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The harmful impact of stigma on individuals struggling with opioid addiction

People in recovery from opioid use disorder often struggle with decisions to tell others about their past substance use, treatment, and/or recovery. Although disclosures that go well can lead to social support that is helpful for recovery, disclosures that go poorly can lead to stigma that can harm recovery. Valerie Earnshaw, associate professor in the College of Human Development and Family Sciences at the University of Delaware, specializes in speaking about addiction and stigma and can speak on this phenomenon.  She recently spoke about this topic a the annual Marion H. Steele Symposium at UD.  Earnshaw charted the growth of the opioid crisis in the United States, discussed stigma as a complex social process with the power to affect health outcomes and shared her work on an intervention she designed to help people with the disclosure process. She can be contacted by clicking her "View Profile" button. 

On this day in 1869 - they drove in the "Golden Spike." We have rail experts ready if you're covering

The Golden Spike and railroad history are not merely relics of the past; they represent pivotal moments in human innovation and connectivity that continue to shape our present and future. This event matters to the public because it commemorates the completion of the first transcontinental railroad in the United States, symbolizing unity, progress, and the spirit of exploration. Delving into this historical milestone offers numerous story angles that captivate a broad audience: The impact of railroads on westward expansion and economic growth Stories of perseverance and labor in building the transcontinental railroad Technological advancements in railway engineering and construction Cultural and social transformations brought about by the railroad Environmental implications of railroad expansion and modern-day sustainability efforts Tourism and heritage preservation initiatives centered around railroad history As we celebrate the Golden Spike and reflect on railroad history, it's an opportune time for journalists to explore these multifaceted narratives that resonate with audiences worldwide. Connect with an Expert about transportation and railroad history: Allan Zarembski Professor of Practice Civil and Environmental Engineering; Director, Railway Engineering and Safety Program · University of Delaware James Kieselburg Director · Milwaukee School of Engineering James McCommons Associate Professor · Movable Type Management Danaya Wright Professor/Director · University of Florida To search our full list of experts visit www.expertfile.com Photo Credit:  Tom Barrett

