Monthly Archives: July 2017

MCAP newsletter

As the blossoms of spring give way to sprawling summer leaves, we too are beginning to soak up the sun, breath in the fresh air, and harness a renewed energy as we work to support Medfield youth! In keeping with the bustle of the spring season, March, April, and May were busy MCAP months! On March 16th during the Medfield High School Spring Athletics Night, MCAP member Sue Andersen-Navalta gave a short presentation on the impact of substance use on the teen brain and body. Parent attendees were presented with the opportunity to sign up to view the Hidden in Plain Sight exhibit in a “parent coffee” style format, with both morning and evening presenta-tions available. MCAP also had a resource table at MHS’ “The Other Talk” event, educating parents about protecting their teens against substance misuse as they prepare to enter college and at Dr. Ruth Potee’s talk about the impact of substance use on the developing teen brain. As you may know, Massachusetts communities are facing a growing opioid epidemic. In this issue, our education series focuses on providing you with relevant information so that you can be informed about opioids and addiction prevention. Wishing you health and happiness! Warmly, MCAP Coalition Members MCAP Newsletter: Welcome Medfield Cares About Prevention (MCAP) Stay in touch! Website: https://www.medfieldcares.org Email: info@medfieldcares.org Medfield Cares About Prevention (MCAP) Working together to promote mental health and prevent alcohol, marijuana, and other drug use amongst our youth Spring 2017 Volume 2, Issue 1 “…Bringing people together to ensure community programs work!” Inside This Issue: Opioids 2 Hidden in Plain Sight: Parent Coffees 4 MYTT Summit 5 Recent Events 6 Teen Corner 6 Next Issue 6 Member Spotlight: Sue Andersen-Navalta 7 Page 2 Medfield Cares About Prevention Opioids By Annette Anderson, Pharmacist CVS — MCAP Team Member* Talk to your kids! They are listening! The opioid drug epidemic has been highly reported in the news and is impacting our communities and families. Prescription opioids are commonly known by the names oxycodone, hydrocodone, morphine, hydromorphone, and fentanyl and are sometimes prescribed to mitigate pain after a surgery for an injury, wisdom teeth removal, or other medical procedure. Opioids are essentially synthetic forms of the street drug heroin and interact with receptors in the central nervous system to bring about a blockage of pain sensations from the body. Opioids also cause feelings of a “high”, a feeling of intense pleasure brought about by a release of certain neurotransmitters in the central nervous system. After a period of only 72 hours/3 days, the body develops a dependence upon opioids. The body changes in such a way that it regards the opioids as necessary for its wellbeing, much as it regards glucose and oxygen as vital for survival. After 3 days of exposure to an opioid, sudden removal of this medication will cause symptoms of nausea, irritability, insomnia and emotional outbursts. Dependence begins to develop for every person after 3 days of exposure because our biology is all the same. Addiction develops when the pleasure experienced from opioid use outweighs the risk of the negative symptoms of withdrawal and the opioid is taken beyond the initial legitimate medical need (It is estimated that 85% of people who become addicted were first exposed to opioids for a legitimate medical need.) Additionally, the body learns how to more efficiently metabolize the opioid with continued exposure. Over time, this increased efficiency in metabolism causes the patient to require higher doses of that opioid to create the same pleasurable feeling, the “high”. If the patient runs out of his or her prescribed opioid medication, there is a risk that the person will turn to heroin to avoid withdrawal symptoms and to achieve the same pleasurable effects of the opioids. Heroin is widely available, low in cost, and bypasses the opioid prescriber who may question the continued use. *Annette is a pharmacist who works at the Medfield CVS. She routinely educates parents, youth and senior citizens about the safe use of prescription medication and is providing vital information to consider as a patient Volume 2, Issue 1 Page 3 While opioid medication may be the appropriate drug for some conditions there are important guidelines to consider as a patient or caregiver and to discuss with your medical practitioner. Pain treatment guidelines:  Any continued, or chronic, source of pain needs to be diagnosed by a health care professional. A proper diagnosis will guide the medical practitioner as to what method of treatment is most appropriate for the patient.  Explore other treatment options with your medical practitioner. Some pharmaceutical pain treatment options besides opioids are non-steroidal anti-inflammatories, such as ibuprofen, naproxen and aspirin. Also, acetaminophen, prescription steroids and muscle relaxants may be used. There are also many non-pharmaceutical pain relief options such as heat or cold therapy, physical therapy, alternative medicine and surgical interventions. When the use of an opioid is warranted:  Know that the risk of dependence rises as the length of opioid therapy increases and the dosage increases.  