Macomb County Research Articles

Tracking Chlamydia and Syphilis in the Detroit Metro Area by Molecular Analysis of Environmental Samples.

This paper describes one of the first studies applying wastewater surveillance to monitor Chlamydia and Syphilis and back-estimate infections in the community, based on bacterial shedding and wastewater surveillance data. Molecular biology laboratory methods were optimized, and a workflow was designed to implement wastewater surveillance tracking Chlamydia and Syphilis in the Detroit metro area (DMA), one of the most populous metropolitan areas in the U.S. Untreated composite wastewater samples were collected weekly from the three main interceptors that service DMA, which collect wastewater and discharge it to the Great Lakes Water Authority Water Resource Recovery Facility. Additionally, untreated wastewater was also collected from street manholes in three neighborhood sewersheds in Wayne, Macomb, and Oakland counties. Centrifugation, DNA extraction, and ddPCR methods were optimized and performed, targeting Chlamydia trachomatis and Treponema pallidum, the causative agents of Chlamydia and Syphilis, respectively. The limit of blank and limit of detection methods were determined experimentally for both targets. Both targets were detected and monitored in wastewater between December 25th, 2023, and April 22nd, 2024. The magnitudes of C. trachomatis and T. pallidum concentrations observed in neighborhood sewersheds were higher as compared to the concentrations observed in the interceptors. Infections of Chlamydia and Syphilis were back-estimated through an optimized formula based on shedding dynamics and wastewater surveillance data, which indicated potentially underreported conditions relative to publicly available clinical data.

Abstract PR019: Evaluating the role of ambient air pollution in racial disparities of colorectal cancer incidence and survival in metropolitan Detroit

Abstract Colorectal cancer (CRC) is the third most diagnosed cancer in the United States and the third leading cause of cancer-related deaths. Moreover, Non-Hispanic Black (NHB) individuals have the highest rates of CRC incidence and mortality in the United States. We have become increasingly aware of the potential impact of social determinants of health (SDOH) on colorectal physiology and carcinogenesis. Other than individual and neighborhood level socioeconomic status (SES), neighborhood quality can also affect an individual’s risk of exposure to harmful environmental contaminants including ambient air pollution. Moreover, as NHB individuals are more likely to live in areas of lower area-level SES they experience these effects even further. We sought to understand whether higher exposure rates to fine particulate matter (PM2.5) played a role in racial differences in CRC incidence and survival in metropolitan Detroit. To do this, we obtained data from the Environmental Protection Agency (EPA) Environmental Justice Mapping and Screening Tool through the Georgetown University Environmental Impact Data Collective (EIDC) and patient data from the Metropolitan Detroit Cancer Surveillance System (MDCSS) registry. Incidence rates were calculated using population data from the American Community Survey. Associations between PM2.5 exposure and CRC incidence were estimated using Poisson modeling. Data were obtained for NHB (n=3778) and Non-Hispanic White (NHW) (n=9727) individuals diagnosed with invasive CRC between 2010 and 2019 in Wayne, Oakland, and Macomb counties, including their geocoded census tract at diagnosis as well as demographic and clinical features. Vital status was reported as months from the date of diagnosis to either death or last contact. PM2.5 metrics were converted to the national percentile of PM2.5 in the air utilizing the Bayesian space-time downscaling fusion model for derived estimates of air quality at the census tract level. Survival was assessed using Cox Proportional Hazards modeling. We found that an increase in the PM2.5 percentile increased the risk for CRC overall for NHB and NHW patients (Relative Risk [RR] = 1.80, 95% Confidence Interval [CI] = 1.55 - 2.08, p-value <0.0001). This association was even stronger among NHB patients (RR = 7.94, 95% CI = 5.45 - 11.52, p-value < 0.0001), but was not statistically significant among NHW patients (RR = 1.12, 95% CI = 0.95 – 1.32, p-value = 0.16). PM2.5 exposure was not associated with survival overall or stratified by race. We conclude that ambient air pollution, particularly PM2.5, increases the risk of CRC cancer and disproportionately affects NHB patients but may not play a role in mortality risk. These results highlight the importance of environmental justice research in biomedical research and the need for a better understanding of the etiology of CRC within and among differing genetic ancestries and races by evaluating the genetic and epigenetic differences in patient tumor samples. Citation Format: Natalie G. Snider, Theresa Hastert, Ed Peters, Elena M. Stoffel, Laura Rozek, Ann Schwartz, Kristen Purrington. Evaluating the role of ambient air pollution in racial disparities of colorectal cancer incidence and survival in metropolitan Detroit [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr PR019.

