Archive for the ‘General’ category
Every time a different disease surfaces in the news like MERS, Ebola or Enterovirus D 68, one of the first questions people ask is, “Is there a vaccine for it?” A new documentary created for NOVA on PBS – Vaccines – Calling the Shots recently outlined the history of vaccines and the possibility of vaccine-preventable diseases returning to the U.S. It’ll take an hour to watch, but it’s excellent – especially for us public health enthusiasts.
One of the roles we play in any outbreak is making sure that our partners in the state have all the information they need to respond to a situation and be safe in that response. I’ve posted about our continuing education of those partners, but now we’ve created a one-page stop for partner.
Our Ebola Preparedness website contains all the information we’ve sent out through our Health Alert Network. There are toolkits for hospitals, outpatient clinics, EMS providers and laboratories.
We will continue to push information to our partners, especially as things change. We anticipate new information today about personal protective gear . So stay tuned
In 1348, London was 4 million strong, but within 2.5 years a third of those had “fallen down.” The streets were narrow and cramped, often piled ankle deep with human and animal waste. The putrid smell contaminated everything in the city. Those infected with the new and ghastly plague placed posies in their pockets and rosaries around their necks. Their symptoms include severe fever, chills, headache, muscle weakness and pain, swollen lymph nodes, and sometimes respiratory or GI illness. Between one third and two thirds of Europe’s population was decimated within just a few decades.
The plague was known then as the Black Death, but it’s recognized today as the bacteria Yersinia pestis. Scientific advances have turned it from a fearsome figure to a controllable nuisance. Arizona has not had a single plague case in the past 5 years; the last confirmed case was in 2007.
Unfortunately for our rodent brethren, this is not the case. In the 1300s, rats of the Rattus rattus variety were the primary rodent carrier of the fleas that spread plague. Now the burden falls to others. Prairie dogs, squirrels, rabbits, cats, and their predators have been found to be carriers of plague in Arizona. Most recently fleas collected in Doney Park, near Flagstaff, tested positive for Yersinia pestis.
Staying safe from plague is pretty easy – pets should have flea protection (cats are susceptible), and people should use insect repellant if they’re in flea-infested areas. People and pets should stay away from dead animals and wild animal burrows. Human infections are rare, but early antibiotic intervention is the key to successful treatment. When we apply what we’ve learned about biology, sanitation, and public health over the years, the serious diseases of our ancestors become mere nursery rhymes for our children.
For the last few months we’ve been reviewing our medical marijuana rules to make changes to them in response to an Arizona Superior Court judge’s decision. In addition to the changes needed to comply with the Court’s ruling, also proposing other changes to the medical marijuana rules that affect qualifying patients, caregivers, and dispensaries that include:
- Reducing the fees for qualifying patients who are 65 years of age or older, under 18 years of age, veterans, receiving SSI or SSDI benefits, or receiving hospice services;
- Reducing the fees for the caregivers of qualifying patients who are under 18 years of age or receiving hospice services;
- Adding a process for qualifying patients who are incapacitated and have a guardian to get a registry identification card;
- Adding palliative care of PTSD to the list of qualifying medical conditions;
- Clarifying requirements for the cultivation of marijuana;
- Revising procedures for allocating dispensary registration certificates;
- Clarifying who can sign documents and make requests on behalf of a dispensary; and
- Clarifying requirements for inventory control, dispensing and transporting medical marijuana, and accepting donated marijuana.
After posting drafts of revised rules in February and June and meeting with people affected by the rules in June and July, we’re now posting a third draft, which includes changes based on the comments we received, and an on-line survey for comments on the new draft. Based on the comments that we receive on the third draft, we’ll submit a Notice of Proposed Rulemaking which will include official Oral Proceedings. After that, we’ll finalize the new regulations. We plan to have the revised rules in effect by Summer 2015. Here are the new draft rules.
A few weeks ago I issued a Director’s Decision that will authorize the use of marijuana (under the AZ Medical Marijuana Act) for patients undergoing treatment for PTSD. Medical marijuana certifications will be valid only for palliative care (not treatment). I delayed the implementation date until January 1 to allow time for certifying physicians, dispensary medical directors, and dispensary agents to develop policies, procedures, and educational materials before the decision takes effect.