Minimize opioid drug use to the shortest interval possible (to minimize the risk of dependence).  If it is necessary to take the opioid for longer than 3 days, the patient should be aware there will be withdrawal symptoms. These symptoms can be minimized by working with the practitioner to slowly discontinue the opioid and, possibly, receive short term pharmaceutical support to mitigate withdrawal symptoms.  Once the medical need for the pain relief provided by the opioid is done, safely removing any remaining medication from the household will prevent the temptation to continue taking the medication. This will also ensure that the opioid medication does not get into the hands of someone without a prescription.  Medications can be returned to many local police stations in the take-back drug collection bin for safe disposal.  If after slow elimination of the medication, there is still a desire to use the opioid despite there not being a medical need, the patient or caretaker should contact the medical provider immediately to be evaluated for opioid addiction. Drug Take Back at the Public Safety Building Volume 2, Issue 1 Page 4 By Dawn Alcott, LICSW — Director of Medfield Youth Outreach and MCAP Leadership Team Member MCAP desires to provide opportunities that support parents and increase their knowledge about protective and risk factors to reduce substance misuse in Medfield youth. Hidden in Plain Sight (HIPS) is an ages 21+ exhibit that seeks to build communication between parents and youth. The HIPS exhibit features information about the impact of substance misuse in teens’ lives alongside a staged room where various items may indicate teen substance misuse. Items in the room range from devices used to conceal drugs and alcohol, to subtle suggestions that indicate changes in a teen’s preference in friends, media, and apparel that may indicate substance use. Participants are encouraged to explore each item for themselves. The display is not meant to be scary. It is not meant to have the participant assume that they would find all of the items in a teen’s room, but rather open conversations that lead to deeper dialogues with teens. The exhibit has helps parents recognize the signs of possible substance use so they can act if necessary. The HIPS exhibit is supplemented with educational materials that act as a reminder that teens are going through a process of significant brain development that continues well into their 20’s. Adolescence is a time where the brain is particularly vulnerable to injury or disruption. Substanc-es used during these years can adversely affect brain development. The part of the brain responsible for higher order thinking, impulse control, and anticipating consequences is the last part of the brain to develop. Teens need their parents to set and continually communicate clear and consistent rules and expectations around substance use. Because of the overwhelming success of the HIPS exhibit on Medfield Day, Hidden in Plain Sight will be featured again in connection with various educational opportunities for parents. Hidden in Plain Sight is a “staged room” It is NOT intended to SCARE you or make you assume that you would find all of these items within one teens room. The intention IS to PROVIDE you with knowledge and support you in parenting a connected family. Hidden in Plain Sight: A “Staged Room” Hidden in Plain Sight: A Program the Community is Talking About! Page 5 Medfield Cares About Prevention MetroWest Youth Teaming Together (MYTT) Summit Four Medfield High School students leaders were selected to represent our community at the MetroWest Youth Teaming Together Summit on Monday, April 24th. This day-long event brought youth from across MetroWest to learn from innovators in prevention and develop their own plans for a regional prevention effort for youth by youth. Presenters at the summit included:  Representative Carolyn Dykema: Massachusetts House of Representatives, 8th Middlesex District  Representative Brian Murray: Massachusetts House of Representatives, 10th Worcester District  Ty Sells: Director of Training for Youth to Youth International in Columbus, Ohio  Matt Ganem: Northeast Regional Coordinator of Banyan Treatment Center, host of Banyan Recovery Radio, poet, and author of “The Shadow of an Addict”  Dover Youth 2 Youth: Comprehensive youth empowerment program in New Hampshire where students organize and participate as part of the solution to the drug and violence problem in our communities At the end of the day, students presented their ideas for prevention initiatives to all attendees, including a panel of prevention specialists from across the region. The ideas will be voted on and a grant will be written for the chosen plan to be implemented in MetroWest. It was an invigorating day and we are proud of our Medfield student leaders for their active participation and innovative solutions in addressing the issue of youth substance use. Medfield Cares About Prevention You can bring the HIPS exhibit to a group of your choosing (church or civic group) or plan a parent gathering with a small