Accurately Addressing Crisis in Public Health : Foster Care , Suicide and Opioid Addiction .

The opioid epidemic has unfortunately resulted in a secondary looming crisis ,  and one were innocence plays a vital role . A slow creeping crisis within the Health and Human Resources Administration related to Foster Care and stemming from the removal of parental rights  of those immersed in opioid addiction which leads to heroin addiction (H H A,2018) .In addition to these looming crisis we are also observing an alarming rise in suicide cases (Psychiatry Adviser,2018) .It is important to note that interventions in all three crisis must be implemented expeditiously , as all three issues are considered emergency situations ,in this seance they share likeness in characteristics ; not with standing they are different and distinct in causality and the therapeutic approach should paralleled the root of the issue and not the characteristic as to prevent therapeutic measures not suitable , of good fit and economically sound .

Statistical Data 

Suicide Rates - suicide rates increased in nearly every state from 1999 to 2016 . Suicide is rarely caused by any single factor and mental health issues are only a portion pf causes of suicide . Factors for suicide can include drug abuse , relationship issues , legal problems and financial troubles .More than half of all people who commit suicide do not suffer from mental issues ( CDC Vital Signs , 2018). The states with the highest rates of suicide are as follows : Montana , Kansas , South Carolina , New Hampshire , Oklahoma , Utah,Minnesota ,North Dakota and Wyoming  with 58 % increase since 1999.   The states with rates of;  or between 31-37% are :  Colorado, Maryland , Arkansas, Kentucky ,  Indiana Ohio,Pennsylvania , Wyoming and Massachusetts. States with rates of 19-30% increases are Oregon, Texas , New York , Road Island , Alabama , and Los Angeles. The remainder of the states rates rose by 6-18% which is still very high. 

Foster Care Rates- there were no aquishable statistical data found with regard to crud rates or case counts in the increase in foster care . A study that demonstrates outcomes in the characteristics of the scenario in foster care were obtained from the cdc and the discussion stemming from the outcomes is as follows : Mental , behavioral and developmental disorders identified in childhood often persist into adulthood . This particular study was selected because it lends credence to prior studies related to complex childhood trauma ; such as family separation , child abuse and depraved indifference . 

Opioid Addiction - Statistical data need not be compared because it precedes both issues discussed  previously .   

Critical Analysis - The proposed model to ascertain the looming crisis in Foster Care entitled " What Ever It Takes "  where the goal of the proposed model is to compile a system called TST or Total System Therapy are suitable in its concept because it proposes complete therapeutic care in approaching the crisis and rightfully so because the removal of children from parental neglect prevents depraved indifference and it is considered an emergency , but in evaluating the proposed therapeutic interventions from the model  we find that these are not of suitable fit ,because the proposed interventions are existential in nature and are likely extremely difficult for a developing child to carry out  , on the other hand they are also not congruent with the over all concept of assembling a supportive system fro the child . In simular findings TST interventions would be a reasonable fit to implement in Suicidal idealization and self aggression and self harm , becsuse these interventions accurately address the adult existence and  provides insight into suicidal ideation which addresses the issue on a long term basis . The overarching reason for this is because TST are active learning and must be performed by the person as opposed to a child learning intervention where the child must be guided and incapacitated to perform the proposed interventions for himself . Curiously enough the proposed intervention to address suicide entitled Dialectical Behavioral Therapy or DBT is suitable to address Foster Care   .  The intervention is as follows : Dialectical Behavioral Therapy is cognitive behavioral approach to treatment that synthesizes change based strategies  characteristic of behavior therapy and validation strategies (NIH,2018) ;consistent with acceptance  based treatment , This is a better fit in addressing  family separation and in  preventing child abuse , neglect and indifference it also foments healing through forgiveness particularly when applied to Tele health measures which secures the child allows the process and is consistent with a progressive therapeutic regimen. Further TST currently has no statistical measures to sustain its efficacy and DBT is promising in addressing both immediate crisis intervention in Foster care and Suicide idealization .   Because the three crisi share characteristics careful interventions  should be evaluated as to be accurate in public health interventions and in cost effective health rehabilitation .. 

