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Justice in a medical group

Richard Rawson, Sarah J Cousins, Michael McCann, Regina Pearce, Anne Van Donsel
Opioid overdose deaths in the United States have risen dramatically in the past decade. In response to this public health crisis, Vermont created an innovative system called the "hub-and-spoke" (H & S) system, initiated in January 2013. The H & S system has 7 regional "hubs" that offer methadone and buprenorphine, as well as intensive support, and 77 local "spokes" (primary care settings) that offer buprenorphine (and naltrexone to a much lesser extent). Questionnaires were administered to 80 participants in the H & S system (stratified by geographic region, treatment site, and gender) and 20 participants with opioid use disorder not currently in treatment...
February 2019: Journal of Substance Abuse Treatment
William E Soares, Donna Wilson, Michael S Gordon, Joshua D Lee, Edward V Nunes, Charles P O'Brien, Milvin Shroff, Peter D Friedmann
BACKGROUND: Criminal justice involved (CJS) populations with opioid use disorder (OUD) have high rates of relapse, future arrests, and death upon release. While medication for OUD (MOUD) reduces opioid relapse, concerns regarding diversion and stigma limit treatment in CJS populations. Extended release naltrexone (XR-NTX), as an opioid antagonist, may be more acceptable to CJS administrators. However, the impact of XR-NTX on criminal recidivism remains unknown. METHODS: Arrest data from a published randomized trial comparing XR-NTX to treatment as usual (TAU) was captured by self-report and official state arrest records...
December 3, 2018: Drug and Alcohol Dependence
Katie Bailey, Staci Rising Paquet, Bradley R Ray, Eric Grommon, Evan M Lowder, Emily Sightes
BACKGROUND: In an effort to reduce the increasing number of persons with mental illness (PMI) experiencing incarceration, co-responding police-mental health teams are being utilized as a way to divert PMI from the criminal justice system. Co-response teams are typically an inter-agency collaboration between police and mental health professionals, and in some cases include emergency medical personnel. These teams are intended to facilitate emergency response by linking patients to mental health resources rather than the criminal justice system, thus reducing burdens on both the criminal justice systems as well as local healthcare systems...
November 22, 2018: Health & Justice
Iduna Shah-Beckley, Victoria Clarke, Zoe Thomas
OBJECTIVES: Little research has examined the discourses that shape therapists' sense-making around heterosex. This paper explores the discourses of sexuality and gender underpinning therapists' and non-therapists' responses to a sexual experimentation scenario in a heterosexual relationship. It also considers the value of the novel technique of story completion (SC), in which participants are asked to write a story in response to a hypothetical scenario, for qualitative psychology and psychotherapy research...
November 19, 2018: Psychology and Psychotherapy
Brendan Saloner, Emma E McGinty, Leo Beletsky, Ricky Bluthenthal, Chris Beyrer, Michael Botticelli, Susan G Sherman
Drug overdose is now the leading cause of injury death in the United States. Most overdose fatalities involve opioids, which include prescription medication, heroin, and illicit fentanyl. Current data reveal that the overdose crisis affects all demographic groups and that overdose rates are now rising most rapidly among African Americans. We provide a public health perspective that can be used to mobilize a comprehensive local, state, and national response to the opioid crisis. We argue that framing the crisis from a public health perspective requires considering the interaction of multiple determinants, including structural factors (eg, poverty and racism), the inadequate management of pain, and poor access to addiction treatment and harm-reduction services (eg, syringe services)...
November 2018: Public Health Reports
Johann J Go
Transgender people have among the highest rates of suicide attempts of any group in society, driven strongly by the perception that they do not belong in the sex of their physical body. Gender reassignment surgery (GRS) is a procedure that can change the transgender person's physical body to accord with their gender identity. The procedure raises important ethical and distributive justice concerns, given the controversy of whether it is a cosmetic or medical procedure and the economic costs associated with performing the procedure...
December 2018: Journal of Bioethical Inquiry
Paul P Christopher, Bradley Anderson, Michael D Stein
INTRODUCTION: Civil commitment is an increasingly used policy intervention to combat the opioid epidemic. Yet little is known about persons who get committed and outcomes following commitment for opioid use. In the current cross-sectional study, we compared the characteristics of persons with and without a history of civil commitment, and the correlates of post-commitment abstinence. METHODS: Between October 2017 and May 2018, we surveyed consecutive persons entering a brief, inpatient opioid detoxification (n = 292) regarding their lifetime experiences with civil commitment for opioid use...