group of guests. You provide the participants and we will provide the exhibit! Please contact Dawn or Chelsea at medfieldyouthoutreach@medfield.net or by calling (508) 359-7121 to convey your interest and schedule a gathering (hosted in our office) or at your organization. Volume 2, Issue 1 Page 6 MetroWest Youth Teaming Together (MYTT) Summit Monday, April 24th, 8:30am—3:30pm Crystal Room in Milford, MA The purpose of the Summit was to bring together high school students from across MetroWest to provide education around substance abuse prevention and to provide an opportunity for them to engage with one another in generating youth-driven regional solutions. Dr. Ruth Potee Tuesday, May 2nd, 7:00 pm—8:30 pm Medfield High School Gymnasium Dr. Potee’s expertise in adolescent brain development and its impact on teenage risk-taking, including alcohol and substance abuse, has been featured nationally. She blends scientific research with an understanding of the challenges of raising healthy teens. Parents and other interested members of the community attended to learn what they can do to keep their tweens and teens safer, healthier and substance-free through middle and high school years. If you missed this important presentation, you can watch a similar presentation online that she made in Northampton last year: http://bit.ly/2qSfqwj. Dr. Potee will also be returning to Medfield this fall for a day-long presentation to high school students. Are there any questions you would like answered? Do you have ideas that you want to share regarding prevention efforts in the community? We would love to hear from you! Contact us at info@medfieldcares.org to share your thoughts and questions! Be sure and check out our website for lots of great resources! http://medfieldcares.org/wp/?qards_page=resources-for-teens Recent Events We are in the process of identifying the focus of our next MCAP newsletter and would love your feedback! Do you have a question you might want answered in the upcoming issue? Please feel free to submit any questions, specific area(s) of interest or feedback to us at the following: info@medfieldcares.org MCAP invites parents, youth and professionals to get involved with the coalition. We need parents whose children represent all grade levels and interested youth to join us. Contact us to learn more! We look forward to hearing from you! Next Issue Your feedback will help craft our coalition’s strategic plan for keeping Medfield youth safe! Teen Corner Sue Navalta is the happily married mother of two girls, 16 and 20 year of age, and has lived in Medfield for 20 years. Sue has her Ph.D. from Binghamton University in Psychology/Neuroscience. She then did her post-doctoral fellowship at McLean Hospital/Harvard Medi-cal School, where she has built her career for the last 23 years. Sue has studied the development of the brain’s reward and emotion systems during her ca-reer, with a special emphasis on the transitions between childhood, adolescence, and young adulthood. It is during these transitions that mental illness and drug abuse are likely to ap-pear for the first time, but may also be prevented. Her mission is to determine how the brain develops typically, when things go wrong (such as following child abuse or drug expo-sure), and how to either prevent or intervene when things go wrong. Sue is an executive board member of the National Prevention Science Coalition and gives talks and workshops on adolescent brain development, substance abuse, and child abuse locally, nationally, and internationally. Sue receives federal funding for her research from the National Institutes of Drug Abuse and of Mental Health, as well as a number of founda-tions including the Brain and Behavior Research Foundation and the Tourette’s Syndrome Association. She currently is an Associate Professor of Psychiatry at Harvard Medical School. Within the Town of Medfield, Sue has participated on the leadership team for Medfield Cares About Prevention (MCAP) and has been an MCAP member for 7 years. She also was an active participant in Girl Scouts and is currently a coach of a high school aged community team for Destination Imagination, which she has enjoyed for the past 12 years. Sue Andersen-Navalta Medfield Cares About Prevention Coalition Member Spotlight: Sue Andersen-Navalta Stay in touch! Website: https://www.medfieldcares.org Email: info@medfieldcares.org MCAP, 2016 MCAP is comprised of people who care about youth in Medfield. Whether they live or work here in town, their commitment is to grow a culture of safety and health for the community’s youth. MCAP’s primary focus is on the prevention of sub-stance misuse and the promotion of mental and emotional health. Members represent parents, youth, the public schools, law enforcement, mental health organizations, local businesses, parks & recreation, town government, substance abuse research, local media, healthcare, and faith communities. About MCAP20170726-MCAP Newsletter Spring 2017_Page_220170726-MCAP Newsletter Spring 2017_Page_320170726-MCAP Newsletter Spring 2017_Page_420170726-MCAP Newsletter Spring 2017_Page_520170726-MCAP Newsletter Spring 2017_Page_620170726-MCAP Newsletter Spring 2017_Page_7

