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Chan J, Akiyama MJ, Julian E, Joseph R, McGahee W, Rosner Z, Yang P, MacDonald R. Treating Hepatitis C Virus Infection in Jails as an Offset to Declines in Treatment Activity in the Community, New York City, NY, 2014-2020. AJPM Focus 2024; 3:100185. [PMID: 38322001 PMCID: PMC10844960 DOI: 10.1016/j.focus.2024.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Introduction There are scant data on implementation of large-scale direct-acting antiviral treatment for hepatitis C virus in jails in the U.S. New York City Health + Hospitals/Correctional Health Services aimed to scale up hepatitis C virus treatment in the New York City jail system. This study describes the trends in annual hepatitis C virus treatment in New York City jails compared with those in Medicaid-funded treatment in the New York City community from 2014 to 2020. Methods In this observational study, we extracted annual counts of direct-acting antiviral prescriptions for hepatitis C virus for those (1) in the New York City community who were covered by Medicaid and (2) those detained in New York City jails for 2014-2020. Data sources were New York City Department of Health and Mental Hygiene annual reports and Correctional Health Services treatment records, respectively. We used linear regression analysis to test for significant trends in annual treatment in these 2 cohorts during 2015-2019. Results From 2015 to 2019, treatments started in New York City jails increased annually (p=0.001), whereas Medicaid-funded prescriptions in the New York City community declined since a peak in 2015 (p<0.001). In 2019, New York City jail-based treatment initiations totaled the equivalent of 10% of treatment covered by Medicaid in New York City, up from 0.3% in 2015. Conclusions Scale up of jail-based hepatitis C virus treatment is an important strategy to offset declines observed in the community. Addressing barriers to care in jail, such as improving testing, linkage to care, and affordability of direct-acting antivirals for jail-based health services, can help sustain high levels of treatment in U.S. jails and other carceral facilities.
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Affiliation(s)
- Justin Chan
- NYC Health + Hospitals/Bellevue, New York, New York
- Department of Medicine, NYU Grossman School of Medicine, New York, New York
| | - Matthew J. Akiyama
- NYC Health + Hospitals/Correctional Health Services, NYC Health + Hospitals, New York, New York
- Montefiore Einstein Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Emily Julian
- NYC Health + Hospitals/Correctional Health Services, NYC Health + Hospitals, New York, New York
| | - Rodrigue Joseph
- NYC Health + Hospitals/Correctional Health Services, NYC Health + Hospitals, New York, New York
| | - Wendy McGahee
- NYC Health + Hospitals/Correctional Health Services, NYC Health + Hospitals, New York, New York
| | - Zachary Rosner
- Department of Medicine, NYU Grossman School of Medicine, New York, New York
- NYC Health + Hospitals/Correctional Health Services, NYC Health + Hospitals, New York, New York
| | - Patricia Yang
- NYC Health + Hospitals/Correctional Health Services, NYC Health + Hospitals, New York, New York
| | - Ross MacDonald
- Department of Medicine, NYU Grossman School of Medicine, New York, New York
- NYC Health + Hospitals/Woodhull, NYC Health + Hospitals, New York, New York
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Cherian T, Lim S, Katyal M, Goldfeld KS, McDonald R, Wiewel E, Khan M, Krawczyk N, Braunstein S, Murphy SM, Jalali A, Jeng PJ, Rosner Z, MacDonald R, Lee JD. Impact of jail-based methadone or buprenorphine treatment on non-fatal opioid overdose after incarceration. Drug Alcohol Depend 2024; 259:111274. [PMID: 38643529 DOI: 10.1016/j.drugalcdep.2024.111274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/13/2024] [Accepted: 03/18/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Non-fatal overdose is a leading predictor of subsequent fatal overdose. For individuals who are incarcerated, the risk of experiencing an overdose is highest when transitioning from a correctional setting to the community. We assessed if enrollment in jail-based medications for opioid use disorder (MOUD) is associated with lower risk of non-fatal opioid overdoses after jail release among individuals with opioid use disorder (OUD). METHODS This was a retrospective, observational cohort study of adults with OUD who were incarcerated in New York City jails and received MOUD or did not receive any MOUD (out-of-treatment) within the last three days before release to the community in 2011-2017. The outcome was the first non-fatal opioid overdose emergency department (ED) visit within 1 year of jail release during 2011-2017. Covariates included demographic, clinical, incarceration-related, and other characteristics. We performed multivariable cause-specific Cox proportional hazards regression analysis to compare the risk of non-fatal opioid overdose ED visits within 1 year after jail release between groups. RESULTS MOUD group included 8660 individuals with 17,119 incarcerations; out-of-treatment group included 10,163 individuals with 14,263 incarcerations. Controlling for covariates and accounting for competing risks, in-jail MOUD was associated with lower non-fatal opioid overdose risk within 14 days after jail release (adjusted HR=0.49, 95% confidence interval=0.33-0.74). We found no significant differences 15-28, 29-56, or 57-365 days post-release. CONCLUSION MOUD group had lower risk of non-fatal opioid overdose immediately after jail release. Wider implementation of MOUD in US jails could potentially reduce post-release overdoses, ED utilization, and associated healthcare costs.
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Affiliation(s)
- Teena Cherian
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY 11101, USA.
| | - Sungwoo Lim
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY 11101, USA
| | - Monica Katyal
- New York City Health + Hospitals/Correctional Health Service, 55 Water Street, New York, NY 10041, USA
| | - Keith S Goldfeld
- New York University Grossman School of Medicine, 180 Madison Ave, New York, NY 10010, USA
| | - Ryan McDonald
- New York University Grossman School of Medicine, 180 Madison Ave, New York, NY 10010, USA
| | - Ellen Wiewel
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY 11101, USA
| | - Maria Khan
- New York University Grossman School of Medicine, 180 Madison Ave, New York, NY 10010, USA
| | - Noa Krawczyk
- New York University Grossman School of Medicine, 180 Madison Ave, New York, NY 10010, USA
| | - Sarah Braunstein
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY 11101, USA
| | - Sean M Murphy
- Weill Cornell Medical College, 425 East 61st Street, New York, NY 10065, USA
| | - Ali Jalali
- Weill Cornell Medical College, 425 East 61st Street, New York, NY 10065, USA
| | - Philip J Jeng
- Weill Cornell Medical College, 425 East 61st Street, New York, NY 10065, USA
| | - Zachary Rosner
- New York City Health + Hospitals/Correctional Health Service, 55 Water Street, New York, NY 10041, USA
| | - Ross MacDonald
- New York University Grossman School of Medicine, 180 Madison Ave, New York, NY 10010, USA
| | - Joshua D Lee
- New York University Grossman School of Medicine, 180 Madison Ave, New York, NY 10010, USA
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Lim S, Cherian T, Katyal M, Goldfeld KS, McDonald R, Wiewel E, Khan M, Krawczyk N, Braunstein S, Murphy SM, Jalali A, Jeng PJ, Rosner Z, MacDonald R, Lee JD. Jail-based medication for opioid use disorder and patterns of reincarceration and acute care use after release: A sequence analysis. J Subst Use Addict Treat 2024; 158:209254. [PMID: 38072387 PMCID: PMC10947890 DOI: 10.1016/j.josat.2023.209254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/25/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Treatment with methadone and buprenorphine medications for opioid use disorder (MOUD) during incarceration may lead to better community re-entry, but evidence on these relationships have been mixed. We aimed to identify community re-entry patterns and examine the association between in-jail MOUD and a pattern of successful reentry defined by rare occurrence of reincarceration and preventable healthcare utilization. METHODS Data came from a retrospective, observational cohort study of 6066 adults with opioid use disorder who were incarcerated in New York City jails and released to the community during 2011-14. An outcome was community re-entry patterns identified by sequence analysis of 3-year post-release reincarceration, emergency department visits, and hospitalizations. An exposure was receipt of in-jail MOUD versus out-of-treatment (42 % vs. 58 %) for the last 3 days before discharge. The study accounted for differences in baseline demographic, clinical, behavioral, housing, and criminal legal characteristics between in-jail MOUD and out-of-treatment groups via propensity score matching. RESULTS This study identified five re-entry patterns: stability (64 %), hospitalization (23 %), delayed reincarceration (7 %), immediate reincarceration (4 %), and continuous incarceration (2 %). After addressing confounding, 64 % and 57 % followed the stability pattern among MOUD and out-of-treatment groups who were released from jail in 2011, respectively. In 2012-14, the prevalence of following the stability pattern increased year-by-year while a consistently higher prevalence was observed among those with in-jail MOUD. CONCLUSIONS Sequence analysis helped define post-release stability based on health and criminal legal system involvement. Receipt of in-jail MOUD was associated with a marker of successful community re-entry.
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Affiliation(s)
- Sungwoo Lim
- New York City Department of Health and Mental Hygiene, Queens, NY, United States of America.
| | - Teena Cherian
- New York City Department of Health and Mental Hygiene, Queens, NY, United States of America
| | - Monica Katyal
- NYC Health and Hospitals/Correctional Health Services, New York, NY, United States of America
| | - Keith S Goldfeld
- New York University Grossman School of Medicine, New York, NY, United States of America
| | - Ryan McDonald
- New York University Grossman School of Medicine, New York, NY, United States of America
| | - Ellen Wiewel
- New York City Department of Health and Mental Hygiene, Queens, NY, United States of America
| | - Maria Khan
- New York University Grossman School of Medicine, New York, NY, United States of America
| | - Noa Krawczyk
- New York University Grossman School of Medicine, New York, NY, United States of America
| | - Sarah Braunstein
- New York City Department of Health and Mental Hygiene, Queens, NY, United States of America
| | - Sean M Murphy
- Weill Cornell Medical College, New York, NY, United States of America
| | - Ali Jalali
- Weill Cornell Medical College, New York, NY, United States of America
| | - Philip J Jeng
- Weill Cornell Medical College, New York, NY, United States of America
| | - Zachary Rosner
- NYC Health and Hospitals/Correctional Health Services, New York, NY, United States of America
| | - Ross MacDonald
- New York University Grossman School of Medicine, New York, NY, United States of America
| | - Joshua D Lee
- New York University Grossman School of Medicine, New York, NY, United States of America
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Bendriss G, MacDonald R, McVeigh C. Microbial Reprogramming in Obsessive-Compulsive Disorders: A Review of Gut-Brain Communication and Emerging Evidence. Int J Mol Sci 2023; 24:11978. [PMID: 37569349 PMCID: PMC10419219 DOI: 10.3390/ijms241511978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 08/13/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). Dysbiosis, an imbalance in the gut microbial composition, has been associated with various health conditions, including mental health disorders, autism, and inflammatory diseases. While the exact mechanisms underlying OCD remain unclear, this review presents a growing body of evidence suggesting a potential link between dysbiosis and the multifaceted etiology of OCD, interacting with genetic, neurobiological, immunological, and environmental factors. This review highlights the emerging evidence implicating the gut microbiota in the pathophysiology of OCD and its potential as a target for novel therapeutic approaches. We propose a model that positions dysbiosis as the central unifying element in the neurochemical, immunological, genetic, and environmental factors leading to OCD. The potential and challenges of microbial reprogramming strategies, such as probiotics and fecal transplants in OCD therapeutics, are discussed. This review raises awareness of the importance of adopting a holistic approach that considers the interplay between the gut and the brain to develop interventions that account for the multifaceted nature of OCD and contribute to the advancement of more personalized approaches.