Tale of Two Counties With the Same Telehealth Story: Experience with Cancer Genetics Testing During COVID-19 at a Community Hospital

Introduction: With the onset of the COVID-19 pandemic in 2020, the utilization of telemedicine now offered an alternative diagnostic and treatment resource to providers in many areas of medicine including oncology and cancer genetics. This care option paired with genetic testing labs’ ability to send saliva-based DNA collection kits to patients, enabled our community hospital in Detroit to offer diagnostic testing without the patient coming to a healthcare setting for a host of reasons. Social determinants of health have been found to influence success with telehealth, and this study sought to analyze how successful telehealth cancer genetics care was throughout the Detroit Metro area. Methods: Patient demographics for in person visits six months before COVID were analyzed, and then compared with demographics of patients during the 2020-2021 pandemic period where visits were telehealth. Results: Pre-pandemic there were , 192 unique patients seen in person with the top three cities patients were from were Detroit (12.1%), Clinton Township (8.3%), and Saint Clair Shores (10.4%). During the pandemic, with telehealth as the major modality, the top three cities were Macomb (7.2%), Detroit (7%), and Clinton Township (7%). Detroit is in Wayne County, while St.Clair Shores and Clinton Township are in Macomb County. Per the US Census Bureau Macomb county has a median income of $64,641 and Wayne county has a median income of $49,359, and poverty level in Macomb county is 9.2% versus in Wayne the level is 20%. Conclusions: This paper outlines the challenges of initiating a telemedicine program in an urban community area and highlights the benefits of a concierge service in serving cancer patients who may have economic and historically poor perceived technologic abilities.

Historic Tales of Macomb County by Barb Pert Templeton

Reviewed by: Historic Tales of Macomb County by Barb Pert Templeton Katie Doelle Barb Pert Templeton. Historic Tales of Macomb County. Charleston, SC: The History Press, 2020. Pp 142. Index. Photographs. Paperback: $21.99. Macomb County was founded in 1818 and named after War of 1812 veteran Alexander Macomb Jr. Today, Macomb County, part of Metro Detroit, has the fifth-largest population in Michigan. Historic Tales of Macomb County provides a superb introduction to the history of Macomb and the unsung heroes who have left their mark on the community. The book, presented in Barb Pert Templeton's own voice, brings to life some interesting facts about the twenty-seven villages, cities, and townships, including the people who have made a difference to the district. Each of the fourteen chapters features the origins of the township and its name, a select history, and its size (in miles and population), along with tales of several prominent people who have resided in the respective villages and cities. [End Page 159] The focus is on the people who have left a lasting impression on their community—politicians, inventors, soldiers, and farmers—including Mayor Tom Welsh (St. Clair Shores), Governor Alexander J. Groesbeck (Warren) and librarian Naomi Gibbing (Utica). Many of the individuals and families Templeton presents are significant residents of the county, who not only left their mark locally, but also on the state, and, in some cases, nationally. Some of the standout subjects include the Weiss family, who supplied roses to the White House; Shirley A. Mason, the quiet but likable art teacher who became the inspiration for Sybil in the best-selling 1973 non-fiction book by Flora Rheta Schreiber and the 1976 TV movie; and Franklin Harold Hayward, a painter and sculptor whose paintings were displayed in museums in France, England, and across the United States. Templeton also introduces the reader to immigrants who traveled thousands of miles to the United States and made Macomb County their home. Among them are the Kuchenmeister family, who arrived from Germany in 1884, and Robert Nelson Sr., who, with his three acrobat brothers, sailed from England to the United States in 1886 and made Mount Clemens his permanent home in 1887. While it is these lesser-known individuals who take center stage, Templeton also presents stories of nationally known individuals such as Joe Louis, Harlan Perry Howard, and Thomas Edison. What makes the book particularly interesting is the insight Templeton provides on the smaller townships in Macomb County. For instance, the community of Memphis, located in just one square mile with 1,200 residents, has provided the United States with a Country Music Hall of Fame songwriter, a significant lawmaker (inducted into the Michigan Women's Hall of Fame), and the builder of Michigan's first self-propelled vehicle in 1884. Templeton clearly enjoys sharing the history of Macomb County. As a journalist and freelance writer in Metro Detroit, she has selected content that highlights the significance of the communities and covers a broad spectrum of topics, dates, and locations. No two stories are the same, and it is evident Templeton had a lot of fun researching the material, delving into history, and telling significant tales. Historic Tales of Macomb County will prove popular to lifelong residents of the county, to people like me who are new to the area, or to those who take pleasure in discovering noteworthy stories about the place they live. Local history enthusiasts will also enjoy the book. [End Page 160] Katie Doelle St. Clair Shores, Michigan Copyright © 2022 Historical Society of Michigan