References

CDC(2018) Suicide Rising Across The USA . Centers for Disease Control Vital Signs . Retrieved from http://www.cdc.gov

NIH(2018) Collaborative Adolescent Research on Emotions and Suicide (CARES) Retrieved from http://www. clinical trials.gov/et2/show/NCTO1528020

Psychiatry Advisor (2018) Suicide Rates on the rise in nearly every state ,Says New CDC Report. Retrieved from http://psychiatry advisor. com

Campus Security and Student Safety Measures .Next Steps in Public Health

The quote from author S Shepard "( There is a lot going on in the world  these days and unfortunately ; due to recent events  campus security has become a bit  of a buzz word)". These remarks made by the author should be headed because they describe aspects of the attack at a High school just days before the school year 2018 were coming to a close . This particular piece is written in plain language or rather technical writing rather than scientific writing because in public health we use technical writing to avoid bias to multicultural populations . The author is justifying the use of attack resistant doors which will be implemented as a public health measure very soon through out school campus across the United States (Shepard,2018) . Attack resistant doors will be further described , but first we must evaluate the type of society which know merit the implementation of such doors to maintain safety and security in the learning setting . So what type of society are we observing and addressing in public health ?  Well when we begin an appraisal of the type of society that merit these types of intervention ; we begin by observing the defining characteristics of the society. when we do we conclude that the society are a pathological one , the definition of pathological is the following (1) being such to a degree that is extreme , excessive , or markedly abnormal . The second definition that are given is the following (2) altered or caused by disease , or indicative of disease . A person and or community can be pathological as seen often times in communities taken over by drugs , or a person who is mentally challenged , but societies can also become pathological when these issues become rampant with little public health intervention  hense, the term pathological society. Attack resistant doors and school guard glass are a new product which are part of new security measures implemented in door way systems ; these systems work by dwarfing and or delaying the entry into particular areas by an attacker , thereby sealing them off from the student body and teaching professionals , This system not only repeals an attacker but also provides a great time frame for first res ponders to minimize MCE . The opening meets test standards for forced entry and ballistics resistant levels of protection for various threats set forth based on the FBIs active shooter reports. The attacker resistant doors assembly can withstand an intense four minute physical attacker after being shot 60 times with 7.62 NATO rounds. This public health intervention is guided towards assuring the education of and security of students who attend public schools across the U.S and are part of the protection from foreign and domestic attacks upon the most vulnerable and innocent / 


References

Shepard , S (2018) Attack Resistant Doors . Retrived from http://www.hsph.harvard.edu/communications /home/communications-resources

Shi ,L &Johnson . J.A (2014) Novick and Morrows Public Health Administration .Principles for Population -Based Management . 3rd ed Bartlett Jones Publishing USA     

Policies in Social and Behavioral Science : Interventions in the Incarcerated Individual

House Rules S.2349 which passed the house on 5/17/2018 states the following "An Inter agency working group shall study Federal efforts to collect data on sexual violence. Working group shall have 180 days to collect said data  Subtitle b of house rules S.2349 states that among the working group  the following agencies shall convene (1) CDC (2) Dep of Education (3) HHS (4) DOI. Subtitle C from the same policy states that working group shall make consideration of the following when collecting data related to sexually violent crimes , define what activities constitute and differentiates a sexual crime . Whether reports that use the same terms for acts of sexual violence are collected the same . Whether the context which lead to an  act is accounted for in reports and whether the data collected is presented in a way that allows the general public to understand what acts of sexual violence are included in each measurement . Item five from subtitles C states that working group shall take measures in avoiding double counting incidents. .

Policy Analysis
     The above implemented policy is formidable and meets  current situations found in the  DOJ , particularly were it relates to cases on the bench within local  and  state jails . An example of why this policy is formidable may be examined when reading the text from the article entitled " New York City by the Numbers " where the following statistical data are found : Of the more than 58,000 admissions to the city jails last year 2017 43,345 were jailing of unique individual . Nearly 3,800 inmates had been held more than 10 other times, and about 800 were jailed wore than 20 times during the years 2008 through 2017 .  But the most significant statistical data are that 30,443 had been jailed once before from the year 2007 -2017 . This is significant because apart from the obvious recidivism are post jailed rehabilitative practices and there effectiveness . In the article entitled Incarceration and the Mentally ill written by L Cruz, 2015 the same recommendations found in policy # S.2349 were suggested . Findings from that research study were the following Census were extremely high with the majority of jailed individuals were made up of Hispanics and Black males , city jails had a 99% population with some type of mental incapacity Vs Federal Jails and the number one mental incapacity was related to impulse control issues rather than organic mental illness  . In addition two out of every three males is jailed in the United States every day, and the Jail census is the highest among all countries of the world . Currently there 35 out of every 100 people have active cases in the bench or docket  (L, Cruz 2015). The policy is important because it allows the working group to examine  the factors found in the study related to the incarcerated individual with mental illness and to engage in interventions in Social and Behavioral health that lower recidivism , deter incarceration and prevent poverty because incarceration affect not only the economy but threaten the United States work force , infrastructure and ability of its citizens to compete with other countries  .


