Noelle Swan

Public health

In Los Angeles, a national model for how to police the mentally ill

Screen Shot 2015-09-27 at 4.47.57 PMJune 15, 2015 – They called her the “million dollar woman.”

Los Angeles 911 dispatchers heard from her on a daily basis – sometimes multiple times.

The complaint was always the same: The caller said she couldn’t breathe. Each time, emergency crews packed her into an ambulance. And each time, unable to find any medical problem, emergency room doctors released her without treatment.

Those ER visits cost the city more than $1 million in a single year – and did little to assist the woman, says Lt. Lionel Garcia, longtime director of the L.A. Police Department’s Mental Evaluation Unit (MEU).

It wasn’t until mental health clinicians working directly with the LAPD got involved that the root causes of the woman’s distress became clear: She was lonely and experiencing delusions. Once she was connected with supportive services, the 911 calls ceased.

Read the full story on here.

Lapses at high-security CDC labs reveal culture of negligence

Screen Shot 2015-09-27 at 4.47.57 PMJuly 16, 2014 – Revelations of safety breaches at federal biosecurity laboratories reveal gaping holes in safety protocols, a lack of independent oversight, and an apparent culture of hubris among researchers who work with dangerous biological agents, biosecurity experts say.

In the past week, the director of the Centers for Disease Control and Prevention (CDC) announced three separate incidents:

  • In June, scientists at the CDC’s Bioterrorism Rapid Response and Advanced Technology lab exposed 80 unprotected workers to pathogenic anthrax.
  • Weeks earlier, the CDC’s influenza lab shipped samples of a benign avian flu virus that had been cross-contaminated with more pernicious strain to a US Department of Agriculture facility.
  • Researchers at a Federal Drug Administration lab operated by National Institutes and Health uncovered long forgotten vials containing the smallpox virus circa 1954 that were supposed to be consigned to international repositories.

The incidents have shone a light on a broader issue of lapses in safety and security at bio labs operated and funded by the federal government.

“The only thing that is new here is the public attention,” says Rutgers chemical biology professor Richard Ebright, who is scheduled to testify before a subcommittee of the House Energy and Commerce Committee Wednesday. He says internal audits by the USDA and the CDC have shown “major violations in training, in engineering controls, and in operating procedures for work with biological weapons agents in labs.”

Historically, such reviews have been presented to oversight committees within the same agencies that perform and fund the biological research. “We need a federal agency that is independent of the agencies that perform and fund the work,” Professor Ebright adds.

Read the full story on here.

E-cigarettes: what the FDA wants to regulate and what it doesn’t

Screen Shot 2015-09-27 at 4.47.57 PMApril 24, 2014 – An electronic cigarette looks like a cigarette, glows like a cigarette, and delivers nicotine like a cigarette, but in the eyes of the federal government, it doesn’t yet fall under federal regulation of cigarettes. The Food and Drug Administration wants to change that.

The FDA on Thursday announced a proposal to extend its tobacco authority to include tobacco-derivative products, including e-cigarettes.

“This proposed rule is the latest step in our efforts to make the next generation tobacco-free,” outgoing Health and Human Services Secretary Kathleen Sebelius said in a statement.

Read the full story on here.

Toxic coal ash poses persistent threat to US waters

Screen Shot 2015-09-27 at 4.47.57 PMMarch 30, 2014 – Ben Adkins grew up on North Carolina’s Dan River.

“This place was where I first knew God was real,” Mr. Adkins drawls, gazing down at a narrow segment of the river known as Draper Landing. That’s where he learned to fish and swim as a boy, where he first felt a spiritual connection to nature, he says. Gesturing toward his 2-year-old son, Benson, he adds, “I was planning on teaching him how to fish and swim right here, too.

“Now, I wouldn’t let my dog come in here,” Adkins adds.

Less than two months earlier, a storm pipe underneath an unlined coal ash basin two miles upstream from Draper Landing ruptured and spewed more than 30,000 tons of coal ash into the Dan. The plume of gray sludge spread 70 miles downstream, depositing toxins along the way.

The accident occurred less than a month after a broken storage tank in West Virginia leaked 10,000 gallons of a foaming agent used to wash coal into the Elk River. Some 300,000 residents were warned not to use their tap water for anything but flushing for five days.

Both of these insults to waterways were unintentional. In fact, in each case, it was a byproduct of processes designed to benefit the environment by reducing air pollution.

Read the full story on here.

W.Va. chemical spill: Is more regulation needed for toxic substances?

Screen Shot 2015-09-27 at 4.47.57 PMJanuary 10, 2014 – The chemical spill in Charleston, W.Va., that contaminated the Elk River and left 300,000 residents without access to water raises new questions about the regulation of chemicals used in coal processing.

The compound in question, Crude MCHM (4-methylcyclohexane methanol), is a chemical foam used to wash coal and remove impurities that contribute to pollution during combustion. Eastman Chemical Co., the manufacturer, has identified the compound as a skin irritant that could be potentially harmful if ingested.