High abundance of human herpesvirus 8 in wastewater from a large urban area.

This study assesses the diversity and abundance of Human Herpesviruses (HHVs) in the influent of an urban wastewater treatment plant using shotgun sequencing, metagenomic analysis and qPCR. Influent wastewater samples were collected from the three interceptors that serve the City of Detroit and Wayne, Macomb and Oakland counties between November 2017 to February 2018. The samples were subjected to a series of processes to concentrate viruses which were further sequenced and amplified using qPCR. All nine types of HHV were detected in wastewater. Human Herpesvirus 8 (HHV-8), known as Kaposi's sarcoma herpesvirus, which is only prevalent in 5-10% of USA population, was found to be the most abundant followed by HHV-3 or Varicella-zoster virus. The high abundance of HHV-8 in the Detroit metropolitan area may be attributed to the HIV-AIDS outbreak that was ongoing in Detroit during the sampling period. The approach described in this paper can be used to establish a baseline of viruses secreted by the community as a whole. Sudden changes in the baseline would identify changes in community health and immunity.

Abstract 106: Covid-19 Pandemic Impact on Ems Runs and Resuscitation Attempts

Background: The frequency of EMS runs, resuscitation attempts, & out of hospital cardiac arrest survival within a pandemic period has not been studied within the Detroit and metro Detroit region in Michigan. To analyze and study the consequences associated with the spread of COVID-19 within two Michigan counties, a retrospective review from two different medical control authorities (MCA) was completed. We hypothesized the number of out of hospital cardiac arrests and EMS runs to increase during the COVID-19 pandemic, while resuscitation attempts to decrease. Methods: This is a retrospective review study. Records from two MCAs, the Detroit East Medical Control Authority (DEMCA) and the Macomb County Medical Control Authority (MCMCA), were utilized and data was extracted and extrapolated. Each of these MCAs oversee Emergency Medical Services (EMS) within their respective counties. DEMCA provides coverage for the eastern region of Wayne County and MCMCA serves all of Macomb County. Runs, dead-on-scene numbers, & resuscitation attempts were each assessed from March through May of 2019 & 2020. Results: There were nearly double the number of EMS runs for out of hospital cardiac arrest during the 3 main months of the pandemic. In March through May 2020 there were 1756 runs with a mean age of 62.7 years vs. 988 runs during the same period in 2020 with a higher mean age of 65.1 years (p<0.01). This difference was most pronounced in April, which was the height of the pandemic in Michigan (782 vs. 312). The higher number of EMS runs was also more pronounced in Wayne county (1.86 times 2019 numbers) compared to Macomb County (1.65 times 2019 numbers). Resuscitation was attempted on 566 (32.2%) during the pandemic compared to 222 (22.5%) during the same period in the prior year (OR 0.61, 95% CI 0.51 - 0.73, p<0.01). The proportion of patients transferred from the field to an ED did not change significantly (2.6% in the control period vs. 2.1% during the pandemic, p=0.325). Conclusion: There was a 1.78 fold rise in out of hospital cardiac arrest EMS runs during the peak months of the pandemic in metro Detroit compared to the same period in 2019. Despite national concerns on the safety of resuscitation with Covid-19, a higher proportion of patients had resuscitation attempted during the pandemic.

