Objectives: Buprenorphine treatment significantly reduces morbidity and mortality for people with opioid use disorder. Fear of precipitated withdrawal remains a barrier to starting buprenorphine for patients who use synthetic opioids, particularly fentanyl. We aim to evaluate the development and implementation of a buprenorphine low dose overlap initiation (LDOI) protocol in an urban public health community pharmacy.
View Article and Find Full Text PDFObjectives: Contingency management (CM) is one of the most effective treatments for stimulant use disorder but has not been leveraged for people with stimulant-associated cardiomyopathy (SA-CMP), a chronic health condition with significant morbidity and mortality. We aimed to determine the feasibility and acceptability of a multidisciplinary addiction/cardiology clinic with CM for patients with SA-CMP and to explore barriers and facilitators to engagement and recovery.
Methods: We recruited patients with a hospitalization in the past 6 months, heart failure with reduced ejection fraction (<40%) and stimulant use disorder to participate in Heart Plus, a 12-week addiction/cardiology clinic with CM in an urban, safety-net, hospital-based cardiology clinic, which took place March 2021 through June 2021.
In this study, we consider the patient, provider, and public health repercussions of San Francisco's (SF) COVID-related response to homelessness using tourist hotels to house people experiencing homelessness (PEH). We describe the demographics, medical comorbidities, and healthcare utilization patterns of a subset of PEH who accessed the shelter-in-place (SIP) hotel sites during the 2020-2021 pandemic. We focus on how SIP hotels impacted connection to outpatient care and higher-cost emergency utilization.
View Article and Find Full Text PDFBackground: Efforts to confront the type 2 diabetes (T2D) epidemic have been stymied by an absence of effective communication on policy fronts. Whether art can be harnessed to reframe the T2D discourse from an individual, biomedical problem to a multilevel, communal and social problem is not known.
Method: We explored whether spoken word workshops enable young artists of color to convey a critical consciousness about T2D.
Background: More than half of homeless adults are of age ≥ 50 years. Falls are a common cause of morbidity in older adults in the general population. Risk factors for falls in the general population include poor health, alcohol use, and exposure to unsafe environments.
View Article and Find Full Text PDFCochlear implants (CIs) provide access to auditory information that can affect vocal control. For example, previous research shows that, when producing a sustained vowel, CI users will alter the pitch of their voice when the feedback of their own voice is perceived to shift. Although these results can be informative as to how perception and production are linked for CI users, the artificial nature of the task raises questions as to the applicability of the results to real-world vocal productions.
View Article and Find Full Text PDFMany individuals with bilateral cochlear implants hear different pitches when listening with their left versus their right cochlear implant. This conflicting information could potentially increase the difficulty of singing with cochlear implants. To determine if bilateral cochlear implants are detrimental for singing abilities, ten perilingually/postlingually deaf bilateral adult cochlear implant users were asked to sing "Happy Birthday" when using their left, right, both, or neither cochlear implant.
View Article and Find Full Text PDFLatina women living in low-income communities frequently report a high prevalence of feeling physically and/or emotionally "unwell." Formative focus groups were used to design a 3-session stress reduction curriculum called ¡Venga y Relájese! (Come and relax yourself!). Survey data from 5 Milwaukee cohorts and 1 Peruvian cohort revealed statistically significant improvements in general health status, perceived stress status, and confidence to manage future stress among women who completed all sessions (n=54).
View Article and Find Full Text PDFPurpose: To evaluate the role of urbanization as an effect modifier for the association between specific chronic conditions and number of conditions with health-related quality of life (QOL).
Methods: We analyzed cross-sectional data from the CRONICAS Cohort Study conducted in Lima (highly urbanized), Tumbes (semi-urban), as well as rural and urban sites in Puno. Exposures of interest were chronic bronchitis, depressive mood, hypertension, type 2 diabetes, and a composite variable aggregating the number of chronic conditions (the four exposures plus heart disease and stroke).