Instructional videos to assist veterans

Videos to assist veterans

MCLE_logo MCLE joins Veterans Legal Services in educational initiative–series of training videos

Massachusetts Continuing Legal Education, Inc.and Veterans Legal Services are pleased to announce an online initiative to assist veterans and those in the legal profession and elsewhere who strive to serve veterans in their transition to civilian life. We recognize the difficulties combat veterans from the Vietnam, Iraq, and Afghanistan theaters often face upon return and that these difficulties often involve legal issues. Fortunately, in the Commonwealth, there are individuals and groups, private and public, who will “walk the walk” with veterans to assist them with legal problems that bear on employment, housing, education, finances, medical care, and criminal law.

To help educate and train those in the legal profession and others who seek to help veterans, we are making available a series of brief training videos addressing common issues experienced by military veterans returning to civilian life. Other videos will follow throughout the year. We hope that veterans and those who advocate for them find this series helpful and instructive.

If you are interested in assisting veterans or for more information, contact Veterans Legal Services at lynn@veteranslegalservices.org.

Watch NowThomas R. Capasso, Director, Probation Records Unit,
Office of the Massachusetts Commissioner of Probation

Sealing of Massachusetts Criminal Records »
Recorded Thursday, October 20, 2016 (18:21)

A primer on how to assist veterans in sealing, and in some cases unsealing, their criminal records, this training video addresses both court and administrative processes and references the following essential forms:
How to Seal Your Adult Convictions (G.L. c. 276, § 100A)
How to Seal Your Juvenile Record (G.L. c. 276, § 100B)
How to Seal Your Adult Non-Convictions (G.L. c. 276, § 100C)

Watch NowHon. Raymond G. Dougan (ret.)
Boston Municipal Court

Credit Card Debt »
Recorded Tuesday, January 11, 2017 (12:15)

Veterans returning from overseas duty are finding that they must cope with an increasingly cashless society where credit card debt can quickly become overwhelming. In this training video, Justice Dougan addresses veterans who may have defaulted on a credit card obligation and who need to know what events and procedural choices await them and what options and benefits they enjoy.

Watch NowT. Keith Fogg
Visiting Professor of Law at Harvard Law School, Director of the Federal Tax Clinic at Harvard Legal Services Center

The Tax Man Cometh and What To Do About It »
Recorded Monday, February 27, 2017 (9:41)

In this informative training video, Professor Fogg discusses where veterans with civil tax matters can get help. He describes the various phases of controversies with the IRS – from initial IRS examination to litigation in the U.S. Tax Court to the collection phase – and then explores the different options available to those who are not able to pay the full debt owed. He also discusses the consequences of failing to file tax returns and how veterans may be able to take advantage of the IRS’s Innocent Spouse Relief provisions to be relieved of joint-and-several liability for taxes in circumstances such as divorce.

Watch NowDonald R. Lassman, Esq.
Law Office of Donald R. Lassman, Needham

Bankruptcy Primer for Veterans and Their Advocates »
Recorded Wednesday, June 14, 2017 (10:47)

In this informative training video directed towards veterans, their advocates and attorneys, Attorney Lassman provides a basic primer on personal bankruptcy. Addressing five main questions of interest, he (1) summarizes the primary reasons individuals file for bankruptcy; (2) after identifying alternatives to bankruptcy, explains how federal bankruptcy protection can help provide individuals with a fresh start; (3) highlights the various warning signs that suggest bankruptcy may be imminent; (4) clearly and succinctly describes the bankruptcy process, the steps involved, and a typical timeline; and (5) concludes with suggestions on how and where veterans can get help.

Junior-B meeting

John Kelly, his architect and 40B consultant held a meeting for neighbors last night at the Legion, attended by about 100. The current iteration of the proposed development is in fact two separate 40B’s, a 25 unit townhouse ownership one on the cemetery side of Rte. 27, and a 75 unit rental 40B on the DPW side, with 25 units in townhouses and 50 units in what they are calling a midrise, but what Mr. Kelly slipped once to call a highrise – a 5 story, I think, apartment building. To qualify as a 40B, so as to gain the greater density than zoning allows, the ownership 40B will have 5 affordable units.

I think the plans are available at the town website.