Abstract B43: Disparities in mortality and five-year survival by race and socioeconomic status in white and African American women diagnosed with breast cancer in metropolitan Detroit

Abstract Background: Racial and, to a lesser extent, socioeconomic disparities in breast cancer incidence and mortality have been well documented; however, little is known about whether observed racial disparities differ by socioeconomic status. Methods: We used data from the population-based Metropolitan Detroit Cancer Surveillance System to estimate hazard ratios of death for non-Hispanic white (N = 31,102, including 8,174 deaths) and African-American women (N = 9,257, including 3,133 deaths) ages 18 and older diagnosed with incident, invasive breast cancer with recorded stage between 2000 and 2013 in Oakland, Wayne, and Macomb counties in Michigan and to estimate 5-year survival percentages for women diagnosed between 2000 and 2008 (N = 18,922). Neighborhood poverty was measured using the proportion of households with incomes below the federal poverty level in 2000 in the women's census tracts of residence at diagnosis. We used Cox proportional hazards models controlling for age at diagnosis, year of diagnosis, and cancer stage at diagnosis to estimate hazard ratios (HR) and 95% confidence intervals (CI) associated with mortality. Standard errors were adjusted to account for unobserved correlation between residents of the same census tracts. Results: Risk of death in African-American women diagnosed with breast cancer was 57% higher than for white women (HR: 1.57, 95% CI: 1.48, 1.67), and this association attenuated when also controlling for neighborhood poverty (HR: 1.31, 95% CI: 1.20, 1.42). Living in high-poverty neighborhoods was associated with a 77% higher risk of death (HR: 1.77, 95% CI: 1.64, 1.91), and this association also attenuated when controlling for race (HR: 1.46, 95% CI: 1.33, 1.62). Risk of death was higher for African-American women than for white women at every level of neighborhood poverty, although the associations were stronger in the lowest poverty areas (HR associated with being African-American: 1.68, 95% CI: 1.33, 2.12) than in the highest-poverty areas (HR: 1.23, 95% CI 1.08, 1.40). Among white women, higher neighborhood poverty was associated with higher risk of death (HR for high- vs. low-poverty areas: 1.57, 95% CI: 1.37, 1.79), but living in higher-poverty areas was not associated with mortality among African-American women with breast cancer (HR for high- vs. low-poverty areas: 1.21, 95% CI: 0.96, 1.51). Five-year survival was higher in white women (77.6%) than in African-American women (65.3%) overall. This difference in 5-year survival was largest for women living in the lowest-poverty areas (81.5% for whites vs. 70.1% for African-Americans), but was much smaller for women in the highest-poverty areas (66.2% for whites vs. 62.3% for African Americans). Conclusions: Although important disparities in mortality exist for African-American women compared with white women with breast cancer, disparities also exist by socioeconomic status, particularly for white women. The extent to which these disparities could be due to treatment differences, age at diagnosis, and type of breast cancer is being examined. It is important to consider socioeconomic status in addition to race when identifying and addressing disparities in breast cancer outcomes. Citation Format: Theresa A. Hastert, Ann G. Schwartz, Terrance L. Albrecht. Disparities in mortality and five-year survival by race and socioeconomic status in white and African American women diagnosed with breast cancer in metropolitan Detroit. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B43.