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Lim S, Cherian T, Katyal M, Goldfeld KS, McDonald R, Wiewel E, Khan M, Krawczyk N, Braunstein S, Murphy SM, Jalali A, Jeng PJ, MacDonald R, Lee JD. Association between jail-based methadone or buprenorphine treatment for opioid use disorder and overdose mortality after release from New York City jails 2011-17. Addiction 2023; 118:459-467. [PMID: 36305669 PMCID: PMC9898114 DOI: 10.1111/add.16071] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/27/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Opioid overdose is a leading cause of death during the immediate time after release from jail or prison. Most jails in the United States do not provide methadone and buprenorphine treatment for opioid use disorder (MOUD), and research in estimating its impact in jail settings is limited. We aimed to test the hypothesis that in-jail MOUD is associated with lower overdose mortality risk post-release. DESIGN, SETTING AND PARTICIPANTS Retrospective, observational cohort study of 15 797 adults with opioid use disorder who were released from New York City jails to the community in 2011-2017. They experienced 31 382 incarcerations and were followed up to 1 year. MEASUREMENTS The primary outcomes were death caused by accidental drug poisoning and all-cause death. The exposure was receipt of MOUD (17 119 events) versus out-of-treatment (14 263 events) during the last 3 days before community re-entry. Covariates included demographic, clinical, behavioral, housing, health-care utilization and legal characteristics variables. We performed a multivariable, mixed-effect Cox regression analysis to test association between in-jail MOUD and deaths. FINDINGS The majority were male (82%) and their average age was 42 years. Receiving MOUD was associated with misdemeanor charges, being female, injection drug use and homelessness. During 1 year post-release, 111 overdose deaths occurred and crude death rates were 0.49 and 0.83 per 100 person-years for in-jail MOUD and out-of-treatment groups, respectively. Accounting for confounding and random effects, in-jail MOUD was associated with lower overdose mortality risk [adjusted hazard ratio (aHR) = 0.20, 95% confidence interval (CI) = 0.08-0.46] and all-cause mortality risk (aHR = 0.22, 95% CI = 0.11-0.42) for the first month post-release. CONCLUSIONS Methadone and buprenorphine treatment for opioid use disorder during incarceration was associated with an 80% reduction in overdose mortality risk for the first month post-release.
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Affiliation(s)
- Sungwoo Lim
- New York City Department of Health and Mental Hygiene, Queens, NY
| | - Teena Cherian
- New York City Department of Health and Mental Hygiene, Queens, NY
| | - Monica Katyal
- Health and Hospital Correctional Health Services, New York, NY
| | | | - Ryan McDonald
- New York University Grossman School of Medicine, New York, NY
| | - Ellen Wiewel
- New York City Department of Health and Mental Hygiene, Queens, NY
| | - Maria Khan
- New York University Grossman School of Medicine, New York, NY
| | - Noa Krawczyk
- New York University Grossman School of Medicine, New York, NY
| | - Sarah Braunstein
- New York City Department of Health and Mental Hygiene, Queens, NY
| | | | - Ali Jalali
- Weill Cornell Medical School, New York, NY
| | | | - Ross MacDonald
- Health and Hospital Correctional Health Services, New York, NY
| | - Joshua D. Lee
- New York University Grossman School of Medicine, New York, NY
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Stachowicz M, Jokubauskas P, Bagiński B, MacDonald R, Harlov D. A revised structure for the rare earth fluoride gagarinite-(Ce) from experimental synthesis by fluid-induced alteration of chevkinite-(Ce). Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322092294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Triggle CR, Mohammed I, Bshesh K, Marei I, Ye K, Ding H, MacDonald R, Hollenberg MD, Hill MA. Metformin: Is it a drug for all reasons and diseases? Metabolism 2022; 133:155223. [PMID: 35640743 DOI: 10.1016/j.metabol.2022.155223] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 12/15/2022]
Abstract
Metformin was first used to treat type 2 diabetes in the late 1950s and in 2022 remains the first-choice drug used daily by approximately 150 million people. An accumulation of positive pre-clinical and clinical data has stimulated interest in re-purposing metformin to treat a variety of diseases including COVID-19. In polycystic ovary syndrome metformin improves insulin sensitivity. In type 1 diabetes metformin may help reduce the insulin dose. Meta-analysis and data from pre-clinical and clinical studies link metformin to a reduction in the incidence of cancer. Clinical trials, including MILES (Metformin In Longevity Study), and TAME (Targeting Aging with Metformin), have been designed to determine if metformin can offset aging and extend lifespan. Pre-clinical and clinical data suggest that metformin, via suppression of pro-inflammatory pathways, protection of mitochondria and vascular function, and direct actions on neuronal stem cells, may protect against neurodegenerative diseases. Metformin has also been studied for its anti-bacterial, -viral, -malaria efficacy. Collectively, these data raise the question: Is metformin a drug for all diseases? It remains unclear as to whether all of these putative beneficial effects are secondary to its actions as an anti-hyperglycemic and insulin-sensitizing drug, or result from other cellular actions, including inhibition of mTOR (mammalian target for rapamycin), or direct anti-viral actions. Clarification is also sought as to whether data from ex vivo studies based on the use of high concentrations of metformin can be translated into clinical benefits, or whether they reflect a 'Paracelsus' effect. The environmental impact of metformin, a drug with no known metabolites, is another emerging issue that has been linked to endocrine disruption in fish, and extensive use in T2D has also raised concerns over effects on human reproduction. The objectives for this review are to: 1) evaluate the putative mechanism(s) of action of metformin; 2) analyze the controversial evidence for metformin's effectiveness in the treatment of diseases other than type 2 diabetes; 3) assess the reproducibility of the data, and finally 4) reach an informed conclusion as to whether metformin is a drug for all diseases and reasons. We conclude that the primary clinical benefits of metformin result from its insulin-sensitizing and antihyperglycaemic effects that secondarily contribute to a reduced risk of a number of diseases and thereby enhancing healthspan. However, benefits like improving vascular endothelial function that are independent of effects on glucose homeostasis add to metformin's therapeutic actions.
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Affiliation(s)
- Chris R Triggle
- Department of Pharmacology, Weill Cornell Medicine in Qatar, P.O. Box 24144, Education City, Doha, Qatar; Department of Medical Education, Weill Cornell Medicine in Qatar, P.O. Box 24144, Education City, Doha, Qatar.
| | - Ibrahim Mohammed
- Department of Medical Education, Weill Cornell Medicine in Qatar, P.O. Box 24144, Education City, Doha, Qatar
| | - Khalifa Bshesh
- Department of Medical Education, Weill Cornell Medicine in Qatar, P.O. Box 24144, Education City, Doha, Qatar
| | - Isra Marei
- Department of Pharmacology, Weill Cornell Medicine in Qatar, P.O. Box 24144, Education City, Doha, Qatar
| | - Kevin Ye
- Department of Biomedical Physiology & Kinesiology, Simon Fraser University, Burnaby, British Columbia V5A 1S6, Canada
| | - Hong Ding
- Department of Pharmacology, Weill Cornell Medicine in Qatar, P.O. Box 24144, Education City, Doha, Qatar; Department of Medical Education, Weill Cornell Medicine in Qatar, P.O. Box 24144, Education City, Doha, Qatar
| | - Ross MacDonald
- Distribution eLibrary, Weill Cornell Medicine in Qatar, P.O. Box 24144, Education City, Doha, Qatar
| | - Morley D Hollenberg
- Department of Physiology & Pharmacology, a Cumming School of Medicine, University of Calgary, T2N 4N1, Canada
| | - Michael A Hill
- Dalton Cardiovascular Research Center, Department of Medical Pharmacology & Physiology, School of Medicine, University of Missouri, Columbia 65211, MO, USA
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Bedard R, Huxley-Reicher Z, Burke K, MacDonald R, Yang P. Aging In Jail: Retrospective Analysis Of Older Patients In New York City's Jail System, 2015-19. Health Aff (Millwood) 2022; 41:732-740. [PMID: 35500184 DOI: 10.1377/hlthaff.2021.01518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There are currently more adults age fifty-five or older incarcerated in the United States than ever before. Little is known about the epidemiology or health care needs of geriatric patients in jails, where the majority of the population is being held in pretrial detention. We performed a retrospective analysis of electronic health record data to characterize the demographics, health conditions, and health care use of people age fifty-five or older who were incarcerated in the New York City jail system between 2015 and 2019. People in this age group accounted for 4 percent of admissions to the jails in 2009, ten years before the study's end date; 7 percent of admissions in 2015, when the study began; and 8.5 percent of admissions by 2019. They were more likely to report being homeless; suffer from a serious mental illness designation; carry a higher burden of chronic, infectious, and serious medical illnesses; be hospitalized during their incarceration; and die in jail custody than their younger counterparts. All elements of the criminal justice system need to be attuned to the vulnerabilities of this group, implement targeted interventions to divert them from incarceration when possible, and minimize harms for those who end up incarcerated.
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Affiliation(s)
- Rachael Bedard
- Rachael Bedard , Harvard Law School, Boston, Massachusetts
| | | | | | - Ross MacDonald
- Ross MacDonald, NYC Health + Hospitals, New York, New York
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Gad H, Al‐Nassr N, Mohammed I, Khan A, MacDonald R, Mussleman P, Malik RA. Effect of Ramadan fasting in patients with type 2 diabetes mellitus treated with sodium-glucose cotransporter 2 inhibitors: A systematic review and meta-analysis. J Diabetes Investig 2022; 13:822-829. [PMID: 34953158 PMCID: PMC9077738 DOI: 10.1111/jdi.13741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/05/2021] [Accepted: 12/12/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS/INTRODUCTION Sodium-glucose cotransporter 2 inhibitors (SGLT-2i) improve glycemic control and weight, but might be associated with dehydration, hypotension and ketoacidosis, especially in patients with type 2 diabetes mellitus who fast during Ramadan. This meta-analysis evaluates the effects of Ramadan fasting on patients with type 2 diabetes mellitus treated with SGLT-2i. MATERIALS AND METHODS A literature search was carried out in PubMed, Embase and the Cochrane Library. Quality assessment was carried out using the ROBINS-I and Cochrane tools for risk of bias, and analyses were carried out using RevMan version 5.3. RESULTS A total of five studies were included in this meta-analysis. During Ramadan, there was a significant reduction in glycated hemoglobin (P < 0.00001) and diastolic blood pressure (P = 0.006), with a non-significant trend for a reduction in weight (P = 0.44) and systolic blood pressure (P = 0.67). The number and severity of hypoglycemic episodes was lower in patients with type 2 diabetes mellitus treated with SGLT-2i compared with sulfonylureas. There was no significant change in estimated glomerular filtration rate, β-hydroxybutyrate, bicarbonate or anion gap. However, we identified considerable heterogeneity among studies, and a lack of head-to-head studies with structured outcome reporting on the risks and benefits of SGLT-2i during Ramadan. CONCLUSIONS This systematic review and meta-analysis shows that patients with type 2 diabetes treated with SGLT2i's during Ramadan have an improvement in HbA1c, less hypoglycemia and no major adverse effects.