Suburban Coalition calls it quits

This email today from the now defunct Suburban Coalition.  Too bad, as I found their meetings really interesting and informative (to say nothing of convenient, as they were often held at the Newton Marriott).  The Town of Medfield was a member for a number of years.  Former Senator Timilty always used to say the real divide at the legislature was city reps versus towns reps, not so much Republican versus Democrat.

===========================================

At our last business meeting, on July 10, 2017, a vote was taken to dissolve the Suburban Coalition. This action took place after several years of efforts to sustain our work with a very small number of active volunteers. While we believe our mission is as important and relevant as ever, we simply no longer have the capacity to carry out the mission in a meaningful way.

 

The Suburban Coalition was founded in the 1980’s in response to Proposition 2 ½. The mission of the organization has been to ensure that smaller municipalities have a voice on Beacon Hill. We strove to ensure that every community had the funding, resources and support from the state to deliver the essential services of life safety, education and infrastructure maintenance to its citizens. We believe that thriving communities contribute to a strong commonwealth. During the past several decades, our efforts have made a difference. The Suburban Coalition was the first organization to advocate for the Senior Circuit Breaker, bringing property tax relief to seniors. More recently, we advocated for changes to Municipal Health Insurance and have been active in efforts to both establish the Foundation Budget Review Commission and to ensure that the recommendations of the FBRC are implemented.

 

Thanks go to many people and organizations for efforts and support over the years. Most of all, thank you to all who attended our meetings and took our message back to your boards and communities, and to your legislators. Without your input and participation, we would not have been as successful as we were. Please continue to advocate for your communities, your citizens and your students.

 

Thank you to the boards and committees who joined the Suburban Coalition. You made us stronger by adding your names to the list of those supporting our positions and efforts.

Thank you to the many legislators who welcomed us into your offices or came to our meetings and listened to our views. Listening to our views and sharing yours helped all of us move forward productively.

 

Thank you to the organizations who partnered with us over the years. Several organizations supported the efforts of the Suburban Coalition by providing data, sharing expertise, participating in our meetings and publicizing our meetings to their members.

 

The core workers of the Suburban Coalition has always been a relatively small group of dedicated, passionate volunteer advocates. Some have come and gone as circumstances in their lives dictated; others have stayed the course for a very long time. These people spent countless hours identifying and debating the issues, developing positions, meeting with legislators, planning events and trying to build a sustainable structure for the organization. To all those who have, at one time or another, been a key part of the Suburban Coalition, thank you so much for all your time, knowledge, passion, and willingness to stay the course as long as you did.

Advocating and participating in government is no less important today than it was in the 1980’s when the Suburban Coalition was founded. Our government, our democracy, works best when many voices are heard. Our Commonwealth is healthier and stronger when the resources are available for all communities and citizens to thrive. The core group of volunteers who have steered the Suburban Coalition over the years will continue to participate and advocate on behalf of their communities and fellow citizens. We trust that those of you who have followed and supported the organization will too.

 

Please feel free to contact me with any questions.

 

Sincerely,

Dorothy Presser

President

Lyme Disease on WBUR this week

From Chair Kaldy, Chair of the Lyme Disease Study Committee, and along with Frank Perry, the leader of the remarkably successful Town of Medfield deer culling program, which the state reportedly considers as a paradigm –

Great article on the issue of funding tick/lyme research.
Science Shortfall: Why Don't We Know How Best To Fight Ticks And Lyme Disease?

Science Shortfall: Why Don’t We Know How Best To Fight Ticks And Lyme Disease?

In this 2014 photo, an informational card about ticks distributed by the Maine Medical Center Research Institute is seen in the woods in Freeport, Maine. (Robert F. Bukaty/AP)closemore
In this 2014 photo, an informational card about ticks distributed by the Maine Medical Center Research Institute is seen in the woods in Freeport, Maine. (Robert F. Bukaty/AP)

Part of our Losing to Lyme series

Beneath the midsummer Martha’s Vineyard sun, the gentle wind breathes waves of motion into a flag-sized swath of white fabric laid out on a large rock. Suddenly, an eye-catching bit of motion: a black, eight-legged speck on the move. Tick scientist Sam Telford pounces. He snatches it with his tweezers and tucks it into a small plastic vial with a satisfying pop.

There, the deer tick, endemic carrier of Lyme disease and other infections, lands in a comfy habitat of green leaves Telford has prepared for it. “I need these ticks to stay alive,” he says.