One good training option for physicians (and other clinicians) was recently uploaded to the Agency for Healthcare Research and Quality‘s website. It’s entitled “Psychological and Pharmacological Treatments for Adults with Posttraumatic Stress Disorder (PTSD)”. The CME/CE activities are accredited for a multi-disciplinary audience of health care practitioners and provides 1.0 AMA PRA Category 1 Credit™ as well as Certified Contact Hours for Case Managers, Certified Health Education Specialists, Nurse Practitioners, Registered Nurses, and Pharmacists.
The monograph examines various evidence-based treatments for adults with PTSD. It covers the benefits, harms, and comparative effectiveness of various treatment strategies for adults including the comparative effectiveness of psychological treatments.
We’re reaching out to certifying physicians and other interested healthcare personnel to let them know about this resource so that they’re better informed about the latest data regarding evidence-based treatment of PTSD.
The vast majority of Arizonans are born in hospitals. Shortly after delivery the electronic paperwork to establish an Arizona birth certificate gets input and processed. Even babies delivered at home attended by a midwife (about 1% of Arizona births) have their birth certificate information captured and processed.
Many years ago, especially in Arizona’s Indian Country, some folks were born at home and the paperwork to establish an Arizona birth certificate wasn’t filled out at the time. Years later (sometimes decades) these same folks need their birth certificate – but we don’t have any information on the birth in our Vital Records database. When people want a birth certificate like that, it’s called a “delayed birth certificate”.
There are state statutes and rules that govern what’s needed to get a delayed birth certificate. For elder tribal members, some of the documents may be difficult to get. However, they may have easily accessible official tribal documents that provide the information that we need to firmly establish the required birth facts to process a certificate.
Over the last few months, we’ve been working with tribal governments to develop a procedure to make it easier for elder tribal members to use their tribal documents to get a delayed birth certificate. We crossed the finish line last week, when we adopted a new Substantive Policy Statement that outlines and streamlines the process for tribal elders.
A big shout out to Lena Fowler (County Supervisor, Coconino County), Senator Carlyle Begay (Arizona State Senate), Representative Albert Hale (Arizona State House of Representatives), Tom Ranger (Division Director, Division of Human Resources, Navajo Nation), John Lewis (Former Executive Director, Inter Tribal Council of Arizona, Inc.), and ADHS staff Khaleel Hussaini, Krystal Colburn, Celia Nabor, Toni Miller, and Jeff Bloomberg, for helping to put together this new document. We’re confident this new procedure will make it easier for Arizona tribal elders to get their birth certificate. Well done team.
A couple weeks ago I wrote about our new Community Profiles Dashboards. They’re a huge leap forward for public health professionals, city planners, non-profit organizations, medical providers and anyone interested in health data. The data are arranged on the Dashboards – in state, county, and Primary Care Areas – to provide several options to compare and explore data.
This week we take a look at how the dashboard can help public health gather data it needs to address one of our winnable battles, reducing suicide. More than 1,100 of those were in Arizona last year. To develop effective public health prevention and intervention programs to prevent suicide, we have to understand our communities. Looking at the raw numbers of suicides isn’t enough to develop new strategies. Public health professionals need more information, including where we have higher numbers of suicides and the health and demographic indicators in that area.
In this Community Profiles Dashboards Video Tutorial we look at rural and metropolitan areas of the state to identify where suicide rates are higher than the overall Arizona rate to get a better understanding of the relationships between demographic information and the higher rates. When we looked at the communities with higher suicide rates, we found that all of these communities either had an older population or a higher population of Native Americans, and that all of the communities had lower educations levels. This isn’t a definitive answer to the question of why these areas have higher rates, but it gives us a starting point. The Dashboards aren’t meant to solve public health problems; it’s a tool to help public health better target our resources and intervention strategies.
One of our key interventions has been training people across the state in Mental Health First Aid. Since 2011, more than 7,000 people have learned the warning signs of suicide and what to do when there is a concern. You can find out more about the free classes on our website.
Child-serving organizations and community leaders will be meeting at the 2014 National Latino Children’s Summit on October 3rd in Phoenix. It’s called The State of Latino Children: Our Future – and it’ll focus on health, child safety, education and more.
At the summit, Dyanne Herrera from our Office of Women and Children’s Health will provide a data overview and bring focus to the mobilization around children’s health. Dyanne will be joined by colleagues who will update the participants about connecting children to healthcare; Parent Ambassador Programs in the schools; public private partnerships and opportunities for building positive environments. For more information about the summit community partners and agenda, visit the website.