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Affiliation(s)
- Hoda Gad
- Department of MedicineWeill Cornell Medicine‐QatarDohaQatar
| | - Noor Al‐Nassr
- Department of MedicineWeill Cornell Medicine‐QatarDohaQatar
| | | | - Adnan Khan
- Department of MedicineWeill Cornell Medicine‐QatarDohaQatar
| | | | | | - Rayaz A. Malik
- Department of MedicineWeill Cornell Medicine‐QatarDohaQatar
- Institute of Cardiovascular MedicineUniversity of ManchesterManchesterUK
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Gad H, Petropoulos IN, Khan A, Ponirakis G, MacDonald R, Alam U, Malik RA. Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta-analysis. J Diabetes Investig 2022; 13:134-147. [PMID: 34351711 PMCID: PMC8756328 DOI: 10.1111/jdi.13643] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Corneal confocal microscopy (CCM) is a rapid non-invasive ophthalmic imaging technique that identifies corneal nerve fiber damage. Small studies suggest that CCM could be used to assess patients with diabetic peripheral neuropathy (DPN). AIM To undertake a systematic review and meta-analysis assessing the diagnostic utility of CCM for sub-clinical DPN (DPN- ) and established DPN (DPN+ ). DATA SOURCES Databases (PubMed, Embase, Central, ProQuest) were searched for studies using CCM in patients with diabetes up to April 2020. STUDY SELECTION Studies were included if they reported on at least one CCM parameter in patients with diabetes. DATA EXTRACTION Corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal nerve fiber length (CNFL), and inferior whorl length (IWL) were compared between patients with diabetes with and without DPN and controls. Meta-analysis was undertaken using RevMan V.5.3. DATA SYNTHESIS Thirty-eight studies including ~4,000 participants were included in this meta-analysis. There were significant reductions in CNFD, CNBD, CNFL, and IWL in DPN- vs controls (P < 0.00001), DPN+ vs controls (P < 0.00001), and DPN+ vs DPN- (P < 0.00001). CONCLUSION This systematic review and meta-analysis shows that CCM detects small nerve fiber loss in subclinical and clinical DPN and concludes that CCM has good diagnostic utility in DPN.
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Affiliation(s)
- Hoda Gad
- Department of MedicineWeill Cornell Medicine‐QatarDohaQatar
| | | | - Adnan Khan
- Department of MedicineWeill Cornell Medicine‐QatarDohaQatar
| | | | | | - Uazman Alam
- Diabetes and Neuropathy ResearchDepartment of Eye and Vision Sciences and Pain Research InstituteInstitute of Ageing and Chronic DiseaseUniversity of Liverpool and Aintree University Hospital NHS Foundation TrustLiverpoolUK
- Department of Diabetes and EndocrinologyRoyal Liverpool and Broadgreen University NHS Hospital TrustLiverpoolUK
- Division of Endocrinology, Diabetes and GastroenterologyUniversity of ManchesterManchesterUK
| | - Rayaz A Malik
- Department of MedicineWeill Cornell Medicine‐QatarDohaQatar
- Institute of Cardiovascular MedicineUniversity of ManchesterManchesterUK
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Lee JD, Malone M, McDonald R, Cheng A, Vasudevan K, Tofighi B, Garment A, Porter B, Goldfeld KS, Matteo M, Mangat J, Katyal M, Giftos J, MacDonald R. Comparison of Treatment Retention of Adults With Opioid Addiction Managed With Extended-Release Buprenorphine vs Daily Sublingual Buprenorphine-Naloxone at Time of Release From Jail. JAMA Netw Open 2021; 4:e2123032. [PMID: 34495340 PMCID: PMC8427378 DOI: 10.1001/jamanetworkopen.2021.23032] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Extended-release buprenorphine (XRB), a monthly injectable long-acting opioid use disorder (OUD) treatment, has not been studied for use in corrections facilities. OBJECTIVE To compare treatment retention following release from jail among adults receiving daily sublingual buprenorphine-naloxone (SLB) vs those receiving XRB. DESIGN, SETTING, AND PARTICIPANTS This open-label, randomized comparative effectiveness study included 52 incarcerated adults in New York City observed for 8 weeks postrelease between June 2019 and May 2020. Participants were soon-to-be-released volunteers from 1 men's and 1 women's jail facility who had OUDs already treated with SLB. Follow-up treatment was received at a primary care clinic in Manhattan. Data were analyzed between June 2020 and December 2020. INTERVENTIONS XRB treatment was offered prior to release and continued monthly through 8 weeks after release. SLB participants continued to receive daily directly observed in-jail SLB administration, were provided a 7-day SLB supply at jail release, and followed up at a designated clinic (or other preferred clinics). MAIN OUTCOMES AND MEASURES Buprenorphine treatment retention at 8 weeks postrelease. RESULTS A total of 52 participants were randomized 1:1 to XRB (26 participants) and SLB (26 participants). Participants had a mean (SD) age of 42.6 (10.0) years; 45 participants (87%) were men; and 40 (77%) primarily used heroin prior to incarceration. Most participants (30 [58%]) reported prior buprenorphine use; 18 (35%) reported active community buprenorphine treatment prior to jail admission. Twenty-one of 26 assigned to XRB received 1 or more XRB injection prior to release; 3 initiated XRB postrelease; and 2 did not receive XRB. Patients in the XRB arm had fewer jail medical visits compared with daily SLB medication administration (mean [SD] visits per day: XRB, 0.11 [0.03] vs SLB, 1.06 [0.08]). Community buprenorphine treatment retention at week 8 postrelease was 18 participants in the XRB group (69.2%) vs 9 in the SLB group (34.6%), and rates of opioid-negative urine tests were 72 of 130 tests in the XRB group (55.3%) and 50 of 130 tests in the SLB group (38.4%). There were no differences in rates of serious adverse events, no overdoses, and no deaths. CONCLUSIONS AND RELEVANCE XRB was acceptable among patients currently receiving SLB, and patients had fewer in-jail clinic visits and increased community buprenorphine treatment retention when compared with standard daily SLB treatment. These results support wider use and further study of XRB as correctional and reentry OUD treatment. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03604159.
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Affiliation(s)
- Joshua D. Lee
- Department of Population Health, New York University Grossman School of Medicine, New York
- Department of Medicine, New York University Grossman School of Medicine, New York
| | - Mia Malone
- Department of Population Health, New York University Grossman School of Medicine, New York
| | - Ryan McDonald
- Department of Population Health, New York University Grossman School of Medicine, New York
| | - Anna Cheng
- Department of Population Health, New York University Grossman School of Medicine, New York
| | - Kumar Vasudevan
- Department of Population Health, New York University Grossman School of Medicine, New York
- Department of Medicine, New York University Grossman School of Medicine, New York
| | - Babak Tofighi
- Department of Population Health, New York University Grossman School of Medicine, New York
- Department of Medicine, New York University Grossman School of Medicine, New York
| | - Ann Garment
- Department of Medicine, New York University Grossman School of Medicine, New York
| | - Barbara Porter
- Department of Medicine, New York University Grossman School of Medicine, New York
| | - Keith S. Goldfeld
- Department of Population Health, New York University Grossman School of Medicine, New York
| | - Michael Matteo
- Correctional Health Services, NYC Health + Hospitals, New York, New York
| | - Jasdeep Mangat
- Correctional Health Services, NYC Health + Hospitals, New York, New York
| | - Monica Katyal
- Correctional Health Services, NYC Health + Hospitals, New York, New York
| | - Jonathan Giftos
- Correctional Health Services, NYC Health + Hospitals, New York, New York
| | - Ross MacDonald
- Department of Medicine, New York University Grossman School of Medicine, New York
- Correctional Health Services, NYC Health + Hospitals, New York, New York
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12
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Chan J, Burke K, Bedard R, Grigg J, Winters J, Vessell C, Rosner Z, Cheng J, Katyal M, Yang P, MacDonald R. COVID-19 in the New York City Jail System: Epidemiology and Health Care Response, March-April 2020. Public Health Rep 2021; 136:375-383. [PMID: 33673760 PMCID: PMC8580401 DOI: 10.1177/0033354921999385] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES People detained in correctional facilities are at high risk for infection with severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). We described the epidemiology of the COVID-19 outbreak in a large urban jail system, including signs and symptoms at time of testing and risk factors for hospitalization. METHODS This retrospective observational cohort study included all patients aged ≥18 years who were tested for COVID-19 during March 11-April 28, 2020, while in custody in the New York City jail system (N = 978). We described demographic characteristics and signs and symptoms at the time of testing and performed Cox regression analysis to identify factors associated with hospitalization among those with a positive test result. RESULTS Of 978 people tested for COVID-19, 568 received a positive test result. Among symptomatic patients, the most common symptoms among those who received a positive test result were cough (n = 293 of 510, 57%) and objective fever (n = 288 of 510, 56%). Of 257 asymptomatic patients who were tested, 58 (23%) received a positive test result. Forty-five (8%) people who received a positive test result were hospitalized for COVID-19. Older age (aged ≥55 vs 18-34) (adjusted hazard ratio [aHR] = 13.41; 95% CI, 3.80-47.33) and diabetes mellitus (aHR = 1.99; 95% CI, 1.00-3.95) were significantly associated with hospitalization. CONCLUSIONS A substantial proportion of people tested in New York City jails received a positive test result for COVID-19, including a large proportion of people tested while asymptomatic. During periods of ongoing transmission, asymptomatic screening should complement symptom-driven COVID-19 testing in correctional facilities. Older patients and people with diabetes mellitus should be closely monitored after COVID-19 diagnosis because of their increased risk for hospitalization.
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Affiliation(s)
- Justin Chan
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
| | - Kelsey Burke
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
| | - Rachael Bedard
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
| | - James Grigg
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
| | - John Winters
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
| | - Colleen Vessell
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
| | - Zachary Rosner
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
| | - Jeffrey Cheng
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
| | - Monica Katyal
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
| | - Patricia Yang
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
| | - Ross MacDonald
- Correctional Health Services, NYC Health + Hospitals, New York, NY, USA
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13
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Abstract
Journal impact factors, publication charges and assessment of quality and accuracy of scientific research are critical for researchers, managers, funders, policy makers, and society. Editors and publishers compete for impact factor rankings, to demonstrate how important their journals are, and researchers strive to publish in perceived top journals, despite high publication and access charges. This raises questions of how top journals are identified, whether assessments of impacts are accurate and whether high publication charges borne by the research community are justified, bearing in mind that they also collectively provide free peer-review to the publishers. Although traditional journals accelerated peer review and publication during the COVID-19 pandemic, preprint servers made a greater impact with over 30,000 open access articles becoming available and accelerating a trend already seen in other fields of research. We review and comment on the advantages and disadvantages of a range of assessment methods and the way in which they are used by researchers, managers, employers and publishers. We argue that new approaches to assessment are required to provide a realistic and comprehensive measure of the value of research and journals and we support open access publishing at a modest, affordable price to benefit research producers and consumers.