Tufts scientist Sam Telford snatches a tick with his tweezers. (David Scales for WBUR)
Tufts scientist Sam Telford snatches a tick with his tweezers. (David Scales for WBUR)

Telford will gather dozens of them in the course of a Chilmark morning, as part of research that has brought him tick-hunting to Martha’s Vineyard so many times that he’s lost count. For 30 years, Telford, a professor and epidemiologist at Tufts University’s Cummings School of Veterinary Medicine, has been working to understand ticks and the diseases they spread to humans.

These years have brought some progress: We have widely accepted practices for personal tick-bite protection, from repellents to body checks. But the biggest and most important question remains unanswered: How do we stop the spread of Lyme?

“What have we done for Lyme disease?” Telford asks. “The incidence keeps increasing and increasing, the distribution keeps increasing and increasing.”

Good Science Is Hard To Do

Take, for example, deer control. One of Telford’s first projects, back in the 1980s, looked at what happened to tick numbers when the deer population on Great Island in south Cape Cod was reduced.

http://d3kwtionx0p7im.cloudfront.net/embeds/newsletter/article/commonhealth.html?initialWidth=348&childId=iframe-embed-2&parentTitle=Science%20Shortfall%3A%20Why%20Don%27t%20We%20Know%20How%20Best%20To%20Fight%20Ticks%20And%20Lyme%20Disease%3F%20%7C%20CommonHealth&parentUrl=http%3A%2F%2Fwww.wbur.org%2Fcommonhealth%2F2017%2F07%2F14%2Fscience-fighting-ticks-lyme

The $20,000-per-year study showed that cutting the number of deer worked to cut the number of ticks, which depend on sucking deer blood during their life cycle. But it lacked definitive proof that the drop in ticks also brought a drop in Lyme disease, because the modest funding did not cover a study big enough to draw a clear conclusion.

Deer studies like Telford’s illustrate a central problem with Lyme and tick-borne disease prevention: We don’t know the most effective recipe to reduce tick populations and prevent Lyme because the studies that would definitively answer questions like that have not been done. Should your town follow Telford’s advice and cull deer populations? Spray public spaces? Trim back trails? Do all of the above?

The problem is complex, too complex for a simple answer.

“For a very long time, people have been looking for that silver bullet or the magic answer to make Lyme disease go away,” says Catherine Brown, the state’s public health veterinarian. “We’ve known for a while now that’s just not going to happen.”

“For a very long time, people have been looking for that silver bullet or the magic answer to make Lyme disease go away. We’ve known for a while now that’s just not going to happen.”

Catherine Brown, the state’s public health veterinarian

Put another way, trying to fight Lyme is like “trying to solve a multivariate equation with 18 variables and only knowing two of them,” says Henry Lind, the co-chair of the Barnstable County Lyme/Tick-Borne Diseases Task Force.

Ideally, when scientists do a study, they control all important factors, then change just one or two and observe the impact. But in an environment as complex as what surrounds tick-borne diseases, many factors affect the ecosystem.

We know deer, white-footed mouse and chipmunk populations are important in the tick life cycle. We know if they have a lot of food one year, they have more babies. We know ticks like warm, humid areas like leafy underbrush, and thrive in warm, wet summers but their numbers dwindle in drought.

Then there’s what humans do — whether we wear personal protection, put on repellent, spray our lawns, treat our pets, check our bodies for ticks. And while we can control our own behavior, we can’t control the whole ecosystem, especially the weather and food supply for rodents.

Finally, we can’t just count the number of ticks at the end of a study because what we really care about is the number of human infections. Some studies show impressive reductions in the numbers of ticks, but don’t show much impact on the number of infections.

In the face of this complexity, scientists have to do high-quality studies to give more certainty to the results. But that means large studies that span years and large areas to be more sure the results aren’t just due to weather changes or other things outside our control. All of that costs a lot of money.

Take, for example, a recent high-quality study led by Alison Hinckley, a CDC scientist. The researchers sprayed yards once a year with tick-killing chemicals and looked for the effect on tick bites and infections.

It was a two-year, randomized, double-blind, placebo-controlled study. It’s tough to get higher quality than that. It looked at over 2,700 households in three states. And it went further than most studies by looking not just at the numbers of ticks but also the number of tick-borne infections.

All of this cost about $3 million, a huge sum in the world of entomology and ecology.

