To describe 4 unique models of operationalizing wastewater-based surveillance (WBS) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in jails of graduated sizes and different architectural designs. We summarize how jails of Cook County, Illinois (average daily population [ADP] 6000); Fulton County, Georgia (ADP 3000); Middlesex County, Massachusetts (ADP 875); and Washington, DC (ADP 1600) initiated WBS between 2020 and 2023. Positive signals for SARS-CoV-2 via WBS can herald a new onset of infections in previously uninfected jail housing units.
View Article and Find Full Text PDFHIV and hepatitis C virus (HCV) testing for all people in jail is recommended by the CDC. In the community, there are barriers to HIV and HCV testing for minoritized people. We examined the relationship between race and infectious diseases (HIV, HCV, syphilis) testing in one Massachusetts jail, Middlesex House of Corrections (MHOC).
View Article and Find Full Text PDFJails and prisons in the United States house people with elevated rates of mental health and substance use disorders. The goal of this cross-sectional study was to evaluate the frequency of racial/ethnic differences in the self-report of mental illness and psychiatric medication use at jail entry. Our sample included individuals who had been incarcerated between 2016 and 2020 at the Middlesex Jail & House of Correction, located in Billerica, MA.
View Article and Find Full Text PDFBackground: Given the personal and public consequences of untreated/undertreated OUD among persons involved in the justice system, an increasing number of jails and prisons are incorporating medication for opioid use disorder (MOUD) into their system. Estimating the costs of implementing and sustaining a particular MOUD program is vital to detention facilities, which typically face modest, fixed health care budgets. We developed a customizable budget impact tool to estimate the implementation and sustainment costs of numerous MOUD delivery models for detention facilities.
View Article and Find Full Text PDFPurpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes.
View Article and Find Full Text PDFTime spent in jail can provide opportunities to deliver comprehensive medical care, including screening and treatment for HIV; however, engagement in HIV care postrelease is often fragmented. Identifying ways to improve the transition of care from jail to community for people with HIV (PWH) may help with engagement in HIV care postrelease. We evaluated the current HIV care transition processes of one jail in Massachusetts and identified change ideas to facilitate improving the transition of care from the jail to the community for PWH.
View Article and Find Full Text PDFBackground: As cases of COVID-19 climb worldwide, academic medical centers (AMCs) are scrambling to balance the increasing demand for medical services while maintaining safe learning environments. The scale and nature of the current pandemic, limitations on key resources, risks of transmission, and the impact on trainee wellbeing pose additional challenges to AMCs. We propose a framework for AMCs to utilize in facilitating health system, organization and program-level adjustments to meet the needs of medical trainees during the pandemic.
View Article and Find Full Text PDFPurpose: We determined empirical medical therapy practice patterns for idiopathic infertility.
Materials And Methods: We performed a survey of 7,745 practicing American Urological Association members from July to November 2010. Respondents were questioned on empirical medical therapy use, patient evaluation and selection, and preferred medications.
Objective: We evaluated the safety of simultaneous bilateral renal procedures performed using hand-assisted laparoscopy (HAL) with the patient in the supine position.
Materials And Methods: After securely strapping the patient to the table, a hand-port device is placed via a 7-cm supraumbilical or peri-umbilical incision with two to four 5-mm to 12-mm trocars placed bilaterally. During a 3-year period, 8 bilateral HAL renal operations were initiated (upper pole partial nephrectomies, 3 nephroureterectomies, 3 bilateral nephrectomies, and right nephrectomy with left adrenalectomy).
Introduction: The aim of this study was to assess the amount of training necessary for a midcareer urologic surgeon to incorporate hand-assisted laparoscopic (HAL) renal surgery into an academic practice.
Materials And Methods: A urologist (JAB) without laparoscopic surgical experience in his fifth year of practice completed a 3-month minifellowship at a high-volume center primarily to learn HAL nephrectomy (HALN), during which he performed 15 HALNs (and 2 HAL nephroureterectomies) and assisted during 5 HALNs. Surgical outcomes and resident surgical participation on nephrectomy cases at the home medical center during the 6 months prior to (phase 1) and after (phase 2) the fellowship were evaluated.