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Affiliation(s)
- Chris R Triggle
- Departments of Medical Education & Pharmacology, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Ross MacDonald
- Distributed eLibrary, Weill Cornell Medicine-Qatar, Doha, New York, Qatar
| | - David J Triggle
- School of Pharmacy and Pharmaceutical Sciences, State University of New York, Buffalo, New York, USA
| | - Donald Grierson
- School of Biosciences, University of Nottingham, Loughborough, UK
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Akiyama MJ, Ross J, Rimawi F, Fox A, Jordan AO, Wiersema J, Litwin AH, Kaba F, MacDonald R. Knowledge, attitudes, and acceptability of direct-acting antiviral hepatitis C treatment among people incarcerated in jail: A qualitative study. PLoS One 2020; 15:e0242623. [PMID: 33264311 PMCID: PMC7710033 DOI: 10.1371/journal.pone.0242623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 11/03/2020] [Indexed: 01/27/2023] Open
Abstract
Introduction While U.S. jails are critical sites for engagement in HCV care, short lengths-of-stay often do not permit treatment in jail. Therefore, linkage to HCV care after incarceration is crucial. However, little is known about HCV treatment acceptability among justice-involved individuals in U.S. jails. The goal of this study was to understand knowledge, attitudes, and acceptability of HCV treatment among people living with HCV in the New York City (NYC) jail system. Methods We recruited 36 HCV-antibody-positive individuals in the NYC jails using clinical data reports and performed semi-structured interviews to explore participants’ attitudes toward HCV treatment in jail and following return to the community. We continued interviews until reaching thematic saturation and analyzed interviews using an inductive, thematic approach. Results Participants were mostly male, Latina/o, with a mean age of 40 years. Nearly all were aware they were HCV antibody-positive. Two thirds of participants had some awareness of the availability of new HCV therapies. Key themes included: 1) variable knowledge of new HCV therapies affecting attitudes toward HCV treatment, 2) the importance of other incarcerated individuals in communicating HCV-related knowledge, 3) vulnerability during incarceration and fear of treatment interruption, 4) concern for relapse to active drug use and HCV reinfection, 5) competing priorities (such as other medical comorbidities, ongoing substance use, and housing), 6) social support and the importance of family. Conclusions Patient-centered approaches to increase treatment uptake in jail settings should focus on promoting HCV-related knowledge including leveraging peers for knowledge dissemination. In addition, transitional care programs should ensure people living with HCV in jail have tailored discharge plans focused on competing priorities such as housing instability, social support, and treatment of substance use disorders.
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Affiliation(s)
- Matthew J. Akiyama
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
- * E-mail:
| | - Jonathan Ross
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Fatimah Rimawi
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Aaron Fox
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Alison O. Jordan
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
| | - Janet Wiersema
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
| | - Alain H. Litwin
- Department of Medicine, University of South Carolina School of Medicine–Greenville, Greenville, South Carolina, United States of America
- Department of Medicine, Prisma Health, Greenville, South Carolina, United States of America
- Clemson University School of Health Research, Clemson, South Carolina, United States of America
| | - Fatos Kaba
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
| | - Ross MacDonald
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
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Chan J, Kaba F, Schwartz J, Bocour A, Akiyama MJ, Rosner Z, Winters A, Yang P, MacDonald R. The hepatitis C virus care cascade in the New York City jail system during the direct acting antiviral treatment era, 2014-2017. EClinicalMedicine 2020; 27:100567. [PMID: 33150329 PMCID: PMC7599312 DOI: 10.1016/j.eclinm.2020.100567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/13/2020] [Accepted: 09/11/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND High patient turnover presents challenges and opportunity to provide hepatitis C virus (HCV) care in US jails (remand facilities). This study describes the HCV care cascade in the New York City (NYC) jail system during the direct-acting antiviral (DAA) treatment era. METHODS Patients admitted to the NYC jail system from January 2014 through December 2017 were included in this retrospective cohort analysis. We describe rates of screening, diagnosis, linkage to jail-based care, and treatment among the overall cohort, and among subgroups with long jail stays (≥120 days) or frequent stays (≥10 admissions). The study protocol was approved by a third-party institutional review board (BRANY, Lake Success, NY). FINDINGS Among the 121,371 patients in our analysis, HCV screening was performed in 40,219 (33%), 4665 (12%) of whom were viremic, 1813 (39%) seen by an HCV clinician in jail, and 248 (5% of viremic patients) started on treatment in jail. Having a long stay (adjusted risk ratio [aRR] 8·11, 95% confidence interval [CI] 6·98, 9·42) or frequent stays (aRR 1·51, 95% CI 1·04, 2·18) were significantly associated with being seen by an HCV clinician. Patients with long stays had a higher rate of treatment (14% of viremic patients). Sustained virologic response at 12 weeks was achieved in 147/164 (90%) of patients with available virologic data. INTERPRETATION Jail health systems can reach large numbers of HCV-infected individuals. The high burden of HCV argues for universal screening in jail settings. Length of stay was strongly associated with being seen by an HCV clinician in jail. Treatment is feasible among those with longer lengths of stay. FUNDING None.
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Affiliation(s)
- Justin Chan
- Correctional Health Services, NYC Health + Hospitals, 55 Water Street, 18th floor, New York, NY 10041, United States
- Corresponding authors.
| | - Fatos Kaba
- Correctional Health Services, NYC Health + Hospitals, 55 Water Street, 18th floor, New York, NY 10041, United States
| | - Jessie Schwartz
- Bureau of Communicable Diseases, Viral Hepatitis Program, New York City Department of Health and Mental Hygiene, Long Island City, NY 11101, United States
| | - Angelica Bocour
- Bureau of Communicable Diseases, Viral Hepatitis Program, New York City Department of Health and Mental Hygiene, Long Island City, NY 11101, United States
| | - Matthew J Akiyama
- Montefiore Medical Center, Albert Einstein College of Medicine, 1621 Eastchester Road, Bronx, NY 10461, United States
| | - Zachary Rosner
- Correctional Health Services, NYC Health + Hospitals, 55 Water Street, 18th floor, New York, NY 10041, United States
| | - Ann Winters
- Bureau of Communicable Diseases, Viral Hepatitis Program, New York City Department of Health and Mental Hygiene, Long Island City, NY 11101, United States
| | - Patricia Yang
- Correctional Health Services, NYC Health + Hospitals, 55 Water Street, 18th floor, New York, NY 10041, United States
| | - Ross MacDonald
- Correctional Health Services, NYC Health + Hospitals, 55 Water Street, 18th floor, New York, NY 10041, United States
- Corresponding authors.
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Capaldi N, Kao KT, MacDonald R, Grainger KC, Joseph S, Shepherd S, Mason A, Wong SC. Feasibility of Dual Energy X-Ray Absorptiometry Based Images for Measurement of Height, Sitting Height, and Leg Length in Children. J Clin Densitom 2020; 23:472-481. [PMID: 30098887 DOI: 10.1016/j.jocd.2018.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/20/2018] [Accepted: 06/20/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Interpretation of pediatric bone mineral density by dual energy absorptiometry (DXA) requires adjustment for height (Ht). This is often not easily obtainable in nonambulant subjects. AIMS To investigate the feasibility of using DXA images to evaluate measurements of Ht, sitting height (SH), and leg length (LL). METHODOLOGY A total of 2 observers performed measurements of Ht, SH, and LL on 3 separate occasion using DXA digital images in 125 children. Intraclass correlation and relative technical error of measurement (rTEM) were performed to assess reliability of repeated measurements. In 25 children, Ht and SH were measured in clinic on the same day and Bland-Altman analysis was performed to compare DXA measured Ht, SH, LL with clinic measurements for these 25 children. RESULTS Intraclass correlation for DXA based Ht, SH, and LL measurements ranged from 0.996 to 0.998 (p < 0.0001). rTEM of Ht, SH, and LL for observer 1 was 0.0016%, 0.002%, and 0.0034%, respectively. rTEM of Ht, SH, and LL between observer 1 and 2 was 0.0047%, 0.0049%, and 0.0087%, respectively. Mean difference between clinic and DXA measurements from Bland-Altman plots were +0.57 cm (95% confidence interval [CI] -0.54 to +1.68) for Ht, +1.33cm (-1.60 to +4.24) for SH, and -0.76cm (-3.88 to +2.37) for LL. CONCLUSIONS Our study demonstrated for the first time that Ht, SH, and LL in children can be measured very precisely using DXA images. Ht can be measured accurately. We believe this may be a convenient method to obtain Ht measurements to allow size adjustment of DXA bone mineral density in immobile children with chronic conditions.
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Affiliation(s)
- N Capaldi
- School of Medicine, University of Glasgow, Glasgow, United Kingdom; Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow
| | - K T Kao
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow
| | - R MacDonald
- School of Medicine, University of Glasgow, Glasgow, United Kingdom; Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow
| | - K C Grainger
- Department of Sports Science, London Metropolitan University, London
| | - S Joseph
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow; Paediatric Neurosciences Research Group, Royal Hospital for Children, Glasgow, United Kingdom
| | - S Shepherd
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow
| | - A Mason
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow
| | - S C Wong
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow.
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Chan J, Schwartz J, Kaba F, Bocour A, Akiyama MJ, Hobstetter L, Rosner Z, Winters A, Yang P, MacDonald R. Outcomes of Hepatitis C Virus Treatment in the New York City Jail Population: Successes and Challenges Facing Scale up of Care. Open Forum Infect Dis 2020; 7:ofaa263. [PMID: 33123613 PMCID: PMC7580175 DOI: 10.1093/ofid/ofaa263] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/23/2020] [Indexed: 12/19/2022] Open
Abstract
Background The population detained in the New York City (NYC) jail system bears a high burden of hepatitis C virus (HCV) infection. Challenges to scaling up treatment include short and unpredictable lengths of stay. We report on the clinical outcomes of direct-acting antiviral (DAA) treatment delivered by NYC Health + Hospitals/Correctional Health Services in NYC jails from 2014 to 2017. Methods We performed a retrospective observational cohort study of HCV patients with detectable HCV ribonucleic acid treated with DAA therapy while in NYC jails. Some patients initiated treatment in jail, whereas others initiated treatment in the community and were later incarcerated. Our primary outcome was sustained virologic response at 12 weeks (SVR12). Results There were 269 patients included in our cohort, with 181 (67%) initiating treatment in jail and 88 (33%) continuing treatment started in the community. The SVR12 virologic outcome data were available for 195 (72%) individuals. Of these, 172 (88%) achieved SVR12. Patients who completed treatment in jail were more likely to achieve SVR12 relative to those who were released on treatment (adjusted risk ratio, 2.93; 95% confidence interval, 1.35-6.34). Of those who achieved SVR12, 114 (66%) had a subsequent viral load checked. We detected recurrent viremia in 18 (16%) of these individuals, which corresponded to 10.6 cases per 100 person-years of follow-up. Conclusions Hepatitis C virus treatment with DAA therapy is effective in a jail environment. Future work should address challenges related to discharging patients while they are on treatment, loss to follow-up, and a high incidence of probable reinfection.