This Is a Critical Moment: Delaware Must Not Go Backward in Health Equity

The proposed Delaware House Bill 350 is well-intended but would have terrible consequences for Delaware’s most vulnerable populations. There is a better way. By LeRoi S. Hicks, M.D., MPH, FACP As a Black physician who has dedicated his 25-year career to understanding and addressing health equity, I am deeply concerned about Delaware’s proposed House Bill 350, which aims to address rising health care costs by establishing a body of political appointees that would oversee the budgets of Delaware’s nonprofit hospitals. While the goal of bending the cost curve in health care may be well-intentioned, this bill will have horrific consequences for Delaware’s most vulnerable populations, including Black people, Hispanic people and other groups that have been traditionally underserved in health care. We can and must work together to solve this problem and provide the right care, in the right place, at the right time. A tale of two cities To borrow a phrase from Charles Dickens, Delaware, like much of America, is a tale of two cities. The experience of life—including a healthy, safe environment and access to good-quality health care—is vastly different depending on where you live and your demographic background. In the city of Wilmington, for example, ZIP codes that are just a few miles apart represent more than 20 years difference in life expectancy. This is not OK—it’s a sign that we have serious structural problems in our communities that are causing harm to people and making their lives shorter. Importantly, chopping $360 million out of Delaware’s hospital budgets, as House Bill 350 would do in year one, is not going to help this problem—it’s going to make it worse. And in doing so, it would ultimately make health care in Delaware more expensive—not less expensive. The key to lowering health care costs is to improve quality, access and equity Data show that about 5% of patients in the United States account for more than 50% of all health care costs. These are primarily patients who have complex and poorly managed chronic conditions that cause them to end up in the most expensive care settings—hospitals, operating rooms, emergency departments. The key to driving down health care costs is to improve quality and equity so that everyone is supported in achieving their best health, and these high users of the most expensive kinds of care are better supported in managing their health conditions such as diabetes or heart failure in the appropriate way. In doing so, they prevent the need for costly emergency or “rescue” care. Let’s do more—not less—of what we already know works Health care is not a one-size-fits-all industry. The delivery of care for patients across a diverse population requires multiple interventions at the same time. These interventions are designed not only to improve the quality of care but also to close the gap in terms of health care disparities. That’s important, because when we improve care and outcomes for the most vulnerable populations, we tend to get things right for everyone. One type of intervention is about doing exactly the right things for a patient based on the evidence of what will help—and doing nothing extra that will cause harm or generate additional costs without providing additional benefit. An example of this might be ensuring that every patient who has a heart attack gets a certain drug called a beta blocker right after their heart attack, and they receive clear guidance and support on the actions they must take to reduce their risk of a second heart attack, such as regular exercise and good nutrition. The second type of intervention is for the highest-risk populations. These are patients who live in poor communities where there are no gyms and no grocery stores, and people commonly have challenges with transportation and lack of access to resources that makes it difficult—sometimes impossible—to follow their plan for follow-up care. They lack access to high-nutrient food that reduces their risk of a second heart attack. They also live in areas where there are fewer health care providers compared to more affluent areas. These interventions tend to be very intensive and do not generate income for health systems; in fact, they require significant non-reimbursed investment, but they are necessary to keep our most vulnerable patients healthy. The medical community has developed interventions for these populations that are proven to work. A local example is the Delaware Food Pharmacy program, which connects at-risk patients with healthy food and supports their ability to prepare it. The program helps patients improve their overall health and effectively manage their chronic conditions so they can prevent an adverse event that would put them back in the hospital or emergency department. When we work together, we succeed We’ve seen incredible examples of how this work can be successful right here in Delaware. Delaware was the first state in the country to eliminate a racial disparity in colorectal cancer, and we did this by expanding cancer services, including making it easy for vulnerable people to get preventive cancer care and screenings. This is an incredible success story that continues to this day, and it was the result of thoughtful, detail-oriented partnerships among the state and the health care community. The work continues as we collaborate to reduce the impact and mortality of breast cancer in our state. Unfortunately, these kinds of interventions are the first thing to go when health care budgets get slashed, because they don’t generate revenue and are not self-sustaining. These kinds of activities need to be funded—either through grants or an external funder, or by the hospitals and health care systems. By narrowly focusing on cost, we risk losing the progress we have made Delaware House Bill 350, as it’s proposed, would cause harm in two ways: First, it would compromise our ability to invest in these kinds of interventions that work. Second, it increases the risk that higher-cost health services and programs that are disproportionately needed by people in vulnerable communities could become no longer available in Delaware. In states where the government has intervened in the name of cutting costs, like Vermont and Massachusetts, we see the consequences–less quality and reduced equitable access to much-needed services. House Bill 350 will widen the gap between those who have means and those who are more vulnerable. These changes will lead to increased disease burden on these populations. They will end up in the emergency room more and hospitalized more, which is by far the most expensive kind of care. That’s not what anyone wants—and it’s the opposite of what this bill was intended to accomplish. At this moment, in Delaware, we have an opportunity to put our state on a sustainable path to better health for all Delawareans. House Bill 350 is not that path. However, the discussion that House Bill 350 has started is something that we can build on by bringing together the stakeholders we need to collaborate with to solve these complicated problems. That includes Delaware’s government and legislators, the hospitals and health centers, the insurance, pharmacy and medical device industries, and most importantly, patients and the doctors who care for them. LeRoi Hicks, M.D., is the campus executive director for ChristianaCare, Wilmington Campus.

Sunday is Cinco de Mayo. Do you know the history behind the day?

Celebrated annually on May 5th, Cinco de Mayo commemorates the Mexican army's victory over French forces at the Battle of Puebla in 1862. While often associated with festive gatherings and cultural celebrations, Cinco de Mayo also holds significant relevance beyond its historical origins, offering various story angles that appeal to a broad audience. Cultural significance and heritage preservation: Explore the historical context of Cinco de Mayo and its importance in Mexican culture, highlighting the traditions, food, music, and art associated with the holiday. Immigration and identity: Examine how Cinco de Mayo is celebrated in different parts of the world, particularly in the United States, and its role in shaping the Mexican-American identity and fostering cross-cultural understanding. Political implications and national pride: Investigate the political undertones of Cinco de Mayo, considering its significance in Mexican nationalism and its portrayal in international relations. Economic impact and tourism: Analyze the economic implications of Cinco de Mayo festivities, including the boost in tourism, sales of Mexican-themed products, and the commercialization of cultural heritage. Education and historical awareness: Discuss the educational value of Cinco de Mayo in schools and communities, examining how it promotes historical awareness, tolerance, and multiculturalism. Social justice and activism: Explore how Cinco de Mayo intersects with social justice movements, addressing issues such as immigration reform, cultural appropriation, and representation in media and politics. By covering these angles, journalists can provide their audiences with a deeper understanding of Cinco de Mayo beyond its surface-level festivities, fostering meaningful dialogue and engagement with the holiday's historical, cultural, and societal significance. Connect with an Expert about Cinco de Mayo: Margarita R. Ochoa Associate Professor and Associate Chair of History · Loyola Marymount University Timothy Matovina Chair, Department of Theology · University of Notre Dame Rodrigo Vargas Professor, Ecosystem Ecology and Environmental Change · University of Delaware Heather Chiero, PhD Associate Professor of History, Anthropology and Philosophy · Augusta University To search our full list of experts visit www.expertfile.com Photo Credit: Daniel Lloyd Blunk-Fernández

