Trauma Informed Delaware

In October, 2018, Governor Carney signed Executive Order 24, making Delaware a trauma-informed state.  This order directs the Family Services Cabinet Council to develop tools for training state employees and community partners on the impact of exposure to adverse childhood experiences (ACEs), to promote ACE awareness, and to improve services and  interventions for children and families exposed to trauma. The Family Services Cabinet Council is leading efforts to ensure that Delaware becomes a trauma-informed state
by promoting a Trauma Awareness Month in Delaware.

Since that time, First Lady Tracey Quillen Carney has brought together a variety of partners to launch Trauma Informed Delaware (TID), a statewide public-private-nonprofit coalition. The goal is to coordinate a sustainable, community-based trauma awareness, prevention, and early intervention system that advances resilience through:
• Access to quality behavioral and integrated health care
• Strength-based services for youth and adults
• Education for providers and the community

 

APHA Call for Abstracts

Present on Behalf of DPHA at the APHA Annual Meeting (Scientific Sessions, Posters) Public Health 3.0 builds on the past successes and provides a new focus where public health is no longer defined solely by the public health department and its traditional programs. The APHA Council of Affiliates (CoA) is …

Surgeon General’s Message on the Current Measles Outbreaks

Dear Partners,

The Nation’s Doctor would like to share a very important message with you about the current measles outbreaks occurring throughout our country.

Measles is a highly-contagious respiratory disease caused by a virus. It spreads through the air through coughing and sneezing. Measles starts with a fever, runny nose, cough, red eyes, and sore throat, and is followed by a rash that spreads all over the body.

Measles is so contagious that if one person has it, 9 out of 10 people around that person will also become infected if they’re not yet vaccinated. You can get measles just by being in a room where a person with measles has been, even up to two hours after that person has left.  And what is even more worrisome is that an infected person can spread measles to others even before the infected person develops symptoms—from four days before they develop the measles rash through four days afterwards.

The good news is that measles can be prevented with the MMR (measles, mumps, and rubella) vaccine.

The MMR vaccine has an excellent safety record and is highly effective. It is one of the most effective vaccines we have in our country.

Surgeon General Adams hopes you will share his message with your networks. It’s up to us to protect the health of our communities.

For more information, please visit CDC.gov

Office of the Surgeon General

in memoriam – LTG William Herbert Duncan, MD (DE NG Ret.)

 LTG WILLIAM H. DUNCAN. M.D.

18 February 1930 – 19 December 2018

Authored by Joseph Kestner MD; Past-President (2006-2008) and current Board member, Delaware Academy of Medicine / Delaware Public Health Association

Bill was a native Delawarean hailing from New Castle.  He attended the William Penn High School and graduated from the PS DuPont High School in Wilmington.  After a year at the University of Delaware he entered the U.S. Military Academy by means of a competitive appointment as the son of a deceased veteran of WW II.  Following graduation from West Point in 1952 and some training which included jump school he was sent to Korea as an infantry lieutenant.  At the completion of his military obligation he entered Temple University Medical School graduating in 1959.  An internship at the Delaware Hospital followed.  Bill then opened a family medicine practice at Foulk and Silverside Roads in North Wilmington.  Shortly thereafter Bill was appointed the part time supervisor of the Delaware Hospital ER.  Following the merger of the Delaware, Memorial and Wilmington General Hospitals, Bill became the director of ambulatory and emergency services of the Wilmington Medical Center, a full time position.  In 1975 Bill was appointed vice president for medical affairs at St. Francis Hospital

This is when I first met Bill.   He and I interacted on the credentials committee where applications to join the medical staff were reviewed and evaluated.  On occasion there was controversy.  Bill always valued the perspective of the committee members. Bill was also a source of advice on dealing with hospital administrators.  If there was an adverse event or unexpected death (prior to review committees) Bill would be on the phone wanting to know the details.  As an examiner for the FAA and air traffic controllers he would follow up on patients he referred.  We worked together on nominating committees where he was transparent and open to advice and suggestions.  Bill retired from St. Francis in 1993.

All during this time Bill was active in the PA and later the DE National Guard eventually as commanding officer of the 116th Surgical Hospital (Mobile Army) and later as commander of the 261st Signal Command.  During his military career Bill served in three branches of the army:  Infantry, Medical Corps and Signal Corps.  He retired from the National Guard in 1987 receiving many recognitions and awards.  Bill was appointed a charter member of the Army Historical Foundation.  His lifelong interest in the military also continued with the Delaware National Guard Heritage Committee and the Delaware Military Museum.

Bill was the 19th president of the Delaware Academy of Medicine in 1976 and 77.  He was chairman of the planning committee for the Academy’s 50th anniversary celebration in 1980.  This three day event included cultural, educational and social activities.  Some notable speakers included Isaac Asimov, Ph.D., Eli Ginsberg, Ph.D., and Edmond Pelligrino, M.D.  Bill believed his most significant accomplishment while president of the Academy was to stabilize a precarious financial situation.

