Pinellas County Research Articles

Overdose deaths before and during the COVID-19 pandemic in a US county.

Globally, overdose deaths increased near the beginning of the COVID-19 pandemic, which created availability and access barriers to addiction and social services. Especially in times of a crisis like a pandemic, local exposures, service availability and access, and system responses have major influence on people who use drugs. For policy makers to be effective, an understanding at the local level is needed. This retrospective epidemiologic study from 2019 through 2021 compares immediate and 20-months changes in overdose deaths from the pandemic start to 16 months before its arrival in Pinellas County, FL We examine toxicologic death records of 1,701 overdoses to identify relations with interdiction, and service delivery. There was an immediate 49% increase (95% CI 23-82%, p < 0.0001) in overdose deaths in the first month following the first COVID deaths. Immediate increases were found for deaths involving alcohol (171%), heroin (108%), fentanyl (78%), amphetamines (55%), and cocaine (45%). Overdose deaths remained 27% higher (CI 4-55%, p = 0.015) than before the pandemic through 2021.Abrupt service reductions occurred when the pandemic began: in-clinic methadone treatment dropped by two-thirds, counseling by 38%, opioid seizures by 29%, and drug arrests by 56%. Emergency transport for overdose and naloxone distributions increased at the pandemic onset (12%, 93%, respectively) and remained higher through 2021 (15%, 377%,). Regression results indicate that lower drug seizures predicted higher overdoses, and increased 911 transports predicted higher overdoses. The proportion of excess overdose deaths to excess non-COVID deaths after the pandemic relative to the year before was 0.28 in Pinellas County, larger than 75% of other US counties. Service and interdiction interruptions likely contributed to overdose death increases during the pandemic. Relaxing restrictions on medical treatment for opioid addiction and public health interventions could have immediate and long-lasting effects when a major disruption, such as a pandemic, occurs. County level data dashboards comprised of overdose toxicology, and interdiction and service data, can help explain changes in overdose deaths. As a next step in predicting which policies and practices will best reduce local overdoses, we propose using simulation modeling with agent-based models to examine complex interacting systems.

Application of UAV Structure-From-Motion Photogrammetry to a Nourished Beach for Assessment of Storm Surge Impacts, Pinellas County, Florida

Application of UAV Structure-From-Motion Photogrammetry to a Nourished Beach for Assessment of Storm Surge Impacts, Pinellas County, Florida

Cross-Sectional Food Environment Observations Conducted for Small Supplemental Nutrition Assistance Program Authorized Retailers in Pinellas County, Florida, Suggest Limited Availability and High Cost of Some Healthful Food Items

ABSTRACT We assessed store-level food availability, quality, variety, depth of stock, and cost at small Supplemental Nutrition Assistance Program (SNAP)-authorized retailers and compared stocking patterns to proposed United States Department of Agriculture criteria. Food environment observations were conducted at 82 retailers from June to December 2019 in Pinellas County, Florida, and descriptively analyzed. Less than one-third of retailers stocked frozen fruit, fresh or frozen vegetables, tortillas, whole-wheat bread, low-fat milk, fresh or frozen meat, fish or meat alternatives, dried beans, or healthier frozen meals. Twenty-two and 26% had at least seven SNAP-eligible varieties of fruits and vegetables and protein products, respectively.

Association Between Co-Occurring Anxiety and Depression With Drug Overdose Encounters in the Emergency Department Among Adolescents and Young Adults in the Era of COVID-19

PurposeCOVID-19 risk mitigation efforts could have negatively impacted anxiety, depression, and substance use among adolescents and young adults. MethodsWe analyzed 45,223 emergency department visits from April 2018 to March 2022 of patients aged 12–21 in Pinellas County, Florida. ResultsFrequency of overdose, anxiety, and depression significantly increased from the pre-COVID-19 to the COVID-19 period. Anxiety (adjusted odds ratio: 1.49, 95% confidence interval: 1.11, 1.98) and depression (adjusted odds ratio: 2.89, 95% confidence interval: 2.15, 3.88) were associated with significantly higher odds of overdose during COVID-19. DiscussionMental health and overdose among adolescents and young adults worsened during COVID-19, necessitating greater screening and treatment in primary care.

