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Dr. Robert Pack, associate dean for Academic Affairs in ETSU’s College of Public Health, joined leaders from public health schools in four other states in the Appalachian region to discuss with members of the U.S. Congress the complex and dynamic processes at work in the opioid crisis. Pack joined his colleagues in sharing findings on unique approaches to address the course of the epidemic as well as discuss how university-based public health experts are assisting affected communities by bringing traditional and novel epidemic control strategies to bear on the disease.

Abstract available through Pharmacotherapy.

Opioid analgesics are commonly used to treat acute and chronic pain; in 2016 alone, more than 60 million patients had at least 1 prescription for opioid analgesics filled or refilled. Despite the ubiquitous use of these agents, the effectiveness of long-term use of opioids for chronic noncancer pain management is questionable, yet links among long-term use, addiction, and overdose deaths are well established. Because of overprescribing and misuse, an opioid epidemic has developed in the United States. The health and economic burdens of opioid abuse on individuals, their families, and society are substantial. Part 1 of this supplement will provide a background on the burden of pain and the impact of opioid abuse on individuals, their families, and society; the attempts to remedy this burden through prescription opioid use; and the eventual downward spiral into the current opioid epidemic, including an overview of opioid analgesics and opioid use disorder and the rise in opioid-related deaths

The mental health of healthcare workers during the Ebola outbreak in West Africa was a serious concern for healthcare professionals and the mental health field. One area in West Africa where healthcare workers played a significant role during the Ebola outbreak of 2014 and 2015 was Sierra Leone. This qualitative research study was designed to explore the perceptions of Sierra Leoneans healthcare workers' mental health, how they coped, and treatment they received while providing care for Ebola virus patients. This study, with a phenomenological research approach, used purposeful sampling to recruit 10 healthcare workers to participate in semi structured, open-ended interviews. The stress theory model and a hermeneutic phenomenology conceptual framework were used as a lens of analysis to understand the views of healthcare workers who worked directly with Ebola virus patients in Freetown, Sierra Leone. The results of the analysis of the collected data produced 9 major themes. The major themes suggest that healthcare workers experienced mental health symptoms such as depression and anxiety, personal thoughts and feelings such as insomnia, and suicidal ideation. Strategies for coping included using the Bible; and the detrimental impact included facing discrimination after the Ebola outbreak. Most of the healthcare workers blame the government for not providing adequate coping resources, which led to the personal consequence of hopelessness. This study may benefit mental health professionals working in an epidemic. Additionally, this study may contribute to social change by providing a deeper understanding of the mental health system and healthcare workers in Freetown, Sierra Leone.

It is evident from the past forty years of research, debate and literature that the New World was far more populated in 1492 than was previously thought. However, despite the expanding field of study most works omit the effects that epidemics had on the tribes of the Great Plains, particularly those located in present-day Canada, and the works that have been published deal mainly with demographics and fail to delve into how disease affected intertribal relations. As well, almost all studies of disease and the Great Plains tribes end by 1850 or start in 1880. Therefore, the decades from 1860 through to the 1870s are largely ignored and become even more of a mystery when considering the fact that the eventual subjugation of the Plains Natives soon came when the Numbered Treaties commenced in 1871.<p>The omission of research on epidemics from 1860 to 1880 has left historians to concentrate on other reasons for the collapse of the Plains lifestyle, primarily the disappearance of the buffalo, which was crucial to Native existence in the parkland/grassland regions. Although this was obviously a very important factor in weakening warrior societies on the Plains, it was by no means the sole factor. In fact, the smallpox epidemic of 1870-71 and its after effects played an important role in debilitating Native nations, especially great tribes like the Plains Cree in present-day Saskatchewan. Food supplies could not be maintained and starvation became prevalent throughout the Great Plains in the winter of 1870-71. Malnutrition certainly would also have led to further secondary complications such as fertility problems and pulmonary illnesses, such as pneumonia, which would have contributed to the impact of the epidemic through a continued loss of population and disruption of intertribal functioning. Through analysis of the consequences of this epidemic on the Plains Cree it becomes increasingly apparent that disease played a much greater role in leading Natives towards treaty negotiations and settlement than has been formerly thought. This is not to say that epidemics in themselves were the main reason for the collapse of the Plains Cree culture, but rather they deserve to be included along with the traditional causes such as the disappearance of the buffalo.

