NAS rates increase to Alarming Rates . Public Health Administration Crisis Intervention

Methadon a full Mu-Opined agonist is the recommended treatment for opined dependence during pregnancy . Prenatal exposure to methadone is associated with a neonatal abstinence syndrome (NAS) characterized by Central Nervous System Hyper irritability and Autonomic Nervous System Dysfunction , which often requires medication (NIH,2018). CDC data related to Neonatal Abstinence Syndrom implies an increase in cases . NAS rates increased five fold since the year 2000 . As of the year 2012  there was an average of one infant born with NAS  every twenty five minutes in the United States  accounting for an estimated 1.5 billion in health care spending .

Dramatic increase in Maternal Opined use and Neonatal Abstinence Syndrome is very troublesome because  of the nature of its clinical characteristics ; a syndrome is a group of symptoms which involves intense medical interventions . In addition in the year 2012 when rates were rising the tally for yearly increase where 21,732 , as it stands these rates are alarming with one infant with NAS born every 25 minutes ; a scathing amount; and deeply disturbing in Public Health  .Opioid dependence during pregnancy is compounded by multiple risk factors contributing to adverse maternal , neonatal and long term developmental consequences . Improved treatment options should reduce the public health and medical costs associated with the treatment of neonates exposed to opioid which in 2008 was estimated at 70.6 million  to 112.6 million in the United States alone . Among the developmental issues involved in NAS cases public health need to evaluate future issues related to Social and Behavioral health that of future populations , future work force , future mental health of said exposed population and the fruition of chronic health conditions . During the 1980's public health administration were baffled by similar issues and this is well documented in such publications as : The Future of Public Health , published by The Academies Press .  What will the future population be like? , what will their conduct be ?  , what will be their moral system ? . These are all questions that pose extreme concern ; as it stands public health are scrambling to find homes for infants and children who's parents suffer from addiction with an increase in foster care as well .

References

CDC(2018) Neonatal Abstinence Syndrome . Centers for Disease Control

DOI: 10.1056/NEJMua 1005859 New England Journal of Medicine

Hyperbaric Chamber Treatment in Burn Victims and the Diabetic Wound : Efficiency in its Delivery .

Hyperbaric Oxygen Therapy (HBOT) has been promoted as an effective treatment for diabetic foot wounds  , and the first controlled trial for this indication was reported in the 1960s (ADA,2018). HBOT reduces the risk of amputation with an odds ratio of 0.24 which are very good measure outcomes in Psychometric. The rational for indicating measures as being one involving Psychometric is because any treatment involving human maneuvering is measured as Psychometric.  In the seven studies performed using the Hyperbaric chamber which were published in the 1980s all tests were proven to aid in wound healing , including control trials pre study . But concerns related to cost efficiency were noted as being six hour treatments at a rate of 50,000 to health insurance and 200,000 to private pay . Hyperbaric Chamber Therapy is also useful in treating burn victims ,particularly those who have suffered from inhalation injury such as endobronchial debre , inhaled toxins , and chemical burns (Hart et al, 1985) .Brochial cast or acute endobronchial debris and exudate can cause obstruction of distal airways contributing to ventilation -perfusion mismatches and secondary infection ; in addition it a well known clinical fact that  smoke inhalation causes hemorrhages in small blood vessels  which is often not diagnosed in Emergency room departments when smoke inhalation victims are triashed .   The physiological process of inhalation injury is complex and involves a variable and often unpredictable degree of direct local thermal and chemical exposure reactive immune response , systemic effects of inhaled toxins ; accrual of endo trachial debres , and secondary infection . HBOT is a useful and  cost effective intervention with burn victims because of nutritional factors . To better understand this rational one would have to understand Cellular Respiration  and Boyles Law. . Cellular respiration involves the equation of a chemical process called   Covalence where atoms collide to elicit a chemical reaction, in the case of cellular respiration the atoms involved are O2 + C6 H2O 6 these are one oxygen and one glucose ; these atoms collide with CO2+ H20 + ATP or one Carbon Dioxide , one Oxygen , and one ATP or energy. The atoms co vales to form necessary states and enter into the cell with the assistance of the Mitochondria  Boyles Law states that at a constant temperature and at an atmospheric pressure of no more than 30 feet this covalence will not suffer any changes and thus tissue damage will not occur . Why is this important in the treatment of the diabetic patient and burn victim ? . Because the single most important factor in the success of the treatment are related to Nutritional status . This is true because ATP are micro molecules or glucose chains , and the burn victims sole issue in clinical practice are protein loss.  For this reason Nutritional stability need to be present in the individual being treated with the Hyperbaric Chamber as to permit convalece between the atoms , ATP and the mitochondria .