‘If I get Corona, I get Corona’: COVID-19 protocols and beach tourism in Pinellas County, Florida

ABSTRACT When COVID-19 emerged in January of 2020, few anticipated the duration and global reach of this disaster event. This paper reports on the ethnographic findings of Rob Porter who found himself ‘locked down’ in Pinellas County, Florida at the beginning of the pandemic. Using ethnographic research methods including participant observation, interviews, and photography this essay reports on the changing nature of the tourism industry; supply chain challenges and substitutions; public health mandates; and political messaging. All of these variables significantly influenced the health and sustainability of the tourism industry in Pinellas County. Finally, we explore the need for adaptation in the industry so that it can weather future disaster events.

A Qualitative Evaluation of an Adapted Assertive Community Treatment Program: Perspectives During COVID-19.

The Pinellas County Empowerment Team (PCET) was an adapted assertive community treatment (ACT) program created to meet the needs of Pinellas County residents with serious behavioral health concerns and high frequency of hospitalization (medical and psychiatric) and incarceration. Recent research demonstrates that individuals participating in ACT programs can transition to lower-intensity services. To understand the needs and barriers in transitioning PCET clients to lower-intensity services and the unique experiences during the coronavirus (COVID-19) pandemic, the researchers conducted a qualitative evaluation which includes a case record review and in-depth interviews with clients of PCET and staff members. Our findings indicated several barriers to transitioning PCET clients, including a lack of sufficient behavioral health support outside the ACT program and some clients' concerns regarding their abilities once out of the program.

Utility of machine learning for segmenting camera trap time‐lapse recordings

AbstractCamera trap time‐lapse recordings can collect vast amounts of data on wildlife in their natural settings. Transforming these data into information useful to ecologists is a major challenge. Machine learning techniques show promise for becoming important tools in the cost‐effective analysis of camera trap data, but only if they become readily available to researchers without requiring advanced computing skills and resources. We present a new suite of software tools that reduce the amount of human effort needed to segment time‐lapse, camera trap recordings in preparation for analysis. The tools incorporate a convolutional neural network trained to detect a focal species and to generate a draft video segmentation indicating the ranges of time when the focal species is present. We evaluated the utility of our neural network by comparing manual and automatic segmentations of 64 time‐lapse recordings of gopher tortoise (Gopherus polyphemus) burrows, recorded in Pinellas County, Florida, USA between 25 November 2020 and 30 November 2020. The neural network correctly found 130 of the 145 segments containing tortoises (89.7%), whereas student graders found 135 segments (93.1%). A year of experience using the new software suite in an ongoing study of gopher tortoises deploying 12 camera traps indicates one person, assisted by machine learning algorithms, can segment a week's worth of time‐lapse recordings—11.5 hours of standard‐speed video—in under 3 hours. We concluded that the use of machine learning algorithms is practical and allows researchers to process large volumes of time‐lapse data with minimal human effort.

Modeling and Simulating Adaptation Strategies Against Sea-Level Rise Using Multiagent Deep Reinforcement Learning

Sea-level rise (SLR) problem, which is a major outcome of climate change, has been well documented and studied. Although it is globally observed due to climate change, local projections are needed to plan SLR adaptation strategies accurately. Since SLR is a community-wide multistakeholder problem at the local level, adaptation strategies can be more successful if the main stakeholders, e.g., government, residents, and businesses, collaborate in shaping them. Simulating the local socioeconomic system around SLR, including the interactions between essential stakeholders and nature, can be an effective way of evaluating different adaptation strategies and planning the best strategy for the local community. This work presents how such an SLR socioeconomic system can be modeled as a Markov decision process (MDP) and simulated using multiagent reinforcement learning (RL). The proposed multiagent RL framework serves two purposes. It provides a general scenario planning tool to investigate the cost–benefit analysis of natural events (e.g., flooding and hurricane) and agents’ investments (e.g., infrastructure improvement). It also shows how much the total cost due to SLR can be reduced over time by optimizing the adaptation strategies. We demonstrate the proposed scenario planning tool using available economic data and sea-level projections for Pinellas County, Florida, in a case study.

On the Geographic Balance of Risk and Amenity: Changes in Evacuation Zones and Their Ripples in Housing Prices in Pinellas County, FL

This study considers the balance of amenities and coastal hazards on housing prices between 2000 and 2015. We test whether risk communication via hurricane evacuation zone (a proxy for storm-surge risk and coastal flooding) affects sales price while controlling for relevant property characteristics, beach frontage, flood zones, and proximity to the coast. Additionally, we employ a difference-in-difference technique to test whether two highly publicized updates to evacuation zone maps, which changed the status of many homes in the county, led to price penalties for homes. We focus our study on areas of the new evacuation zone maps that reclassified parcels into zones associated with higher coastal surge exposure. This approach allows us to isolate the effects of risk communication about a property independent of changes to its insurance premiums or actual hazard exposure. We find that amenities are associated with significant bonuses and hazard variables correlated with price penalties, and homes in areas reclassified “up” in hazard zone classification have lost value. Our findings shed light on how information changes about hazards may affect coastal real estate markets as concerns about coastal hazards and exposure to storm-related surges increase along with climate change.