And it didn’t work. That is, tick numbers dropped by 63 percent but tick sightings and infections didn’t change. Maybe people got ticks from the areas of their yards that weren’t sprayed, like gardens. Or maybe they got infected while on hikes. And, since it was only a two-year study, maybe rainy spring weather made spraying less effective.

An editorial in the same journal, headlined in part “Still No Silver Bullet,” lamented: “Unfortunately, this study confirms that effective prevention of tick-borne disease remains arduous and will likely rely on multiple methods.”

But the study wasn’t a waste. It answered an important question and offers opportunities for digging deeper in the next study.

Richard Ostfeld, a senior scientist at the Cary Institute of Ecosystem Studies, wants to do that next-step research. He and his co-director, Felicia Keesing of Bard College, have been encouraged by a recent trend toward “integrated tick management” that includes multiple ways to reduce tick populations, then checking the impact on rates of Lyme disease.

Their randomized, double-blind, placebo-controlled study will look at the effect of two interventions: a sprayed fungus that kills ticks, and bait boxes that drop a tiny amount of tick poison on small mammals. Because ticks don’t respect property boundaries, the study examines whole neighborhoods instead of just treating single yards.

It will track four groups of neighborhoods:

  • Where yards are sprayed with the tick-killing fungus
  • Where bait boxes with the tick-poison are installed
  • Where both are done
  • “Control” neighborhoods that get placebos (water spray and/or bait boxes with no tick poison)

The researchers will then compare the tick encounters and infections of each group. The goal, as the study puts it, is to “answer once and for all whether we can prevent cases of tick-borne disease by treating the areas around people’s homes.”

Follow The (Lack Of) Money

Thus far, Ostfeld and Keesing’s five-year study, called the Tick Project, has raised only $5.5 million of the $8.8 million it needs — 90 percent of it from the Cohen Foundation, and the rest from various donors and state and federal sources.

Such high-quality studies do not come cheap. “Those studies are very difficult and expensive to do,” says Dr. Ben Beard, chief of the bacterial disease branch in the CDC’s Division of Vector-Borne Diseases. An additional challenge: Funding is often allocated for specific diseases, he says, but the problem is broader — tick-borne diseases in general.

From 2006 to 2010, about $370 million in federal research money went to tick-borne diseases, according to an Institute of Medicine report, with over half of it spent on tularemia, an uncommon disease but cause for concern because of its potential use in bioterrorism. Funding dropped off dramatically as concern about bioterrorism waned.

Most money spent on Lyme goes to basic biology research, relatively little to research trying to understand the best tick reduction and prevention strategies. Today, according to an analysis of the NIH grant database, almost two-thirds of 2016 research funds for Lyme disease went to study basic biology. Another third went to studies looking for better diagnostics. Research of the kind done by Ostfeld and Telford was less than 10 percent of the 2016 total: only about $1.2 million.

Even in a state like Massachusetts, where Lyme is so widespread, state funding for research is highly unlikely. “State government quite frankly doesn’t have the money to be funding medical research,” says Rep. David Linsky of Natick, who chaired a legislative commission on Lyme. “I’d like to see the federal government that is really the source of funding for extensive research put some more money into Lyme disease.”

And funding is always tight for ecologists who study ticks and the animals they crawl on. For example, Telford doesn’t have research funding that supports his tick-gathering trips to the Vineyard. Like virtually every scientist, he’s had grants denied, including his most recent proposal to try to bring back Lymerix, the Lyme disease vaccine that was pulled from the market in 2002.

The limited funding means the science on preventing ticks is filled with smaller studies, many without controls, with small sample sizes, small geographic areas, that don’t look at the impact on human infections.

The result is a plethora of studies with confusing results, like the deer studies: Some, like Telford’s, show deer reduction works. Others seem to show it doesn’t work as well. None of the studies have conclusively linked deer reduction to effects on human cases of Lyme disease.

Scientists simply just don’t have the funds to do enough high-quality studies. As Ostfeld says, “the obstacle is more financial, not intellectual.”

Falling Between The Funding Cracks

Research on preventing Lyme also falls between the cracks in scientific funding. The National Institutes of Health fund research on better diagnosis and treatment of human disease, so they are not likely to fund field ecology research, even for Lyme disease, Ostfeld says.

The National Science Foundation funds ecology research, but its budget is much smaller than the NIH budget. An $8 million study could be as much as 10 percent of their ecology budget in any given year. And they do not tend to focus on public health.