This thesis studies robustness against large-scale failures in communications networks. If failures are isolated, they usually go unnoticed by users thanks to recovery mechanisms. However, such mechanisms are not effective against large-scale multiple failures. Large-scale failures may cause huge economic loss. A key requirement towards devising mechanisms to lessen their impact is the ability to evaluate network robustness. This thesis focuses on multilayer networks featuring separated control and data planes. The majority of the existing measures of robustness are unable to capture the true service degradation in such a setting, because they rely on purely topological features. One of the major contributions of this thesis is a new measure of functional robustness. The failure dynamics is modeled from the perspective of epidemic spreading, for which a new epidemic model is proposed. Another contribution is a taxonomy of multiple, large-scale failures, adapted to the needs and usage of the field of networking. / Esta tesis estudia la robustez contra fallos de gran escala en redes de comunicaciones. Si los fallos son aislados, usualmente pasan inadvertidos para los usuarios gracias al uso de mecanismos de recuperación. Sin embargo, tales mecanismos no son efectivos contra fallos múltiples de gran escala. Los fallos de gran escala pueden causar grandes pérdidas económicas. Un requisito clave a la hora de diseñar mecanismos efectivos para reducir los efectos negativos es la habilidad de evaluar la robustez de la red. Esta tesis se centra en redes multinivel que poseen planos de control y de datos separados. La mayoría de las medidas de robustez existentes no capturan correctamente la verdadera degradación de los servicios en tales escenarios porque basan la evaluación en propiedades puramente topológicas. Una de las contribuciones de esta tesis es una nueva métrica de robustez funcional. La dinámica de los fallos se modela desde la perspectiva de la propagación de epidemias, para lo cual un nuevo modelo epidémico es propuesto. Otra contribución es una taxonomía de los fallos múltiples de gran escala, adaptado a las necesidades y uso del campo de las redes de comunicaciones.

It is evident from the past forty years of research, debate and literature that the New World was far more populated in 1492 than was previously thought. However, despite the expanding field of study most works omit the effects that epidemics had on the tribes of the Great Plains, particularly those located in present-day Canada, and the works that have been published deal mainly with demographics and fail to delve into how disease affected intertribal relations. As well, almost all studies of disease and the Great Plains tribes end by 1850 or start in 1880. Therefore, the decades from 1860 through to the 1870s are largely ignored and become even more of a mystery when considering the fact that the eventual subjugation of the Plains Natives soon came when the Numbered Treaties commenced in 1871.<p>The omission of research on epidemics from 1860 to 1880 has left historians to concentrate on other reasons for the collapse of the Plains lifestyle, primarily the disappearance of the buffalo, which was crucial to Native existence in the parkland/grassland regions. Although this was obviously a very important factor in weakening warrior societies on the Plains, it was by no means the sole factor. In fact, the smallpox epidemic of 1870-71 and its after effects played an important role in debilitating Native nations, especially great tribes like the Plains Cree in present-day Saskatchewan. Food supplies could not be maintained and starvation became prevalent throughout the Great Plains in the winter of 1870-71. Malnutrition certainly would also have led to further secondary complications such as fertility problems and pulmonary illnesses, such as pneumonia, which would have contributed to the impact of the epidemic through a continued loss of population and disruption of intertribal functioning. Through analysis of the consequences of this epidemic on the Plains Cree it becomes increasingly apparent that disease played a much greater role in leading Natives towards treaty negotiations and settlement than has been formerly thought. This is not to say that epidemics in themselves were the main reason for the collapse of the Plains Cree culture, but rather they deserve to be included along with the traditional causes such as the disappearance of the buffalo.

Recent developments in nanotechnology have enabled the fabrication of nanomachines with very limited sensing, computation, communication, and action capabilities. The network of communicating nanomachines is envisaged as nanonetworks that are designed to accomplish complex tasks such as drug delivery and health monitoring. For the realization of future nanonetworks, it is essential to develop novel and efficient communication and networking paradigms. In this thesis, the first step towards designing a mobile ad hoc molecular nanonetwork (MAMNET) with electrochemical communication is taken. MAMNET consists of mobile nanomachines and infostations that share nanoscale information using electrochemical communication whenever they have a physical contact with each other. In MAMNET, the intermittent connectivity introduced by the mobility of nanomachines and infostations is a critical issue to be addressed. In this thesis, an analytical framework that incorporates the effect of mobility into the performance of electrochemical communication among nanomachines is presented. Using the analytical model, numerical analysis for the performance evaluation of MAMNET is obtained. Results reveal that MAMNET achieves adequately high throughput performance to enable frontier nanonetwork applications with sufficiently low communication delay.