References

L ,Cruz(2015 ) Incarceration and the Mentally Ill . Capella University .Minnesota USA 

Retrieved from http:/www.bo.nyc.ny.us/cgi.park2/2018/of-the-more-than-58,000-admissions-tocity-jails-last-year-howmany-inmates-had-been-there-before/ . New York by the Numbers .

Comparison Between SDG UN and CDC Under Five Child Mortality .Public Health Perspective .

New estimates in levels and trends in child mortality report for 2015 ; released by the UN Inter agency group for child mortality estimation UN /GME indicate that although the global progress has been substantial (16,000) children under five still die every day , and the 53% drop is not enough to meet the Millennium Development Goals which call for two thirds reduction in under five mortality rates (You & Hug,2015) between 1990 and 2015 . The remarkable decline in under five mortality rates from the year 2000 onward remained at the same level as in the year 2000. Most child deaths are caused by disease or USHD Usual Childhood Diseases , that are readily preventable and treatable with proven cost effective and quality delivered interventions . Infectious disease and neonatal complications are responsible for the vast majority of under five deaths globally As accelerations of the pace of progress is urgently required to achieve the sustainable development goals (SDG) targets on child survival ; particularly in high mortality countries like Sub Saharan Africa trends in child death should be revisited , analyzed and presented to gain a more accelerated step in preventable child death . As stated in the three pillars for SDG some of the following child death causality are highlighted in this piece to continue on the path which meets goals , therefor this will concentrate on social , behavioral issues that serve to hinder progress in said SDG for 2030 .  Current causes of under five child deaths are the six conditions presented and account for approximately 70% of all deaths , the first is acute lower respiratory conditions  , the second is pneumonia at 19% , the third is diarrhea at 18% ,the fourth cause of child death is malaria ; at 8% and the fifth cause is measles at 4% , the sixth cause is HIV at 3% and the combined lower respiratory infections , asphyxia at birth and other infections constitute 37% which combined total 89% of all child deaths respectively . Trending issues related to these deaths, when appraised are pertaining to one of the pillars in SDG  goals  (Social and Behavioral Progress) . Among the trending issues are (1) child abuse , (2) poverty , (3) Sanitation ,(4) Medical Insufficiency (5) Medical Insufficiency (6) Malnutrition (7) Housing  and Psychological abuse (CDC.gov, 2018). When the child death rates presented by the Centers for Disease Control are matched to Sustainable Development Goals and Global Child Mortality Rates the following data can be analyzed . First we can plainly see that the causes  for child death are distinct when we compare CDC data and SDG UN data  CDC causes are psycho social in nature and SDG UN causes are physical in nature . CDC data can be appraised as " the psycho social leading to the physical death of the child under five , where as SDG UN data can be appraised as the physical leading to the psychological death or integral death of the child under five . So why does this occur , further more why are children under five at highest risk particularly and placing emphasis on CDC data ? . One of the overarching reasons is because of the neurological system , in children the brain is not fully developed until the age of five ; meaning that when you receive your neonate he or she is in the Raw what is placed or encoded into his brain up until the age five is really what you will get , see after the age of five the growth is physical . Some of the repercussions of error messages in children under five can be attributed to exposure (environmental ) such as low concept , erroneous reward , abuse both physical and emotional , and immorality . These psychosocial tasks are part of the child under fives development right along with gross and fine motor skills , there for in order to meet SDG 2030 goals we should concentrate on providing regional interventions in public health and consider integration of SDG in family court systems as well as providing genographs in clinical health from birth to early adulthood . Community health are a big portion in the survival of the child as well . As stated in the paper entitled The Sandwich Generation Cruz ,L  2014 one of the over arching reasons for violence in child hood is child rearing . The majority of the factors that lead to under five child death stated in CDC data are Depraved Indifference which should be a focal point for accomplishing SDG 2030 goals .