Bill was an author.  His Founders of the Medical Society of Delaware, was published in 2017.  He was working on a biography of James Tilton, M.D., a founder of the Medical Society of Delaware and its 1st president at the time of his death.  He documented the service of Delaware Physician Veterans of WW II (1994) and the Korean War (2000) in the Delaware Medical Journal.  His most recent effort, the Contemporary Veterans Project published in the Delaware Medical Journal in Nov-Dec 2018 was to recognize the service of those Delaware Physician Veterans post Korean War.  This is where Bill and I reconnected.  It was my honor to assist Bill in completing this project and identifying every possible Delaware physician veteran post Korean War.  This collaboration was interesting, rewarding and fun – all because of Bill Duncan.

Bill was a leader.  He was open, transparent, articulate and he listened.  He had a vision of what was to be accomplished.  He led infantry units, medical services, the St. Francis Hospital Medical Staff, Temple University Alumni, a U.S. Army Mobile Surgical Hospital and Signal Battalion, the Medical Society of Delaware and the Delaware Academy of Medicine.  One thing to recognize is whatever Bill did – he did well.

He would on occasion speak of his Dad, a soldier and veteran of WW I and WW II who died when Bill was quite young.  I can just imagine what Bill’s Dad might say if he was here today, “Well done, son.  Mission accomplished.”

Ted Kestner, M.D.

To see an interview of Bill Duncan, MD, taped in 2012, click here

A Moment With Our New President, Dr. Omar Khan

For someone who has no idea how to answer the question ‘where do you see yourself in 5 years’, it is difficult to comprehend the magnitude of 88 years.  That’s the length of time the Delaware Academy of Medicine has been around. I joined not because of this history, but because of what the foundation established by this history meant for the future.  I joined when my friend and colleague Dr. Arun Malhotra collared me in the parking lot of the Academy office (part of the Christiana Hospital campus) and suggested I do so.  Not being a joiner by nature, I still agreed to be part of this group which my smart and dynamic colleague belonged to. I discovered there other smart, dynamic colleagues, keenly interested in quite an unusual question: how to continuously be relevant to the membership, to the community, to Delaware- even if it meant challenging and reinventing one’s mission.

Over the last 10 years I have had the privilege of learning from the finest leaders from medicine, dentistry, public health, nursing, social sciences, and indeed all disciplines connected with the health sciences.  Your Delaware Academy of Medicine has grown to encompass the broadest possible mission of serving health by also becoming the Delaware Public Health Association (DPHA).  We have formed partnerships with all those interested in the same as us: serving and improving the health of our community.

I am incredibly grateful to the leadership of Dr. Dan Meara, a scholar, gentleman and friend.  His steady leadership and wisdom over the last few years have been instrumental in maintaining our strength.  Our incredible Board- which is really 2 Boards, that of the Academy of Medicine, and the Advisory Council of the DPHA- deserve our heartfelt thanks for volunteering on behalf of the Delaware community to keep our work on track.

The staff of the Academy are a well-kept secret, which I intend to make less well-kept during my tenure. They are an exceptional team, comprising Tim Gibbs (Executive Director), Kate Smith, Elizabeth Lenz, Elizabeth Healy- all of whom put together our diverse programming from Mini Medical School to the University of Delaware’s Osher Lifelong Learning Institute; plan, edit, and published the acclaimed and popular Delaware Journal of Public Health; administer student loans for medical and dental students; host a continual stream of student interns; optimize our partner relationships; keep us on sound financial footing – and oh yes, spend most waking minutes thinking about new and innovative ways to do what we do.  It’s an always-exhilarating (occasionally exhausting J) place to work.

And that is just the local work. Add to that our leadership role in the American Public Health Association, partnership with the National Academy of Medicine and Fogarty International Center of the NIH; and extensive national involvement in various national organizations on the part of our Board and Advisory Council Members. We truly Think Locally and Act Globally.

Some of the best moments in caring for others is getting to know one’s colleagues.  As the practice environment has changed, as have we.  Fewer community physicians come to the hospital, yet the health systems are now more engaged in the health of communities. I see incredible possibilities for collaboration ahead- for delivering increasing value to our patients and communities. And it remains rooted in the power of relationships- the unique Delaware way of accomplishing important tasks through the personal touch.

Over the next couple of years, I hope to get to know as many of you as possible, and I hope you will do likewise.  Our team is embedded in the fabric of all you do and those you serve.  My bio is here, and closeby you will find profiles of all our Board Members.

