Background: The United States opioid crisis has been worsened by the emergence of fentanyl adulterated or associated with the veterinary sedative xylazine. Designated by the White House as an "emerging threat to the US" in 2023, xylazine use is associated with severe skin wounds.
Methods: This research explored beliefs, concerns, and treatment behaviors for skin wounds among 93 participants recruited outside of a Philadelphia, Pennsylvania harm reduction agency who reported past-6-month history of a skin wound via a cross-sectional survey administered August-September 2022 (group 1; = 33).
This report describes a public-private partnership supported, in part, by federal 340B funds between a community pharmacy and a harm reduction organization. The partnership provides life-saving health care services within a neighborhood disproportionately affected by substance use, poverty, homelessness, and crime and may serve as a model for other communities in need.
View Article and Find Full Text PDFBackground: Recommendations exist to guide clinicians on a comprehensive psychosocial (PS) evaluation prior to Mechanical Circulatory Support (MCS) implantation.
Objectives: Assess adoption, beliefs, methodologies, and barriers to completion of the 2018 ISHLT/APM/AST/ICCAC/STSW Recommendations for Psychosocial evaluation of adult cardiothoracic transplant and long term mechanical circulatory support.
Methods: Cross-sectional survey distributed to all 183 implanting LVAD centers in North America via mail and email.
Hepatitis C (HCV) is a highly prevalent infection in current and former IV drug users. Current estimates indicate that over 70% of those in methadone maintenance treatment programs (MMTs) have HCV, but only 11% have initiated treatments despite availability of new treatments that are easily tolerated and can cure infection in about 8 weeks. We conducted a pilot randomized trial at four Philadelphia, PA MMTs to test acceptability, feasibility and promise of efficacy of our "Take Charge, Get Cured" mobile health (mHealth) treatment decision tool, developed through extensive formative work that included methadone patients' input and targeted directly to concerns of methadone patients with Hepatitis C (HCV).
View Article and Find Full Text PDFWhile most methadone maintenance treatment (MMT) patients have hepatitis C (HCV), less than 11% initiate treatment. The objective of this study was to assess this population's perceptions of HCV treatment. We surveyed 100 HCV+ MMT patients from four urban programs, asking scaled attitude scores about factors that may affect treatment decisions.
View Article and Find Full Text PDFBackground: The International Society for Heart & Lung Transplantation (ISHLT) guidelines for Mechanical Circulatory Support (MCS) includes assessment of four elements of psychosocial functioning prior to Left Ventricular Assist Device (LVAD) implantation. Information about the practices and impact of assessments of psychosocial functioning are limited.
Objective: To describe the psychosocial function assessment practices used within US LVAD programs and the influence of psychosocial assessment results on clinical decisions for LVAD patient selection.
Objective: Patients prescribed methadone maintenance treatment (MMT) demonstrate elevated prevalence of hepatitis B virus (HBV), hepatitis C virus, and HIV. Government agencies recommend testing for these infections in MMT programs, but uptake is limited.
Methods: We audited infection-related policies and practices of all 14 MMT programs in Philadelphia, Pennsylvania, in 2015.
Introduction: Exclusive breastfeeding (EBF) benefits the life course health development of infants, families, and society. Professional health associations recommend EBF for 4 months, and many now recommend EBF for 6 months. Yet only 18.
View Article and Find Full Text PDFAm J Public Health
October 2014
Objectives: We reviewed the complexities of school-related immunization policies, their relation to immunization information systems (IIS) and immunization registries, and the historical context to better understand this convoluted policy system.
Methods: We used legal databases (Lexis-Nexis and Westlaw) to identify school immunization records policies for 50 states, 5 cities, and the District of Columbia (Centers for Disease Control and Prevention "grantees"). The original search took place from May to September 2010 (cross-referenced in July 2013 with the list on http://www.
The human papillomavirus (HPV) vaccine has the potential to reduce rates of cervical cancer and other HPV-related morbidity among Hispanic women who are disproportionately affected by this disease. Understanding the barriers faced by this population is an important public health goal. In this qualitative pilot study, 17 mothers and grandmothers of adolescent girls from diverse Hispanic backgrounds in a large northeastern city in the United States were interviewed to examine attitudes regarding vaccine acceptability.
View Article and Find Full Text PDFContext: Immunization Information Systems (IIS), or registries, were developed to improve effectiveness and efficiency in immunization services. Complex laws that govern IIS and immunization records are developed at the state-level, interact with each other, and may impact utility for all immunization stakeholders. As states develop Health Information Exchange laws they may also interact with IIS laws.
View Article and Find Full Text PDFInfluenza is responsible for significant morbidity and mortality in the United States. Despite long-standing national recommendations, only 47% of adults with a high-risk condition received the influenza vaccine in 2009-2010. Subspecialty practices provide a significant portion of ambulatory care visits for high-risk adults and understanding their role in the immunization infrastructure may increase immunization rates, decrease public health burden, and reduce influenza-associated disease.
View Article and Find Full Text PDFCertain population groups are at risk for inadequate prenatal care and transmission of perinatal infections. Philadelphia's birth cohort comprises largely at-risk groups and its infant mortality rate is among the nation's highest. This study identifies factors associated with infectious disease screening, treatment, and prevention in Philadelphia.
View Article and Find Full Text PDFAn estimated 5 million Americans are chronically infected with hepatitis B or C. They face socially and clinically significant reductions in mental and physical health. Improved coping and compliance with clinical therapies and harm-reducing behaviors can improve quality of life and, potentially, treatment outcomes.
View Article and Find Full Text PDFJ Am Med Dir Assoc
November 2003
Objectives: To determine the levels of knowledge and beliefs about pneumococcal disease and the pneumococcal polysaccharide vaccine (PPV), the level of PPV use, PPV-related practices, and factors associated with PPV use in Pennsylvania's nursing homes.
Design/setting: A 68-item, cross-sectional survey of Nursing Directors at a random sample of PA nursing homes (291) was conducted between April and June 1999. Survey results and facility characteristics were used to describe vaccination practices, estimate the vaccination level and determine through bivariate analysis, associations between vaccination level and facility characteristics and practices.