#ExpertSpotlight: 10th anniversary of Flint, MI, water crisis beginning

The 10th anniversary of the Flint, MI water crisis marks a pivotal moment in environmental justice and public health awareness. This event matters deeply to the public as it sheds light on systemic failures in infrastructure management, government accountability, and the disproportionate impacts of environmental hazards on marginalized communities. Here are several sub-topics that could be of interest to a broad audience: Health Impacts and Long-term Consequences: Explore the lingering health effects on residents exposed to lead-contaminated water, including neurological disorders, developmental delays, and mental health challenges. Government Response and Accountability: Investigate the role of local, state, and federal authorities in addressing the crisis, including accountability measures taken against officials responsible for the negligence and mismanagement. Community Resilience and Activism: Highlight the resilience of Flint residents and grassroots organizations in advocating for clean water access, demanding justice, and implementing community-led solutions. Infrastructure Challenges Nationwide: Examine the broader implications of Flint's water crisis on infrastructure investment, maintenance, and regulation across the United States, particularly in aging urban areas. Policy Reforms and Prevention Efforts: Discuss policy reforms enacted post-crisis to prevent similar incidents, such as improvements in water quality testing, infrastructure upgrades, and measures to ensure environmental justice. Legacy of Environmental Injustice: Analyze the broader socio-economic factors contributing to environmental injustices like the Flint water crisis, including racial disparities in access to clean water and the intersectionality of poverty and environmental hazards. This anniversary presents an opportunity for journalists to revisit the ongoing repercussions of the Flint water crisis, amplify the voices of affected communities, and advocate for sustainable solutions to prevent similar tragedies in the future. Connect with an Expert about the Flint, MI water crisis: To search our full list of experts visit www.expertfile.com Gerald Kauffman Project Director, Water Resources Center, Institute for Public Administration; Assistant Professor, Biden School of Public Policy and Administration · University of Delaware Viviane Yargeau Professor, Department of Chemical Engineering · McGill University Jared L. Cohon University Professor · Carnegie Mellon University Joe Brown Assistant Professor, Environmental Engineering · Georgia Tech - COE For journalists with questions or looking to cover the streaming wars, here is a select list of experts. Photo Credit: Bruno Guerrero

Covering 4/20? Our experts can help you see through the smoke | Media Advisory

As 4/20 approaches, the spotlight once again turns to the evolving landscape of marijuana legalization and its broader societal impacts. This annual observance not only marks a cultural moment for cannabis enthusiasts but also prompts discussions about the legal, economic, and public health implications of marijuana use in the United States. Here are key story angles for journalists to explore: Legalization efforts and state-by-state updates: Tracking the progress of marijuana legalization initiatives across the country and analyzing the legal frameworks governing recreational and medicinal cannabis use. Economic opportunities and challenges: Investigating the economic impact of the cannabis industry, including job creation, tax revenue generation, and business opportunities, as well as regulatory hurdles and market fluctuations. Social justice and equity in cannabis legalization: Examining efforts to address historical inequities in drug enforcement and incarceration through policies such as expungement, social equity programs, and community reinvestment. Public health and safety considerations: Assessing the health effects of marijuana use, the regulation of cannabis products, and efforts to mitigate potential risks such as underage consumption and impaired driving. Cannabis culture and mainstream acceptance: Exploring the evolving perceptions of marijuana in society, including trends in consumption habits, cannabis tourism, and its portrayal in media and popular culture. International perspectives on marijuana policy: Comparing approaches to marijuana legalization and regulation in other countries and evaluating lessons learned for U.S. policymakers and stakeholders. Connect with an Expert about Marijuana in America: For journalists with questions or looking to cover the streaming wars? here is a select list of experts. To search our full list of experts visit www.expertfile.com Robert Mikos Professor of Law · Vanderbilt University Michael Ostrowsky Professor of Sociology · Southern Utah University Jennifer Whitehill Associate Professor of Health Policy and Management · University of Massachusetts Amherst Daniele Piomelli Distinguished Professor · UC Irvine Almut Winterstein Distinguished Professor · University of Florida Photo Credit: Dylan Mullins