Half the Story: Paul Clemens, Made in Detroit: A South of 8 Mile Memoir

Half the Story:Paul Clemens, Made in Detroit: A South of 8 Mile Memoir Robert Fishman (bio) Paul Clemens has an important story to tell in this memoir,1 but it is not the story we expect. Born in Detroit in 1973, he grew up as part of a rapidly shrinking minority: white people in the Motor City. We anticipate a literate Eminem, but Clemens is honest enough to admit that his real contacts with the life and culture of black Detroit have been minimal. He had no love for the music—the best locus for racial crossovers—indeed almost no real contact with black Detroit, because he was educated in the still largely white Catholic parochial system. The real story in this memoir is the story of Clemens's father. He is the one genuinely "made in Detroit," born in 1944 when the city was truly "the arsenal of Democracy," a man who, in his son's words, "worshipped at the altar of the internal combustion engine." His work was making cars, and his only leisure was repairing and racing them. As Clemens observes, his father was part of that hardbellied stratum of white America where, to borrow from Heller in Catch-22, the men were possessed of a variety of useful, necessary skills that would keep them in a low-income group all of their lives. There was nothing the men couldn't build, nothing they couldn't fix, no problem they couldn't solve—and it would never do them a bit of good economically. . . . Though largely uneducated, they were skilled enough to go into business for themselves, running towing services, bump shops, and pinstriping places, only to find that being self-employed meant long hours, huge headaches, a lack of health insurance, and—when one's clientele is also working-class— [End Page 404] being entirely at the whim of an economy in which very little trickles down (p. 34). Clemens's memoir is the tragedy of that "hardbellied stratum," at least those like his father who stayed in Detroit. They asked for relatively little: a tough, demanding job in "the industry" that paid enough to afford a modest bungalow for their family without the wife having to work outside the home; a stable neighborhood of people like themselves; a nearby parish church and good parochial schools; and a city government that provided basic services and security. Asking little, they got less. Despite his skills and work ethic, Clemens's father was caught in the backwash of the declining automobile industry. For some reason that Clemens never makes clear, his father never attained the relative security of a job in one of the Big Three plants with UAW membership benefits. Instead, he bumped from one specialized parts supplier to another as the companies went bankrupt. From a bungalow near Six Mile on Detroit's east side in the sixties, the Clemens family followed a dwindling remnant of whites to Seven Mile in the seventies and Eight Mile in the eighties. The neighbors tended to be retired people on fixed incomes with an even more blinkered mentality, who kept the house in Detroit so that a cop or fireman son could pretend that he was still living in the city. Meanwhile, Clemens's mother worked cleaning other people's houses in Grosse Pointe so that Paul could attend Catholic schools in Macomb County (those nearer by in the city having closed.) If Clemens's father with his working-class values is the unexpected hero of the memoir, the antihero is equally unexpected: Coleman Young, Detroit's first black mayor, who held office an incredible twenty years, from 1973 to 1993. For Detroit's white population, Young symbolized their powerlessness. "White people," as the mayor once put it, "find it very difficult to live in an environment they don't control" (p. 19), and he was not inclined to ease their difficulties. Clemens quotes with obvious approval Ze'ev Chafets's description of Coleman Young's Detroit as "the first major Third World City in the United States. The trappings are all there—showcase projects, black-fisted symbols, an external enemy and the cult of personality" (p. 15...

Measurement of concrete internal strain using a three-dimensional transducer system

A new three-dimensional transducer system is introduced in this paper, which enables the measurement of six internal components of strain tensor in concrete members. Laboratory tests and strain analyses were carried out to evaluate this tranducer system. The results show that the system is effective in measuring internal strains of concrete members. It was then embedded in a reinforced concrete bridge deck in Macomb County, Michigan. Field tests were conducted to measure the strains in the deck under truck wheel load. The results were used to understand the deck's strain and stress behavior under truck wheel load.