December 1, 2018: Drug and Alcohol Dependence
Steve O'Hern, Jennie Oxley
OBJECTIVES: The number of casualty road crashes in Australia has steadily reduced over the past few decades; however, a concurrent reduction has not been achieved for crashes involving cyclists. This has resulted in a disproportionate overrepresentation of cyclists in fatal injury statistics. This article explores the contributing factors and injury mechanisms among coronial reported fatal cyclist crashes in Australia. METHODS: The National Coronial Information System (NCIS) is a remote data entry and retrieval system containing detailed coronial information managed by the Victorian Department of Justice and Regulation...
October 18, 2018: Traffic Injury Prevention
Kelly E Moore, Robyn L Hacker, Lindsay Oberleitner, Sherry A McKee
Justice-involved individuals with substance use problems have heightened risk of relapse and recidivism after release from incarceration, making reentry a critical time to provide evidence-based treatments (EBTs) for substance use; however, the extent to which reentry interventions incorporate EBTs for substance use is unclear. This systematic review identified studies of reentry interventions in the past 10 years that address substance use, assessed whether EBTs were used, and explored which interventions were effective in reducing substance use and recidivism postrelease...
October 11, 2018: Psychological Services
Kathleen A McGinnis, Amy C Justice, Janet P Tate, Henry R Kranzler, Hilary A Tindle, William C Becker, John Concato, Joel Gelernter, Boyang Li, Xinyu Zhang, Hongyu Zhao, Kristina Crothers, Ke Xu
A validated, scalable approach to characterizing (phenotyping) smoking status is needed to facilitate genetic discovery. Using established DNA methylation sites from blood samples as a criterion standard for smoking behavior, we compare three candidate electronic medical record (EMR) smoking metrics based on longitudinal EMR text notes. With data from the Veterans Aging Cohort Study (VACS), we employed a validated algorithm to translate each smoking-related text note into current, past or never categories. We compared three alternative summary characterizations of smoking: most recent, modal and trajectories using descriptive statistics and Spearman's correlation coefficients...
October 4, 2018: Addiction Biology
Magda Mokhtar, Sonya M S Azab, Shaimaa Hassan, Hanan Said Ez-Elarab
Medico-legal case (MLC) represents an integral part of medical practice in the emergency departments and causalities. Therefore, the physicians should have the sufficient knowledge of their roles and responsibilities while handling these cases to aid legal justice. This study on the physicians working in governmental hospitals in Cairo aimed to assess physicians' knowledge, practice and attitude regarding handling of MLCs. The study included 452 physicians working in 7 governmental hospitals in Cairo. There were non-significant differences in physicians' knowledge, practice and attitude scores according to their age groups, gender, job titles or duration of work experience...
November 2018: Journal of Forensic and Legal Medicine
Alejandra Vasquez, Marina Gaínza-Lein, Iván Sánchez Fernández, Nicholas S Abend, Anne Anderson, J Nicholas Brenton, Jessica L Carpenter, Kevin Chapman, Justice Clark, William D Gaillard, Tracy Glauser, Joshua Goldstein, Howard P Goodkin, Yi-Chen Lai, Tobias Loddenkemper, Tiffani L McDonough, Mohamad A Mikati, Anuranjita Nayak, Eric Payne, James Riviello, Dmitry Tchapyjnikov, Alexis A Topjian, Mark S Wainwright, Robert C Tasker
OBJECTIVE: We aimed to evaluate and compare the status epilepticus treatment pathways used by pediatric status epilepticus research group (pSERG) hospitals in the United States and the American Epilepsy Society (AES) status epilepticus guideline. METHODS: We undertook a descriptive analysis of recommended timing, dosing, and medication choices in 10 pSERG hospitals' status epilepticus treatment pathways. RESULTS: One pathway matched the timeline in the AES guideline; nine pathways described more rapid timings...
September 2018: Pediatric Neurology
Hannah Farrimond, Charles Abraham
BACKGROUND: Public health leadership in England has taken a distinctive international stance by identifying the potential public health benefit of e-cigarettes for smoking cessation. This includes the development of a ground-breaking set of national guidelines for developing e-cigarette friendly stop smoking services. However, little is known about the views of staff engaged within these services and whether or how such services are becoming e-cigarette friendly. This study aimed to investigate the uptake and usage of e-cigarette guidance, from the perspective of those enacting tobacco cessation interventions 'on the ground'...