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Affiliation(s)
- Justin Chan
- Correctional Health Services, NYC Health + Hospitals, New York, New York, USA
| | - Jessie Schwartz
- Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Fatos Kaba
- Correctional Health Services, NYC Health + Hospitals, New York, New York, USA
| | - Angelica Bocour
- Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Matthew J Akiyama
- Correctional Health Services, NYC Health + Hospitals, New York, New York, USA.,Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Laura Hobstetter
- Correctional Health Services, NYC Health + Hospitals, New York, New York, USA
| | - Zachary Rosner
- Correctional Health Services, NYC Health + Hospitals, New York, New York, USA
| | - Ann Winters
- Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Patricia Yang
- Correctional Health Services, NYC Health + Hospitals, New York, New York, USA
| | - Ross MacDonald
- Correctional Health Services, NYC Health + Hospitals, New York, New York, USA
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Borzie K, Jasper N, Southall DP, MacDonald R, Kola AA, Dolo O, Magnus A, Watson SD, Casement M, Dahn B, Jallah W. Monitoring intrapartum fetal heart rates by mothers in labour in two public hospitals: an initiative to improve maternal and neonatal healthcare in Liberia. BMC Pregnancy Childbirth 2020; 20:362. [PMID: 32536345 PMCID: PMC7294611 DOI: 10.1186/s12884-020-02921-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 04/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In low-resource settings with few health workers, Fetal Heart Rate (FHR) monitoring in labour can be inconsistent and unreliable. An initiative to improve fetal monitoring was implemented in two public hospitals in rural Liberia; the country with the second lowest number of midwives and nurses in the world (1.007 per 10,000 of the population). The initiative assessed the feasibility of educating women in labour to monitor their own FHR and alert a midwife of changes detected. METHODS Four hundred seventy-four women admitted in labour without obstetric complications were approached. Four hundred sixty-one consented to participate (97%) and 13 declined. Those consenting were trained to monitor their FHR using a sonicaid for approximately 1 minute immediately following the end of every uterine contraction and to inform a midwife of changes. If changes were confirmed, standard clinical interventions for fetal distress (lateral tilt, intravenous fluids and oxygen) were undertaken and, when appropriate, accelerated delivery by vacuum or Caesarean section. Participants provided views on their experiences; subsequently categorized into themes. Neonatal outcomes regarding survival, need for resuscitation, presence of birth asphyxia, and treatment were recorded. RESULTS Four hundred sixty-one out of 474 women gave consent, of whom 431 of 461 (93%) completed the monitoring themselves. Three hundred eighty-seven of 400 women who gave comments, reported positive and 13 negative experiences. FHR changes were reported in 28 participants and confirmed in 26. Twenty-four of these 26 FHR changes were first identified by mothers. Fetal death was identified on admission during training in one mother. Thirteen neonates required resuscitation, with 12 admitted to the neonatal unit. One developed temporary seizures suggesting birth asphyxia. All 26 neonates were discharged home apparently well. In 2 mothers, previously unrecognized obstetric complications (cord prolapse and Bandl's ring with obstructed labour) accompanied FHR changes. Resuscitation was needed in 8 neonates without identified FHR changes including one of birth weight 1.3 Kg who could not be resuscitated. There were no intrapartum stillbirths in participants. CONCLUSIONS Women in labour were able to monitor and detect changes in their FHR. Most found the experience beneficial. The absence of intrapartum stillbirths after admission and the low rate of poor neonatal outcomes are promising and warrant further investigation.
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Affiliation(s)
- K Borzie
- CB Dunbar Hospital, Gbarnga, Liberia
| | - N Jasper
- Fish Town Hospital, Fish Town, Liberia
| | - D P Southall
- Maternal and Childhealth Advocacy International (MCAI), 1 Columba Court, Laide, Highland, IV22 2NL, Scotland.
| | | | - A A Kola
- MCAI, CB Dunbar Hospital, Gbarnga, Liberia
| | | | - A Magnus
- CH Rennie Hospital, Kakata, Liberia
| | | | | | - B Dahn
- University of Liberia, Monrovia, Liberia
| | - W Jallah
- Ministry of Health and Social Welfare, Monrovia, Liberia
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Chan PY, Kaba F, Lim S, Katyal M, MacDonald R. Identifying demographic and health profiles of young adults with frequent jail incarceration in New York City during 2011-2017. Ann Epidemiol 2020; 46:41-48.e1. [PMID: 32451196 DOI: 10.1016/j.annepidem.2020.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/21/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to investigate incarceration patterns among young adults in New York City jails from mid-2011 through 2017, with an aim that identification of frequently incarcerated young "hot spotters" may inform early interventions. METHODS We examined electronic health records for 3114 individuals with no known prior jail admission and admitted within 4.5 years after turning age 18 years. We used group-based trajectory analysis to identify hot spotters and compared their characteristics with those of other trajectory groups. We repeated the analysis for three older adult groups for additional comparison. RESULTS Five percent of the young individuals became hot spotters (mean = 7.7 incarcerations). They were more likely to be homeless (27.1% vs. 7.2%-16.4% in other trajectory groups), have substance use disorders (95.2% vs. 73.2%-89.8%), and mental health needs (65.7% vs. 28.5%-53.3%), and be incarcerated for theft-related charges (52.7% vs. 32.0%-49.6%) and misdemeanors (34.8 vs. 25.5%-29.4%). They differed in charge profile and homelessness compared with older hot spotters. CONCLUSIONS Some young adults are at risk of frequent incarceration. Tailored health- and behavior-related interventions may preclude cyclical incarceration and address barriers to well-being and stability.
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Affiliation(s)
- Pui Ying Chan
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY.
| | - Fatos Kaba
- Correctional Health Services, New York City Health + Hospitals, New York, NY
| | - Sungwoo Lim
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY
| | - Monica Katyal
- Correctional Health Services, New York City Health + Hospitals, New York, NY
| | - Ross MacDonald
- Correctional Health Services, New York City Health + Hospitals, New York, NY
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Akiyama MJ, Columbus D, MacDonald R, Jordan AO, Schwartz J, Litwin AH, Eckhardt B, Carmody E. Linkage to hepatitis C care after incarceration in jail: a prospective, single arm clinical trial. BMC Infect Dis 2019; 19:703. [PMID: 31395019 PMCID: PMC6686449 DOI: 10.1186/s12879-019-4344-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/31/2019] [Indexed: 12/13/2022] Open
Abstract
Background Hepatitis C virus (HCV) is a major public health problem in correctional settings. HCV treatment is often not possible in U.S. jails due to short lengths of stay. Linkage to care is crucial in these settings, but competing priorities complicate community healthcare engagement and retention after incarceration. Methods We conducted a single arm clinical trial of a combined transitional care coordination (TCC) and patient navigation intervention and assessed the linkage rate and factors associated with linkage to HCV care after incarceration. Results During the intervention, 84 participants returned to the community after their index incarceration. Most participants were male and Hispanic, with a history of mental illness and a mean age of 45 years. Of those who returned to the community, 26 (31%) linked to HCV care within a median of 20.5 days; 17 (20%) initiated HCV treatment, 15 (18%) completed treatment, 9 (11%) had a follow-up lab drawn to confirm sustained virologic response (SVR), and 7 (8%) had a documented SVR. Among those with follow-up labs the known SVR rate was (7/9) 78%. Expressing a preference to be linked to the participant’s existing health system, being on methadone prior to incarceration, and feeling that family or a loved one were concerned about the participant’s wellbeing were associated with linkage to HCV care. Reporting drinking alcohol to intoxication prior to incarceration was negatively associated with linkage to HCV care. Conclusion We demonstrate that an integrated strategy with combined TCC and patient navigation may be effective in achieving timely linkage to HCV care. Additional multicomponent interventions aimed at treatment of substance use disorders and increasing social support could lead to further improvement. Trial registration Clinicaltrials.gov NCT04036760 July 30th, 2019 (retrospectively registered).
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Affiliation(s)
- Matthew J Akiyama
- Montefiore Medical Center/Albert Einstein College of Medicine, 3300 Kossuth Ave, Bronx, NY, 10467, USA. .,New York University School of Medicine, New York, NY, USA.
| | - Devin Columbus
- New York University School of Medicine, New York, NY, USA
| | - Ross MacDonald
- New York City Health + Hospitals, Correctional Health Services, New York, NY, USA
| | - Alison O Jordan
- New York City Health + Hospitals, Correctional Health Services, New York, NY, USA
| | - Jessie Schwartz
- New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Alain H Litwin
- University of South Carolina School of Medicine, Greenville, South Carolina, USA.,Clemson University School of Health Research, Clemson, South Carolina, USA.,Prisma Health - Upstate, Greenville, South Carolina, USA
| | | | - Ellie Carmody
- New York University School of Medicine, New York, NY, USA
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Diaz-Montes T, Velez-Mejia C, Sittig M, MacDonald R, Gushchin V, Ducie J, Ryu H, Sardi A. Electrolyte and hematological abnormalities in patients with advanced epithelial ovarian cancers treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) or neoadjuvant chemotherapy plus CRS/HIPEC. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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Diaz-Montes T, Velez-Mejia C, Sittig M, MacDonald R, Gushchin V, Ducie J, Ryu H, Sardi A. Comparison of perioperative and demographic variables among exceptional and poor responders ovarian cancer patients managed with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Huxley-Reicher Z, Maldjian L, Winkelstein E, Siegler A, Paone D, Tuazon E, Nolan ML, Jordan A, MacDonald R, Kunins HV. Witnessed overdoses and naloxone use among visitors to Rikers Island jails trained in overdose rescue. Addict Behav 2018; 86:73-78. [PMID: 29175025 DOI: 10.1016/j.addbeh.2017.11.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/06/2017] [Accepted: 11/15/2017] [Indexed: 10/18/2022]
Abstract
With the opioid overdose mortality rates rising nationally, The New York City Department of Health and Mental Hygiene (NYC DOHMH) has worked to expand overdose rescue training (ORT) and naloxone distribution. This study sought to determine rates of overdose witnessing and naloxone use among overdose rescue-trained visitors to the NYC jails on Rikers Island. We conducted a six-month prospective study of visitors to NYC jails on Rikers Island who received ORT. We collected baseline characteristics of study participants, characteristics of overdose events, and responses to witnessed overdose events, including whether the victim was the incarcerated individual the participant was visiting on the day of training. Bivariate analyses compared baseline characteristics of participants who witnessed overdoses to those who did not, and of participants who used naloxone to those who did not. Overall, we enrolled 283 participants visiting NYC's Rikers Island jails into the study. Six months after enrollment, we reached 226 participants for follow-up by phone. 40 participants witnessed 70 overdose events, and 28 participants reported using naloxone. Of the 70 overdose events, three victims were the incarcerated individuals visited on the day of training; nine additional victims were recently released from jail and/or prison. Visitors to persons incarcerated at Rikers Island witness overdose events and are able to perform overdose rescues with naloxone. This intervention reaches a population that includes not only those recently released, but also other people who experienced overdose.