Regular dental visits and dental anxiety in an adult dentate population

The objective of this study was to investigate factors associated with regular dental visits in an adult population. A representative sample of non-institutionalized dentate adults (aged 18 through 69 years) from the Detroit tricounty area (Wayne, Macomb and Oakland counties) was randomly selected using list-assisted random digit dialing. The authors collected the data through a self-administered questionnaire that asked for information about regular dental visits, private dental insurance, perceived oral health status and dental treatment experience. The authors used Corah's Dental Anxiety Scale to measure respondents' dental anxiety level. They also conducted a descriptive analysis and a logistic regression analysis. A final sample of 630 adults who resided in 368 households participated in this study. Seventy-two percent of respondents had dental insurance (excluding Medicaid). About 63 percent reported that they visited a dentist regularly. About 12 percent of adults had high dental anxiety (a score of 13 or higher on the Corah scale). A logistic regression model found that dental anxiety, dental insurance status and perceived oral health status were significantly associated with regular dental visits after accounting for sociodemographic factors such as sex, age and income. Among those who had dental insurance, dentally anxious adults were significantly less likely to visit dentists regularly. However, this association was not significant among respondents without dental insurance. Dental insurance, perceived oral health status and dental anxiety were associated with regular dental visits. Dental anxiety was an influencing factor in regular dental visit behavior, especially among adults who had private dental insurance. Practitioners need to be educated about the causes of dental anxiety and receive training in how to treat the problem.

New Private Hospital Fills Gap in City’s MH System

Back to table of contents Previous article Next article Community NewsFull AccessNew Private Hospital Fills Gap in City’s MH SystemDavid MilneDavid MilneSearch for more papers by this authorPublished Online:16 Apr 2004https://doi.org/10.1176/pn.39.8.0019Mental health care officials in Detroit are optimistic that a new hospital planned to open there later this year will help fill the gap left by the closure of Northville Psychiatric Hospital, the state’s largest hospital for mental health care and one of the last public mental health facilities in Detroit.When Northville closed last May, it left hundreds of Detroit-area patients scrambling for care in hospitals around the state (Psychiatric News, February 7, 2003). The city lost almost half of its hospital beds for mentally ill people—from 1,965 in 1994 to 1,088 last year—during the administration of former Gov. John Engler (R).The new 90-bed private hospital on Detroit’s east side, known as the Circle of Life Health Care, will serve Wayne, Oakland, and Macomb counties. It will provide acute, short-term, long-term, and intensive care for 60 adults and 30 children and intake service for people who show up at the door.The hospital is a project of a group of health care professionals and a Detroit real estate executive who saw a need for intensive therapy in a clinical setting after many of the hospitals for mentally ill individuals closed. The facility has already obtained a certificate of need from the state, a precondition to being issued a license. It must now get the approval of the Joint Commission on Accreditation of Healthcare Organizations after its visitation in August.Relatives of patients who opposed the transfers and long distances they had to travel to see loved ones welcomed the new hospital as they consider visitations and important part of therapy.“If the proposal for the new hospital is sound, the facility would be a much-needed resource, and it would be great to get people from this part of the state back into the area again for long-term care, instead of having to move hundreds of miles away,” Mark Reinstein, Ph.D., president of the Mental Health Association in Michigan, told Psychiatric News.“One of the potential problems, if this all gets off the ground, is what happens if service payers and managers refuse to use the facility or will use it only for acute stays but nothing longer,” he added.Hubert C. Huebl, M.D., president of NAMI Michigan, said he was glad to hear of the first mental health hospital in years to be opened privately.“I’m all for it because there is a need for long-term beds,” he told Psychiatric News, “but many questions need to be answered.”These include whether the hospital will take Medicaid patients and whether insurance companies will be willing to pay the hospitals’ rates for people who need long-term care.Huebl thinks it would be a good idea for the hospital to provide subacute care, such as that offered by a 24-bed unit in Mt. Clemens. He is trying to get similar ones developed in Wayne County, which includes Detroit, to accommodate about 100 people who are now housed in Kalamazoo Psychiatric Hospital and elsewhere. He is also communicating with Hope Network, which is based in Grand Rapids.After complaints from people with mental illness and their relatives, Gov. Jennifer Granholm (D) appointed a special commission to study the need for inpatient care for people with mental illness since most of the state’s psychiatric hospitals have been closed. Michigan has closed more hospitals than any other state during the last 20 years.Three members of the Michigan Psychiatric Society serve on the commission: Tom Carli, M.D., Michelle Reid, M.D., and Rajiv Tandon, M.D. ▪ ISSUES NewArchived