References


CDC (2018) Violence Prevention . Retrieved fromhttp://www.cdc.gov/violenceprevention/childabuseneglect/Abuse-Head-Trauma.html

You ,D & Hug, L (2015) Levels and Trends in Child Mortality . Report 2015,Estimates Developed by the UN Inter agency Group for Child Mortality Estimation UNICEF New York       

Cruz ,L (2014) The Sandwich Generation . An Evidence Based Toolin Public Health . Capella University Minniapolis MN USA

Ebola : Interleukin 2 and COX 1 and 2 Tracking Exposure at a Cellular Level

This week a viral epidemic were reported in stemming from the region of Congo Africa and Monrovia .  While  this is the 10th or so outbreak of Ebola Virus l the exposure mechanism are a question of debate among Africans ; all the while there have been 14 deaths reported and they even have a rap song dedicated to the virus . Make no mistake this is a deadly virus although it is not actively placed in the United States Department of Defense list of Biological Weapons , this is probably because the virus is contained with a vaccine ( Tierno,2002) The role of immune mechanism in the pathogenesis of Ebola Hemorrhagic Fever (EHF) remains to be elucidated . In Villinger et al paper re guarding  Cytokine levels of patients who died of EHF virus as compared to controls and recovered patients a marked elevation of INF level > 100 pg/ml was observed in  sequential serum samples from all fatal EHF cases compared to controls and recovered patients (Villinger et al ,2002). Markedly elevated serum levels of interleukin (IL-2) ,IL-10 tumor necrosis factor INF -a and IFN -a were also noted in fatal EHF cases , however these had a high level of variability. The overarching difference in the infected cases from the controls and recovered patients were the variability in Interleukin ,mRNA quantification and in immune activation . Why is this variability significant ? , because the fatal cases demonstrated a higher variability ? perhaps . A second glance at immune response in Ebola cases can be appraised in David Urdals paper stemming from the observation of Interleukin 2 1984 were the author and researcher cites a similar immune response when he compared fatal cases from unaffected cases . In his patent paper he writes the following : [ the success of many normal immune response require the participation of T Cells. The proliferation of T Cells to sufficiently large numbers to enable them to assume an effective role in immune responses is controlled by the presence of the polypeptide growth hormone interleukin 2 acts on T Cells must express  this receptor . 

Analysis
As stated in the thesis statement new Ebola cases have been reported in Congo and Liberia in the past week where at least 14 people have succumb to the infection . The overarching reason for infection as cited by Doctors without borders is the consumption of bush meat , this is being denied by the population because the agent has not been tracked to markets , how ever when we analyze the exposure type and the incubation period along with the disease development we can confidently estimate that the likely focus for infection is probably bush meat being consumed by the population . Bush meat are animals usually found in forests , such as monkeys , antelopes and bush dogs .polypeptides are amino acid chains formed in tissue . These are directly formed from the consumption of meat , further host - agent response elicits immune response from Interleukin 2 which activate T Cells and cytokine level elevation occur when the immune system is responding to infection by way of oesinophiles and eosinophils ; but the biggest evidence that the population has been infected from bush meat consumption is Cox 1 and Cox 2 which are immune responses that stem from prostaglandin activation . Prostaglandin response are associated from polypeptide and polypeptide are amino acid chains that form from meat consumption . This a perfect time to intervene in epidemic control and to re think commodity trade that are effective ,prevent the spread of infection and disease and are bilateral beneficial.

References

Tierno,P.H (2002) The Secret Life of Germs .Pocket Books New York USA

Villinger, F ; Rollin,P.E;Bovar, S.S; Chikkala, N.F ; Winter, J ; Spristrom, J.S; Zaki,S.R ; Swanipole,A.A; & Clearence , J.F (1999) Markedly Elevated Levels of Interferon (INF-y ) IFN -a ,Interleukin (IL-2) ,IL-10 , and Tumor Necrosis Factor -a Associated with Fatal Ebola Virus Infection. The Journal of Infectious Disease .       