References

Lipski, B.A Berendt,A.B ( 2010) Hyperbaric Oxygen Therapy for Diabetic Foot Wounds . American Diabetic Association . Retrieved from http://www.care.diabetesjournals.org/content/33/5/1143

Hart,G.B ; Strauss , M.B ; Lemon,P.A & Daniel,D (1985) Treatment of Smoke Inhalation by Hyperbaric Oxygene . Journal of Emergency Medicine  vol 5 Issue 3     

Cost of Data Breeches :Past Present and Future in Public Health .

In the year 2014 the United States was rocked by several large data breaches ; when we appraise data breaches we take into consideration intent , motivation , target , and typology , Previously consumers rarely thought about the security on their credit or debit card ; but all that changed when Target stores reported that 400 million debit and credit card numbers had been stolen during the holiday shopping time in 2014 . This incident both rocked the United States and was a catalyst for cyber crimes analysis . In January of the year 2013 Neiman Marcus was hacked resulting in the breach of consumer information credit and debit card information ; this hack lasted until October of 2013 and was notably affected in store consumer purchase and not in online purchases .Originally the store estimated that at least 1.1 mullion cardholders were affected (Harde,K 2014) . In august of the year 2015 Community Health Systems reported that 4.5 million patient data had been hacked ina cyber attack that resulted in the breach of social security data , patient Identification , and other related data . CHS reported that this breach may have been unforeseen for up to five years .in filing with the Securities and Exchange Commission the Company said no credit card numbers were exposed (Forbes .com, 2016) . In another data breach incident involving E bay 145 million users  were compromised from data breaches and yet in another incident Equifax was also compromised when they lost  consumers social security data , birth dates , and addresses to a hacking incident including drivers license data of more than 145 million consumers of these 209,000 credit card data were exposed (Forbes.com, 2015) . Fortune Magazine also reported  that one of the biggest data thefts had taken place in a health corporation )Anthem) were the results of a nation wide investigation demonstrated that 78.8 million  patients data had been exposed to hacking resulting in the data breach of the Century ; costing the health care company over 100 million dollars in governmental fines .  This was a very big issue to those of use constructing Nursing Software , regulating Nurse vocabulary and compiling IT health care net works that both met the challenges of the recently implemented CMS HIT or Centers for Medicaid Health Information (EMR) System and New ICD 9 EMR at the time it seemed as though we were in a constant do over . Today reports from the Pokemon Institute are as follows : IBM Security , Hewlett Packard Security and Voltage have managed to lower the breach in financial and health data by implementing data systems that meet current challenges  to data security and cyber attacks . The way in which this was accomplished were by performing a thorough transnational study entitled : The 2017 cost of data breach study global overview in this study the cohort consisted of 419 companies researched for data breach and the participatory interventions resulted in a decrease  from 4.00 to 3.62 million the average cost for each lost or stolen record containing sensitive and confidential information . In the year 2016 there was also a decrease from 158 tp 141 million in expenditures of data breach interventions (Ponemon ,2018) Despite the decrease in cost for data loss there still remains an increase of 1.8% in data breaches . Public Health concerns in data breaches and cyber attack surveillance and prevention are guided towards securing Utilities Grid performance , Safety and in Administrative accountability ( Shi & Johnson,2017) combining public health systems and engineering  to secure public health .

References

Forbes(2018) Money Builder . Retrieved from http://www. forbes .com /sites /money  builder/2015/01/13 the-big -data -breaches -of2014/4/001eed1efe6

CSD (2018)The 17  biggest data breaches of the 21st century.Retrieved from http://www.csd online.com/watch?v=wllpg2RK1vc

Ponemon (2018)2017 Cost of Data Breach Study Global Overview . IBM Securities for the Ponemon Institute

Shi, L & Johnson, J.A(2016) Novick & Morrows Public Health Administration .Principles for Population Based Management . Bartlett Jones Publishing

       

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