Michigan County Recognizes Value Of Jail-Diversion Program

Back to table of contents Previous article Next article Government NewsFull AccessMichigan County Recognizes Value Of Jail-Diversion ProgramDavid MilneDavid MilneSearch for more papers by this authorPublished Online:7 Nov 2003https://doi.org/10.1176/pn.38.21.0011Macomb County, Mich., is launching a program to prevent the inappropriate incarceration of mentally ill, low-risk criminals by diverting them to treatment facilities instead of jail. Once the diversion program is established, a mental health court will be set up to let judges have more oversight over offenders while they are in treatment.The new system is expected to lighten judicial caseloads, reduce jail overcrowding, and enable offenders to be seen only once in court. Both the diversion program and the mental health court are expected to be fully operational by the end of the year.“I think that the Macomb program, coordinated with other pre- and post-jail diversion programs and other community mental health services, is a welcome addition to the services available to persons with mental illness and developmental disabilities in Michigan,” Michele Reid, M.D., past president of the Michigan Psychiatric Society and medical director of Detroit/Wayne County Community Mental Health (CMH), told Psychiatric News.Reid believes that mental health courts would be most effective if Michigan had outpatient commitment, as do most other states. At present involuntary commitment orders in Michigan must be initiated during a hospitalization, and only after discharge is there a period of mandated treatment. Without the ability to order treatment through the mental health code, she said, implementation will be less effective than it could be.The driving force behind the new program and its main coordinator is Macomb County probate judge Kathryn A. George, a staunch advocate for improving the county’s mental health system.“Right now the system is begging for changes,” she said.In 1999 a study of jails by the Michigan Department of Community Mental Health found more than half of all inmates in three counties suffered from mental illness, most commonly major depression, bipolar disorder, schizophrenia, and psychotic disorders“Michigan has no mental health court with a prebooking option, so if Macomb starts one that would be very important because we need to see how such a court might work in a major Michigan county,” Mark Reinstein, Ph.D., president and CEO of the Mental Health Association in Michigan, told Psychiatric News.“This is not to suggest that mental health courts are the only steps that should be taken. Evidence indicates our state may have a virtual epidemic of persons with mental illness winding up in the justice system, and this problem needs to be attacked comprehensively across multiple fronts,” Reinstein added.Although the public mental health system in Michigan reports being involved in a host of diversion activities, Reinstein questioned whether diversion is being carried out to the extent that the system generally claims it is. In 2002, the first year that CMH programs were asked to report to the state, the number of individuals diverted was only 71. He said the low number may be due to underreporting.Reid said that the mental health code and contract with each community mental health services require jail-diversion services to be available and that there are at least 47 programs serving Michigan’s 83 counties.Neither Reid nor Reinstein believe that mental health courts are stigmatizing as some have contended or come too late in the process of helping mentally ill lawbreakers. They feel it is far more stigmatizing and dangerous for someone who has committed a minor offense due to lack of or inadequate treatment to wind up incarcerated. ▪ ISSUES NewArchived

ABSTRACT: Lithofacies Description and Reservoir Characterization of a Niagaran Pinnacle Reef, Macomb County, Michigan

ABSTRACT: Lithofacies Description and Reservoir Characterization of a Niagaran Pinnacle Reef, Macomb County, Michigan

A 3D Seismic Investigation of the Ray Gas Storage Reef in Macomb County, Michigan: ABSTRACT

A 3D Seismic Investigation of the Ray Gas Storage Reef in Macomb County, Michigan: ABSTRACT

A 3-D Seismic Investigation of the Ray Gas Storage Reef, Macomb County, Michigan: ABSTRACT

A 3-D Seismic Investigation of the Ray Gas Storage Reef, Macomb County, Michigan: ABSTRACT

The Enemy is Us

On February 21st of this year the Detroit Free Press carried an article about an act that “appalled” some people in southeastern Michigan. The story claimed that citizens and politicians were “ready to throw the book at Macomb County library officials for pitching 20,000 volumes” from their collections in Mount Clemens. As a result of this action, some public officials suggested that “the county cut in half the library's $500,000 for new books.”