Locating Neighborhood Displacement Risks to Climate Gentrification Pressures in Three Coastal Counties in Florida

Residential displacement as a result of climate change impacts will manifest on varied temporal and spatial scales affecting both coastal and inland communities. As coastal residents contend with more frequent shocks and stress from sea-level rise, many will eventually need to abandon their homes and property. Inland communities consisting of socioeconomically vulnerable populations with less exposure to climate change impacts will presumably be at risk for residential displacement. This study uses three counties in Florida—Duval, Pinellas, and Miami-Dade—as cases, and employs publicly available data. The well-known principal components analysis generated representative components of housing, socioeconomic, and demographic characteristics known to predispose neighborhoods to the risk of secondary residential displacement. An additive model fit to the individual principal components analysis retained six components for Duval and Miami-Dade counties and seven for Pinellas county. The subsequent displacement risk categorization captures interrelationships between neighborhood socioeconomic and biophysical risk and allows for the identification of areas with higher secondary displacement risks. High potential second-order displacement was found in 30 percent, 25 percent, and 20 percent of the block groups in Duval, Miami-Dade, and Pinellas counties, respectively. This article serves as a framework to operationalize factors that predispose a neighborhood to climate gentrification driven by sea-level rise.

Opioid-Related Overdose Fatality Cases in Two Florida Counties.

Introduction:This study evaluates trends in drug-related death cases within both Pasco and Pinellas County, Florida, from the calendar years 2011 to 2016. Specifically, it focuses on opioids and the role of fentanyl in overdose-related mortality in rural versus suburban populations.Methods:Two sets of data from each calendar year were obtained from a Medical Examiner's Office. These data were compared by year to assess differences using the nonparametric ANOVA test with the statistical software SAS, University Edition. Binary logistic regression was performed to assess which drugs occurred most frequently in the presence or absence of fentanyl.Results:There was not a significant difference in the month of the year or the day of the week that drug-related fatalities occurred. More drug-related mortalities occurred during daylight hours (e.g., 8:00 AM–4:00 PM) and more fentanyl-related mortalities occurred in Pinellas County compared to Pasco County. Fentanyl and heroin tended to co-occur in mortalities, while ethanol, hydrocodone, morphine, oxycodone, and methadone were negatively associated with fentanyl-related overdose cases.Conclusion:The characteristics of drug-related mortalities identified here may be used to better target interventions against drug abuse and overdose.

70. Adolescent Access to HIV Testing and PreP in Leon County (Tallahassee, Florida): Challenges and Opportunities

The first phase of Florida’s Unified Ending the Epidemic Plan initiative focuses on areas where the HIV burden is highest including: Broward, Duval, Hillsborough, Miami-Dade, Orange, Palm Beach and Pinellas counties. Individuals ages 13-24 make up 16.3% of new HIV infections in Florida and ∼25% of Leon County residents are ages 13-24, higher than their proportion in Florida or the U.S. overall. Florida law recommends HIV testing beginning at age 13 and allows adolescent testing without parental consent.

Rapid adaptation during the COVID crisis: Challenges experienced in delivering service to those with Opioid Use Disorders.