The CDC would be a logical funding source, but it does not have a large external research program in this area. CDC researchers are helping with Ostfeld’s study, he says, but there’s “no way in the world they could fund an $8 million, five-year project.”

“We always have a wish list of unfunded studies, but there are a lot of competing disease issues,” Dr. Beard of the CDC says. Some recently announced funding for “vector-borne diseases” may help.

To sum it all up: “With over 300,000 new cases each year, the scope of the problem definitely hasn’t been addressed by the scale of the funding,” says Dr. Tom Mather of the University of Rhode Island. “I’m not sure when and if we can change that — maybe when there are 500,000 new cases of Lyme every year. Or maybe when ticks fly.”

And things look likely to get worse before they get better. Dr. Beard said in a presentation last year that he sees a troubling trend of less money going into tick-borne disease and not enough scientists specializing in it. “It’s not the disease outbreak du jour that gets the attention of the media,” he says.

So, no magic bullet. Little money. No simple answer to a number of questions about what communities should do. But Telford of Tufts, perseveres — still pushing for deer reduction, among other anti-tick tactics, and still arguing that communities and neighborhoods need to join forces to address the problem together.

He keeps his lab afloat from a hodgepodge of sources — a small grant here, some funds from collaborations there — and with the help of his wife, Heidi Goethert, also a trained scientist, who works in the lab full-time but only gets paid half-time to stretch the money as far as possible.

In early June, he submitted another National Institutes of Health grant to study a Powassan-like tick-borne virus, but it will be months before he hears the results.

“I remain hopeful,” Telford says. “I remain also very guarded in my optimism.”

David Scales MD, Ph.D., is a physician at Cambridge Health Alliance and Harvard Medical School. He can be found on Twitter @davidascales.

Related:

 

Lee Alinsky new Chair of MEC

This emailed memo came today from the now former chair of the Medfield Energy Committee, Fred Bunger, who is moving to Wellesley to be nearer to family.  Medfield benefited hugely from Fred’s excellent, thoughtful, and persistent stewardship of the MEC.  Fred engineered the town becoming a Green Community last year, with all that entails, including the receipt of a $148,000 DOER grant and the development of a plan to reduce the town’s future energy consumption by 20% – a reduction which is over an above the 30% reduction that the MEC had already helped the town achieve under the original MEC Chair, Marie Zack Nolan.  That grant money is now being used to undertake a recommissioning of the HVAC controls at the Medfield High School and the Blake Middle School, the town’s two biggest energy users, so as to make both operate more efficiently.

town seal

TOWN OF MEDFIELD

Energy Committee

TOWN HOUSE, 459 MAIN STREET MEDFIELD, MASSACHUSETTS 02052-2009

TO:  Select Board, Town Administrator and Facilities Director

DATE: July 12, 2017

SUBJECT:  New Energy Committee Chair

Dear Sirs,

This letter is to confirm that the Medfield Energy Committee has chosen Lee Alinsky as Chairman, by vote of the members in attendance at the June 8, 2017 Energy Committee meeting.

 

I will be moving from Medfield in September 2017, so can no longer serve on the Energy Committee.

 

Please make Lee welcome and give him the excellent support you have given me for the past two years.  Your ongoing support of the Energy Committee will continue to help the Town achieve its efficiency goals.

 

Thank you for the honor of serving you.

 

Sincerely,

Fred Bunger

 

cc.: Medfield Energy Committee members

Meals tax revenue

meals tax

Medfield netted $135,123 for FY 16 (the last year for which we have the complete yearly figures) from our meals tax, which our annual town meeting (ATM) enacted a few years ago.  I think of the meals tax as the town’s chance to tax the residents of our surrounding towns for enjoying our excellent restaurants.   At the Tuesday meeting of the Board of Selectmen Mike Sullivan shared his historic record of our net since the ATM adopted the meals tax.  I especially like the trajectory and the rate of growth.  I also especially like seeing documentation that our restaurants are doing increasingly much more business year over year.

LOCAL MEALS TAX RECEIPTS FY15 - FY17 FISCAL YEAR SEPTEMBER DECEMBER MARCH JUNE TOTAL 15 16 17 $7,916 $33,405 $37,559 $30,743 $31,924 $36,886 $30,672 $29,462 $98,793 $36,886 $32,908 $135,123 $37,589