ERPOS Extreme Risks Protection Orders and their Impact Upon College Settings .

ERPOS allows law enforcement ; with approval from the court system to remove firearms from individuals who are a demonstrated threat to themselves or others and, temporarily prevent individuals from purchasing new firearms.  ERPOS is defined as Extreme  Risk Protection Orders. According to New ERPOS rules DOJ will provide emergency and crisis training to Stop school violence , furthermore ERPOS rules permits inquiry into college and university student back round  bypassing FERPA,  which provide students privacy from school officials to inquire about students past mental health; and or current mental health status. conversely FERPA also prevents parents from  inquiring about student college performance and how these relate to student mental health  This is  very surprising because FERPA is one of the only laws that protect students rights to privacy from pell grant lenders , scholarship and fellowship grantees , school officials , parents and other agencies interested in college students mental health status . On the other hand most recently Howard TH Chan school of public health reported on April of 2018 that mental health issues are already on the rise among college students . Opioid addiction is also on the rise among college students as is gun control issues . So why is ERPOS rules  such a concern ? because ERPOS does not Honor FERPA rules and can be used to invade a students privacy .

Analysis
Questions surrounding ERPOS are plentiful . One of the questions that I have regarding ERPOS  is can it also be used to evaluate student fitness for receiving a GI bill grant ? How will ERPOS be implemented into school campus ? What is the Middle States Commission role when ERPOS is implemented into campuses?    .How will this new Act affect professorship right to mold students , for instance in bioethics or ethics were students demonstrate change in mental status and development ; will this also be confused with an altered mental status were ERPOS might be used to erroneously implement vigilance upon a student because his demeanor has changed .

What Say You?

References

 retrieved from http://www.hsph.harvard.edu/communications/home/communications-resources

Experimentors Challenge : Scientific and Scholarly Writing .

New experiments are often designed to provide evidence that may support explanation reconciling conflicting experiments in the research literature dealing with a particular problem. An example of this can be found in the study performed by authors  Mathis, Sheir , Brunsen  & Carducci (1980) where dealing with the effects of predictable and unpredictable patterns of aversive stimulation on the experience of negative physical symptoms , such as shortness of breath , ringing ears ,watery eyes, sweaty hands , flushed face and stiff muscles(Jung , 1999) The described symptomatic can be misleading and or conflicting where scientific writing is concerned . Performing a scientific study is only half of the scientists duty and of his or her knowledge base . Simply because the researcher has completed a research study  this does qualify said research study for publishing. . A  researcher may find  multiple issues when writing a research paper , this may also be further hindered when translating said paper to another language and or submitting this paper to peer review  for publishing particularly when a construct tool , method  causal links, or time series are involved in the research tasks interpretation may be difficult and also the research conclusion ( Baker , 1999) . Larkin , Dierk & Shotman also provide insights with regard to scientific research writing in descriptive study designs which bear a large weight on studies that usually succumb to the stipulated issues mentioned above when they write the following [ Focus on the translation and validation of measurement instruction has left a gap in the discussion on how to construct multilingual qualitative tools , such as interviews , methods of forward and backwards  translations have been criticized for weak conceptual equivalence ; a crucial issues when multiple language interview methods are used ]. There critique of an example study design is the following :Through the creative arts metaphor of weaving , the author  of the evaluated study described an  alternative process of multi centric translation used in the development of interview guide designed to explore the impact of translation of palliative care patients in six different countries . Four identified core construct illuminate this multi centric process; cohesion , congruence , clarity , and courtesy. Mutual reciprocity between researcher and translator offers greater possibility for construction of nuance and meaning particularly where cultural parameters influence the collection of  sensitive data from vulnerable populations. Scholarly work is detrimental to producing healthy populations and it begins with a clean research design and ends with rigorous scientific writing , especially when social and behavioral science are a focus within a research design this must always remain unbiased and ethical .

References

Baker, T (1999) Doing Social Research 3rd ed Mc Graw Hill Publishings

Jung, J (1982) The Experimentors Challenge: Methods and Issues in Psychological Research . Mc Millan Publishing New York.

Larkin,F.J ; Dierk de Costieri B ; & Shotman, P (2007) Multilingual Translation :Issues in Qualitative Research . Reflections on a Metaphorical Process. Pub Med