Adaptation is an accepted part of implementing evidence-based practices. COVID-19 presented a unique opportunity to examine adaptation in evolving contexts. Delivering service to people with opioid use disorder during the pandemic required significant adaptation due to revised regulations and limited service access. This report evaluated changes to addiction medication services caused by the pandemic, challenges encountered in rapidly adapting service delivery, and initial impressions of which changes might be sustainable over time. Qualitatively-evaluated structured interviews (N = 20) were conducted in late 2020 with key informants in Pinellas County (FL) to assess the pandemic's impact. Interviewees represented a cross-section of the professional groups including direct SUD/HIV service providers, and sheriff's office, Department of Health, and regional clinical program administrative staff. The interview questions examined significant changes necessitated by the pandemic, challenges encountered in adapting to this evolving context, and considerations for sustained change. The most significant changes to service delivery identified were rapid adaptation to a telehealth format, and modifying service consistent with SAMHSA guidance, to allow for 'take-home' doses of methadone. Limitations imposed by access to technology, and the retraining of staff and patients to give and receive service differently were the most common themes identified as challenging adaptation efforts. Respondents saw shifts towards telehealth as most likely to being sustained. COVID-19 provided an unprecedented opportunity to examine adaptation in a fast-paced, dynamic, and evolving context. Adaptations identified will only be sustained through multisystem collaboration and validation. Results suggest that additional components could be added to implementation frameworks to assess rapid adaptation during unplanned events, such as access to additional resources or local decision-making that impacts service delivery. Findings will also be integrated with quantitative data to help inform local policy decisions. Adaptation is an accepted part of implementing evidencebased practices. COVID-19 presented a unique opportunity to examine rapid adaptation necessitated within evolving contexts. Delivering services to people with opioid use disorder required significant adaptation due to changing regulations and limited access to lifesaving services. This study examined changes in service delivery due to the pandemic, challenges encountered in rapid adaptation, and initial impressions of which changes might be sustainable over time. Qualitatively-evaluated structured interviews were conducted with a cross-section of professional groups (direct substance use disorder (SUD) and human immunodeficiency virus (HIV) service providers, and sheriff's office, Department of Health, and clinical program administrative staff) in Pinellas County (FL). The most significant changes to service delivery were rapid adaptation to a telehealth format and increased allowance for 'takehome' doses of methadone medication. Limitations imposed by access to technology, as well as the education of and staff and patients were the most common themes identified as challenges. Respondents saw shifts towards telehealth as most likely to be sustained. COVID-19 provided an unprecedented opportunity to examine adaptation in a fast-paced, dynamic, and evolving context. Adaptations will only be sustained through multisystem collaboration and validation. Findings suggest that additional components could be added to implementation frameworks to assess rapid adaptation during unplanned events, such as access to additional resources or local decision-making that impacts service delivery.

Predictors of Osprey Nest Success in a Highly Urbanized Environment

ABSTRACT Ospreys (Pandion haliaetus) are adaptable fish-eating raptors that readily nest on artificial structures in heavily human-dominated areas. Although the Osprey is a well-studied species, few researchers have investigated the factors that influence nest success and productivity in an urban environment. We monitored Osprey nests from 2013 to 2017 in highly urbanized Pinellas County, located on the west coast of central Florida, USA. We used logistic exposure models to assess the effects of timing of nesting, nest attributes (nest substrate, height), and landscape-level variables (inter-nest distance, distance to water, and surrounding habitat type) on daily survival rate (DSR) of Osprey nests. The number of active nests (i.e., nests with eggs) in the study area ranged from 53 in 2013 to 79 in 2016, with an overall total of 329 during the 5-yr study. Although most nests produced at least one young near fledging age, 131 of the nests failed. We attributed 45% of nest failures to storm events and 50% to unknown causes. The best logistic exposure model specification included only two variables: the discrete variable representing the date incubation started and the nominal variable indicating the year 2015. Osprey nests initiated earlier in the season were more likely to survive, and later nests (initiated after 22 April) averaged only one fledgling each. Osprey nests in 2015 had the highest DSR and relatively few failed due to storms. Our results supported previous research indicating that early nesters were more successful than late nesters. Our results also indicate that storms may play a role in nest success of Ospreys in Florida. Other variables, such as the amount of urbanized land surrounding Osprey nests did not appear to influence nest survival, indicating that Ospreys can be productive even in highly urban environments.

Another new exotic bark beetle in Florida: Ernoporus parvulus (Eggers, 1943) (Coleoptera: Curculionidae: Scolytinae), with additional taxonomic changes.

The bark beetle, Ernoporus parvulus (Eggers, 1943) was collected from Pinellas County, Florida, USA representing the first North American record of the genus. Two species previously described from the Caribbean were examined and are synonymous: Ernoporus minutus (Bright Torres, 2006) syn. nov. and E. exquisitus (Bright, 2019) syn. nov. This beetle is likely an overlooked exotic from Africa, known only from sea hibiscus, Talipariti tiliaceum (L.) Fryxell (Malvaceae). There is no evidence that this is a threat to commercial or ornamental Hibiscus and related species.

