisions. The Brexit HIA is a unique example which can inform international HIA practice.

scholarly journals Sampling and analyses of polychlorinated dibenzo dioxins (PCDDs) and polychlorinated dibenzo furans (PCDFs) emissions in South Africa: A practitioner’s guide

2016 ◽  
Vol 24 (2) ◽  
pp. 29-32
Author(s):  
D.L. Posthumus ◽  
G.B. Woollatt
Keyword(s):  
Public Health ◽  
South Africa ◽  
Environmental Protection ◽  
Environmental Protection Agency ◽  
Health Impact ◽  
The United States ◽  
Protection Agency ◽  
Draft Report ◽  
Limit Values ◽  
The Impact

Dioxins and furans are toxic chemicals. A draft report released for public comment in September 1994 by the US Environmental Protection Agency clearly describes dioxin as a serious public health threat. The public health impact of dioxins may rival the impact that dichlorodiphenyltrichloroethane (DDT) had on public health in the 1960’s. According to the United States Environmental Protection Agency(USEPA) report, not only does there appear to be no “safe” level of exposure to dioxin, but levels of dioxin and dioxin-like chemicals have been found in the general US population that are “at or near levels associated with adverse health effects.”  With this in mind the purpose of this paper is to provide an overview of the current dioxin and furan emissions from industry in South Africa, in terms of compliance with the relevant emission limit values (ELVs) and the current challenges faced with the monitoring and analysis thereof.

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