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24
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O'Regan R, MacDonald R, Boyle JG, Hughes KA, McKenzie J. 'CPR for Feet' care bundle to improve foot assessment in inpatient diabetes. BMJ Open Qual 2018; 7:e000196. [PMID: 30234169 PMCID: PMC6135470 DOI: 10.1136/bmjoq-2017-000196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 07/12/2018] [Accepted: 07/31/2018] [Indexed: 11/04/2022] Open
Abstract
Aims The Scottish Inpatient Diabetes Foot Audit conducted in 2013 revealed that 57% of inpatients had not had their feet checked on admission, 60% of those at risk did not have pressure relief in place and 2.4% developed a new foot lesion. In response, the Scottish Diabetes Foot Action Group launched the ‘CPR for Feet’ campaign. The aim of this project was to raise awareness of the ‘Check, Protect and Refer’ (CPR) campaign as well as improve the assessment and management of inpatients with diabetes. Methods A quality improvement project underpinned by Plan-Do-Study-Act (PDSA) methodology was undertaken. The first and second cycles focused on staff education and the implementation of a ‘CPR for Feet’ assessment checklist using campaign guidelines, training manuals and modules. The third and fourth cycles focused on staff feedback and the implementation of a ‘CPR for Feet’ care bundle. Results Baseline measurements revealed 28% of patients had evidence of foot assessment. Medical and nursing staff reported to be largely unaware of the ‘CPR for Feet’ campaign (13%). Fifty-two per cent of inpatients with diabetes had their feet assessed and managed correctly following the second PDSA cycle. After completion of the third and fourth PDSA this number improved further to 72% and all staff reported to be aware of the campaign. Conclusions The introduction of a ‘CPR for Feet’ care bundle improved the assessment of inpatients with diabetes.
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Affiliation(s)
- Rhea O'Regan
- Department of Diabetes, Glasgow Royal Infirmary, Glasgow, UK
| | - Ross MacDonald
- Department of Diabetes, Glasgow Royal Infirmary, Glasgow, UK
| | - James G Boyle
- Department of Diabetes, Glasgow Royal Infirmary, Glasgow, UK
| | | | - Joyce McKenzie
- Department of Diabetes, Glasgow Royal Infirmary, Glasgow, UK
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25
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Siegler A, Rosner Z, MacDonald R, Ford E, Venters H. Head Trauma in Jail and Implications for Chronic Traumatic Encephalopathy in the United States: Case Report and Results of Injury Surveillance in NYC Jails. J Health Care Poor Underserved 2018; 28:1042-1049. [PMID: 28804076 DOI: 10.1353/hpu.2017.0095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Because there is no standard reporting of injuries in jails and prisons, the national burden of head trauma during incarceration is unclear. We report on a case of repeated head trauma in the New York City (NYC) jail system, data on the incidence of head trauma and mild traumatic brain injury (mTBI), and compare those findings with national estimates. The case report revealed 64 injurious events over two years, 44% resulting in a head injury and 25% resulting in emergency hospitalization. During the 42 months of this analysis, 10,286 incidents of head trauma occurred in the NYC jail system. Mild TBI occurred in 1,507 of these instances. The rate of head trauma and mTBI was 269.0 and 39.4 per 1,000 person-years, respectively. The lack of reporting head trauma in correctional settings means that national prevalence estimates of these critical health outcomes miss the vulnerable cohort of incarcerated individuals.
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26
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MacDonald R. i019 Does fibromyalgia influence biologic therapy response among patients with axial spondyloarthritis? results from the BSRBR-AS. Rheumatology (Oxford) 2018. [DOI: 10.1093/rheumatology/key075.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ross MacDonald
- Epidemiology, University of Aberdeen, Aberdeen, UNITED KINGDOM
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27
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Kalra R, Kollisch SG, MacDonald R, Dickey N, Rosner Z, Venters H. Staff Satisfaction, Ethical Concerns, and Burnout in the New York City Jail Health System. J Correct Health Care 2018; 22:383-392. [PMID: 27742860 DOI: 10.1177/1078345816668339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article reviewed a program evaluation conducted among correctional health care staff in New York City (NYC) using a 68-question electronic survey to assess satisfaction, attitudes, and beliefs in relation to ethics and burnout of health care employees in NYC jails. Descriptive statistics were tabulated and reviewed, and further assessment of burnout and ethics was performed through group sessions with participants. This evaluation has led to changes in agency policies and procedures and an emphasis on the human rights issue of the dual loyalty challenges that the security setting places on the overall mission to care for patients.
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Affiliation(s)
- Ramneet Kalra
- NYC Department of Health and Mental Hygiene, Long Island City, NY, USA
| | | | | | | | | | - Homer Venters
- NYC Health and Hospitals Corporation, New York, NY, USA
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Abstract
The United States incarcerates more people than any other country in the world. The scale of mass incarceration ensures that almost all practicing physicians will treat formerly incarcerated patients. Yet the majority of physicians receive little training on this topic. In this paper, we will outline the need for expanded education on the interface between incarceration and health, describe initiatives taking place within the New York City jail system and nationally, and describe future directions for curriculum development. We conclude by highlighting the important role health care workers can play in transforming our criminal justice system and ending mass incarceration.
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Affiliation(s)
- Jonathan Giftos
- The director of clinical education for the NYC Health + Hospitals Division of Correctional Health Services in New York City, and a clinical instructor of medicine at the Albert Einstein College of Medicine and a voluntary attending physician in the Bronx Transitions Clinic at Montefiore's Comprehensive Health Care Center
| | - Andreas Mitchell
- A fourth-year medical student at Harvard Medical School, and served as co-chair of the student leadership committee of the Harvard Medical School Center for Primary Care and is a student member of the board of the Academic Consortium on Criminal Justice Health
| | - Ross MacDonald
- The chief medical officer for the NYC Health + Hospitals Division of Correctional Health Services in New York City, and an assistant professor of medicine at New York University School of Medicine
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29
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Whibley D, MacDonald R, Macfarlane GJ, Jones GT. Constructs of health belief and disabling distal upper limb pain. Scand J Pain 2017; 13:91-97. [PMID: 28850538 DOI: 10.1016/j.sjpain.2016.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/20/2016] [Accepted: 07/21/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Musculoskeletal pain in the distal upper limb is common and is a cause of disability and healthcare consultation. At the time of presentation individuals reporting similar pain severities may report different levels of related disability. The biopsychosocial model proposes that health beliefs may help explain this difference. The aim of this cross-sectional study was to identify underlying constructs of health belief in those referred to physiotherapy with pain in the distal upper limb and investigate whether these constructs moderated the relationship between pain severity and extent of disability. METHOD Health beliefs were assessed using an instrument included in a questionnaire completed before randomisation to the Arm Pain Trial (ISRCTN79085082). Ordinal responses to statements about health beliefs were used to generate a polychoric correlation matrix. The output from this matrix was then used for Exploratory Factor Analysis to determine underlying constructs. The moderating influence of the identified health belief constructs was then tested using interaction terms in linear regression models. RESULTS 476 trial participants contributed data, age range 18-85 (mean 48.8, SD 13.7), 54% female. Five health belief constructs were identified: beliefs about hereditary factors, beliefs about movement and pain, beliefs about locus of control, beliefs about the role of lifecourse/lifestyle factors, and beliefs about prognosis. The only health belief construct found to moderate the pain-disability relationship was beliefs about prognosis, with greater pessimism resulting in higher levels of disability at mild-to-moderate levels of pain severity (B -0.17, 95% CI -0.30, -0.036). CONCLUSION This exploratory cross-sectional study identified five constructs of health belief from responses to a previously used set of statements investigating fear avoidance and illness beliefs in a clinical population with pain in the distal upper limb. Of these constructs, beliefs about prognosis were found to moderate the relationship between pain and disability. IMPLICATIONS At the time of referral to physiotherapy it may be beneficial to assess patients' perception of prognosis. For those with higher than expected disability for the presenting level of pain, and pessimism about prognosis, focused reassurance may play an important part in initial consultation. Longitudinal study is required to support the findings from this study and investigate whether a causal relationship exists. Future investigations should confirm the health belief constructs proposed.
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Affiliation(s)
- Daniel Whibley
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Scotland, UK
- Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Scotland, UK
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work,University of Aberdeen, Scotland, UK
| | - Ross MacDonald
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Scotland, UK
- School of Mathematics and Statistics, University of St Andrews, Scotland, UK
| | - Gary J Macfarlane
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Scotland, UK
- Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Scotland, UK
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work,University of Aberdeen, Scotland, UK
| | - Gareth T Jones
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Scotland, UK
- Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Scotland, UK
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work,University of Aberdeen, Scotland, UK
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30
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MacDonald R, Akiyama MJ, Kopolow A, Rosner Z, McGahee W, Joseph R, Jaffer M, Venters H. Feasibility of Treating Hepatitis C in a Transient Jail Population. Open Forum Infect Dis 2017; 4:ofx142. [PMID: 28852680 PMCID: PMC5569928 DOI: 10.1093/ofid/ofx142] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/05/2017] [Indexed: 01/29/2023] Open
Abstract
Jails represent a critical component of the public health response to HCV elimination. We report on outcomes of 104 patients receiving HCV treatment from January 1, 2014 to June 30, 2016 in a large urban jail setting. Our data demonstrate that treatment in jails is feasible, but many barriers remain.