However, the West Virginia American Water Co., the utility that supplies the affected area, was concerned enough about the public health effects of the chemical to insist that residents refrain from using tap water to bathe in or even wash clothing.

In actuality, little is known about the human health effects of MCHM. While Eastman has produced a material safety data sheet (MSDS), as is legally required for all chemical compounds used in industry under the Occupational Safety and Health Act of 1970, much of the information appears to be incomplete.

“There are so many aspects of this chemical that there is no information about, including its general toxicity,” says Sheldon Krimsky, a professor of environmental policy at Tufts University in Medford, Mass. “They don’t have any information on human health effects.”

Read the full story on here.

Antismoking crusade has saved 8 million lives in 50 years, study says

Screen Shot 2015-09-27 at 4.47.57 PMJanuary 7, 2014 – Fifty years ago, many Americans considered smoking to be harmless if not beneficial to their health. That is until Jan. 11, 1964, when the surgeon general released the first ever report on smoking and health and declared smoking to be harmful.

Since that report, states, hospitals, and public health institutions have launched a multi-front campaign to change the public perception of smoking through a myriad of tobacco controls. Mandatory health warnings on cigarette packages, additional taxes, and public education campaigns have become ubiquitous during the past 50 years.

Such efforts have paid off to the tune of 8 million lives and a total of 157 million years of life saved, a new study released Tuesday from Yale University School of Public Health found. That’s an additional 20 years for each person that quit or never started smoking as a result of tobacco controls, with one quarter of those years gained under the age of 65.

Read the full story on here.

Getting to the guts of autism

Screen Shot 2015-09-27 at 4.29.23 PMApril 29, 2013 – To roughly two million Americans struggling with autism, chronic stomach problems have long been just another side effect. Now, it looks like the issues in their guts could actually be aggravating—or even triggering—their symptoms of autism.

A new arm of autism research has begun to explore the possibility that problems in the gut microbiome—an entire ecosystem of bacteria residing within the digestive tract that is responsible for extracting energy from food—could actually play a role in exacerbating or even causing behaviors and symptoms associated with autism.

While researchers from a variety of disciplines around the world are turning their attention to the stomach, University of Delaware Professor of Chemical and Biomolecular Engineering Prasad Dhurjati is helping to put their work into context.

For full story see archived Delaware Public Media (formerly Delaware First Media) article here.

Delaware seeks to fill persistent shortfall in child mental health services

Screen Shot 2015-09-27 at 4.29.23 PMAugust 3, 2013 –  The state of Delaware has seen slow progress so far in its efforts to bring specialized child and adolescent psychiatric care to Sussex and Kent counties, despite a devastating string of 11 teen suicides and 116 suicide attempts in southern Delaware last year.

Many of the suicides occurred while a special task force was examining unmet child and adolescent mental health needs following the arrest and conviction of Earl B. Bradley for sexually abusing more than 100 patients in his pediatric practice, which left Kent and Sussex County mental health providers scrambling to find skilled support for the victims.

In March 2012, the task force issued a series of recommendations for expanding care in southern Delaware, including a top-priority charge to attract at least two psychiatrists trained to work with adolescents and children to establish a private practice in Sussex County.

For full story see archived Delaware Public Media (formerly Delaware First Media) article here.

Risky business: Turning to sex for survival

Screen Shot 2015-09-27 at 4.56.21 PMJune 29, 2013 – When Travis turned his first trick, he still had an apartment in Roslindale and a job as a retail clerk.

He was doing “well enough” financially until January 2010, when his shifts were cut to just five hours per week. His housemate helped him pay his rent for as long as she could.

He looked for additional work, but with youth unemployment at the highest rate seen in decades, he came up empty-handed. And while the fractured job market has driven many young people back to their family home, this was not an option for Travis.

He has not felt welcome at home since coming out to his family as gay.

Travis heard that an acquaintance had made a fair amount of money by selling sex to older men. The idea seemed risky, but he was facing the possibility of becoming homeless within the month. He felt desperate. Hesitantly, he went with this acquaintance to meet two men willing to pay for sex in a motel room. He made some money, but not enough to pay his rent. He soon landed on the street.

“The number of times that I have slept outside while it was snowing is just too many for anyone. Nobody should have to sleep outside in the snow,” he said. “The idea of getting to sleep in a motel bed and earning some cash by having sex with a stranger became more appealing.”

Read the full story on here

Families dealing with autism navigate the unknown

Screen Shot 2015-09-29 at 10.48.47 PMJan. 17, 2013 – Heather Cannon of Murray has three boys on the autism spectrum. Her eight-year-old son Neil started showing signs of extreme distress during his first Christmas. She recalls him shrieking as if in pain at the sound of family members unwrapping presents, and to this day he still has difficulty handling sensory stimulation. At five-years-old, he was diagnosed with Asperger Syndrome, a higher functioning form of autism spectrum disorder. By this time, Cannon’s toddler twin boys, Evan and Dylan, now six, were displaying symptoms of their own.