Concepts and habits from gasoline refueling found to mislead EV charging

Many electric vehicle (EV) drivers carry over concepts and habits acquired from driving gasoline cars when they are charging of EVs – but the mismatch leads to time wasted, inconvenience and “range anxiety” about not finding a charger when needed, according to a new study published in the journal Energy. The research was carried out by Professors Willett Kempton of the University of Delaware and Frances Sprei of Chalmers University in Sweden, both experts in EV technology and usage. They interviewed EV users in both Sweden and the United States, finding unanticipated and previously unreported concepts and habits of EV charging. Among the other findings: If industry and consumers take advantage of these findings, that could lead to more effective charging methods, help new EV buyers adapt, and inform planning of charging stations. Novice EV drivers, and even many of those who had months of EV experience, monitor the battery charge gauge while driving, then when the gauge is low, seek a charging station to recharge. This “monitor gauge” model is derived from driving gasoline-powered vehicles. By contrast, the study found that a few experienced EV drivers had developed a strategy of selecting a trigger event, and using it to spur them to plug in their EV. “Some of the more sophisticated EV users had picked a repeating event that happens at a place they can plug in and at a time or event lasting several hours. This is common when returning home at the end of the day or arriving at work," Kempton said. “A few people had selected unexpected triggers, such as shopping, and for one, when walking his dog in the evening.” To arrange an interview with Kempton, visit his profile and click on the "contact button" – this message will reach him directly. Or contact UD's media relations department.

With the Port of Baltimore all but closed, how will the supply chain be impacted?

Following the incident of the container ship crashing into the Francis Scott Key Bridge at the Port of Baltimore and the bridge collapsing, there are now some supply chain concerns. While they may not be felt right away by consumers, there are a number of businesses that will be affected by it. Rick Franza, PhD, professor in Augusta University's James M. Hull College of Business and an expert on operations and supply chain management, said one immediate impact is where container ships will be diverted to for offloading. The Port of Baltimore is a major shipping hub and ranks first among U.S. ports for autos and light trucks. Now those ships will have to find other ports to unload their goods, which becomes a logistical problem as much as anything. “Most ports on the East Coast are at 70% to 80% capacity, which is where you want to be. You don’t want to have much more than that, but they’re going to have to,” said Franza. “It could affect a good bit of the eastern half of the United States.” Ports in Savannah, Charleston and New York, among others, will have to become the destination for those currently sitting outside Baltimore and those en route from around the world. The good news, Franza said, is that most foreign car manufacturers have plants in the United States so it will likely only affect those consumers looking for a certain brand or even a specific model. Baltimore is also one of the furthest inland ports and has the best rail service coming from it. The outbound goods coming off the ships will now face more of a transportation hurdle when they are diverted to another port. “It’s not just the capacity of the port, that’s one thing, but it’s also their capacity of the outbound items,” he said. “It may be more trucks are needed, and new routes are needed to move inventory. It now becomes a whole different set of providers for the trucks because it’s no longer the people in Baltimore.” Franza added companies will also have to decide which distribution centers they may want to use, whether it’s closer to the area they serve or closer to the port. All those factors affect where the items from overseas end up. While it’s not a good scenario, at the end of the day, he feels the consumer likely won’t see much of an impact. “First of all it’s going to take a while before we see any effect on certain things,” Franza said. “The bad news for inflation is that it’s going to raise the cost of transportation for the goods coming off the ships. Will businesses absorb the cost or pass them along to consumers?” Looking to know more? Then let us help. Richard Franza, PhD, is available to speak with media about trending issues like inflation, small business and the economy – simply click on his icon now to arrange an interview today.