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Affiliation(s)
- Ross MacDonald
- Correctional Health Services, New York City Health + Hospitals, Bronx; and
| | - Matthew J Akiyama
- Correctional Health Services, New York City Health + Hospitals, Bronx; and.,Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Aimee Kopolow
- Correctional Health Services, New York City Health + Hospitals, Bronx; and
| | - Zachary Rosner
- Correctional Health Services, New York City Health + Hospitals, Bronx; and
| | - Wendy McGahee
- Correctional Health Services, New York City Health + Hospitals, Bronx; and
| | - Rodrigue Joseph
- Correctional Health Services, New York City Health + Hospitals, Bronx; and
| | - Mohamed Jaffer
- Correctional Health Services, New York City Health + Hospitals, Bronx; and
| | - Homer Venters
- Correctional Health Services, New York City Health + Hospitals, Bronx; and
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Affiliation(s)
- Byron Alex
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - David B. Weiss
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Fatos Kaba
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Zachary Rosner
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - David Lee
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Sungwoo Lim
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Homer Venters
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Ross MacDonald
- New York City Department of Health and Mental Hygiene, New York, NY, USA
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Akiyama MJ, Kaba F, Rosner Z, Alper H, Kopolow A, Litwin AH, Venters H, MacDonald R. Correlates of Hepatitis C Virus Infection in the Targeted Testing Program of the New York City Jail System. Public Health Rep 2016; 132:41-47. [PMID: 28005477 PMCID: PMC5298495 DOI: 10.1177/0033354916679367] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The objective of this study was to understand predictors of hepatitis C virus (HCV) antibody positivity in a large urban jail system in New York City. METHODS We examined demographic characteristics, risk behaviors, and HCV antibody prevalence among 10 790 jail inmates aged 16 to 86 who were screened from June 13, 2013, to June 13, 2014, based on birth cohort or conventional high-risk criteria. We used logistic regression analysis to determine predictors of HCV antibody positivity. RESULTS Of the 10 790 inmates screened, 2221 (20.6%) were HCV antibody positive. In the multivariate analysis, HCV antibody positivity was associated most strongly with injection drug use (IDU; adjusted odds ratio [aOR] = 35.0; 95% confidence interval [CI], 28.5-43.0). Women were more likely than men to be infected with HCV (aOR = 1.3; 95% CI, 1.1-1.5). Compared with non-Hispanic black people, Hispanic (aOR = 2.1; 95% CI, 1.8-2.4) and non-Hispanic white (aOR = 1.7; 95% CI, 1.5-2.1) people were more likely to be infected with HCV. Non-IDU, recidivism, HIV infection, homelessness, mental illness, and lower education level were all significantly associated with HCV infection. The prevalence rate of HCV infection among a subset of inmates born after 1965 who denied IDU and were not infected with HIV was 5.6% (198 of 3529). Predictors of HCV infection among this group included non-IDU as well as being non-Hispanic white, Hispanic, recidivist, and homeless. CONCLUSION These data reveal differences in HCV infection by sex, race/ethnicity, and socioeconomics in a large jail population, suggesting that a focused public health intervention is required and that universal screening may be warranted. Further sensitivity and cost-benefit analyses are needed to make this determination.
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Affiliation(s)
- Matthew J. Akiyama
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Fatos Kaba
- New York City Health + Hospitals Correctional Health Services, New York, NY, USA
| | - Zachary Rosner
- New York City Health + Hospitals Correctional Health Services, New York, NY, USA
| | - Howard Alper
- New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Aimee Kopolow
- New York City Health + Hospitals Correctional Health Services, New York, NY, USA
| | - Alain H. Litwin
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Homer Venters
- New York City Health + Hospitals Correctional Health Services, New York, NY, USA
| | - Ross MacDonald
- New York City Health + Hospitals Correctional Health Services, New York, NY, USA
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Akiyama M, MacDonald R, Jordan A, Laraque F, Columbus D, Maurantonio M, Schwartz J, Pham V, Carmody E. Hepatitis C in the Correctional-Community Continuum of Care: Poor Baseline Linkage Rates and Early Improvement With Care Coordination. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Matthew Akiyama
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Ross MacDonald
- New York City Health and Hospitals, Correctional Health Services, New York, New York
| | - Alison Jordan
- New York City Health and Hospitals, Correctional Health Services, New York, New York
| | - Fabienne Laraque
- Viral Hepatitis Surveillance, Prevention and Control Program, New York City Department of Health and Mental Hygiene, New York, New York
| | - Devin Columbus
- Division of Infectious Diseases and Immunology, New York University Medical Center, New York, New York
| | - Michael Maurantonio
- Division of Infectious Diseases and Immunology, New York University Medical Center, New York, New York
| | - Jessie Schwartz
- Viral Hepatitis Surveillance, Prevention and Control Program, New York City Department of Health and Mental Hygiene, New York, New York
| | - Vinh Pham
- Division of Infectious Diseases and Immunology, New York University Medical Center, New York, New York
| | - Ellie Carmody
- Division of Infectious Diseases and Immunology, New York University Medical Center, New York, New York
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Bayoumy K, MacDonald R, Dargham SR, Arayssi T. Bibliometric analysis of rheumatology research in the Arab countries. BMC Res Notes 2016; 9:393. [PMID: 27501954 PMCID: PMC4977706 DOI: 10.1186/s13104-016-2197-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 08/01/2016] [Indexed: 01/06/2023] Open
Abstract
Background The Arab world has seen an increase in the burden of musculoskeletal diseases. No bibliometric studies have characterized rheumatology research in the Arab world. This study evaluates the productivity and impact of rheumatology research in the Arab world. Methods We searched the Web of Science Core Collection for rheumatology publications, from 1976 to 2014, for each of the Arab League (AL) countries, North America, Europe and Asia. For the AL countries, the overall trend of publications and citations was analyzed, while considering the paper type and collaborations. Results The AL countries published 944 rheumatology papers over the period studied. The number of publications increased by a factor of 2.77 (95 % CI, 2.75–2.78) each decade, and citations increased by a factor of 2.36 (95 % CI, 0.96–5.82). The absolute number of papers included in the top-10 rheumatology journals remained constant but the proportion decreased. Papers involving collaboration among AL countries were found to increase over time. Conclusions Overall, the AL countries lag in research productivity and impact compared to other regions. Three countries are responsible for the majority of publications, while four countries receive the majority of citations. Electronic supplementary material The online version of this article (doi:10.1186/s13104-016-2197-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Karim Bayoumy
- Weill Cornell Medicine - Qatar, Education City, Al-Luqta Street, P.O.Box 24144, Doha, Qatar
| | - Ross MacDonald
- Distributed eLibrary, Weill Cornell Medicine - Qatar, Education City, Al-Luqta Street, P.O.Box 24144, Doha, Qatar
| | - Soha Roger Dargham
- Biostatistics, Epidemiology, and Biomathematics Research Core, Weill Cornell Medicine - Qatar, Education City, Al-Luqta Street, P.O.Box 24144, Doha, Qatar
| | - Thurayya Arayssi
- Department of Internal Medicine, Weill Cornell Medicine - Qatar, Education City, Al-Luqta Street, P.O.Box 24144, Doha, Qatar.
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Akiyama MJ, Kaba F, Rosner Z, Alper H, Holzman RS, MacDonald R. Hepatitis C Screening of the "Birth Cohort" (Born 1945-1965) and Younger Inmates of New York City Jails. Am J Public Health 2016; 106:1276-7. [PMID: 27196656 DOI: 10.2105/ajph.2016.303163] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To examine uptake of screening for all individuals born between 1945 and 1965 (referred to by the Centers for Disease Control and Prevention as the "birth cohort") and outline preliminary HCV prevalence data in the New York City jail system. METHODS Data were extracted from electronic health records for all individuals screened for HCV between June 13, 2013, and June 13, 2014, in New York City jails. We used the Abbott EIA 2.0 HCV antibody assay for testing. RESULTS In the year of study, 56 590 individuals were incarcerated; 15.1% were born between 1945 and 1965, and 84.6% were born after 1965. HCV screening was completed for 64.1% of the birth cohort and for 11.1% born after 1965, with 55.1% and 43.8% of cases found in these groups, respectively. The overall seropositivity rate was 20.6%. CONCLUSIONS Birth cohort screening in a large jail system identified many HCV cases, but HCV infection was common among younger age groups. PUBLIC HEALTH IMPLICATIONS Universal screening may be warranted pending further study including cost-effectiveness analyses.
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Affiliation(s)
- Matthew J Akiyama
- Matthew J. Akiyama and Robert S. Holzman are with the Division of Infectious Diseases, New York University School of Medicine, New York. Fatos Kaba, Zachary Rosner, Howard Alper, and Ross MacDonald are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Fatos Kaba
- Matthew J. Akiyama and Robert S. Holzman are with the Division of Infectious Diseases, New York University School of Medicine, New York. Fatos Kaba, Zachary Rosner, Howard Alper, and Ross MacDonald are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Zachary Rosner
- Matthew J. Akiyama and Robert S. Holzman are with the Division of Infectious Diseases, New York University School of Medicine, New York. Fatos Kaba, Zachary Rosner, Howard Alper, and Ross MacDonald are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Howard Alper
- Matthew J. Akiyama and Robert S. Holzman are with the Division of Infectious Diseases, New York University School of Medicine, New York. Fatos Kaba, Zachary Rosner, Howard Alper, and Ross MacDonald are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Robert S Holzman
- Matthew J. Akiyama and Robert S. Holzman are with the Division of Infectious Diseases, New York University School of Medicine, New York. Fatos Kaba, Zachary Rosner, Howard Alper, and Ross MacDonald are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Ross MacDonald
- Matthew J. Akiyama and Robert S. Holzman are with the Division of Infectious Diseases, New York University School of Medicine, New York. Fatos Kaba, Zachary Rosner, Howard Alper, and Ross MacDonald are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
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Jaffer M, Ayad J, Tungol JG, MacDonald R, Dickey N, Venters H. Improving Transgender Healthcare in the New York City Correctional System. LGBT Health 2016; 3:116-21. [DOI: 10.1089/lgbt.2015.0050] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mohamed Jaffer
- Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, New York
| | - John Ayad
- Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, New York
| | - Jose Gabriel Tungol
- Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, New York
| | - Ross MacDonald
- Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, New York
| | - Nathaniel Dickey
- Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, New York
| | - Homer Venters
- Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, New York
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Di Gregoli K, Somerville M, George S, MacDonald R, Jackson C, Johnson J. Galectin-3 regulates macrophage behaviour and modulates atherosclerotic plaque compostion. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2015.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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French J, Purificacion S, Brown E, MacDonald R, Wilson L, Kumar E, Bird L, Brady J, Milosevic M, Mitera G. Each Cancer Journey Begins With One Shared Step: Patient Engagement and Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Skerker M, Dickey N, Schonberg D, MacDonald R, Venters H. Improving antenatal care in prisons. Bull World Health Organ 2015; 93:739-740. [PMID: 26600618 PMCID: PMC4645433 DOI: 10.2471/blt.14.151282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 03/05/2015] [Accepted: 03/07/2015] [Indexed: 01/13/2023] Open
Affiliation(s)
- Molly Skerker
- City University of New York, Hunter College of Sociology, New York, United States of America (USA)
| | - Nathaniel Dickey
- The New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, 42-09 28th St, Queens, NY, 11101, USA
| | - Dana Schonberg
- Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA
| | - Ross MacDonald
- The New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, 42-09 28th St, Queens, NY, 11101, USA
| | - Homer Venters
- The New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, 42-09 28th St, Queens, NY, 11101, USA
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MacDonald R, Kaba F, Rosner Z, Vise A, Weiss D, Brittner M, Skerker M, Dickey N, Venters H. The Rikers Island Hot Spotters: Defining the Needs of the Most Frequently Incarcerated. Am J Public Health 2015; 105:2262-8. [PMID: 26378829 DOI: 10.2105/ajph.2015.302785] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We used "hot spotting" to characterize the persons most frequently admitted to the New York City jail system in 2013. METHODS We used our Correctional Health Services electronic health record to identify 800 patients admitted in 2013 who returned most since November 2008. We compared them to a randomly selected control group of 800 others admitted in 2013, by using descriptive statistics and cross-tabulations, including data through December 2014. RESULTS The frequently incarcerated individuals had a median of 21 incarcerations (median duration 11 days), representing 18 713 admissions and $129 million in custody and health costs versus $38 million for the controls. The frequently incarcerated were significantly older (42 vs 35 years), and more likely to have serious mental illness (19% vs 8.5%) and homelessness (51.5% vs 14.7%) in their record. Significant substance use was highly prevalent (96.9% vs 55.6%). Most top criminal charges (88.7%) for the frequently incarcerated were misdemeanors; assault charges were less common (2.8% vs 10.4%). CONCLUSIONS Frequently incarcerated persons have chronic mental health and substance use problems, their charges are generally minor, and incarceration is costly. Tailored supportive housing is likely to be less costly and improve outcomes.