Affecting one in 88 people nationwide, autism is a complex disorder with a diverse array of symptoms. She and her husband have learned over the years that if Neil starts to become aggressive it’s likely because his stomach hurts. “People think of [autism] in terms of a mental issue, but it’s systemic, affecting gastrointestinal systems, vision, social skills, and behavior,” says Cannon.

This reality can make families feel helpless and since the risk factors for autism in the majority of patients are still unknown, each family finds their own ways to cope.

Read the full story on here.

Testing, testing…HIV: Taking the stigma out of AIDS testing

Screen Shot 2015-09-27 at 4.56.21 PMJuly 13, 2012 – “College-educated black women who live in the suburbs and date lawyers don’t get HIV and AIDS. This just doesn’t apply to you,” Kimberly Wilson remembers her doctor saying back in 2004.

That was the first time she asked her physician for an HIV-test.

Four years, seven bouts of shingles and five requests for an HIV-test later, Wilson was admitted to Boston Medical Center. She had stopped in hoping to get some prescription cough syrup. Emergency room doctors ordered a chest X-ray.

“The technician who took the X-ray of my lungs thought the machine was broken, because the lung was so black, ” Wilson recalls.

The machine had not malfunctioned; Wilson’s lungs were coated with thrush, a yeast infection common among patients with compromised immune systems. Soon, she was diagnosed with Pneumocystis carinii pneumonia (PCP), an opportunistic infection commonly associated with HIV.

Four years after she first requested an HIV-test, Wilson learned that she was HIV-positive. Today, she manages her condition through a myriad of medications and describes her health as excellent. But she believes that an earlier diagnosis could have eliminated years of pain and suffering.

Read the full story on here

Chronic national shortage of child and adolescent psychiatrists takes heaviest toll on low income families

Screen Shot 2015-09-27 at 4.56.21 PMJuly 13, 2012 – “I don’t know exactly what happened to drive that young man in Aurora to shoot those people, but I do know that many people like him suffer while undiagnosed and untreated,” said Jess Shatkin, an associate professor of child and adolescent psychiatry at New York University.

July 20 marks one year since James Eagan Holmes massacred 12 people and injured 70 more inside an Aurora, Colorado movie theater. Since then, Adam Lanza opened fire in a Newtown, Connecticut elementary school; a 20-year-old college student killed four people in Orange County, California during a drive-by shooting; and a 19-year-old in New Orleans opened fire on a Mother’s Day parade.

In each of these tragedies, images of isolated and despondent young male perpetrators have emerged in the aftermath. And after each tragedy, the nation vowed to launch a national discussion of mental health.

In fact, millions of young people in America are suffering from untreated mental illness, and the American healthcare system is not equipped to care for them, according to experts in child and adolescent psychiatry. The U.S. Surgeon General’s office estimates that only 20 percent of emotionally disturbed children receive mental health services.

Read the full story on here.

New autism insurance law offers some some financial relief

Screen Shot 2015-09-27 at 4.29.23 PMDecember 11, 2012 – Many Delaware parents of children with autism have been drowning in medical bills as they struggle to pay out-of-pocket for services not covered by their health insurance. Delaware’s new autism insurance law, which goes into effect today, promises to ease the burden for some but will likely not cover everyone.

While most second graders worry about fractions, vocabulary words, and cooties, Gabe Otinsky of Middletown, Del. spent second grade repeatedly getting suspended from school and dreaming nightly that his father was dying. When he started telling his parents that he would rather be dead than alive, they decided to pull him out of public school and educate him at home.

In many ways, Gabe is a lot like his peers. He loves playing video games, building with Legos, and playing the guitar.

But he is also autistic and has difficulty processing sensory input. That means that things like flushing toilets, hairdryers, and scratchy clothes, which would be minor distractions to most kids, are extremely upsetting for Gabe, explains his mother Kathleen Otinsky.

For full story see archived Delaware Public Media (formerly Delaware First Media) article here.

Weighing new prescription for doctor/patient communication

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December 20, 2011 – Every day countless people see their primary care physician for sick visits, routine physicals, and to follow up on chronic conditions. On average, patients spend 8-15 minutes face-to-face with their doctors. Doctors have checklists that they need to push through in addition to any concerns that the patients may have. Appointments fly by and patients often feel they have just spun out of a revolving door.

What if after appointments patients could go online and review the their primary care physicians’ notes? What if they could share them with their family and caregivers?

Researchers at the Beth Israel Deaconess Medical Center (BIDMC) in Boston have done just that. For one year, patients were granted access to the doctors’ note section of the hospital’s existing online patient portal—a secure website where patients can access lab results and medication lists. Study authors released a preliminary report of the trial today in the Annals of Internal Medicine detailing physicians’ and patients’ expectations for the program.

“Knowledge is power. If patients understand more and have more knowledge about what the doctor is thinking, they’ll be more empowered to make better decisions,” said Jan Walker, RN, MBA, member of the research team at BIDMC and Harvard Medical School and the study’s lead author.

Read the full story archived from the now-defunct New England Post here.


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