Rethinking Caregiving Support for the Sandwich Generation

The "sandwich generation" refers to adults who are simultaneously caring for their children as well as older parents or relatives. This places unique strains on caregivers, who must balance their family responsibilities with work and their own self-care. As Guy Weissinger, PhD, MPhil, RN, the Diane Foley Parrett Endowed Assistant Professor at Villanova University's M. Louise Fitzpatrick College of Nursing, notes, many feel like they are being "shortchanged" on both sides—unable to fully support their children or their aging relatives. The result is stress, guilt and difficult decisions about how to allocate limited time and resources. "Hard decisions are also a psychological tax," Dr. Weissinger says. "You have to use the resource of time and brain energy to weigh the options, so it compounds on itself every time they intersect. And that's complicated and hard." These challenges have only increased due to larger societal shifts, according to Melissa O'Connor, PhD, MBA, RN, FGSA, FAAN, the M. Louise Fitzpatrick Endowed Professor in Community and Home Health Nursing in the College of Nursing. "For the first time in the history of the world, older adults will outnumber children in the United States by 2035," said Dr. O'Connor. This rise in numbers of older adults foreshadows a looming caregiving crisis, as more seniors will require care without enough nurses and family caregivers to meet the need. The sandwich generation can also feel overwhelmed due to lack of training in managing complex care needs. As Dr. O'Connor states, there is "no caregiver school"—instead it's "baptism by fire." Learning wound care, managing feeding tubes, giving medications and handling dementia behaviors on the fly can take an emotional toll. Caregiver stress and burnout have also been linked to declines in physical and mental health, and financial strain, as well as increased elder abuse (though unintentional), she says. Dr. O'Connor believes that home health services can serve as a critical resource for supporting overwhelmed sandwich generation caregivers. Home health nurses, aides, therapists and social workers can provide skilled care, educate family members, assess safety and coordinate services. "Home health can make or break someone's success at staying home,” Dr. O'Connor says. "It can also make or break the stress levels of patients and caregivers. If caregivers have support, they can do a really good job." However, misconceptions about home health care persist. Many do not understand what home health services entail or worry about strangers entering their home. Although refusing home health may seem like the safer option to some, the consequences of caregivers trying to provide care without assistance can be dire. Isolated and overwhelmed caregivers who don't have support oftentimes end up seeing their older adult parents experience health declines that necessitate nursing home placement, which takes a financial toll on families as well. From Dr. Weissinger's perspective, the caregiving crisis is a "family and a systems issue." "This is a systematic problem, so we need policy changes at the state, national and organizational levels to address it. We can't solve society-level problems through individual responses," he says. Supporting caregivers and easing this crisis will require policy changes at the highest levels along with a societal shift in how we view and assist caregivers. Though individual families feel the squeeze, truly addressing the caregiving crisis demands broad, systemic solutions. With an aging population, the need for action in the form of policy change is more urgent than ever.

Tackling Tik Tok - Our expert explains what the problem is and what's next for the Chinese owned app

TikTok is one of the most popular social media sites in the world. In the United States, more than 170 million people and businesses use the app on a regular basis. Now, the federal government has taken the first step in banning the China-based app unless the ownership group, ByteDance, sells TikTok. The House of Representatives passed a bipartisan bill in support of the ban, and now it awaits Congress to act. President Joe Biden has indicated he would sign the bill banning TikTok unless it’s sold, but whether it reaches his desk remains to be seen. This stems from the fear that China uses user information to their advantage. According to Lance Hunter, PhD, associate professor of political science in Pamplin College of Arts, Humanities and Social Sciences, the concern is well deserved. “Even if it’s a privately-owned enterprise, China can still control it, they can still manipulate it to some degree as if it was a state -owned enterprise,” said Hunter. Hunter’s research focuses on how informational warfare attacks influence politics worldwide. He said the algorithm TikTok uses can play a major role in informational warfare on two fronts. “One, it’s the data gathering, and that can be used for micro targeting because basically what TikTok can do is collect the data and provide information as to what certain individuals respond to an this is exactly how you can persuade them.” “Also, there is empirical evidence that China has used TikTok before to try to influence elections to some degree. One example in the 2022 midterm elections in which some candidates from both parties were targeted by TikTok accounts that were controlled by a propaganda agency operating within the Chinese government.” Hunter added the TikTok algorithm is more advanced than some other social media platforms and more effective in knowing what people like and why they like it. With so many AI-generated posts, it can be difficult for the consumer to decipher what is legitimate, and what isn’t. There are some red flags for people to be on the lookout for. “One thing the average person can do is be very wary of what you’re seeing and ask yourself does this seem legitimate?” he added. “If everyone is saying the exact same thing, that’s a tell sometimes. Also, where does this information originate from, and what are the timestamps on the posts? Something else is to look at the individual who made the post. Who are these people and who’s following them? You may be able to see if they are legitimate accounts.” While China, and Russia for that matter, are trying to influence people in several ways, Hunter said they are also trying to cause division among the American people. “They do want to influence elections at times, absolutely. But one of their other goals, and sometimes even more predominant goals for them, is to increase division, increase polarization, and that’s a great way to do that,” Hunter said. “Even if you have a temporary reaction, you’ve increased that division which could have longer term effects.” Are you covering this important and ongoing story? Then let us help with your stories and questions. Lance Hunter is an assistant professor of political science with a background in international relations. His research focuses on how terrorist attacks influence politics in democratic countries and how political decisions within countries affect conflicts worldwide. He is available to speak with media about this important topic - simply click on his icon to arrange an interview today.