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Affiliation(s)
- Ross MacDonald
- All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Fatos Kaba
- All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Zachary Rosner
- All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Allison Vise
- All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - David Weiss
- All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Mindy Brittner
- All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Molly Skerker
- All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Nathaniel Dickey
- All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
| | - Homer Venters
- All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY
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Milovanov V, Sardi A, MacDonald R, Gushchin V. 2204 Predicting incomplete cytoreduction and aborted hyperthermic intraperitoneal chemotherapy procedures in patients with peritoneal carcinomatosis. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31121-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kaba F, Solimo A, Graves J, Glowa-Kollisch S, Vise A, MacDonald R, Waters A, Rosner Z, Dickey N, Angell S, Venters H. Disparities in Mental Health Referral and Diagnosis in the New York City Jail Mental Health Service. Am J Public Health 2015; 105:1911-6. [PMID: 26180985 PMCID: PMC4539829 DOI: 10.2105/ajph.2015.302699] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To better understand jail mental health services entry, we analyzed diagnosis timing relative to solitary confinement, nature of diagnosis, age, and race/ethnicity. METHODS We analyzed 2011 to 2013 medical records on 45,189 New York City jail first-time admissions. RESULTS Of this cohort, 21.2% were aged 21 years or younger, 46.0% were Hispanic, 40.6% were non-Hispanic Black, 8.8% were non-Hispanic White, and 3.9% experienced solitary confinement. Overall, 14.8% received a mental health diagnosis, which was associated with longer average jail stays (120 vs 48 days), higher rates of solitary confinement (13.1% vs 3.9%), and injury (25.4% vs 7.1%). Individuals aged 21 years or younger were less likely than older individuals to receive a mental health diagnosis (odds ratio [OR] = 0.86; 95% confidence interval [CI] = 0.80, 0.93; P < .05) and more likely to experience solitary confinement (OR = 4.99; 95% CI = 4.43, 5.61; P < .05). Blacks and Hispanics were less likely than Whites to enter the mental health service (OR = 0.57; 95% CI = 0.52, 0.63; and OR = 0.49; 95% CI = 0.44, 0.53; respectively; P < .05), but more likely to experience solitary confinement (OR = 2.52; 95% CI = 1.88, 3.83; and OR = 1.65; 95% CI = 1.23, 2.22; respectively; P < .05). CONCLUSIONS More consideration is needed of race/ethnicity and age in understanding and addressing the punishment and treatment balance in jails.
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Affiliation(s)
- Fatos Kaba
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
| | - Angela Solimo
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
| | - Jasmine Graves
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
| | - Sarah Glowa-Kollisch
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
| | - Allison Vise
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
| | - Ross MacDonald
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
| | - Anthony Waters
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
| | - Zachary Rosner
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
| | - Nathaniel Dickey
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
| | - Sonia Angell
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
| | - Homer Venters
- Fatos Kaba, Angela Solimo, Jasmine Graves, Sarah Glowa-Kollisch, Allison Vise, Ross MacDonald, Anthony Waters, Zachary Rosner, Nathaniel Dickey, and Homer Venters are with the Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene, Queens, NY. Sonia Angell is with the Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene
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Graves J, Steele J, Kaba F, Glowa-Kollisch S, Ramdath C, Rosner Z, MacDonald R, Dickey N, Venters H. Traumatic Brain Injury Focus Groups as a Means to Understand Violence among Adolescent Males in the NYC Jail System. J Health Care Poor Underserved 2015; 26:345-57. [PMID: 25913334 DOI: 10.1353/hpu.2015.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Because we previously identified high rates of past TBI among adolescents arriving in the New York City (NYC) jail system we engaged adolescents in nine TBI focus groups to characterize better the level of understanding regarding the relationship between TBI and violence. During these groups, the following themes emerged: 1) physical and psychological impacts of violence; 2) roots of violence; 3) the use of violence as capital in the face of a marginalized social status; and 4) the inevitability of violence, particularly in a jail setting. Although these focus groups were initiated as a means to engage adolescents around the clinical problem of TBI, their observations are strongly centered in the larger context of violence. These results suggest that intervening in the problem of TBI among our patients will require broad-based changes in the environmental and interpersonal realities, both in the jail setting, and the communities where these adolescents reside.
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Glowa-Kollisch S, Graves J, Dickey N, MacDonald R, Rosner Z, Waters A, Venters H. Data-Driven Human Rights: Using Dual Loyalty Trainings to Promote the Care of Vulnerable Patients in Jail. Health Hum Rights 2015. [DOI: 10.2307/healhumarigh.17.1.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kaba F, Diamond P, Haque A, MacDonald R, Venters H. Traumatic brain injury among newly admitted adolescents in the New York city jail system. J Adolesc Health 2014; 54:615-7. [PMID: 24529834 DOI: 10.1016/j.jadohealth.2013.12.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 12/11/2013] [Accepted: 12/11/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE Relatively little is known about the prevalence of traumatic brain injury (TBI) among adolescents who come into contact with the criminal justice system. METHODS We undertook screening for TBI among newly admitted adolescents in the New York City jail system using a validated TBI screening tool. A convenience sample of 300 male and 84 female screenings was examined. RESULTS Screening revealed that 50% of male and 49% of female adolescents enter jail with a history of TBI. Incidence of TBI was assessed using patient health records, and revealed an incidence of 3,107 TBI per 100,000 person-years. CONCLUSIONS Elevated prevalence and incidence of TBI among incarcerated adolescents may relate to criminal justice involvement as well as friction in jail. Given the large representation of violence as a cause of TBI among our patients, we have begun focus groups with them to elicit meaningful strategies for living with and avoiding TBI.
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Affiliation(s)
- Fatos Kaba
- New York City Department of Health and Mental Hygiene, Queens, New York
| | - Pamela Diamond
- Division of Health Promotion and Behavioral Sciences, University of Texas, Houston, Texas
| | - Alpha Haque
- New York City Department of Health and Mental Hygiene, Queens, New York
| | - Ross MacDonald
- New York City Department of Health and Mental Hygiene, Queens, New York
| | - Homer Venters
- New York City Department of Health and Mental Hygiene, Queens, New York.
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MacDonald R, Rosner Z, Venters H. Case series of exercise-induced rhabdomyolysis in the New York City jail system. Am J Emerg Med 2014; 32:466-7. [DOI: 10.1016/j.ajem.2013.08.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 08/22/2013] [Accepted: 08/24/2013] [Indexed: 11/25/2022] Open
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Kaba F, Lewis A, Glowa-Kollisch S, Hadler J, Lee D, Alper H, Selling D, MacDonald R, Solimo A, Parsons A, Venters H. Solitary confinement and risk of self-harm among jail inmates. Am J Public Health 2014; 104:442-7. [PMID: 24521238 DOI: 10.2105/ajph.2013.301742] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to better understand acts of self-harm among inmates in correctional institutions. METHODS We analyzed data from medical records on 244 699 incarcerations in the New York City jail system from January 1, 2010, through January 31, 2013. RESULTS In 1303 (0.05%) of these incarcerations, 2182 acts of self-harm were committed, (103 potentially fatal and 7 fatal). Although only 7.3% of admissions included any solitary confinement, 53.3% of acts of self-harm and 45.0% of acts of potentially fatal self-harm occurred within this group. After we controlled for gender, age, race/ethnicity, serious mental illness, and length of stay, we found self-harm to be associated significantly with being in solitary confinement at least once, serious mental illness, being aged 18 years or younger, and being Latino or White, regardless of gender. CONCLUSIONS These self-harm predictors are consistent with our clinical impressions as jail health service managers. Because of this concern, the New York City jail system has modified its practices to direct inmates with mental illness who violate jail rules to more clinical settings and eliminate solitary confinement for those with serious mental illness.
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Affiliation(s)
- Fatos Kaba
- All authors are with the New York City Department of Health and Mental Hygiene, Queens, NY
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MacDonald R, Parsons A, Venters HD. The triple aims of correctional health: patient safety, population health, and human rights. J Health Care Poor Underserved 2013; 24:1226-34. [PMID: 23974393 DOI: 10.1353/hpu.2013.0142] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Correctional health systems represent some of the largest health systems in the United States, caring for patients with high rates of morbidity and mortality. The poorly understood realm of correctional health care represents a missed opportunity to integrate care for these patients with care provided by community health providers. Three aims are integral to effective correctional health: patient safety, population health, and human rights. Patient safety and population health are well-defined aims in community health care systems and emerging in correctional settings. Dual loyalty and other unique challenges in correctional settings make the human rights aim absolutely essential for promoting correctional health.
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Lockington D, MacDonald R, King S, Weir C, Winter A, Aitken C. Multiplex PCR testing requires a robust multi-disciplinary strategy to effectively manage identified cases of chlamydial conjunctivitis. Scott Med J 2013; 58:77-82. [DOI: 10.1177/0036933013482635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Introduction Implementation of an in-house polymerase chain reaction (PCR) multiplex assay by West of Scotland Specialist Virology Centre to improve sample processing means all viral eye swabs are now routinely tested for Adenovirus, Herpes simplex, Varicella and Chlamydia. Concern was raised regarding subsequent management and sexual health attendance for Chlamydia-positive patients identified in eye casualty. Methods A retrospective review of virology results identified 76 Chlamydia-positive patients from 1914 eye swabs (4%) from May 2007 to April 2008. Of these results, 12 originated from Glasgow eye casualty and available clinical notes were cross-referenced with the sexual health network (Sandyford). Results Identified issues included no documentation of implications of testing, poor communication of positive results and poor referral pathways to sexual health for assessment; all leading to inadequate management. A shared care network was created to address these issues. A designated sexual health advisor was identified to improve sexual health referral, specialist assessment, standardised management and contact tracing. Re-audit showed more consistent follow-up. Conclusion New PCR technology has resulted in a shared care approach to address corresponding implications of testing. Effective communication with a structured protocol and a central point of contact has improved follow-up and ensures appropriate best practice management of chlamydial conjunctivitis.
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Affiliation(s)
- D Lockington
- ST6 Ophthalmology, Tennent Institute of Ophthalmology, Gartnavel General Hospital, UK
| | - R MacDonald
- SpR Genito-Urinary Medicine, Sandyford Initiative, UK
| | - S King
- Sexual Health Advisor, Sandyford Initiative, UK
| | - C Weir
- Consultant Ophthalmologist, Tennent Institute of Ophthalmology, Gartnavel General Hospital, UK
| | - A Winter
- Consultant, Genito-Urinary Medicine, Sandyford Initiative, UK
| | - C Aitken
- Consultant Virologist, Regional Virology Department, Gartnavel General Hospital, UK
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