Utilization of microcomputer and telecommunications technologies in the development of a local environmental management and risk assessment program

An environmental management and risk assessment program (EMRAP) was designed and implemented by the Macomb County Health Department in 1985 to address health problems associated with hazardous materials exposures. The establishment of a toxicological resource center provides a focal point for the rapid assembly, assessment and dissemination of toxicological and biomedical information. The program utilizes a microcomputer with toxicological/biomedical software as well as a telecommunication linkage to public and private databases. The need for first responder agencies, e.g., fire and police, to effectively manage toxic materials incidents prompted a proposed design modification of the existing EMRAP computer/telecommunication system. The result will be 24-h, 7-d accessibility to biomedical/risk analytical databases by a remote telecommunication information system.

UTILIZATION OF MICROCOMPUTER AND TELECOMMUNICATIONS TECHNOLOGIES IN THE DEVELOPMENT OF A LOCAL ENVIRONMENTAL MANAGEMENT AND RISK ASSESSMENT PROGRAM

An environmental management and risk assessment program (EMRAP) was designed and implemented by the Macomb County Health Department in 1985 to address health problems associated with hazardous materials exposures. The establishment of a toxicological resource center provides a focal point for the rapid assembly, assessment and dissemination of toxicological and biomedical information. The program utilizes a microcomputer with toxicological/biomedical software as well as a telecommunication linkage to public and private databases. The need for first responder agencies, e.g., fire and police, to effectively manage toxic materials incidents prompted a proposed design modification of the existing EMRAP computer/telecommunication system. The result will be 24-h, 7-d accessibility to biomedical/risk analytical databases by a remote telecommunication information system.

Norwalk virus enteric illness acquired by swimming exposure.

In an epidemic of gastrointestinal illness strongly associated with swimming at a recreational park in Macomb County, Michigan, in July, 1979, the authors demonstrated the value of serologic testing to detect Norwalk virus infection. Rises in antibody titer to Norwalk virus were noted in all 11 individuals tested. Electron microscopy on stools from 20 ill individuals revealed only one with Norwalk virus-like particles. This particle was shown by radioimmunoassay and immune electron microscopy not to be Norwalk virus and not to have stimulated detectable antibodies in this individual. These results not only indicate that electron microscopy is insensitive in detecting Norwalk virus, but that it has the potential to mislead. A low rate of respiratory symptoms was associated with gastrointestinal illness in this Norwalk virus outbreak. The route of exposure might have been important for this. The outbreak was also noteworthy in that, although there was evidence of familial clusters of resistance, a very high percentage of the population was proved to be susceptible to the Norwalk virus.

Norwalk gastrointestinal illness: an outbreak associated with swimming in a recreational lake and secondary person-to-person transmission.

An outbreak of gastrointestinal illness in which headache, low grade fever and myalgia were common symptoms occurred among persons who visited a recreational park in Macomb County, Michigan, on July 13-16, 1979. The temporal clustering of onsets of 121 persons who were the first in their households to become ill suggested an incubation period ranging from 4-77 hours. A history of swimming in the park's lake was elicited with significantly greater frequency from these persons than from park visitors who were not ill (age standardized odds ratio = 4.8; 95% confidence interval, 1.8-12.7). One hundred twenty-six park visitors who became ill were household contacts of index patients who had swum in the lake; at least 62 of these 126 cases were probably due to secondary transmission. A secondary attack rate of 19% was observed in household contacts who had not visited the park. Serologic studies identified Norwalk virus as the etiologic agent. The source of the contamination of the lake could not be determined. Although some water samples collected just before and after the epidemic period had high coliform counts, the geometric mean coliform density of all samples collected on those days was within the limits established by the Environmental Protection Agency as acceptable for recreational contact water.