Factors controlling longshore variations of beach changes induced by Tropical Storm Eta (2020) along Pinellas County beaches, west-central Florida

Tropical Storm Eta impacted the coast of west-central Florida from 11 November to 12 November 2020 and generated high waves over elevated water levels for over 20 hours. A total of 148 beach and nearshore profiles, spaced about 300 m (984 ft) apart, were surveyed one to two weeks before and one to eight days after the storm to examine the beach changes along four barrier islands, including Sand Key, Treasure Island, Long Key, and Mullet Key. The high storm waves superimposed on elevated water level reached the toe of dunes or seawalls and caused dune erosion and overwash at various places. Throughout most of the coast, the dune, dry beach, and nearshore area was eroded and most of the sediment was deposited on the seaward slope of the nearshore bar, resulting in a roughly conserved sand volume above closure depth. The longshore variation of beach-profile volume loss demonstrates an overall southward decreasing trend, mainly due to a southward decreasing nearshore wave height as controlled by offshore bathymetry and shoreline configurations. The Storm Erosion Index (SEI) developed by Miller and Livermont (2008) captured the longshore variation of beach-profile volume loss reasonably well. The longshore variation of breaking wave height is the dominant factor controlling the longshore changes of SEI and beach erosion. Temporal variation of water level also played a significant role, while beach berm elevation was a minor factor. Although wider beaches tended to experience more volume loss from TS Eta due to the availability of sediment, they were effective in protecting the back beach and dune area from erosion. On the other hand, smaller profile-volume loss from narrow beach did not necessarily relate to less dune/ structure damage. The opposite is often true. Accurate evaluation of a storm’s severity in terms of erosion potential would benefit beach management especially under the circumstance of increasing storm activities due to climate change.

Beware of Superbugs in a Post-COVID World.

Beware of Superbugs in a Post-COVID World.

Toward a Multiplex Network Theory of Interlocal Service Contracting

AbstractDebates about risk in interlocal service contracts treat contracts as discrete dyadic exchanges. We challenge this notion by advancing a multiplex network contacting approach, which asserts that interlocal contracting represents a multiplex network phenomenon, defined as overlapping multiple service contract networks. Simultaneous treatment of multiple networks is required to understand how local governments mitigate contract risks. We claim that local governments create multiplex network structures comprising more than one service contract networks in order to reduce service contracting risks. Multivariate exponential random graph models were fit to joint high‐risk and low or mixed‐risk contract networks involving eight local government services in Pinellas County, Florida. The results demonstrate that local governments mitigate risk by creating multiplex reciprocity and multiplex network closure in contracts that involve multiple services.

Concentrations of para-Fluorofuranylfentanyl in Paired Central and Peripheral Blood Collected during Postmortem Death Investigations.

The opioid epidemic in the USA has been associated with an increasing mortality rate in large part due to the emergence and proliferation of synthetic opioids over the last 15 years. Fentanyl and its analogs have played a large part in these statistics due to their potency and toxicity. Fluorofuranylfentanyl (FFF) is a fentanyl analog that emerged in the USA in 2018 and was associated with numerous adverse events and deaths. During this study, a liquid chromatography tandem mass spectrometry workflow was developed to accurately identify the isomer of FFF present (ortho- vs. meta- vs. para-) in medicolegal death investigation cases from Pinellas County, Florida. FFF was quantified in central and peripheral blood samples collected at autopsy. In addition, the metabolism of FFF was studied using liquid chromatography quadrupole time-of-flight mass spectrometry. para-FFF was quantitatively confirmed in 29 postmortem cases; no other isomer of FFF was detected. Central blood concentrations ranged between 0.66 and 73 ng/mL (mean = 11 ± 14 ng/mL, median = 10 ng/mL) and peripheral blood concentrations ranged between 0.53 and 23 ng/mL (mean = 5.7 ± 6.4 ng/mL, median = 2.7 ng/mL). A comparison of central to peripheral blood concentrations was evaluated to determine the possibility of postmortem redistribution. The metabolism of ortho-FFF was studied and found to undergo metabolic processes similar to fentanyl, producing ortho-fluorofuranyl-norfentanyl, fluoro-4-anilino-N-phenethylpiperidine, and hydroxylated species. The results of this study demonstrate the toxicity of FFF and its implication in medicolegal death investigations. Laboratories must remain aware of new or re-emerging fentanyl analogs, as they pose significant risks to public health and public safety.

Travel-associated Measles in a Person Born Before 1957—Pinellas County, Florida, 2019

Travel-associated Measles in a Person Born Before 1957—Pinellas County, Florida, 2019