This space is intended as a place for dialogue – for con khan-versation.  Having suffered through countless ‘Wrath of Khan’ jokes since 1982, I figured it’s my turn.   So, talk to us. Tell us what you like, what you’d like us to be, where you’d like us to go. What would you like us to do the next 88 years?  Keep it interesting, fun, constructive.  That’s the plan.  Let’s drive!

Innovative Discoveries Series

Exploring the Geography of Health in the US: the Impact of Health Factors and County-level Demographics

Improving population health requires a firm understanding of geographic influences of modifiable health factors, and, to do so, requires measuring and mapping the relationship between health outcomes, factors, as well as demographics. Using 2017 County Health Ranking data for 3,108 US counties, we investigated the spatial patterning in these relationships using spatial regression methods. Although we found that spatial patterning in health outcomes was substantially explained by spatial differences in levels of health factors, substantial residual spatial patterning remained. Findings suggested that both the outcomes and the health factors of neighboring counties have an impact on the outcomes for a given county. Finally, using geographically weighted regression models, we found that the associations of health factors with outcomes showed substantial spatial patterning and varied significantly across the US. Greater understanding of the spatial heterogeneity we observed is important to identifying the most effective interventions and evidence-based policies to improve population health.

Presented By:

Loni Tabb, PhD, MS

Associate Professor, Biostatistics, Department of Epidemiology and Biostatistics, Drexel University

Free!  Lunch will be served!

This activity has been approved for AMA PRA Category 1 Credit.

REGISTER ONLINE TODAY!

Friday, June 21, 2019
Noon to 1 p.m.
In-person: Christiana Hospital,Room 1100
Online: Watch live at https://bluejeans.com/361095905
Or join meeting ID 361095905 on the BlueJeans app on your smartphone or tablet

This activity has been approved for AMA PRA Category 1 Credit.

Upcoming Lectures:

June 28: CANDOR: Christiana Care’s Journey to Communication and Resolution

Statement on Vaccines

Vaccines Continue to be Tested and Proven Safe

American Academy of Pediatrics. (2017). American Academy of Pediatrics Emphasizes Safety and Importance of Vaccines. Retrieved from https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-Pediatrics-Emphasizes-Safety-and-Importance-of-Vaccines.aspx

Centers for Disease Control and Prevention. (2016). Infant Immunizations FAQs. Retrieved from https://www.cdc.gov/vaccines/parents/parent-questions.html

Institute of Medicine. (2004). Immunization Safety Review: Vaccines and Autism. Retrieved from https://www.nap.edu/catalog/10997/immunization-safety-review-vaccines-and-autism

U.S. Food and Drug Administration. (2015).  Thimerosal in Vaccines: Questions and Answers. Retrieved from http://www.fda.gov/BiologicsBloodVaccines/Vaccines/QuestionsaboutVaccines/UCM070430#q5

In light of recent claims by politicians or appointees that vaccines are linked to autism, or are unsafe when administered according to the recommended schedule, or contain dangerous products like Thimerosal, the public health community and the Delaware Academy of Medicine/Delaware Public Health Association continue to come down on the side of science.

The Food and Drug Administration (FDA) Center for Biologics Evaluation and Research is responsible for regulating vaccines in the United States.  Before a vaccine can be licensed for public use, it must be tested for safety in the laboratory, in animals, and in human clinical trials.  Human clinical trials include looking for common adverse events in a few participants (phase 1), several hundred volunteers looking for local reactions and general side effects like fever (phase 2), and establishing the effectiveness of the vaccine and determining less common side effects with thousands of participants (phase 3).  If a vaccine is to be given at the same time as another vaccine, the two vaccines are tested together (FDA, 2015).  If a dangerous effect is found, that vaccine is not licensed for public use.

Vaccines are continuously monitored following licensure by the Vaccine Adverse Event Reporting System (VAERS), which is run by both the FDA and the Centers for Disease Control (CDC).  The VAERS is a national system that collects all reports of adverse events following vaccination.  Phase 4 clinical studies are also conducted to further evaluate the new vaccine, and population based studies are conducted through the use of databases like the Vaccine Safety Datalink (VSD) for the lifetime of the use of the vaccine (FDA, 2015).

The Institute of Medicine (IOM) Immunization Safety Review Committee “favors rejection of a causal relationship between thimerosal-containing vaccines and autism” (IOM, 2004).  Despite this finding, “all vaccines routinely recommended for children 6 years of age or younger and marketed in the U.S. contain no thimerosal or only trace amounts” (FDA, 2015).

“Infants and young children who follow immunization schedules that spread out shots – or leave out shots – are at risk of developing diseases during the time that shots are delayed” (CDC, 2016). Vaccines “keep communities healthy, and protect some of the most vulnerable in our society” (American Academy of Pediatrics, 2017).  The Delaware Academy of Medicine will continue to advocate for vaccines and vaccine use in the state of Delaware and the United States.