August 3, 2018: Harm Reduction Journal
Deanna R Befus, Kristen Hassmiller Lich, Shawn M Kneipp, Janet P Bettger, Remy R Coeytaux, Janice C Humphreys
BACKGROUND: A dearth of effective and affordable treatment options has rendered nonpharmacological self-management a crucial part of living with migraine-a debilitating neurobiological condition without cure that disproportionately disables vulnerable women. OBJECTIVE: The aim of the study was to describe the development and use of a systems thinking, problem-structuring data collection approach that was applied to the study of migraine self-management with women in diverse social locations...
September 2018: Nursing Research
Carol C Gould
The concept of solidarity has recently come to prominence in the healthcare literature, addressing the motivation for taking seriously the shared vulnerabilities and medical needs of compatriots and for acting to help them meet these needs. In a recent book, Prainsack and Buyx take solidarity as a commitment to bear costs to assist others regarded as similar, with implications for governing health databases, personalized medicine, and organ donation. More broadly, solidarity has been understood normatively to call for 'standing with' or assisting fellow community members and possibly also distant others in regard to their needs, whether for its own sake or in order to realize the demands of justice...
July 25, 2018: Bioethics
Yassin Karay, Houda Hallal, Christoph Stosch
Objective: The internationalization of teaching and studying as well as increasing numbers of students with increasingly heterogeneous educational biographies and lifestyles require universities to develop awareness of this diversity and the need for adequate diversity management. For some diversity criteria at least it has been proven that they can influence the individual study success of students. The Dean's Office of the Medical Faculty of the University of Cologne has empirically determined a stable prognosis parameter for study progression on the basis of selected criteria in order to enable early detection of students in need of guidance...
2018: GMS Journal for Medical Education
Catherine A Grodensky, David L Rosen, Colleen M Blue, Anna R Miller, Steve Bradley-Bull, Wizdom A Powell, Marisa E Domino, Carol E Golin, David A Wohl
Prison inmates suffer from a heavy burden of physical and mental health problems and have considerable need for healthcare and coverage after prison release. The Affordable Care Act may have increased Medicaid access for some of those who need coverage in Medicaid expansion states, but inmates in non-expansion states still have high need for Medicaid coverage and face unique barriers to enrollment. We sought to explore barriers and facilitators to Medicaid enrollment among prison inmates in a non-expansion state...
June 22, 2018: Journal of Urban Health: Bulletin of the New York Academy of Medicine
M E Kelly, F Patterson, S O'Flynn, J Mulligan, A W Murphy
BACKGROUND: The purpose of this paper is to systematically review the literature with respect to stakeholder views of selection methods for medical school admissions. METHODS: An electronic search of nine databases was conducted between January 2000-July 2014. Two reviewers independently assessed all titles (n = 1017) and retained abstracts (n = 233) for relevance. Methodological quality of quantitative papers was assessed using the MERSQI instrument. The overall quality of evidence in this field was low...
June 15, 2018: BMC Medical Education
Rohini J Haar, Casey B Risko, Sonal Singh, Diana Rayes, Ahmad Albaik, Mohammed Alnajar, Mazen Kewara, Emily Clouse, Elise Baker, Leonard S Rubenstein
BACKGROUND: Violent attacks on and interferences with hospitals, ambulances, health workers, and patients during conflict destroy vital health services during a time when they are most needed and undermine the long-term capacity of the health system. In Syria, such attacks have been frequent and intense and represent grave violations of the Geneva Conventions, but the number reported has varied considerably. A systematic mechanism to document these attacks could assist in designing more protection strategies and play a critical role in influencing policy, promoting justice, and addressing the health needs of the population...
April 2018: PLoS Medicine
Jesse T Young, Ed Heffernan, Rohan Borschmann, James R P Ogloff, Matthew J Spittal, Fiona G Kouyoumdjian, David B Preen, Amanda Butler, Lisa Brophy, Julia Crilly, Stuart A Kinner
BACKGROUND: People with mental illness and substance use disorder are over-represented in prisons. Injury-related mortality is elevated in people released from prison, and both mental illness and substance use disorder are risk factors for injury. Effective care coordination during the transition between criminal justice and community service providers improves health outcomes for people released from prison. However, the health outcomes and support needs of people with dual diagnosis (co-occurring mental illness and substance use disorder) released from prison are poorly understood...
May 2018: Lancet. Public Health
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