This article describes a process of evaluating and adapting existing clinical practice guidelines (CPGs) for homeless individuals by different healthcare providers in multiple healthcare settings across the country. Data were collected using a standardized evaluation tool in nine sites across the United States. Clinicians completed an evaluation of the CPG after every use. Most clinicians used the CPG five times. Descriptive statistics were reported on the characteristics of the clinicians, and the utility of the guidelines and written comments. Clinicians had an average of 12 years of clinical experience, 8 years of which were specifically spent working with homeless individuals. Ninety-one percent of the clinicians practiced in urban settings. The majority of clinicians felt the adapted guidelines met evaluation criteria. The major weaknesses reported the delineation of outreach and case management activities. Results did not vary by clinicians' disciplines, years of experience, or any other indicators. Clients and clinicians providing primary care to homeless individuals may benefit from utilizing Health Care for the Homeless Clinicians' Network adapted CPGs to assure quality, evidenced-based care to a vulnerable population.
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http://dx.doi.org/10.1111/j.1745-7599.2005.00079.x | DOI Listing |
BMC Infect Dis
January 2025
Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, PO Box 100009, Gainesville, FL, 32610, USA.
Background: Cluster and contact investigations aim to identify and treat individuals with tuberculosis (TB) and latent TB infection (LTBI). Although genotyped cluster investigations may be superior to contact investigations in generating additional epidemiological links, this may not necessarily translate into reducing infections. Here, we investigated the impact of genotyped cluster investigations compared to standard contact investigations on the LTBI care cascade in a low incidence setting.
View Article and Find Full Text PDFCNS Spectr
January 2025
Faculty of Medicine and Psychology, Universita degli Studi di Roma La Sapienza, Rome, Italy.
The history of Italian general psychiatry and forensic psychiatry over the last 50 years has been unique in the European and Western healthcare landscape. Western politicians often visit Italy to observe the successful community-based systems that have developed in that country.This article represents a first step toward a necessary attempt, to explore how specific political decisions, such as the Italian one, have produced positive outcomes for patients with psychotic disorders, outcomes not observed in many Western countries, which are instead grappling with negative outcomes such as the complicated management of homelessness and the incarceration of people who would instead require psychiatric care.
View Article and Find Full Text PDFJ Hand Surg Am
January 2025
Cooper University Hospital, Camden, NJ.
Purpose: Xylazine has been associated with necrotic soft tissue wounds that have placed a challenging burden on patients who inject drugs in the Philadelphia region's health care system over the last few years. An analysis of our initial experience is being presented to guide future treatment and directions for future research.
Methods: A retrospective review of 55 patients with patient-reported xylazine use and associated upper-extremity wounds at a single institution was performed.
BMC Health Serv Res
January 2025
Faculty of Health Sciences, Durban University of Technology, Durban, 4001, South Africa.
Introduction: Prenatal care is crucial, but accessing healthcare services has been a challenge for pregnant homeless women in Africa. The majority in this marginalised group are not screened for common pregnancy complications such as preeclampsia, infection, and stillbirth. Therefore, this scoping review aims to explore the barriers to accessing prenatal healthcare services for pregnant homeless women in Africa.
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